2022-10-25T07:50:49-05:00 2021-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2021-01-01 810232121 Bozeman Deaconess Health Services BOZE 4064145000 915 Highland Boulevard Bozeman MT 59715 Brad Ludford CFO 4064145000 2022-09-30 1 Brad Ludford 999009999 Kim Hunwardsen CPA P00484560 6122536500 2022-09-26 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z Bozeman Health Brad Ludford 915 Highland Boulevard Bozeman MT 59715 153541900 0 X www.bozemanhealth.org X 1911 MT To improve community health and quality of life for residents and visitors of the Bozeman, MT area. 13 12 998 232 1236213 0 3305217 690773 123163404 152604237 108487 62326 107631 184564 126684739 153541900 791715 113500 0 0 82256384 103026670 0 0 0 39929579 47851595 122977678 150991765 3707061 2550135 166060049 178954474 119891086 130061842 46168963 48892632 X To improve community health and quality of life. 0 0 59889615 57808606 Bozeman Health Medical Group employs physicians under the Bozeman Health system umbrella. This group of providers compassionately serves the patients of Bozeman Health Deaconess Hospital, Big Sky Medical Center, Bozeman Health Urgent Care, and Bozeman Health Convenience Care, LLC. 12331325 20451815 In efforts to reach our community and surrounding area in multiple facets of healthcare, the Bozeman Health system operates additional healthcare facilities which allows more access and levels of care.Big Sky Medical Center had 55 admissions and saw 5,515 patients in the Emergency Room and over 6,200 in the clinic in 2021. The net revenue yield on these operations was only 64.4%, or $3,646 per equivalent ER visit. With challenging core staffing and related costs, the operating expense (excluding interest, taxes and depreciation) was $1,186 per equivalent ER visit. This resulted in a $1.7M operating loss for the year. Bozeman Health is committed to providing access and patient care to the Big Sky community in spite of the financial operational challenges the facility continues to face.Bozeman Health also continues to operate our Main Street Urgent Care as an outpatient healthcare access point. With a 54.9% yield on $6.3M of patient charges and operating costs of $5.7M, the Urgent Care netted a gain of $524K in 2021. 10106256 113500 74343816 Bozeman Health serves as the parent company of the Bozeman Health system. As the corporate parent, management, general and administrative services are centralized here and provided to the operating units caring for our patients. These administrative and support services aim to optimize executive, organizational and financial responsibilities to allow the health system to continue to grow and serve the population. In this past year, Bozeman Health had 26,770 days, 227,013 outpatient hospital visits, 337,872 outpatient clinic visits, 34,726 emergency room visits and performed 8,236 surgeries. 82327196 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 220 0 1 998 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 X Carrie Morasko 4064145039 915 Highland Blvd Bozeman MT 59715 Katie Daughenbaugh Chair 1.00 1.00 X X 0 0 0 Dennis Munson 1st Vice Chair 1.00 1.00 X X 0 0 0 Signe Farris Vice Chair 1.00 0.00 X X 0 0 0 Don Beeman Secretary 1.00 0.00 X X 0 0 0 Kerri Brown Treasurer 1.00 1.00 X X 0 0 0 John How Director 1.00 0.00 X 0 0 0 Jerry Cashman Director 1.00 1.00 X 0 0 0 Bruce Hamory Director 1.00 0.00 X 0 0 0 Kerry Petitt Director 1.00 1.00 X 0 0 0 Walt Sales Director 1.00 1.00 X 0 0 0 Alyce Schultz Director 1.00 0.00 X 0 0 0 Dane Sobek Director/Cardiologist 50.00 1.00 X 748165 0 42253 Amy Strader Director 1.00 0.00 X 0 0 0 John Hill CEO 20.00 30.00 X 822614 0 151637 Brad Ludford CFO 20.00 30.00 X 416231 0 75289 Darci Bentson CAO 20.00 30.00 X 409577 0 77221 Kathryn Bertany President of Hospitals 20.00 30.00 X 604999 0 80326 Mark Williams Chief Physician Officer 20.00 30.00 X 572398 0 78480 Diane Patterson Chief Nursing Officer 20.00 30.00 X 276174 0 41240 Tamara Havenhill-Jacobs Chief Information Officer 20.00 30.00 X 346729 0 64862 Edie Willey Chief People Officer 20.00 30.00 X 275212 0 51440 Nathaniel Madsen Cardiology 50.00 0.00 X 721339 0 42241 Peter Walsh Gastroenterologist 50.00 0.00 X 648586 0 44153 Justin Thomas Oncologist 50.00 0.00 X 623733 0 46329 Andrew Gentry Gastroenterologist 50.00 0.00 X 605039 0 44055 Kleanthis Dendrinos Gastroenterologist 50.00 0.00 X 591613 0 36241 Gordon Davidson Former Officer CFO 0.00 X 236459 0 0 Elizabeth Lewis Former Key Employee COO 0.00 X 285648 0 0 8184516 0 875767 249 1 1 0 Nuwest Group Holdings LLC 325 118th Ave SE Ste 300 Bellevue WA 98005 Contract Labor 11924137 Absaroka Emergency Physicians 1184 N 15th Street Suite 1 Bozeman MT 59715 ER Physicians Fee 6588793 Montana Linen Supply LLC 20900 E Frontage Rd Ste A Belgrade MT 59730 Linen Cleaning 1163988 Impact Advisors LLC PO Box 379 Naperville IL 605660379 Software Consulting/Build 1079011 System4 of Idaho 82 S Baltic Place Ste 116 Meridian ID 83642 Facility Cleaning 727863 48 690773 690773 Hlth System Corp Services 900099 65756318 65756318 Hlth System Physician Services 621110 57808606 57808606 Patient Service Revenue 621110 18285629 18285629 Pharmacy Revenue 446110 1454368 218155 1236213 9299316 9299316 152604237 62326 62326 184564 0 184564 184564 184564 153541900 151368024 1236213 246890 X 99500 99500 14000 14000 5144745 962999 4181746 82708490 60408181 22300309 3115912 2492654 623258 7361854 3172990 4188864 4695669 3066912 1628757 682372 24800 657572 153946 153946 62493 62493 15100423 1634713 13465710 2031421 2031421 685075 205771 479304 1361179 213441 1147738 307107 25015 282092 204738 16677 188061 1195144 1195144 5355436 5355436 2499781 67085 2432696 Equipment Rent & Mainte 12275909 485600 11790309 Medical Supplies 2850694 2800722 49972 Goodwill Impairment 869549 869549 Taxes and Licenses 622606 75156 547450 1593722 10400 1583322 150991765 82327196 68664569 0 69477801 64185839 5270510 5917525 151977 316967 345128 7115883 11554638 105715139 41428983 53243634 64286156 6603761 7885430 14594891 14566918 6956395 6086845 2328230 4125995 166060049 178954474 25063065 31893805 205000 20884085 20560584 8773901 3458029 65170035 73944424 119891086 130061842 X 44176897 46727032 1992066 2165600 46168963 48892632 166060049 178954474 X 2550135 173534 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 56400 0 1 6093 62493 0 Part II-B, Line 1: Hired consultant to provide lobbying services in connection with governmental affairs representation to ensure hospital, community, and employee interests and needs are represented. Bozeman Deaconess Health Services reimburses certain professional membership dues of employees, a portion of such membership dues are used by the professional associations for lobbying activities. The dues for MHA, AHA, and Leading Age were $6,093. 20745993 973493 3399161 584515 24534132 18430208 41677 2623596 349488 20745993 16272305 227769 3135666 1205532 18430208 16828400 335927 -723008 169014 16272305 14747913 223082 2235283 377878 16828400 0.64337 0.15871 0.19792 0 1 1 16497145 16497145 30302136 5192945 25109191 46239220 36236038 10003182 12676638 12676638 64286156 Investment in Affiliated Organizations 14566918 F 14566918 Deposits 4888 Capitalized Lease Obligation 1730875 Due To Affliates 71264094 Estimated third-party payor settlements 946000 Estimated liability to beneficiaries -1433 73944424 X Part V, Line 4: Each endowment fund is privy to a separate agreement. Donations made for each purpose shall be received, held, and invested by the Bozeman Deaconess Foundation according to established policies governing gift acceptance, investment, and distribution. The principal of the fund shall be retained in perpetuity. The interest income is utilized for the greatest needs of the designated department. Policy says the organization can use a portion of interest for operations. The endowment fund reported in Line 1 is currently being held by a related organization, Bozeman Deaconess Foundation, and benefits Bozeman Health and related system entities. Due to this relationship the endowment fund is being reported all the Form 990, Schedule D, Part V for all three related entities. Part X, Line 2: The Organization believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 1 1 1 0 0 498768 35573 463195 0.00310 2869542 2093693 775849 0.00510 3368310 2129266 1239044 0.00820 670101 210649 459452 0.00300 15392 15392 0.00010 1775613 1572727 202886 0.00130 99500 99500 0.00070 2560606 1783376 777230 0.00510 5928916 3912642 2016274 0.01330 3100 8581 8581 0.00010 3100 8581 8581 0.00010 1 1389028 0 1782752 3735340 -1952588 X 1 1 1 Rocky Mountain Surgical Center LLC Outpatient Surgical Center 0.51010 0.00000 0.48990 2 Deaconess Intercity Imaging LLC Radiology 0.77500 0.00000 0.22500 3 Spanish Peaks Plaza LLC Real Estate 0.69940 0.00000 0.30060 4 West Bozeman Surgery Center LLC Outpatient Surgical Center 0.35070 0.00000 0.30000 1 1 Big Sky Medical Center 334 Town Center Ave Big Sky MT 59716 www.bigskymedicalcenter.com 13563 X X X X Big Sky Medical Center LLC 1 0 0 1 X X X X X X X X X 20 1 1 1 1 X https://www.bozemanhealth.org/chna/ X 1 20 1 https://www.bozemanhealth.org/chna/ 0 1 X 150.000000000000 250.000000000000 X X X X 1 1 X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X X 1 X 0 X X X X 1 X 0 1 Big Sky Medical Center, LLC Part V, Section B, Line 5: To solicit input from key informants, those individuals who have a broad interest in the health of the community, an Online Key Informant Survey (OKIS) was implemented as part of the CHNA process. The list for this survey included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. 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. In total, 25 individuals responded to the OKIS in the spring of 2020 from the following organizations many of which work directly with low-income, minority, or other medically underserved populations:Big Sky Community Organization Big Sky Fire Department Big Sky ResortBig Sky School District 72Bozeman Health Family Medicine Clinic, Big Sky Community Health Partners, West Yellowstone Conoco Big Sky Gallatin County Sheriff's Department Harrison Public School DistrictHuman Resource Development, Big Sky Community Food BankMadison County Public Health Department Schmieding Dental GroupSheridan School DistrictTown of West Yellowstone West Yellowstone Schools Woman in Action, Big Sky Big Sky Medical Center, LLC Part V, Section B, Line 6a: Bozeman Health Deaconess Hospital Big Sky Medical Center, LLC Part V, Section B, Line 6b: Community Health Partners, Gallatin City-County Health Department Big Sky Medical Center, LLC Part V, Section B, Line 11: We conducted a CHNA in 2020, which guides our implementation strategy for 2021-2023. The needs identified and adopted by BSMC are:-Behavioral Health (includes mental health and substance abuse)-Access to Healthcare Services-Nutrition & Physical Activity -Injury & ViolenceIn the current year the facility has taken the following actions:Access to healthcare services: Strategy #1: Provide free preventative health services through the HealthCare Connections mobile screening program. Strategy #2: Host and share the Bozeman Health podcast, All Things Health Behavioral health: Strategy #1: Implement Youth Aware of Mental Health (YAM) programming in high schools and middle schools Strategy #2: Champion and disseminate community-wide awareness and stigma reduction education efforts. Nutrition and physical activity:Strategy #1: Convene and support the 5210+ Gallatin County coalition Strategy #2: Support Go Noodle access for school in Park, Madison, and Gallatin Counties Injury and Violence: Strategy #1: Provide Stepping On fall prevention trainings. Strategy #2: Promote the Stop the Bleed campaign. Strategy #3: Host community events to raise awareness, reduce stigma, provide resources, and promote domestic violence prevention. The organization will not address the following needs identified:*Cancer: We will focus on preventing some of the root causes of certain cancers by promoting healthy diets and physical activity. Screening for certain cancers will remain a key part of our work to increase access to healthcare.*Diabetes: We will focus on prevention by promoting healthy diets and physical activity.*Heart disease and stroke: We will focus on prevention by promoting healthy diets and physical activity.*Oral health: We have chosen to prioritize resources on higher acuity community needs.*Potentially disabling conditions: Although we are not directly addressing this need, by focusing on prevention healthy diets and physical activity we expect to see some positive impact.*Respiratory disease: Our care teams are currently engaged in providing care in this area. We will continually assess and be responsive to opportunities to expand programming and/or outreach.*Sexual health: Our care teams are currently engaged in providing care in this area. We will continually assess and be responsive to opportunities to expand programming and/or outreach.*Tobacco use: We will work to decrease tobacco use through our behavioral health and nutrition & physical activity priority areas. Big Sky Medical Center, LLC Part V, Section B, Line 13h: Any individual and their dependents who are at 150% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. In addition, Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but the patient must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Big Sky Medical Center, LLC Part V, Section B, Line 16j: Medical Advocacy Services in Healthcare (MASH) will give out our financial application after determining a patient is ineligible for federal and state programs. A summary of the financial assistance policy is attached to billing invoices, posted in the patient admissions area, and provided to patients upon admission to the hospital facility. Big Sky Medical Center, LLC Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be billed gross charges on elective procedures. Schedule H, Part V, Section B, Line 16a-16c: https://www.bozemanhealth.org/patients-and-visitors/patient-financial-services/financial-assistance/ 6 1 - Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Imaging Center 2 - Rocky Mountain Surgery Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 Outpatient Surgical Center 3 - Hospice of Southwest Montana LLC 3810 Valley Commons Dr Ste 1 Bozeman MT 59715 Hospice Services 4 - Bozeman Health Urgent Cares LLC 1006 W Main Bozeman MT 59715 Outpatient Health Care 5 - Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 Contracted Physician Services 6 - Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Health Care Part I, Line 3c: Any individual and their dependents who are at 150% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. In addition, Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but the patient must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Part I, Line 7: The cost to charge ratio from Worksheet 2 was used to obtain the costs related to Charity Care, Medicaid, and Other Means-Tested Programs. All net benefit expenses were calculated using direct costs and revenue with reasonable indirect overhead allocation methods. Benefits are allocated at 23% of payroll dollars. For Subsidized Services, other indirect overhead costs are allocated based on historical reasonableness of 15% of total expenses. Our internal system does record patient revenues based on type (inpatient vs. outpatient vs. emergency) and payor (Medicaid, Medicare, Commercial, Self-Pay, etc.). Related costs are then determined based on the pro-rated share as a percentage of the total. For example, if Medicaid comprises 7% of a department's revenue, Medicaid expenses are calculated at 7% of the total as well.Lines 7e, 7f, 7i are based on actual expenses. Part I, Line 7g: Amount of cost attributable to a physician clinic is $1,775,613. The Urgent Care disregarded entity was reported as a subsidized services, pulling out the financial assistance and Medicaid to report separately as appropriate. Part II, Community Building Activities: The expenses reported are for the Healthy Living Campaign. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. Part III, Line 4: The footnote to the organization's financial statements that describes implicit price concessions is located in Footnote 1 on pages 15-17 of the attached financial statements. Part III, Line 8: The entire amount of shortfall should be considered a community benefit.The Medicare shortfall represents a cost absorbed by the Hospital as a result of providing care to Medicare patients. The contract driving this loss is a nondiscretionary contract, as is providing the services to this population of individuals. The cost of providing this benefit to the community should be reportable as such. Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.For the Joint Ventures, Net Medicare Revenue was used as the revenue received, and that percentage of total revenues was applied against operating expenses to determine related costs. The Joint Venture portion of the shortfall is $1,482,882. Part III, Line 9b: Providing the patient, either directly or through its contracted collection agency with at least one written notice informing the patient about the Extraordinary Collection Actions that we intend to take if the patient does not submit an Application for Financial Assistance or pay the amount due by at least thirty days following the date of the notice. The notice will include a copy of the plain language summary and will not be mailed or delivered to a patient earlier than 30 days prior to the end of the Notification Period.No Extraordinary Collection Actions will be undertaken during the 120 day Notification Period, during which time we will take reasonable efforts to determine whether the patient is eligible for Financial Assistance. After the 120 day Notification Period, an Extraordinary Collection Action will be undertaken only if the patient has received the 30 day written notice described above. Part VI, Line 2: In addition to the CHNA, Bozeman Health Big Sky Medical Center (BSMC) assesses community health care needs in a number of ways. We look at other available health data and reports for our service area provided by the State of Montana and our local City-County Health Department. We also work closely with area non-profits and social service providers to hear about the needs of their clients / customers to help inform our outreach strategies and community health improvement efforts. Part VI, Line 3: Bozeman Health is deeply committed to providing financial assistance to patients needing, but unable to afford, medically necessary health care services. As a hospital operating in the Bozeman Health system, Big Sky Medical Center (BSMC) posts notice of its Financial Assistance Policy in all admitting areas, as well as on the website. At the earliest feasible time, BSMC will attempt to determine whether a patient has third party coverage for any part of the hospital services provided. If a patient does not have third party coverage, a patient advocate from the MASH program will screen all inpatient cases and any outpatient cases exceeding $1,000 in total charges to determine if the patient qualifies for third party funding. If not, the patient advocate will explain the Financial Assistance Policy and give the patient an application if desired. In circumstances where payment in full will cause financial hardship that will significantly harm the patient or patient's family, the applicant may be asked to visit with Consumer Credit Counseling Services to further review their financial situations. Upon request, patients may be asked to complete an application for Medicaid participation or for coverage by other governmental payment programs. Patient bills also contain billing information explaining financial options and provide contact information to the appropriate resources. Part VI, Line 4: BH Big Sky Medical Center (BSMC) primarily serves a three zip code region in Gallatin County Montana: 59716 Big Sky, 59730 Gallatin Gateway, and 59758 West Yellowstone (note in certain zip code boundary definitions, 59716 Big Sky is in both Gallatin and Madison County-although the most populous area is in Gallatin County). These 3 communities account for more than 74% of clinic visits at BSMC Big Sky Clinic in 2018. In addition, these same communities account for 24.2% of BSMC's inpatient admissions while 75.8% were of patients originating outside Montana-likely driven by the Big Sky area being a popular tourist destination.The population of the tri-zip code area was an estimated 6,523 (59716: 2,208, 59730: 2,065, and 59758: 2,250) in 2018 (IBM Watson Health). The average median household income (weighted by number of households) in the combined communities was an estimated $59,770 and 12.5% of the population was estimated to be in poverty in 2017 (ACS 5yr estimates, 2017). 2018 estimates suggest that 12.7% of the population in the tri-zip code area are covered by Medicaid, 6.6% are uninsured, and 15.5% are insured under Medicare (IBM Watson Health, 2018). Bozeman Health Big Sky Medical Center is the only hospital in the BSMC three zip code service area, and is one of two hospitals in Gallatin County (BH BSMC and BH Deaconess Hospital). The low income population within Gallatin County is designated as a Primary Care HPSA and the total geographic population of Gallatin County is designated as a Mental Health Professional Shortage (HPSA) Geographic Area HPSA based on 2019 HPSA data.(https://dphhs.mt.gov/publichealth/primarycare/-shortage-area-designations) Part VI, Line 5: The governing body of Bozeman Health is comprised of individuals who represent our community and live in our service area; a majority of whom are independent of the organization. To ensure immediate access to care, we have an open medical staff and require each medical staff member to care for anyone presenting in the Emergency Department. As an organization, we devote a significant amount of funds into maintaining and advancing high-level, innovative, and responsive patient care. This includes recent investments in expanding integrated behavioral health, access to telepsychiatry, and embedding crisis response in our facility. We also use surplus funds, among other ways, to award multiyear scholarships to college students studying health professions, support medical and nursing students at our facility, and provide community health improvement grants to local organizations who are working in alignment with our community benefit priority area. Part VI, Line 6: Bozeman Deaconess Health Services owned a majority interest in Deaconess Intercity Imaging, LLC and Rocky Mountain Surgery Center in the current tax year. Although these joint ventures are not licensed hospitals, these organizations hold similar policies regarding providing care to all members of the community and offering financial assistance as determined by ability to pay. 1 Montana Immigrant Justice Alliance PO Box 4803 Bozeman MT 59772 263644922 501(c)(3) 7500 0 Improve access to healthcare services for our Latinx community members Greater Gallatin United Way 945 Technology Blvd 101F Bozeman MT 59718 810384820 501(c)(3) 25000 0 Support human service needs within our service area MT State University Anna P Sherrick Hall RM 210 Bozeman MT 59717 816010045 501(c)(3) 7500 0 Support improving access to Health Services in our service area Gallatin Valley Farm to School PO Box 563 Bozeman MT 59771 453528080 501(c)(3) 8000 0 Support healthy lifestyles in our service area Thrive PO Box 4325 Bozeman MT 59772 363501185 501(c)(3) 10000 0 Support human service needs within our service area 5 0 Scholarships 14 14000 Part I, Line 2: Recipients of grants and assistance prepare informational reports substantiating the use of the funds that were earmarked to support community health programs. Involvement of Bozeman Deaconess Health Services staff and/or administration as volunteers in the activities being supported also ensures proper usage of funds. Scholarships provided are paid directly to the institute on behalf of the recipient. X X X 1 1 0 0 0 0 0 0 0 John Hill CEO 638277 0 168558 0 15779 0 130076 0 22941 0 975631 0 0 0 Dane Sobek Director/Cardiologist 694087 0 53250 0 828 0 17400 0 25828 0 791393 0 0 0 Nathaniel Madsen Cardiology 667549 0 53250 0 540 0 17400 0 25817 0 764556 0 0 0 Peter Walsh Gastroenterologist 511678 0 134532 0 2376 0 17400 0 27728 0 693714 0 0 0 Kathryn Bertany President of Hospitals 541715 0 60154 0 3130 0 59900 0 21524 0 686423 0 0 0 Justin Thomas Oncologist 471099 0 152274 0 360 0 17400 0 29904 0 671037 0 0 0 Mark Williams Chief Physician Officer 471368 0 92252 0 8778 0 64527 0 15063 0 651988 0 0 0 Andrew Gentry Gastroenterologist 536088 0 68123 0 828 0 17400 0 27630 0 650069 0 0 0 Kleanthis Dendrinos Gastroenterologist 521373 0 69700 0 540 0 17400 0 19817 0 628830 0 0 0 Brad Ludford CFO 343844 0 68145 0 4242 0 48731 0 27668 0 492630 0 0 0 Darci Bentson CAO 343886 0 62529 0 3162 0 50313 0 28018 0 487908 0 0 0 Tamara Havenhill-Jacobs Chief Information Officer 289445 0 54122 0 3162 0 40749 0 25223 0 412701 0 0 0 Edie Willey Chief People Officer 224739 0 47765 0 2708 0 34481 0 18058 0 327751 0 0 0 Diane Patterson Chief Nursing Officer 245458 0 15000 0 15716 0 20629 0 21517 0 318320 0 0 0 Elizabeth Lewis Former Key Employee COO 0 0 0 0 285648 0 0 0 0 0 285648 0 220027 0 Gordon Davidson Former Officer CFO 0 0 0 0 236459 0 0 0 0 0 236459 0 236459 0 Part I, Lines 4a-b Line 4a: In 2021, Elizabeth Lewis received severance payments in the amount of $65,621. Part II, column (F) also reports a deferred compensation stock option payouts of $236,459 for Gordon Davidson and $220,027 for Elizabeth Lewis that were previously reported as deferred compensation. Line 4b: Schedule J, Part II, column (c) reflects contributions paid by the organization into their individual 457(f) plan. The following contributions were made in 2021. John Hill: $84,586 Brad Ludford: $31,331 Darci Bentson: $32,913 Kathryn Bertany: $42,500 Mark Williams: $47,127 Diane Patterson: $20,629 Tamara Havenhill-Jacobs: $23,349 Edie Willey: $17,081 A Montana Facility Finance Authority 364615155 61240MBM8 2014-11-05 23005852 Refinance 2004 bond issued 3/4/2004; fund add'n of Big Sky Medical Facility 0 0 0 A 2140885 23008884 3032 377976 17500000 5127876 2015 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 Date Rebate Computation Performed Issuer Name: Montana Facility Finance Authority Date the Rebate Computation was Performed: 06/21/2019 Schedule K, Part I, Line A(e): Part I issue price and Part II Line 3 bond proceeds differ due to interest earned on the proceeds. Form 990, Part VI, Section A, line 7a The Yellowstone Conference of the Methodist Church confirms the Board Members and has authority to appoint the clergy member of the board. Form 990, Part VI, Section A, line 7b Changing the Articles of Incorporation in relationship to the process of selecting board membership must be approved by the Yellowstone Conference of the United Methodist Church. Form 990, Part VI, Section A, line 8b The organization does not have any committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Planning and Finance Committee will review the Form 990 with the Finance Team and will make a recommendation to the full Board for acceptance. A copy of the 990 is provided to the Board of Directors prior to filing. Form 990, Part VI, Section B, line 12c An annual Disclosure Statement is obtained from the Board, Operating Committee, and Executive Team Members. Disclosures are reviewed with the Conflict of Interest (COI) Panel (Compliance Officer, Board Compliance Committee Chair, Chief Executive Officer, & Chief Legal Officer). The COI Panel assesses the disclosure, develops an acknowledgement and management plan. The management plan is reviewed with the affected member, if the COI Panel and the member are unable to resolve the disclosure, the disclosure is reported to the Board Compliance Committee for further review. Conflicts are addressed annually in writing and verbally during meetings. If a COI exists, the member shall not participate in any deliberations or vote regarding the transaction or arrangement at issue, and shall not be present in the meeting room for any part of the deliberations or vote relating to the transaction or arrangement. Form 990, Part VI, Section B, line 15 The Executive Compensation Committee receives a formal presentation by an independent compensation consultant (as selected by the Board) qualified to perform compensation reviews including usage of comparability data. This person presents recommendations to the Compensation Committee of the Board. The Compensation Committee makes recommendations to the full Board on an annual basis for Officers and Senior Administration. This annual process was performed in fall 2020 to determine 2021 compensation. Form 990, Part VI, Section C, line 19 Tax documents required to be available for public inspection are available upon request. The audited financial statements are required to be attached to the Form 990 and provided to the Municipal Securities Rulemaking Board, which is our tax-exempt bonds trustee, via an on-line, central filing location called Electronic Municipal Market Access (EMMA). The financial statements can be obtained by the general public at the EMMA website. Form 990, Part IX, line 11g Other Fees: Program service expenses 1,634,713. Management and general expenses 13,465,710. Fundraising expenses 0. Total expenses 15,100,423. Form 990, Part XI, line 9: Change in Temp Restricted Investment of Foundation 173,534. Big Sky Medical Center LLC 334 Town Center Ave Big Sky MT 59716 474718253 Healthcare - Inpatient and Outpatient Servcies MT 13652604 29595583 Bozeman Deaconess Health Services Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 822848277 Healthcare-Ambulatory Clinic Outpatient Care MT 648444 1188919 Bozeman Deaconess Health Services Bozeman Health Urgent Cares LLC 1006 W Main Bozeman MT 59715 465318746 Healthcare - Physician Outpatient Care MT 6302810 11775157 Bozeman Deaconess Health Services Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 475126599 Physician Employment & Contract to Bozeman Health System MT 62601587 6878927 Bozeman Deaconess Health Services Bozeman Deaconess Foundation dba Bozeman Health Foundation 931 Highland Blvd Suite 3200 Bozeman MT 59715 841407943 Raise funds to support Bozeman Deaconess Health Services MT 501(c)(3) Line 7 Bozeman Deaconess Health Services 1 Bozeman Health Deaconess Hospital 915 Highland Blvd Bozeman MT 59715 474717998 Healthcare - Inpatient and Outpatient Services MT 501(c)(3) Line 3 Bozeman Deaconess Health Services 1 Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 810666871 Healthcare - Imaging Services MT Bozeman Deaconess Health Services Related 799737 4506741 0 1 0.77500 Rocky Mountain Surgical Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 364462300 Healthcare - Surgical Services MT Bozeman Deaconess Health Services Related 3293059 3757250 0 0 0.51010 Spanish Peaks Plaza LLC 120 N 19th Ave Suite A Bozeman MT 59718 810539803 Rental Real Estate for VA Med Clinic & Chiro MT Bozeman Deaconess Health Services Related 5332 272467 0 1 0.69940 Bozeman HealthUSP Surgery Centers LLC 14201 Dallas Parkway Dallas TX 75254 823991148 Ambulatory Surgery Center TX Bozeman Deaconess Health Services Related -1522474 -612522 0 0 0.50100 Bozeman Deaconess Real Estate Development Corp PO Box 10490 Bozeman MT 59719 205496567 Sale of real estate property and residences to seniors MT Bozeman Deaconess Health Services C 4670404 -18928 1.00000 1 0 0 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 1 Bozeman Deaconess Foundation L 112351 General ledger and corp. records Bozeman Health Deaconess Hospital L 123546950 General ledger and corp. records Deaconess Intercity Imaging LLC S 775000 General ledger and corp. records Bozeman Deaconess Foundation C 690773 General ledger and corp. records Bozeman Deaconess Foundation Q 74180 General ledger and corp. records Rocky Mountain Surgical Center LLC S 3583746 General ledger and corp. records Bozeman Deaconess Foundation M 162961 General ledger and corp. records