2020-08-17T11:07:43-05:00 2019-09-30 810446334 DOUGLAS WILSON & COMPANY PC 1000 FIRST AVENUE SOUTH GREAT FALLS MT 59401 990 2018-10-01 810530457 NORTHERN ROCKIES MEDICAL CENTER INC NORT 4068732251 802 SECOND STREET SE CUT BANK MT 59427 CHERIE TAYLOR CEO 4068732251 2020-08-17 1 HEIDI BRANDT P01728511 4067614645 72.174.36.34 2020-08-17 08:41:34 MD P C10D37500AA378137F36BAC146330B05E857F42E C10D37500AA378137F36BAC146330B05E857F42E 2018 2020-09-23 17:36:50Z CHERIE TAYLOR 802 SECOND STREET SE CUT BANK MT 59427 9295929 0 X WWW.NRMCINC.ORG X 2001 MT NORTHERN ROCKIES MEDICAL CENTER PROVIDES QUALITY HEALTHCARE THAT SERVES OUR COMMUNITIES IN A PRIVATE, SAFE, AND CARING ENVIRONMENT. 10 9 104 9 0 0 190383 43465 8321041 8879339 543 443 300000 372682 8811967 9295929 0 0 0 0 5597415 5410420 0 0 0 4087426 3560605 9684841 8971025 -872874 324904 3508410 3751049 1650348 1568083 1858062 2182966 X NORTHERN ROCKIES MEDICAL CENTER PROVIDES QUALITY HEALTHCARE THAT SERVES OUR COMMUNITIES IN A PRIVATE, SAFE, AND CARING ENVIRONMENT. 0 1 7021613 9252464 PROVIDE INPATIENT, OUTPATIENT, AND CLINICAL HEALTHCARE SERVICES TO RESIDENTS OF GLACIER COUNTY AND THE SURROUNDING AREAS. 7021613 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 11 0 1 104 1 0 0 0 0 0 0 0 0 0 0 X 10 9 1 0 0 0 1 1 0 1 0 0 0 0 1 1 1 1 1 1 1 0 X TREASURE BERKRAM 4068732251 802 SECOND STREET SE CUT BANK MT 59427 RICK BILLMAN BOARD CHAIRMAN 1.00 X X 0 0 0 LON PETERSON BOARD VICE CHAIRMAN 1.00 X X 0 0 0 JOYCE LEWIS SECRETARY 1.00 X X 0 0 0 DR MARK HAEMIG BOARD TRUSTEE 1.00 X 0 0 0 GAIL DAVIS BOARD TRUSTEE 1.00 X 0 0 0 RICHARD GANNON BOARD TRUSTEE 1.00 X 0 0 0 LINDA LUTHER BOARD TRUSTEE 1.00 X 0 0 0 LARRY SCHWINDT BOARD TRUSTEE 1.00 X 0 0 0 BRIAN SUTTLE BOARD TRUSTEE 1.00 X 0 0 0 HENRY CLAY CHIEF OF STAFF / MD 40.00 X 328700 0 0 CHERIE TAYLOR CEO 40.00 X 117606 0 0 TREASURE BERKRAM CFO 40.00 X 95756 0 0 SUZANNAH BEALS CNO 40.00 X 103250 0 0 NIALL ATKINSON FNP 48.00 X 177911 0 0 GREGORY COWART CRNA 40.00 X 221693 0 0 STEVE TRIPONEY FNP 48.00 X 156903 0 0 JUSTIN PERRY PHYSICAL THERAPIST 40.00 X 112469 0 0 MADIA RODRIGUEZ-MORALES FNP 40.00 X 143219 0 0 MICHAEL D'AMBROSE MD 40.00 X 405846 0 0 1863353 0 0 7 0 1 0 ASSOCIATED EMPLOYERS PO BOX 81087 BILLINGS MT 591081087 EMPLOYER HEALTH INSURANCE 371087 GUARDIAN HEALTHCARE PROVIDERS 105 W PARK DRIVE SUITE 100 BRENTWOOD TN 370275062 LOCUM NURSING COVERAGE 344046 KALISPELL REGIONAL HOSPITAL 310 SUNNYVIEW LANE KALISPELL MT 59901 CONTRACT SERVICES 304357 VISTA STAFFING SOLUTIONS INC FILE 50834 LOS ANGELES CA 900740834 LOCUM EMERGENCY ROOM COVERAGE 294126 JOHN HANCOCK RETIREMENT PLAN PO BOX 600 BUFFALO NY 142010600 RETIREMENT PLAN SERVICES 219655 10 21746 21719 43465 NET PATIENT SERVICE RE 621110 7739402 7739402 BED TAX REVENUE 621110 809164 809164 OTHER PATIENT REVENUE 621110 321323 321323 RELATED RENTAL 621110 9450 9450 8879339 443 443 COUNTY TAX REVENUE 624100 300000 300000 OTHER NON-PATIENT 624100 72682 72682 372682 9295929 9252464 0 0 4698837 3848904 849933 711583 582871 128712 212497 55385 157112 33869 1071 32798 64423 61169 3254 31464 31464 254822 254822 185993 14981 171012 PURCHASED SERVICES 1480901 1115197 365704 SUPPLIES 547693 513873 33820 REPAIRS AND MAINTENANCE 249742 249682 60 UTILITIES 156501 156501 0 342700 167157 175543 8971025 7021613 1949412 0 527844 362947 876620 1067087 188344 172341 31014 22793 4038659 3101059 1085558 937600 113882 121173 685148 1067108 3508410 3751049 1081024 1184476 10982 569324 372625 1650348 1568083 X 1858062 2182966 1858062 2182966 3508410 3751049 324904 0 X 0 1 X 0 0 X 0 0 0 1 1 1 1 1 1 0 0 PART II-B, LINE 1: DUES PAID WHICH INCLUDE A LOBBYING PORTION TO MHA (MONTANA HOSPITAL ASSOCIATION) IN THE AMOUNT OF $118 AND AHA OF $700. 101008 14153 115161 384684 98236 286448 215423 153039 62384 3323391 2849784 473607 937600 BED TAX RECEIVABLE 663078 COUNTY TAXES RECEIVABLE 367000 OTHER RECEIVABLES 37030 1067108 9295929 0 9295929 0 9295929 8971025 0 8971025 0 8971025 1 1 X 1 X 1 X 1 0 1 1 87652 87652 0.00980 3344973 2887337 457636 0.05100 3432625 2887337 545288 0.06080 244220 21750 222470 0.02480 244220 21750 222470 0.02480 3676845 2909087 767758 0.08560 1 196667 2872191 2861689 10502 X 1 1 1 1 NORTHERN ROCKIES MEDICAL CENTER INC 802 SECOND STREEN NE CUT BANK MT 59427 WWW.NRMCINC.ORG 13337 X X X NORTHERN ROCKIES MEDICAL CENTER INC 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X WWW.NRMCINC.ORG X 1 18 1 WWW.NRMCINC.ORG 0 1 X 200.000000000000 200.000000000000 X X 1 1 X X X 1 X WWW.NRMCINC.ORG X WWW.NRMCINC.ORG X WWW.NRMCINC.ORG X X X X X 1 X 0 X X X 1 X 0 0 NORTHERN ROCKIES MEDICAL CENTER INC PART V, SECTION B, LINE 5: PART V, SECTION B, LINE 5: A STEERING COMMITTEE WAS CONVENED TO ASSIST NORTHERN ROCKIES MEDICAL CENTER IN CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT. A DIVERSE GROUP OF COMMUNITY MEMBERS REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY. (EX. PUBLIC HEALTH, AND THE UNDERSERVED - LOW INCOME, UNDERINSURED, ELDERLY, YOUTH, AND TRIBAL/AMERICAN INDIAN) CAME TOGETHER IN FEBRUARY 2019. THE GROUP INCLUDED A MEMBERS OF THE GLACIER COUNTY HEALTH DEPARTMENT, GLACIER COMMUNITY HEALTH CENTER, GLACIER CARE CENTER, PASTORAL COUNCIL, CUT BANK TRAILS, OPPORTUNITIES INC, AND EMPLOYEES OF NORTHERN ROCKIES MEDICAL CENTER (CEO, CFO, COMMUNITY HEALTH IMP SPECIALIST, DIRECTOR OF ACUTE CARE SERVICES), ETC. NORTHERN ROCKIES MEDICAL CENTER INC PART V, SECTION B, LINE 11: PART V, SECTION B, LINE 11: 1.THE NEED TO IMPROVE ACCESS TO, AND AWARENESS OF AVAILABLE RESOURCES AND SERVICES THROUGH ENHANCED COORDINATION AND COLLABORATION WITH COMMUNITY PARTNERS WILL BE ADDRESSED BY EXPANDING NRMC'S COORDINATION AND COLLABORATION EFFORTS WITH AREA PARTNERS TO ENHANCE ACCESS TO HEALTH CARE AND COMMUNITY RESOURCES. 2. THE NEED TO ENHANCE NRMC PROGRAMS AND SERVICES THAT PROMOTE HEALTH AND WELLNESS IN GLACIER COUNTY WILL BE ADDRESSED BY INCREASING THE COMMUNITY'S KNOWLEDGE AND ACCESS TO PROGRAMS AND SERIVCES THAT IMPROVE POPULATION HEALTH. NRMC WILL ALSO EXPLORE OPPORTUNITES TO ENHANCE CARE COORDINATION AND POPLULATION HEALTH EFFORTS. 3. THE NEED TO STRENGTHEN ACCESS TO BEHAVIORAL HEALTH WILL BE ADDRESSED BY EXPLORING OPPORTUNITIES TO EXPAND BEHAVIORAL HEALTH RESOURCES AND SERVICES AT NRMC. NRMC WILL ALSO SUPPORT LOCAL BEHAVIORAL AND MENTAL HEALTH SERVICES AND INITIATIVES. 4. THE NEED TO ENHANCE SENIOR SERVICES AND OUTREACH TO SUPPORT GLACIER COUNTY'S AGING POPULATION TO AGE IN PLACE WILL BE ADDRESSED BY DETERMINING THE FEASIBILITY OF EXPANDING ACCESS VIA ALTERNATIVE / REMOTE CARE METHODOLOGIES TO REDUCE THE BURDEN OF TRAVEL AND REDUCE ISOLOATION. NORTHERN ROCKIES MEDICAL CENTER INC PART V, SECTION B, LINE 13B: PART V, SECTION B, LINE 13B: FOR FINANCIAL ASSISTANCE (UNINSURED) FPG IS USED. FOR FINANCIAL HARDSHIP (INSURED), A DEBT/INCOME PERCENTAGE IS USED. A PATIENT'S GROSS INCOME IS COMPARED TO THEIR TOTAL EXPENSES AND A DEBT/INCOME PERCENTAGE IS CALCULATED. THIS PERCENTAGE THEN DETERMINES THE AMOUNT OF DISCOUNTED OR FREECARE THAT IS PROVIDED. 100%, 80%, 60%, 40%, AND 20% IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE TABLE. PART I, LINE 7: COMMUNITY BENEFIT EXPENSE IS CALCULATED FROM THE COST-TO-CHARGE RATIO PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION PROMOTES THE COMMUNITY'S HEALTH BY PARTICIPATING IN ANNUAL HEALTH FAIRS THAT ENCOMPASS ALL AREAS OF WELLNESS INCLUDING DIABETES SCREENING, BONE DENSITY, AND BLOOD PRESSURE CHECKS. THEY PARTNERED WITH THE LOCAL PHARMACY TO PROVIDE FLU SHOTS AND THE RED CROSS TO PROVIDE A BLOOD DRIVE. THROUGHOUT THE YEAR, THE ORGANIZTION DOES FREE BLOOD PRESSURE CHECKS AND PARTICIPATES IN A FREE PHYSICAL THERAPY EQUIPMENT LOAN PROGRAM TO ASSIST WITH REHABILITATION AT HOME. PART III, LINE 2: TO DETERMINE THE AMOUNTS USED ON LINE 2, PART III, THE AMOUNTS WRITTEN OFF TO BAD DEBT ARE WHAT ARE LEFT OVER AFTER ANY APPLICABLE DISCOUNTS, INSURANCE, AND PAYMENTS HAVE BEEN APPLIED. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBT FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS BY USING HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. PATIENT RECEIVABLES ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE PART III, LINE 4: IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE,THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBT FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FORRECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 8: MEDICARE ALLOWABLE COST IS BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CMS. PART III, LINE 9B: THE FINANCIAL ASSISTANCE POLICY AND MEDICARE BAD DEBT POLICY ARE APPLIED UNIFORMLY ACROSS ALL PATIENTS, REGARDLESS OF PAYOR STATUS. PART VI, LINE 2: A STEERING COMMITTEE WAS CONVENED TO ASSIST NORTHERN ROCKIES MEDICAL CENTER IN CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT. A DIVERSE GROUP OF COMMUNITY MEMBERS REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY. (EX. PUBLIC HEALTH, AND THE UNDERSERVED - LOW INCOME, UNDERINSURED, ELDERLY, YOUTH, AND TRIBAL/AMERICAN INDIAN) CAME TOGETHER IN FEBRUARY 2019. THE GROUP INCLUDED A MEMBERS OF THE GLACIER COUNTY HEALTH DEPARTMENT, GLACIER COMMUNITY HEALTH CENTER, GLACIER CARE CENTER, PASTORAL COUNCIL, CUT BANK TRAILS, OPPORTUNITIES INC, AND EMPLOYEES OF NORTHERN ROCKIES MEDICAL CENTER (CEO, CFO, COMMUNITY HEALTH IMP SPECIALIST, DIRECTOR OF ACUTE CARE SERVICES), ETC. PART VI, LINE 3: THE ORGANIZATION'S SELF PAY PATIENT REPRESENTATIVE WORKS