2020-05-12T14:51:16-05:00 2019-06-30 GREEN HEALTH GROUP PC 110 5TH ST S SUITE 106 GLASGOW MT 592302338 990 2018-07-01 810226578 NORTHEAST MONTANA HEALTH SERVICES NORT 4066536500 315 KNAPP STREET WOLF POINT MT 59201 MARGARET NORGAARD CEO 4066536500 2020-05-11 true DANIEL GREEN P01311679 4062632615 2020-05-12 52.38.98.93 2020-05-12 14:51:16 CD P 299715511C6F2C3736520DF5CC568F95C9BA9327 1B655D9F0016D2B0262AB607CA00CC8D2F4DE9CA 2018 2021-01-29 14:40:06Z MARGARET NORGAARD 315 KNAPP STREET WOLF POINT MT 59201 29983776 false X WWW.NEMHS.NET X 1948 MT TO DELIVER QUALITY, COST-EFFECTIVE HEALTH CARE TO THE COMMUNITIES THAT WE SERVE FOR IMPROVEMENT OF HUMAN LIFE. 7 6 455 15 1463749 222309 611977 28225888 28531179 172637 389409 411344 444662 29032178 29977227 0 0 15950564 16302452 0 69602 14209545 13043199 30160109 29345651 -1127931 631576 38741981 38479669 16350901 15435122 22391080 23044547 TO DELIVER QUALITY, COST-EFFECTIVE HEALTH CARE TO THE COMMUNITIES THAT WE SERVE FOR IMPROVEMENT OF HUMAN LIFE. false false 25803769 28531179 PROVIDE QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES TO THE PATIENTS THAT WE SERVE. 25803769 true true false true false false false false false false true true false true false true false true false false false false false false true false true true false false true true false false false false false false false false false false false false false false false true true true false false true 32 0 true 455 true true true false false false false false false false false false false false X 7 6 false false false false false false false true true false false true true true true true true true true false X DEMI WILKINSON 4066536500 315 KNAPP ST WOLF POINT MT 59201 X MARK ZILKOSKI MD MEDICAL STAF 1.00 40.00 X 0 209680 133381 SHANE GIBSON CHAIRMAN 2.00 X 0 0 0 DALLAS O'CONNOR TREASURER 1.00 X 0 0 0 RJ DOORNEK DIRECTOR 1.00 X 0 0 0 STEVE HACKLEY DIRECTOR 1.00 X 0 0 0 STEPHANIE MCGOWAN DIRECTOR 1.00 X 0 0 0 DANA BUCKLES TRIBAL REP 1.00 X 0 0 0 MARGARET NORGAARD CEO 40.00 X 171880 0 28119 ROGER FISHER COO 40.00 X 131227 0 748 DEMI WILKINSON CFO 40.00 X 115003 0 11004 HANZ ARNSTON RN 40.00 X 148439 0 10469 VICKI HOUSTON RN 40.00 X 143239 0 10430 ELAINE LONG RN-VP NURSIN 40.00 X 140462 0 12165 MARYANN AVERY RN 40.00 X 139132 0 10400 LORI COLLINS RN 40.00 X 138472 0 11885 1127854 209680 228601 8 false true false AVENTUS OUTREACH LLC 11301 CORPORATE BLVD BLD 400 STE315 ORLANDO FL 32717 REF LAB SVCS 1054350 BILLINGS CLINIC PO BOX 30277 BILLINGS MT 59107 COMPUTER SUPP 433228 BIG SKY LOCUMS 4865 BLUE SPRUCE CIRCLE BILLINGS MT 59103 LOCUM TENENS 267309 DRAGE FAMILY EMERGENCY INC 1912 E HICKORY POINT CIRCLE SANDY UT 84092 LOCUM TENENS 266385 CERNER PO BOX 959156 ST LOUIS MO 63195 EHR SERVICES 263792 5 620 45419 14500 551438 611977 PATIENT REVENUE 621500 24962300 24962300 RETAIL PHARMACIES 446110 3568879 2105130 1463749 28531179 389409 389409 14601 620 6549 8052 HOSPITAL DISTRICT TAX 900099 425034 425034 GAIN ON SALE OF ASSETS 900099 11576 11576 436610 29977227 27893449 1463749 X 428835 428835 13406973 11795242 1559622 52109 110173 93691 16133 349 1260108 997854 252115 10139 1096363 924775 167274 4314 52378 52378 85099 85099 3308335 3308285 50 37999 37999 678157 446548 231159 450 263802 217188 45585 1029 271336 218219 53117 82757 64898 17853 6 38563 22334 16228 1 289633 229951 59682 1167218 1018788 148430 299151 223302 75849 MEDICAL SUPPLIES 3917949 3851699 66250 COGS 1058648 1058648 REPAIRS & MAINTENANCE 737437 618549 117786 1102 BED TAXES 405308 405308 349429 308490 40886 53 29345651 25803769 3472280 69602 5141965 4341877 1291638 1213544 6933498 8059269 963648 874000 405231 403843 29758840 21342423 8455339 8416417 6149763 6484635 9400899 8686084 38741981 38479669 6832986 6550743 8833813 8328216 684102 556163 16350901 15435122 X 22243112 22914150 147968 130397 22391080 23044547 38741981 38479669 X 631576 21891 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2067 2067 false SCHEDULE C, PART II-B, LINE 1 0.11 PERCENT OF MHA DUES PAID TO MHA, WHICH WAS 27, 22.73 PERCENT OF DUES PAID TO MHA FOR AHA, WHICH WAS 2,012, AND 2.80 PERCENT OF DUES PAID TO MHA FOR LEADINGAGE WHICH WAS 28 (2,067 COMBINED) WERE USED FOR LOBBYING EXPENSES BY MHA. 28950 28950 15826415 11024117 4802298 13903475 10318306 3585169 8416417 5458004 C BOND FUNDS 1026631 F 6484635 RECEIVABLE-WOLF POINT CLINIC ASSOC 6282747 RECEIVABLE-RIVERSIDE FAMILY CLINIC 2308337 WORK COMP TRUST DEPOSIT 95000 8686084 X 30005667 21891 21891 29983776 -6549 -6549 29977227 29352200 29352200 -6549 -6549 29345651 SCHEDULE D, PAGE 3, PART X IT IS THE JUDGMENT OF MANAGEMENT THAT THE COMPANY HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT WOULD BE SUBJECT TO CHANGE UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. SEE PAGE 10 IN THE NORTHEAST MONTANA HEALTH SERVICES, INC. AND AFFILIATES NOTES TO CONSOLIDATED FINANCIAL STATEMENTS JUNE 30, 2019 AND 2018. SCHEDULE D, PAGE 4, PART XI, LINE 4B FUNDRAISING EXPENSES NETTED AGAINST REVENUE -6,549 SCHEDULE D, PAGE 4, PART XII, LINE 4B FUNDRAISING EXPENSES NETTED AGAINST REVENUE -6,549 EMS FUNDRAISER 15221 620 14601 869 907 1400 3373 15221 620 14601 869 907 1400 3373 6549 8052 true true X true X true X true true true false false 514193 514193 0.01750 514193 514193 0.01750 3328620 1372969 1955651 0.06660 3328620 1372969 1955651 0.06660 3842813 1372969 2469844 0.08420 86558 86558 0.00290 86558 86558 0.00290 true 388248 5506655 5464271 42384 X true true 2 1 NEMHS - TRINITY HOSPITAL 315 KNAPP STREET WOLF POINT MT 59201 WWW.NEMHS.NET X X X X 2 NEMHS - POPLAR COMMUNITY HOSPITAL 211 H STREET EAST POPLAR MT 59255 WWW.NEMHS.NET X X X X NEMHS - TRINITY HOSPITAL 1 false false true X X X X X X X X X X 18 true true false true X WWW.NEMHS.NET X X true 18 true WWW.NEMHS.NET false false true X 100.000000000000 200.000000000000 X X X true true X X X true X WWW.NEMHS.NET X WWW.NEMHS.NET X WWW.NEMHS.NET X X X X X true X false X X X X true X X false false NEMHS - POPLAR COMMUNITY HOSPITAL 2 false false true X X X X X X X X X X 18 true true false true X WWW.NEMHS.NET X X true 18 true WWW.NEMHS.NET false false true X 100.000000000000 200.000000000000 X X X true true X X X true X WWW.NEMHS.NET X WWW.NEMHS.NET X WWW.NEMHS.NET X X X X X true X false X X X X true X X false false FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND ARE IDENTIFIED THROUGH THE CHNA. FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 5 IN DECEMBER 2018, A SURVEY WAS MAILED TO A RANDOMLY CHOSEN SAMPLE OF 300 RESIDENTS IN THE PRIMARY SERVICE AREA TO SOLICIT THEIR INPUT. RIVERSIDE FAMILY CLINIC AND WOLF POINT CLINIC ASSOCIATION WERE EACH GIVEN 25 COPIES OF THE SURVEY TO HAVE PATIENTS FILL OUT WHILE WAITING FOR THEIR APPOINTMENTS. THE SURVEY WAS ALSO MADE AVAILABLE ONLINE THROUGH SURVEY MONKEY AND MARKETED VIA THE FACILITY'S WEBSITE AND FACEBOOK PAGE. THIS YEAR A LIVE VIDEO PRESENTATION INTRODUCING THE SURVEY WAS ADDED HOPING TO INCREASE THE COMMUNITY'S RESPONSE. MAIL RETURNS AND ON-LINE SURVEYS WERE COMBINED WHICH RESULTED IN 191 SURVEYS BEING RETURNED. THREE FOCUS GROUPS AND FOUR KEY INFORMANT INTERVIEWS WERE HELD IN POPLAR AND WOLF POINT DESIGNED TO REPRESENT VARIOUS CONSUMER GROUPS OF HEALTH CARE INCLUDING SENIOR CITIZENS, MEDICALLY UNDERSERVED, LOW-INCOME, UNDERINSURED, MINORITY CITIZENS, LOCAL COMMUNITY MEMBERS, AND STUDENTS. ALSO, A CONSULTATION WITH THE COUNTY PUBLIC HEALTH NURSE WAS CONDUCTED TO SOLICIT HER INPUT. THE FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE FACILITATED AND CONDUCTED ON BEHALF OF NEMHS BY THE MONTANA OFFICE OF RURAL HEALTH. FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 6A NORTHEAST MONTANA HEALTH SERVICES - POPLAR COMMUNITY HOSPITAL. FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 7D THE CHNA IS ALSO AVAILABLE AT THE PUBLIC LIBRARY. FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 11 NEMHS AND ASSOCIATES IDENTIFIED 17 NEEDS TO ADDRESS. THREE GOALS WITH STRATEGIES AND ACTIVITES WERE DEVELOPED TO ADDRESS A VARIATION OF THOSE 17 NEEDS. NEMHS AND ASSOCIATES IDENTIFIED 7 OF THOSE NEEDS THAT COULD NOT BE ADDRESSED. NEEDS TO BE ADDRESSED: 1. HEALTHY COMMUNITY INCLUDING ACCESS TO HEALTHCARE AND OTHER SERVICES, HEALTHY BEHAVIORS AND LIFESTYLES. 2. FOCUS GROUP PARTICIPANTS FELT HIRING ADDITIONAL PHYSICIANS WAS IMPORTANT FOR IMPROVING COMMUNITY'S ACCESS TO HEALTHCARE. 3. 13.83% OF SURVEY RESPONDENTS RATED NEMHS SERVICES AS "FAIR- OR "POOR". 4. RESPONDENTS DELAYED OR DID NOT GET NEEDED HEALTHCARE SERVICES. 5. DELAYS IN RECEIVING HEALTHCARE INCLUDING TOO LONG TO WAIT FOR AN APPOINTMENT, IT COSTS TOO MUCH, AND COULD NOT GET AN APPOINTMENT. 6. RESPONDENTS CONSIDER THE GENERAL HEALTH OF THE COMMUNITY TO BE UNHEALTHY. 7. NEED FOR MORE EXERCISE WITHIN THE COMMUNITY AS 23% OF THE COMMUNITY EXERCISES 20 MINUTES OR LESS, THREE TO FIVE TIMES A MONTH OR LESS. 8. 35% OF ADULTS AND 38% OF CHILDREN 2-5 YEARS OLD ARE CONSIDERED OVERWEIGHT OR OBESE. 9. LACK OF OPTIONS FOR EXERCISE FOR ALL AGES DURING THE WINTER. 10. NEED FOR MORE HEALTH EDUCATION AND OUTREACH RELATED TO DIET/NUTRITION, EXERCISE AND PREVENTION. 11. DIABETES HOSPITALIZATION RATES IN ROOSEVELT COUNTY ARE HIGHER THAN THE STATE. 12. SUICIDE RATES IN ROOSEVELT COUNTY ARE HIGHER THAN THE STATE. 13. ROOSEVELT COUNTY ADULTS REPORT HIGHER RATES OF POOR MENTAL HEALTH DAYS THAN THE STATE. 14. TOP HEALTH CONCERNS REPORTED BY SURVEY RESPONDENTS WERE ALCOHOL AND SUBSTANCE ABUSE, CHILD ABUSE/NEGLECT, DIABETES, AND MENTAL HEALTH. 15. 27.32% OF RESPONDENTS REPORTED EXPERIENCING PERIODS OF AT LEAST THREE CONSECUTIVE MONTHS WHERE THEY FELT DEPRESSED ON MOST DAYS. 16. MENTAL HEALTH AND ACCESS TO MENTAL HEALTH SERVICES WAS A TOP CONCERN AT ALL FOCUS GROUP MEETINGS. 17. FOCUS GROUPS IDENTIFIED BEHAVIORAL HEALTH SUPPORT, TRAUMA, ALCOHOL & SUBSTANCE ABUSE, AND SUICIDE PREVENTION AS TOP CONCERNS OF THE COMMUNITY. GOALS, STRATEGIES, AND ACTIVITIES TO ADDRESS NEEDS: 1. INCREASE ACCESS TO HEALTHCARE SERVICES IN THE NEMHS SERVICE AREA. STRATEGIES FOR IMPLEMENTATION: 1.1 - INCREASE ACCESS TO PRIMARY AND SPECIALTY CARE SERVICES BY CONTINUING EFFORTS TO RECRUIT NEW PRIMARY CARE PROVIDERS, OFFER REACH CAMP ANNUALLY TO SUPPORT STUDENTS INTERESTED IN HEALTHCARE, PROVIDE LOCAL CNA AND NURSE TRAINING OPPORTUNITIES, PARTNER WITH MILES CITY COMMUNITY COLLEGE TO HOST NURSING CLINICAL SITE ROTATIONS FOR STUDENTS, AND DEVELOP A COMMUNITY MARKETING CAMPAIGN TO ANNOUNCE NURSE PRACTITIONER AND NURSING STUDENT PLACEMENTS. 1.2 - STUDY OPPORTUNITIES TO EXPAND SPECIALTY SERVICES BY REACHING OUT TO REGIONAL PARTNERS TO EXPLORE SPECIALTY SERVICE EXPANSION. 1.3 - INCREASE EFFORTS TO ENHANCE COMMUNITY KNOWLEDGE OF AVAILABLE SERVICES BY DEVELOPING A NEW/ENHANCED MARKETING CAMPAIGN TO EDUCATE STAFF AND COMMUNITY ABOUT AVAILABLE SERVICES, EXPLORE EXPANDING OUTREACH EFFORTS TO INCLUDE VARIOUS MODALITIES, AND DEVELOPING MARKETING MATERIALS FOR FACILITY WAITING ROOM TELEVISIONS HIGHLIGHTING NEWS/UPDATES AND EDUCATIONAL MATERIAL. 2. BROADEN NEMHS HEALTH AND WELLNESS OUTREACH EFFORTS IN ROOSEVELT COUNTY. STRATEGY FOR IMPLEMENTATION: 2.1 - CONTINUE CURRENT AND DEVELOP NEW COMMUNITY EVENTS/PROGRAMS THAT PROMOTE HEALTH AND WELLNESS BY EXPLORING THE FEASIBILITY TO HIRE SEASONAL STAFF TO COORDINATE NEMHS WELLNESS EFFORTS, DEVELOPING A WALKING PROGRAM FOR THE COMMUNITY TO INCREASE PHYSICAL ACTIVITY, EXPLORE OFFERING NEW COMMUNITY EVENTS/PROGRAMS THAT PROMOTE ACTIVITY, SEEK OPPORTUNITIES TO SUPPORT LOCAL YOUTH AND ADULT RECREATIONAL TEAMS, AND CONTINUE TO SPONSOR COMMUNITY EVENTS THAT PROMOTE HEALTH AND WELLNESS. 3. IMPROVE ACCESS TO MENTAL HEALTH SERVICES AT NEMHS. STRATEGIES FOR IMPLEMENTATION: 3.1 - EXPLORE OPPORTUNITIES TO ADVANCE ACCESS TO MENTAL HEALTH SERVICES BY EXPLORING THE FEASIBILITY OF OFFERING CONTRACTED PSYCHIATRIC-MENTAL HEALTH NURSE PRACTITIONER SERVICES VIA VIDEO TECHNOLOGY, EXPLORING THE FEASIBILITY OF OFFERING LIMITED/REGULAR PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER SERVICES VIA IN-PERSON CONSULTS, AND CONVENING REGIONAL CAH ADMINISTRATORS TO DISCUSS POTENTIAL REGIONAL MODES TO ADDRESS/SUPPORT MENTAL HEALTH CRISIS SERVICES. 3.2 - EDUCATE COMMUNITY AND STAFF ON TOPICS RELATED TO MENTAL/BEHAVIORAL HEALTH THROUGH EXPLORING LOCAL/REGIONAL TRAINING OPPORTUNITIES FOR NEMHS STAFF ON BEST PRACTICES RELATED TO MENTAL HEALTH VIA REGIONAL OR STATE PARTNERS, AND DEVELOPING A MARKETING AND OUTREACH PLAN TO EDUCATE COMMUNITY ON AVAILABLE NEHMS MENTAL HEALTH SERVICES. NEEDS THAT COULD NOT BE ADDRESSED: 1. DOMESTIC VIOLENCE AND TRAUMA WERE IDENTIFIED AS HIGH AREAS OF CONCERN, BUT OTHER COMMUNITY PARTNERS HAVE ACTIVE PROGRAMS WITHIN THE FORT PECK TRIBES AND SCHOOL DISTRICTS. FAMILY DYNAMICS AND SOCIOECONOMIC FACTORS ARE BEYOND OUR FINANCIAL AND WORKFORCE/EXPERTISE SCOPE. 2. COST OF CARE WAS RATED THE SECOND HIGHEST REASON FOR NOT GETTING OR DELAYING NEEDED MEDICAL SERVICES. WE HAVE RESEARCHED OUR RATES COMPARED TO OTHER FACILITIES IN OUR SERVICE AREA AS WELL AS TERTIARY CENTERS AND WE HAVE FOUND THEM TO BE COMPETITIVE. WE ALSO COMPLETED A CHARGE MASTER REVIEW WHICH COMPARED OUR FACILITY WITH LIKE FACILITIES AND MEDICARE ALLOWABLE RATES. 3. EYE AND DENTAL SERVICES WERE IDENTIFIED AS NEEDED SERVICES NOT CURRENTLY AVAILABLE FOR BOTH ADULTS AND CHILDREN. THESE SERVICES ARE AVAILABLE TO TRIBAL MEMBERS THROUGH INDIAN HEALTH SERVICES AND HEALTH PROMOTION DISEASE PREVENTION. THERE IS ALSO A PRIVATE, LOCAL DENTIST. PROVIDING DENTAL SERVICES IS BEYOND THE SCOPE OF NEMHS AT THIS TIME. 4. 24.3% OF ADULTS IN ROOSEVELT COUNTY ARE BELOW THE POVERTY LEVEL AND 25% OF ADULTS ARE UNDERINSURED. THE TRIBAL SPONSORED HEALTH INSURANCE PROGRAM IS AVAILABLE TO ALL MEMBERS WHO ARE UNDERINSURED OR NOT INSURED. NEMHS HAS A SLIDING FEE SCALE THROUGH THE RIVERSIDE FAMILY CLINIC AND WOLF POINT CLINIC ASSOCIATION. 5. THE TEEN BIRTHRATE IN ROOSEVELT COUNTY IS 101.9 PER 1,000 BIRTHS COMPARED TO 32 PER 1,000 FOR THE STATE. TEEN PREGNANCY IS A COMPLEX ISSUE IN THE COMMUNITY FOR MANY DIFFERENT REASONS. MONTANA DPHHS HAS GRANTS AVAILABLE THAT ARE ADDRESSING TEENAGE PREGNANCY. NEMHS DOES NOT HAVE THE WORKFORCE AVAILABLE OR FINANCIAL RESOURCES TO CONDUCT A MEANINGFUL STUDY AT THIS TIME. 6. ROOSEVELT COUNTY HAS A RATE OF 857.1 PER 100,000 PEOPLE WITH HEPATITUS C COMPARED TO 112.95 PER 100,000 FOR THE STATE. HEPATITUS C RATES ARE TRADITIONALLY HIGH WITHIN MONTANA'S TRIBAL POPULATIONS. SOME STEPS HAVE BEEN TAKEN TO ADDRESS THIS ISSUE; INDIAN HEALTH SERVICES HAS IMPLEMENTED A NEEDLE EXCHANGE TO HELP FIGHT THE HEPATITIS CRISIS. 7. THE UNINTENTIONAL INJURY DEATH RATE FOR ROOSEVELT COUNTY IS 96.7 PER 100,000 PEOPLE COMPARED TO 41.3 PER 100,000 FOR THE STATE. SOME OF THIS CAN BE ATTRIBUTED TO MONTANA NOT HAVING A PRIMARY SEATBELT LAW AND NO CONSISTENT DUI CHECK POINTS. NEMHS CONTINUES TO PROMOTE HEALTHY BEHAVIORS THAT CAN REDUCE UNINTENTIONAL INJURY IN THE CLINICS, EMERGENCY DEPARTMENTS, AND THE COMMUNITY AT LARGE. FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND ARE IDENTIFIED THROUGH THE CHNA. FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 5 IN DECEMBER 2018, A SURVEY WAS MAILED TO A RANDOMLY CHOSEN SAMPLE OF 300 RESIDENTS IN THE PRIMARY SERVICE AREA TO SOLICIT THEIR INPUT. RIVERSIDE FAMILY CLINIC AND WOLF POINT CLINIC ASSOCIATION WERE EACH GIVEN 25 COPIES OF THE SURVEY TO HAVE PATIENTS FILL OUT WHILE WAITING FOR THEIR APPOINTMENTS. THE SURVEY WAS ALSO MADE AVAILABLE ONLINE THROUGH SURVEY MONKEY AND MARKETED VIA THE FACILITY'S WEBSITE AND FACEBOOK PAGE. THIS YEAR A LIVE VIDEO PRESENTATION INTRODUCING THE SURVEY WAS ADDED HOPING TO INCREASE THE COMMUNITY'S RESPONSE. MAIL RETURNS AND ON-LINE SURVEYS WERE PURGED WHICH RESULTED IN 191 SURVEYS BEING RETURNED. THREE FOCUS GROUPS AND FOUR KEY INFORMANT INTERVIEWS WERE HELD IN POPLAR AND WOLF POINT DESIGNED TO REPRESENT VARIOUS CONSUMER GROUPS OF HEALTH CARE INCLUDING SENIOR CITIZENS, MEDICALLY UNDERSERVED, LOW-INCOME, UNDERINSURED, MINORITY CITIZENS, LOCAL COMMUNITY MEMBERS, AND STUDENTS. ALSO, A CONSULTATION WITH THE COUNTY PUBLIC HEALTH NURSE WAS CONDUCTED TO SOLICIT HER INPUT. THE FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE FACILITATED AND CONDUCTED ON BEHALF OF NEMHS BY THE MONTANA OFFICE OF RURAL HEALTH. FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 6A NORTHEAST MONTANA HEALTH SERVICES - TRINITY HOSPITAL. FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 7D THE CHNA IS ALSO AVAILABLE AT THE PUBLIC LIBRARY. FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 11 NEMHS AND ASSOCIATES IDENTIFIED 17 NEEDS TO ADDRESS. THREE GOALS WITH STRATEGIES AND ACTIVITES WERE DEVELOPED TO ADDRESS A VARIATION OF THOSE 17 NEEDS. NEMHS AND ASSOCIATES IDENTIFIED 7 OF THOSE NEEDS THAT COULD NOT BE ADDRESSED. NEEDS TO BE ADDRESSED: 1. HEALTHY COMMUNITY INCLUDING ACCESS TO HEALTHCARE AND OTHER SERVICES, HEALTHY BEHAVIORS AND LIFESTYLES. 2. FOCUS GROUP PARTICIPANTS FELT HIRING ADDITIONAL PHYSICIANS WAS IMPORTANT FOR IMPROVING COMMUNITY'S ACCESS TO HEALTHCARE. 3. 13.83% OF SURVEY RESPONDENTS RATED NEMHS SERVICES AS "FAIR- OR "POOR". 4. RESPONDENTS DELAYED OR DID NOT GET NEEDED HEALTHCARE SERVICES. 5. DELAYS IN RECEIVING HEALTHCARE INCLUDING TOO LONG TO WAIT FOR AN APPOINTMENT, IT COSTS TOO MUCH, AND COULD NOT GET AN APPOINTMENT. 6. RESPONDENTS CONSIDER THE GENERAL HEALTH OF THE COMMUNITY TO BE UNHEALTHY. 7. NEED FOR MORE EXERCISE WITHIN THE COMMUNITY AS 23% OF THE COMMUNITY EXERCISES 20 MINUTES OR LESS, THREE TO FIVE TIMES A MONTH OR LESS. 8. 35% OF ADULTS AND 38% OF CHILDREN 2-5 YEARS OLD ARE CONSIDERED OVERWEIGHT OR OBESE. 9. LACK OF OPTIONS FOR EXERCISE FOR ALL AGES DURING THE WINTER. 10. NEED FOR MORE HEALTH EDUCATION AND OUTREACH RELATED TO DIET/NUTRITION, EXERCISE AND PREVENTION. 11. DIABETES HOSPITALIZATION RATES IN ROOSEVELT COUNTY ARE HIGHER THAN THE STATE. 12. SUICIDE RATES IN ROOSEVELT COUNTY ARE HIGHER THAN THE STATE. 13. ROOSEVELT COUNTY ADULTS REPORT HIGHER RATES OF POOR MENTAL HEALTH DAYS THAN THE STATE. 14. TOP HEALTH CONCERNS REPORTED BY SURVEY RESPONDENTS WERE ALCOHOL AND SUBSTANCE ABUSE, CHILD ABUSE/NEGLECT, DIABETES, AND MENTAL HEALTH. 15. 27.32% OF RESPONDENTS REPORTED EXPERIENCING PERIODS OF AT LEAST THREE CONSECUTIVE MONTHS WHERE THEY FELT DEPRESSED ON MOST DAYS. 16. MENTAL HEALTH AND ACCESS TO MENTAL HEALTH SERVICES WAS A TOP CONCERN AT ALL FOCUS GROUP MEETINGS. 17. FOCUS GROUPS IDENTIFIED BEHAVIORAL HEALTH SUPPORT, TRAUMA, ALCOHOL & SUBSTANCE ABUSE, AND SUICIDE PREVENTION AS TOP CONCERNS OF THE COMMUNITY. GOALS, STRATEGIES, AND ACTIVITIES TO ADDRESS NEEDS: 1. INCREASE ACCESS TO HEALTHCARE SERVICES IN THE NEMHS SERVICE AREA. STRATEGIES FOR IMPLEMENTATION: 1.1 - INCREASE ACCESS TO PRIMARY AND SPECIALTY CARE SERVICES BY CONTINUING EFFORTS TO RECRUIT NEW PRIMARY CARE PROVIDERS, OFFER REACH CAMP ANNUALLY TO SUPPORT STUDENTS INTERESTED IN HEALTHCARE, PROVIDE LOCAL CNA AND NURSE TRAINING OPPORTUNITIES, PARTNER WITH MILES CITY COMMUNITY COLLEGE TO HOST NURSING CLINICAL SITE ROTATIONS FOR STUDENTS, AND DEVELOP A COMMUNITY MARKETING CAMPAIGN TO ANNOUNCE NURSE PRACTITIONER AND NURSING STUDENT PLACEMENTS. 1.2 - STUDY OPPORTUNITIES TO EXPAND SPECIALTY SERVICE BY REACHING OUT TO REGIONAL PARTNERS TO EXPLORE SPECIALTY SERVICE EXPANSION. 1.3 - INCREASE EFFORTS TO ENHANCE COMMUNITY KNOWLEDGE OF AVAILABLE SERVICES BY DEVELOPING A NEW/ENHANCED MARKETING CAMPAIGN TO EDUCATE STAFF AND COMMUNITY ABOUT AVAILABLE SERVICES, EXPLORE EXPANDING OUTREACH EFFORTS TO INCLUDE VARIOUS MODALITIES, AND DEVELOPING MARKETING MATERIALS FOR FACILITY WAITING ROOM TELEVISIONS HIGHLIGHTING NEWS/UPDATES AND EDUCATIONAL MATERIAL. 2. BROADEN NEMHS HEALTH AND WELLNESS OUTREACH EFFORTS IN ROOSEVELT COUNTY. STRATEGY FOR IMPLEMENTATION: 2.1 - CONTINUE CURRENT AND DEVELOP NEW COMMUNITY EVENTS/PROGRAMS THAT PROMOTE HEALTH AND WELLNESS BY EXPLORING THE FEASIBILITY TO HIRE SEASONAL STAFF TO COORDINATE NEMHS WELLNESS EFFORTS, DEVELOPING A WALKING PROGRAM FOR THE COMMUNITY TO INCREASE PHYSICAL ACTIVITY, EXPLORE OFFERING NEW COMMUNITY EVENTS/PROGRAMS THAT PROMOTE ACTIVITY, SEEK OPPORTUNITIES TO SUPPORT LOCAL YOUTH AND ADULT RECREATIONAL TEAMS, AND CONTINUE TO SPONSOR COMMUNITY EVENTS THAT PROMOTE HEALTH AND WELLNESS. 3. IMPROVE ACCESS TO MENTAL HEALTH SERVICES AT NEMHS: STRATEGIES FOR IMPLEMENTATION: 3.1 - EXPLORE OPPORTUNITIES TO ADVANCE ACCESS TO MENTAL HEALTH SERVICES BY EXPLORING THE FEASIBILITY OF OFFERING CONTRACTED PSYCHIATRIC-MENTAL HEALTH NURSE PRACTITIONER SERVICES VIA VIDEO TECHNOLOGY, EXPLORING THE FEASIBILITY OF OFFERING LIMITED/REGULAR PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER SERVICES VIA IN-PERSON CONSULTS, AND CONVENING REGIONAL CAH ADMINISTRATORS TO DISCUSS POTENTIAL REGIONAL MODES TO ADDRESS/SUPPORT MENTAL HEALTH CRISIS SERVICES. 3.2 - EDUCATE COMMUNITY AND STAFF ON TOPICS RELATED TO MENTAL/BEHAVIORAL HEALTH THROUGH EXPLORING LOCAL/REGIONAL TRAINING OPPORTUNITIES FOR NEMHS STAFF ON BEST PRACTICES RELATED TO MENTAL HEALTH VIA REGIONAL OR STATE PARTNERS, AND DEVELOPING A MARKETING AND OUTREACH PLAN TO EDUCATE COMMUNITY ON AVAILABLE NEHMS MENTAL HEALTH SERVICES. NEEDS THAT COULD NOT BE ADDRESSED: 1. DOMESTIC VIOLENCE AND TRAUMA WERE IDENTIFIED AS HIGH AREAS OF CONCERN, BUT OTHER COMMUNITY PARTNERS HAVE ACTIVE PROGRAMS WITHIN THE FORT PECK TRIBES AND SCHOOL DISTRICTS. FAMILY DYNAMICS AND SOCIOECONOMIC FACTORS ARE BEYOND OUR FINANCIAL AND WORKFORCE/EXPERTISE SCOPE. 2. COST OF CARE WAS RATED THE SECOND HIGHEST REASON FOR NOT GETTING OR DELAYING NEEDED MEDICAL SERVICES. WE HAVE RESEARCHED OUR RATES COMPARED TO OTHER FACILITIES IN OUR SERVICE AREA AS WELL AS TERTIARY CENTERS AND WE HAVE FOUND THEM TO BE COMPETITIVE. WE ALSO COMPLETED A CHARGE MASTER REVIEW WHICH COMPARED OUR FACILITY WITH LIKE FACILITIES AND MEDICARE ALLOWABLE RATES. 3. EYE AND DENTAL SERVICES WERE IDENTIFIED AS NEEDED SERVICES NOT CURRENTLY AVAILABLE FOR BOTH ADULTS AND CHILDREN. THESE SERVICES ARE AVAILABLE TO TRIBAL MEMBERS THROUGH INDIAN HEALTH SERVICES AND HEALTH PROMOTION DISEASE PREVENTION. THERE IS ALSO A PRIVATE, LOCAL DENTIST. PROVIDING DENTAL SERVICES IS BEYOND THE SCOPE OF NEMHS AT THIS TIME. 4. 24.3% OF ADULTS IN ROOSEVELT COUNTY ARE BELOW THE POVERTY LEVEL AND 25% OF ADULTS ARE UNDERINSURED. THE TRIBAL SPONSORED HEALTH INSURANCE PROGRAM IS AVAILABLE TO ALL MEMBERS WHO ARE UNDERINSURED OR NOT INSURED. NEMHS HAS A SLIDING FEE SCALE THROUGH THE RIVERSIDE FAMILY CLINIC AND WOLF POINT CLINIC ASSOCIATION. 5. THE TEEN BIRTHRATE IN ROOSEVELT COUNTY IS 101.9 PER 1,000 BIRTHS COMPARED TO 32 PER 1,000 FOR THE STATE. TEEN PREGNANCY IS A COMPLEX ISSUE IN THE COMMUNITY FOR MANY DIFFERENT REASONS. MONTANA DPHHS HAS GRANTS AVAILABLE THAT ARE ADDRESSING TEENAGE PREGNANCY. NEMHS DOES NOT HAVE THE WORKFORCE AVAILABLE OR FINANCIAL RESOURCES TO CONDUCT A MEANINGFUL STUDY AT THIS TIME. 6. ROOSEVELT COUNTY HAS A RATE OF 857.1 PER 100,000 PEOPLE WITH HEPATITUS C COMPARED TO 112.95 PER 100,000 FOR THE STATE. HEPATITUS C RATES ARE TRADITIONALLY HIGH WITHIN MONTANA'S TRIBAL POPULATIONS. SOME STEPS HAVE BEEN TAKEN TO ADDRESS THIS ISSUE; INDIAN HEALTH SERVICES HAS IMPLEMENTED A NEEDLE EXCHANGE TO HELP FIGHT THE HEPATITIS CRISIS. 7. THE UNINTENTIONAL INJURY DEATH RATE FOR ROOSEVELT COUNTY IS 96.7 PER 100,000 PEOPLE COMPARED TO 41.3 PER 100,000 FOR THE STATE. SOME OF THIS CAN BE ATTRIBUTED TO MONTANA NOT HAVING A PRIMARY SEATBELT LAW AND NO CONSISTENT DUI CHECK POINTS. NEMHS CONTINUES TO PROMOTE HEALTHY BEHAVIORS THAT CAN REDUCE UNINTENTIONAL INJURY IN THE CLINICS, EMERGENCY DEPARTMENTS, AND THE COMMUNITY AT LARGE. 2 WOLF POINT CLINIC ASSOCIATION 301 KNAPP STREET WOLF POINT MT 59201 RURAL HEALTH CLINIC RIVERSIDE FAMILY CLINIC PO BOX 629 POPLAR MT 59255 RURAL HEALTH CLINIC PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION THE COST OF BAD DEBT REMOVED FROM THE COMMUNITY BENEFIT EXPENSE IN COLUMN C IS 164,815. PHYSICIAN CLINIC COSTS ARE NOT INCLUDED IN SUBSIDIZED HEALTH CARE SERVICES. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION USED ADJUSTED COST TO CHARGE RATIOS FOR PATIENT CARE FROM THE MEDICARE COST REPORT, ADJUSTED FOR BED TAX AND WORKFORCE DEVELOPMENT EXPENSE. BAD DEBT EXPENSE AND FINANCIAL ASSISTANCE ARE ALREADY EXCLUDED FROM THE MEDICARE COST REPORT. PART II - COMMUNITY BUILDING ACTIVITIES THE STAFF AT NEMHS DESIGNATES TIME FOR THE DEVELOPMENT OF COMMUNITY HEALTH PROGRAMS AND PARTNERSHIPS. THESE ACTIVITIES/INITIATIVES OFTEN TARGET ENVIRONMENTAL STRATEGIES, ECONOMIC DEVELOPMENT AND LEADERSHIP, ADVOCACY AND SUPPORT THAT INDIRECTLY AFFECT THE HEALTH OF THE COMMUNITY. PART II, LINE 8: NEMHS IS LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREA AND SPENT 62,558 TO RECRUIT PHYSICIANS AND OTHER HEALTH PROFESSIONALS NEEDED IN THE COMMUNITY. THE COST IS COMPRISED OF PAYMENTS TO RECRUITING FIRMS, NEWSPAPER AND PERIODICALS ADVERTISING, LEGAL FEES FOR FOREIGN PROFESSIONALS, AND TRAVEL AND LODGING FOR SITE VISITS. THE ENTITY ALSO ENTERED INTO AN ARRANGEMENT COSTING 24,000 WITH MILES COMMUNITY COLLEGE TO RECRUIT/TRAIN NURSING STUDENTS THROUGH THEIR PRACTICAL ASSESSMENTS TO HOPEFULLY RECRUIT AND RETAIN NURSING STUDENTS AS THEY ARE LICENSED. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY THE ORGANIZATION'S PATIENT CARE COST TO CHARGE RATIO, AFTER ELIMINATING BAD DEBT, FINANCIAL ASSISTANCE, BED TAX, AND COMMUNITY BENEFIT EXPENSE, IS APPLIED TO GROSS BAD DEBT CHARGES TO ARRIVE AT THE COST OF BAD DEBT. DISCOUNTS REDUCE REVENUE AND ARE NOT RECORDED AS BAD DEBT. PAYMENTS RECEIVED ON PREVIOUSLY WRITTEN OFF ACCOUNTS ARE RECORDED AS RECOVERIES OF BAD DEBT WHICH REDUCE BAD DEBT EXPENSE. NONE OF THE BAD DEBT IS CONSIDERED ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE. BAD DEBTS ARE AN INEVITABLE RESULT OF OPERATING A NON-PROFIT HOSPITAL. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS THE BAD DEBT EXPENSE FOOTNOTE IS ON PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8 - MEDICARE EXPLANATION THERE IS NO MEDICARE SHORTFALL. MEDICARE COSTS ON PART III, LINE 6 ARE DIRECTLY FROM THE MEDICARE COST REPORT, PLUS AMBULANCE MEDICARE COSTS BASED ON THE AMBULANCE COST-TO-CHARGE RATIO ON THE COST REPORT. MEDICARE REVENUE ON PART III, LINE 5 IS DIRECTLY FROM THE MEDICARE COST REPORT, PLUS AMBULANCE MEDICARE REVENUE FROM THE MEDICARE PS&R REPORT. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION THE ORGANIZATION USES A SLIDING SCALE BASED ON FEDERAL POVERTY GUIDELINES, AND ALSO A MEDICALLY INDIGENT TEST REGARDLESS OF INCOME, TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. THE ORGANIZATION DOES NOT ATTEMPT TO COLLECT CHARGES APPROVED AS FINANCIAL ASSISTANCE UNLESS THE PATIENT QUALIFIES FOR DISCOUNTED CARE AND THEN DEFAULTS ON THE PAYMENT PLAN ON THE BALANCE OF THE ACCOUNT. THIS IS A SPECIFIC POLICY FOR PATIENTS QUALIFYING FOR FREE OR DISCOUNTED CARE. PART VI, LINE 2 - NEEDS ASSESSMENT PURSUANT TO THE PROVISIONS OF THE AFFORDABLE CARE ACT, NEMHS ADOPTED A COMMUNITY HEALTH NEEDS ASSESSMENT PLAN AND AN IMPLEMENTATION STRATEGY DURING FISCAL YEARS 2019, 2016 AND 2013 (TAX YEARS 2018, 2015 AND 2012). THESE ARE A CONTINUATION AND EXPANSION OF WHAT WE ARE ALREADY DOING TO BETTER SERVE OUR COMMUNITY. WE ARE DILIGENTLY TRACKING LOCAL TRENDS IN HEALTH CARE NEEDS THROUGH AN CUSTOM SURVEY SOLUTIONS PATIENT SATISFACTION SURVEY GIVEN TO ALL INPATIENTS AS WELL AS THE USE OF OUR INTERNAL BALANCED SCORE CARD. A SELECTED TEAM OF MANAGERS MEET QUARTERLY TO DISCUSS OUTCOMES FROM OUR SURVEY REPORTS AND BALANCED SCORE CARD FINDINGS. HERE IS ONE OF OUR PAST FINDINGS: PATIENTS EXPRESSED THEIR DISSATISFACTION WITH HAVING TO TRAVEL OVER 50 MILES TO RECEIVE PHYSICAL THERAPY SERVICES. SOME PATIENTS EXPRESSED FRUSTRATION WITH HAVING TO PLAN EXTENDED STAYS IN BILLINGS AFTER MAJOR SURGERIES THAT REQUIRE PHYSICAL THERAPY FOLLOWUP BECAUSE THE SERVICES WERE NOT OFFERED LOCALLY. A GROUP OF MANAGERS WAS BROUGHT TOGETHER TO PLAN A FEASIBILITY STUDY IN BRINGING PHYSICAL THERAPY SERVICES TO NEMHS, AND SEVERAL PLANS WERE MADE. A PHYSICAL THERAPIST FROM A NEIGHBORING COMMUNITY WAS ABLE TO MAKE A COMMITMENT TO COME ON AS AN EMPLOYEE FOR A YEAR. AS THERE WAS NO SPACE AVAILABLE IN A HOSPITAL WING, A SPACE WAS EMPTIED AND DESIGNATED FOR PHYSICAL THERAPY IN THE LONG TERM CARE CENTER. PHYSICAL THERAPY SERVICES WAS TO BE OFFERED FOR BOTH INPATIENTS AND OUTPATIENTS WITH OUTSIDE REFERRALS BEING ACCEPTED FOUR DAYS A WEEK. THIS WAS TO BE A TEST TO MAKE SURE PHYSICAL THERAPY SERVICES COULD BE FEASIBLY OFFERED IN THE LONG TERM AT NEMHS. NEMHS MADE THE INVESTMENT TO DELIVER THE SERVICES NEEDED IN THE COMMUNITY. THE ENTITY HAS ATTEMPTED TO KEEP THE PHYSICAL THERAPIST POSITION FULL EVEN THOUGH THERE WAS A TIMEFRAME. THIS WAS NOT POSSIBLE DUE TO BEING IN A RURAL SHORTAGE AREA. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE NORTHEAST MONTANA HEALTH SERVICES EMPLOYS TWO SOCIAL SERVICE EMPLOYEES TO ASSIST PATIENTS WITH THEIR FINANICAL NEEDS AND OPTIONS. COMMUNITY ADVERTISEMENT IS USED TO EDUCATE PATIENTS AND SUPPORT IS GIVEN ON A ONE-ON-ONE BASIS TO ASSIST COMMUNITY MEMBERS. PATIENTS ARE NOTIFIED BY THE BILLING DEPARTMENT OF OUR POLICY FOR FINANCIAL ASSISTANCE AND ARE SENT A SIMPLE APPLICATION. OUR WEBSITE PROVIDES DETAILS OF OUR FINANCIAL ASSISTANCE POLICY AND THE FINANCIAL ASSISTANCE AVAILABLE. THE PATIENT INVOICES INCLUDE A STATEMENT ABOUT THE FINANCIAL ASSISTANCE POLICY AND HOW TO FIND FURTHER INFORMATION. PART VI, LINE 4 - COMMUNITY INFORMATION THE ORGANIZATION OPERATES ON THE FORT PECK RESERVATION. GEOGRAPHICALLY THIS IS A REMOTE LOCATION WHERE ACCESS TO OTHER HEALTH FACILITIES IS AT LEAST 50 MILES AWAY. WITH SEVERE WEATHER CONDITIONS OFTEN RESULTING IN BLIZZARDS AND IMPASSABLE ROADS, NORTHEAST MONTANA HEALTH SERVICES IS THE FRONTLINE OF CARE FOR THE COMMUNITY. THE POPULATION OF SIOUX AND ASSINIBOINE TRIBAL MEMBERS MAKE UP OUR HIGHEST CONCENTRATION OF PATIENTS WITH DISPARITIES THAT INCLUDE CULTURAL BARRIERS, LOW HOUSEHOLD INCOME, HIGH UNEMPLOYMENT RATES, HIGHER RATES OF TOBACCO, ALCOHOL AND ILLEGAL DRUG USE, AS WELL AS HIGHER THAN AVERAGE RATES OF HEART DISEASE, DIABETES, FETAL ALCOHOL SYNDROME, AND SUICIDE. AS WE CONTINUE OUR EFFORTS TO SERVE THE PUBLIC THROUGH HEALTHCARE AND EDUCATION, THERE IS PROGRESS BEING MADE TO IMPROVE THE QUALITY OF LIFE FOR COMMUNITY MEMBERS. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH NORTHEAST MONTANA HEALTH SERVICES IS GOVERNED BY A VOLUNTARY BOARD OF COMMUNITY MEMBERS REPRESENTING THE GEOGRAPHICAL AREAS OF OUR PRIMARY SERVICE AREA. OUR HOSPITALS PROVIDE 24/7 EMERGENCY SERVICE COVERAGE TO TREAT PATIENTS, INCLUDING THOSE THAT ARE UNABLE TO PAY. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM TWO AFFILIATED RURAL HEALTH CLINICS, WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC, PROVIDE PROFESSIONAL PHYSICIAN AND OTHER PROVIDER SERVICES WHILE NORTHEAST MONTANA HEALTH SERVICES PROVIDES INPATIENT AND OUTPATIENT HOSPITAL SERVICES AND SKILLED NURSING SERVICES. THE TWO RURAL HEALTH CLINICS ARE OPERATED, AND SUBSIDIZED IF NEEDED, BY NORTHEAST MONTANA HEALTH SERVICES. ADDITIONAL INFORMATION PART V: WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC ARE RURAL HEALTH CLINICS THAT ARE OPERATED AND SUBSIDIZED BY NORTHEAST MONTANA HEALTH SERVICES. THEIR REVENUE AND EXPENSES ARE NOT INCLUDED ON NORTHEAST MONTANA HEALTH SERVICES' FORM 990. X false true false false false false false false false MARK ZILKOSKI MD MEDICAL STAFF REP 209680 133381 343061 MARGARET NORGAARD CEO 171880 2763 25356 199999 HANZ ARNSTON RN 148439 1113 9356 158908 VICKI HOUSTON RN 143239 1074 9356 153669 ELAINE LONG RN-VP NURSING 140462 2809 9356 152627 LORI COLLINS RN 138472 2529 9356 150357 SCHEDULE J, PAGE 1, PART I, LINE 4 MARK ZILKOSKI, MD 0 131,284 0 SCHEDULE J, PART III THE COMPENSATION OF MARK ZILKOSKI, MD IS AN EXPENSE OF WOLF POINT CLINIC ASSOCIATION, A RELATED PARTY. A MT FACILITY FINANCE AUTHORITY BONDS 364615155 2017-01-31 9820000 REFUNDING OF 2007B REVENUE BONDS false false false A 9820000 794798 8827353 196400 1449 2017 true false true true A false false false false false false true A false false false false false false false false false A false FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS REVIEWED AND APPROVED BY THE CEO AND CFO AND IS DISTRIBUTED TO THE GOVERNING BOARD FOR REVIEW PRIOR TO BEING FILED. FORM 990, PAGE 6, PART VI, LINE 12C THE MEMBERS OF THE GOVERNING BOARD SIGN CONFLICT OF INTEREST STATEMENTS ANNUALLY IN WHICH THEY ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST. IF A POTENTIAL CONFLICT DOES EXIST, THE BOARD CHAIRMAN WILL REMIND MEMBERS AND ASK THEM TO ABSTAIN FROM VOTING. THESE CONFLICTS ARE DULY NOTED IN THE MINUTES. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD APPROVES THE WAGES OF THE CEO AND OTHER TOP MANAGEMENT OFFICIALS IN THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 15B THE CEO APPROVES THE WAGES OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS ARE AVAILABLE FROM CFO UPON REQUEST. FORM 990, PART VII THE MEDICAL STAFF REPRESENTATIVE ON THE GOVERNING BOARD, MARK ZILKOSKI, M.D., IS EMPLOYED BY WOLF POINT CLINIC ASSOCIATION, A RELATED PARTY, AS A FULL TIME PHYSICIAN WHICH IS INCLUDED AT 40 HOURS PER WEEK. FORM 990, PART IX, LINE 11G PURCHASED SERVICES & LOCUMS 2,082,350 0 50 CONTRACT NURSING STAFF 991,447 0 0 CONTRACT LABORATORY STAFF 234,488 0 0 TOTAL 3,308,285 0 50 FORM 990, PART XI, LINE 9 FUNDRAISING EXPENSES NETTED AGAINST REVENUE 6,549 FUNDRAISING EXPENSES NETTED AGAINST REVENUE -6,549 RIVERSIDE FAMILY CLINIC PO BOX 629 POPLAR MT 59255 810474760 CLINIC MT 501C3 3 NEMHS true WOLF POINT CLINIC ASSOCIATION 301 KNAPP STREET WOLF POINT MT 59201 810386812 CLINIC MT 501C3 3 NEMHS true NEMHS CHARITABLE FOUNDATION INC PO BOX 341 POPLAR MT 59255 383732814 SUPPORT MT 501C3 7 N/A false NE MT STAT AIR AMB COOP 519 PLEASANT STREET MILES CITY MT 59301 204748673 AIR AMBUL MT 501C3 12B N/A false FAITH LUTHERAN HOME FOUNDATION INC 1000 6TH AVE N WOLF POINT MT 59201 810483586 SUPPORT MT 501C3 PF N/A false false false true false false false false false false false false false false false true false false false true NEMHS CHARITABLE FOUNDATION C 35445 CASH GIFTS NEMHS CHARITABLE FOUNDATION O 63636 DIRECT EXPENSE FAITH LUTHERAN HOME FOUNDATION C 9974 CASH GIFTS RIVERSIDE FAMILY CLINIC S 581733 DECREASE IN RECEIVABLE WOLF POINT CLINIC ASSOCIATION S 133082 DECREASE IN RECEIVABLE