2023-04-28T15:29:37-05:00 2022-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2021-07-01 264230898 Barrett Hospital Development Corporation BARR 4066833000 600 Highway 91 South Dillon MT 59725 Tina Giem CFO 4066833000 2023-04-28 1 Tina Giem 999009999 Kim Hunwardsen CPA P00484560 6122536500 2023-04-28 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z Barrett Hospital & Healthcare Scott Manis 600 Highway 91 South Dillon MT 59725 43506921 0 X www.barretthospital.org X 2009 MT Barrett Hospital & HealthCare provides compassionate care, healing, and health-improving service to all community members throughout life's journey. 5 4 313 19 0 0 5463219 570069 38452998 42114730 344681 717061 67310 67921 44328208 43469781 0 18121 0 0 19666209 20852958 0 0 0 17145239 20701333 36811448 41572412 7516760 1897369 67300968 64346161 31171323 27916571 36129645 36429590 X Barrett Hospital & HealthCare provides compassionate care, healing, and health-improving service to all community members throughout life's journey. 0 0 37785391 18121 42114730 Barrett Hospital & HealthCare is an 18 licensed bed acute care critical access hospital. Our patients are served by an inpatient hospital, 24-hour emergency department, and a provider based clinic. Our ancillary services include diagnostic imaging, laboratory, inpatient and outpatient surgery, physical and occupational therapy, non-surgical pain management, vein care, integrated behavioral health, transitional care, chronic care management, home health, hospice, cardiac rehab, pharmacy, cardiopulmonary, respiratory and diabetic education.Continued on Schedule OThe hospital provided 1,678 days of acute care services, 456 observation days and 476 swing bed days. In addition, the hospital provided 30,508 clinic visits, 34,795 outpatient visits, 4,678 emergency room visits, 3,879 home health visits and 1,076 hospice days. 37785391 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 74 0 1 313 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 4 0 1 0 0 1 0 0 1 0 0 0 1 1 1 1 1 1 0 1 0 X Tina Giem 4066833006 600 Highway 91 South Dillon MT 59725 Nicholas Fromm Physician 40.00 0.00 X 400246 0 26849 Gregory Moore Physician 31.20 0.00 X 352277 0 43909 Sandra McIntyre Physician 40.00 0.00 X 347196 0 48108 Patrick Rasch Physician 40.00 0.00 X 310840 0 41130 Hallie Tipton Physician 40.00 0.00 X 283158 0 39656 Tina Giem CFO 40.00 0.50 X 144791 0 23292 Carol Kennedy CCO (July-May) 40.00 0.00 X 141878 0 18944 Patti Mitchell Chair 0.50 0.00 X X 5957 0 0 Ken Westman CEO (Jul-Jan) 40.00 2.00 X 0 0 0 Scott Manis Interim CEO (Jan-Jun) 40.00 2.00 X 0 0 0 Nate Finch Vice Chair 0.50 0.00 X X 0 0 0 Susan Briggs Director 0.50 0.00 X 0 0 0 Shane Puyear Director 0.50 0.00 X 0 0 0 Lawrence Morrisroe Director 0.50 0.00 X 0 0 0 1986343 0 241888 29 0 1 0 Medical Solutions LLC PO Box 3037 Omaha NE 68103 Traveling Nursing Services 321250 David Fortenberry 605 7th Ave East Kalispell MT 59901 Physician 302290 Daniel Richards 13929 Buck Hollow Cove Bluffdale UT 84065 Physician 245750 Eide Bailly LLP PO Box 7112 Billings MT 59103 Tax/Audit 221702 Logan Health Medical Center 310 Sunnyview Lane Kalispell MT 59901 Nuclear Medicine Services 203401 7 483713 36412 49944 570069 Net Patient Service Revenue 621110 41254090 41254090 Mortgage Subsidy 900099 381298 381298 479342 479342 42114730 517109 517109 105061 37140 67921 67921 67921 197018 2934 0 0 197018 2934 199952 199952 43469781 42114730 0 784982 X 18121 18121 349778 7216 342562 16416411 15834883 581528 691134 653534 37600 2269401 2147933 121468 1126234 1066448 59786 692209 692209 33484 33484 81176 81176 2224 2224 5612238 4579377 1032861 89803 88818 985 655531 568648 86883 48938 31357 17581 480130 480080 50 32943 22623 10320 124615 109872 14743 1263594 1252989 10605 2277097 2277097 931150 810791 120359 Medical Supplies 4849992 4849868 124 Provision for Bad Debts 1462122 1462122 Repairs and Maintenance 889437 862495 26942 MT Medicaid Bed Tax 458317 332037 126280 716333 329082 387251 41572412 37785391 3787021 0 925 925 14876818 13011850 5405734 5693940 960715 913576 408988 338967 54602658 24609111 30387536 29993547 15170694 14259812 19924 14948 69634 118596 67300968 64346161 3145599 3145884 2170226 42471 24562143 23509491 1293355 1218725 31171323 27916571 X 36129645 36429590 36129645 36429590 67300968 64346161 X 1897369 -1585050 -3999 -8375 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 2224 0 0 0 2224 0 Part II-B, Line 1: The Organization is a member of several organizations that take part in lobbying. A portion of the dues paid to the various organizations is for lobbying costs. These various organizations advocate on behalf of their members by supporting legislation that is in their collective interests. 1796813 1796813 35882175 11131026 24751149 14619862 12171208 2448654 2303808 1306877 996931 29993547 Estimated Third Party Payor Settlements 546283 Leases 672442 1218725 39159015 -1585050 -2725716 -4310766 43469781 0 43469781 38850695 3999 3999 38846696 2725716 2725716 41572412 Part XI, Line 2d - Other Adjustments: Interest expense reported in revenue on financial statements -1,263,594. Provision for bad debt reported in revenue on financial statements -1,462,122. Part XII, Line 4b - Other Adjustments: Interest expense reported in revenue on financial statements 1,263,594. Provision for bad debt reported in revenue on financial statements 1,462,122. 1 1 X 1 X 0 1 1 1 0 1 1 279000 279000 0.00700 279000 279000 0.00700 8937 8755 182 0.00000 479687 13061 466626 0.01160 11265067 8470322 2794745 0.06970 11753691 8492138 3261553 0.08130 12032691 8492138 3540553 0.08830 7338 7338 0.00020 1677 1677 0.00000 52088 27356 24732 0.00060 61103 27356 33747 0.00080 1 1462122 0 9066030 8992149 73881 X 1 1 1 1 Barrett Hospital Development Corp 600 MT Hwy 91 S Dillon MT 59725 www.barretthospital.org 13549 X X X X Provider based clinic Barrett Hospital Development Corporation 1 0 0 1 X X X X X X X X X 19 1 0 1 1 X www.barretthospital.org X 1 19 1 www.barretthospital.org 0 1 X 200.000000000000 X X X X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X 1 X 0 X X X X 1 X 0 0 Barrett Hospital Development Corporation Part V, Section B, Line 5: Barrett Hospital & HealthCare and the Beaverhead County Health Department participated in the Community Health Services Development (CHSD) program, administered by the Montana Office of Rural Health, which was utilized to create the CHNA. A steering committee was convened to assist Barrett Hospital & HealthCare and Beaverhead County Health Department in conducting a CHSD. A diverse group of community members representing various organizations and populations within the community (ex. Public health, elderly, uninsured) came together in January 2020. 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 results of the survey and key informant interviews and to assist in prioritization of health needs. In February 2020, surveys were mailed out to residents in Beaverhead and Madison Counties, Barrett Hospital & HealthCare's service area. Survey respondents had the ability to complete the survey mailed to them, or via an online survey hosted at Montana State University's Human Ecology Learning and Problem Solving (HELPS) web portal. The survey was based on a design that has been used extensively in the states of Washington, Wyoming, Alaska, Montana and Idaho. The survey was designed to provide each facility with information from local residents regarding:-Demographics of respondents-Hospitals, primary care providers and specialists used, plus reasons for selection-Local healthcare provider usage-Services preferred locally-Perception and satisfaction of local healthcare-Overall health of the communityBarrett Hospital & HealthCare provided a list of outpatient and inpatient admissions. Those zip codes with the greatest number of admissions were selected to be included in the survey. A random list of 800 residents was then selected with the assistance of the MSU HELPS Lab.Additionally, 15 key informant interviews were conducted in March and April of 2020. Participants were identified as people living in Barrett Hospital & HealthCare's and the Beaverhead County Health Department's service area. Barrett Hospital Development Corporation Part V, Section B, Line 6b: Beaverhead County Public Health Barrett Hospital Development Corporation Part V, Section B, Line 11: The most recently completed CHNA identified the following prioritized health needs within the community which the organization will address:1. Additional mental health resources2. Paid staffing for EMS3. Economic growth4. Support services for low-income individuals and families5. Affordability6. General/basic retailThe following prioritized health needs identified within the community will not be addressed:1. Lower cost of health insurance and payment assistance programs2. Dermatology and ENT ServicesThe prioritized health needs as determined through the assessment process and which the facility will be addressing can be grouped into the following healthcare issues:1. Mental and Behavioral Health2. Access to Healthcare ServicesDuring the course of the year, Barrett Hospital & HealthCare continued its work on many of the needs addressed in the 2020 CHNA. The investigation of EMR-integrated monitoring as an addition to telehealth provider visits is ongoing, with review of additional opportunities for weight scales and blood sugars under review. Marketing of telehealth services and community education on the availability of options, as well as how to access such options, is ongoing via strategy and marketing meetings.The pain management program continued to grow, seeing 25-35 patients per month. Marketing of the program continues in an effort to educate the community on the availability and access to the program.The hospital continues active participation in ACO MSSP to promote wellness care and better manage chronic illnesses, and has added an FTE in the coordinated care department for chronic care management and population health initiatives. The hospital and Monida Healthcare Network entered into a clinically integrated network, with a focus on wellness promotion and chronic care management, and is working with a third party vendor on data mining.Work to improve access to mental and behavioral health services remains active between Barrett Hospital and local school counselors. The hospital continues to remain active in LAC and ACES, promoting campaigns for mental health awareness, and is participating in a grant for community crisis response. Barrett Hospital & HealthCare continues to offer integrated behavioral health care into primary care functions, as well as continuing to improve crisis response in the ED via 24/7 on-call telepsychiatry services via a contracted vendor. Part V, Line 16a-16c: Part V, Line 16a, FAP Website:https://www.barretthospital.org/patient-financial-informationPart V, Line 16b, FAP Application Website:https://www.barretthospital.org/patient-financial-informationPart V, Line 16c, FAP Plain Language Summary Website:https://www.barretthospital.org/patient-financial-information Part I, Line 3c: The Organization does not provide discounted care. If a patient qualifies for financial assistance, their full bill is written off. Part I, Line 6a: The organization mailed the community benefit report to their Beaverhead County residents as well as portions of Madison and Jefferson county. The community benefit report is also available on the facility website and in public waiting areas throughout the facility. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Community Health Services on line 7e and Health Professions Education on line 7f were determined using actual costs. Subsidized health services on line 7g was determined using the costing methods to prepare the cost reports. Part I, Ln 7 Col(f): The amount of bad debt expense removed from the denominator is $1,462,122. Part II, Community Building Activities: Barrett Hospital & Healthcare is an active community emergency preparedness advocate and partners with the county Public Health Director and community organizations (e.g. YMCA) on community wellness initiatives. Barrett Hospital & HealthCare maintains over a mile of walking trails on the campus grounds for community member use. Barrett Hospital & HealthCare partners with local volunteer EMS services and law enforcement to provide education and training. Part III, Line 2: Bad debt expense is reported at charges as recorded by the organization. All discounts and payments on a patient's account are accounted for prior to determining bad debt expense. Part III, Line 4: The footnote to the Organization's financial statements can be found on page 17 and 18 of the attached audited financial statements. Part III, Line 8: The facility is designated as a Critical Access Hospital and is reimbursed by Medicare at 101% of Medicare's costs.Medicare allowable costs were obtained from the 2021 Medicare cost report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services. Part III, Line 9b: Once a patient applies for financial assistance, their accounts are held at Barrett Hospital & HealthCare or at our extended business office until a determination has been made on their eligibility for financial assistance. Accounts are not sent to collections during the period the patient is eligible for assistance. If an application does not contain all necessary documentation, the patient is notified of all missing elements and an extended deadline is set for the patient to provide additional documentation. All applicants for financial assistance are notified in writing upon approval or denial of financial assistance. Part VI, Line 2: Barrett Hospital & HealthCare uses various tools throughout the year to assess additional community health needs including utilization of a Patient/Family Advisory Council, reviewing patient surveys regarding services provided at Barrett Hospital, and participating in community-wide health initiatives. Part VI, Line 3: Barrett Hospital & HealthCare is committed to implementing and applying their billing and collection policy in a consistent manner while making every effort to assist patients with limited means to receive the support necessary for their financial obligations whether the patient is insured or uninsured.Financial Assistance Policy (FAP) information can be found on our website. The FAP is distributed in multiple patient areas of our clinic (exam rooms/front desk) and hospital (public areas/registration desks). Our Financial Assistance Policy is advertised monthly in a local publication and copies have been mailed out to area businesses and churches in our service area to be posted in their buildings. There is written notification regarding our FAP on every bill that is sent to the patient/guarantor. When calling patients to educate them on their benefits, we advise patients that if they have concerns about the estimated patient costs that they can discuss them with our financial counselors. All patients calling in to discuss their bills or setup payment plans are routed through the financial counselors for process consistency and to provide the best resources available to the patient. A financial assistance notification also prints on after visit summaries and discharge instructions that are provided to patients after all visits. Part VI, Line 4: Barrett Hospital & HealthCare serves the majority of Beaverhead County and Western Madison County residents. The primary service area includes 9 zip codes through Beaverhead County and 5 zip codes in Madison County. The size and rural makeup of Barrett Hospital's service area play a significant role in the services Barrett Hospital & HealthCare provides. Beaverhead County is the largest county in the State of Montana and consists of a population of approximately 9,246 with a population density of 1.7 people per square mile. The nearest major hospital is 64.4 miles from Barrett Hospital.The population aged 65+ in Beaverhead County is 20.6% which is higher than the demographics for the State of Montana (17.2%) and national demographics (14.9%) for this population group. The upsurge in population aged 65+ continues to increase the need for senior services including healthcare.Socioeconomic factors also play a role in the health of the population that Barrett Hospital & HealthCare services. Beaverhead County has a higher percentage of the population that falls below the federal poverty levels and higher uninsured rates than National and State of Montana measures. 16.1% of the population of Beaverhead County is considered low income and falls below the federal poverty levels compared to 14.4% for the State of Montana. The median income for Beaverhead County is $43,880, which is lower than the Montana median income of $50,801. Beaverhead County also has an uninsured rate of 18%, as compared to the State of Montana rate of 17% and the national measure at 15.7%. Part VI, Line 5: Barrett Hospital & HealthCare is dedicated to providing high value healthcare and services for our community. All surplus revenues are reinvested into the facility, equipment, or programs at Barrett Hospital & HealthCare. The funds are utilized for quality initiatives to improve patient care, expand our facility, expand available services, and advance training programs. As a not-for-profit health system, Barrett Hospital & HealthCare reinvests profits into the community by helping manage chronic conditions including diabetes, promoting wellness, and providing programs to serve the poor and uninsured. In addition, Barrett Hospital is invested in the education and training of physician residents, medical students and other medical professional students at our site including 13 physician resident/students and PA/NP students and 21 occupational therapy, nursing, EMT, laboratory scientists and diagnostic imaging students. Barrett Hospital & HealthCare offers low cost wellness programs (e.g. weight loss, lab screenings, student-athlete sports physicals) to the community, is an active community emergency preparedness partner, provides trauma prevention education, and partners with the county Public Health Director and community organizations (e.g. YMCA) on community wellness initiatives. Barrett Hospital & HealthCare sponsors the local Cancer Support Community gatherings and maintains over a mile of walking trails on the campus grounds for community member use. Barrett Hospital & HealthCare subsidizes the Home Health and Hospice programs for the community and partners with local volunteer EMS services and law enforcement to provide education and training.Barrett Hospital & HealthCare participates in government sponsored health programs including Medicare, Medicaid, CHIP, Veteran's Affairs, and Tricare. Barrett Hospital & HealthCare relies on community involvement to help keep in touch with the current needs of the community. Barrett Hospital & HealthCare has a 5 member board of trustees. The members of the board are publicly elected residents of Beaverhead County. In addition, Barrett Hospital has a large volunteer program. Approximately 19 volunteers contribute their time and efforts to the hospital. The hospital also relies on community members for various advisory councils including the Patient Advisory Council. Barrett Hospital & HealthCare is the only hospital in Beaverhead County. Medical staff privileges in the hospital are open to all qualified physicians and providers. Barrett Hospital operates an emergency room