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HOT SPRINGS COUNTY HOSPITAL DIST: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
HOT SPRINGS COUNTY HOSPITAL DIST (EIN 83-6000182)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-05
IRS object ID
202101259349300935
Schema version
2019v5.0
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)
Return2021-05-05T09:35:44-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN830332861PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KOERWITZ MICHEL WRIGHT & ASSOC PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1362AddressLine1Txt
CityTHERMOPOLISCityNm
State AbbreviationWYStateAbbreviationCd
ZIP82443ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN836000182EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOT SPRINGS COUNTY HOSPITAL DISTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHOTSBusinessNameControlTxt
Phone3078643121PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 E ARAPAHOE STREETAddressLine1Txt
CityTHERMOPOLISCityNm
State AbbreviationWYStateAbbreviationCd
ZIP82443ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSHELLY LARSONPersonNm
Person TitleCFOPersonTitleTxt
Phone3078643121PhoneNum
Signature2021-05-03SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHAEL J WRIGHTPreparerPersonNm
PTINP00488529PTIN
Phone3078643173PhoneNum
Preparation2021-05-05PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1HOT SPRINGS HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerMARGIE MOLITOR SEE STATEMENT 1PrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 E ARAPAHOE STAddressLine1Txt
CityTHERMOPOLISCityNm
State AbbreviationWYStateAbbreviationCd
ZIP82443ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$27,646,108GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HSCMH.ORGWebsiteAddressTxt
Type Of Organization OtherYes (X)TypeOfOrganizationOtherInd
Other Organization DscHOSP. DIST.OtherOrganizationDsc
Formation1944FormationYr
Legal Domicile StateWYLegalDomicileStateCd
Activity Or MissionPARTNERING WITH OUR COMMUNITY FOR QUALITY HEALTH AND HEALING.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee192TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$447,508PYContributionsGrantsAmt
CY Contributions Grants$177,018CYContributionsGrantsAmt
PY Program Service Revenue$24,020,554PYProgramServiceRevenueAmt
CY Program Service Revenue$24,773,492CYProgramServiceRevenueAmt
PY Investment Income$11,829PYInvestmentIncomeAmt
CY Investment Income-$17,647CYInvestmentIncomeAmt
PY Other Revenue$1,551,556PYOtherRevenueAmt
CY Other Revenue$2,636,106CYOtherRevenueAmt
PY Total Revenue$26,031,447PYTotalRevenueAmt
CY Total Revenue$27,568,969CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$12,090,072PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,068,028CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$11,604,401PYOtherExpensesAmt
CY Other Expenses$13,088,812CYOtherExpensesAmt
PY Total Expenses$23,694,473PYTotalExpensesAmt
CY Total Expenses$26,156,840CYTotalExpensesAmt
PY Revenues Less Expenses$2,336,974PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,412,129CYRevenuesLessExpensesAmt
Total Assets BOY$21,266,966TotalAssetsBOYAmt
Total Assets EOY$49,255,545TotalAssetsEOYAmt
Total Liabilities BOY$8,721,987TotalLiabilitiesBOYAmt
Total Liabilities EOY$35,298,437TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$12,544,979NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$13,957,108NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionPARTNERING WITH OUR COMMUNITY FOR QUALITY HEALTH AND HEALING.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangeYes (true)SignificantChangeInd
Expense$22,584,880ExpenseAmt
DescHOT SPRINGS COUNTY MEMORIAL HOSPITAL, A NOT FOR PROFIT, COMMUNITY HOSPITAL, PROVIDES COMPASSIONATE MEDICAL CARE FOR ALL, REGARDLESS OF THEIR ABILITY TO PAY. HSCMH OFFERS 24/7 EMERGENCY CARE (1,924 VISITS), INPATIENT SERVICES (1,446 PATIENT DAYS), OUTPATIENT SERVICES (13,316 VISITS), BIG HORN CLINIC RURAL HEALTH CLINIC (3,717 VISITS), RED ROCK WORLAND (1976 VISITS), HSCH SURGICAL CLINIC (431 VISITS), RED ROCK FAMILY PRACTICE RIVERTON (0 VISITS), AND RED ROCK FAMILY PRACTICE CLINIC THERMOPOLIS(12,488 VISITS). THE HOSPITAL HAS A FINANCIAL ASSISTANCE PROGRAM UNDER WHICH SERVICES ARE PROVIDED FOR FREE OR AT A REDUCED RATE. CHARITY CARE AWARDED UNDER THE FINANCIAL ASSISTANCE PROGRAM TOTALED 318,649. THE COST OF CHARITY CARE FOR THE YEAR ENDED JUNE 30, 2020 BASED ON DIRECT AND INDIRECT COST OF PROVIDING CHARITY CARE SERVICES WAS 193,806. MANY EMPLOYEES ARE TEACHERS IN THE EDUCATION PROGRAMS OPEN TO THE PUBLIC SUCH AS CERTIFIED NURSING ASSISTANT AND CARDIOPULMONARY RESUSCITATION. AN AGREEMENT WITH THE UNIVERSITY OF WYOMING, CENTRAL WYOMING COLLEGE AND NORTHWESTERN WYOMING COLLEGE ENCOURAGES NURSING, PHARMACY, AND SOCIAL SERVICES STUDENTS TO INTERN AT HSCMH. HEALTH INFORMATION LINKS ARE AVAILABLE ON THE HSCMH WEBSITE. COMFORT CARTS AND FREE MEALS ARE AVAILABLE FOR FAMILIES DURING STRESSFUL CONDITIONS. BIG HORN CLINIC, RED ROCK FAMILY PRACTICE THERMOPOLIS AND RED ROCK FAMILY PRACTICE WORLAND CLINIC PROVIDES REDUCED OR FREE EXAMS FOR SCHOOL ATHLETICS, MEDICINE ASSISTANCE, BLOOD PRESSURE SCREENING AND COMMUNITY EDUCATION SEMINARS. HSCMH OFFERS SCHOLARSHIPS TO QUALIFYING CANDIDATES WANTING TO ADVANCE THEIR EDUCATION TO THE BETTERMENT OF THE HOSPITAL AND COMMUNITY. COMMUNITY RESOURCE TRAINING FOR HIGH SCHOOL STUDENTS AND WWAMI (WASHINGTON, WYOMING, ALASKA MONTANA, IDAHO)MEDICAL EDUCATION PROGRAM, WHICH PROMOTES MEDICAL EDUCATION IN WESTERN STATES, ARE TWO LONG-TIME PROGRAMS IN WHICH HSCMH PARTICIPATES.Desc
Total Program Service Expenses$22,584,880TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
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 InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
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 OutstandingYes (true)LoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document88IRPDocumentCnt
IRP Document W2 G88IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee192EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
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 Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
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)
PersonSHELLY LARSONPersonNm
Phone3078643121PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 E ARAPAHOE STAddressLine1Txt
CityTHERMOPOLISCityNm
State AbbreviationWYStateAbbreviationCd
ZIP824432402ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
JASON WEYER
PHYSICIAN40.00Yes (X)$459,192$0$11,200
WADE BOMENGEN
PHYSICIAN40.00Yes (X)$455,645$0$11,200
MATHEY MATTSON
PHYSICIAN40.00Yes (X)$387,486$0$11,200
HALLIE BISCHOFF
PHYSICIAN40.00Yes (X)$353,097$0$11,200
SUSAN BRIGHT
PHYSICIAN40.00Yes (X)$272,673$0$6,689
SHELLY LARSON
CFO40.00$125,382$0$5,779Yes (X)
DAN HERDT
SEC/TREAS2.00$0$0$0Yes (X)Yes (X)
MELISSA JOHNSON
DIRECTOR2.00$0$0$0Yes (X)
DAVID KOERWITZ
DIRECTOR2.00$0$0$0Yes (X)
HEATH OVERFIELD
VICE CHAIRMA2.00$0$0$0Yes (X)Yes (X)
BILL WILLIAMS
CHAIRMAN2.00$0$0$0Yes (X)Yes (X)
MARGIE MOLITOR SEE STATEMENT 1
CEO40.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,053,475TotalReportableCompFromOrgAmt
Total Other Compensation$57,268TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
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
SLETTEN CONSTRUCTION
1020 N 27TH ST SUITE 3BILLINGSMT59101CONSTRUCTION$9,354,848
HOLISTIC PAIN MANAGEMENT RYAN SHEDD
PO BOX 1476LOVELANDCO80539AGENCY STAFF$736,560
HEALTHTECH MGT SER (SEE STATEMENT 3)
5110 MARYLAND WAY STE 2BRENTWOODTN37027MNGMT/CONTRACT$686,525
MORTIMORE AMBULANCE
620 ARAPAHOE STTHERMOPOLISWY82443AMBULANCE SRVS$316,980
BILLINGS CLINIC
1020 N 27TH STBILLINGSMT59101IT MAIN/LAB SVC$297,936
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
All Other Contributions$177,018AllOtherContributionsAmt
Total Contributions$177,018TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE$24,008,380$24,008,380
OTHER OPERATING REVENUE$765,112$765,112
FieldValueIRS element (for citing)
Total Program Service Revenue$24,773,492TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,671TotalRevenueColumnAmt
Related Or Exempt Func Income$34,671RelatedOrExemptFuncIncomeAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$16,270RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$2,295RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$13,975RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,975TotalRevenueColumnAmt
Related Or Exempt Func Income$13,975RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$22,526OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$74,844OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$52,318OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$52,318TotalRevenueColumnAmt
Related Or Exempt Func Income-$52,318RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
SPECIAL PURPOSE TAX$1,144,552$1,144,552
INSURANCE PROCEEDS$957,515$957,515
PROPERTY TAX$520,064$520,064
FieldValueIRS element (for citing)
Other Revenue Total$2,622,131OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$27,568,969TotalRevenueColumnAmt
Related Or Exempt Func Income$27,391,951RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,690,760TotalAmt
Program Services$9,830,462ProgramServicesAmt
Management And General$860,298ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$258,970TotalAmt
Program Services$238,252ProgramServicesAmt
Management And General$20,718ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,279,026TotalAmt
Program Services$1,176,704ProgramServicesAmt
Management And General$102,322ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$839,272TotalAmt
Program Services$772,130ProgramServicesAmt
Management And General$67,142ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$639,156TotalAmt
Management And General$639,156ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$129,121TotalAmt
Management And General$129,121ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$41,750TotalAmt
Management And General$41,750ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,952,618TotalAmt
Program Services$3,665,663ProgramServicesAmt
Management And General$286,955ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,186,633TotalAmt
Program Services$4,053,795ProgramServicesAmt
Management And General$132,838ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,011,236TotalAmt
Program Services$1,005,983ProgramServicesAmt
Management And General$5,253ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$128,975TotalAmt
Program Services$118,495ProgramServicesAmt
Management And General$10,480ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$125,020TotalAmt
Program Services$125,020ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,360,516TotalAmt
Program Services$1,156,439ProgramServicesAmt
Management And General$204,077ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$145,893TotalAmt
Program Services$145,893ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
IMPAIRMENT LOSS$957,515$957,515
DUES & SUBSCRIPTIONS$298,301$91,647$206,654
RECRUITMENT$92,761$22,438$70,323
LICENSE FEES$19,317$250$19,067

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$26,156,840TotalAmt
Program Services$22,584,880ProgramServicesAmt
Management And General$3,571,960ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,294,770BOYAmt
EOY$7,629,742EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,533,348BOYAmt
EOY$9,860,616EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,355,271BOYAmt
EOY$5,391,199EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$11,215BOYAmt
EOY$3,958EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$740,239BOYAmt
EOY$877,058EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$180,212BOYAmt
EOY$215,552EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$39,233,678LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$14,656,978LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$9,561,331BOYAmt
EOY$24,576,700EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$590,580BOYAmt
EOY$700,720EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$21,266,966BOYAmt
EOY$49,255,545EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,035,524BOYAmt
EOY$4,270,640EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$9,339BOYAmt
EOY$4,319,062EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,677,124BOYAmt
EOY$26,708,735EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,721,987BOYAmt
EOY$35,298,437EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,032,628BOYAmt
EOY$4,096,492EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,512,351BOYAmt
EOY$9,860,616EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,544,979BOYAmt
EOY$13,957,108EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$21,266,966BOYAmt
EOY$49,255,545EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,412,129ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
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 D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$614,079OtherCostOrOtherBasisAmt
Book Value$614,079BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$17,955,144OtherCostOrOtherBasisAmt
Depreciation$6,154,452DepreciationAmt
Book Value$11,800,692BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,664,455OtherCostOrOtherBasisAmt
Depreciation$8,502,526DepreciationAmt
Book Value$12,161,929BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$24,576,700TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLONG TERM NOTES PAYABLEDesc
Amt$26,708,735Amt
FieldValueIRS element (for citing)
Total Liability$26,708,735TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$27,568,969TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$27,568,969RevenueSubtotalAmt
Total Revenue Per Form990$27,568,969TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$26,156,840TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$26,156,840ExpensesSubtotalAmt
Total Expenses Per Form990$26,156,840TotalExpensesPerForm990Amt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
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$200,640TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$200,640NetCommunityBenefitExpnsAmt
Total Expense0.00770TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,722,683TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,140,025DirectOffsettingRevenueAmt
Net Community Benefit Expns$582,658NetCommunityBenefitExpnsAmt
Total Expense0.02230TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,923,323TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,140,025DirectOffsettingRevenueAmt
Net Community Benefit Expns$783,298NetCommunityBenefitExpnsAmt
Total Expense0.02990TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$193,065TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$55,663DirectOffsettingRevenueAmt
Net Community Benefit Expns$137,402NetCommunityBenefitExpnsAmt
Total Expense0.00530TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,592,123TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,051,105DirectOffsettingRevenueAmt
Net Community Benefit Expns$541,018NetCommunityBenefitExpnsAmt
Total Expense0.02070TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,785,188TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,106,768DirectOffsettingRevenueAmt
Net Community Benefit Expns$678,420NetCommunityBenefitExpnsAmt
Total Expense0.02590TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,708,511TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,246,793DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,461,718NetCommunityBenefitExpnsAmt
Total Expense0.05590TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$1,289,819BadDebtExpenseAmt
Bad Debt Expense Attributable$386,946BadDebtExpenseAttributableAmt
Reimbursed By Medicare$11,340,600ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$11,208,853CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$131,747MedicareSurplusOrShortfallAmt
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line1HEALTHTECH MGMT SRVBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesMANAGEMENTPrimaryActivitiesTxt
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOT SPRINGS COUNTY HOSPITAL DISTRICBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 E ARAPAHOEAddressLine1Txt
CityTHERMOPOLISCityNm
State AbbreviationWYStateAbbreviationCd
ZIP82443ZIPCd
FieldValueIRS element (for citing)
Critical Access HospitalYes (X)CriticalAccessHospitalInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1HOT SPRINGS COUNTY HOSPITAL DISTRICBusinessNameLine1Txt
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 Conducted19CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.HSCMH.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt20ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLWWW.HSCMH.ORG & WWW.HOTSPRINGSHEALTH.CStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.HSCMH.ORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.HSCMH.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.HSCMH.ORGFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (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
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 3ETHE COMMUNITY OF HOT SPRINGS COUNTY HAS SIGNIFICANT HEALTH NEEDS. THE CHNA SELLECTED BEHAVIORAL HEALTH SERVICES POVERTY AND OPIOIDS AS PRIORITIES TO BE ADDRESSED.
FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 5PART V FACILITY INFORMATION FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRICT-PART V, LINE 5 THE COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE IS COMPRISED OF THE HOSPITAL REPRESENTATIVES, MARGIE MOLITOR, RN, CHIEF EXECUTIVE OFFICER, NINA LANDIS, RN, CHIEF NURSING OFFICER, MIRANDA NELSON, BSW SOCIAL WORKER; HOT SPRINGS COUNTY PUBLIC HEALTH, TRICIA MCPHIE, RN, PUBLIC HEALTH OFFICER AND HOT SPRINGS COUNTY COMMUNITY PREVENTION PROGRAM, JENNIFER CHENEY, COORDINATOR. IN ADDITION, THE FOLLOWING MEMBERS OF THE HOT SPRINGS COUNTY PREVENTION COALITION MEMBERS PROVIDED INPUT FOR THE DEVELOPMENT OF THE COMMUNITY HEALTH NEEDS ASSESSEMENT. THE MEMBERS INCLUDED, TRICIA MCPHIE, RN, PUBLIC HEALTH OFFICER, JENNIFER CHENEY, COORDINATOR, HOT SPRINGS COUNTY COMMUNITY PREVENTION PROGRAM; KATIE HILMER, WELLSPRING COUNSELING; CURTIS CHENEY, ASSISTANT COUNTY ATTORNEY; MARY ANN RUSH, EXECUTIVE DIRECTOR THERMOPOLIS CHAMBER OF COMMERCE; RANAE BALDES, HOT SPRINGS COUNTY VICTIM WITNESS PROGRAM; SHARON SKIVER WYOMING PIONEER HOME ADMINISTRATOR; MARY GORDON, PUBLIC HEALTH RESPONSE COORDINATOR; SHERIFF JERIMIE KRAUSHAAR, HOT SPRINGS COUNTY SHERIFF DEPARTMENT; CATHERINE CRUMPLER, WISDOM TREE COUNSELING; ALLAN BRAATEN, EXECUTIVE DIRECTOR WELLSPRING COUNSELING SERVICES, DAISY TORRES, EXECUTIVE DIRECTOR, HOPE AGENCY; BETH LEWIS, EXECUTIVE DIRECTOR, CHILDRENS RESOURCE CENTER EXECUTIVE DIRECTOR, PENNY HERDT, ADMINISTRATIVE ASSISTANT HOT SPRINGS COUNTY COMMISSIONERS, BARB RICE, HOT SPRINGS COUNTY YOUTH ALTERNATIVES; PENNIE ANDERSON, SUPERVISOR, DEPARTMENT OF FAMILY SERVICES; ELISA DANIELS, HOT SPRINGS COUNTY SCHOOL DISTRICT COUNSELOR, AND JILL VAN HULE, HEAD START. FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRICT-PART V, LINE 6B. REFER TO FACILITY 1-PART V, LINE 5, SEE ABOVE.
FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 11THE COMMUNITY HEALTH NEEDS WERE PRIORITIZED BASED ON THE FOLLOWING FIVE CRITERIA: 1.MAGNITUDE/SCALE OF THE PROBLEM 2.SEVERITY OF THE PROBLEM 3.HEALTH DISPARITIES 4.IMPORTANCE TO THE COMMUNITY 5.ABILITY TO LEVERAGE THE THREE PRIORITY COMMUNITY HEALTH NEEDS CHOSEN WERE BEHAVIORAL HEALTH, POVERTY AND OPIODS. THE GOAL FOR BEHAVIORAL HEALTH IS TO HAVE MORE ACCESS TO BEHAVIORAL HEALTH SERVICES. POVERTY GOALS INCLUDED DECREASING PROVERTY AND INCREASING SERVICES. THE OPIOD GOALS INCLUDE REDUCTION IN USE AND EDUCATION. THE COMMUNITY PARTNERS FOR THESE THREE INITIATIVES INCLUDE HOT SPRINGS COUNTY PREVENTION COALITION, HOT SPRINGS COUNTY SCHOOL DISTRICT 1, WELLSPRING COUNSELING CENTER, LAW ENFORCEMENT, COUNTY ATTORNEY'S OFFICE, HOPE AGENCY WISDOM TREE COUNSELING, YOUTH ALTERNATIVES PROGRAM, HELP CENTER, YELLOWSTONE COMMUNITY ASSISTANCE NETWORK, DEPARTMENT OF FAMILY SERVICES, HOT SPRINGS COUNTY PUBLIC HEALTH, MINISTERIAL ALLIANCE, RIVER OF LIFE FELLOWSHIP, HOT SPRINGS COUNTY SENIOR CENTER, MESSIAH'S MALL.

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3CTHE FACILITIES CRITERIA FOR ELIGIBLITY FOR FREE OR DISCOUNTED CARE IS BASED ON THE FEDERAL PROVERTY GUIDELINES, FAMILY SIZE, AND THE PATIENT'S EQUITY RESOURCES (ASSETS LESS MEDICAL DEBT). IN ADDITION, THE PATIENT AND FAMILY MEMBERS MUST RECEIVE A DENIAL FROM MEDICAID OR OTHER PUBLIC ASSISTANCE PROGRAMS. EXTENUATING CIRCUMSTANCES (DEATH, ACTS OF NATURE, ETC.) ARE CONSIDERED IN DETERMINING ELIGIBILTY FOR FINANCIAL ASSISTANCE.
SCHEDULE H, PART I, LINE 7GTHE SUBSIDIZED HEALTH SERVICES WERE CALCULATED FOR SERVICES PROVIDED TO PATIENTS WHO ARE TREATED IN THE FACILITIES EMERGENCY ROOM. THIS DOES NOT INCLUDE ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC.
SCHEDULE H, PART III, LINE 2ACCOUNTS DEEMED TO BE UNCOLLECTIBLE ARE WRITTEN OFF AS ALLOWED BY THE LAWS AND REGULATIONS OF THE STATE OF WYOMING. ACCOUNTS WRITTEN OFF HAVE BEEN FULLY PROVIDED FOR IN THE ALLOWANCE FOR BAD DEBTS. THE FACILITIES ESTIMATE OF BAD DEBT WHICH WOULD QUALIFY FOR FINANCIAL ASSISTANCE IS BASED ON THE STANDARD INDUSTRY BENCHMARK AND THE REVIEW OF BAD DEBT ACCOUNTS AT THE TIME OF WRITE-OFF. NO COMMUNITY BENEFIT IS CLAIMED FOR ANY PORTION OF THE BAD DEBT. PART III, LINE 3 BAD DEBT EXPENSE METHODOLOGY SEE ABOVE, SAME METHODOLOGY FOR PART III, LINE 2
SCHEDULE H, PART III, LINE 4TEXT OF FINANCIAL STATEMENT FOOTNOTE (SEE PAGE 25, NOTE 3 OF THE AUDITED FINANCIALS). ACCOUNTS DEEMED TO BE UNCOLLECTIBLE ARE WRITTEN OFF AS ALLOWED BY THE LEGISLATION OF THE STATE OF WYOMING. ACCOUNTS WRITTEN OFF HAVE BEEN FULLY PROVIDED FOR IN THE PROVISION FOR BAD DEBT.
SCHEDULE H, PART III, LINE 8THE HOSPITAL IS LICENSED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AS A CRITICAL ACCESS HOSPITAL. AS A CRITICAL ACCESS HOSPITAL IT IS REIMBURSED ON 101% OF COSTS LESS THE 2% SEQUESTRATION ADJUSTMENT. THE HOSPTITAL UTILIZED THE ANNUAL COST REPORT FOR FISCAL YEAR JUNE 30, 2020 WHICH IT IS REQUIRED TO SUBMIT TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AS THE SOURCE TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE IN CONNECTION WITH THE REVENUE RECEIVED FROM MEDICARE.
SCHEDULE H, PART III, LINE 9BTHE HOSPITAL MAKES EVERY EFFORT TO COMPLETE A FINANCIAL EVALUATION AT THE EARLIST POSSIBLE POINT IN THE REVENUE CYCLE FOR ALL PATIENTS INDICATING AN INABILITY TO MEET THEIR FINANCIAL OBLIGATIONS. A FINANCIAL ASSISTANCE PROGRAM APPLICATION IS COMPLETED ONCE ALL OTHER OPTIONS FOR REIMBURSEMENTS HAVE BEEN EXHAUSTED.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
JASON WEYER
PHYSICIAN$459,192$11,200$459,192$11,200
WADE BOMENGEN
PHYSICIAN$455,645$11,200$455,645$11,200
MATHEY MATTSON
PHYSICIAN$387,486$11,200$387,486$11,200
HALLIE BISCHOFF
PHYSICIAN$353,097$11,200$353,097$11,200
SUSAN BRIGHT
PHYSICIAN$272,673$6,689$272,673$6,689

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

FieldValueIRS element (for citing)
PersonDR BISCHOFFPersonNm
Relationship With OrgEMPLOYEERelationshipWithOrgTxt
Loan PurposeRECRUITMENTLoanPurposeTxt
Loan From OrganizationYes (X)LoanFromOrganizationInd
Original Principal$25,000OriginalPrincipalAmt
Balance Due$3,958BalanceDueAmt
DefaultfalseDefaultInd
Board Or Committee ApprovalYes (true)BoardOrCommitteeApprovalInd
Written AgreementYes (true)WrittenAgreementInd
FieldValueIRS element (for citing)
Total Balance Due$3,958TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 2, PART III, LINE 3DURING THE YEAR ENDED JUNE 30, 2020 THE HOSPITAL PURCHASED OR STARTED ADDITIONAL CLINICS OR PRACTICES AS FOLLOWS: ON JANUARY 1, 2020, THE HOSPITAL ACQUIRED CERTAIN ASSETS AND THE OPERATIONS OF A GENERAL SURGERY PHYSICIAN PRACTICE, HOT SPRINGS HEALTH SURGICAL CLINIC , HEREAFTER "SURGICAL CLINIC", LOCATED IN THERMOPOLIS, WYOMING. THE PURCHASED ASSETS, LIABILITIES, AND THE OPERATIONS OF THE SURGICAL CLINIC WERE TRANSFERRED TO THE HOSPITAL AND BECAME A DEPARTMENT OF THE HOSPITAL. AT THE TIME OF THE PURCHASE, THE SURGICAL CLINIC EMPLOYED 3 FULL TIME AND 1 PART TIME STAFF (1 PHYSICIAN AND 4 NON-PROVIDER STAFF). THE OPERATION WAS PURCHASED AT A NET TOTAL PURCHASE PRICE OF 119,246 REPRESENTING A TOTAL NET APPRAISED VALUE OF 123,776 LESS ASSUMPTION OF LIABILITIES OF 4,529. THE NET PURCHASE PRICE WAS ALLOCATED TO: EQUIPMENT 17,400 INVENTORY 8,790 INTANGIBLE ASSETS 97,585 LESS ASSUMPTION OF LIABILITIES: - EMPLOYEE BENEFIT LIABILITIES (4,529) -------------- NET PURCHASE PRICE 119,246 ON APRIL 1, 2020, THE HOSPITAL ACQUIRED CERTAIN ASSETS AND THE OPERATIONS OF A PHYSICIAN PRACTICE, COWBOY MEDICAL GROUP DOING BUSINESS AS RED ROCK FAMILY PRACTICE-WORLAND, HEREAFTER "RRFP-WORLAND", LOCATED IN WORLAND, WYOMING. THE PURCHASED ASSETS, LIABILITIES, AND THE OPERATIONS OF RRFP- WORLAND WERE TRANSFERRED TO THE HOSPITAL AND BECAME A DEPARTMENT OF THE HOSPITAL AND A PROVIDER BASED RURAL HEALTH CLINIC. PRIOR TO THE PURCHASE OF RRFP-WORLAND, THE HOSPITAL PROVIDED ADMINISTRATIVE SERVICES THROUGH ITS LIMITED LIABILITY COMPANY, HOT SPRINGS PHYSICIAN PRACTICE MANAGEMENT, LLCA (SEE DISCUSSION BELOW). THE MANAGEMENT AND ADMINISTRATIVE SERVICE AGREEMENT WAS TERMINATED EFFECTIVE WITH THE PURCHASE OF RRFP-WORLAND. AT THE TIME OF THE PURCHASE, RRFP-WORLAND EMPLOYED 5 FULL TIME AND 8 PART TIME STAFF (2 FULL TIME ADVANCED PRACTITIONERS, 3 PART TIME PHYSICIANS AND 3 FULL TIME NON-PROVIDER STAFF AND 5 PART TIME NON-PROVIDER STAFF). THE OPERATION WAS PURCHASED AT A NET TOTAL PURCHASE PRICE OF 231,868 WHICH REPRESENTS THE TOTAL NET APPRAISED VALUE. NO LIABILITIES WERE ASSUMED. THE NET PURCHASE PRICE WAS ALLOCATED TO: ACCOUNTS RECEIVABLE 117,416 EQUIPMENT 10,106 INVENTORY 14,711 INTANGIBLE ASSETS 89,635 LESS ASSUMPTION OF LIABILITIES: - -------------- NET PURCHASE PRICE 231,868 ON JUNE 18, 2020, THE HOSPITAL OPENED A FAMILY PRACTICE CLINIC, HOT SPRINGS HEALTH-RIVERTON IN RIVERTON, WYOMING, HEREAFTER "HSH-RIVERTON". THE CLINIC OPERATES AS A DEPARTMENT OF THE HOSPITAL. HSH-RIVERTON HAS 4 PART- TIME EMPLOYEES (1 PART TIME PHYSICIAN, 1 PART TIME ADVANCED PRACTITIONER AND 2 PART TIME NON-PROVIDER STAFF).
FORM 990, PAGE 2, PART III, LINE 4AHOT SPRINGS COUNTY MEMORIAL HOSPITAL, A NOT FOR PROFIT, COMMUNITY HOSPITAL, PROVIDES COMPASSIONATE MEDICAL CARE FOR ALL, REGARDLESS OF THEIR ABILITY TO PAY. HSCMH OFFERS 24/7 EMERGENCY CARE (1,924 VISITS), INPATIENT SERVICES (1,446 PATIENT DAYS), OUTPATIENT SERVICES (13,316 VISITS), BIG HORN CLINIC RURAL HEALTH CLINIC (3,717 VISITS), RED ROCK WORLAND (1976 VISITS), HSCH SURGICAL CLINIC (431 VISITS), RED ROCK FAMILY PRACTICE RIVERTON (0 VISITS), AND RED ROCK FAMILY PRACTICE CLINIC THERMOPOLIS(12,488 VISITS). THE HOSPITAL HAS A FINANCIAL ASSISTANCE PROGRAM UNDER WHICH SERVICES ARE PROVIDED FOR FREE OR AT A REDUCED RATE. CHARITY CARE AWARDED UNDER THE FINANCIAL ASSISTANCE PROGRAM TOTALED 318,649. THE COST OF CHARITY CARE FOR THE YEAR ENDED JUNE 30, 2020 BASED ON DIRECT AND INDIRECT COST OF PROVIDING CHARITY CARE SERVICES WAS 193,806. MANY EMPLOYEES ARE TEACHERS IN THE EDUCATION PROGRAMS OPEN TO THE PUBLIC SUCH AS CERTIFIED NURSING ASSISTANT AND CARDIOPULMONARY RESUSCITATION. AN AGREEMENT WITH THE UNIVERSITY OF WYOMING, CENTRAL WYOMING COLLEGE AND NORTHWESTERN WYOMING COLLEGE ENCOURAGES NURSING, PHARMACY, AND SOCIAL SERVICES STUDENTS TO INTERN AT HSCMH. HEALTH INFORMATION LINKS ARE AVAILABLE ON THE HSCMH WEBSITE. COMFORT CARTS AND FREE MEALS ARE AVAILABLE FOR FAMILIES DURING STRESSFUL CONDITIONS. BIG HORN CLINIC, RED ROCK FAMILY PRACTICE THERMOPOLIS AND RED ROCK FAMILY PRACTICE WORLAND CLINIC PROVIDES REDUCED OR FREE EXAMS FOR SCHOOL ATHLETICS, MEDICINE ASSISTANCE, BLOOD PRESSURE SCREENING AND COMMUNITY EDUCATION SEMINARS. HSCMH OFFERS SCHOLARSHIPS TO QUALIFYING CANDIDATES WANTING TO ADVANCE THEIR EDUCATION TO THE BETTERMENT OF THE HOSPITAL AND COMMUNITY. COMMUNITY RESOURCE TRAINING FOR HIGH SCHOOL STUDENTS AND WWAMI (WASHINGTON, WYOMING, ALASKA MONTANA, IDAHO)MEDICAL EDUCATION PROGRAM, WHICH PROMOTES MEDICAL EDUCATION IN WESTERN STATES, ARE TWO LONG-TIME PROGRAMS IN WHICH HSCMH PARTICIPATES.
FORM 990, PAGE 6, PART VI, LINE 3HSCMH CONTRACTS WITH HEALTHTECH MANAGEMENT SERVICES, INC. FOR MANAGEMENT SERVICES INCLUDING THE CEO POSITION. THE CEO IS EMPLOYED BY HEALTHTECH MANAGEMENT SERVICES, INC.
FORM 990, PAGE 6, PART VI, LINE 11BTHE CURRENT FISCAL YEAR 6/30/20 FORM 990 WAS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES FOR DISCUSSION AND REVIEW. THE ENTIRE BOARD OF DIRECTORS APPROVED THE CURRENT FISCAL YEAR 6/30/20 FORM 990 AT A REGULARLY SCHEDULED BOARD MEETING.
FORM 990, PAGE 6, PART VI, LINE 12CTHE HOSPITAL HAS A FORMAL CONFLICT OF INTEREST POLICY WHICH REQUIRES EMPLOYEES TO MAKE A PROMPT WRITTEN FULL DISCLOSURE OF ANY POTENTIAL SITUATION WHICH MAY INVOLVE A CONFLICT OF INTEREST. THE POLICY PROVIDES A LIST OF POTENTIAL CONFLICTS. EMPLOYEES WHO VIOLATE THE POLICY ARE SUBJECT TO DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION. THE POLICY IS REVIEWED AT LEAST 2 TIMES A YEAR WITH EMPLOYEES; THE ANNUAL SKILLS FAIR AND THE ANNUAL EMPLOYEE EVALUATION. THE EMPLOYEE COMPLETES AND SIGNS A NEW DISCLOSURE AT THE TIME OF THEIR EVALUATION. THE HOSPITAL DOES REQUIRE GOVERNING BOARD MEMBERS, OFFICERS, MANAGERS, AND MEDICAL REPRESENTATIVES WITH ADMINISTRATIVE RESPONSIBILITY TO DISCLOSE IN WRITING ALL POTENTAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS AS WELL.
FORM 990, PAGE 6, PART VI, LINE 15ATHE ORGANIZATION'S CEO IS A LEASED-EMPLOYEE, WHO CONDUCTS THE EVALUATION AND COMPARABILITY OF SALARY DATA.
FORM 990, PAGE 6, PART VI, LINE 15BTHE ORGANIZATION COMPLETES AN ANNUAL REVIEW OF OTHER KEY EMPLOYEES AND COMPLETES A COMPARISON OF SALARIES WITH WYOMING HOSPITAL ASSOCIATION SALARY SURVEY DATA. THE ANNUAL REVIEW IS COMPLETED BY THE CEO.
FORM 990, PAGE 6, PART VI, LINE 19THE ORGANIZATION IS A GOVERNMENTAL ENTITY, ALL BOARD OF TRUSTEE MEETINGS ARE PUBLIC MEETINGS. ALL REPORTS (NOT CONSIDERED CONFIDENTIAL) ARE SUBJECT TO THE OPEN MEETING LAWS UNDER STATE OF WYOMING LAWS. IN ADDITION THESE DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION IN ACCORDANCE WITH FEDERAL AND STATE LAW.
FORM 990, PART IX, LINE 11GAMBULANCE SERVICES 309,876 0 0 COLLECTION FEES 0 246,219 0 CONSULTING FEES 142,339 0 0 CONTRACT AND PURCH SERVICES 986,357 0 0 COST REPORT 0 9,850 0 PHYSICIAN FEES 1,566,876 0 0 PUBLIC RELATIONS/ADVERTISING 0 30,886 0 STAFFING AGENCY FEES 660,215 0 0 TOTAL 3,665,663 286,955 0