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POWELL COUNTY MEMORIAL HOSPITAL ASSOCIATION: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
POWELL COUNTY MEMORIAL HOSPITAL ASSOCIATION (EIN 81-0469886)
Tax period
2023-07-01 to 2024-06-30
Filed
2025-05-08
IRS object ID
202541289349303444
Schema version
2023v6.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2025-05-08T15:59:49-05:00ReturnTs
Tax Period End2024-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1105 E PINE ST UPPER FLOORAddressLine1Txt
CityMISSOULACityNm
State AbbreviationMTStateAbbreviationCd
ZIP59802ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN810469886EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1POWELL COUNTY MEMORIAL HOSPITAL ASSOCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPOWEBusinessNameControlTxt
Phone4068462212PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11100 HOLLENBACK LANEAddressLine1Txt
CityDEER LODGECityNm
State AbbreviationMTStateAbbreviationCd
ZIP59722ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJAENA RICHARDSPersonNm
Person TitleCEOPersonTitleTxt
Phone4068462212PhoneNum
Signature2025-04-22SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSAM BRUNSON CPAPreparerPersonNm
PTINP01696998PTIN
Phone4067281800PhoneNum
Preparation2025-04-22PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1DEER LODGE MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJAENA RICHARDSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11100 HOLLENBACK LANEAddressLine1Txt
CityDEER LODGECityNm
State AbbreviationMTStateAbbreviationCd
ZIP59722ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$26,751,100GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressDLMED.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1991FormationYr
Legal Domicile StateMTLegalDomicileStateCd
Activity Or MissionTO PROVIDE PATIENT FOCUSED HEALTHCARE.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee175TotalEmployeeCnt
Total Volunteers7TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$346,550PYContributionsGrantsAmt
CY Contributions Grants$66,207CYContributionsGrantsAmt
PY Program Service Revenue$23,509,843PYProgramServiceRevenueAmt
CY Program Service Revenue$25,762,684CYProgramServiceRevenueAmt
PY Investment Income$155,376PYInvestmentIncomeAmt
CY Investment Income$372,730CYInvestmentIncomeAmt
PY Other Revenue$387,878PYOtherRevenueAmt
CY Other Revenue$542,353CYOtherRevenueAmt
PY Total Revenue$24,399,647PYTotalRevenueAmt
CY Total Revenue$26,743,974CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$12,789,409PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,430,435CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$10,580,149PYOtherExpensesAmt
CY Other Expenses$11,610,389CYOtherExpensesAmt
PY Total Expenses$23,369,558PYTotalExpensesAmt
CY Total Expenses$25,040,824CYTotalExpensesAmt
PY Revenues Less Expenses$1,030,089PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,703,150CYRevenuesLessExpensesAmt
Total Assets BOY$41,385,725TotalAssetsBOYAmt
Total Assets EOY$42,409,090TotalAssetsEOYAmt
Total Liabilities BOY$19,475,401TotalLiabilitiesBOYAmt
Total Liabilities EOY$18,403,858TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$21,910,324NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$24,005,232NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE PATIENT FOCUSED HEALTHCARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$21,641,146ExpenseAmt
Grant$0GrantAmt
Revenue$26,255,066RevenueAmt
DescTHE HOSPITAL PROVIDES DAILY PATIENT CARE SERVICES AND IS THE ONLY SOURCE OF THESE SERVICES IN THE AREA. THE HOSPITAL NOW ALSO HAS AN AMBULANCE SERVICE.Desc
Total Program Service Expenses$21,641,146TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (1)BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document46IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee175EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJENNIFER SPRINGPersonNm
Phone4068462212PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11100 HOLLENBACK LANEAddressLine1Txt
CityDEER LODGECityNm
State AbbreviationMTStateAbbreviationCd
ZIP59722ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JACK ANDERSON
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
TERRY MOSIER
VICE PRESIDENT1.00Yes (X)Yes (X)$0$0$0
JIM DECKER
SECRETARY/TREASURER1.00Yes (X)Yes (X)$0$0$0
HOWARD NECKELS
DIRECTOR1.00Yes (X)$0$0$0
CARLEE HANSEN
DIRECTOR1.00Yes (X)$0$0$0
COLTER CUMIN
DIRECTOR1.00Yes (X)$0$0$0
ED MCCARTHY
DIRECTOR1.00Yes (X)$0$0$0
JENNIFER SPRING
CFO40.00Yes (X)$166,771$0$8,532
TONY PFAFF
CEO40.00Yes (X)$0$0$0
ANDREW BECK
CNO40.00$173,795$0$33,448Yes (X)
JAENA RICHARDS
COO40.00$211,742$0$38,393Yes (X)
JUDITH WILSON
MD24.00$243,127$0$14,166Yes (X)
LORI DRUMM
DO32.00$260,074$0$43,769Yes (X)
VAUGHN JOHNSON
MD40.00$394,283$0$37,239Yes (X)
PATRICK KRACH
COO32.00$231,747$0$14,361Yes (X)
SCOT MURRAY
MD32.00$488,928$0$56,239Yes (X)
SUMERA QAMAR
MD32.00$279,629$0$13,851Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,450,096TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$259,998TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K19IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SCOTT RIGDON CRNA MPHTRANSCENDENT A
330 TRIPLE TREE RDBOZEMANMT59715ANESTHESIA AND PAIN MGMT. SERVICES$684,586
CYPRESS HEALTHCARE LLC
791 EASTSIDE ROADDEER LODGEMT59722MANAGEMENT, CEO AND TRAVEL$655,973
CHAD COLVIN DBA HIGH MTN CRITIAL CA
926 W SHERASON DREAGLEID836167156EMERGENCY ROOM PHYSICIAN$391,198
MAYO COLLABORATIVE SERVICES
PO BOX 9146MINNEAPOLISMN55480REFERENCE LAB$297,059
MONIDA SHARED IMAGING
1200 S RESERVE STE HMISSOULAMT59801MRI SERVICES$243,702
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Related Organizations$1,899RelatedOrganizationsAmt
Government Grants$38,957GovernmentGrantsAmt
All Other Contributions$25,351AllOtherContributionsAmt
Total Contributions$66,207TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621110$22,979,123$22,979,123
UTILIZATION FEE REVENUE621110$2,035,128$2,035,128
OTHER OPERATING REVENUE621110$748,433$748,433
FieldValueIRS element (for citing)
Total Program Service Revenue$25,762,684TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$273,470TotalRevenueColumnAmt
Exclusion$273,470ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$53,005RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$3,034RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$49,971RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$49,971TotalRevenueColumnAmt
Exclusion$49,971ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$103,352OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$4,092OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$99,260OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$99,260TotalRevenueColumnAmt
