2025-05-15T13:00:31-05:00 2024-06-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2023-07-01 816016920 DANIELS MEMORIAL HOSPITAL DANI 4064872296 PO BOX 400 SCOBEY MT 59263 KODY BRINTON CEO 4064872296 2025-05-12 1 0 TYLER JOHNSON P01604007 6123764500 2025-05-05 2023 2025-03-06 01:10:19Z DANIELS MEMORIAL HEALTHCARE CENTER KODY BRINTON PO BOX 400 SCOBEY MT 59263 12010411 0 X WWW.DANIELSMEMORIALHEALTHCARE.ORG X 1956 MT SEE SCHEDULE O WE ARE DEDICATED TO ENRICHING THE HEALTH OF THOSE WE SERVE AND TO STRENGTHENING OUR COMMUNITY FOR THE FUTURE. 10 10 90 11 0 0 96248 210945 11938261 10892615 5902 32199 602214 874652 12642625 12010411 0 5042 0 0 4963552 5911156 10500 42000 42000 7514379 5227984 12488431 11186182 154194 824229 8965699 9386252 1929867 1524620 7035832 7861632 WE ARE DEDICATED TO ENRICHING THE HEALTH OF THOSE WE SERVE AND TO STRENGTHENING OUR COMMUNITY FOR THE FUTURE. 0 0 7688778 5042 10892615 DANIELS MEMORIAL HOSPITAL PROVIDES HEALTH PROFESSIONAL SERVICES SUCH AS ACUTE CARE, SKILLED SWING BED, EMERGENCY, INPATIENT, AND OUTPATIENTS CARE. 7688778 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 1 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 6 0 90 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 10 10 0 1 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X KODY BRINTON 4064872296 105 5TH AVE E SCOBEY MT 59263 X JACK PITTENGER CHAIR 1.00 0.00 X X 0 0 0 TANNER TROWER VICE CHAIR 1.50 0.00 X X 0 0 0 JEDDA BARRON SECRETARY 1.00 0.00 X X 0 0 0 JANITZIA NELSON TREASURER 1.00 0.00 X X 0 0 0 MIKE BJARKO TRUSTEE 1.50 0.00 X 0 0 0 KYMBER CARNEY TRUSTEE 1.00 0.00 X 0 0 0 CLIFF HAMES TRUSTEE 1.00 0.00 X 0 0 0 PAUL KANNING TRUSTEE 1.00 0.00 X 0 0 0 CHASE THOMPSON TRUSTEE 1.00 0.00 X 0 0 0 ARLENE KEGLEY TRUSTEE 1.00 0.00 X 0 0 0 WYATT WILDER TRUSTEE 1.00 0.00 X 0 0 0 KODY BRINTON CHIEF EXECUTIVE OFFICER 40.00 1.00 X 0 0 0 DEANNA FERESTAD NURSE PRACTIONER 40.00 0.00 X 188812 0 43234 SHIRLEY RELLER PHYSICAL THERAPIST 40.00 0.00 X 151644 0 40150 JESSICA WINGE-PETERSON DIRECTOR OF NURSING SERVICES 40.00 0.00 X 139585 0 20035 AUDREY SUMMER RADIOLOGY MANAGER 40.00 0.00 X 118208 0 4687 JENNY BERRYHILL PHYSICAL THERAPIST 40.00 0.00 X 116898 0 37338 715147 0 145444 15 0 1 1 PRN STAFFING 173 AUSTRIAN ROAD VIDA MT 59274 CONTRACT STAFFING 960670 BILLINGS CLINIC PO BOX 30357 BILLINGS MT 59107 MANAGEMENT 767116 RASMUSSEN ROOFING 312 BRYAN STREET FLAXVILLE MT 59222 PROJECT CONTRACTOR 527180 WILDERNESS MEDICAL STAFFING PO BOX 30729 SPOKANE WA 99223 CONTRACT STAFFING 369794 MONTANA HEALTH NETWORK 519 PLEASANT STREET MILES CITY MT 59301 CONTRACT STAFFING 349348 9 54792 127982 28171 210945 PATIENT SERVICE REVENUE 623000 10579145 10579145 340B REVENUE 456110 313470 313470 