2022-05-11T12:56:17-05:00 2021-06-30 GREEN HEALTH GROUP PC 405 FOURTH AVENUE NORTH GLASGOW MT 59230 990 2020-07-01 810231786 FRANCES MAHON DEACONESS HOSPITAL FRAN 4062283500 621 3RD STREET SOUTH GLASGOW MT 59230 CAMI KALINSKI DIRECTOR OF FINANCE 4062283660 2022-05-09 true CAMI KALINSKI XXX-XX-XXXX DANIEL GREEN P01311679 4062632615 2022-05-11 2020 2022-09-23 18:48:47Z CAMI KALINSKI 621 3RD STREET SOUTH GLASGOW MT 59230 43023502 false X WWW.FMDH.ORG X 1914 MT TO 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. 9 7 320 22 466421 95962 7516848 31276844 34530063 388334 658163 332 318428 31761472 43023502 0 0 16271100 16455812 0 69877 13956787 14601242 30227887 31057054 1533585 11966448 84266652 90280300 10079222 4579141 74187430 85701159 TO ADVANCE THE COORDINATED DELIVERY OF HEALTH SERVICES, GUIDED WITH RESPECT FOR THE INDIVIDUAL NEEDS OF OUR PATIENTS, THEREBY IMPROVING 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GUTTENBERG COO 40.00 X 174069 0 22951 CAMI KALINSKI DIRECTOR OF 40.00 X 148642 0 5177 ERIKA BENGOCHEA TRUSTEE 1.00 X 0 0 0 ANNIE CAPDEVILLE TRUSTEE 1.00 X 0 0 0 DON FAST PRESIDENT 2.00 X 0 0 0 PATRICK MENGE SECRETARY/TR 1.00 X 0 0 0 STAN OZARK VICE PRESIDE 1.00 X 0 0 0 MARISA SATHER TRUSTEE 1.00 X 0 0 0 KARLA ZERBE TRUSTEE 1.00 X 0 0 0 3398264 179989 38 false true false SYNERGY SURGICALISTS PC 280 W KAGY BLVD STE D 320 BOZEMAN MT 59715 CONTRACT STAFF 749402 COMPHEALTH INC PO BOX 972651 DALLAS TX 753972651 CONTRACT STAFF 296160 MEDICAL INFORMATION TECHNOLOGY INC PO BOX 74569 CHICAGO IL 60696 DATA PROCESSING 280521 CLOUDWAVE DEPT CH 19800 PALATINE IL 600559800 SVC CONTRACTS 247608 GE PRECISION HEALTHCARE LLC PO BOX 96483 CHICAGO IL 60693 SVC CONTRACTS 210052 9 11131 7497456 8261 7516848 PATIENT REVENUE 621500 33576323 33576323 PROFESSIONAL RADIOLOGY 621110 663422 425302 238120 GLASGOW CLINIC RENT 531120 168301 168301 OTHER RENTAL INCOME 531120 62017 62017 HI-LINE MEDICAL SRVCS RENT 531120 60000 60000 34530063 658163 658163 PARTNERSHIP INCOME 900099 227454 227454 PAYROLL TAX CREDITS 900099 58974 58974 COUNTY CONTRIBUTION 900099 32000 32000 318428 43023502 35040233 466421 1192150 572825 619325 12143460 9849412 2251712 42336 355654 271940 82279 1435 1749980 1323084 415536 11360 1014568 818102 193696 2770 231041 231041 53209 53209 939609 624576 314846 187 122389 122389 812364 308019 503892 453 322867 255184 67133 550 52857 41164 11676 17 55974 48912 7039 23 3886396 3242421 636980 6995 350838 287573 62748 517 MEDICAL SUPPLIES 5531355 5531355 REPAIRS & MAINTENANCE 1618811 1390391 225800 2620 PROPERTY TAXES 268505 268505 FOOD & DIETARY SUPPLIES 240471 185163 54755 553 114556 104841 9654 61 31057054 24854962 6132215 69877 14532021 8528450 5350392 5776047 4095230 3825243 952131 1019372 678390 804471 53962897 34500032 21481023 19462865 14804128 27928727 22373337 22935125 84266652 90280300 4978720 3761710 4687178 100000 413324 717431 10079222 4579141 X 74187430 85701159 74187430 85701159 84266652 90280300 X 11966448 2356252 -2808971 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3715 3715 30983462 30987177 1000000 250000 1000000 1000000 1000000 1000000 4000000 6000000 65908 54336 3942 3715 127901 250000 250000 250000 250000 1000000 1500000 62404 51101 113505 SCHEDULE C, PART II-A FOR TAX YEAR 2020 THERE WERE NOT ANY GRASSROOTS LOBBYING EXPENDITURES. 88748 88748 32556287 18182376 14373911 21317862 16317656 5000206 19462865 MUTUAL FUNDS 10501882 F CERTIFICATES OF DEPOSIT 8481630 F EQUITIES 7422288 F GOVERNMENTAL BONDS 1513199 F CASH & CASH EQUIVALENTS 9728 C 27928727 INTERCOMPANY AND OTHER RECEIVABLES 16090353 INVESTMENTS IN JOINT VENTURES 3217453 MEDICARE/MEDICAID RECEIVABLES 2670185 INTEREST IN FMDH FOUNDATION 957134 22935125 MEDICARE & MEDICAID PAYABLES 717431 717431 X 42570795 2356252 15 2356267 40214528 2808974 2808974 43023502 31057066 12 12 31057054 31057054 SCHEDULE D, PAGE 3, PART X THE 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 2D ROUNDING 15 SCHEDULE D, PAGE 4, PART XI, LINE 4B SBA PPP LOAN FORGIVEN TY20, IN BOOK REVENUE TY19 2,808,974 SCHEDULE D, PAGE 4, PART XII, LINE 2D ROUNDING 12 true true true X 1.400000000000 true X 2.400000000000 true true false true true 162989 162989 0.00520 162989 162989 0.00520 26392 26392 0.00080 3503704 1785430 1718274 0.05530 668 668 3530764 1785430 1745334 0.05620 3693753 1785430 1908323 0.06140 true 14116148 13976384 139764 X true true 1 1 FRANCES MAHON DEACONESS HOSPITAL 621 3RD ST S GLASGOW MT 59230 WWW.FMDH.ORG X X X X FRANCES MAHON DEACONESS HOSPITAL 1 false false true X X X X X X X X X X 18 true false true true X WWW.FMDH.ORG X true 18 true WWW.FMDH.ORG false false true X 140.000000000000 240.000000000000 X X X X true true X X X X true X WWW.FMDH.ORG X WWW.FMDH.ORG X WWW.FMDH.ORG X X X X X true X false X X X X true X false true 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 5 TO 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 6B VALLEY COUNTY PUBLIC HEALTH DEPARTMENT FACILITY 1, FRANCES MAHON DEACONESS HOSPITAL - PART V, LINE 11 THE 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 24 SOME 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. 1 GLASGOW CLINIC INC 621 THIRD STREET SOUTH GLASGOW MT 59230 RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 7G THERE IS NO COST OF BAD DEBT TO REMOVE FROM THE COMMUNITY BENEFIT EXPENSE IN COLUMN C. SCHEDULE H, PART I, LINE 7 USED 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 2 THE 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 4 THERE 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 8 THERE 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 9B THE 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 2 PURSUANT 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 3 FRANCES 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 4 FRANCES 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 5 FRANCES 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 6 FRANCES 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 VI PART 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. X X X false false false false false false false false false LOUIS BAILEY PHYSICIAN MEMBER 581921 9975 16695 608591 NICOLE LORENZ MD 503389 9975 8306 521670 KEVIN ROSS MD 445783 9975 13396 469154 DAVID KNIERIM MD 438034 9975 8306 456315 ANDREW FAHLGREN MD 425015 9975 9416 444406 ANNE MILLARD BRADLEY MD 404511 9975 13123 427609 RANDY HOLOM CEO 276900 9646 13123 299669 ELLEN GUTTENBERG COO 174069 6256 16695 197020 CAMI KALINSKI DIRECTOR OF FINANCE 148642 5166 11 153819 SCHEDULE J, PART III A 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. FIRST COMMUNITY BANK BOARD MEMBERS 10713171 BANKING & INVESTING false SCHEDULE L, PART V THE 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. FORM 990, PAGE 6, PART VI, LINE 6 MEMBERSHIP 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 7A THERE 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 11B THE 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 12C CONFLICTS 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 15A THE BOARD OF TRUSTEES APPROVES THE CEO'S COMPENSATION. FORM 990, PAGE 6, PART VI, LINE 15B THE 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 19 ALL WRITTEN POLICIES ARE KEPT IN THE OFFICE OF THE DIRECTOR OF FINANCIAL SERVICES AND ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9 ROUNDING 15 SBA PPP LOAN FORGIVEN TY20, IN BOOK REVENUE TY19 -2,808,974 ROUNDING -12 TOTAL -2,808,971 FMDH FOUNDATION 621 3RD STREET SOUTH GLASGOW MT 59230 810406872 SUPPORT MT 501C3 7 NA false PRAIRIE RIDGE VILLAGE LLP 521 4TH AVE S GLASGOW MT 59230 810515202 ASSTLIVING MT 501C3 10 NA false NE MT STAT AIR AMBULANCE COOPERATIV 519 PLEASANT STREET MILES CITY MT 59301 204748673 AIR AMBULA MT 501C3 12B NA false HI-LINE MEDICAL SERVICES INC 621 THIRD STREET SOUTH GLASGOW MT 59230 208393201 PHARMACY MT N/A false GLASGOW CLINIC INC 621 THIRD STREET SOUTH GLASGOW MT 59230 810341714 CLINIC MT N/A false true false true true false false false false false true false false false false true false false true true FMDH FOUNDATION O 52774 STAFF & OTHER ITEMS GLASGOW CLINIC PC J 168301 RENTAL INCOME GLASGOW CLINIC PC R 2754184 CHANGE IN RECEIVABLE HI-LINE MEDICAL SERVICES INC J 60000 RENTAL INCOME HI-LINE MEDICAL SERVICES INC S -1070033 CHANGE IN RECEIVABLE PRAIRIE RIDGE VILLAGE LLP D 3137183 LOAN BALANCE PRAIRIE RIDGE VILLAGE LLP A 166445 INTEREST RECEIVED ON LOAN FMDH FOUNDATION C 11131 SUPPORT FOR TAX YEAR 2020 THERE WERE NOT ANY GRASSROOTS LOBBYING EXPENDITURES.