CENTRAL MONTANA MEDICAL FACILITIES INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL MONTANA MEDICAL FACILITIES INC (EIN 23-7169043)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-06
- IRS object ID
- 202111269349301966
- Schema version
- 2019v5.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-06T14:17:54-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237169043 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Central Montana Medical Facilities Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 4065387711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 Wendell Avenue | AddressLine1Txt |
| City | Lewistown | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59457 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Cody Langehn | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 4065387711 | PhoneNum |
| Signature | 2021-05-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2021-05-06 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Central Montana Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Cody Langehn | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 Wendell Avenue | AddressLine1Txt |
| City | Lewistown | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59457 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $38,465,804 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.cmmc.health | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1971 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | The mission of CMMC is to be the leader in assuring community based quality healthcare. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 310 | TotalEmployeeCnt |
| Total Volunteers | 120 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,084,512 | PYContributionsGrantsAmt |
| CY Contributions Grants | $627,180 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $36,891,543 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $36,641,852 | CYProgramServiceRevenueAmt |
| PY Investment Income | $253,820 | PYInvestmentIncomeAmt |
| CY Investment Income | $270,818 | CYInvestmentIncomeAmt |
| PY Other Revenue | $600,587 | PYOtherRevenueAmt |
| CY Other Revenue | $545,997 | CYOtherRevenueAmt |
| PY Total Revenue | $38,830,462 | PYTotalRevenueAmt |
| CY Total Revenue | $38,085,847 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $20,886,396 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $23,287,930 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $119,935 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,744,678 | PYOtherExpensesAmt |
| CY Other Expenses | $18,081,915 | CYOtherExpensesAmt |
| PY Total Expenses | $36,631,074 | PYTotalExpensesAmt |
| CY Total Expenses | $41,369,845 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,199,388 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,283,998 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $32,154,222 | TotalAssetsBOYAmt |
| Total Assets EOY | $43,203,325 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,101,647 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,170,560 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,052,575 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $20,032,765 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of Central Montana Medical Center is to be the leader in assuring community based quality healthcare. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $32,101,957 | ExpenseAmt |
| Revenue | $36,641,852 | RevenueAmt |
| Desc | Central Montana Medical Facilities, Inc. operates a 25-bed critical access hospital located in Lewistown, Montana.Hospital Inpatient Services for FY 2020:Number of beds: 25Provided 1,606 acute days of care and 1,054 swing bed days of care for 29.1% occupancy rate. Emergency Services for FY 2020:Provided for 4,797 Emergency visits.24-hour Physician coverage available.OB Services for FY 2020:Provided for 86 births in Central MontanaCommunity care and services are also provided through the many reduced price services and free clinics, fairs, and programs offered throughout the year. Due to the Covid-19 Pandemic many of our services were not held to keep community members and employees safe. What we were able to complete include but are not limited to the following (all costs are estimates):1. Sixteen foot clinics were held in 2019-2020 in Denton, Stanford, and the Hobson communities. A total of 178 people were served, all received discounted health care. Total community benefits expense of $1,488.2. Due to Covid Pandemic CMMC was unable to hold our Safe Sitter Course (babysitting class).3. Instead of a Health Fair, CMMC offered lab draws during your birth month at discounted prices. A total of 260 persons participated, with expenses such as staff time and supplies were $5,564.4. CMMC served our community in a multitude of ways throughout 2019-2020 fiscal year. Staff were involved in several community boards, staff helped serve luncheons at our local Council on Aging, we did hold CPR/First Aid Classes, an impact concussion testing sessions which 107 community members took advantage of, we did hold our annual REACH Camp for 24 individuals and we held several support groups including dementia and diabetes.The facilities maintain records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy. The amount of charges foregone for services provided under the Facilities charity care policy were approximately $722,122 for the fiscal year. Total direct and indirect costs related to these foregone charges were $467,000 based on an average ratio of cost to gross charges.Awards received for FY 2020 were:* Top 100 Critical Access Hospital iVantange Health Analytics (6 years in a row)* NOSORH Performance Leadership Award (3 years in a row)* MHA PIN- Performance Improvement Network (3 years in a row)* Dr. Christina Marchion received the Dr. Frank Newman Rural Health award for Rural Health Education in Montana. | Desc |
| Total Program Service Expenses | $32,101,957 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 52 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 310 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Alan R Aldrich | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4065357711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 Wendell Ave | AddressLine1Txt |
| City | Lewistown | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59457 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| Dr Gardner Smith | |||||||
| Surgeon | 40.00 | Yes (X) | $447,998 | $0 | $20,096 | ||
| Dr Amy A LePage | |||||||
| ER Physician | 40.00 | Yes (X) | $353,035 | $0 | $20,713 | ||
| Dr Michael Sura | |||||||
| Member | 40.00 | $337,644 | $0 | $29,454 | Yes (X) | ||
| Dr Christina Marchion | |||||||
| Physician | 40.00 | Yes (X) | $320,051 | $0 | $31,431 | ||
| Dr Tamara Welsh | |||||||
| Member | 40.00 | $273,655 | $0 | $11,497 | Yes (X) | ||
| James Fox | |||||||
| CRNA | 40.00 | Yes (X) | $244,165 | $0 | $10,156 | ||
| Rene DeGuzman | |||||||
| Anesthetist | 40.00 | Yes (X) | $218,339 | $0 | $27,314 | ||
| Alan R Aldrich | |||||||
| CFO/Co-CEO | 40.00 | $213,148 | $0 | $24,263 | Yes (X) | ||
| Dr Laura Bennett | |||||||
| Co-CEO | 40.00 | $212,346 | $0 | $23,631 | Yes (X) | ||
| Karin White | |||||||
| CNO until February | 40.00 | $123,081 | $0 | $12,082 | Yes (X) | ||
| Dave Phillips - Chair until | |||||||
| Oct/Vice Chair starting Nov | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| Bret Carpenter - Member | |||||||
| until Oct/Chair starting Nov | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| Carl Seilstad | |||||||
| Vice Chair until October | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| Jennifer Saunders | |||||||
| Secretary/Treasurer | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| Josh Webber | |||||||
| Member until October | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Marvin Mauws | |||||||
| Member | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Corry Arntzen | |||||||
| Member | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Brandon Bantz | |||||||
| Member | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Keith Cook | |||||||
| Member | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Erik Wood | |||||||
| Member | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Nick Econom | |||||||
| Member | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Kim Vincent | |||||||
| Member | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Karin Durbin | |||||||
| Member | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Ashley Morris | |||||||
| Member starting October | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,743,462 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $210,637 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 24 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Billings Clinic | |||||
| PO Box 37000 | Billings | MT | 59107 | Mgmt & Radiology Med Dir Fees | $1,189,768 |
| Crist Krogh Alke & Nord PLLC | |||||
| 2708 1st Ave N Suite 300 | Billings | MT | 59457 | Legal Services | $315,000 |
| Hall Render Killian Heath & Lyman P | |||||
| 999 17th Street Suite 800 | Denver | CO | 80202 | Legal Services | $287,342 |
| Fusion Medical Staffing | |||||
| PO Box 82674 | Lincoln | NE | 685012674 | Medical Staffing | $167,652 |
| Oaas Law Firm | |||||
| 618 W Main | Lewistown | MT | 59457 | Legal Services | $145,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $532,788 | GovernmentGrantsAmt |
| All Other Contributions | $94,392 | AllOtherContributionsAmt |
| Total Contributions | $627,180 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Revenue | 621110 | $33,601,940 | $33,601,940 |
| Special Programs | 900099 | $2,024,747 | $2,024,747 |
| Pharmacy Revenue | 446110 | $879,648 | $879,648 |
| Cafeteria | 722210 | $135,517 | $135,517 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $36,641,852 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $211,146 | TotalRevenueColumnAmt |
| Exclusion | $211,146 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $643,840 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $97,843 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $545,997 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $545,997 | TotalRevenueColumnAmt |
| Exclusion | $545,997 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $341,786 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $282,114 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $59,672 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $59,672 | TotalRevenueColumnAmt |
| Exclusion | $59,672 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,085,847 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $36,641,852 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $816,815 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,317,103 | TotalAmt |
| Program Services | $835,191 | ProgramServicesAmt |
| Management And General | $481,912 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,162 | TotalAmt |
| Management And General | $94,162 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,154,011 | TotalAmt |
| Program Services | $14,458,013 | ProgramServicesAmt |
| Management And General | $3,624,310 | ManagementAndGeneralAmt |
| Fundraising | $71,688 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $430,932 | TotalAmt |
| Program Services | $285,373 | ProgramServicesAmt |
| Management And General | $145,559 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,080,253 | TotalAmt |
| Program Services | $1,693,091 | ProgramServicesAmt |
| Management And General | $376,601 | ManagementAndGeneralAmt |
| Fundraising | $10,561 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,211,469 | TotalAmt |
| Program Services | $969,175 | ProgramServicesAmt |
| Management And General | $238,335 | ManagementAndGeneralAmt |
| Fundraising | $3,959 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $300,000 | TotalAmt |
| Management And General | $300,000 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $513,670 | TotalAmt |
| Management And General | $513,670 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,785 | TotalAmt |
| Management And General | $42,785 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,363,637 | TotalAmt |
| Program Services | $2,934,186 | ProgramServicesAmt |
| Management And General | $1,429,451 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,681 | TotalAmt |
| Program Services | $88,260 | ProgramServicesAmt |
| Management And General | $1,717 | ManagementAndGeneralAmt |
| Fundraising | $27,704 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,858,564 | TotalAmt |
| Program Services | $1,830,407 | ProgramServicesAmt |
| Management And General | $1,024,026 | ManagementAndGeneralAmt |
| Fundraising | $4,131 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,137,348 | TotalAmt |
| Program Services | $903,517 | ProgramServicesAmt |
| Management And General | $232,031 | ManagementAndGeneralAmt |
| Fundraising | $1,800 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,163 | TotalAmt |
| Program Services | $93,300 | ProgramServicesAmt |
| Management And General | $33,863 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,948 | TotalAmt |
| Program Services | $112,928 | ProgramServicesAmt |
| Management And General | $73,970 | ManagementAndGeneralAmt |
| Fundraising | $50 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,829 | TotalAmt |
| Program Services | $168,209 | ProgramServicesAmt |
| Management And General | $51,620 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,517,802 | TotalAmt |
| Program Services | $1,173,575 | ProgramServicesAmt |
| Management And General | $344,227 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $604,333 | TotalAmt |
| Program Services | $604,333 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|---|
| Medical Supplies | $3,415,604 | $3,415,604 | ||
| Bad Debt Allowance | $2,045,368 | $2,045,368 | ||
| Equipment Rental and Ma | $373,048 | $373,006 | $42 | |
| Taxes and Licenses | $112,374 | $23,676 | $88,698 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,761 | TotalAmt |
| Program Services | $94,745 | ProgramServicesAmt |
| Management And General | $51,016 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,369,845 | TotalAmt |
| Program Services | $32,101,957 | ProgramServicesAmt |
| Management And General | $9,147,953 | ManagementAndGeneralAmt |
| Fundraising | $119,935 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,137,505 | BOYAmt |
| EOY | $12,998,243 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,367,797 | BOYAmt |
| EOY | $7,442,282 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $780,241 | BOYAmt |
| EOY | $700,672 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $264,546 | BOYAmt |
| EOY | $440,143 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $44,724,239 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $31,536,920 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,469,961 | BOYAmt |
| EOY | $13,187,319 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,158,582 | BOYAmt |
| EOY | $3,964,696 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,975,590 | BOYAmt |
| EOY | $4,469,970 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,154,222 | BOYAmt |
| EOY | $43,203,325 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,847,192 | BOYAmt |
| EOY | $4,672,375 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $8,339,770 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,602,829 | BOYAmt |
| EOY | $3,486,772 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,651,626 | BOYAmt |
| EOY | $2,419,272 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,772,500 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $479,871 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,101,647 | BOYAmt |
| EOY | $23,170,560 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,348,829 | BOYAmt |
| EOY | $16,862,898 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,703,746 | BOYAmt |
| EOY | $3,169,867 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,052,575 | BOYAmt |
| EOY | $20,032,765 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,154,222 | BOYAmt |
| EOY | $43,203,325 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$3,283,998 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$201,933 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $466,121 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $123,009 | OtherCostOrOtherBasisAmt |
| Book Value | $123,009 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,306,087 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,645,707 | DepreciationAmt |
| Book Value | $7,660,380 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,530,033 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,775,121 | DepreciationAmt |
| Book Value | $3,754,912 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,765,110 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,116,092 | DepreciationAmt |
| Book Value | $1,649,018 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,187,319 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Long-Term Prepaid Expenses | $647,619 |
| Due from Foundation | $3,169,867 |
| Other Receivables | $652,484 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,469,970 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Estimated Third-Party Payor Settlements | Desc |
| Amt | $479,871 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $479,871 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $35,903,793 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$201,933 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$2,045,368 | OtherRevenueAmt |
| Revenue Not Reported | -$2,247,301 | RevenueNotReportedAmt |
| Revenue Subtotal | $38,151,094 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$65,247 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$65,247 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $38,085,847 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $39,422,320 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $97,843 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $97,843 | ExpensesNotReportedAmt |
| Expenses Subtotal | $39,324,477 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,045,368 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,045,368 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $41,369,845 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | The Facilities 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 financial statements. The Facilities 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. |
| Part XI, Line 2d - Other Adjustments: | Provision for Bad Debts Reported in Expenses for Tax Purposes -2,045,368. |
| Part XI, Line 4b - Other Adjustments: | Contributions for Specific Purposes Recorded in Fund Balance for F/S 32,596. Rental Expenses Reported in Revenue for Tax Purposes -97,843. |
| Part XII, Line 2d - Other Adjustments: | Rental Expenses Reported in Revenue for Tax Purposes 97,843. |
| Part XII, Line 4b - Other Adjustments: | Provision for Bad Debts Reported in Expenses for Tax Purposes 2,045,368. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $467,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $467,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01190 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,256,526 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,514,105 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $742,421 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01890 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,723,526 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,514,105 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,209,421 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03080 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 12 | ActivitiesOrProgramsCnt |
| Persons Served | 1486 | PersonsServedCnt |
| Total Community Benefit Expns | $36,448 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,006 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $31,442 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,099,116 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,933,131 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,165,985 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 12 | ActivitiesOrProgramsCnt |
| Persons Served | 1486 | PersonsServedCnt |
| Total Community Benefit Expns | $13,135,564 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,938,137 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,197,427 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13220 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 12 | ActivitiesOrProgramsCnt |
| Persons Served | 1486 | PersonsServedCnt |
| Total Community Benefit Expns | $16,859,090 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,452,242 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,406,848 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16300 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 548 | PersonsServedCnt |
| Total Community Benefit Expns | $4,042 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,012 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 548 | PersonsServedCnt |
| Total Community Benefit Expns | $4,042 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,012 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,045,368 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,763,936 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,778,203 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$14,267 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Central Montana Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 408 Wendall Avenue | AddressLine1Txt |
| City | Lewistown | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59457 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.cmmc.health | WebsiteAddressTxt |
| State License | 12894 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Home Health / Hospice | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Central Montana Medical Facilities Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.cmmc.health/resources/reports/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.cmmc.health/resources/reports/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 3j: Secondary Data: County Profile, Demographic Trends and Economic Impacts |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 5: A Steering Committee was convened to assist Central Montana Medical Center in conducting CHSD. A diverse group of community members representing various organizations and populations within the community (ex. public health, elderly, uninsured) came together. The Steering Committee met twice during the CHSD process; first to discuss health concerns in the community and offer their perspective in designing the survey instrument and again to review results of the survey and focus groups and to assist in the prioritization of health needs to address. |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 6b: The Needs Assessment was formed by a committee. Central Montana Community Health Center in Lewiston was included as part of this. |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 7d: The Needs Assessment is available at the Foundation Office, Administration Assistant Office and at Central Montana Medical Center hospital website. |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 11: The Organization completed a new CHNA during the 6/30/19 FYE. Survey respondents identified the community's top health concerns as: Alcohol abuse/substance abuse; Cancer; Overweight/obesity.The following summary briefly represents the goals and corresponding strategies which the facility will execute to address the prioritized health needs:Goal 1: Expand access to behavioral health services at Central Montana Medical CenterStrategy 1.1: Develop a workforce and processes to support CMMC's behavioral health activities1. Have developed and continued Behavioral Health services with CMMC LCSW;2. Expanded Psychiatric outreach with Dr. Davis and Shelly Andrus3. CMMC hired a full time, onsite Psychiatric NP to start 12/1/2021.Strategy 1.2: Support local community efforts that address behavioral health needs in the CMMC service area1. With the addition of the onsite Psychiatric NP, we will be able to service our community & surrounding areas with improved and expanded accessStrategy 1.3: Ensure sustainability of collaborative care efforts at CMMC which help screen and provide resources for behavioral health needs1. Ongoing effort to continually perform real time screening. Goal 2: Increase access to healthcare services at Central Montana Medical Center.Strategy 2.1: Increase access to primary care services at CMMC1. Extended evening hours found to be successful and used regularly. Expanded to 3 days a week. 2. Hired additional primary care IM, Dr. Amaral. Strategy 2.2: Increase access to specialty care services at CMMC1. Expanded telemedicine with Rheumatology and Endocrinology. Future of PM & R (Physician Medicine & Rehab) specialist onsite. 2. Continue to look at service gaps with specialists. 3. Hired full time, onsite Interventional Radiologist. Goal 3: Enhance patient understanding of healthcare billing, insurance, and navigation of patient financial programs.Strategy 3.1: Improve CMMC education and outreach efforts related to billing, insurance and financial health 1. With EMR conversion, the statements are clearer and easier to understand and both clinic & hospital bills are on the same statement. Future community education still needed. Goal 4: Enhance population health education and outreach in the CMMC service area. This goal is still of importance, however with Covid, many of the population health initiatives did not occur. However, unified efforts for public health were of importance and successful during 2020 Covid.Strategy 4.1: Continue population health related outreach through CMMCStrategy 4.2: Develop community resource to increase knowledge of available health and wellness opportunitiesThe following needs were identified in our most recent CHNA and will not be addressed:1. Secondary data shows Fergus County has a higher unintentional injury death rate (per 100,000 population) compared to state and nation. Additionally, significantly more 2019 survey respondents felt that "Work/farm/ranch related accidents/injuries" were a serious health concern.2. 12.5% of survey respondents indicated cost had prohibited them from getting or taking their prescription medication regularly.3. Top reason identified for survey respondents who delayed or not receive needed care was cost (33.3%).Rationale of needs that were unable to address were as follows:* We live in an ag community where farm accidents are prevalent.* CMMC offers programs/charity care to assist with paying for healthcare costs/medicine at healthcare priced services that are based on current market conditions. CMMC provides Navigator services to the community. CMMC has affiliated with Billings Clinic (as of June 2017) to provide additional healthcare services and physicians. |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 13h: Eligibility is based on patient's family size, family gross income, personal assets, and other medical debts. |
| Central Montana Medical Facilities, Inc. | Part V, Section B, Line 16j: A summary of the financial assistance policy is also posted in the hospital facility's emergency room, waiting rooms, and admissions offices. |
| Part V, Line 16a, FAP Website: | https://www.cmmc.health/for-patients/billing-and-financial-assistance/ |
| Part V, Line 16b, FAP Application Website: | https://www.cmmc.health/for-patients/billing-and-financial-assistance/ |
| Part V, Line 16c, FAP Plain Language Summary Website: | https://www.cmmc.health/for-patients/billing-and-financial-assistance/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Central Montana Medical Center - DME | ||||
| 202 4th Avenue South | Lewistown | MT | 59457 | HME/DME Services |
| 2 - Central Montana Medical Center - Clinic | ||||
| 410 Wendell Ave | Lewistown | MT | 59457 | Physician Clinic |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | Eligibility is based on patient's family size, family gross income, personal assets, and other medical debts. |
| Part I, Line 7: | The Organization used an average overall ratio of costs to gross charges which addresses all patient segments in order to calculate charity care. Community health improvement services were based on expenses recorded in the general ledger. Medicaid and subsidized health services are reported according to costs allocated to the relevant cost centers on the Medicare cost report. |
| Part I, Ln 7 Col(f): | The amount of bad debt expense removed from the denominator of the calculation was $2,045,368. |
| Part II, Community Building Activities: | Community Building activities promoted the health of the communities served by providing service and donations for a healthy, active, and educated public. Central Montana Medical Center staff donated time to community boards, such as LEPC (Lewistown Emergency Preparedness Community), Central Montana Youth Challenge, EPI Committing Meeting, and the DUI Task Force. By being a part of these community meetings CMMC staff provides a range of knowledge to the community members with a foundation on health and medical needs. All of these programs benefit central Montana area and promote health and wellness. |
| Part III, Line 2: | Bad debt expense is reported at charges as recorded by the organization.Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year. |
| Part III, Line 4: | Footnote from organization's financial statements: The footnote that describes bad debt expense is found on page 10 of the attached audit report. |
| Part III, Line 8: | 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.All of the Medicare shortfall should be treated as a community benefit. The Organization treats individuals regardless of the ability to pay. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. |
| Part III, Line 9b: | On every patient statement it states that the Hospital assistance application is available upon request. Applications received prior to 120 days are not referred to a collection agency to be processed accordingly. Any application received from day 120-240 are immediately returned from any collection agency for the application to be processed. Applications are available upon request and on the website for clients to access. |
| Part VI, Line 2: | Currently, CMMC assesses the health care needs of the community by the number of responses to ads and articles released through the local media. Also tracked were the kinds of support requested of CMMC such as children's safety, wellness initiatives and healthcare assessments. In FYE 2019 CMMC completed a Community Health Needs Assessment with the help of Montana State University. Mail and phone surveys were completed and "town hall" type meetings were held in Lewistown, as well as some smaller surrounding communities. |
| Part VI, Line 3: | CMMC has financial assistance signage posted in the admissions areas and the ER waiting area. A pamphlet explaining our financial assistance program, the application process and contact information is available at all hospital registration areas. The Charity Care policy and application along with a checklist and contact information is posted on our website on the internet. Prior to discharge someone from discharge planning discusses with the patient the availability of various government benefits, such as Medicaid, and assists the patient with qualifications for such programs, where applicable. Assistance with filling out the Charity Care application is also provided at this time. Private Pay in-patients are informed of Charity Care either prior to scheduled admission by physician referral or prior to discharge from the facility. We also send out information with first time statements. All other patients are informed upon inquiry. |
| Part VI, Line 4: | Lewistown is an agricultural community and the county seat for Fergus County Montana. Lewistown is located in the center of Montana and is surrounded by five mountain ranges: the Snowies, the Judiths, the Moccasins, the Belts and the Highwoods. Lewistown's elevation is 3,963 feet with 3,102 people per square mile (average).The city of Lewistown and the surrounding rural towns are supported by one hospital, Central Montana Medical Center. Fergus County is located in a federally designated medically underserved area. As of the census of 2015, the population of Lewistown MT is 9,200 with a 2010 estimate of 9,105 people. There is an estimate of 4,615 males compared to 4,585 females. March 2016 cost of living index in our zip code (59457) is 83.1%, U.S. average is 100. Lewistown Montana has an estimate of 11,096 people per square mile with our land area at an estimated 829.1 square miles.Real estate property taxes paid for housing units with mortgages in 2015 was $1,326. Renter-occupied apartments were 31% compared to the state average of 33%.The median resident age for this zip code is 45.8 years old with an average household size of 2.2 people.The population 25 years and over in 59457 shows High school or higher: 94.0%, Bachelor's degree or higher: 29.1%, Graduate or professional degree: 6.9%, Unemployed: 2.8%, Mean travel time to work (commute): 10.8 minutesInformation obtained from www.city-data.com/city/Lewistown-Montana.html |
| Part VI, Line 5: | The CMMC Governing Board consisted of 16 volunteer community members including residents from Grass Range, Winifred, Hobson and 2 members from our affiliate, Billings Clinic. CMMC extends medical staff privileges to qualified physicians based upon community needs.Surplus funds, when available, are applied to patient care needs, equipment and building maintenance and medical education requirements. The expenditure of these funds is approved by the Governing Board which meets on a monthly basis. |
| Part VI, Line 6: | CMMC is part of an affiliated health care system with Billings Clinic. Central Montana Medical Center is involved in promoting community health by participating in Population Health programs offered by Medicare and other third party insurers. Billings Clinic and CMMC collaborate on Population Health and Care Coordination initiatives that are provided to the community. CMMC has an independent Care Coordination department focused on promoting the health of the individuals in our community. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dr Gardner Smith | ||||||||||||||
| Surgeon | $447,998 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $21,100 | $0 | $469,098 | $0 | $0 | $0 |
| Dr Amy A LePage | ||||||||||||||
| ER Physician | $353,035 | $0 | $0 | $0 | $0 | $0 | $617 | $0 | $20,096 | $0 | $373,748 | $0 | $0 | $0 |
| Dr Michael Sura | ||||||||||||||
| Member | $337,644 | $0 | $0 | $0 | $0 | $0 | $9,358 | $0 | $21,188 | $0 | $368,190 | $0 | $0 | $0 |
| Dr Christina Marchion | ||||||||||||||
| Physician | $320,051 | $0 | $0 | $0 | $0 | $0 | $11,338 | $0 | $20,383 | $0 | $351,772 | $0 | $0 | $0 |
| Dr Tamara Welsh | ||||||||||||||
| Member | $273,655 | $0 | $0 | $0 | $0 | $0 | $11,497 | $0 | $1,097 | $0 | $286,249 | $0 | $0 | $0 |
| James Fox | ||||||||||||||
| CRNA | $244,165 | $0 | $0 | $0 | $0 | $0 | $10,156 | $0 | $1,115 | $0 | $255,436 | $0 | $0 | $0 |
| Rene DeGuzman | ||||||||||||||
| Anesthetist | $218,339 | $0 | $0 | $0 | $0 | $0 | $7,219 | $0 | $21,193 | $0 | $246,751 | $0 | $0 | $0 |
| Alan R Aldrich | ||||||||||||||
| CFO/Co-CEO | $213,148 | $0 | $0 | $0 | $0 | $0 | $8,859 | $0 | $16,538 | $0 | $238,545 | $0 | $0 | $0 |
| Dr Laura Bennett | ||||||||||||||
| Co-CEO | $212,346 | $0 | $0 | $0 | $0 | $0 | $7,166 | $0 | $16,757 | $0 | $236,269 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Fergus County Montana | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 816001358 | BondIssuerEIN |
| CUSIP | 000000000 | CUSIPNum |
| Bond Issued | 2014-05-01 | BondIssuedDt |
| Issue Price | $4,500,000 | IssuePriceAmt |
| Purpose | Emergency and laboratory expansion and remodel of existing facility | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,013,226 | RetiredAmt |
| Total Proceeds | $4,500,000 | TotalProceedsAmt |
| Capital Expenditures | $4,500,000 | CapitalExpendituresAmt |
| Substantial Completion | 2015 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Annie Davis | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Family Member of Board Member | RelationshipDescriptionTxt |
| Transaction | $94,162 | TransactionAmt |
| Transaction | Payment of Compensation | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 2 | Dr. Smith and Dr. Church did outreach to Harlow Clinic for surgery and podiatry. As of July 1, 2019 Dr. Martignoni came on staff and is our new Internal Medicine Physician. |
| Form 990, Part VI, Section A, line 1 | The Executive Committee includes the President or Chair, Vice President or Vice Chair, Secretary and Treasurer and 2 members-at-large and their authority is similar to that of the full governing board. |
| Form 990, Part VI, Section A, line 6 | The organization has two classes of membership: Class A general membership and Class B membership, with the sole member of the Class B Membership being Billings Clinic. Class A Membership in the Corporation shall consist of residents of Central Montana residing within the counties of Fergus, Judith Basin and Petroleum who are at least eighteen (18) years of age and who have or shall indicate their interest in the maintenance of adequate medical facilities and high standards of medical care in the area, served by CMMC, and who indicate a willingness and desire to be a member of the Corporation by attending and signing the register at the Corporation's annual meeting. |
| Form 990, Part VI, Section A, line 7a | The board has two classes of directors. Class A Directors are elected by the Class A Members and Class B Directors are appointed by the Billings Clinic. There shall be at last nine but no more than thirteen Class A Directors. There shall be at least one but no more than two Billings Clinic Directors, as determined by Billings Clinic from time to time. Each Class A Director must reside within the counties of Fergus, Judith Basin or Petroleum. Two Class A Directors must be physicians holding privileges on CMMC's active Medical Staff. Further, so long as the Corporation remains obligated for the repayment of any long-term tax-exempt financing, underwritten through Fergus County, Montana, one Class A Director shall be selected from the Fergus County Commissioners. The Board and Billings Clinic shall communicate concerning the appointment of Billings Clinic Directors with the objective of selecting individuals who will work cooperatively with the Class A Directors for the benefit of CMMC. |
| Form 990, Part VI, Section A, line 7b | Any amendment to the bylaws affecting the voting rights and powers of membership, must be approved by both a two-thirds majority of the board present at any regular or special meeting of the board and Billings Clinic. Additionally, Billings Clinic must consent to any amendment of the bylaws relating to CMMC's purpose, the membership, the members of the board, including but not limited to the number of directors, the composition of the board, the term of office of directors or the method or way in which directors are elected or selected. |
| Form 990, Part VI, Section B, line 11b | A draft copy of the Form 990 is reviewed by the CFO and Board of Directors prior to its filing. |
| Form 990, Part VI, Section B, line 12c | The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy by discussing at the Board of Director Meetings and obtaining signed statements from members. All officers, board members, and key employees are covered by the policy. The board determines whether conflicts exist and all potential conflicts are reviewed by the board. Any person with a conflict is not allowed to vote on conflicted issues. |
| Form 990, Part VI, Section B, line 15a | The Board of Directors established the compensation for Interim Co-CEO's Alan Aldrich and Dr. Laura Bennett. This process take place on an annual basis. |
| Form 990, Part VI, Section C, line 19 | The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. A copy may be requested by calling, emailing, walk-in or via mail. |
| Form 990, Part IX, line 11g | Medical/Professional Fees: Program service expenses 1,153,182. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,153,182. Service Contracts: Program service expenses 719,037. Management and general expenses 323,614. Fundraising expenses 0. Total expenses 1,042,651. Purchased Services: Program service expenses 1,061,967. Management and general expenses 1,105,837. Fundraising expenses 0. Total expenses 2,167,804. |
| Form 990, Part XI, line 9: | Change in Interest in Central Montana Foundation 466,121. |