10892615 31699 31699 500 0 500 500 500 HOSPITAL TAX REVENUE 623000 736377 736377 MISCELLANEOUS REVENUE 900099 170893 170893 INVESTMENT FROM INSURANCE CAPTIVE 900001 -32618 -32618 874652 12010411 10892615 0 906851 X 5042 5042 4713973 3128232 1585741 96265 61995 34270 764629 485131 279498 336289 224141 112148 52927 52927 51930 51930 42000 42000 2867025 1957703 909322 22116 716 21400 217664 167911 49753 214864 165222 49642 49119 11976 37143 18880 2554 16326 8867 7005 1862 373979 338223 35756 66102 820 65282 MEDICAL SUPPLIES 644588 626494 18094 REPAIRS AND MAINTENANCE 200130 190292 9838 FOOD SUPPLY 116412 116412 BAD DEBT EXPENSE 96297 96297 227084 102612 124472 11186182 7688778 3455404 42000 3127290 2793870 744308 502589 1429686 1314476 94933 110283 286399 236212 90491 94545 8188128 5391221 2138786 2796907 0 269234 1053806 1268136 8965699 9386252 949785 829489 219395 138239 760687 556892 1929867 1524620 X 6935832 7861632 100000 0 7035832 7861632 8965699 9386252 824229 1571 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1385 1385 0 PART II-B, LINE 1: DANIELS MEMORIAL HOSPITAL PAYS MEMBERSHIP DUES TO THE MONTANA HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION, A PORTION OF WHICH IS USED BY THOSE ASSOCIATIONS TO LOBBY ON BEHALF OF THEIR MEMBERS. 13500 13500 4957833 3625872 1331961 2807819 1765349 1042470 408976 408976 2796907 COST REPORT SETTLEMENT RECEIVABLE 866098 RIGHT-OF-USE LEASE ASSETS 214584 SUBSCRIBERS EQUITY IN INSURANCE CAPTIVE 182344 RESIDENT CASH 5110 1268136 COST REPORT SETTLEMENT PAYABLE 235000 RIGHT-OF-USE LEASE LIABILITIES 211609 GUARANTEE OF PATIENT LOANS 110283 556892 X 11915685 1571 1571 11914114 96297 96297 12010411 11089885 0 11089885 96297 96297 11186182 PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FORM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. FEDERAL AND STATE INCOME TAXES ARE PAID ON NONEXEMPT UNRELATED BUSINESS INCOME IN ACCORDANCE WITH THE CODE. CURRENT ACCOUNTING GUIDELINES REQURIE AN ORGANIZATION TO DETERMINE WHETHER IT IS MORE-LIKELY-THAN-NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE HOSPITAL RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. FEDERAL RETURNS FOR TAX YEARS 2020 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 96,297. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 96,297. X X X X X 1 BANNACK GROUP LLC PO BOX 1823 BOZEMAN MT 59715 CAPITAL CAMPAIGN 0 300000 42000 0 300000 42000 MT SCHEDULE G, PART I, LINE 2B, COLUMN (V) THE HOSPITAL AND ITS SUPPORTING ORGANIZATION, DANIELS MEMORIAL HOSPITAL FOUNDATION, ARE CONDUCTING A CAPITAL CAMPAIGN IN WHICH THE FOUNDATION WILL COLLECT ALL CONTRIBUTIONS. THE HOSPITAL AND THE FOUNDATION ARE SPLITTING THE PROFESSIONAL FEES. THE HOSPITAL'S PORTION THE SHARE FEE WAS $42,000 FOR FY2024. 