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FRANCES MAHON DEACONESS HOSPITAL: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
FRANCES MAHON DEACONESS HOSPITAL (EIN 81-0231786)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-11
IRS object ID
202241319349303349
Schema version
2020v4.0
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)
Return2022-05-11T12:56:17-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1GREEN HEALTH GROUP PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1405 FOURTH AVENUE NORTHAddressLine1Txt
CityGLASGOWCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59230ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN810231786EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FRANCES MAHON DEACONESS HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFRANBusinessNameControlTxt
Phone4062283500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1621 3RD STREET SOUTHAddressLine1Txt
CityGLASGOWCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59230ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCAMI KALINSKIPersonNm
Person TitleDIRECTOR OF FINANCEPersonTitleTxt
Phone4062283660PhoneNum
Signature2022-05-09SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstCAMIPersonFirstNm
Person LastKALINSKIPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDANIEL GREENPreparerPersonNm
PTINP01311679PTIN
Phone4062632615PhoneNum
Preparation2022-05-11PreparationDt
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCAMI KALINSKIPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1621 3RD STREET SOUTHAddressLine1Txt
CityGLASGOWCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59230ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$43,023,502GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FMDH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1914FormationYr
Legal Domicile StateMTLegalDomicileStateCd
Activity Or MissionTO ADVANCE THE COORDINATED DELIVERY OF HEALTH SERVICES, GUIDED WITH RESPECT FOR THE INDIVIDUAL NEEDS OF OUR PATIENTS, THEREBY IMPROVING THE HEALTH OF OUR REGIONAL COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee320TotalEmployeeCnt
Total Volunteers22TotalVolunteersCnt
Total Gross UBI$466,421TotalGrossUBIAmt
PY Contributions Grants$95,962PYContributionsGrantsAmt
CY Contributions Grants$7,516,848CYContributionsGrantsAmt
PY Program Service Revenue$31,276,844PYProgramServiceRevenueAmt
CY Program Service Revenue$34,530,063CYProgramServiceRevenueAmt
PY Investment Income$388,334PYInvestmentIncomeAmt
CY Investment Income$658,163CYInvestmentIncomeAmt
PY Other Revenue$332PYOtherRevenueAmt
CY Other Revenue$318,428CYOtherRevenueAmt
PY Total Revenue$31,761,472PYTotalRevenueAmt
CY Total Revenue$43,023,502CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$16,271,100PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,455,812CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$69,877CYTotalFundraisingExpenseAmt
PY Other Expenses$13,956,787PYOtherExpensesAmt
CY Other Expenses$14,601,242CYOtherExpensesAmt
PY Total Expenses$30,227,887PYTotalExpensesAmt
CY Total Expenses$31,057,054CYTotalExpensesAmt
PY Revenues Less Expenses$1,533,585PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$11,966,448CYRevenuesLessExpensesAmt
Total Assets BOY$84,266,652TotalAssetsBOYAmt
Total Assets EOY$90,280,300TotalAssetsEOYAmt
Total Liabilities BOY$10,079,222TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,579,141TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$74,187,430NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$85,701,159NetAssetsOrFundBalancesEOYAmt
MissionTO ADVANCE THE COORDINATED DELIVERY OF HEALTH SERVICES, GUIDED WITH RESPECT FOR THE INDIVIDUAL NEEDS OF OUR PATIENTS, THEREBY IMPROVING THE HEALTH OF OUR REGIONAL COMMUNITY.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$24,854,962ExpenseAmt
Revenue$34,530,063RevenueAmt
DescPROVIDE QUALITY MEDICAL CARE TO PATIENTS.Desc
Total Program Service Expenses$24,854,962TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstYes (true)ReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (true)BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document20IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee320EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCAMI KALINSKIPersonNm
Phone4062283660PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1621 3RD ST SAddressLine1Txt
CityGLASGOWCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59230ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndOfficerOfficerInd
LOUIS BAILEY
PHYSICIAN ME40.00Yes (X)$581,921$0$26,670
NICOLE LORENZ
MD0.00$503,389$0$18,28140.00Yes (X)
KEVIN ROSS
MD10.00$445,783$0$23,37130.00Yes (X)
DAVID KNIERIM
MD10.00$438,034$0$18,28130.00Yes (X)
ANDREW FAHLGREN
MD10.00$425,015$0$19,39130.00Yes (X)
ANNE MILLARD BRADLEY
MD18.00$404,511$0$23,09822.00Yes (X)
RANDY HOLOM
CEO40.00Yes (X)$276,900$0$22,769Yes (X)
ELLEN GUTTENBERG
COO40.00$174,069$0$22,951Yes (X)
CAMI KALINSKI
DIRECTOR OF40.00$148,642$0$5,177Yes (X)
ERIKA BENGOCHEA
TRUSTEE1.00Yes (X)$0$0$0
ANNIE CAPDEVILLE
TRUSTEE1.00Yes (X)$0$0$0
DON FAST
PRESIDENT2.00Yes (X)$0$0$0
PATRICK MENGE
SECRETARY/TR1.00Yes (X)$0$0$0
STAN OZARK
VICE PRESIDE1.00Yes (X)$0$0$0
MARISA SATHER
TRUSTEE1.00Yes (X)$0$0$0
KARLA ZERBE
TRUSTEE1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,398,264TotalReportableCompFromOrgAmt
Total Other Compensation$179,989TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K38IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SYNERGY SURGICALISTS PC
280 W KAGY BLVD STE D 320BOZEMANMT59715CONTRACT STAFF$749,402
COMPHEALTH INC
PO BOX 972651DALLASTX753972651CONTRACT STAFF$296,160
MEDICAL INFORMATION TECHNOLOGY INC
PO BOX 74569CHICAGOIL60696DATA PROCESSING$280,521
CLOUDWAVE
DEPT CH 19800PALATINEIL600559800SVC CONTRACTS$247,608
GE PRECISION HEALTHCARE LLC
PO BOX 96483CHICAGOIL60693SVC CONTRACTS$210,052
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Related Organizations$11,131RelatedOrganizationsAmt
Government Grants$7,497,456GovernmentGrantsAmt
All Other Contributions$8,261AllOtherContributionsAmt
Total Contributions$7,516,848TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT REVENUE621500$33,576,323$33,576,323
PROFESSIONAL RADIOLOGY621110$663,422$425,302$238,120
GLASGOW CLINIC RENT531120$168,301$168,301
OTHER RENTAL INCOME531120$62,017$62,017
HI-LINE MEDICAL SRVCS RENT531120$60,000$60,000
FieldValueIRS element (for citing)
Total Program Service Revenue$34,530,063TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$658,163TotalRevenueColumnAmt