Exclusion$99,260ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
Desc340B REVENUEDesc
Business621110BusinessCd
Total Revenue Column$492,382TotalRevenueColumnAmt
Related Or Exempt Func Income$492,382RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$492,382OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$26,743,974TotalRevenueColumnAmt
Related Or Exempt Func Income$26,255,066RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$422,701ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$938,842TotalAmt
Program Services$827,932ProgramServicesAmt
Management And General$110,910ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,135,892TotalAmt
Program Services$8,058,456ProgramServicesAmt
Management And General$1,077,436ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$289,476TotalAmt
Program Services$254,739ProgramServicesAmt
Management And General$34,737ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,323,044TotalAmt
Program Services$2,044,279ProgramServicesAmt
Management And General$278,765ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$743,181TotalAmt
Program Services$653,999ProgramServicesAmt
Management And General$89,182ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$15,691TotalAmt
Management And General$15,691ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,027,284TotalAmt
Program Services$3,259,463ProgramServicesAmt
Management And General$767,821ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$95,946TotalAmt
Program Services$225ProgramServicesAmt
Management And General$95,721ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$290,611TotalAmt
Program Services$207,860ProgramServicesAmt
Management And General$82,751ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$390,017TotalAmt
Program Services$69,994ProgramServicesAmt
Management And General$320,023ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$218,600TotalAmt
Program Services$218,600ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$105,988TotalAmt
Program Services$65,717ProgramServicesAmt
Management And General$40,271ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$498,597TotalAmt
Program Services$478,653ProgramServicesAmt
Management And General$19,944ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,220,640TotalAmt
Program Services$1,171,814ProgramServicesAmt
Management And General$48,826ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$308,277TotalAmt
Program Services$295,946ProgramServicesAmt
Management And General$12,331ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$2,882,533$2,786,055$96,478
REPAIRS & MAINTENANCE$494,269$395,812$98,457
LICENSES & TAXES$444,018$377,573$66,445
BAD DEBT EXPENSE$226,417$226,417

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$391,501TotalAmt
Program Services$247,612ProgramServicesAmt
Management And General$143,889ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$25,040,824TotalAmt
Program Services$21,641,146ProgramServicesAmt
Management And General$3,399,678ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$882,702BOYAmt
EOY$1,004,251EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,910,218BOYAmt
EOY$7,821,267EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,589,799BOYAmt
EOY$3,660,408EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$38,157BOYAmt
EOY$31,517EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$595,032BOYAmt
EOY$518,231EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$236,123BOYAmt
EOY$289,123EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$31,162,342LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$10,468,576LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$21,439,440BOYAmt
EOY$20,693,766EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$5,346,421BOYAmt
EOY$6,002,802EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$35,698BOYAmt
EOY$35,698EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,312,135BOYAmt
EOY$2,352,027EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$41,385,725BOYAmt
EOY$42,409,090EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,934,066BOYAmt
EOY$2,871,036EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,125,000BOYAmt
EOY$10,650,000EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,416,335BOYAmt
EOY$4,882,822EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$19,475,401BOYAmt
EOY$18,403,858EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$21,910,324BOYAmt
EOY$24,005,232EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$21,910,324BOYAmt
EOY$24,005,232EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$41,385,725BOYAmt
EOY$42,409,090EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,703,150ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$391,758NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$695,642OtherCostOrOtherBasisAmt
Book Value$695,642BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,969,566OtherCostOrOtherBasisAmt
Depreciation$5,587,898DepreciationAmt
Book Value$17,381,668BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,490,030OtherCostOrOtherBasisAmt
Depreciation$4,880,678DepreciationAmt
Book Value$2,609,352BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,104OtherCostOrOtherBasisAmt
Book Value$7,104BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$20,693,766TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
BOND FUNDS$2,111,149
INVESTMENT IN YELLOWSTONE INSURANCE EXCHANGES RRG$165,878
INVESTMENT IN MONIDA SHARED IMAGING$75,000
FieldValueIRS element (for citing)
Total Book Value Other Assets$2,352,027TotalBookValueOtherAssetsAmt
Total Rev Etc Audited Fincl Stmt$26,736,500TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$391,758NetUnrealizedGainsInvstAmt
Other Revenue$3,034OtherRevenueAmt
Revenue Not Reported$394,792RevenueNotReportedAmt
Revenue Subtotal$26,341,708RevenueSubtotalAmt
Other Revenues Not Included$402,266OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$402,266RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$26,743,974TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$24,641,592TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$3,034OtherExpensesIncludedAmt
Expenses Not Reported$3,034ExpensesNotReportedAmt
Expenses Subtotal$24,638,558ExpensesSubtotalAmt
Other Expenses Not Included$402,266OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$402,266ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$25,040,824TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:DIRECT RENT EXPENSE DEDUCTED FROM GROSS RENTS FOR 990 REVENUE 3,034.
PART XI, LINE 4B - OTHER ADJUSTMENTS:340B PHARMACEUTICAL EXPENSES NETTED W/ REVENUE ON FINANCIAL STATEMENTS 175,849. BAD DEBT EXPENSE NETTED W/ REVENUE ON FINANCIAL STATEMENTS 226,417.
PART XII, LINE 2D - OTHER ADJUSTMENTS:DIRECT RENT EXPENSE DEDUCTED FROM GROSS RENTS FOR 990 REVENUE 3,034.
PART XII, LINE 4B - OTHER ADJUSTMENTS:340B PHARMACEUTICAL EXPENSES NETTED W/ REVENUE ON FINANCIAL STATEMENTS 175,849. BAD DEBT EXPENSE NETTED W/ REVENUE ON FINANCIAL STATEMENTS 226,417.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other250.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$257,213TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$257,213NetCommunityBenefitExpnsAmt
Total Expense0.01030TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,322,488TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,352,218DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,579,701TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,352,218DirectOffsettingRevenueAmt
Net Community Benefit Expns$257,213NetCommunityBenefitExpnsAmt
Total Expense0.01030TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$70,163TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,500DirectOffsettingRevenueAmt
Net Community Benefit Expns$67,663NetCommunityBenefitExpnsAmt
Total Expense0.00270TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,500NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$56,645TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,030DirectOffsettingRevenueAmt
Net Community Benefit Expns$47,615NetCommunityBenefitExpnsAmt
Total Expense0.00190TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,887TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$14,887NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$144,195TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,530DirectOffsettingRevenueAmt
Net Community Benefit Expns$132,665NetCommunityBenefitExpnsAmt
Total Expense0.00530TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,723,896TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,363,748DirectOffsettingRevenueAmt
Net Community Benefit Expns$389,878NetCommunityBenefitExpnsAmt
Total Expense0.01560TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$600TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$600NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,510TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,510NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,773TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,773NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,883TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$17,883NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$226,417BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$8,406,712ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$8,446,504CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$39,792MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line11 CYPRESS HEALTHCARE LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesMANAGEMENT SERVICESPrimaryActivitiesTxt
Org Profit Or Ownership0.00000OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership1.00000OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership0.00000PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1POWELL COUNTY MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11100 HOLLENBACK LANEAddressLine1Txt
CityDEER LODGECityNm
State AbbreviationMTStateAbbreviationCd
ZIP59722ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.DLMED.ORGWebsiteAddressTxt
State License12992StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1POWELL COUNTY MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW. DLMED.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.DLMED.ORGStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care250.000000000000FPGFamilyIncmLmtFreeCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.DLMED.ORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.DLMED.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.DLMED.ORGFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
POWELL COUNTY MEMORIAL HOSPITALPART V, SECTION B, LINE 5: A STEERING COMMITTEE WAS CONVENED TO ASSIST DEER LODGE MEDICAL CENTER IN CONDUCTING CHSD. A DIVERSE GROUP OF COMMUNITY MEMBERS REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY (EX. PUBLIC HEALTH, ELDERLY, UNINSURED) CAME TOGETHER IN OCTOBER 2021. FOR A LIST OF ALL STEERING COMMITTEE MEMBERS AND THEIR AFFILIATIONS, SEE APPENDIX A OF THE CHNA. THE STEERING COMMITTEE MET TWICE DURING THE CHSD PROCESS; FIRST TO DISCUSS HEALTH CONCERNS IN THE COMMUNITY AND OFFER THEIR PERSPECTIVE IN DESIGNING THE SURVEY INSTRUMENT, AND AGAIN TO REVIEW RESULTS OF THE CHNA AND TO ASSIST IN THE PRIORITIZATION OF HEALTH NEEDS.
POWELL COUNTY MEMORIAL HOSPITALPART V, SECTION B, LINE 6B: THE MONTANA STATE UNIVERSITY OFFICE OF RURAL HEALTH, AREA HEALTH EDUCATION CENTER, FACILITATED THE PREPARATION OF OUR COMMUNITY HEALTH NEEDS ASSESSMENT.
POWELL COUNTY MEMORIAL HOSPITALPART V, SECTION B, LINE 11: CHNA SIGNIFICANT NEED #1: ENHANCE DEER LODGE MEDICAL CENTER'S HEALTH AND WELLNESS OUTREACH IN POWELL COUNTY.STRATEGY #1: EXPAND AND ENHANCE HEALTH AND WELLNESS PROGRAMS AND RESOURCES AT DEER LODGE MEDICAL CENTER.ACTIVITIES: EXPLORE OPPORTUNITIES TO EXPAND PLANETREE MINDFULNESS AND WELLNESS PROGRAMS THROUGH DLMC TO THE COMMUNITY; SUSTAIN THE NUTRITIONAL OUTREACH CAMPAIGN (SUCH AS MONTHLY HEALTHY RECIPES TO BE FEATURED IN CAF AND SHARED ON THE DLMC FACEBOOK PAGE) THAT PROMOTE PREVENTION AND HEALTHY DIETS; CONTINUE TO PROVIDE HEALTH EDUCATION OPPORTUNITIES THAT PROMOTE HEALTH AND WELLNESS (I.E., PRE-DIABETES SUPPORT GROUP, TRIM THE TOWN, WOMEN'S NIGHT OUT, STOP THE BLEED, ANNUAL HEALTH FAIR, ETC.); SUSTAIN THE PROGRAM THAT FITS CHILD CAR SEATS FOR LOCAL FAMILIES. STRATEGY #2: CONTINUE TO SUPPORT AND SPONSOR ACTIVITIES AND PROGRAMS THAT PROMOTE PHYSICAL ACTIVITY IN POWELL COUNTY.ACTIVITIES: DLMC WILL CONTINUE TO PROVIDE STAFF TO PARTICIPATE ON THE LOCAL TRAIL COMMITTEE AND EXPLORE OPPORTUNITIES TO RAISE AWARENESS OF LOCAL TRAILS AND PROMOTE TRAIL UTILIZATION (I.E., BIKE WALK MONTANA, WALKING RX TRAILS); SPONSOR LOCAL ADULT AND YOUTH RECREATIONAL LEAGUES; CONTINUE TO HOST COMMUNITY EVENTS THAT PROMOTE PHYSICAL ACTIVITY (I.E., GOLF TOURNAMENT, ANNUAL HEALTH WALK, ETC.); CONTINUE TO PROVIDE YOUTH SPORTS PHYSICALS, CONCUSSION SCREENING AND HELMET PROMOTION PROGRAM.CHNA SIGNIFICANT NEED #2: ACCESS TO HEALTHCARE SERVICES IN POWELL COUNTY.STRATEGY #1: IMPROVE AND SUSTAIN ACCESS TO HEALTHCARE SERVICES IN POWELL COUNTY.ACTIVITIES: CONTINUE TO IMPLEMENT CARDIAC PULMONARY REHABILITATION PHASE TWO (I.E., MONITOR/TRACK PHYSICAL ACTIVITY AND NUTRITION AMONG IDENTIFIED ELIGIBLE PATIENTS THROUGH QUALIFYING EVENTS). CONTINUE TO REFER PROGRAM "GRADUATES" TO PHASE THREE (I.E., COMPLIMENTARY PASSES TO FITNESS CENTER TO REDUCE BARRIERS TO CONTINUING PHYSICAL ACTIVITY); DEVELOP AND IMPLEMENT A COMMUNITY INTEGRATED HEALTH PROFESSIONAL (CIH) PROGRAM DEPLOYING PARAMEDICS TO PROVIDE ADDITIONAL SERVICES TO HELP COMMUNITY MEMBERS ACCESS CARE IN NON-EMERGENCY SITUATIONS (I.E., POST DISCHARGE FOLLOW-UP, PREVENTIVE CARE, CHRONIC DISEASE MANAGEMENT, REFERRALS TO COMMUNITY HEALTH SERVICES, MEDICATION MANAGEMENT AND SET UP, HOME SAFETY CHECKS, ETC.); DLMC WILL CONTINUE TO WORK WITH AREA PARTNERS TO SUSTAIN AMBULANCE SERVICES IN POWELL COUNTY. DLMC WILL ALSO SUSTAIN THE PEDIATRIC PREPAREDNESS GOLD STANDARD AND CONTINUE PROVIDING REGULAR TRAINING AND SUPPLIES TO THE LOCAL QUICK RESPONSE UNITS; CONTINUE TO SUPPORT ANNUAL LOW-COST LABS AND MONTHLY FOOT CARE CLINICS; CONTINUE SPONSORING MONTHLY HEALTH OUTREACH OPPORTUNITIES THROUGH THE LOCAL SENIOR CENTER (I.E., BLOOD PRESSURE CHECKS, MEDICATION MANAGEMENT, ETC.); EXPLORE THE FEASIBILITY OF RECRUITING ADDITIONAL PRIMARY CARE PROVIDERS LOCALLY; SUSTAIN PATIENT NAVIGATOR SERVICES LINKING PATIENTS TO COMMUNITY RESOURCES. FACILITATE PRESUMPTIVE ELIGIBILITY STATUS FOR PROGRAMS LIKE MEDICAID, MEDICARE, 340B PROGRAM, ETC. IMPLEMENT METHODOLOGY AND PROTOCOLS TO SHARE FINANCIAL ASSISTANCE RESOURCES WITH THE COMMUNITY (I.E., CLINIC, EMERGENCY ROOM, DLMC WEBSITE, ETC.); CONTINUE TO IMPLEMENT TELEHEALTH CRISIS PROTOCOLS WHEN PATIENTS IN CRISIS PRESENT IN THE EMERGENCY ROOM; CONTINUE TO OFFER TELEPSYCHIATRY SERVICES LOCALLY, INCLUDING MEDICATION ASSISTANCE; CONTINUE TO OFFER TELE-ONCOLOGY SERVICES THROUGH DLMC. DLMC WILL HOST AN OPEN HOUSE IN JUNE 2022 TO RAISE THE COMMUNITY'S AWARENESS OF THIS SERVICE.STRATEGY #2: IMPROVE KNOWLEDGE OF SERVICES AVAILABLE THROUGH DEER LODGE MEDICAL CENTER AND IN THE COMMUNITY.ACTIVITIES: CONTINUE TO CONVENE A DLMC WORKGROUP/ADMINISTRATIVE TEAM TO DISCUSS CURRENT OUTREACH EFFORTS, GAPS AND NEW OPPORTUNITIES (I.E., ADA COMPLIANCE, WEBSITE DEVELOPMENT, ETC.). CONTINUE TO SUPPORT THE COMMUNITY RESOURCES PAGE ON DLMC WEBSITE THAT WAS BUILT DURING THE LAST IMPLEMENTATION PERIOD; CONTINUE TO SHARE OUTREACH FLYERS, HANDOUTS, AND MESSAGES ON THE SCREEN IN LOBBY DETAILING LOCAL RESOURCES (I.E., SENIOR SERVICES, MENTAL HEALTH RESOURCES, NEW SERVICES, FINANCIAL ASSISTANCE, ETC.); REVISIT OUTREACH/INFORMATION MATERIALS ABOUT DLMC PROVIDERS AND SERVICES (I.E., GRIEF SUPPORT GROUPS, TELEHEALTH SERVICES, ETC.) THAT WERE CREATED DURING THE LAST IMPLEMENTATION PERIOD; CONTINUE TO PROVIDE EDUCATION THROUGH PRESENTATIONS TO LOCAL ORGANIZATIONS (I.E., ROTARY CLUB, PUBLIC HEALTH, LOCAL SCHOOLS, ETC.).DLMC IS UNABLE TO ADDRESS THE FOLLOWING NEEDS AT THIS TIME:1. 59.2% OF SURVEY RESPONDENTS NOTED "ALCOHOL/SUBSTANCE ABUSE" AS A TOP HEALTH CONCERN FOR THE COMMUNITY. DEER LODGE MEDICAL CENTER (DLMC) PRIMARY CARE PROVIDERS COUNCIL PATIENTS ON SUBSTANCE ABUSE AS NEEDED BASED ON THE INDIVIDUAL AS PART OF THE GENERAL CARE. AS NECESSARY, PATIENTS ARE REFERRED TO SPECIALISTS FOR FURTHER HELP/TREATMENT.2. SURVEY RESPONDENTS INDICATED TO WHAT DEGREE THEIR LIFE HAS BEEN NEGATIVELY AFFECTED BY THEIR OWN OR SOMEONE ELSE'S SUBSTANCE ABUSE ISSUES, INCLUDING ALCOHOL, PRESCRIPTION, OR OTHER DRUGS: "A LITTLE (16.3%), "SOMEWHAT" (22.0%), AND "A GREAT DEAL" (16.3%). DEER LODGE MEDICAL CENTER (DLMC) PRIMARY CARE PROVIDERS COUNCIL PATIENTS ON SUBSTANCE ABUSE AS NEEDED BASED ON THE INDIVIDUAL AS PART OF THE GENERAL CARE. AS NECESSARY, PATIENTS ARE REFERRED TO SPECIALISTS FOR FURTHER HELP/TREATMENT.3. FOCUS GROUP PARTICIPANTS WERE INTERESTED IN AN IMPROVEMENT TO SENIOR SERVICES LOCALLY SPECIFICALLY ADDITIONAL SENIOR HOUSING OPTIONS AND HOME HEALTH SERVICES. COMMUNITY HOUSING IS BEYOND THE SCOPE OF THE SERVICES BEING FOCUSED ON BY DLMC. COMMUNITY GROUPS (I.E., COUNCIL ON AGING, RENAISSANCE, ETC.) ARE ACTIVE MEMBERS ON DLMC'S PATIENT FAMILY ADVISORY COUNCIL. DLMC SUPPORTS THESE SERVICES AND INITIATIVES AS POSSIBLE.4. 44.8% OF SURVEY RESPONDENTS INDICATED DESIRE IN "URGENT CARE" SERVICES AVAILABLE LOCALLY. ALL SERVICES PROVIDED THROUGH AN URGENT CARE MODEL ARE AVAILABLE THROUGH THE EXISTING DLMC CLINIC. THE RESOURCE AND STAFFING OF AN URGENT CARE WERE NOT IDENTIFIED AS A PRIORITY AT THIS TIME. BASED ON VOLUMES, WALK IN PATIENTS ARE TYPICALLY ABLE TO BE SEEN SAME DAY THROUGH THE DLMC CLINIC.

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:PCMH USED COST-TO-CHARGE RATIOS FROM ITS MOST RECENT MEDICARE COST REPORT TO DETERMINE THE COST OF FINANCIAL ASSISTANCE, MEDICAID, PROVIDING REDUCED COST SPORTS PHYSICALS, AND PROVIDING REDUCED COST LABS. COST ACCOUNTING, WHICH INCLUDED ALL SEGMENTS (INPATIENT, OUTPATIENT, ER, ET AL) WAS USED TO DETERMINE ALL OTHER AMOUNTS REPORTED IN THE TABLE.BAD DEBT EXPENSE WAS NOT A FACTOR IN CALCULATING THE PERCENTAGES FOR COLUMN F.
FORM 990, SCH H, PART I LINE C:WE ONLY OFFER A 100% WRITE OFF AT 250% OF FPG, OR IF OUT-OF-POCKET OBLIGATIONS RESULTING FROM MEDICAL SERVICES PROVIDED BY DLMC OVER THE LAST 12 MONTHS EXCEED 30% OF FAMILY INCOME.
PART II, COMMUNITY BUILDING ACTIVITIES:ECONOMIC DEVELOPMENT: DONATED TO THE BIG SKY DRAFT HORSE EXPO AND TERRITORIAL DAYS.COMMUNITY SUPPORT: CFO SERVED ON THE POWELL COUNTY PUBLIC HEALTH BOARD AND OTHER PCMH/DLMC STAFF ATTENDED/PRESENTED AT THE MEETINGS. EMS DIRECTOR SERVICED AS A MEMBER OF THE POWELL COUNTY PLANNING BOARD. ADMIN TEAM MEMBER ATTENDED ROTARY CLUB MEETINGS. WORKFORCE DEVELOPMENT: PROVIDED INTERNSHIPS FOR LOCAL HIGH SCHOOL STUDENTS INTERESTED IN PURSUING A CAREER IN HEALTHCARE. MENTORED MSU STUDENTS PARTICIPATING IN A HEALTHCARE LEAN INTERNSHIP.
PART III, LINE 2:TREND ANALYSIS OF SELF-PAY ACCOUNT COLLECTIONS IS USED TO CREATE AN INITIAL ESTIMATE THE PROVISION FOR BAD DEBT ON SELF-PAY ACCOUNTS RECEIVABLE AT FISCAL YEAR-END. THE ESTIMATE IS THEN REDUCED FOR IMPLICIT PRICE CONCESSIONS. THE INCREASE OR DECREASE IN THE PROVISION IS ADJUSTED TO BAD DEBT EXPENSE. SUBSEQUENT COLLECTIONS RECEIVED ON ACCOUNTS PREVIOUSLY WRITTEN OFF REDUCE THE CURRENT BAD DEBT EXPENSE.
PART III, LINE 3:NONE OF THE ABOVE BAD DEBT IS INCLUDED AS COMMUNITY BENEFIT.
PART III, LINE 4:SEE PAGE 14 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:BY CONTINUING TO TREAT PATIENTS ELIGIBLE FOR MEDICARE, THE HOSPITAL ALLEVIATES THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES. COST ACCOUNTING (VIA THE MEDICARE COST REPORT) WAS USED TO DETERMINE THE ALLOWABLE MEDICARE COSTS.
PART III, LINE 9B:PER OUR POLICY DLMC (PCMH) WILL NOT ENGAGE IN ECAS, EITHER DIRECTLY OR BY ANY DEBT COLLECTION AGENCY OR OTHER PARTY TO WHICH DLMC HAS REFERRED THE PATIENT'S DEBT, BEFORE REASONABLE EFFORTS ARE MADE TO DETERMINE WHETHER A RESPONSIBLE INDIVIDUAL(S) IS ELIGIBLE FOR ASSISTANCE UNDER THE FAP.
PART VI, LINE 2:PCMH CONTINUES TO WORK THE LOCAL SCHOOLS, THE POWELL COUNTY PUBLIC HEALTH DEPARTMENT, POWELL COUNTY LOCAL EMERGENCY PREPAREDNESS COMMITTEE, MAJOR EMPLOYERS (SUN MOUNTAIN LUMBER, MONTANA STATE PRISON), LOCAL NURSING HOMES, POWELL COUNTY SENIOR CITIZEN CENTER, AND POWELL COUNTY COUNCIL ON AGING TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY WE SERVE. WE STRONGLY ENCOURAGE EMPLOYEES TO VOLUNTEER, ON PCMH TIME, FOR ORGANIZATIONS THAT STRIVE TO IMPROVE THE WELL-BEING OF OUR COMMUNITY MEMBERS.
PART VI, LINE 3:PCMH STRIVES TO MEET WITH EVERY SELF-PAY PATIENT TO DETERMINE THEIR ABILITY TO PAY, AND OFFER FINANCIAL ASSISTANCE, MEDICAID PRESUMPTIVE ELIGIBILITY SCREENING, OR MONTHLY PAYMENT PLANS AS NEEDED. BEFORE TURNING AN ACCOUNT OVER TO 3RD PARTY COLLECTORS, WE PERFORM A REVIEW TO SEE IF THEY MEET THE PRESUMPTIVE ELIGIBILITY CRITERIA OF OUR FINANCIAL ASSISTANCE POLICY. SIGNS ARE POSTED THROUGHOUT THE FACILITY, ESPECIALLY AT PATIENT INTAKE AREAS, THAT NOTIFY PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. NOTICES ARE ALSO INCLUDED WITH BILLING STATEMENTS. WITH OUR RECENT REMODELING PROJECT, WE MADE SURE TO INCORPORATE A SEPARATE OFFICE THAT IS EASILY ACCESSIBLE FOR PATIENTS TO DISCUSS THEIR ACCOUNTS IN PRIVATE WITH OUR PATIENT ACCESS MANAGER.
PART VI, LINE 4:PCMH SERVES THE COUNTIES OF POWELL, GRANITE, DEER LODGE, AND SILVER BOW, AND ALSO PROVIDES SERVICES TO INMATES AT THE MONTANA STATE PRISON.
PART VI, LINE 5:THE GOVERNING BOARD OF PCMH CONSISTS OF RESIDENTS OF THE HOSPITAL'S PRIMARY SERVICE AREA. EMPLOYEES NOR INDEPENDENT CONTRACTORS (OTHER THAN DISCLOSED ON THIS FORM) OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF, ARE ALLOWED TO BE BOARD MEMBERS.PCMH EXTENDS MEDICAL STAFF PRIVILEGES TO QUALIFIED PROVIDERS IN THE COMMUNITY. WE'VE ALSO CONTRACTED WITH SEVERAL VISITING SPECIALISTS TO OFFER SERVICES NOT OTHERWISE AVAILABLE IN OUR COMMUNITY (CARDIOLOGY, PAIN MANAGEMENT, UROLOGY, PODIATRY, TELEPSYCHIATRY).PCMH CONTINUALLY REINVESTS SURPLUS FUNDS BY UPDATING OUR FACILITIES AND EQUIPMENT AND EMPLOYING ADDITIONAL STAFF TO EXPAND THE SERVICES OFFERED TO THE COMMUNITY OR IMPROVE CURRENTLY OFFERED SERVICES. THE HOSPITAL CONTINUES TO OPERATE POWELL EMERGENCY MEDICAL SERVICE, WHICH BOUGHT OUT THE FLAILING LOCAL VOLUNTEER AMBULANCE COMPANY IN 2020, TO ENSURE THAT THE COMMUNITY WOULD CONTINUE TO HAVE AMBULANCE SERVICES. ALTHOUGH PEMS RECEIVES A LARGE AMOUNT OF LEVY MONEY TO OPERATE THE SERVICE, IT REALIZED A NET LOSS FOR FISCAL YEAR 2024. SURPLUS FUNDS ARE ALSO USED TO OFFER PROGRAMS AT FREE OR REDUCED CHARGES TO THE COMMUNITY, SUCH AS THE FOLLOWING:- FREE FOOT CARE CLINIC FOR THE AGING, DISABLED, AND DIABETIC COMMUNITY - FREE BASELINE CONCUSSION TESTING FOR LOCAL STUDENT ATHLETES- LOW-COST SPORTS PHYSICALS TO LOCAL STUDENT ATHLETES- SCHOLARSHIPS TO HIGH SCHOOL STUDENTS PURSUING DEGREES IN HEALTH CARE- OFFERING LOW-COST LAB WORK TWO DAYS A YEAR AND DURING A PATIENT'S BIRTH MONTH.- OFFERING INTERNSHIP OPPORTUNITIES TO LOCAL HIGH SCHOOL STUDENTS INTERESTED IN CAREERS IN HEALTHCARE, AND MENTORING COLLEGE STUDENTS INTERNING IN HOSPITAL LEAN PROJECTS.- WE PROVIDE FREE TRAINING AND SUPPLIES TO LOCAL QUICK RESPONSE UNITS, VOLUNTEER FIRE DEPARTMENTS, AND VOLUNTEER AMBULANCE SERVICES.- MAINTAIN A COMMUNITY PLAYGROUND THAT PROVIDES A SAFE AREA FOR THE LOCAL YOUTH TO ENJOY HEALTHY OUTDOOR PLAY.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
SCOT MURRAY
MD$485,428$0$3,500$0$0$0$16,500$0$39,739$0$545,167$0$0$0
VAUGHN JOHNSON
MD$390,783$0$3,500$0$0$0$0$0$37,239$0$431,522$0$0$0
LORI DRUMM
DO$256,574$0$3,500$0$0$0$13,550$0$30,219$0$303,843$0$0$0
SUMERA QAMAR
MD$276,129$0$3,500$0$0$0$0$0$13,851$0$293,480$0$0$0
JUDITH WILSON
MD$239,627$0$3,500$0$0$0$0$0$14,166$0$257,293$0$0$0
JAENA RICHARDS
COO$208,242$0$3,500$0$0$0$10,850$0$27,543$0$250,135$0$0$0
PATRICK KRACH
COO$228,247$0$3,500$0$0$0$0$0$14,361$0$246,108$0$0$0
ANDREW BECK
CNO$170,295$0$3,500$0$0$0$9,123$0$24,325$0$207,243$0$0$0
JENNIFER SPRING
CFO$163,271$0$3,500$0$0$0$8,189$0$343$0$175,303$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 1AFormAndLineReferenceDesc
ExplanationTHE ORGANIZATION PAYS CEO, TONY PFAFF'S DUES TO ROCK CREEK CATTLE COMPANY AS THE ORGANIZATION USES THE FACILITY FOR DINING AND LODGING WHEN RECRUITING PHYSICIANS AND OTHER KEY EMPLOYEES. THIS IS NOT INCLUDED IN TONY'S TAXABLE INCOME.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1MONTANA FACILITY FINANCE AUTHORITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN364615115BondIssuerEIN