1 1 1 X 1 X 1 1 1 0 0 73519 73519 0.00660 1960880 1682630 278250 0.02510 2034399 1682630 351769 0.03170 62088 35035 27053 0.00240 131371 107700 23671 0.00210 193459 142735 50724 0.00450 2227858 1825365 402493 0.03620 1 96297 0 4622541 5231859 -609318 X 1 1 1 1 DANIELS MEMORIAL HOSPITAL PO BOX 400 SCOBEY MT 59263 WWW.DANIELSMEMORIALHEALTHCARE.COM 12791 X X X X RURAL HEALTH CLINIC DANIELS MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X 21 1 0 1 1 X SEE PART V, LINE 7D X X 1 22 1 SEE PART V, LINE 7D 0 1 X 200.000000000000 400.000000000000 0 1 X X 1 X SEE PART V, LINE 16J X SEE PART V, LINE 16J X SEE PART V, LINE 16J X X X X X X X 1 X 0 X X X X 1 0 1 DANIELS MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: FIVE KEY INFORMANT INTERVIEWS WERE CONDUCTED TO IDENTIFY IMPORTANT LOCAL HEALTHCARE ISSUES, HOW TO IMPROVE THE HEALTH OF THE COMMUNITY, AND GAPS IN HEALTH SERVICES. IN ADDITION, SURVEYS WERE PROVIDED TO 600 HOUSEHOLDS IN THE DMHC SERVICE AREA WITH 127 COMPLETED SURVEYS BEING RETURNED. DANIELS MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN COOPERATION WITH THE MONTANA OFFICE OF RURAL HEALTH. DANIELS MEMORIAL HOSPITAL PART V, SECTION B, LINE 7D: DANIELS MEMORIAL HOSPITAL CHNA AND IMPLEMENTATION CAN BE FOUND AT THE FOLLOWING WEBSITES: WWW.DANIELSMEMORIALHEALTHCARE.ORG DANIELS MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THE FOLLOWING SIGNIFICANT NEEDS:GOAL 1: IMPROVE ACCESS TO HEALTHCARE SERVICES IN DANIELS COUNTY.STRATEGY 1.1: INCREASE ACCESS TO PRIMARY CARE SERVICES AT DANIELS MEMORIAL HEALTHCARE CENTER (DMHC).ACTIVITIES: SINCE LAST YEAR, WE HAVE BEEN ABLE TO STABILIZE OUR MEDICAL STAFF BY ADDING THREE NEW PROVIDERS, THUS IMPROVING ACCESS TO PRIMARY CARE SERVICES. CREATE EDUCATION AND OUTREACH PLAN TO RAISE AWARENESS OF SERVICES THAT ADVANCED PRACTICE PROVIDERS CAN PROVIDE LOCALLY AND DMHC IS WORKING TO EXPAND DESIRED PRIMARY CARE SERVICES. WE CONTINUE TO WORK WITH BILLINGS CLINIC AND ITS SPECIALTY PROVIDERS TO EXPAND OUR TELEHEALTH/TELEMEDICINE SERVICES. OUR TEAM HAS BEEN WORKING DILIGENTLY WITH THE LOCAL SCHOOL DISTRICT TO INTRODUCE HEALTH PROFESSIONS TO HIGH SCHOOL STUDENTS, STARTING DURING THE SOPHOMORE AND JUNIOR YEAR OR HIGH SCHOOL. OUR CNA PROGRAM CONTINUES TO HAVE AT LEAST ONE TO THREE ENROLLEES EVERY YEAR. STRATEGY 1.2: EXPLORE OPPORTUNITIES TO ENHANCE ACCESS TO SPECIALTY CARE IN DANIELS COUNTY.ACTIVITIES: DETERMINE OPPORTUNITIES TO SUSTAIN SPECIALTY SERVICES VIA TELEMEDICINE AT DANIELS MEMORIAL HEALTHCARE CENTER; IMPROVE EDUCATION AND OUTREACH TO DMHC STAFF AND THE SERVICE AREA ABOUT THE SPECIALTY SERVICES THAT ARE AVAILABLE LOCALLY VIA TELEMEDICINE; EXPLORE OPPORTUNITIES TO