that is accessible to anyone needing care regardless of their ability to pay. The emergency room has approximately 4,000 visits annually.Additionally, Barrett Hospital and HealthCare operates a walk-in clinic 5 days per week. 1 Barrett Hospital Foundation Inc 600 Highway 91 South Dillon MT 59725 363597000 501(c)(3) 0 18121 FMV Various Foundation Gala Expenses paid for by Hospital and office supplies Fundraising Assistance 1 0 Part I, Line 2: The Organization assists the related Foundation, Barrett Hospital Foundation, Inc., by paying expenses related to fundraising events and office supplies. The CFO signs off on all expenditures and accounting personnel ensure proper reporting is being done. 0 0 0 0 0 0 0 0 0 Nicholas Fromm Physician 380746 0 0 0 19500 0 11600 0 15309 0 427155 0 0 0 Gregory Moore Physician 326527 0 0 0 25750 0 20300 0 23669 0 396246 0 0 0 Sandra McIntyre Physician 230029 0 91417 0 25750 0 20300 0 27868 0 395364 0 0 0 Patrick Rasch Physician 202555 0 88785 0 19500 0 14500 0 26690 0 352030 0 0 0 Hallie Tipton Physician 207491 0 56167 0 19500 0 14500 0 25216 0 322874 0 0 0 Tina Giem CFO 135821 0 0 0 8970 0 8970 0 14383 0 168144 0 0 0 Carol Kennedy CCO (July-May) 134678 0 0 0 7200 0 7200 0 11804 0 160882 0 0 0 Part I, Line 3 Ken Westman, CEO, and Scott Manis, Interim CEO, receive compensation from an unrelated management company, HealthTech Management Services. The organization relies on HealthTech Management Services to have a process in place for determining compensation for the CEO. Form 990, Part VI, Section A, line 3 HealthTech Management Services provides general management services including the employment of our CEO, Ken Westman, and Interim CEO, Scott Manis. Ken Westman received $333,027 in compensation and benefits from HealthTech Management Services during the 2021 calendar year. Scott Manis started with the organization in January of 2022 so he did not receive any 2021 calendar year compensation. Form 990, Part VI, Section A, line 6 The sole member of the organization is the Public Hospital District, Beaverhead County (d/b/a Barrett Hospital and Healthcare) a Montana statutory public hospital district. Form 990, Part VI, Section A, line 8b There are no committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b An electronic copy of the 990 is presented to the Board during their regular board meeting for review and approval. Form 990, Part VI, Section B, line 12c Annually all employees, the CEO, and board members are required to complete a conflict of interest statement. All possible conflicts of interest are reviewed by the Compliance Committee. The Committee determines what, if any, action is necessary for the individual with the potential conflict to take to avoid said conflict. For board members, this would include recusing themselves during discussions/voting on related matters. Form 990, Part VI, Section B, line 15b Ken Westman and Scott Manis receive compensation from an unrelated management company, HealthTech Management Services. The organization relies on HealthTech Management Services to have a process in place for determining compensation for our CEO. The Board of Directors approves the management agreement. Barrett Hospital & HealthCare participates in an annual salary survey with the Montana Hospital Association, which reviews all employee salary ranges, including the CFO, with like healthcare organizations throughout the State of Montana. The salary of the CCO is compared to national salary surveys, and all compensation grades are adjusted, as necessary, and reviewed with Leadership Council for approval. Physician/provider compensation is reviewed for fair market value with legal counsel upon execution or renewal of an employment agreement or contract. The Board of Directors reviews and approves all physician/provider agreements/contracts. The Board of Directors approves all other wages/salaries, including that of the CFO and CCO during the annual budget process. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy and financial statements available upon request. Form 990, Part IX, line 11g Purchased Services: Program service expenses 1,943,995. Management and general expenses 1,032,861. Fundraising expenses 0. Total expenses 2,976,856. Professional Fees: Program service expenses 1,738,295. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,738,295. Physician Fees: Program service expenses 897,087. Management and general expenses 0. Fundraising expenses 0. Total expenses 897,087. Form 990, Part XI, line 9: Audit restatement for adoption of new lease standard -8,375. Public Hospital District for Beaverhead County 600 Highway 91 South Dillon MT 59725 810357909 Healthcare MT N/A 0 Barrett Hospital Foundation Inc 600 Highway 91 South Dillon MT 59725 363597000 Fundraising for Hospital MT 501(c)(3) Line 7 N/A 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 1