2020-11-06T11:59:39-06:00 2019-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2019-01-01 810232121 Bozeman Deaconess Health Services BOZE 4064145000 915 Highland Boulevard Bozeman MT 59715 Brad Ludford CFO 4064145000 2020-11-05 1 Kim Hunwardsen CPA P00484560 6122536500 2020-10-16 63.233.88.226 2020-11-05 13:40:30 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 F4E1B545B5A64400ED95821F5295FDCB6EE8A6F8 2019 2021-01-29 14:40:06Z Bozeman Health Brad Ludford 915 Highland Boulevard Bozeman MT 59715 111687168 0 X www.bozemanhealth.org X 1911 MT To improve community health and quality of life for residents and visitors of the Bozeman, MT area. 11 10 620 302 1078130 -212126 481565 416028 101344014 107132793 -1509028 291662 94056 147846 100410607 107988329 377000 692215 0 0 65443442 72162512 0 0 0 43720579 34579088 109541021 107433815 -9130414 554514 121251849 128437016 79845082 86104643 41406767 42332373 X To improve community health and quality of life. 0 0 42949203 40077473 Bozeman Health Medical Group employs physicians under the Bozeman Health system umbrella. This group of providers compassionately serves the patients of Bozeman Health Deaconess Hospital, Big Sky Medical Center, Bozeman Health Urgent Care, and Bozeman Health Convenience Care, LLC. 9382174 11072319 In efforts to reach our community and surrounding area in multiple facets of healthcare, the Bozeman Health system operates additional healthcare facilities which allows more access and levels of care.Big Sky Medical Center had 34 admissions and saw 4,175 patients in the Emergency Room and over 5,300 in the clinic in 2019. The net revenue yield on these operations was only 60.1%, or $566 per equivalent ER visit. With challenging core staffing and related costs, the operating expense (excluding interest, taxes and depreciation) was $808 per equivalent ER visit. This resulted in a $3.7M operating loss for the year. Bozeman Health is committed to providing access and patient care to the Big Sky community in spite of the financial operational challenges the facility continues to face.Bozeman Health also continues to operate our Main Street Urgent Care as an outpatient healthcare access point. With a 55.1% yield on $2.9M of patient charges and operating costs of $3.4M, the Urgent Care netted a loss of ($459k) in 2019. 39725894 692215 55983001 Bozeman Health serves as the parent company of the Bozeman Health system. As the corporate parent, management, general and administrative services are centralized here and provided to the operating units caring for our patients. These administrative and support services aim to optimize executive, organizational and financial responsibilities to allow the health system to continue to grow and serve the population. In this past year, Bozeman Health had 20,364 inpatient days, 209,445 outpatient hospital visits, 243,757 outpatient clinic visits, 32,439 emergency room visits and performed 9,052 surgeries. 92057271 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 214 0 1 620 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 X Carrie Morasko 4064145039 915 Highland Blvd Bozeman MT 59715 John Hill CEO 35.00 15.00 X 769088 0 120083 Nathaniel Madsen Cardiology 50.00 0.00 X 712111 0 41641 Dane Sobek MD 2nd V.C. (Jan-Jun)/Director (Jul-Dec) 50.00 1.00 X X 708750 0 41653 Kleanthis Dendrinos Gastroenterologist 50.00 0.00 X 596428 0 35641 Peter Walsh Gastroenterologist 50.00 0.00 X 581009 0 42353 Blair Erb Cardiology 50.00 0.00 X 580282 0 32545 Andrew Gentry Gastroenterologist 50.00 0.00 X 566189 0 43455 Elizabeth Lewis COO (Jan-Mar) 25.00 25.00 X 528748 0 19342 Brad Ludford CFO 15.00 35.00 X 358874 0 55932 Darci Bentson CAO 25.00 25.00 X 346456 0 68011 Gordon Davidson Former CFO 0.00 0.00 X 398385 0 0 Brian Brown Chair (Jan-Jun) 1.00 1.00 X X 0 0 0 Katie Daughenbaugh 1st V.C. (Jan-Jun)/Chair (Jul-Dec) 1.00 1.00 X X 0 0 0 Kerri Brown Director (Jan-Jun)/2nd V.C. (Jul-Dec) 1.00 1.00 X X 0 0 0 Robert Watson Secretary (Jan-Jun) 1.00 1.00 X X 0 0 0 John How Secretary (Jul-Dec) 1.00 1.00 X X 0 0 0 Dennis Munson Treas. (Jan-Jun)/1st V.C. (Jul-Dec) 1.00 1.00 X X 0 0 0 Don Beeman Treasurer (Jul-Dec) 1.00 1.00 X X 0 0 0 Peter Buerhaus Director 1.00 1.00 X 0 0 0 Jerry Cashman Director 1.00 1.00 X 0 0 0 Kerry Petitt Director 1.00 1.00 X 0 0 0 Walt Sales Director 1.00 1.00 X 0 0 0 Amy Strader Director 1.00 1.00 X 0 0 0 6146320 0 500656 172 1 1 0 Absaroka Emergency Physicians 1184 N 15th Street Suite 1 Bozeman MT 59715 ER Physicians Fee 6192340 Gallatin Valley Anesthesia 3805 Valley Commons Dr Ste 7 Bozeman MT 59718 Anesthesia Services 1650159 ROI Healthcare Solutions LLC 1595 Peachtree Pkwy Ste 204-239 Cumming GA 30041 Consulting Services 1322874 Montana Linen Supply LLC 20900 E Frontage Rd Ste A Belgrade MT 59730 Linen Cleaning 1116269 The Noliwhite Group LLC PO Box 680217 Franklin TN 370680217 Consulting Services 421331 22 416028 416028 Hlth System Corp Services 900099 50418081 50418081 Hlth System Physician Services 621110 40077473 40077473 Patient Service Revenue 621110 9769993 9769993 Pharmacy Revenue 446110 1268388 190258 1078130 5598858 5598858 107132793 280100 280100 147846 0 147846 147846 147846 3710401 3698839 11562 11562 11562 107988329 106054663 1078130 439508 692215 692215 3021471 751377 2270094 398385 398385 57886732 54722860 3163872 2382830 2328374 54456 5295404 4367888 927516 3177690 2805117 372573 1089736 67156 1022580 154800 154800 62365 62365 8937244 5831399 3105845 1942269 1864868 77401 547199 503663 43536 1385716 1002303 383413 292048 228298 63750 194699 152199 42500 1446867 1446867 5974976 5974976 2203110 54157 2148953 Equipment Rent & Mainte 6444535 6368588 75947 Medical Supplies 1723901 1721977 1924 Goodwill Impairment 869549 869549 1310074 1018189 291885 107433815 92057271 15376544 0 37580431 35234957 3321552 5498746 472337 311990 279288 310583 3598979 3609959 86421572 30384853 52034131 56036719 5936218 6528785 7606008 10757599 8695493 7825944 1727412 2321734 121251849 128437016 18181593 19796279 21491088 21192587 9572467 8950061 30599934 36165716 79845082 86104643 X 39915322 40469836 1491445 1862537 41406767 42332373 121251849 128437016 X 554514 371092 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 56400 0 1 5965 62365 0 Part II-B, Line 1: Hired consultant to provide lobbying services in connection with governmental affairs representation to ensure hospital, community, and employee interests and needs are represented. Bozeman Deaconess Health Services reimburses certain professional membership dues of employees, a portion of such membership dues are used by the professional associations for lobbying activities. The dues for MHA and AHA were $5,965. 16272305 227769 3135666 1205532 18430208 16828400 335927 -723008 169014 16272305 14747913 223082 2235283 377878 16828400 13928221 122889 843418 146615 14747913 13788550 99933 216493 176755 13928221 0.68470 0.15840 0.15680 0 1 1 11816783 11816783 29576645 3420192 26156453 42628755 26964661 15664094 2399389 2399389 56036719 Investment in Affiliated Organizations 10757599 F 10757599 Deposits 9488 Capitalized Lease Obligation 5387466 Due To Affliates 30768762 36165716 X Part V, Line 4: Each endowment fund is privy to a separate agreement. Donations made for each purpose shall be received, held, and invested by the Bozeman Deaconess Foundation according to established policies governing gift acceptance, investment, and distribution. The principal of the fund shall be retained in perpetuity. The interest income is utilized for the greatest needs of the designated department. Policy says the organization can use a portion of interest for operations. The endowment fund reported in Line 1 is currently being held by a related organization, Bozeman Deaconess Foundation, and benefits Bozeman Health and related system entities. Due to this relationship the endowment fund is being reported all the Form 990, Schedule D, Part V for all three related entities. Part X, Line 2: The Organization believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 1 1 1 0 0 425987 3245 422742 0.00400 1962139 1100668 861471 0.00810 2388126 1103913 1284213 0.01210 314692 61982 252710 0.00240 15000 15000 0.00010 3022582 2747680 274902 0.00260 692215 692215 0.00650 4044489 2809662 1234827 0.01160 6432615 3913575 2519040 0.02370 1 1171072 0 2109326 3888007 -1778681 X 1 1 1 Rocky Mountain Surgical Center LLC Outpatient Surgical Center 0.51010 0.00000 0.48990 2 Deaconess Intercity Imaging LLC Radiology 0.77500 0.00000 0.22500 3 Spanish Peaks Plaza LLC Real Estate 0.69940 0.00000 0.30060 1 1 Big Sky Medical Center 334 Town Center Ave Big Sky MT 59716 www.bigskymedicalcenter.com 13563 X X X X Big Sky Medical Center LLC 1 0 0 1 X X X X X X X X X 17 1 1 1 1 X See Part V, Section B, Line 7d X 1 17 1 See Part V, Section B, Line 10a 0 1 X 150.000000000000 250.000000000000 X X X X 1 1 X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X X 1 X 0 X X X X 1 X 0 1 Big Sky Medical Center, LLC Part V, Section B, Line 5: To solicit feedback from key community stakeholders, we utilized an Online Key Informant Survey and collected responses in March and April of 2017. We asked the Key Informants to rate the degree