EXPAND CURRENT SPECIALTY SERVICES AT DANIELS MEMORIAL HEALTHCARE CENTER (I.E., ECHOCARDIOGRAMS, EXPANDED ULTRASOUND, AND WOMEN'S HEALTH, ETC.). OVER THE LAST YEAR, WE HAVE WORKED WITH OUR PSYCHIATRIC NURSE PRACTITIONER, AND OUR VARIOUS REHABILITATION THERAPISTS TO OFFER TELEMEDICINE/TELEHEALTH VISITS. WE HAVE SEEN AN IMPACT IN OUR ABILITY TO SERVE PEOPLE AND ACCOMMODATE THEIR SCHEDULES THROUGH THIS TELEHEALTH OFFERING.STRATEGY 1.3: SUPPORT LOCAL TRANSPORTATION SERVICES THAT ASSIST COUNTY RESIDENTS IN ACCESSING HEALTHCARE SERVICES IN THE REGION.ACTIVITIES: CONTINUE PARTICIPATION AND SUPPORT OF THE DANIELS COUNTY PUBLIC TRANSPORTATION TO AND FROM MEDICAL APPOINTMENTS AT DMHC AND WITHIN THE REGION FOR PATIENTS WHO DO NOT HAVE ACCESS TO RELIABLE TRANSPORTATION. DANILES COUNTY TRANSPORTATION IS CONTINUOUSLY LOOKING FOR QUALIFIED, INTERESTED DRIVERS TO FURTHER PROVIDE TRANSPORTATION SERVICES TO THOSE IN OUR COMMUNITIES, INCLUDING BUT NOT LIMITED TO THOSE 60 YEARS OF AGE AND UP. WORKING WITH MONTANA DEPARTMENT OF TRANSPORTATION, OUR TRANSPORTATION PROGRAM WILL BE PURCHASING A NEW VAN THIS UPCOMING YEAR.STRATEGY 1.4: SUPPORT AND EXPAND SERVICES THAT ASSIST DANIELS COUNTY SENIORS TO AGE IN PLACE. ACTIVITIES: CONTINUE TO PROVIDE SERVICES THAT ASSIST SENIORS TO AGE IN PLACE (I.E., VISITING NURSE, ADULT DAYCARE, LIFELINE, WHIRLPOOL, ETC.); CONTINUE TO PROVIDE ACCESS TO HEALTHY MEALS THROUGH MEALS ON WHEELS PROGRAM FOR SENIORS IN DANIELS COUNTY. OUR STAFF MEMBERS ALSO VOLUNTEER WITH THE STEPPING UP PROGRAM, SPONSORED THROUGH THE COUNTY PUBLIC HEALTH DEPARTMENT, THAT PROVIDES FALL PREVENTION CLASSES TO MEMBERS OF OUR COMMUNITY.GOAL 2: ENHANCE DANIELS MEMORIAL HEALTHCARE CENTER'S SUPPORT OF AND OUTREACH FOR HEALTH AND WELLNESS IN DANIELS COUNTY.STRATEGY 2.1: SUPPORT COMMUNITY PROGRAMS AND EVENTS THAT ENCOURAGE HEALTHY BEHAVIORS AND LIFESTYLES.ACTIVITIES: THIS LAST YEAR, OUR COMMUNITY RELATIONS MANAGER SPEARHEADED OUR FIRST ANNUAL COMMUNITY HEALTH FAIR AT OUR FACILITY. THE EVENT WAS WELL ATTENDED. THIS EVENT ALLOWED VARIOUS HEALTH FOCUS ORGANIZATIONS TO PARTICIPATE. THE COMMUNITY WAS ABLE TO TOUR THE HOSPITAL, VISITING EACH BOOTH LEARNING ABOUT THE DIFFERENT HEALTH SERVICES OUR FACILITY OFFERS, AS WELL AS THE COMMUNITY OFFERS. THEY WERE EVEN ABLE TO HAVE OUR LOCAL FIRE DEPARTMENT AND EMS CREW HAVE AN AMBULANCE AND A FIRE RESPONSE VEHICLE SO COMMUNITY MEMBERS COULD VIEW AND LEARN MORE ABOUT THEIR FIRST RESPONSE PROGRAMS.WE CONTINUE TO SUPPORT COMMUNITY HEALTH AND WELLNESS PROGRAMS AND EVENTS THAT PROMOTE HEALTHY BEHAVIORS, ACTIVITIES, AND SHARE HEALTH EDUCATION (SPONSOR TOWER HILL WALK AND GOLF TOURNAMENT, DMHC PRESENCE VIA AN ANNUAL FAIR BOOTH AND PROVIDE SPORTS PHYSICALS AT LOCAL SCHOOLS).GOAL 3: IMPROVE ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES AT DANIELS MEMORIAL HEALTHCARE CENTER.STRATEGY 3.1: EXPLORE OPPORTUNITIES TO ADVANCE ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES.ACTIVITIES: EXPLORE EXPANDING THE UTILIZATION OF TELEHEALTH MENTAL HEALTH SERVICES (I.E., PSYCHIATRIC NURSE PRACTITIONER); REASSESS CURRENT COMMUNITY AND REGIONAL PARTNERS/RESOURCES THAT STRENGTHEN ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES.STRATEGY 3.2: CONTINUE SUPPORT OF CURRENT MENTAL AND BEHAVIORAL HEALTH EFFORTS IN DANIELS COUNTY.ACTIVITIES: DUE TO THE ORIGINATING MEMBERS IN THE COMMUNITY WHO SERVED ON THE DANIELS COUNTY MENTAL HEALTH ADVISORY COMMITTEE NO LONGER LIVING IN THE COUNTY, THIS LOCAL COMMITTEE CURRENTLY DOES NOT EXIST. THERE ARE PLANS TO REVITALIZE THIS COMMITTEE IN THE NEAR FUTURE.DMHC IS UNABLE TO ADDRESS THE FOLLOWING NEEDS AT THIS TIME:1. 9.2% OF SURVEY RESPONDENTS INDICATED THEY HAD DIFFICULTY GETTING A PRESCRIPTION OR TAKING THEIR MEDICATION REGULARLY DUE TO COST IN THE LAST YEAR. IN PARTNERSHIP WITH SERVICE FAMILY PHARMACY, DANIELS MEMORIAL JOINED THE 340B PROGRAM AND ARE FINE TUNING THE DETAILS. THE 340B PROGRAM ISDESIGNED TO ASSIST IN MAKING PRESCRIPTIONS MORE AFFORDABLE FOR PATIENTS WHO ARE FINANCIALLY NEEDY.2. 2.1% OF SURVEY RESPONDENTS WERE CONCERNED ABOUT NOT HAVING ENOUGH FOOD TO EAT IN THE LAST YEAR. DANIELS MEMORIAL HEALTHCARE CENTER PROVIDES MONETARY AND FOOD DONATIONS TO THE LOCAL FOOD PANTRY AS WELL AS REFERS COMMUNITY MEMBERS WHEN NECESSARY. PROVIDING A ROBUST STRATEGY TO ADDRESS FOOD INSECURITY IS CHALLENGING, HOWEVER DMHC IS IN PARTNERSHIP WITH THE CHAMBER OF COMMERCE AND DANIELS COUNTY PUBLIC HEALTH DEPARTMENT TO EXPLORE SOLUTIONS TO ADDRESS FOOD INSECURITY LOCALLY. DANIELS MEMORIAL HOSPITAL PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND FINANCIAL ASSISTANCE APPLICATION ARE AVAILABLE ONLINE AT WWW.DANIELSMEMORIALHEALTHCARE.ORG/FINANCIAL-ASSISTANCE/. DANIELS MEMORIAL HOSPITAL PART V, SECTION B, LINE 24: PATIENT CARE WHICH IS NOT MEDICALLY NECESSARY INCLUDING ELECTIVE, COSMETIC, EXPERIMENTAL OR DEEMED TO BE GENERALLY NOT REIMBURSABLE BY TRADITIONAL INSURANCE CARRIERS AND GOVERNMENTAL PAYERS SHALL NOT BE CONSIDERED ELIGIBLE FOR CHARITY CARE. PART I, LINE 3C: TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, AN INDIVIDUAL MUST RECEIVE MEDICALLY NECESSARY HEALTH CARE SERVICES AT DANIELS MEMORIAL HOSPITAL, COMPLETE A FINANCIAL ASSISTANCE APPLICATION INCLUDING ALL REQUIRED SUPPORTING DOCUMENTATION, AND HAVE INCOME BELOW 400% OF THE FEDERAL POVERTY LEVEL BASED ON THEIR FAMILY SIZE.THERE ARE INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR CHARITY CARE DISCOUNTS, BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE DUE TO LACK OF SUPPORTING DOCUMENTATION. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED BASED ON INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE STATE-FUNDED PRESCRIPTION PROGRAMS, HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC, PARTICIPATION IN THE WOMEN INFANTS AND CHILDREN (WIC) PROGRAM, FOOD STAMP ELIGIBILITY, SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY, LOW-INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS, PATIENT IS DECEASED WITH NO KNOWN ESTATE, AND ENERGY ASSISTANCE PROGRAM ELIGIBILITY.THE ADMINISTRATOR CAN REVIEW ACCOUNTS ON A CASE-BY-CASE BASIS AND LOOK FOR INDICATION THAT THE FULL PAYMENT MAY CAUSE SOCIAL AND FINANCIAL HARDSHIP SO AS TO SIGNIFICANTLY HARM THE PATIENT OR THE FAMILY UNIT. PART I, LINE 7: A COST-TO-CHARGE RATIO WAS CALCULATED USING WORKSHEET 2. ALL AMOUNTS ON LINE 7 WERE CALCULATED USING THE WORKSHEETS PROVIDED IN THE SCHEDULE H INSTRUCTIONS. PART I, LINE 7G: IMMUNIZATIONS ARE THE ONLY SUBSIDIZED HEALTH SERVICE BEING REPORTED IN PART 1, LINE 7G. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 96,297. PART III, LINE 2: THE AMOUNT OF BAD DEBT EXPENSE IS THE BAD DEBT EXPENSE LESS BAD DEBT RECOVERY FROM THE INCOME STATEMENT. PART III, LINE 3: THE ORGANIZATION DOES NOT HAVE A METHODOLOGY TO CALCULATE WITH REASONABLE ACCURACY THE PORTION OF OUR BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT FAILED TO COMPLETE AN APPLICATION. PART III, LINE 4: SEE THE "PATIENT ACCOUNTS RECEIVABLES AND EXPECTED CREDIT LOSSES" PARAGRAPHS ON PAGE 7 OF THE HOSPITAL'S ATTACHED AUDITED FINANCIAL STATEMENTS FOR AN EXPLANATION OF THE ORGANIZATION'S BAD DEBT EXPENSE. PART III, LINE 8: THE COST TO CHARGE RATION IS USED TO DETERMINE COMMUNITY BENEFIT. THIS IS DONE BY APPLYING THE RATIO TO THE TOTAL MEDICARE REVENUE. A SHORTFALL OR OVERAGE IN ANY GIVEN YEAR IS A RESULT OF THE TIMING OF PAYMENTS FROM MEDICARE ON AN INTERIM BASIS AND WHEN FINAL SETTLEMENT IS MADE. MANAGEMENT USES ESTIMATES TO CALCULATE SUCH SETTLEMENTS BUT ACTUAL RESULTS VARY FROM THOSE ESTIMATES. ADDITIONALLY, SHORTFALLS CAN RESULT FROM VARIOUS EXPENSES THAT ARE INCURRED BY THE FACILITY WHICH ARE CONSIDERED NON-REIMBURSABLE BY MEDICARE.SINCE PART OF THE COSTS ARE NOT REIMBURSED IT IS ONLY PRUDENT TO CONSIDER THIS SHORTFALL TO BE A BENEFIT TO THE COMMUNITY. ALSO MEDICARE RECIPIENTS ARE PART OF THE CHARITABLE CLASS AND SO THE PROVISION OF THE MEDICAL CARE FURTHERS THIS CHARITABLE CLASS. PART III, LINE 9B: NOTIFICATION ABOUT THE DMHC CHARITY AVAILABILITY FORM, WHICH SHALL INCLUDE A CONTACT NUMBER, SHALL BE DISSEMINATED BY DMHC BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, THE PUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS. INFORMATION SHALL ALSO BE INCLUDED ON THE FACILITY WEBSITES AND IN THE CONDITIONS OF ADMISSION FORM. SUCH INFORMATION SHALL BE PROVIDED IN THE PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED DMHC. REFERRAL OF PATIENTS FOR CHARITY MAY BE MADE BY ANY MEMBER OF THE DMHC STAFF OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL WORKERS, SOCIAL WORKERS, ETC. A REQUEST FOR CHARITY MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE FOR THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. PART VI, LINE 2: PRIMARILY DMHC WORKS CLOSELY WITH THE PUBLIC HEALTH DEPARTMENT AND LOCAL EMS, FIRE AND LAW ENFORCEMENT TO WORK TOGETHER TO ADDRESS ISSUES WITHIN THE COMMUNITY. PART VI, LINE 3: WE INFORM THE PUBLIC ABOUT PROGRAMS, I.E. MEDICARE/MEDICAID THROUGH ADVERTISEMENT IN PRINT AND RADIO, PAMPHLETS IN THE WAITING ROOM, AND SOCIAL SERVICE VISITS WITH PATIENTS. PART VI, LINE 4: WE ARE DESIGNATED A FRONTIER CRITICAL ACCESS HOSPITAL. THE COUNTY HAS 1,690 PEOPLE. WE ARE FIVE HOURS AWAY FROM A TERTIARY HOSPITAL AND THREE HOURS AWAY FROM A SECONDARY HOSPITAL. PART VI, LINE 5: WE ARE GOVERNED BY A COMMUNITY BOARD REPRESENTING THE FULL SERVICES AREA. WE ALSO PARTICIPATE IN EASTERN MONTANA TELEMEDICINE AND ARE ABLE TO OFFER VISITS WITH MULTIPLE SPECIALTY PROVIDERS. 0 0 0 0 0 0 0 0 0 0 DEANNA FERESTAD NURSE PRACTIONER 185237 0 3575 0 0 0 5664 0 37570 0 232046 0 0 0 SHIRLEY RELLER PHYSICAL THERAPIST 151569 0 75 0 0 0 4549 0 35601 0 191794 0 0 0 JESSICA WINGE-PETERSON DIRECTOR OF NURSING SERVICES 139510 0 75 0 0 0 4188 0 15847 0 159620 0 0 0 JENNY BERRYHILL PHYSICAL THERAPIST 116823 0 75 0 0 0 2338 0 35000 0 154236 0 0 0 FORM 990, PART VII, SECTION A, LINE 5 DANIELS MEMORIAL HOSPITAL CONTRACTS WITH BILLING CLINIC TO PROVIDE SERVICES DIRECTLY TO THE HOSPITAL AND MANAGEMENT. INCLUDED IN THE FEES PAID TO BILLINGS CLINIC IS THE COMPENSATION FOR KODY BRINTON, SEE BELOW FOR DETAILS. BASE SALARY - $150,804 EMPLOYER CONTRIBUTION TO MEDICAL AND DENTAL -$27,488 EMPLOYER CONTRIBUTION TO LIFE INSURANCE AND LONG-TERM DISABILITY - $469 FORM 990, PART VI, SECTION A, LINE 3 DANIELS MEMORIAL HOSPITAL HAS A MANAGEMENT AGREEMENT WITH BILLINGS CLINIC. THEY PROVIDE MANAGEMENT, IT, AND ACCOUNTING SERVICES. INCLUDED IN THE FEES PAID TO BILLINGS CLINIC IS THE COMPENSATION FOR HOSPITAL'S CURRENT CEO, KODY BRINTON. DURING 2023, THE CEO RECEIVED THE FOLLOWING AS COMPENSATION FOR SERVICES PROFIDED TO THE HOSPITAL: BASE SALARY - $150,804 EMPLOYER CONTRIBUTION TO MEDICAL AND DENTAL -$27,488 EMPLOYER CONTRIBUTION TO LIFE INSURANCE AND LONG-TERM DISABILITY - $469 FORM 990, PART VI, SECTION A, LINE 4 THE ARTICLES OF INCORPORATION WERE AMENDED IN NOVEMBER 2023 TO CHANGE THE CRITERIA FOR