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BIG HORN COUNTY MEMORIAL HOSPITAL AND HEALTH CARE FOUNDATION: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
BIG HORN COUNTY MEMORIAL HOSPITAL AND HEALTH CARE FOUNDATION (EIN 81-0504410)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-13
IRS object ID
202131339349305303
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 ReturnHeader

FieldValueIRS element (for citing)
Return2021-05-13T16:05:20-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN810504410EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BIG HORN COUNTY HOSPITAL AND HEALTH CAREBusinessNameLine1Txt
Business Name Line2FOUNDATIONBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlBIGHBusinessNameControlTxt
Phone4066652310PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line117 NORTH MILES AVENUEAddressLine1Txt
CityHARDINCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59034ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKRISTI GATRELLPersonNm
Person TitleCEOPersonTitleTxt
Phone4066652310PhoneNum
Signature2021-05-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonROBERT E SCHILEPreparerPersonNm
PTINP00369682PTIN
Phone6123764500PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerWILLIAM HODGESPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line117 NORTH MILES AVENUEAddressLine1Txt
CityHARDINCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59034ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,192,434GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BIGHORNHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateMTLegalDomicileStateCd
Activity Or MissionBENEFIT AND SUPPORT OF BIG HORN HOSPITAL ASSOCIATIONActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers4TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$164,881PYContributionsGrantsAmt
CY Contributions Grants$591,560CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$50,995PYInvestmentIncomeAmt
CY Investment Income$25,373CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$215,876PYTotalRevenueAmt
CY Total Revenue$616,933CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$738,719CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$54,990PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$43,667CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$30,371PYOtherExpensesAmt
CY Other Expenses$24,221CYOtherExpensesAmt
PY Total Expenses$85,361PYTotalExpensesAmt
CY Total Expenses$806,607CYTotalExpensesAmt
PY Revenues Less Expenses$130,515PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$189,674CYRevenuesLessExpensesAmt
Total Assets BOY$828,787TotalAssetsBOYAmt
Total Assets EOY$623,875TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$828,787NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$623,875NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE FUNDRAISING AND FINANCIAL SUPPORT TO BIG HORN HOSPITAL ASSOCIATION FOR PROJECTS TO INCREASE AND IMPROVE SERVICES AT THE HOSPITAL AND NURSING HOME AND THEIR PATIENTS/RESIDENTS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$738,719ExpenseAmt
Grant$738,719GrantAmt
Revenue$0RevenueAmt
DescVARIOUS PROGRAMS, PROVIDING SUPPORT TO BIG HORN HOSPITAL TO COVER OPERATING COSTS, PATIENT CARE AND OTHER FUNDING NEEDS. DURING THE MAJORITY OF THE YEAR, FUNDRAISING CONTINUED FOR "BUILDING YOUR HEALTHCARE FUTURE" CAPITAL CAMPAIGN THAT BEGAN IN FISCAL YEAR 2019 TO RAISE FUNDS FOR AN $11M REMODEL PROJECT FOR BIG HORN HOSPITAL. THIS PROJECT WILL INCLUDE A NEW ER WING WITH ADDITIONAL ER BAYS, CONSOLIDATION OF PATIENT ROOMS, IMAGING DEPARTMENTS, AND NURSES STATION. MORE HIPPA COMPLIANT CHECK IN FOR PATIENTS.UNFORTUNATELY DUE TO THE PANDEMIC ALL FUNDRAISING EFFORTS CEASED AS OF MARCH 2020. BIG HORN HOSPITAL WAS UNABLE TO ORGANIZE EVENTS ND THE STAFF INVOLVED WITH ANY FUNDRAISING HAD TO MOVE THEIR EFFORTS TO THE EVERCHANGING WORK LANDSCPE ASSOCIATED WITH A PANDEMIC. THIS INCLUDES THE FACT THAT OUR FOUNDATION DIRECTOR IS ALSO OUR PUBLIC HEALTH DIRECTOR.Desc
Total Program Service Expenses$738,719TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art ContributionYes (1)DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ROXIE CAINBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4066652310PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line117 NORTH MILES AVENUEAddressLine1Txt
CityHARDINCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59034ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
DR SHANNON WAGENMAN
BOARD MEMBER0.2040.00Yes (X)$0$172,815$23,168
ROXIE CAIN
CONTROLLER1.0039.00$0$114,914$23,168Yes (X)
KRISTI GATTRELL
CEO1.0039.00$0$118,878$16,761Yes (X)
WILLIAM HODGES
EXECUTIVE DIRECTOR25.0015.00$0$98,528$16,761Yes (X)
TERRY BULLIS
CHAIRMAN0.200.40Yes (X)$0$0$0Yes (X)
THOR TORSKE
SECRETARY/TREASURER0.200.40Yes (X)$0$0$0Yes (X)
JAMES SEYKORA
FUNDRAISING CHAIR0.200.40Yes (X)$0$0$0
DONNA STRICKER
AUXILIARY MEMBER0.200.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$505,135TotReportableCompRltdOrgAmt
Total Other Compensation$79,858TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$24,560RelatedOrganizationsAmt
All Other Contributions$567,000AllOtherContributionsAmt
Noncash Contributions$500NoncashContributionsAmt
Total Contributions$591,560TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,505TotalRevenueColumnAmt
Exclusion$23,505ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$577,369SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$575,501SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,868SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,868TotalRevenueColumnAmt
Exclusion$1,868ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$616,933TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$25,373ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$738,719TotalAmt
Program Services$738,719ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$40,617TotalAmt
Management And General$40,617ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$81TotalAmt
Management And General$81ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,969TotalAmt
Management And General$2,969ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$833TotalAmt
Management And General$833ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$6,206TotalAmt
Management And General$6,206ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$400TotalAmt
Management And General$400ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$11,944TotalAmt
Management And General$11,944ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,447TotalAmt
Management And General$1,447ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,092TotalAmt
Management And General$1,092ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmt
TAXES & LICENSES$2,089$2,089
DUES & SUBSCRIPTIONS$210$210

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$806,607TotalAmt
Program Services$738,719ProgramServicesAmt
Management And General$67,888ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$69,687BOYAmt
EOY$55,845EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,819BOYAmt
EOY$5,831EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$753,281BOYAmt
EOY$562,199EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$828,787BOYAmt
EOY$623,875EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$828,787BOYAmt
EOY$623,875EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$828,787BOYAmt
EOY$623,875EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$828,787BOYAmt
EOY$623,875EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$189,674ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$15,238NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1BIG HORN HOSPITAL ASSOCIATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN810384618EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$738,719SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$738,719SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1BIG HORN HOSPITAL ASSOCIAITIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line117 N MILES AVENUEAddressLine1Txt
CityHARDINCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59034ZIPCd
FieldValueIRS element (for citing)
Recipient EIN810384618RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$738,719CashGrantAmt
Purpose Of GrantBOND PAYMENT ASSISTANCE; ROOF OVER SWING BED, GENERAL OPERATING SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ONLY TRANSFERS WERE TO A RELATED ORGANIZATION. THESE FUNDS ARE TRACKED THROUGH THE ORGANIZATION'S INTERNAL FINANCIAL REPORTING PROCESS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonDR SHANNON WAGENMANPersonNm
TitleBOARD MEMBERTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$172,815CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$2,500DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$20,668NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$195,983TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule M IRS990ScheduleM

Works Of Art WorksOfArtGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$500NoncashContributionsRptF990Amt
Method Of Determining RevenuesDONOR VALUEDMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE MEMBERSHIP OF THE FOUNDATION, SUBJECT TO AVAILABILITY TO SERVE, CONSISTS OF AT LEAST THE FOLLOWING: A. THREE MEMBERS OF THE BOARD OF DIRECTORS OF BIG HORN HOSPITAL ASSOCIATION OF BIG HORN COUNTY, MONTANA. B. ONE MEMBER OF THE ACTIVE MEDICAL STAFF OF BIG HORN HOSPITAL OF BIG HORN COUNTY, MONTANA, WHO IS A RESIDENT OF BIG HORN COUNTY. C. SUCH OTHER MEMBERS AS DETERMINED AND AUTHORIZED BY THE FOREGOING EXISTING MEMBERSHIP. ALL MEMBERS OF EXISTING AUXILIARY ORGANIZATIONS WHICH ARE AFFILIATED WITH BIG HORN HOSPITAL ASSOCIATION ARE ENTITLED TO BECOME MEMBERS OF THE FOUNDATION.
FORM 990, PART VI, SECTION A, LINE 7ATHREE MEMBERS OF THE BOARD OF DIRECTORS ARE DULY APPOINTED AND ACTING MEMBERS OF THE BOARD OF DIRECTORS OF BIG HORN HOSPITAL ASSOCIATION. THEY ARE ELECTED BY THE BOARD OF DIRECTORS OF BIG HORN HOSPITAL ASSOCIATION. ONE MEMBER OF THE BOARD OF DIRECTORS IS ELECTED BY THE ACTIVE MEDICAL STAFF OF BIG HORN COUNTY MEMORIAL HOSPITAL.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WAS REVIEWED IN DETAIL BY BOTH THE HOSPITAL CEO AND CONTROLLER, AS WELL AS THE FOUNDATION DIRECTOR. THE BOARD MEMBERS WERE PROVIDED A COPY OF THE FORM 990 AFTER IT WAS FILED.
FORM 990, PART VI, SECTION B, LINE 12CREGULAR COMPLIANCE MEETINGS DISCUSS ANY ACTUAL CONFLICTS OR POTENTIAL CONFLICTS. THERE IS ALSO A HOTLINE NUMBER TO CALL FOR COMPLIANCE OR HIPAA ISSUES THAT IS OPERATED BY MONTANA HOSPITAL ASSOCIATION, NOT BIG HORN HOSPITAL ASSOCIATION. BOARD MEMBERS SIGN YEARLY CONFLICT OF INTEREST STATEMENTS AND IF A CONFLICT OCCURS ON A SPECIFIC ITEM, THEY ABSTAIN FROM THE VOTE ON THAT ITEM.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE UNAVAILABLE TO THE PUBLIC.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1BIG HORN HOSPITAL ASSOCIATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line117 NORTH MILES AVENUEAddressLine1Txt
CityHARDINCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59034ZIPCd
FieldValueIRS element (for citing)
EIN810384618EIN
Primary ActivitiesHOSPITALPrimaryActivitiesTxt
Legal Domicile StateMTLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 3PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd