NORTHERN MONTANA HOSPITAL: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- NORTHERN MONTANA HOSPITAL (EIN 81-0231787)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-04-28
- IRS object ID
- 202331189349300038
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-04-28T09:46:52-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810231787 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Montana Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 4062652211 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1231 | AddressLine1Txt |
| City | Havre | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 595011231 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | David Henry | PersonNm |
| Person Title | President/CEO | PersonTitleTxt |
| Phone | 4062652211 | PhoneNum |
| Signature | 2023-04-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | David | PersonFirstNm |
| Person Last | Henry | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2023-04-27 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | David Henry | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1231 | AddressLine1Txt |
| City | Havre | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 595011231 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $78,348,230 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.nmhcare.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1921 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | Provision of healthcare services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 727 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | $453,375 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,126,843 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,397,127 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $73,352,770 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $74,663,300 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,007,864 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,273,470 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$1,350 | PYOtherRevenueAmt |
| CY Other Revenue | $2,034 | CYOtherRevenueAmt |
| PY Total Revenue | $81,486,127 | PYTotalRevenueAmt |
| CY Total Revenue | $78,335,931 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $87,569 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $55,788 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $37,093,185 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $36,879,469 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $28,648 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $33,666,851 | PYOtherExpensesAmt |
| CY Other Expenses | $38,045,876 | CYOtherExpensesAmt |
| PY Total Expenses | $70,847,605 | PYTotalExpensesAmt |
| CY Total Expenses | $74,981,133 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $10,638,522 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,354,798 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $100,637,284 | TotalAssetsBOYAmt |
| Total Assets EOY | $97,934,448 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,790,765 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,568,225 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $83,846,519 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $86,366,223 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To deliver high quality comprehensive healthcare services to the Hi-Line communities. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $60,180,703 | ExpenseAmt |
| Grant | $55,788 | GrantAmt |
| Revenue | $74,663,300 | RevenueAmt |
| Desc | Northern Montana Hospital (Hospital) includes 49 acute care hospital beds, 135 skilled nursing beds, 10 assisted living beds and two medical clinics located in Havre, Montana. The Hospital provides quality healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation of the Hospital, it is recognized that not all individuals possess the ability to purchase these essential services. It is the Hospital's mission to serve the surrounding area by providing healthcare services and healthcare education to all community members. Continued on Schedule O...During the year ended June 30, 2022, the Hospital provided $12,434 of medical services, based on charges, to individuals who were determined unable to purchase such services under the Hospital's charity care policy and guidelines. In addition to free care and/or subsidized care, care is also provided at below cost rates to persons covered by governmental programs. Recognizing its mission to the community, services are provided to both Medicare and Medicaid patients. The unreimbursed value of providing care to these patients was $58,229,535 for the year ended June 30, 2022. During the fiscal year ended June 30, 2022, the Hospital provided over 3,600 days of hospital services. The nursing home provided just under 24,000 resident days during the year.The Hospital also provides community care and services through many healthcare activities and programs provided to support the community. These activities include wellness programs, community education programs, senior services, healthcare screening, special programs for specific groups, published articles, radio programs, and a variety of community supported activities. The Hospital also received many hours of volunteer help from the community residents. | Desc |
| Total Program Service Expenses | $60,180,703 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 55 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 727 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kim Lucke VP of Finance | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4062652211 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1231 | AddressLine1Txt |
| City | Havre | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59501 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| David C Henry | ||||||||
| President/CEO | 53.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Rick Stevens | ||||||||
| Chair | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| David Leeds | ||||||||
| Vice Chair | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Miles Hamilton | ||||||||
| Treasurer | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Karrie Lien MD | ||||||||
| Secretary | 40.00 | 1.00 | Yes (X) | Yes (X) | $454,875 | $0 | $40,622 | |
| Andrew Carlson | ||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Debbie Healy | ||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Jennifer Patrick | ||||||||
| Trustee starting in March | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Paul Tuss | ||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Kirsten Kammerzell | ||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Kevin Harada MD | ||||||||
| Chief of Medical Staff | 40.00 | 1.00 | Yes (X) | $504,039 | $0 | $38,626 | ||
| J Gary Grow PhD | ||||||||
| Trustee-IPD Member | 40.00 | 1.00 | Yes (X) | $200,257 | $0 | $19,221 | ||
| Cameron Acor DPM | ||||||||
| Trustee-IPD Member | 40.00 | 1.00 | Yes (X) | $228,419 | $0 | $38,317 | ||
| Tom Patrick | ||||||||
| Trustee (Jul-Mar) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Kim Lucke | ||||||||
| VP of Finance | 53.00 | 2.00 | Yes (X) | $132,953 | $0 | $24,164 | ||
| Christen Obresley | ||||||||
| Vice President | 51.00 | 4.00 | Yes (X) | $166,849 | $0 | $18,582 | ||
| Walter Smith MD | ||||||||
| Radiologist | 40.00 | 0.00 | $664,316 | $0 | $40,159 | Yes (X) | ||
| Michelle Cameron-Donaldson MD | ||||||||
| Orthopedic Surgeon | 40.00 | 0.00 | $637,110 | $0 | $28,739 | Yes (X) | ||
| Damian Ymzon MD | ||||||||
| General Surgeon | 40.00 | 0.00 | $514,370 | $0 | $39,459 | Yes (X) | ||
| Rajeev Rajendra MD | ||||||||
| Oncology | 40.00 | 0.00 | $409,555 | $0 | $27,617 | Yes (X) | ||
| Ernest V Smith MD | ||||||||
| Emergency Medicine | 40.00 | 0.00 | $398,624 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,311,367 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $315,506 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 53 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Slate Healthcare LLC | |||||
| 2100 West Loop South Suite 900 | Houston | TX | 77027 | Staffing | $3,920,638 |
| NuWest | |||||
| 325 118th Ave SE 300 | Bellevue | WA | 98005 | Staffing | $2,116,060 |
| Associated Construction Management | |||||
| 12 North Broadway | Belgrade | MT | 59714 | Construction Services | $1,310,079 |
| Coronis Health | |||||
| 5963 Exchange Rd Suite 114 | Sykesville | MD | 21784 | Purchase Services | $997,539 |
| Hayes Locums LLC | |||||
| 6700 N Andrews Ave Suite 600 | Ft Lauderdale | FL | 33309 | Staffing | $670,589 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 23 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $19,000 | RelatedOrganizationsAmt |
| Government Grants | $2,348,639 | GovernmentGrantsAmt |
| All Other Contributions | $29,488 | AllOtherContributionsAmt |
| Total Contributions | $2,397,127 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Net Patient Service Revenue | 621110 | $46,162,126 | $46,162,126 | |
| Pharmacy | 446110 | $26,994,252 | $26,540,877 | $453,375 |
| Healthcare Consulting | 900099 | $380,143 | $380,143 | |
| Cafeteria Revenue | 722514 | $251,098 | $251,098 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $875,681 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $875,681 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $74,663,300 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $752,700 | TotalRevenueColumnAmt |
| Exclusion | $752,700 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $11,800 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,766 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,034 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,034 | TotalRevenueColumnAmt |
| Exclusion | $2,034 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $523,303 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $2,533 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $523,303 | SecuritiesAmt |
| Other | -$2,533 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $520,770 | TotalRevenueColumnAmt |
| Exclusion | $520,770 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $78,335,931 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $74,209,925 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $453,375 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,275,504 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,788 | TotalAmt |
| Program Services | $55,788 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,930,332 | TotalAmt |
| Program Services | $1,492,800 | ProgramServicesAmt |
| Management And General | $437,532 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,293,853 | TotalAmt |
| Program Services | $24,466,068 | ProgramServicesAmt |
| Management And General | $5,803,307 | ManagementAndGeneralAmt |
| Fundraising | $24,478 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $487,880 | TotalAmt |
| Program Services | $394,024 | ProgramServicesAmt |
| Management And General | $93,462 | ManagementAndGeneralAmt |
| Fundraising | $394 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,700,472 | TotalAmt |
| Program Services | $1,373,343 | ProgramServicesAmt |
| Management And General | $325,755 | ManagementAndGeneralAmt |
| Fundraising | $1,374 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,466,932 | TotalAmt |
| Program Services | $1,992,356 | ProgramServicesAmt |
| Management And General | $472,583 | ManagementAndGeneralAmt |
| Fundraising | $1,993 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $504,000 | TotalAmt |
| Program Services | $100,800 | ProgramServicesAmt |
| Management And General | $403,200 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,372 | TotalAmt |
| Management And General | $15,372 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,667 | TotalAmt |
| Management And General | $90,667 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,313,951 | TotalAmt |
| Program Services | $2,054,807 | ProgramServicesAmt |
| Management And General | $3,259,144 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,941 | TotalAmt |
| Management And General | $279,941 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,695,491 | TotalAmt |
| Program Services | $953,066 | ProgramServicesAmt |
| Management And General | $742,016 | ManagementAndGeneralAmt |
| Fundraising | $409 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,478,603 | TotalAmt |
| Program Services | $1,182,882 | ProgramServicesAmt |
| Management And General | $295,721 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,095,062 | TotalAmt |
| Program Services | $1,561,907 | ProgramServicesAmt |
| Management And General | $533,155 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,957 | TotalAmt |