MEMBERSHIP IN THE ORGANIZATION FROM (A) TAXPAYERS OF DANIELS COUNTY AND/OR INDIVIDUALS WHO CONTRIBUTED TO OR PATRONIZED THE DANIELS MEMORIAL HOSPITAL ASSOCIATION BY THE TIME OF THE ORGANIZATION'S ANNUAL MEETING TO (B) INDIVIDUALS AGE 18 OR OLDER WITH A MAILING ADDRESS IN DANIELS COUNTY, SHERIDAN COUNTY, ROOSEVELT COUNTY, OR VALLEY COUNTY, MONTANA, WHO HAS REGISTERED AS A MEMBER BY COMPLETING AND SUBMITTING A MEMBER REGISTRATION FORM PRIOR TO THE ORGANIZATION'S ANNUAL MEETING. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE CORPORATION SHALL BE 18 YEARS OF AGE WITH A MAILING ADDRESS IN DANIELS COUNTY, SHERIDAN COUNTY, ROOSEVELT COUNTY, OR VALLEY COUNTY, MONTANA WHO IS REGISTERED AS A MEMBER BY COMPLETING AND SUBMITTING A MEMBER REGISTRATION FORM PRIOR TO THE ORGANIZATION'S ANNUAL MEETING. THIS IS THE ONLY CLASS OF MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A THE CHAIR OF THE HOSPITAL DISTRICT AUTHORITY FOR DANIELS COUNTY, MONTANA IS A VOTING MEMBER OF THE BOARD. ALL OTHER BOARD MEMBERS ARE APPOINTED BY MAJORITY VOTE OF THE MEMBERSHIP AT THE MEMBERS' ANNUAL MEETING FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PROVIDED TO THE BOARD MEMBERS FOR REVIEW AFTER APPROVAL BY THE CEO. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS, EMPLOYEES, VOLUNTEERS, CONTRACTED WORKFORCE AND MEDICAL STAFF. CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND SIGNED BY ALL TRUSTEES AND BY THE LEADERSHIP TEAM UPON JOINING THE ORGANIZATION AND ANNUALLY THEREAFTER. ANY CONFLICTS OF INTEREST ARE REVIEWED AND MONITORED BY THE ADMINISTRATIVE COUNCIL AND/OR COMPLIANCE COMMITTEE. IF IT APPEARS AN INDIVIDUAL HAS VIOLATED THE CONFLICT OF INTEREST POLICY, A MEMBER OF THE COMPLIANCE COMMITTEE, HUMAN RESOURCES, OR LEGAL DEPARTMENT WILL INVESTIGATE AND TAKE APPROPRIATE ACTION UP TO AND INCLUDING TERMINATION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF TRUSTEES REVIEWS AND MAKES DECISIONS ON THE COMPENSATION PACKAGE FOR THE CEO. THE CEO COMPENSATION IS PART OF THE MANAGEMENT CONTRACT PAID TO THE OUTSIDE MANAGEMENT COMPANY. ALL MANAGERS REPORT TO THE CEO AND THE CEO REVIEWS AND MAKES DECISIONS ON THE MANAGER'S COMPENSATION. BOARD OFFICERS ARE NOT COMPENSATED. THE CEO REVIEWS MHA WAGE SURVEY INFORMATION AS WELL AS INTERNAL EQUITY TO DETERMINE COMPENSATION OF KEY EMPLOYEES. THESE PROCESSES LAST OCCURRED IN 2024. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 1,957,703. MANAGEMENT AND GENERAL EXPENSES 909,322. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,867,025. DANIELS MEMORIAL HOSPITAL FOUNDATION 105 5TH AVENUE SCOBEY MT 59263 363461891 COMMUNITY HEALTHCARE SUPPORT MT 501(C)(3) LINE 12D, III-O N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0