to which various health issues are a problem in their community. Follow-up questions asked them to describe why they identify problem areas as such, and how theses might be better addressed. In total, we invited 68 Key Informants via email including physicians and advanced practice clinicians, public and community health representatives, health professionals, social service providers, and community leaders to participate. Of the 68 invited, 40 participated. Input was gathered from several individuals whose organizations work with low-income, minority populations, or other medically underserved populations. These populations include: African-Americans, domestic violence victims, elderly, English as a second language, foreign visitors to Yellowstone, those with geographic barriers, Hispanic, homeless, immigrants, LGBTQ, low-income, Medicare/Medicaid recipients, mentally ill, Native Americans, non-English speaking, seasonal workers, undocumented immigrants, uninsured/underinsured, veterans, women and children Big Sky Medical Center, LLC Part V, Section B, Line 6a: Bozeman Health Deaconess Hospital Big Sky Medical Center, LLC Part V, Section B, Line 6b: Community Health Partners Gallatin City-County Health Department Big Sky Medical Center, LLC Part V, Section B, Line 7d: Hospital Website:www.bozemanhealth.org/media/1433/2017_prc_chna_report_bsmc.pdf Big Sky Medical Center, LLC Part V, Section B, Line 11: Based on the CHNA and community / stakeholder input, BSMC adopted the following priority areas:1. Behavioral Health (Mental Health + Substance Abuse)2. Access to Health Services 3. Healthy Lifestyles (Nutrition, Physical Activity & Weight + Heart Disease & Stroke)4. Injury & Violence During 2019, BSMC worked in a couple of the priority areas:1.Behavioral Health-We expanded our Youth Aware of Mental Health (YAM) program to 9th grade youth in Big Sky.-We hosted a Mental Health First Aid Training for community members.-We planned for the launch of a mental health awareness and stigma reduction campaign, Man Therapy.2. Access to Health Services -We continued to operate our mobile screening program, HealthCare Connections, offer free preventive health screenings and services to community members.3. Healthy Lifestyles -We continued to support GoNoodle for all the middle schools in the BSMC service area.-We established the 5210+ Gallatin County Coalition, and launched a community-wide campaign around the national 5210 framework.4. Injury and Violence -We completed the planning process for a Relationship Violence Symposium for community providers. Big Sky Medical Center, LLC Part V, Section B, Line 13h: Any individual and their dependents who are at 150% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but they must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Big Sky Medical Center, LLC Part V, Section B, Line 16j: Medical Advocacy Services in Healthcare (MASH) will give out our financial application after determining patient is ineligible for federal and state programs. A summary of the financial assistance policy is attached to billing invoices, posted in patient admissions area, and provided to patient on admission to the hospital facility. Big Sky Medical Center, LLC Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be billed gross charges on elective procedures. Schedule H, Part V, Section B, Line 16a-16c: Line 16a:https://www.bozemanhealth.org/media/1572/financial-assistance.pdfLine 16b:https://www.bozemanhealth.org/media/1578/financial-assistance-application-2019-english-final.pdfLine 16c:https://www.bozemanhealth.org/media/1574/fa-policy-plain-language-summary.pdf Schedule H, Part V, Section B, Line 10a www.bozemanhealth.org/media/2044/20182020-bsmc-cbsp-final.pdf 6 1 - Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Imaging Center 2 - Rocky Mountain Surgery Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 Outpatient Surgical Center 3 - Hospice of Southwest Montana LLC 3810 Valley Commons Dr Ste 1 Bozeman MT 59715 Hospice Services 4 - Bozeman Health Urgent Cares LLC 1006 W Main Bozeman MT 59715 Outpatient Health Care 5 - Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 Contracted Physician Services 6 - Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Health Care Part I, Line 3c: Any individual and their dependents who are at 150% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but they must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Part I, Line 7: The cost to charge ratio from Worksheet 2 was used to obtain the costs related to Charity Care, Medicaid, and Other Means-Tested