Related Or Exempt Func Income$658,163RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PARTNERSHIP INCOME900099$227,454$227,454
PAYROLL TAX CREDITS900099$58,974$58,974
COUNTY CONTRIBUTION900099$32,000$32,000
FieldValueIRS element (for citing)
Other Revenue Total$318,428OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$43,023,502TotalRevenueColumnAmt
Related Or Exempt Func Income$35,040,233RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$466,421UnrelatedBusinessRevenueAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,192,150TotalAmt
Program Services$572,825ProgramServicesAmt
Management And General$619,325ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$12,143,460TotalAmt
Program Services$9,849,412ProgramServicesAmt
Management And General$2,251,712ManagementAndGeneralAmt
Fundraising$42,336FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$355,654TotalAmt
Program Services$271,940ProgramServicesAmt
Management And General$82,279ManagementAndGeneralAmt
Fundraising$1,435FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,749,980TotalAmt
Program Services$1,323,084ProgramServicesAmt
Management And General$415,536ManagementAndGeneralAmt
Fundraising$11,360FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,014,568TotalAmt
Program Services$818,102ProgramServicesAmt
Management And General$193,696ManagementAndGeneralAmt
Fundraising$2,770FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$231,041TotalAmt
Management And General$231,041ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$53,209TotalAmt
Management And General$53,209ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$939,609TotalAmt
Program Services$624,576ProgramServicesAmt
Management And General$314,846ManagementAndGeneralAmt
Fundraising$187FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$122,389TotalAmt
Management And General$122,389ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$812,364TotalAmt
Program Services$308,019ProgramServicesAmt
Management And General$503,892ManagementAndGeneralAmt
Fundraising$453FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$322,867TotalAmt
Program Services$255,184ProgramServicesAmt
Management And General$67,133ManagementAndGeneralAmt
Fundraising$550FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$52,857TotalAmt
Program Services$41,164ProgramServicesAmt
Management And General$11,676ManagementAndGeneralAmt
Fundraising$17FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$55,974TotalAmt
Program Services$48,912ProgramServicesAmt
Management And General$7,039ManagementAndGeneralAmt
Fundraising$23FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,886,396TotalAmt
Program Services$3,242,421ProgramServicesAmt
Management And General$636,980ManagementAndGeneralAmt
Fundraising$6,995FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$350,838TotalAmt
Program Services$287,573ProgramServicesAmt
Management And General$62,748ManagementAndGeneralAmt
Fundraising$517FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL SUPPLIES$5,531,355$5,531,355
REPAIRS & MAINTENANCE$1,618,811$1,390,391$225,800$2,620
PROPERTY TAXES$268,505$268,505
FOOD & DIETARY SUPPLIES$240,471$185,163$54,755$553

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$114,556TotalAmt
Program Services$104,841ProgramServicesAmt
Management And General$9,654ManagementAndGeneralAmt
Fundraising$61FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$31,057,054TotalAmt
Program Services$24,854,962ProgramServicesAmt
Management And General$6,132,215ManagementAndGeneralAmt
Fundraising$69,877FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$14,532,021BOYAmt
EOY$8,528,450EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,350,392BOYAmt
EOY$5,776,047EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$4,095,230BOYAmt
EOY$3,825,243EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$952,131BOYAmt
EOY$1,019,372EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$678,390BOYAmt
EOY$804,471EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$53,962,897LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$34,500,032LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$21,481,023BOYAmt
EOY$19,462,865EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$14,804,128BOYAmt
EOY$27,928,727EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$22,373,337BOYAmt
EOY$22,935,125EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$84,266,652BOYAmt
EOY$90,280,300EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,978,720BOYAmt
EOY$3,761,710EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$4,687,178BOYAmt
EOY$100,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$413,324BOYAmt
EOY$717,431EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,079,222BOYAmt
EOY$4,579,141EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$74,187,430BOYAmt
EOY$85,701,159EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$74,187,430BOYAmt
EOY$85,701,159EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$84,266,652BOYAmt
EOY$90,280,300EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$11,966,448ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,356,252NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$2,808,971OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

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 C IRS990ScheduleC

Total Direct Lobbying TotalDirectLobbyingGrp

FieldValueIRS element (for citing)
Filing Organizations Total$3,715FilingOrganizationsTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$3,715FilingOrganizationsTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$30,983,462FilingOrganizationsTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$30,987,177FilingOrganizationsTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Filing Organizations Total$1,000,000FilingOrganizationsTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Filing Organizations Total$250,000FilingOrganizationsTotalAmt

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Current Year Minus3$1,000,000CurrentYearMinus3Amt
Current Year Minus2$1,000,000CurrentYearMinus2Amt
Current Year Minus1$1,000,000CurrentYearMinus1Amt
Current Year$1,000,000CurrentYearAmt
Total$4,000,000TotalAmt
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$65,908CurrentYearMinus3Amt
Current Year Minus2$54,336CurrentYearMinus2Amt
Current Year Minus1$3,942CurrentYearMinus1Amt
Current Year$3,715CurrentYearAmt
Total$127,901TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Current Year Minus3$250,000CurrentYearMinus3Amt
Current Year Minus2$250,000CurrentYearMinus2Amt
Current Year Minus1$250,000CurrentYearMinus1Amt
Current Year$250,000CurrentYearAmt
Total$1,000,000TotalAmt
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmt

Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$62,404CurrentYearMinus3Amt
Current Year Minus2$51,101CurrentYearMinus2Amt
Total$113,505TotalAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-AFormAndLineReferenceDesc
ExplanationFOR TAX YEAR 2020 THERE WERE NOT ANY GRASSROOTS LOBBYING EXPENDITURES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$88,748OtherCostOrOtherBasisAmt
Book Value$88,748BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$32,556,287OtherCostOrOtherBasisAmt
Depreciation$18,182,376DepreciationAmt
Book Value$14,373,911BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,317,862OtherCostOrOtherBasisAmt
Depreciation$16,317,656DepreciationAmt
Book Value$5,000,206BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$19,462,865TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp (5 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
MUTUAL FUNDS$10,501,882F
CERTIFICATES OF DEPOSIT$8,481,630F
EQUITIES$7,422,288F
GOVERNMENTAL BONDS$1,513,199F
CASH & CASH EQUIVALENTS$9,728C
FieldValueIRS element (for citing)
Total Book Value Program Rltd$27,928,727TotalBookValueProgramRltdAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
INTERCOMPANY AND OTHER RECEIVABLES$16,090,353
INVESTMENTS IN JOINT VENTURES$3,217,453
MEDICARE/MEDICAID RECEIVABLES$2,670,185
INTEREST IN FMDH FOUNDATION$957,134
FieldValueIRS element (for citing)
Total Book Value Other Assets$22,935,125TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescMEDICARE & MEDICAID PAYABLESDesc
Amt$717,431Amt
FieldValueIRS element (for citing)
Total Liability$717,431TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$42,570,795TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$2,356,252NetUnrealizedGainsInvstAmt
Other Revenue$15OtherRevenueAmt
Revenue Not Reported$2,356,267RevenueNotReportedAmt
Revenue Subtotal$40,214,528RevenueSubtotalAmt
Other Revenues Not Included$2,808,974OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,808,974RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$43,023,502TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$31,057,066TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$12OtherExpensesIncludedAmt
Expenses Not Reported$12ExpensesNotReportedAmt
Expenses Subtotal$31,057,054ExpensesSubtotalAmt
Total Expenses Per Form990$31,057,054TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 3, PART XTHE COMPANY FOLLOWS THE GUIDANCE IN THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE COMPANY'S FINANCIAL STATEMENTS.
SCHEDULE D, PAGE 4, PART XI, LINE 2DROUNDING 15
SCHEDULE D, PAGE 4, PART XI, LINE 4BSBA PPP LOAN FORGIVEN TY20, IN BOOK REVENUE TY19 2,808,974
SCHEDULE D, PAGE 4, PART XII, LINE 2DROUNDING 12

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other1.400000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other2.400000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$162,989TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$162,989NetCommunityBenefitExpnsAmt
Total Expense0.00520TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$162,989TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$162,989NetCommunityBenefitExpnsAmt
Total Expense0.00520TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,392TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$26,392NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,503,704TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,785,430DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,718,274NetCommunityBenefitExpnsAmt
Total Expense0.05530TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$668TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$668NetCommunityBenefitExpnsAmt

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,530,764TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,785,430DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,745,334NetCommunityBenefitExpnsAmt
Total Expense0.05620TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,693,753TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,785,430DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,908,323NetCommunityBenefitExpnsAmt
Total Expense0.06140TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Reimbursed By Medicare$14,116,148ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$13,976,384CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$139,764MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FRANCES MAHON DEACONESS HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1621 3RD ST SAddressLine1Txt
CityGLASGOWCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59230ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.FMDH.ORGWebsiteAddressTxt
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 Line1FRANCES MAHON DEACONESS HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)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
OtherYes (X)OtherInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.FMDH.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLWWW.FMDH.ORGStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care140.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care240.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.FMDH.ORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.FMDH.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.FMDH.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 Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
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 (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesYes (true)GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 3E"AREAS OF OPPORTUNITY" REPRESENT THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY, BASED ON THE INFORMATION GATHERED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE GUIDELINES SET FORTH IN HEALTHY PEOPLE 2020.
FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 5TO SOLICIT INPUT FROM INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED AS PART OF THE CHNA PROCESS AND SENT TO A LIST OF RECOMMENDED PARTICIPANTS INCLUDING PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS AND A VARIETY OF OTHER COMMUNITY LEADERS. ALSO, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY, AND OTHER MEDICALLY UNDERSERVED POPULATIONS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. THE PARTICIPANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 64 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. THE INPUT WAS GATHERED BY PROFESSIONAL RESEARCH CONSULTANTS, INC. ON BEHALF OF FRANCES MAHON DEACONESS HOSPITAL IN THE SPRING OF 2019.
FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 6BVALLEY COUNTY PUBLIC HEALTH DEPARTMENT
FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 11THE ONLINE KEY INFORMANT SURVEY PRESENTED THE PARTICIPANTS WITH 19 HEALTH TOPICS AND WERE ASKED TO RATE EACH AS A MAJOR PROBLEM, MODERATE PROBLEM, MINOR PROBLEM, OR NOT A PROBLEM AT ALL IN THEIR OWN COMMUNITY. THESE RESULTS WERE SUMMARIZED AND THROUGH A MEETING WITH INTERNAL AND EXTERNAL STAKEHOLDERS, PRIORITIZATION WAS ACCOMPLISHED USING A PRIORITIZATION EXERCISE THAT GAUGED THE SCOPE & SEVERITY OF THE ISSUES AS WELL AS THE ABILITY OF FRANCES MAHON DEACONESS HOSPITAL TO HAVE SIGNIFICANT IMPACT ON EACH ISSUE. THROUGH DISCUSSION, A CONSENSUS WAS REACHED TO ESTABLISH THE FOLLOWING AS PRIORITIES FOR FRANCES MAHON DEACONESS HOSPITAL TO ADDRESS IN ITS IMPLEMENTATION STRATEGY IN THE COMING YEARS: MENTAL HEALTH, NUTRITION, PHYSICAL ACTIVITY & WEIGHT, AND ACCESS TO HEALTH CARE SERVICES. FMDH IS ADDRESSING THE PRIORITIZED HEALTH NEEDS BY THREE OVERALL GOALS: THE FIRST GOAL IS TO UTILIZE EVIDENCE BASED TACTICS TO ADDRESS BARRIERS TO ACCESSING MENTAL HEALTH SERVICES BY AUGMENTING THE RANGE AND ACCESSIBILITY OF MENTAL/BEHAVIORAL HEALTH SERVICES THROUGH THREE STRATEGIES WHICH ARE TEXT-MESSAGE BASED HEALTH INTERVENTIONS, AN EMPLOYEE ASSISTANCE PROGRAM, AND CRISIS LINES IN SCHOOLS. THE PROGRESS MADE TOWARDS THE FIRST GOAL WAS VALLEY COUNTY CARE COALITION MET, WHICH FMDH IS A PART OF ALONG WITH THE POLICE AND SHERIFF DEPARTMENTS, EASTERN MONTANA HEALTH, AND VALLEY COUNTY HEALTH DEPARTMENT. THERE IS NO FIRM ACTION YET, BUT THE GROUP PLAN IS TO PROMOTE EAP(EMPLOYEE ASSISTANCE PROGRAMS) AND CRISIS LINES IN THE SCHOOLS (LIKE SUICIDE PREVENTION). ALSO, FMDH PARTICIPATED IN A BEHAVIORAL HEALTH GRANT. THE FACILITY DID MAKE AVAILABLE A VIRTUAL VISIT PLATFORM FOR BEHAVIORAL HEALTH VISITS TO CONTINUE DURING THE PANDEMIC. ADDITIONAL PROGRESS MADE TOWARDS THIS GOAL WAS FMDH PAID FOR A WEBSITE SUBSCRIPTION AND OTHER SUPPORT FOR THE VALLEY CARE COALITION. FMDH ALSO PROVIDED MENTAL HEALTH FIRST AID TRAINING AND RELATED BOOKS AND SPONSORED A YOUTH EVENT AND A WALK. THE SECOND GOAL IS TO IMPROVE THE HEALTH OF OUR COMMUNITY BY IMPLEMENTING AND SUPPORTING EVIDENCE BASED APPROACHES TO IMPACT BEHAVIORS RELATED TO NUTRITION, WEIGHT AND PHYSICAL ACTIVITY THEREBY HAVING A POSITIVE IMPACT ON A MULTITUDE OF HEALTH CONDITIONS THROUGH THREE STRATEGIES WHICH ARE OUTDOOR EXPERIENTAL EDUCATION AND WILDERNESS THERAPY, COMMUNITY BASED SOCIAL SUPPORT FOR PHYSICAL ACTIVITY, AND COMPETITIVE PRICING FOR HEALTH FOODS. THE PROGRESS MADE TOWARDS THE SECOND GOAL WAS FMDH AGAIN SPONSORED THE FRESH FRUITS AND VEGETABLE PROGRAM AT THE GLASGOW SCHOOLS AND ALSO SPONSORED THE BILLBOARD SUPPORTING NUTRITION, WEIGHT, AND PHYSICAL ACTIVITY FOR ANOTHER YEAR. COVID-19 DID INTERFERE WITH THE IMPLEMENTATION PLANS FOR THIS GOAL. THE THIRD GOAL IS TO IMPROVE ACCESS TO HEALTH CARE SERVICES THROUGH THREE STRATEGIES WHICH ARE RURAL TRANSPORTATION SERVICES, TRAINING IN MEDICAL EDUCATION, AND COMMUNITY INTEGRATED HEALTH. THE PROGRESS MADE TOWARDS THE THIRD GOAL WAS EMS STAFF PURSUED AND WERE AWARDED A GRANT THAT WILL ALLOW COMMUNITY WORKERS TO GO INTO HOMES TO SEE PATIENTS. THIS IS JUST A PILOT TYPE PROGRAM THAT WE WILL LEARN FROM AS WE GO. FMDH IS ALSO PART OF AN ACO(ACCOUNTABLE CARE ORGANIZATION) WHICH HAD US PUT AN ADVICE LINE IN FOR MEDICARE PATIENTS AS WELL AS SETUP SERVICES LIKE CHRONIC CARE MANAGEMENT(MANAGED BY A NURSE UNDER DIRECTION OF A PHYSICIAN) AND INCREASE OUR NUMBER OF ANNUAL WELLNESS VISITS. OUR IMPLEMENTATION PLAN WAS TRUMPED BY COVID-19. FMDH DID WORK WITH VALLEY COUNTY HEALTH FOR A COMMUNITY SNAPSHOT TESTING AND EDUCATION THROUGH LOCAL MEDIA OUTLETS. WE ALSO SETUP AN ALTERNATIVE CARE SITE FOR RESPIRATORY PATIENTS SO OTHER COMMUNITY HEALTH NEEDS COULD CONTINUE TO BE MET WITHIN THE FACILITY. THE FACILITY DID MAKE AVAILABLE A VIRTUAL VISIT PLATFORM FOR PATIENTS THAT WANTED TO SEE THEIR PHYSICIAN/APP AND WEREN'T COMFORTABLE COMING INTO THE BUILDING OR BEING IN PUBLIC. NINE ADDITIONAL SIGNFICANT HEALTH NEEDS THAT EMERGED FROM THIS COMMUNITY HEALTH NEEDS ASSESSMENT ARE OUTLINED BELOW. THESE NEEDS WILL NOT BE SPECIFICALLY ADDRESSED IN THE IMPLEMENTATION STRATEGY, ALTHOUGH SOME MAY BE ADDRESSED IN SOME WAY THROUGH PROGRAMS TARGETING THE TOP HEALTH NEEDS WHICH WILL BE ADDRESSED. 