| Program Services | $122,088 | ProgramServicesAmt |
| Management And General | $58,869 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,056,999 | TotalAmt |
| Program Services | $1,553,318 | ProgramServicesAmt |
| Management And General | $503,681 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,423,768 | TotalAmt |
| Program Services | $1,139,014 | ProgramServicesAmt |
| Management And General | $284,754 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $12,209,430 | $12,098,321 | $111,109 |
| Contract Labor | $7,394,786 | $7,394,786 | |
| Equipment Rental and Ma | $975,564 | $929,388 | $46,176 |
| Recruitment | $583,793 | $583,793 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,747,492 | TotalAmt |
| Program Services | $1,315,947 | ProgramServicesAmt |
| Management And General | $431,545 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,981,133 | TotalAmt |
| Program Services | $60,180,703 | ProgramServicesAmt |
| Management And General | $14,771,782 | ManagementAndGeneralAmt |
| Fundraising | $28,648 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,439,244 | BOYAmt |
| EOY | $27,008,744 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,297,661 | BOYAmt |
| EOY | $17,875,887 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,695,447 | BOYAmt |
| EOY | $2,823,603 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,435,184 | BOYAmt |
| EOY | $1,204,358 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $71,168,051 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $56,596,433 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,387,129 | BOYAmt |
| EOY | $14,571,618 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,029,695 | BOYAmt |
| EOY | $31,542,830 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,712 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,280,212 | BOYAmt |
| EOY | $2,907,408 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,637,284 | BOYAmt |
| EOY | $97,934,448 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,275,784 | BOYAmt |
| EOY | $6,572,111 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,610,441 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,514,981 | BOYAmt |
| EOY | $1,385,673 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,790,765 | BOYAmt |
| EOY | $11,568,225 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,846,519 | BOYAmt |
| EOY | $86,366,223 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,846,519 | BOYAmt |
| EOY | $86,366,223 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,637,284 | BOYAmt |
| EOY | $97,934,448 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,354,798 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$3,812,963 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $2,977,869 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $8,226 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $8,226 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Lobbying portion of association dues: $8,226 | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $33,053 | BeginningBalanceAmt |
| Additions During Year | $52,021 | AdditionsDuringYearAmt |
| Distributions During Year | $64,417 | DistributionsDuringYearAmt |
| Ending Balance | $20,657 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $145,017 | BeginningYearBalanceAmt |
| Contributions | $7,078 | ContributionsAmt |
| End Year Balance | $152,095 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $138,215 | BeginningYearBalanceAmt |
| Contributions | $6,802 | ContributionsAmt |
| End Year Balance | $145,017 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $132,797 | BeginningYearBalanceAmt |
| Contributions | $5,418 | ContributionsAmt |
| End Year Balance | $138,215 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $126,935 | BeginningYearBalanceAmt |
| Contributions | $5,862 | ContributionsAmt |
| End Year Balance | $132,797 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $121,394 | BeginningYearBalanceAmt |
| Contributions | $5,541 | ContributionsAmt |
| End Year Balance | $126,935 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $75,272 | OtherCostOrOtherBasisAmt |
| Book Value | $75,272 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,400,391 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,915,554 | DepreciationAmt |
| Book Value | $8,484,837 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,698,644 | OtherCostOrOtherBasisAmt |
| Depreciation | $33,431,181 | DepreciationAmt |
| Book Value | $5,267,463 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,993,744 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,249,698 | DepreciationAmt |
| Book Value | $744,046 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,571,618 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Affiliates | $36,493 |
| CMS Advance Payments | $1,349,180 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,385,673 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $74,532,734 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$3,812,963 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$3,812,963 | RevenueNotReportedAmt |
| Revenue Subtotal | $78,345,697 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$9,766 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$9,766 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $78,335,931 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $74,990,899 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $9,766 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $9,766 | ExpensesNotReportedAmt |
| Expenses Subtotal | $74,981,133 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $74,981,133 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Line 1b: | The custodial funds are not reported on the balance sheet of NMH as they are the personal resource funds of the residents to be used only for their personal needs. If the resident passes, the funds either go to the family or back to the state. They are in no way an asset of the organization. |
| Part V, Line 4: | The endowment funds are in the possession of Northern Montana Health Care Foundation, a related organization. The funds are used to provide funding for specific activities and general operations. |
| Part X, Line 2: | The Organization believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. |
| Part XI, Line 4b - Other Adjustments: | Rental expenses included in expenses on financial statements -9,766. |