Programs. All net benefit expenses were calculated using direct costs and revenue with reasonable indirect overhead allocation methods. Benefits are allocated at 23% of payroll dollars. For Subsidized Services, other indirect overhead costs are allocated based on historical reasonableness of 15% of total expenses. Our internal system does record patient revenues based on type (inpatient vs. outpatient vs. emergency) and payor (Medicaid, Medicare, Commercial, Self-Pay, etc.). Related costs are then determined based on the pro-rated share as a percentage of the total. For example, if Medicaid comprises 7% of a department's revenue, Medicaid expenses are calculated at 7% of the total as well.Lines 7e, 7f, 7i are based on actual expenses. Part I, Line 7g: Amount of cost attributable to a physician clinic is $3,022,582. The Urgent Care disregarded entity was reported as a subsidized services, pulling out the financial assistance and Medicaid to report separately as appropriate. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 1,172,072. Part III, Line 2: Bad debt is reported at charges as recorded by the organization and included joint ventures. The bad debt reported on line two is considered to be all due to implicit price considerations. Part III, Line 4: The footnote to the organization's financial statements that describes bad debt expenses is located in Footnote 1 on page 11 of the attached financial statements. Part III, Line 8: The entire amount of shortfall should be considered a community benefit.The Medicare shortfall represents a cost absorbed by the Hospital as a result of providing care to Medicare patients. The contract driving this loss is a nondiscretionary contract, as is providing the services to this population of individuals. The cost of providing this benefit to the community should be reportable as such. Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.For the Joint Ventures, Net Medicare Revenue was used as the revenue received, and that percentage of total revenues was applied against operating expenses to determine related costs. The Joint Venture portion of the shortfall is $1,482,639. Part III, Line 9b: Bozeman Health's Financial Assistance Policy explains the patient notification practice that includes providing the patient, either directly or through its contracted collection agency with at least one written notice informing the patient about the Extraordinary Collection Actions that we intend to take if the patient does not submit an Application for Financial Assistance or pay the amount due by at least thirty days following the date of the notice. The notice will include a copy of the plain language summary and will not be mailed or delivered to a patient earlier than 30 days prior to the end of the Notification Period. No Extraordinary Collection Actions will be undertaken during the 120 day Notification Period, during which time we will take reasonable efforts to determine whether the patient is eligible for Financial Assistance. After the 120 day Notification Period, an Extraordinary Collection Action will be undertaken only if the patient has received the 30 day written notice described above. Extraordinary Collection Actions are defined as those actions that may be taken in the event of non-payment following the expiration of the notification period. These may include the reporting of adverse information about the individual to consumer credit reporting agencies or credit bureaus, garnishment of an individual's wages, and/or commencement of a legal civil action against an individual. As part of Bozeman Health collection practices, any patient account placed in collections will be pulled back from collections should that patient apply for financial assistance within 240 days of receiving their initial patient statement. Part VI, Line 2: In addition to the CHNA, Bozeman Health Big Sky Medical Center (BSMC) assesses community health care needs in a number of ways. The hospital sends representatives to community meetings and conversations related to health and heath care to hear directly from community members - patients, clients, stakeholders, etc. - about their needs. In a related fashion, the hospital also convenes community members - patients, clients, stakeholders, etc. - to solicit feedback about health and health care needs. Finally, the hospital looks at and considers 3rd party projections about health care needs and available local and national trend data when making health care delivery and health improvement decisions. Part VI, Line 3: Bozeman Health is deeply committed