1. SUBSTANCE ABUSE - FMDH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS ALCOHOL, TOBACCO AND OTHER DRUG ISSUES. OTHER COMMUNITY ORGANIZATIONS HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. FMDH FEELS THAT EFFORTS OUTLINED HEREIN TO IMPROVE MENTAL HEALTH WILL HAVE A POSITIVE IMPACT ON THE COMMUNITY'S SUBSTANCE ABUSE, AND THAT A SEPARATE SET OF SUBSTANCE ABUSE INITIATIVES WAS NOT NECESSARY GIVEN LIMITED RESOURCES. 2. TOBACCO USE - FMDH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS ALCOHOL, TOBACCO AND OTHER DRUG ISSUES. OTHER COMMUNITY ORGANIZATIONS HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. FMDH FEELS THAT EFFORTS OUTLINED HEREIN TO IMPROVE CARDIOVASCULAR HEALTH WILL HAVE A POSITIVE IMPACT ON THE COMMUNITY'S TOBACCO USE, AND THAT A SEPARATE SET OF TOBACCO INITIATIVES WAS NOT NECESSARY GIVEN LIMITED RESOURCES. 3. CANCER - ADVISORY COMMITTEE MEMBERS FELT THAT MORE PRESSING HEALTH NEEDS EXISTED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. 4. RESPIRATORY DISEASES - ADVISORY COMMITTEE MEMBERS FELT THAT MORE PRESSING HEALTH NEEDS EXISTED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. 5. INJURY & VIOLENCE PREVENTION - FMDH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. 6. INFANT HEALTH & FAMILY PLANNING - FMDH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. 7. STD HIV/AIDS - FMDH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. 8. DIABETES - FMDH FEELS THAT EFFORTS OUTLINED HEREIN TO IMPROVE NUTRITION, WEIGHT AND PHYSICAL ACTIVITY WILL HAVE A POSITIVE IMPACT ON THE COMMUNITY'S DIABETIC POPULATION, AND THAT A SEPARATE SET OF DIABETIC- SPECIFIC INITIATIVES WAS NOT NECESSARY GIVEN LIMITED RESOURCES. 9. HEART DISEASE & STROKE - FMDH FEELS THAT EFFORTS OUTLINED HEREIN TO IMPROVE NUTRITION, WEIGHT AND PHYSICAL ACTIVITY WILL HAVE A POSITIVE IMPACT ON THE COMMUNITY'S PROPENSITY TOWARD HEART DISEASE AND STROKE, AND THAT A SEPARATE SET OF SPECIFIC INITIATIVES WAS NOT NECESSARY GIVEN LIMITED RESOURCES.
FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 24SOME SERVICES PROVIDED BY THE HOSPITAL ARE CONSIDERED ELECTIVE. ELECTIVE SERVICES ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE THUS A PERSON QUALIFYING FOR A DISCOUNT FOR MEDICALLY NECESSARY SERVICES MAY NEED TO PAY FULL PRICE FOR ELECTIVE SERVICES.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GLASGOW CLINIC INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1621 THIRD STREET SOUTHAddressLine1Txt
CityGLASGOWCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59230ZIPCd
FieldValueIRS element (for citing)
FacilityRURAL HEALTH CLINICFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7GTHERE IS NO COST OF BAD DEBT TO REMOVE FROM THE COMMUNITY BENEFIT EXPENSE IN COLUMN C.
SCHEDULE H, PART I, LINE 7USED ADJUSTED COST TO CHARGE RATIOS FOR PATIENT CARE FROM THE MEDICARE COST REPORT, ADJUSTED FOR BED TAX AND COMMUNITY BENEFIT. IMPLICIT PRICE CONCESSIONS, BAD DEBT, AND FINANCIAL ASSISTANCE ARE ALREADY EXCLUDED FROM THE MEDICARE COST REPORT.
SCHEDULE H, PART III, LINE 2THE ORGANIZATION'S PATIENT CARE COST TO CHARGE RATIO, AFTER ELIMINATING BAD DEBT EXPENSE, FINANCIAL ASSISTANCE, BED TAX, AND COMMUNITY BENEFIT EXPENSE, IS APPLIED TO GROSS BAD DEBT CHARGES, NOT INCLUDING IMPLICIT PRICE CONCESSIONS, TO ARRIVE AT THE COST OF BAD DEBT. DISCOUNTS AND IMPLICIT PRICE CONCESSIONS REDUCE REVENUE AND ARE NOT RECORDED AS BAD DEBT. PAYMENTS RECEIVED ON PREVIOUSLY WRITTEN OFF ACCOUNTS ARE RECORDED AS RECOVERIES OF IMPLICIT PRICE CONCESSIONS OR BAD DEBT, WHICH REDUCE IMPLICIT PRICE CONCESSIONS OR BAD DEBT EXPENSE. PATIENT OBLIGATIONS WHICH QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT RECORDED AS IMPLICIT PRICE CONCESSIONS OR BAD DEBT EXPENSE.
SCHEDULE H, PART III, LINE 4THERE WERE NO BAD DEBT EXPENSES RECORDED AND THEREFORE NO RELATED FOOTNOTE AFTER ADOPTING THE NEW REVENUE RECOGNITION GUIDANCE IN FASB ASU 2014- 09. MOST TRANSACTIONS WHICH PREVIOUSLY WOULD HAVE BEEN RECORDED AS BAD DEBT EXPENSE ARE CLASSIFIED AS IMPLICIT PRICE CONCESSIONS WHICH ARE RECORDED AS REDUCTIONS IN REVENUE VERSUS BAD DEBT EXPENSE. NOTE 4 TO THE CONSOLIDATED FINANCIAL STATEMENTS DISCUSSES IMPLICIT PRICE CONCESSIONS ON PAGES 15 AND 17.
SCHEDULE H, PART III, LINE 8THERE IS A MEDICARE SURPLUS SINCE CRITICAL ACCESS HOSPITALS ARE REIMBURSED 101 PERCENT OF COST FROM MEDICARE, AND THE 2 PERCENT SEQUESTRATION ADJUSTMENT WAS SUSPENDED DURING THE CORONAVIRUS PANDEMIC. MEDICARE COSTS ON PART III, LINE 6 ARE DIRECTLY FROM THE MEDICARE COST REPORT. MEDICARE REVENUE ON PART III, LINE 5 IS DIRECTLY FROM THE MEDICARE COST REPORT.
SCHEDULE H, PART III, LINE 9BTHE ORGANIZATION USES A SLIDING SCALE BASED ON FEDERAL POVERTY GUIDELINES, COMBINED WITH AN ASSET TEST AND A MEDICALLY INDIGENT TEST REGARDLESS OF INCOME, TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. THE ORGANIZATION DOES NOT ATTEMPT TO COLLECT CHARGES APPROVED AS FINANCIAL ASSISTANCE. FOR PATIENTS THAT HAVE HAD A PORTION OF THEIR ACCOUNT WRITTEN OFF AS FINANCIAL ASSISTANCE AND THAT LATER DEFAULT ON THE PORTION THAT WAS DETERMINED TO BE THEIR RESPONSIBILITY, AND THEREFORE IS NOT CONSIDERED FINANACIAL ASSISTANCE, THE ORGAINIZATION DOES ATTEMPT TO COLLECT THIS BALANCE.
SCHEDULE H, PART VI, LINE 2PURSUANT TO THE PROVISIONS OF THE AFFORDABLE CARE ACT, FRANCES MAHON DEACONESS HOSPITAL COMPLETED A COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION PLAN DURING FISCAL YEARS 2013, 2016, & 2019 (TAX YEARS 2012, 2015, & 2018). THESE ASSESSMENTS ARE LOCATED ON THE ENTITY'S WEBSITE. HOWEVER, FRANCES MAHON DEACONESS HOSPITAL (FMDH) HAS TRADITIONALLY INCLUDED COMMUNITY NEEDS ASSESSMENTS IN ITS PLANNING FOR MANY YEARS AND UTILIZES MANY METHODS OF ASSESSING THE PATIENT SERVICES NEEDS FOR OUR SERVICE AREA. THESE INCLUDE BUT ARE NOT LIMITED TO: ANALYSIS OF OUTMIGRATION STATISTICS OBTAINED THROUGH ACCESS TO THE COMPDATA DATABASE PROVIDED THROUGH THE MONTANA HOSPITAL ASSOCIATION AND MODELING OF PATIENT TO POPULATION RATIOS TO IDENTIFY AND PLAN FOR THE APPROPRIATE PROVIDER MIX TO SERVE THE COMMUNITY. IN ADDITION, FMDH PARTICIPATED IN AN AREA HEALTH EDUCATION CENTER LEAD COMMUNITY HEALTH SERVICES DEVELOPMENT ASSESSMENT. IDEAS GENERATED OUT OF EACH OF THESE EFFORTS ARE THEN EVALUATED AS TO THE CAPABILITIES OF OUR ORGANIZATION TO DEVELOP IDENTIFIED SERVICES. MINIMUM CRITERIA FOR DEVELOPMENT OF NEW OR MODIFICATION OF EXISTING SERVICES ARE: THE NEW OR MODIFIED SERVICE CAN REASONABLY FINANCIALLY SUPPORT ITS OPERATION; WE HAVE OR CAN ACQUIRE THE NECESSARY PERSONNEL WITH THE CREDENTIALS TO DELIVER THE SERVICE AND RETAIN ENOUGH PERSONNEL WITH THE REQUIRED SKILL SETS TO AVOID INTERRUPTION OF SERVICE DELIVERY IF SAID PERSONNEL TURN OVER; THE SERVICES CAN BE DELIVERED IN A MANNER THAT ACHIEVES APPROPRIATELY HIGH LEVELS OF PATIENT SATISFACTION.
SCHEDULE H, PART VI, LINE 3FRANCES MAHON DEACONESS HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO HAS THE SOLE RESPONSIBILITY TO WORK WITH PATIENTS TO NAVIGATE OUR FINANCIAL ASSISTANCE PROGRAM. ALL PATIENTS ARE SENT INFORMATION AT THE INITIAL BILLING FOR DELIVERED PATIENT SERVICES THAT DESCRIBES OUR FINANCIAL ASSISTANCE PROGRAM. OUR WEBSITE HAS INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAM ALONG WITH ACCESS TO THE APPLICATION. FRANCES MAHON DEACONESS HOSPITAL ALSO EMPLOYS A STAFF MEMBER THAT IS A CERTIFIED APPLICATION COUNSELOR THAT HELPS COMMUNITY MEMBERS WITH APPLYING FOR INSURANCE AND MEDICAID ON THE MARKETPLACE.
SCHEDULE H, PART VI, LINE 4FRANCES MAHON DEACONESS HOSPITAL IS LOCATED IN GLASGOW MONTANA WHICH IS OVER FOUR HOURS HIGHWAY TRAVEL TIME AWAY FROM ANY TERTIARY MEDICAL CENTER. WHILE OUR PRIMARY SERVICE AREA CONSISTS OF GLASGOW MONTANA AND VALLEY COUNTY, OUR FACILITY AND SPECIALTY SERVICES ALSO DRAW FROM PORTIONS OF THE SURROUNDING COUNTIES OF DANIELS, ROOSEVELT, AND PHILLIPS. THE AREA IS PRIMARILY AGRICULTURAL BASED WITH LOW POPULATION DENSITIES WHICH HOUSES A TOTAL POPULATION OF 24,706 RESIDENTS OVER 13,847.01 SQUARE MILES. THE DIFFERENT AGE GROUPS OF THE SERVICE AREA ARE AS FOLLOWS: 27.0% ARE INFANTS, CHILDREN OR ADOLESCENTS AGES 0-17; ANOTHER 56.5% ARE AGES 18 TO 64, WHILE 16.5% ARE AGES 65 AND OLDER. THE POPULATION IS MOSTLY WHITE, BUT PORTIONS OF OUR EXTENDED SERVICE AREA HAVE HIGH POPULATIONS OF NATIVE AMERICAN ANCESTRY (29.9% IN THE TOTAL SERVICE AREA) TO WHICH WE PROVIDE SERVICES. THE STATISTICS PROVIDED ABOVE ARE BASED ON THE US CENSUS BUREAU AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017).
SCHEDULE H, PART VI, LINE 5FRANCES MAHON DEACONESS HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF. WE ARE GOVERNED BY A VOLUNTARY BOARD OF COMMUNITY PERSONS REPRESENTING MOST OF THE INDIVIDUAL TOWNS OR GEOGRAPHICAL AREAS OF OUR PRIMARY SERVICE AREA. FOR NONELECTIVE SERVICES, WE TREAT PATIENTS WITHOUT REGARD TO ABILITY TO PAY, CONSISTENT WITH OUR ORIGINS AS A HILL BURTON FUNDED FACILITY. ALTHOUGH OUR HILL BURTON OBLIGATION WAS SATISFIED MANY YEARS AGO, WE STILL ADHERE TO THE PRINCIPLES INHERENT IN THAT OBLIGATION. SURPLUS FUNDS ARE RETAINED WITHIN THE ORGANIZATION TO ASSURE FULFILLMENT OF OUR CHARITABLE MISSION BOTH IN THE PRESENT AND IN THE FUTURE.
SCHEDULE H, PART VI, LINE 6FRANCES MAHON DEACONESS HOSPITAL PROVIDES HOSPITAL INPATIENT AND OUTPATIENT SERVICES. GLASGOW CLINIC INC PROVIDES PROFESSIONAL PRIMARY CARE PHYSICIAN, MIDLEVEL PROVIDER, AND SPECIALTY PHYSICIAN SERVICES. HI-LINE MEDICAL SERVICES INC PROVIDES RETAIL PHARMACY SERVICES.
SCHEDULE H, PART VIPART I, LINE 6A: THE FORM 990 SCHEDULE H IS CONSIDERED AN ANNUAL COMMUNITY BENEFIT REPORT AND IT IS AVAILABLE TO THE PUBLIC ON OUR WEBSITE. PART 1, LINE 7E: FMDH CONTRIBUTED TO THE VALLEY COUNTY SCHOOL SNACK PROGRAM AND PAID FOR A WEBSITE SUBSCRIPTION AND OTHER SUPPORT FOR THE VALLEY CARE COALITION. FMDH ALSO PROVIDED MENTAL HEALTH FIRST AID TRAINING & RELATED BOOKS, AND SPONSORED A YOUTH EVENT AND A WALK. PART I, LINE 7I: FMDH CONTRIBUTED TO THE VALLEY COUNTY POOL CAMPAIGN. PART V: GLASGOW CLINIC INC IS A SEPARATE ORGANIZATION THAT IS A RURAL HEALTH CLINIC WHICH INCLUDES SPECIALTY PHYSICIAN PRACTICES. FMDH WHOLLY OWNS AND MANAGES THIS ENTITY AND SUBSIDIZES THE PHYSICIAN PRACTICES AS NEEDED TO ASSURE ACCESS TO AS FULL OF A SCOPE OF SERVICES AS IS APPROPRIATE GIVEN THE NEEDS OF THE COMMUNITY WE SERVE. GLASGOW CLINIC'S REVENUES AND EXPENSES ARE NOT INCLUDED ON FMDH'S FORM 990. HI-LINE MEDICAL SERVICES, INC IS A SEPARATE ORGANIZATION WHICH CONSISTS OF A RETAIL PHARMACY AND IS WHOLLY OWNED AND OPERATED BY FMDH. THEIR REVENUES AND EXPENSES ARE NOT INCLUDED ON FMDH'S FORM 990.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
LOUIS BAILEY
PHYSICIAN MEMBER$581,921$9,975$16,695$608,591
NICOLE LORENZ
MD$503,389$9,975$8,306$521,670
KEVIN ROSS
MD$445,783$9,975$13,396$469,154
DAVID KNIERIM
MD$438,034$9,975$8,306$456,315
ANDREW FAHLGREN
MD$425,015$9,975$9,416$444,406
ANNE MILLARD BRADLEY
MD$404,511$9,975$13,123$427,609
RANDY HOLOM
CEO$276,900$9,646$13,123$299,669
ELLEN GUTTENBERG
COO$174,069$6,256$16,695$197,020
CAMI KALINSKI
DIRECTOR OF FINANCE$148,642$5,166$11$153,819

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART IIIFormAndLineReferenceDesc
ExplanationA PERCENTAGE OF THE COMPENSATION PAID TO KEVIN ROSS, M.D. (74%), DAVID KNIERIM, M.D. (74%), ANDREW FAHLGREN, M.D. (74%), ANNE MILLARD BRADLEY, M.D. (55%), AND NICOLE LORENZ, M.D. (100%) IS AN EXPENSE OF GLASGOW CLINIC INC, A RELATED COMPANY. THE COMPENSATION WAS PAID TROUGH FRANCES MAHON DEACONESS HOSPITAL AS A COMMON PAYMASTER.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FIRST COMMUNITY BANKBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionBOARD MEMBERSRelationshipDescriptionTxt
Transaction$10,713,171TransactionAmt
TransactionBANKING & INVESTINGTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE L, PART VFormAndLineReferenceDesc
ExplanationTHE HOSPITAL CEO IS A BOARD MEMBER OF FIRST COMMUNITY BANK AND ONE BOARD MEMBER IS AN EMPLOYEE OF THE BANK. THE HOSPITAL HAS BANK ACCOUNTS AND INVESTMENTS WITH FIRST COMMUNITY BANK. THE BUSINESS RELATIONSHIP WITH THE BANK IS MANAGED BY THE DIRECTOR OF FINANCIAL SERVICES OF THE HOSPITAL AND SHE HAS A DIRECT REPORTING RELATIONSHIP TO THE BOARD FINANCE COMMITTEE IN THIS REGARD. FURTHER, ANY DECISION MADE BY THE DIRECTOR OF FINANCIAL SERVICES IS GOVERNED BY POLICIES AND PROCEDURES APPROVED BY THE ENTIRE BOARD OF TRUSTEES ON THE RECOMMENDATION OF THE FINANCE COMMITTEE. ADDITIONALLY, FOR ANY PARTICULAR BUSINESS TRANSACTION OR DECISION THAT DIRECTLY INVOLVES FIRST COMMUNITY BANK, THE CEO AND THE BOARD MEMBER WITH A CONFLICT OF INTEREST LEAVE THE BOARD MEETING WHILE THE REMAINING BOARD MEMBERS DELIBERATE OR ACT ON THE MATTER. THE TRANSACTION DOLLAR AMOUNT SHOWN ABOVE IS THE NET DECREASE IN THE HOSPITAL'S BANK ACCOUNT AND INVESTMENT BALANCES WITH FIRST COMMUNITY BANK AND AFFILIATED COMPANIES FOR THE FISCAL YEAR.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 6MEMBERSHIP IN THE FRANCES MAHON DEACONESS HOSPITAL CORPORATION (FMDH) IS ACHIEVED BY VIRTUE OF DONATING AT LEAST 100 TO FMDH, TO THE FRANCES MAHON DEACONESS HOSPITAL FOUNDATION (ALTHOUGH THE FOUNDATION IS A SEPARATE CHARITABLE ENTITY AND NOT CONTROLLED BY THE FMDH CORPORATION, ITS STATED PURPOSE IS TO SUPPORT FMDH AND THE DELIVERY OF HEALTHCARE SERVICES IN VALLEY COUNTY, MONTANA, THROUGH CHARITABLE DONATIONS SUPPORTING SERVICES DEVELOPMENT AND EQUIPMENT PURCHASES), AND LUKE'S 100 (ANOTHER LOCAL CHARITABLE ORGANIZATION SEPARATE FROM FMDH BUT WHICH SUPPORTS FMDH THROUGH ANNUAL DONATIONS). THERE ARE NO DISTINCT CLASSES OF MEMBERS; ALL MEMBERS ARE PART OF A SINGLE MEMBERSHIP CLASS. FMDH CORPORATION MEMBERS EXERCISE NO GOVERNANCE CONTROL OVER FMDH WITH THE EXCEPTION OF THE ABILITY TO BRING CHARGES AGAINST A BOARD MEMBER FOR MALFEASANCE OR NONFEASANCE OF THE DUTIES AND RESPONSIBILITIES OF THE ENTITY WHICH, THROUGH A DUE PROCESS, CORPORATE MEMBERS CAN VOTE A BOARD MEMBER OUT WITH A VOTE OF 2/3 OF CORPORATE MEMBERS PRESENT AND CORPORATE MEMBERS TOTAL AT LEAST 50 MEMBERS OR 5% OF THE TOTAL CORPORATE MEMBERS, WHICHEVER IS FEWER.
FORM 990, PAGE 6, PART VI, LINE 7ATHERE ARE NO DISTINCT CLASSES OF MEMBERS; ALL MEMBERS ARE PART OF A SINGLE MEMBERSHIP CLASS. THE MEMBERS ELECT ALL MEMBERS OF THE FMDH BOARD OF TRUSTEES. ELECTION OF THE GOVERNING BOARD IS GRANTED TO THE FMDH BOARD OF TRUSTEES. HOWEVER, THE FMDH CORPORATION MEMBERS MAY VOTE OUT A TRUSTEE UPON DUE PROCESS. THEY EXERCISE NO OTHER GOVERNANCE OR CONTROL OVER FMDH.
FORM 990, PAGE 6, PART VI, LINE 11BTHE FORM 990 IS REVIEWED BY THE CEO AND DIRECTOR OF FINANCIAL SERVICES AND IS MADE AVAILABLE FOR THE BOARD'S REVIEW PRIOR TO BEING FILED.
FORM 990, PAGE 6, PART VI, LINE 12CCONFLICTS OF INTEREST ARE REQUIRED TO BE REPORTED AT THE FIRST MEETING OF EACH CALENDAR YEAR. IF A BOARD MEMBER HAS A CONFLICT OF INTEREST THEY ARE REQUIRED TO LEAVE THE BOARD MEETING WHILE THE BUSINESS IS BEING DISCUSSED OR ACTED UPON.
FORM 990, PAGE 6, PART VI, LINE 15ATHE BOARD OF TRUSTEES APPROVES THE CEO'S COMPENSATION.
FORM 990, PAGE 6, PART VI, LINE 15BTHE BOARD OF TRUSTEES APPROVES THE COMPENSATION FOR ALL PHYSICIANS EMPLOYED BY FMDH. THE CEO APPROVES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES.
FORM 990, PAGE 6, PART VI, LINE 19ALL WRITTEN POLICIES ARE KEPT IN THE OFFICE OF THE DIRECTOR OF FINANCIAL SERVICES AND ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9ROUNDING 15 SBA PPP LOAN FORGIVEN TY20, IN BOOK REVENUE TY19 -2,808,974 ROUNDING -12 TOTAL -2,808,971

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
FMDH FOUNDATION
621 3RD STREET SOUTHGLASGOWMT59230810406872SUPPORTMT501C37NAfalse
PRAIRIE RIDGE VILLAGE LLP
521 4TH AVE SGLASGOWMT59230810515202ASSTLIVINGMT501C310NAfalse
NE MT STAT AIR AMBULANCE COOPERATIV
519 PLEASANT STREETMILES CITYMT59301204748673AIR AMBULAMT501C312BNAfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
HI-LINE MEDICAL SERVICES INC
621 THIRD STREET SOUTHGLASGOWMT59230208393201PHARMACYMTN/Afalse
GLASGOW CLINIC INC
621 THIRD STREET SOUTHGLASGOWMT59230810341714CLINICMTN/Afalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (true)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
FMDH FOUNDATION
O$52,774STAFF & OTHER ITEMS
GLASGOW CLINIC PC
J$168,301RENTAL INCOME
GLASGOW CLINIC PC
R$2,754,184CHANGE IN RECEIVABLE
HI-LINE MEDICAL SERVICES INC
J$60,000RENTAL INCOME
HI-LINE MEDICAL SERVICES INC
S-$1,070,033CHANGE IN RECEIVABLE
PRAIRIE RIDGE VILLAGE LLP
D$3,137,183LOAN BALANCE
PRAIRIE RIDGE VILLAGE LLP
A$166,445INTEREST RECEIVED ON LOAN
FMDH FOUNDATION
C$11,131SUPPORT

Averaging Attachment AveragingAttachment

FieldValueIRS element (for citing)
ExplanationFOR TAX YEAR 2020 THERE WERE NOT ANY GRASSROOTS LOBBYING EXPENDITURES.ExplanationTxt