| Part XII, Line 2d - Other Adjustments: | Rental expenses included in revenue on Form 990 9,766. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 125.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 225.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 28273 | PersonsServedCnt |
| Total Community Benefit Expns | $17,794,119 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,610,531 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,183,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01580 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 28273 | PersonsServedCnt |
| Total Community Benefit Expns | $17,800,119 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,610,531 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,189,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01590 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 6 | PersonsServedCnt |
| Total Community Benefit Expns | $63 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $63 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 20 | PersonsServedCnt |
| Total Community Benefit Expns | $79 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $79 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 11867 | PersonsServedCnt |
| Total Community Benefit Expns | $10,410,001 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,692,789 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,717,212 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06290 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 210 | PersonsServedCnt |
| Total Community Benefit Expns | $39,719 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $39,719 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 12103 | PersonsServedCnt |
| Total Community Benefit Expns | $10,449,862 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,692,789 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,757,073 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06340 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 40376 | PersonsServedCnt |
| Total Community Benefit Expns | $28,249,981 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,303,320 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,946,661 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07930 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 5900 | PersonsServedCnt |
| Total Community Benefit Expns | $24,125 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,125 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 5900 | PersonsServedCnt |
| Total Community Benefit Expns | $24,125 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,125 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,063,893 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $366,547 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $17,073,474 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $18,739,917 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,666,443 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Montana Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 30 13th Street | AddressLine1Txt |
| City | Havre | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.nmhcare.org | WebsiteAddressTxt |
| State License | 12835 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | 2 provider based rural health clinics | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Montana Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 20 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Section C Supplemental Information | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | www.bullhook.com and www.hillcountyhealth.com | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Section C Supplemental Information | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 125.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 225.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | nmhcare.org/about-us/documents | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://nmhcare.org/about-us/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://nmhcare.org/about-us/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Northern Montana Hospital | Part V, Section B, Line 5: The 2020-2023 Community Health Needs Assessment, which is being conducted during the time of the COVID-19 PHE, this year includes a more focused collaborative effort between the hospital and the Hill County Health Consortium. Northern Montana Hospital partnered with the Hill County Health Consortium to engage the community in a community wide health needs assessment survey tool, process and results. A Facebook survey monkey tool was the technique used to quickly, accurately and reliably provide household-based information about our community's needs. Members of the Hill County Health Consortium, Northern Montana Hospital and other community agencies hit the ground running, sending the survey monkey tool out to the community to help the Northern Montana Hospital collect the primary data. To further gain insight on the health status of our community and surrounding areas that the hospital serves, the following secondary information/data was also reviewed and considered: National statistics, State of Montana statistics, MT DPHHS county/community specific snapshots and facility statistical data and patient care information were utilized in identifying the priority issues for Northern Montana Hospital during this CHNA cycle. |
| Northern Montana Hospital | Part V, Section B, Line 6b: The Hill County Health Consortium effort is spearheaded by the Executive Director of Boys & Girls Club of the Hi-Line, the VP and Regulatory & Community Services of Northern Montana Health Care; RN and Director of Hill County Health Department; and CEO of Bull Hook Community Health Center. |
| Northern Montana Hospital | Part V, Section B, Line 7d: The CHNA is electronically delivered to every member of the Consortium and NMH. Bullhook Community Health Center and the Hill County Health Department all received hard copies available for distribution. |