WITH THE PATIENT TO DETERMINE HIS/HER ELIGIBILITY FOR FEDERAL, STATE, OR LOCAL PROGRAMS THAT THEY MAY QUALIFY FOR. THEY WORK WITH THE PATIENT ONE ON ONE TO QUALIFY THE PATIENT FOR ANY ELIGIBLE CHARITY CARE PROGRAM. PART VI, LINE 4: NORTHERN ROCKIES MEDICAL CENTER SERVES CUT BANK AND THE SURROUNDING GLACIER COUNTY, WHICH ALSO INCLUDES THE BLACKFEET INDIAN RESERVATION. GLACIER COUNTY IS A LOW-INCOME COUNTY. THE PRIMARY INDUSTRY IN GLACIER COUNTY IS AGRICULTURE. PART VI, LINE 5: THE ORGANIZATION PROMOTES THE COMMUNITY'S HEALTH BY PARTICIPATING IN ANNUAL HEALTH FAIRS THAT ENCOMPASS ALL AREAS OF WELLNESS INCLUDING DIABETES SCREENING TO BLOOD PRESSURE CHECKS TO PAID SCREENING. THE ORGANIZATION DOES FREE BLOOD PRESSURE CHECKS AND PARTICIPATES IN A FREE PHYSICAL THERAPY EQUIPMENT PROGRAM TO ASSIST WITH REHABILTATION AT HOME. THE ORGANIZATION IS ALSO PARTICIPATING IN A WORKSITE WELLNESS PILOT PROGRAM WITH THE CUT BANK SCHOOL SYSTEM. THIS PROGRAM PROVIDED LAB DRAWS, WELLNESS PROFILES, AND EXERCISE CLASSES. RESULTS WERE TRACKED TO MONITOR RESULTS. THE ORGANIZATION ALSO PARTICIPATED IN COMMUNITY WELLNESS, PROVIDING A 12 WEEK LIFESTYLE CHALLENGE, EXERCISE CLASSES, AND SPORTS PHYSICALS. X X X X 0 0 0 0 0 0 0 0 0 HENRY CLAY CHIEF OF STAFF / MD 323224 0 0 0 5476 0 0 0 0 0 328700 0 0 0 NIALL ATKINSON FNP 164759 0 0 0 13152 0 0 0 0 0 177911 0 0 0 GREGORY COWART CRNA 216217 0 0 0 5476 0 0 0 0 0 221693 0 0 0 STEVE TRIPONEY FNP 147953 0 0 0 8950 0 0 0 0 0 156903 0 0 0 MICHAEL D'AMBROSE MD 383148 0 0 0 22698 0 0 0 0 0 405846 0 0 0 DR MARK HAEMIG HOSPITAL TRUSTEE FUNDING FOR FACILITY PARTICIPATION IN BALLOT INITIATIVE X 20000 10982 0 1 1 10982 FORM 990, PART III, LINE 3 DISCONTINUATION OF OB SERVICES DUE TO LACK OF UTILIZATION FROM COMMUNITY. FORM 990, PART VI, SECTION A, LINE 2 ONE BOARD MEMBER OWNS A FURNITURE AND HARDWARE STORE. NORTHERN ROCKIES MEDICAL CENTER DOES BUSINESS WITH THE STORE AS IT IS THE ONLY STORE IN TOWN. FORM 990, PART VI, SECTION A, LINE 6 ONE CLASS OF MEMBER WITH $100 MINIMUM DONATION THAT ALLOWS YOU TO VOTE FOR THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7A FOR EVERY $100 DONATED, ONE VOTE IS RECEIVED. FORM 990, PART VI, SECTION A, LINE 8B COMMITTEES DO NOT HAVE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE ORGANIZATION'S INDEPENDENT ACCOUNTANT. DUE TO THE DEADLINE, THE FORM WAS SUBMITTED TO THE IRS PRIOR TO REVIEW AND APPROVAL FROM THE BOARD. ANY CHANGES WILL BE FILED THROUGH THE AMENDMENT PROCESS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ANNUALLY REVIEWS THE POLICY WITH THE BOARD AND REQUESTS ANY CONFLICTS BE DISCLOSED AT EACH BOARD MEETING. CONFLICTS OF INTEREST ARE DISCLOSED TO ADMINISTRATION AND SAFEGUARDS ARE ESTABLISHED TO PROTECT ALL PARTIES. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION PACKAGES ARE APPROVED BY THE BOARD OF DIRECTORS FOR PHYSICIANS, CEO, AND UNIONS. THE ORGANIZATION'S CEO IS RESPONSIBLE FOR THE HIRING OF ALL OTHER STAFF USING COMPARATIVE DATA TO ENSURE REASONABLE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 ALL PUBLIC DOCUMENTS ARE AVAILABLE FOR REVIEW AT THE ORGANIZATION'S ADMINISTRATIVE UPON REQUEST.