CUSIP612043GQ6CUSIPNum
Bond Issued2010-08-01BondIssuedDt
Issue Price$15,000,000IssuePriceAmt
PurposeTO FINANCE THE CONSTRUCTION AND EQUIPPING OF A NEW HEALTH CARE FACILITYPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$3,605,000RetiredAmt
Total Proceeds$15,000,000TotalProceedsAmt
In Reserve Fund$1,184,142InReserveFundAmt
Working Capital Expenditures$13,557,042WorkingCapitalExpendituresAmt
Unspent$258,697UnspentAmt
Substantial Completion2011SubstantialCompletionYr
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
CYPRESS HEALTHCARE LLC
THE HOSPITAL'S CURRENT CEO, TONY PFAFF, OWES CYPRESS HEALTHCARE, LLC$652,074MR. PFAFF IS THE OWNER OF CYPRESS HEALTHCARE, LLC, THE INDEPENDENT CONTRACTOR HIRED TO MANAGE THE HOSPITAL. HE RECEIVES ALL COMPENSATION FOR HIS SERVICES AS CEO FROM CYPRESS HEALTHCARE, LLC.0
JACK ANDERSON
MR. ANDERSEN IS A MEMBER OF PCMC'S BOARD OF DIRECTORS.$39,500MR. ANDERSEN SERVES AS THE HOSPITAL'S PHARMACIST.0
CARLEE HANSEN
MS. HANSEN IS A MEMBER OF PCMH'S BOARD OF DIRECTORS$16,200THE HOSPITAL RENTS AN APARTMENT FROM MS. HANSEN.0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE HOSPITAL HAS A MANAGEMENT AGREEMENT WITH CYPRESS HEALTHCARE, LLC WHICH COVERS ADMINISTRATOR COMPENSATION, MANAGEMENT FEES, AND MISCELLANEOUS EXPENSES SUCH AS TRAVEL. TONY PFAFF, CEO OF THE HOSPITAL, IS THE OWNER OF CYPRESS HEALTHCARE, LLC. OF THE FEES PAID TO CYPRESS HEALTHCARE, $474,719 WERE FOR CEO SERVICES.
FORM 990, PART VI, SECTION B, LINE 11BTHE CEO AND CFO REVIEW THE 990 PRIOR TO ITS FILING. THE BOARD IS THEN INFORMED THE 990 IS AVAILABLE TO BE REVIEWED AT THEIR REQUEST.
FORM 990, PART VI, SECTION B, LINE 12CIN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE ORGANIZATION CAN OBTAIN, WITH REASONABLE EFFORTS, A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION DETERMINATION IS A JOINT EFFORT BY THE MANAGEMENT COMPANY AND THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,616,142. MANAGEMENT AND GENERAL EXPENSES 90,327. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,706,469. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 643,321. MANAGEMENT AND GENERAL EXPENSES 677,494. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,320,815.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION HAS A COMMITTEE WHICH ASSUMES OVERSIGHT OF THE AUDIT/REVIEW OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THERE HAVE BEEN NO CHANGES TO THE POLICY IN THE CURRENT YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1POWELL EMERGENCY MEDICAL SERVICES LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11100 HOLLENBACK LANEAddressLine1Txt
CityDEER LODGECityNm
State AbbreviationMTStateAbbreviationCd
ZIP59722ZIPCd
FieldValueIRS element (for citing)
EIN843599616EIN
Primary ActivitiesAMBULANCE SERVICEPrimaryActivitiesTxt
Legal Domicile StateMTLegalDomicileStateCd
Total Income$1,069,473TotalIncomeAmt
End Of Year Assets$329,765EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1POWELL COUNTY MEMORIAL HOSPITAL ASSOCBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1POWELL COUNTY MEDICAL FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11100 HOLLENBACK LANEAddressLine1Txt
CityDEER LODGECityNm
State AbbreviationMTStateAbbreviationCd
ZIP59722ZIPCd
FieldValueIRS element (for citing)
EIN810438377EIN
Primary ActivitiesRAISE FUNDS FOR POWELL COUNTY MEMORIAL HOSPITAL.PrimaryActivitiesTxt
Legal Domicile StateMTLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 12C, III-FIPublicCharityStatusTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1POWELL COUNTY MEDICAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeCTransactionTypeTxt
Involved$1,899InvolvedAmt