| Northern Montana Hospital | Part V, Section B, Line 11: The most recent CHNA identified the following community needs: 1. Facility and Community Safety2. Employee Retention and Recruitment3. Behavioral Health4. Access to Dental Care5. ObesityThe following two needs will not be addressed by NMH, as there are other community leaders addressing these: 1. Access to Dental Care: The Bullhook Community Health Center and local community dentist continue to address the gaps in dental care within the community. Regular preventive care of teeth and gums is important in maintaining quality of life and overall health. Both cigarette smoking and smokeless tobacco use can cause oral health problems. NMH screen patients age 16 and over for tobacco use. 2. Obesity: Obesity continues to be addressed indirectly through assessment, education and awareness. BMI is evaluated during the patients' visits to their primary care providers. Additionally, focusing on health indicators such as blood pressure, glucose and cholesterol levels gives primary care providers another avenue to discuss and motivate their patients to lose weight. Northern Montana Hospital built and maintains the Community Fitness Park. Area residents enjoy the outdoor destination for walking, soccer, softball/baseball, kite flying, pet walking and family picnics. The Community Fitness Park is featured on the community walking map. Three laps equal one mile.The following needs identified were addressed by NMH:1. Priority Issue One: Facility and Community SafetyNorthern Montana Hospital (NMH) health leaders identified Facility and Community Safety as their top priority. First and foremost, Northern Montana Hospital will provide a safe and considerate work environment for all employees. NMH will have adequate Personal Protective Equipment (PPE) on-site and comprehensive policies on its use and disposal. NMH will guarantee that all employees are educated on pandemic protocols including disaster protocols, which will be included in each employee's annual review. NMH will build a structure to increase our adaptability to quickly bring clarity to situations and be able to change priorities as rapidly as necessary.Throughout FY22 NMH followed federal guidelines and vaccine mandates to promote a safe and considerate work environment. To support NMH employees who were vaccinated by the September 30 deadline. NMH awarded every vaccinated employee an additional holiday. During this period, we transitioned to automated kiosks for visitor and patient screening for signs and symptoms of infection prior. These kiosks were located at the main facility entrances. All non-vaccinated employees were required to wear a facemask and face shield and take a weekly Binax test. NMH launched a vaccine confidence campaign within the community and surrounding area. This campaign included attendance at over a dozen community events from football games to farmer's markets. Billboards were erected and an intense, directed advertising campaign occurred. This advertising campaign included radio, newspaper, Facebook and in-person education.Personal Protective Equipment (PPE) was maintained at adequate levels, and hospital staff were contact traced in cooperation with the Hill County Health Department. Special provisions for pay types were made for employees testing positive. In addition to COVID-19 vaccinations, NMH hosted a drive-through community flu shot clinic and an employee flu clinic.2. Priority Issue 2: Employee Retention and RecruitmentNMH health leaders identified Employee Retention and Recruitment as their second priority. Maintaining an adequate local workforce ensures safe operations of the hospital while providing high-quality healthcare to the community. Successful recruitment and retention practices will minimize the number and duration of vacancies, which in turn can improve quality of care and ensure that services are provided locally to the community.At NMH our employees are our number-one asset. We believe that employee retention involves strategic actions to keep employees motivated and engaged so they elect to remain with the organization reducing employee turnover. During FY22, as our employees dealt with COVID-19 daily and tried to find life balance, NMH promoted our Employee Assistance Program to our employees. This program is free to employees and offers confidential solutions and 24/7 access. Through the EAP, employees can get help with personal, family and work issues. Additionally, NMH made available to all interested employees an education and discussion program entitled "Resilience in the Time of COVID-19". Employees were recognized for their safety efforts related to the COVID-19 vaccine with a "Vaccination Day" holiday being awarded to each vaccinated employee.We continue to recognize our employees individually through the C.A.R.E. (Compassionately Achieving Remarkable Excellence) award and in the "Pickle Barrel". These are recognition programs that allow employees and patients to recognize our staff members. Additionally, we recognize employees and their family members during the graduation season.Since great people usually make a habit of surrounding themselves with other highly capable professionals, during the period we enlisted our staff to help us to recruit "New Talent". NMH believes that some of the best ambassadors for employee recruitment are current employees. We offer referral bonuses to our employees and sign-on bonuses to our candidates. NMH utilizes social media to promote our open positions and advertises on multiple job boards. Our directors promote and embrace flexibility in scheduling and promote and support an inclusive workplace culture. NMH offered its management team the opportunity to immerse themselves in a Director's Boot Camp. Aimed at improving director knowledge of the organization processes and increasing employee engagement, the Boot Camp covered topics including compensation, rewards, discipline, policies and procedures, purchasing, travel and education, to name a few.To try to create a competitive advantage, NMH implemented sign-on bonuses at all levels of the organization. Additionally, an organization-wide compensation evaluation was conducted. Wages were benchmarked and several step scales were revised to include increases, particularly among entry-level positions.3. Priority Issue 3: Behavioral HealthNMH health leaders identified Behavioral Health as their third priority. Mental health is important at every stage of life and affects how people think, feel and act. NMH has made Behavioral Health a significant priority and is committed to reducing the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. NMH has a variety of services available that can positively influence the community's mental health needs and continues to strategize about services that will influence community members mental wellbeing.NMH offers substance use disorder treatment for adults and behavioral health services for adults, adolescents, and children. During the height of the PHE, CDTS and BHS services were offered via telehealth.The providers at the family Medical Center and the Specialty Medical Center use the PHQ-9 screening tool at each visit to assess each patient's depression rating scale. Referrals are made to the behavioral health providers as indicated through the screening tool. |
| Northern Montana Hospital | Part V, Section B, Line 16j: In addition, a summary of the financial assistance policy is posted in the facility's emergency room and waiting rooms as well as admissions offices. The hospital's "Conditions of Treatment" also includes information regarding the financial assistance policy. |
| Northern Montana Hospital | Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. |
| Schedule H, Part V, Line 7a and 10a: | CHNA:nmhcare.org/wp-content/uploads/2021/01/2020-2023-CHNA-CHIP.pdfImplementation Strategy:nmhcare.org/wp-content/uploads/2021/01/2020-2023-CHNA-CHIP.pdf |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - Northern Montana Care Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 24 13th Street | AddressLine1Txt |
| City | Havre | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Nursing Home | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6a: | The Organization's community benefit report was published as a 1/2 page ad in the local newspaper. In addition, a statement about the amount of community benefit the organization provided can be found on our web-site at www.nhmcare.org/about-us/documents/. |
| 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. Unreimbursed Medicaid, line 7b, was calculated using the cost-to-charge ratio derived from Worksheet 2. Community health improvement services, line 7e, health professional education, line 7f, and cash and in-kind donations, line 7i, are actual costs reported in the general ledger. The cost for subsidized health services reported on line 7g was determined using the cost-to-charge ratio derived from worksheet 2. |
| Part II, Community Building Activities: | Reported under community building activities is the maintenance of our fitness park which is open to the public and has both a softball field and soccer field, as well as a paved walking path. It also includes an employee's time for being a member of the Hill County Health Consortium, which collaboratively conducted a Community Health Needs Assessment with several other local public health entities and works to implement the identified unmet needs of the community. |
| Part III, Line 2: | The organization determines its estimate of implicit price concessions based on its historical collection experience with this class of patients and residents. |
| Part III, Line 3: | The estimated amount of implicit price concessions attributable to patients eligible under the Organization's charity care policy is calculated by using the percent of population in the Organization's service area below FPG. The Organization feels it is reasonable to assume at least the same percentage of implicit price concessions is attributable to those that would have qualified for charity care, had the Organization had the information available to determine eligibility. |
| Part III, Line 4: | The footnote to the Organization's financial statements can be found on pages 13-14 of the attached audited financial statements. |
| Part III, Line 8: | Services are provided to patients under the Medicare program knowing that not all costs associated with providing these services will be recovered. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall is considered a community benefit.Medicare allowable cost is based on the Medicare cost report. The Medicare cost report is completed based on the rules & regulations set forth by Centers for Medicare and Medicaid Services. |
| Part III, Line 9b: | The Organization's financial assistance policy provides information on collection practices for those known to qualify for financial assistance. The policy states "During the patient registration or collection process, the Hospital will make an initial determination of eligibility based on verbal or written application for charity care. Pending final eligibility determination, the Hospital will not initiate collection efforts or request for deposits, provided that the responsible party is cooperative with the Hospital's efforts to reach a determination of status." The collection policy currently sends all patients accounts with a private pay balance to a billing service after 120 days. The billing service works directly with the patient to make payment arrangements. If they default on the payment plan the billing service recommends to the hospital to send the account to collections; however if the patient applies for financial assistance within 240 days of the date of the first invoice the hospital pulls the account back from collections and the billing service to review and complete the application process. |
| Part VI, Line 2: | In addition to conducting Community Health Needs Assessments, Northern Montana Hospital assesses the needs of the communities it serves in several ways. NMH reviews the top ten diagnosis in it's two Rural Health Clinics at least quarterly. We also monitor "left without being seen" patients in the Emergency Department. We monitor blood pressure and tobacco and alcohol status with every patient visit. We also have a Diabetes Prevention program that meets at least monthly with enrolled patients. In addition, we have a Chronic Care Management program in which our two Care Coordinators monitor high risk patients via phone calls and a software program called Chronic Care IQ that patients in the program interact with and record their vital signs back to NMH regularly. |