to providing financial assistance to patients needing, but unable to afford, medically necessary health care services. As a hospital operating in the Bozeman Health system, Big Sky Medical Center (BSMC) posts notice of its Financial Assistance Policy in all admitting areas, as well as on the website. At the earliest feasible time, BSMC will attempt to determine whether a patient has third party coverage for any part of the hospital services provided. If a patient does not have third party coverage, a patient advocate from the MASH program will screen all inpatient cases and any outpatient cases exceeding $1,000 in total charges to determine if the patient qualifies for third party funding. If not, the patient advocate will explain the Financial Assistance Policy and give the patient an application if desired. In circumstances where payment in full will cause financial hardship that will significantly harm the patient or patient's family, the applicant may be asked to visit with Consumer Credit Counseling Services to further review their financial situations. Upon request, patients may be asked to complete an application for Medicaid participation or for coverage by other governmental payment programs. Patient bills also contain billing information explaining financial options and provide contact information to the appropriate resources. Part VI, Line 4: BH Big Sky Medical Center (BSMC) primarily serves a three zip code region in Gallatin County Montana: 59716 Big Sky, 59730 Gallatin Gateway, and 59758 West Yellowstone (note in certain zip code boundary definitions, 59716 Big Sky is in both Gallatin and Madison County-although the most populous area is in Gallatin County). These 3 communities account for more than 74% of clinic visits at BSMC Big Sky Clinic in 2018. In addition, these same communities account for 24.2% of BSMC's inpatient admissions while 75.8% were of patients originating outside Montana-likely driven by the Big Sky area being a popular tourist destination.The population of the tri-zip code area was an estimated 6,523 (59716: 2,208, 59730: 2,065, and 59758: 2,250) in 2018 (IBM Watson Health). The average median household income (weighted by number of households) in the combined communities was an estimated $59,770 and 12.5% of the population was estimated to be in poverty in 2017 (ACS 5yr estimates, 2017). 2018 estimates suggest that 12.7% of the population in the tri-zip code area are covered by Medicaid, 6.6% are uninsured, and 15.5% are insured under Medicare (IBM Watson Health, 2018). Bozeman Health Big Sky Medical Center is the only hospital in the BSMC three zip code service area, and is one of two hospitals in Gallatin County (BH BSMC and BH Deaconess Hospital). The low income population within Gallatin County is designated as a Primary Care HPSA and the total geographic population of Gallatin County is designated as a Mental Health Professional Shortage (HPSA) Geographic Area HPSA based on 2019 HPSA data.(https://dphhs.mt.gov/publichealth/primarycare/-shortage-area-designations). Part VI, Line 5: The governing body of BSMC is comprised of individuals who represent our community and live in our primary service area, most of whom are independent of the organization. To ensure immediate access to care, BSMC has an open medical staff and requires each medical staff member to care for anyone presenting in the Emergency Department. As an organization, we devote a significant amount of surplus funds into maintaining a high level of patient care through quality initiatives as well as technology and community investments.Various employees, physicians, administrators, and board members of the Hospital are actively involved in volunteer roles including community board positions in numerous other activities, groups, and organizations that actively promote the health of the community.In 2017, Bozeman Health hired a FTE dedicated to community involvement. The System Program Manager for Community Health Improvement and Partnerships works to align Bozeman Health Deaconess Hospital health improvement initiatives with the needs and desires of the communities served by BHDH. This includes, among other things, representing BHDH at community meetings, and planning and implementing programs with community partners to address needs highlighted in the CHNA. Part VI, Line 6: Bozeman Deaconess Health Services owned a majority interest in Deaconess Intercity Imaging, LLC and Rocky Mountain Surgery Center in the current tax year. Although these joint ventures are not licensed hospitals, these organizations hold similar policies regarding providing care to all members of the community and offering financial assistance as determined by ability to pay. 1 Western Montana Mental Health 140 N Russell Missoula MT 59801 810307814 501(c)(3) 300000 Support mental health needs within our service area Greater Gallatin United Way 945 Technology Blvd 101F Bozeman MT 59718 810384820 501(c)(3) 27500 Support human service needs within our service area Cancer Support Community Montana 102 S 11th Ave Bozeman MT 59715 810542266 501(c)(3) 15000 Support cancer support services within our service area Haven PO Box 752 Bozeman MT 59771 810389914 501(c)(3) 6900 Support domestic violence programs within our service area MT State University Foundation PO Box 172750 Bozeman MT 59717 816001649 501(c)(3) 285715 Support improving access to Health Services in our service area Eagle Mount 6901 Goldenstein Ln Bozeman MT 59715 841383214 501(c)(3) 5000 Support therapeutic services to the disability population in our service area National Interscholastic Cycling League 2414 Sixth Street Berkeley CA 94710 134234305 501(c)(3) 10000 Support healthy lifestyles for youth in our service area Thrive PO Box 4325 Bozeman MT 59772 363501185 501(c)(3) 7500 Support human service needs within our service area Bridger Ski Foundation 851 Bridger Drive STE 1243 Bozeman MT 59771 810384359 501(c)(3) 25000 Support healthy lifestyles for youth in our service area 9 0 Part I, Line 2: Recipients of grants and assistance prepare informational reports substantiating the use of the funds that were earmarked to support community health programs. Involvement of Bozeman Deaconess Health Services staff and/or administration as volunteers in the activities being supported also ensures proper usage of funds. X X X 1 1 0 0 0 0 0 0 0 John Hill CEO 605053 0 121753 0 42282 0 95970 0 25493 0 890551 0 0 0 Nathaniel Madsen Cardiology 657543 0 53425 0 1143 0 16800 0 25816 0 754727 0 0 0 Dane Sobek MD 2nd V.C. (Jan-Jun)/Director (Jul-Dec 656182 0 51425 0 1143 0 16800 0 25828 0 751378 0 0 0 Kleanthis Dendrinos Gastroenterologist 501857 0 94234 0 337 0 16800 0 19816 0 633044 0 0 0 Peter Walsh Gastroenterologist 496963 0 82595 0 1451 0 16800 0 26528 0 624337 0 0 0 Blair Erb Cardiology 518036 0 58000 0 4246 0 16800 0 16720 0 613802 0 0 0 Andrew Gentry Gastroenterologist 507776 0 57140 0 1273 0 16800 0 27378 0 610367 0 0 0 Elizabeth Lewis COO (Jan-Mar) 136793 0 32644 0 359311 0 15411 0 4175 0 548334 0 139133 0 Brad Ludford CFO 328497 0 16644 0 13733 0 29916 0 26976 0 415766 0 0 0 Darci Bentson CAO 288648 0 32165 0 25643 0 41201 0 27785 0 415442 0 0 0 Gordon Davidson Former CFO 0 0 16191 0 382194 0 0 0 0 0 398385 0 108860 0 Part I, Lines 4a-b Line 4a: In 2019, Gordon Davidson received severance payments in the amount of $273,334, and Elizabeth Lewis received severance payments in the amoount of $218,736. Part II, column (F) also reports a deferred compensation stock option payout of $108,860 for Gordon Davidson and $139,133 for Elizabeth Lewis that was previously reported as deferred compensation. Line 4b: Schedule J, Part II, column (c) reflects contributions paid by the organization into their individual 457(f) plan. The following contributions were made in 2019. John Hill: $79,170 Brad Ludford: $29,916 Darci Bentson: $24,401 A Montana Facility Finance Authority 364615155 61240MBM8 2014-11-05 23005852 Refinance 2004 bond issued 3/4/2004; fund add'n of Big Sky Medical Facility 0 0 0 B Montana Facility Finance Authority 364615155 000000000 2015-01-09 6300000 Portion for Big Sky Medical Facility 0 0 0 A 1482341 23008884 3032 377976 17500000 5127876 2015 1 0 0 1 B 429710 6300000 15123 6284877 2016 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 A 1 B 1 Date Rebate Computation Performed Issuer Name: Montana Facility Finance Authority Date the Rebate Computation was Performed: 06/21/2019 Schedule K, Part I, Line A(e): Part I issue price and Part II Line 3 bond proceeds differ due to interest earned on the proceeds. Form 990, Part VI, Section A, line 7a The Yellowstone Conference of the Methodist Church confirms the Board Members and has authority to appoint the clergy member of the board. Form 990, Part VI, Section A, line 7b Changing the Articles of Incorporation in relationship to the process of selecting board membership must be approved by the Yellowstone Conference of the United Methodist Church. Form 990, Part VI, Section A, line 8b The organization does not have any committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b A copy of the 990 is provided to both the Planning and Finance Committee as well as the Board of Directors prior to filing. The Finance Team will review Form 990 in detail with the Planning and Finance Committee. Form 990, Part VI, Section B, line 12c Annual Disclosure Statement is obtained from the Board, Operating Committee, and Executive Team Members. Disclosures are reviewed with the Conflict of Interest (COI) Panel (Compliance Officer, Board Compliance Committee Chair, Chief Executive Officer, & Chief Legal Officer). The COI Panel assesses the disclosure, develops an acknowledgement and management plan. The management plan is reviewed with the affected member, if the COI Panel and the member are unable to resolve the disclosure, the disclosure is reported to the Board Compliance Committee for further review. Conflicts are addressed annually in writing and verbally during meetings. If a COI exists, the member shall not participate in any deliberations or vote regarding the transaction or arrangement at issue, and shall not be present in the meeting room for any part of the deliberations or vote relating to the transaction or arrangement. Form 990, Part VI, Section B, line 15 The Executive Compensation Committee receives a formal presentation by an independent compensation consultant (as selected by the Board) qualified to perform compensation reviews including usage of comparability data. This person presents recommendations to the Compensation Committee of the Board. The Compensation Committee makes recommendations to the full Board on an annual basis for Officers and Senior Administration. This annual process was performed in fall 2018 to determine 2019 compensation. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy, and all tax related information required to be available for public inspection are available via walk-in, telephone call, e-mail, and/or mail-in request. The audited financial statements are required to be attached to the Form 990 and provided to the Municipal Securities Rulemaking Board, which is our tax-exempt bonds trustee, via an on-line, central filing location called Electronic Municipal Market Access (EMMA). The financial statements can be obtained by the general public at the EMMA website. Form 990, Part XI, line 9: Change in Temp Restricted Investment of Foundation 371,092. Big Sky Medical Center LLC 334 Town Center Ave Big Sky MT 59716 474718253 Healthcare - Inpatient and Outpatient Servcies MT 7901500 28702071 Bozeman Deaconess Health Services Bozeman Health Urgent Cares LLC 1006 W Main Bozeman MT 59715 465318746 Healthcare - Physician Outpatient Care MT 2961963 6375704 Bozeman Deaconess Health Services Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 475126599 Physician Employment & Contract to Bozeman Health System MT 42949203 2966376 Bozeman Deaconess Health Services Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 822848277 Healthcare-Ambulatory Clinic Outpatient Care MT 396285 1033831 Bozeman Deaconess Health Services Bozeman Deaconess Foundation dba Bozeman Health Foundation 931 Highland Blvd Suite 3200 Bozeman MT 59715 841407943 Raise funds to support Bozeman Deaconess Health Services MT 501(c)(3) Line 7 Bozeman Deaconess Health Services 1 Bozeman Health Deaconess Hospital 915 Highland Blvd Bozeman MT 59715 474717998 Healthcare - Inpatient and Outpatient Services MT 501(c)(3) Line 3 Bozeman Deaconess Health Services 1 Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 810666871 Healthcare - Imaging Services MT Bozeman Deaconess Health Services Related -55253 2787668 0 1 0.77500 Rocky Mountain Surgical Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 364462300 Healthcare - Surgical Services MT Bozeman Deaconess Health Services Related 3773160 3883710 0 0 0.51010 Spanish Peaks Plaza LLC 120 N 19th Ave Suite A Bozeman MT 59718 810539803 Rental Real Estate for VA Med Clinic & Chiro MT Bozeman Deaconess Health Services Related 11733 256703 0 1 0.69940 Bozeman Deaconess Real Estate Development Corp PO Box 10490 Bozeman MT 59719 205496567 Sale of real estate property and residences to seniors MT Bozeman Deaconess Health Services C 220160 7754530 1.00000 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1 Bozeman Deaconess Foundation C 416028 General ledger and corp. records Bozeman Deaconess Foundation L 177079 General ledger and corp. records Bozeman Deaconess Foundation Q 80954 General ledger and corp. records Bozeman Health Deaconess Hospital L 90482542 General ledger and corp. records Deaconess Intercity Imaging LLC S 251875 General ledger and corp. records Rocky Mountain Surgical Center LLC S 3468965 General ledger and corp. records