2020-07-13T18:46:10-05:00 2019-06-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2018-07-01 810384618 BIG HORN HOSPITAL ASSOCIATION BIGH 4066652310 17 NORTH MILES AVENUE HARDIN MT 59034 KRISTI GATRELL CEO 4066652310 2020-07-09 1 ROBERT E SCHILE P00369682 6123764500 2020-07-09 67.137.57.251 2020-07-09 09:54:12 CD P 9C1DED54EE6A56468881F41BE7A7DD662CF8FCB7 8DF0D5A1DBF8E44DE93554FEEDBEEE801640FE4C 2018 2020-09-22 18:59:49Z KRISTI GATRELL 17 NORTH MILES AVENUE HARDIN MT 59034 16366948 0 X WWW.BIGHORNHOSPITAL.ORG X 1980 MT TO PROVIDE QUALITY MEDICAL AND HEALTH SERVICES IN BIG HORN COUNTY AND SURROUNDING AREAS. 8 7 216 15 0 0 729868 337097 16115573 15562963 62059 325182 75524 55941 16983024 16281183 65615 78292 0 0 9562954 10098373 0 0 0 6473979 6248987 16102548 16425652 880476 -144469 13641693 27308203 2213088 15658251 11428605 11649952 X BIG HORN HOSPITAL ASSOCIATION PROVIDES QUALITY SERVICES AND PROMOTES RESPONSIBLE CHOICES TO ENHANCE THE HEALTH OF OUR COMMUNITIES. 0 0 14013468 78292 15562963 BIG HORN HOSPITAL ASSOCIATION IS COMPRISED OF BIG HORN HOSPITAL AND BIG HORN SENIOR LIVING. BIG HORN HOSPITAL IS A 25-BED ACUTE CARE HOSPITAL. BIG HORN SENIOR LIVING IS A 36-BED NURSING CARE FACILITY AND A 10-UNIT ASSISTED LIVING AND 10-UNIT INDEPENDENT LIVING.DURING THE YEAR ENDED JUNE 30, 2019, BIG HORN COUNTY MEMORIAL HOSPITAL PROVIDED 306 DAYS OF INPATIENT SERVICES, 8,063 OUTPATIENT VISITS (INCLUDING 5,275 ER VISITS) AND 1,470 DAYS OF RESIDENT SERVICES; BIG HORN SENIOR LIVING PROVIDED 12,152 DAYS OF LONG TERM CARE RESIDENT SERVICES, 3,036 DAYS OF ASSISTED LIVING RESIDENT SERVICES.BIG HORN HOSPITAL ASSOCIATION PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDED CARE TO THESE PATIENTS WAS $522,420 FOR THE YEAR ENDED JUNE 30, 2019. 14013468 1 1 0 1 0 0 0 0 1 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 19 0 216 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 1 0 0 1 0 1 1 0 0 0 1 1 1 1 1 1 0 0 X ROXIE CAIN CONTROLLER 4066659222 17 N MILES AVENUE HARDIN MT 59034 TERRY BULLIS CHAIRMAN 0.40 0.20 X X 0 0 0 COLLEEN SCHAAK VICE CHAIRMAN 0.40 0.00 X X 0 0 0 JAMES SEYKORA SECRETARY 0.40 0.20 X X 0 0 0 CHAD FENNER MEMBER (THROUGH DECEMBER 2018) 0.40 0.00 X 0 0 0 DAVID MARK MEMBER 0.40 0.00 X 0 0 0 JERRY SMITH MEMBER 0.40 0.00 X 0 0 0 MATT TORSKE MEMBER 0.40 0.00 X 0 0 0 THOR TORSKE MEMBER 0.40 0.20 X 0 0 0 LARRY VANDERSLOOT MEMBER 0.40 0.00 X 0 0 0 KRISTI GATRELL CEO 39.00 1.00 X 116959 0 21189 ROXIE CAIN CONTROLLER 39.00 1.00 X 108688 0 27104 PAULINE KING PROVIDER 40.00 0.00 X 163008 0 2500 CINDY LEWIS PURCELL RN 40.00 0.00 X 157136 0 1040 CYNTHIA HUGS RN 40.00 0.00 X 187310 0 27104 LINDA TROYER PROVIDER 40.00 0.00 X 137722 0 2961 SHANNON WAGENMAN DIRECTOR OF PROVIDER SERVICES 40.00 0.00 X 142504 0 27104 1013327 0 109002 15 0 1 0 FISHER CONTRUCTION INC 235 MOORE LANE BILLINGS MT 59101 CONSTRUCTION 4921966 CUSHING TERRELL PO BOX 30071 BILLINGS MT 59107 ARCHITECTURAL SERVICES 510225 ATHENA HEALTH PO BOX 415615 BOSTON MA 02241 E.H.R SOFTWARE, LICENSES, SUPPORT 308632 BILLINGS CLINIC RATA PO BOX 30977 BILLINGS MT 59107 RADIOLOGY SERVICES 203621 NXC IMAGING 2118 FOURTH AVENUE SOUTH MINNEAPOLIS MN 55404 MAINTENANCE SERVICES 203002 11 48398 288699 337097 PATIENT REVENUE 621110 15434627 15434627 OTHER PATIENT REVENUE 900099 128336 128336 15562963 325182 325182 94404 85765 8639 8639 8639 CAFETERIA 722210 47302 47302 47302 16281183 15562963 0 381123 X 78292 78292 273940 273940 8145344 7335271 810073 168093 152595 15498 1027544 914564 112980 483452 432933 50519 423 423 167142 73479 93663 1665461 1496369 169092 1111 1111 63058 56938 6120 105808 93402 12406 464303 464303 1036610 1008285 28325 174878 42332 132546 MEDICAL SUPPLIES 909576 907646 1930 OTHER EXPENSES 588089 400503 187586 TAXES & LICENSES 284888 276126 8762 FOOD 272123 272134 -11 515517 471065 44452 16425652 14013468 2412184 0 1042402 0 2365087 2564163 3309266 3571216 100313 137889 382976 412699 118915 169596 24366784 12149700 5020167 12217084 0 5766313 0 0 1302567 2469243 13641693 27308203 1541408 2535643 8001 30032 0 11000000 47864 69995 615815 1644659 0 377922 2213088 15658251 X 11423199 10373135 5406 1276817 11428605 11649952 13641693 27308203 X -144469 -171818 -368104 905738 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 0 PART II-B, LINE 1: A PORTION OF THE DUES PAID TO THE MONTANA HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, AND LEADING AGE (FORMERLY AAHSA) ARE USED FOR LOBBYING PURPOSES. 1 1 X 416071 416071 15252868 11837596 3415272 2525179 312104 2213075 6172666 6172666 12217084 THIRD PARTY RECEIVABLE 2469243 2469243 UNEARNED GRANT REVENUE 235225 CHECKS WRITTEN IN EXCESS OF CASH 142697 377922 PART IV, LINE 2B: THE HOSPITAL ACTS AS A CUSTODIAN FOR THE FUNDS OF THE NURSING HOME RESIDENTS. THOSE FUNDS APPEAR AS RESTRICTED CASH AND ACCOUNTS PAYABLE IN THE BALANCE SHEET. 1 1 X 1 X 1 X 1 1 1 0 0 8177 8177 0.00050 6871105 6415692 455413 0.02800 6879282 6415692 463590 0.02850 6879282 6415692 463590 0.02850 1 161713 0 4373237 4461583 -88346 X 1 0 1 1 BIG HORN HOSPITAL ASSOCIATION 17 NORTH MILES AVENUE HARDIN MT 59034 WWW.BIGHORNHOSPITAL.ORG 12469 X X X BIG HORN HOSPITAL ASSOCIATION 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X HTTPS://WWW.BIGHORNHOSPITAL.ORG X 1 18 1 HTTPS://WWW.BIGHORNHOSPITAL.ORG 0 1 X 150.000000000000 300.000000000000 X X X 1 1 X X X X 1 X HTTPS://WWW.BIGHORNHOSPITAL.ORG X HTTPS://WWW.BIGHORNHOSPITAL.ORG X HTTPS://WWW.BIGHORNHOSPITAL.ORG X X X X X X 1 X 0 X X X X 1 X 0 0 BIG HORN HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: A STEERING COMMITTEE WAS CONVENED TO ASSIST BIG HORN HOSPITAL ASSOCIATION IN CONDUCTING THEIR CNHA. A DIVERSE GROUP OF COMMUNITY MEMBERS REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY (EX. PUBLIC HEALTH, ELDERLY, UNINSURED) CAME TOGETHER IN JAN 2019. SEE LIST BELOW OF ALL GROUPS REPRESENTED ON THE STEERING COMMITTEE. THE STEERING COMMITTEE MET TWICE DURING THE CHNA'S 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 PRIORITIZATIONS OF HEALTH NEEDS TO ADDRESS. GROUPS REPRESENTED ON THE STEERING COMMITTEE:1. BIG HORN COUNTY PUBLIC HEALTH 2. CITY OF HARDIN 3. BHCMH AUXILIARY 4. BIG HORN HOSPITAL ASSOCIATION 5. BIG HORN VALLEY HEALTH CENTER 6. BIG HORN SENIOR LIVING AUXILIARY. BIG HORN HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6B: MONTANA STATE UNIVERSITY AND MONTANA OFFICE OF RURAL HEALTH BIG HORN HOSPITAL ASSOCIATION PART V, SECTION B, LINE 11: IN FY2019 BIG HORN HOSPITAL ASSOCIATION (BHHA) CONTINUED OUR EFFORTS TO INCREASE QUALITY, AFFORDABLE CARE FOR BIG HORN COUNTY AND OUR SURROUNDING AREAS:1. BHHA ENTERED A NEW LEASE TO PROVIDE UPGRADED IMAGING SERVICES FOR OUR RESIDENTS. WE WERE ABLE TO UPGRADE OUR MRI UNIT TO PROVIDE UPDATED TECHNOLOGY AS WELL AS A LARGER BORE TO ACCOMMODATE MORE PATIENTS. WE WERE ALSO ABLE TO PURCHASE A NEW MAMMOGRAPHY UNIT WITH THE ABILITY TO PERFORM 3D BREAST TOMOGRAPHY FOR ADDITIONAL BENEFIT AND EARLY DETECTION POSSIBILITIES FOR OUR PATIENT RIGHT IN THEIR HOMETOWN.2. BHHA ALSO PURCHASED AN UPDATED EKG UNIT TO ALLOW UPGRADED TECHNOLOGY AS WELL AS THE ABILITY TO STORE INFORMATION WITHIN THE ELECTRONIC HEALTH RECORD.3. BHHA MOVED FORWARD WITH AN $11M REMODEL PROJECT. THIS PROJECT WAS FUNDED THRU A $3M TAXABLE BOND ISSUANCE AND AN $8M NON-TAXABLE BOND ISSUANCE. THIS PROJECT EXPANDS OUR CURRENT EMERGENCY DEPARTMENT (ED) TO ACCOMMODATE THE INCREASED VOLUME. THE NEW ED AND PATIENT WING ALSO ALLOW FOR GREATER SECURITY, BOTH PHYSICALLY AND HIPAA, FOR OUR PATIENTS WITH CONTROLLED ACCESS. THIS REMODEL ALSO ALLOWS FOR A DEDICATED AMBULANCE BAY/ENTRANCE. THIS REMODEL WILL ALLOW FOR BETTER PATIENT FLOW AND EASIER ACCESS TO ANCILLARY SERVICES SUCH AS IMAGING AND LABORATORY.4. BHHA BEGAN WORK WITH THE STAFF REGISTERED DIETITIAN TO DEVELOP OUTPATIENT NUTRITIONAL SERVICES FOCUSING ON DIABETIC EDUCATION.5. BHHA ALSO APPLIED FOR AND RECEIVED A HELMSLEY GRANT TO IMPLEMENT EEMERGENCY IN THE EMERGENCY DEPARTMENT. THIS TECHNOLOGY PROVIDES ADDITIONAL RESOURCES FOR STAFF AND PATIENTS. THE STAFF WILL HAVE THE ABILITY TO HAVE AN EMERGENCY ROOM DOCTOR AVAILABLE FOR CONSULTATION. THE DR WILL BE ABLE TO SEE AND HEAR THE PATIENT AND THE STAFF TO AID. THIS SYSTEM WILL ALSO AID WITH DOCUMENTATION AND TRANSFER REQUESTS AMONG OTHER ITEMS. THIS SYSTEM ALSO PROVIDES MUCH NEEDED RESOURCES FOR FINDING MENTAL HEALTH RESOURCES FOR OUR COMMUNITY.6. UNFORTUNATELY, BHHA IS NO LONGER PROVIDING A NAVIGATOR TO ASSIST WITH INSURANCE NEEDS. HOWEVER, THERE IS STILL A NAVIGATOR AT BIG HORN VALLEY HEALTH CENTER THAT WE CAN REFER PATIENTS TO FOR ASSISTANCE. 7. BHHA HAS SEVERAL STAFF MEMBERS WORKING WITH THE LOCAL FQHC (BIG HORN VALLEY HEALTH CENTER) TO ASSIST WHERE POSSIBLE IN COMBATING THE CURRENT OPIOD CRISIS IN OUR COUNTY. THE FQHC RECEIVED A GRANT AND PARTNERED WITH BHHA TO ATTEND TO DEVELOP OPTION TO BATTLE THIS CRISIS. BIG HORN HOSPITAL ASSOCIATION PART V, SECTION B, LINE 16J: WHEN OUR PATIENT ACCOUNTS REPRESENTATIVE BECOMES AWARE OF A PATIENT'S POTENTIAL FINANCIAL HARDSHIP AND/OR SELF PAY STATUS, A COMMUNITY CARE APPLICATION IS SENT TO THAT INDIVIDUAL. PART V, SECTION B, LINES 7A AND 10A A COPY OF THE CHNA IS LOCATED AT:HTTPS://WWW.BIGHORNHOSPITAL.ORGA COPY OF THE CHNA IMPLEMENTATION PLAN IS AT:HTTPS://WWW.BIGHORNHOSPITAL.ORG PART V, SECTION B, LINES 16A, 16B, AND 16C A COPY OF THE FINANCIAL ASSISTANCE POLICY AND THE APPLICATION IS LOCATED AT:HTTPS://WWW.BIGHORNHOSPITAL.ORG/WP-CONTENT/UPLOADS/2017/03/103.12_POLICIES_UNCOMPENSATED-SERVICES_COMMUNITY_CARE.PDF 1 1 - HERITAGE ACRES 200 NORTH MITCHELL AVENUE HARDIN MT 59034 NURSING HOME WITH ASSISTED LIVING AND INDEPENDENT LIVING UNITS PART I, LINE 3C: CHARITY CARE MAY BE GRANTED TO A PATIENT ON A CASE BY CASE BASIS AS DETERMINED BY THE CEO AND CONTROLLER UPON SPECIAL REQUEST BY THE PATIENT DUE TO UNFORSEEN CIRCUMSTANCES. PART I, LINE 7: A COST-TO-CHARGE RATIO DERIVED USING WORKSHEET 2 FROM THE IRS WAS USED TO CALCULATE THE AMOUNTS IN PART I, LINE 7. PART I, LN 7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE EQUAL TO $161,713 INCLUDED IN FORM 990, PART IX, LINE 25 WAS EXCLUDED IN CALCULATING THE PERCENT OF TOTAL EXPENSE IN SCHEDULE H, PART I, LINE 7, COLUMN F. PART III, LINE 2: BHHA USES HISTORICAL DATA TO ESTIMATE BAD DEBT EXPENSE BASED ON THE PAYOR TYPE AND AGE OF THE ACCOUNT. PART III, LINE 3: BIG HORN HOSPITAL ASSOCIATION CANNOT REASONABLY ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT DID NOT COMPLETE AN APPLICATION. PART III, LINE 4: SEE THE "PATIENT AND RESIDENT ACCOUNTS RECEIVABLE" PARAGRAPH IN NOTE 1 ON PAGE 15 OF THE FINANCIAL STATEMENTS FOR A DESCRIPTION OF BIG HORN HOSPITAL ASSOCIATION'S BAD DEBT EXPENSE. PART III, LINE 8: THE MEDICARE SHORTFALL OF $88,346 IS MADE UP MOSTLY OF PATIENT DEDUCTIBLES AND COINSURANCE. IF WE BACK THESE AMOUNTS OUT OF THE SHORTFALL, WE ARE LEFT WITH A TRUE SHORTFALL OF $50,519. THIS AMOUNT IS A RESULT OF THE FEDERAL GOVERNMENT'S SEQUESTRATION IMPLEMENTED BACK IN THE SUMMER OF 2016. THE MEDICARE ALLOWABLE COSTS INCLUDED IN PART III, LINE 6 WERE DERIVED FROM THE JUNE 2019 FILED MEDICARE COST REPORT. PART III, LINE 9B: CATASTROPHIC COMMUNITY CARE: BHHA MAY ALSO WRITE OFF AS COMMUNITY CARE AMOUNTS FOR PATIENTS WITH FAMILY INCOME IN EXCESS OF THE FEDERAL POVERTY STANDARDS WHEN CIRCUMSTANCES INDICATE SEVERE FINANCIAL HARDSHIP OR PERSONAL LOSS AS DETERMINED BY BHHA. EXAMPLES OF THIS WOULD INCLUDE, BUT ARE NOT LIMITED TO, LOSS OF A JOB AFTER TAXES WERE FILED, EXTENSIVE HEALTH ISSUES CAUSING LARGE BILLS ETC PART VI, LINE 2: BHHA CONTINUALLY ASSESSES THE NEEDS OF OUR COMMUNITY THRU SEVERAL AVENUES. IN ADDITION TO PERFORMING A COMMUNITY HEALTH NEEDS ASSESSMENT, BHHA WORKS CLOSELY WITH THE VARIOUS CLINICS IN TOWN TO DISCUSS TRENDS AND SOLUTIONS FOR A VARIETY OF ISSUES INCLUDING HEALTH TRENDS, STAFFING NEEDS AND MAKING PATIENT CARE AS SEAMLESS AS POSSIBLE. BHHA ALSO REVIEWS OUR INTERNAL UTILIZATION TO HELP ASSESS THE NEEDS OF OUR COMMUNITY. THIS ALLOWS BHHA STAFF AND OUR BOARD OF DIRECTORS TO MAKE DECISIONS ABOUT IMPROVEMENT AREAS SUCH AS WHAT EQUIPMENT TO UPGRADE AND WHICH SERVICES TO EXPAND IF POSSIBLE. BHHA IS VERY COMMITTED TO KEEPING AS MANY OF THE COMMUNITY HEALTH CARE NEEDS LOCAL AS POSSIBLE. PART VI, LINE 3: THE FACILITY KEEPS FORMS ON HAND THAT ARE AVAILABLE (IN PLAIN SIGHT) FOR DIFFERENT GOVERNMENT PROGRAMS SUCH AS HEALTHY MT KIDS. THE ADMINISTRATIVE STAFF WILL INFORM ANY PRIVATE PAY PATIENT OF OUR COMMUNITY CARE AND WILL ALSO RELAY THIS INFORMATION TO CUSTOMERS WHEN DISCUSSING PAYMENT OPTIONS FOR OUTSTANDING BILLS. PART VI, LINE 4: BHHA SERVES A HIGH POVERTY LEVEL. WE ARE ON THE EDGE OF THE CROW INDIAN RESERVATION AND HAVE A LOT OF CUSTOMERS WHO UTILIZE INDIAN HEALTH SERVICES AS A PAYOR SOURCE FOR HEALTH CARE. OUR POPULATION HAS A LARGE POPULATION OF MEDICARE AND MEDICAID CUSTOMERS. AS WE SERVE A SMALL TOWN IN MONTANA, THE POPULATION CONSISTS OF A LOT OF CHILDREN AS WELL AS ELDERLY, BOTH OF WHICH UTILIZE OUR HEALTHCARE SYSTEM. PART VI, LINE 5: BHHA DOES HAVE A COMMUNITY BOARD TO HELP NOT ONLY "RUN" THE FACILITY WITH POLICIES AND PROCEDURES, BUT TO GIVE INPUT TO THE MANAGEMENT TEAM ABOUT THE NEEDS THEY SEE FOR THE COMMUNITY IN WHICH THEY LIVE. BHHA IS DEVELOPING MORE EDUCATIONAL PROGRAMS FOR ITEMS SUCH AS WOMEN'S HEALTH, DIABETES MANAGMENT AND SMOKING CESSATION.BHHA USES THE LOCAL PAPERS AND SOCIAL MEDIA (FACEBOOK) AS AN OUTLET FOR GIVING THE PUBLIC INFORMATION ON DIFFERENT TYPE OF HEALTH CONCERNS, SUCH AS DIABETES, WEIGHT LOSS, ETC. BHHA ALSO USED THE COMMUNITY HEALTH NEEDS ASSESSMENT TO TRACK ITEMS THE COMMUNITY WANTS &/OR NEEDS. 1 HERITAGE ACRES AUXILIARY LIMITED PO BOX 474 HARDIN MT 59034 810444017 501(C)(3) 9210 TO SUPPORT GENERAL OPERATIONS BIG HORN COUNTY MEMORIAL HOSPITAL AUXILIARY HC 36 BOX 2065 HARDIN MT 59034 810428249 501(C)(3) 9210 TO SUPPORT GENERAL OPERATIONS BIG HORN COUNTY MEMORIAL HOSPITAL AND HEALTHCARE FOUNDATION 17 NORTH MILES AVENUE HARDIN MT 59034 810504410 501(C)(3) 24560 TO SUPPORT GENERAL OPERATIONS 3 0 PART I, LINE 2: THE GRANTS MADE WERE AN EQUITY TRANSFER AND PASSING ALONG DONATIONS TO RELATED ORGANIZATIONS. THESE FUNDS ARE TRACKED THROUGH THE ORGANIZATION'S INTERNAL FINANCIAL REPORTING PROCESS. X X X 0 0 0 0 0 0 0 0 0 PAULINE KING PROVIDER 163008 0 0 0 0 0 2500 0 0 0 165508 0 0 0 CINDY LEWIS PURCELL RN 157136 0 0 0 0 0 1040 0 0 0 158176 0 0 0 CYNTHIA HUGS RN 187310 0 0 0 0 0 2500 0 24604 0 214414 0 0 0 SHANNON WAGENMAN DIRECTOR OF PROVIDER SERVICES 142504 0 0 0 0 0 2500 0 24604 0 169608 0 0 0 A MONTANA FACILITY FINANCE AUTHORITY 364615155 2018-11-01 8000000 HOSPITAL REMODEL 0 0 0 A 8000000 708645 160000 4257416 0 0 0 0 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 ANGELA SMITH EMPLOYEE'S SPOUSE IS A BOARD MEMBER 140385 EMPLOYEE OF BIG HORN HOSPITAL ASSOCIATION 0 FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE AMENDED IN 2018 TO ELIMINATE THE BIG HORN COUNTY COMMISSIONERS' POWER TO APPROVE THE ELECTION OR APPOINTMENT OF ALL BOARD MEMBERS TO BIG HORN HOSPITAL ASSOCIATION AND TO ELIMINATE THE BIG HORN COUNTY COMMISSIONERS' POWER TO REMOVE ANY DIRECTOR AT LARGE FOR ANY REASON. FORM 990, PART VI, SECTION A, LINE 7A A MEMBER (WHICH MEMBER IS DECEIDED BY A VOTE BETWEEN THE THREE COMMISSIONERS) OF BIG HORN COUNTY COMMISSIONERS IS AUTOMATICALLY DEEMED A MEMBER OF THE BOARD OF DIRECTORS OF BIG HORN HOSPITAL ASSOCIATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED IN DETAIL BY THE CONTROLLER AND CEO. THE FORM 990 WAS PRESENTED TO THE BOARD MEMBERS AT A BOARD MEETING AFTER BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C REGULAR 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. THERE IS ONE BOARD MEMBER THAT HAS A SPOUSE EMPLOYED BY BIG HORN HOSPITAL ASSOCIATION. THEY ABSTAIN FROM ANY VOTES THAT WOULD AFFECT WAGES AND BENEFITS FOR EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15A BIG HORN HOSPITAL ASSOCIATION UTILIZES THE MONTANA HOSPITAL ASSOCIATION SALARY SURVEY TO MAKE SURE EMPLOYEE WAGES ARE COMPARABLE TO SIMILAR JOBS IN SIMILAR AREAS. EXPERIENCE IS ALSO A FACTOR IN THE WAGE. THIS IS REVIEWED EACH FEBRUARY WHEN THE MHA SALARY SURVEY IS AVAILABLE FOR REVIEW. WAGES ARE ADJUSTED WITH THE SCALE IF NEEDED. THE BOARD REVIEWS AND APPROVES THE CEO'S COMPENSATION. THIS WAS LAST DONE IN 2019. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,496,369. MANAGEMENT AND GENERAL EXPENSES 169,092. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,665,461. FORM 990, PART XI, LINE 9: APARTMENT DEPRECIATION -2,977. EQUITY TRANSFERS 908,715. BIG HORN COUNTY MEMORIAL HOSPITAL AND HEALTHCARE FOUNDATION 17 N MILES AVENUE HARDIN MT 59034 810504410 HOSPITAL FUNDRAISING MT 501(C)(3) LINE 12A, I BIG HORN HOSPITAL ASSOCIATION 1 BIG HORN COUNTY MEMORIAL HOSPITAL AUXILIARY HC 36 BOX 2065 HARDIN MT 59034 810428249 FUNDS TO BENEFIT BIG HORN COUNTY MEMORIAL HOSPITAL MT 501(C)(3) LINE 12B, II N/A 0 HERITAGE ACRES AUXILIARY LIMITED PO BOX 474 HARDIN MT 59034 810444017 FUNDS TO BENEFIT HERITAGE ACRES NURSING HOME MT 501(C)(3) LINE 12B, II N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 BIG HORN HOSPITAL FOUNDATION B 24560 ACTUAL CASH GIVEN