| Part VI, Line 3: | Northern Montana Hospital informs and educates patients about their eligibility for assistance through a sign posted at our admissions desk, notes in the brochure we give patients at our clinics, and signs posted at our clinic registration desks. In addition, our collection staff offers charity care as an option when they are discussing the patient's balance as well as the availability of various government benefits, such as Medicaid or state programs. NMH has contracted with a company to assist the patient with qualification for programs such as Medicaid and disability determination.We also publish a community benefit report annually which states how much financial assistance we have given away, and we post our community benefit report on our website noting that we provide financial assistance. |
| Part VI, Line 4: | The Hospital's service area consists of Hill, Blaine, Liberty, Philips and the Big Sandy census district of Choteau counties. The population of this service area is approximately 30,300. The median household income is about $42,000. Approximately 45% of the population has a household income below 200% of the federal poverty guidelines. Approximately 29% of the population is covered by Medicaid, 35% by Medicare, 2.5% by CHIP and about 14% uninsured. Additionally, another 3% of the population is covered by Indian Health Services. The entire service area is considered rural and has been designated a health professional shortage area for all primary medical care, mental health and dental. In addition, the entire service area is designated as a medically underserved area. Northern Montana Hospital is the only local hospital in its service area; however there are 3 critical access hospitals, 4 rural health clinics, 3 community health clinics and 3 IHS-Tribal clinics within its service area. The nearest hospital is a critical access hospital and is 35 miles away. |
| Part VI, Line 5: | More than 50% of Northern Montana Hospital's governing board consists of various local business people who reside within our service area and are not employed or contracted by the organization. Northern Montana Hospital extends medical staff privileges to all qualified physicians in its community. The organization applies surplus funds to improvements in patient care by keeping its medical equipment up to date, sending its employed physicians for further continuing education, supporting nursing education through loan repayment assistance and scholarship programs and supporting health care education through an education assistance program. In addition, the hospital subsidizes its emergency department by offering 24/7 emergent care coverage to all, regardless of their ability to pay. Northern Montana Hospital offers Dialysis services to patients in our service area, despite the fact that this service is provided at a loss to NMH. Without this service, patients would have to travel well over 100 miles each way, 3 times per week to receive this service. Northern Montana Hospital has Sole Community Designation. The nearest PPS hospital is located 110 miles from Havre. Northern Montana Hospital also participates in all government sponsored health programs, such as CHIP, Healthy Montana Kids and the Montana Cervical and Breast Cancer Program, where it accepts payments for services at greatly discounted rates. Several members of Northern Montana Hospital's leadership team serve on other community boards, such as: Havre Chamber of Commerce, Hill County Health Consortium, Local Emergency Planning, Fetal/Infant/Child Mortality Review Board, Havre/Hill County Planning Board, Hill and Blaine County Adult Protective Services Committee, Hill County United Way, HRDC Medical Advisory Board, MSU-N Nursing Advisory Board and the Safe Kids Safe Communities Committee. |
| Part VI, Line 7, Reports Filed With States | MT |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (3 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| Education Assistance | 3 | $4,738 |
| Nursing Scholarships | 4 | $24,850 |
| Nurse Loan Repayment | 3 | $26,200 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 2: | The organization provides education assistance to qualified employees. The organization monitors the use of the assistance by disbursing the funds directly to the institution. |
| Schedule I, Part III: | The Organization will pay up to $5,250 per person per year for educational assistance in a healthcare related field. Not all recipients request the total amount. The Organization anticipates 3-8 recipients per year. The Organization will pay up to $5,000 per person for nursing scholarships. The Organization anticipates 3-6 per year. The Organization will pay up to $7,500 per person for loan repayments. The Organization anticipates 2-4 per year. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Walter Smith MD | ||||||||||||||
| Radiologist | $663,128 | $0 | $0 | $0 | $1,188 | $0 | $5,800 | $0 | $37,053 | $0 | $707,169 | $0 | $0 | $0 |
| Michelle Cameron-Donaldson MD | ||||||||||||||
| Orthopedic Surgeon | $636,696 | $0 | $0 | $0 | $414 | $0 | $5,800 | $0 | $25,500 | $0 | $668,410 | $0 | $0 | $0 |
| Damian Ymzon MD | ||||||||||||||
| General Surgeon | $514,077 | $0 | $0 | $0 | $293 | $0 | $5,800 | $0 | $35,769 | $0 | $555,939 | $0 | $0 | $0 |
| Kevin Harada MD | ||||||||||||||
| Chief of Medical Staff | $503,863 | $0 | $0 | $0 | $176 | $0 | $5,800 | $0 | $34,889 | $0 | $544,728 | $0 | $0 | $0 |
| Karrie Lien MD | ||||||||||||||
| Secretary | $454,036 | $0 | $0 | $0 | $839 | $0 | $5,800 | $0 | $36,679 | $0 | $497,354 | $0 | $0 | $0 |
| Rajeev Rajendra MD | ||||||||||||||
| Oncology | $409,375 | $0 | $0 | $0 | $180 | $0 | $5,800 | $0 | $23,490 | $0 | $438,845 | $0 | $0 | $0 |
| Ernest V Smith MD | ||||||||||||||
| Emergency Medicine | $398,624 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $398,624 | $0 | $0 | $0 |
| Cameron Acor DPM | ||||||||||||||
| Trustee-IPD Member | $227,970 | $0 | $0 | $0 | $449 | $0 | $4,958 | $0 | $34,352 | $0 | $267,729 | $0 | $0 | $0 |
| J Gary Grow PhD | ||||||||||||||
| Trustee-IPD Member | $197,780 | $0 | $0 | $0 | $2,477 | $0 | $4,114 | $0 | $15,936 | $0 | $220,307 | $0 | $0 | $0 |
| Christen Obresley | ||||||||||||||
| Vice President | $166,045 | $0 | $0 | $0 | $804 | $0 | $3,460 | $0 | $15,819 | $0 | $186,128 | $0 | $0 | $0 |
| Kim Lucke | ||||||||||||||
| VP of Finance | $132,192 | $0 | $0 | $0 | $761 | $0 | $2,860 | $0 | $21,880 | $0 | $157,693 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | President/CEO is compensated by an unrelated management company. A related organization and the management company have a process in place to determine the CEO's compensation using the Form 990 of other organizations, a written employment contract, a compensation survey or study, and the approval by the board or compensation committee. |
| Part I, Line 5 | Karrie Lien, Kevin Harada, J. Gary Grow, and Cameron Acor are compensated as a percentage of the prior three months' average gross revenue earned for the hospital by the physician, with the percentage being based on their speciality. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | David C. Henry, President/CEO is employed by Fundamental Financial Group, an unrelated management company. Northern Montana Hospital (NMH), pays the unrelated management company for David's services provided to the Hospital, Northern Montana Health Care, Inc. and Northern Montana Health Care Foundation. The President/CEO's responsibilities include implementing decisions and supervising the management, administration and operation of the Hospital and the related, exempt organizations. The amount of compensation paid during the calendar year 2021 was $517,500. |
| Form 990, Part VI, Section A, line 6 | The sole member of the organization is Northern Montana Health Care, Inc. |
| Form 990, Part VI, Section A, line 7b | The sole member of the organization shall have such rights and powers as are provided for in the Articles of Incorporation, the Bylaws of the organization and the laws of the State of Montana, including but not limited to, the exclusive power: (a) to remove any trustee from any office at any time, with or without cause; (b) to propose and approve (i) a plan of dissolution or liquidation of the organization or (ii) a plan of merger or consolidation of the organization with another corporation; (c) to propose and approve amendments to the articles of incorporation and or the bylaws;(d) to adopt any annual or long-term capital or operational budget or any changes therein exceeding $75,000;(e) to authorize the organization to enter into any contract or engage in any transaction which is not provided for in an annual or long-term capital or operational budget approved by the sole member of the organization where the amount involved exceeds $50,000;(f) to adopt substantive changes to existing long-term or master institutional plans of the organization; (g) to authorize the organization to engage in, or enter into, any transaction providing for the sale, mortgage or other disposition of all or substantially all of the assets of the organization; (h) to organize or acquire, or authorize the organization or acquisition of, any subsidiary or affiliate of the organization; (i) to authorize the organization to enter into any shared service agreement; (j) to approve long-term borrowing of money by the organization or authorize the organization to incur indebtedness involving a mortgage or lien on assets; or (k) to approve the trustees or the President of the organization from a slate prepared by the Nominating Committee of the organization. |
| Form 990, Part VI, Section A, line 8b | No committee has the authority to act on behalf of the board. |
| Form 990, Part VI, Section B, line 11b | The VP of Finance reviews the form. The Board of Directors receives a copy of the reviewed Form 990 via e-mail before it is filed. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy covers all trustees, directors, officers, and key employees. The board identifies potential conflicts from annual disclosures. Disclosures are reviewed by administration after all are gathered. A second conflict disclosure letter is sent out annually to all current and former officers, directors, trustees, and key employees to ensure all potential conflicts are identified. The results of this disclosure form are reviewed by the VP of Finance. The board discusses the potential conflicts and determines if voting on related items would be a conflict of interest. If a conflict is determined to exist, the conflicted individual is excluded from voting on the conflicted item. |
| Form 990, Part VI, Section B, line 15a | The President/CEO is compensated by an unrelated management company. The unrelated management company receives a fee for service for the CEO's service provided to this organization and related organizations, Northern Montana Health Care, Inc (NMHC) and Northern Montana Health Care Foundation, Inc. (NMHCF). In determining the CEO's compensation, the governing board, with the exception of the CEO, meets and reviews NMH and NMHC financial results, CEO's current year priorities, discusses evaluation tools to be used for the CEO's evaluation, how comparative salaries will be obtained and discusses the history of compensation to the CEO. At a second meeting the Board reviews non-financial activity of NMH and NMHC and the results of the CEO evaluations completed by the board members. Then they review and discuss a compensation comparative summary of Montana CEO's compensation. They agree upon a list of the coming year's priorities for the CEO and proposed compensation, with the compensation set by board vote. This annual process was completed during fiscal year 2022. The CEO reviews and approves the compensation for all other officers and physicians. |
| Form 990, Part VI, Section C, line 19 | The organization's governing documents, conflict of interest policy, and financial statements are made available to the public upon request. The financial statements are attached to the Form 990 per the IRS instructions. |
| Form 990, Part XI, line 9: | Minimum Pension Liability Adjustment: 2,777,869. Equity Transfer to Affiliate - Northern Montana Health Care, Inc. -500,000. Restatement reported on consolidated financial statement 700,000. |
| Form 990, Part XII, Line 2c: | The controlling organization, Northern Montana Health Care, Inc.'s Board has a committee that assumes responsibility for oversight of the audit of the financial statements and selection of an independent auditor. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Northern Montana Health Care Inc | |||||||||||
| PO Box 1231 | Havre | MT | 59501 | 810428854 | Supporting Organization | MT | 501(c)(3) | Line 12b, II | N/A | 0 | |
| Northern Montana Health Care Foundation Inc | |||||||||||
| PO Box 1231 | Havre | MT | 59501 | 363464641 | Fundraising | MT | 501(c)(3) | Line 7 | 0 | Northern Montana Health Care Inc | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |