COMMUNITY HOSPITAL OF ANACONDA: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HOSPITAL OF ANACONDA (EIN 81-0303913)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-05
- IRS object ID
- 202023109349302387
- Schema version
- 2019v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-05T16:04:09-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 200079326 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DINGUS ZARECOR & ASSOCIATES PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12015 E MAIN AVE | AddressLine1Txt |
| City | SPOKANE VALLEY | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810303913 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL OF ANACONDA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 4065638512 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 W PENNSYLVANIA | AddressLine1Txt |
| City | ANACONDA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59711 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARGARET HICKEY-BOYNTON | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4065638521 | PhoneNum |
| Signature | 2020-11-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THOMAS DINGUS | PreparerPersonNm |
| PTIN | P00951009 | PTIN |
| Phone | 5092420874 | PhoneNum |
| Preparation | 2020-11-05 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 104.209.44.114 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-05 | IPDt |
| IP Tm | 16:04:09 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 88E8E3E4BAC69E0C9162358B3AA4114E53627D17 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BDB558D2839154CBA244025868728B30AD18FBA5 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOELLEN VILLA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 W PENNSYLVANIA | AddressLine1Txt |
| City | ANACONDA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59711 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $73,946,453 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COMMUNITYHOSPITALOFANACONDA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1969 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE A CARING ENVIRONMENT, RESPONDING WITH EXCELLENCE TO THE HEALTH CARE NEEDS OF THOSE WE SERVE. RESPECTING THE DIGNITY AND RECOGNIZING THE WORTH OF EACH PERSON IS THE FOUNDATION OF OUR COMMITMENT TO CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 480 | TotalEmployeeCnt |
| Total Volunteers | 28 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $78,925 | PYContributionsGrantsAmt |
| CY Contributions Grants | $233,921 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $67,017,466 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $73,114,609 | CYProgramServiceRevenueAmt |
| PY Investment Income | $16,781 | PYInvestmentIncomeAmt |
| CY Investment Income | $59,064 | CYInvestmentIncomeAmt |
| PY Other Revenue | $464,409 | PYOtherRevenueAmt |
| CY Other Revenue | $463,407 | CYOtherRevenueAmt |
| PY Total Revenue | $67,577,581 | PYTotalRevenueAmt |
| CY Total Revenue | $73,871,001 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $27,272 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $51,170 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $35,998,889 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $37,707,318 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $29,442,794 | PYOtherExpensesAmt |
| CY Other Expenses | $32,181,317 | CYOtherExpensesAmt |
| PY Total Expenses | $65,468,955 | PYTotalExpensesAmt |
| CY Total Expenses | $69,939,805 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,108,626 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,931,196 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $57,091,023 | TotalAssetsBOYAmt |
| Total Assets EOY | $63,024,839 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $30,061,434 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $29,931,344 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $27,029,589 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $33,093,495 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE A CARING ENVIRONMENT, RESPONDING WITH EXCELLENCE TO THE HEALTH CARE NEEDS OF THOSE WE SERVE. RESPECTING THE DIGNITY AND RECOGNIZING THE WORTH OF EACH PERSON IS THE FOUNDATION OF OUR COMMITMENT TO CARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $63,786,185 | ExpenseAmt |
| Revenue | $73,871,001 | RevenueAmt |
| Desc | COMMUNITY HOSPITAL OF ANACONDA IS COMPRISED OF A 25-BED CRITICAL ACCESS HOSPITAL AND A 62-BED NURSING HOME FACILITY WHICH PROVIDES HEALTH CARE SERVICES. THE HOSPITAL PROVIDED 5,161 DAYS OF INPATIENT ACUTE CARE SERVICES, 118,084 OUTPATIENT VISITS, 10,611 EMERGENCY ROOM/CONVENIENT CARE VISITS, AND 2,557 SURGERIES. THE NURSING HOME PROVIDED 9,494 DAYS OF RESIDENT SERVICES FOR THE YEAR ENDED DECEMBER 31, 2019. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED CHARGES OF PROVIDING CARE TO THESE PATIENTS WAS 559,930 FOR CHARITY CARE, 28,301,075 FOR MEDICARE, 8,164,588 FOR MEDICAID, AND 13,972,7893 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR ENDED DECEMBER 31, 2019. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $51,170 | ExpenseAmt |
| Grant | $51,170 | GrantAmt |
| Desc | COMMUNITY HOSPITAL OF ANACONDA ALSO SPONSORS NUMEROUS YOUTH GROUPS AND ACTIVITIES WITHIN ITS COMMUNITY. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $63,837,355 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 54 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 480 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARGARET HICKEY-BOYNTON | PersonNm |
| Phone | 4065638512 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 W PENNSYLVANIA | AddressLine1Txt |
| City | ANACONDA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59711 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| LEE ANN BARTOLETTI | |||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| STAN BLAZ | |||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JODI MCCARTHY | |||||||
| SECRETARY/TR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| AUDREY ASPHOLM | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KRISTY MCKAY | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRIS CONNORS | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DIANE BRUNELL | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GENE VUCKOVICH | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| STEPHANIE SORINI | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JACK HAFFEY | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| FREDERICK BARTOLETTI | |||||||
| TRUSTEE/PHYS | 34.00 | Yes (X) | $394,753 | $0 | $22,390 | ||
| JOELLEN VILLA | |||||||
| CEO | 45.00 | Yes (X) | $252,735 | $0 | $14,237 | ||
| MARGARET HICKEY-BOYNTON | |||||||
| CFO | 45.00 | Yes (X) | $194,917 | $0 | $13,074 | ||
| GUS VARNAVUS | |||||||
| PHYSICIAN | 40.00 | $945,427 | $0 | $15,940 | Yes (X) | ||
| CARL SCHILLHAMMER | |||||||
| PHYSICIAN | 40.00 | $575,049 | $0 | $15,940 | Yes (X) | ||
| BERTRAND JONES | |||||||
| PHYSICIAN | 40.00 | $550,014 | $0 | $15,940 | Yes (X) | ||
| JAMES HUEFTLE | |||||||
| PHYSICIAN | 40.00 | $533,956 | $0 | $19,405 | Yes (X) | ||
| GLENN MCLAUGHLIN | |||||||
| PHYSICIAN | 40.00 | $511,981 | $0 | $5,600 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,958,832 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $122,526 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 58 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| LBR GROUP PC | ||||||
| PO BOX 1038 | ANACONDA | MT | 59711 | CONSULTING | $1,464,897 | |
| FLATHEAD UROLOGY PLLC | ||||||
| 210 SUNNYVIEW LN | KALISPELL | MT | 59901 | UROLOGY SERVICE | $661,178 | SUITE 106 |
| DR JONATHAN PINE | ||||||
| 305 W PENN AVE | ANACONDA | MT | 59711 | SURGEON SERVICE | $556,075 | |
| FASTAFF LLC | ||||||
| 5700 SOUTH QUEBEC STREET SUITE 300 | GREENWOOD VILLAGE | CO | 80111 | LOCUMS | $452,469 | |
| DR THOMAS MCMAHON | ||||||
| 401 W PENN AVE | ANACONDA | MT | 59711 | SURGEON SERVICE | $435,073 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $5,328 | RelatedOrganizationsAmt |
| Government Grants | $35,843 | GovernmentGrantsAmt |
| All Other Contributions | $192,750 | AllOtherContributionsAmt |
| Total Contributions | $233,921 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 624100 | $73,075,210 | $73,075,210 |
| RENTAL INCOME | 446110 | $39,399 | $39,399 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $73,114,609 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $108,516 | TotalRevenueColumnAmt |
| Exclusion | $108,516 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $26,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $75,452 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$49,452 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$49,452 | TotalRevenueColumnAmt |
| Exclusion | -$49,452 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MEDICAL STAFF REIMBURSEMENT | 900099 | $240,900 | $240,900 |
| OTHER | 722514 | $98,567 | $98,567 |
| CAFETERIA REVENUE | 900099 | $93,122 | $93,122 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,818 | TotalRevenueColumnAmt |
| Exclusion | $30,818 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $463,407 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $73,871,001 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $73,114,609 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $522,471 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,170 | TotalAmt |
| Program Services | $51,170 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $892,107 | TotalAmt |
| Program Services | $417,143 | ProgramServicesAmt |
| Management And General | $474,964 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,019,867 | TotalAmt |
| Program Services | $30,164,971 | ProgramServicesAmt |
| Management And General | $1,854,896 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $672,315 | TotalAmt |
| Program Services | $633,255 | ProgramServicesAmt |
| Management And General | $39,060 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,900,884 | TotalAmt |
| Program Services | $1,783,478 | ProgramServicesAmt |
| Management And General | $117,406 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,222,145 | TotalAmt |
| Program Services | $2,066,447 | ProgramServicesAmt |
| Management And General | $155,698 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,565,646 | TotalAmt |
| Management And General | $1,565,646 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,403 | TotalAmt |
| Management And General | $71,403 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,908 | TotalAmt |
| Management And General | $92,908 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,134,145 | TotalAmt |
| Program Services | $5,880,561 | ProgramServicesAmt |
| Management And General | $253,584 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $335,242 | TotalAmt |
| Program Services | $656 | ProgramServicesAmt |
| Management And General | $334,586 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,064,600 | TotalAmt |
| Program Services | $1,800,174 | ProgramServicesAmt |
| Management And General | $264,426 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $444,483 | TotalAmt |
| Program Services | $444,483 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,716,714 | TotalAmt |
| Program Services | $1,561,247 | ProgramServicesAmt |
| Management And General | $155,467 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,748 | TotalAmt |
| Program Services | $17,988 | ProgramServicesAmt |
| Management And General | $5,760 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,232 | TotalAmt |
| Program Services | $155,792 | ProgramServicesAmt |
| Management And General | $5,440 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,009,989 | TotalAmt |
| Program Services | $892,905 | ProgramServicesAmt |
| Management And General | $117,084 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,677,886 | TotalAmt |
| Program Services | $1,539,892 | ProgramServicesAmt |
| Management And General | $137,994 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,286,303 | TotalAmt |
| Program Services | $1,278,995 | ProgramServicesAmt |
| Management And General | $7,308 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $14,228,290 | $14,228,290 | |
| HOSPITAL BED TAX | $674,624 | $674,624 | |
| DUES & SUBSCRIPTIONS | $528,699 | $245,075 | $283,624 |
| OTHER EXPENSES | $165,405 | $209 | $165,196 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,939,805 | TotalAmt |
| Program Services | $63,837,355 | ProgramServicesAmt |
| Management And General | $6,102,450 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,997,566 | BOYAmt |
| EOY | $12,577,705 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,188,089 | BOYAmt |
| EOY | $2,590,312 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,951,740 | BOYAmt |
| EOY | $9,072,188 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,785 | BOYAmt |
| EOY | $2,288 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,799,263 | BOYAmt |
| EOY | $1,781,876 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $515,816 | BOYAmt |
| EOY | $520,160 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $43,670,405 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $22,822,554 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,890,396 | BOYAmt |
| EOY | $20,847,851 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,314,682 | BOYAmt |
| EOY | $10,430,205 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $538,348 | BOYAmt |
| EOY | $488,699 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,888,338 | BOYAmt |
| EOY | $4,713,555 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,091,023 | BOYAmt |
| EOY | $63,024,839 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,962,826 | BOYAmt |
| EOY | $5,289,577 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,222,905 | BOYAmt |
| EOY | $2,064,532 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,986,147 | BOYAmt |
| EOY | $20,358,037 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,889,556 | BOYAmt |
| EOY | $2,219,198 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,061,434 | BOYAmt |
| EOY | $29,931,344 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,029,589 | BOYAmt |
| EOY | $33,093,495 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,029,589 | BOYAmt |
| EOY | $33,093,495 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,091,023 | BOYAmt |
| EOY | $63,024,839 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,931,196 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,132,710 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $4,504 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,504 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO A STATE HOSPITAL ASSOCIATION. THE ASSOCIATION USES A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $945,214 | OtherCostOrOtherBasisAmt |
| Book Value | $945,214 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,439,181 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,940,027 | DepreciationAmt |
| Book Value | $16,499,154 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,385,571 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,374,040 | DepreciationAmt |
| Book Value | $3,011,531 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $900,439 | OtherCostOrOtherBasisAmt |
| Depreciation | $508,487 | DepreciationAmt |
| Book Value | $391,952 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $20,847,851 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| MEDICAID SUPPLEMENTAL PAYMENTS | $4,129,060 |
| ESTIMATED THIRD PARTY SETTLEMENTS | $545,485 |
| OTHER RECEIVABLE | $39,010 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,713,555 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED THIRD PARTY SETTLEMENTS | Desc |
| Amt | $2,219,198 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,219,198 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $76,053,163 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $2,132,710 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $49,452 | OtherRevenueAmt |
| Revenue Not Reported | $2,182,162 | RevenueNotReportedAmt |
| Revenue Subtotal | $73,871,001 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $73,871,001 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $69,989,257 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $49,452 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $49,452 | ExpensesNotReportedAmt |
| Expenses Subtotal | $69,939,805 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $69,939,805 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 3, PART X | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE HOSPITAL EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WERE CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF DECEMBER 31, 2019 AND 2018, THE HOSPITAL HAS NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. |
| SCHEDULE D, PAGE 4, PART XI, LINE 2D | LOSS ON DISPOSAL OF ASSETS 49,452 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | LOSS ON DISPOSAL OF ASSETS 49,452 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 1.300000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 2.200000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $251,969 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $251,969 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,166,342 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,166,342 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,418,311 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,166,342 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $251,969 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $399,320 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $399,320 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00570 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,162 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,162 | NetCommunityBenefitExpnsAmt |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,279,334 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,107,563 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,171,771 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08820 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $46,539 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $46,539 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,727,355 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,107,563 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,619,792 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09460 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,145,666 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,273,905 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,871,761 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09830 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $729,300 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $21,033,745 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $21,419,887 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$386,142 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL OF ANACONDA | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 W PENNSYLVANIA | AddressLine1Txt |
| City | ANACONDA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59711 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.COMMUNITYHOSPITALOFANACONDA.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL OF ANACONDA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.COMMUNITYHOSPITALOFANACONDA.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.COMMUNITYHOSPITALOFANACONDA.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 130.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 220.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.COMMUNITYHOSPITALOFANACONDA.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.COMMUNITYHOSPITALOFANACONDA.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.COMMUNITYHOSPITALOFANACONDA.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, COMMUNITY HOSPITAL OF ANACONDA - PART V, LINE 3E | IDENTIFICATION AND PRIORITIZATION OF HEALTH NEEDS BEGIN ON PAGE 57 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE. |
| FACILITY 1, COMMUNITY HOSPITAL OF ANACONDA - PART V, LINE 5 | IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL TOOK INTO ACCOUNT PERSONS INPUT WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL BY INCLUDING ZIP CODES WITH THE LARGEST NUMBER OF ADMISSIONS IN THE SURVEY SAMPLE. THE PROCESS INCLUDED A RANDOM, WRITTEN SURVEY MAILED TO 797 RESIDENTS FROM THESE ZIP CODES, FOLLOWED BY THREE FOCUS GROUPS AND KEY INFORMANT INTERVIEWS. IN ADDITION, A STEERING COMMITTEE OF VARIOUS COMMUNITY MEMBERS WAS FORMED TO ASSIST IN THE DEVELOPMENT OF THE SURVEY INSTRUMENT AND TO PROVIDE A FORUM TO DISCUSS THE COMMUNITY'S ISSUES WITH RESPECT TO HEALTHCARE. |
| FACILITY 1, COMMUNITY HOSPITAL OF ANACONDA - PART V, LINE 6B | IN 2019, THE HOSPITAL COLLABORATED WITH THE MONTANA OFFICE OF RURAL HEALTH TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT TO IMPROVE THE UNDERSTANDING OF THE HEALTH STATUS OF ANACONDA-DEER LODGE COUNTY AND SURROUNDING AREA OF SOUTHWEST MONTANA. |
| FACILITY 1, COMMUNITY HOSPITAL OF ANACONDA - PART V, LINE 11 | THE HOSPITAL WAS NOT ABLE TO ADDRESS ALL HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA DUE TO NOT CURRENTLY HAVING THE STAFF OR FINANCIAL RESOURCES TO DEVOTE TO THE NEED. THE NEEDS IDENTIFIED BUT NOT SPECIFICALLY ADDRESSED INCLUDE DELAYED OR NOT RECEIVING NEEDED MEDICAL SERVICES, CONTINUOUS CARE RETIREMENT COMMUNITY, AND PHYSICAL INACTIVITY. CURRENTLY THE HOSPITAL OFFERS A FINANCIAL ASSISTANCE PROGRAM AS WELL AS ASSISTANCE WITH ANNUAL OPEN ENROLLMENT FOR THE INSURANCE MARKETPLACE AND COULD ALSO PARTNER WITH LOCAL AGENCIES TO ASSIST IN INFORMING THE PUBLIC REGARDING THE PROGRAMS AND SERVICES OFFERED TO THE COMMUNITY. ANACONDA'S HOSPICE HOUSE WAS CONSTRUCTED IN 2018 AS A COMPONENT OF A CONTINUOUS RETIREMENT COMMUNITY AND THE HOSPITAL HAS BEEN EVALUATING CONCEPTS AND POTENTIAL LOCATIONS FOR A CONTINUOUS CARE RETIREMENT COMMUNITY. PUBLIC HEALTH HAS COMMITTED TO SHARING EDUCATIONAL OFFERINGS TO ENSURE COMMUNITY IS KNOWLEDGEABLE ABOUT PROGRAMS RELATED TO COMMUNITY HEALTH ADVOCACY. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| COMMUNITY NURSING HOME OF ANACONDA | ||||
| 600 MAIN | ANACONDA | MT | 59711 | NURSING HOME |
| PINTLER HOME OPTIONS | ||||
| 305 W PENNSYLVANIA | ANACONDA | MT | 59711 | HOME HEALTH AGENCY |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7G | THE HOSPITAL HAS INCLUDED COSTS ASSOCIATED WITH PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES IN PART I, LINE 7G IN THE AMOUNT OF 11,748,486 IN COLUMN C AND 7,363,424 IN COLUMN D. |
| SCHEDULE H, PART I, LINE 7 | THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES FOR FIGURES REPORTED IN THE TABLE (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, MEDICAID PROVIDER TAXES, TOTAL COMMUNITY BENEFIT, AND TOTAL COMMUNITY BUILDING EXPENSES). |
| SCHEDULE H, PART II | EACH SPRING, COMMUNITY HOSPITAL OF ANACONDA (CHA) PROVIDES FREE AND REDUCED SPORTS PHYSICALS INCLUDING A PHYSICAL ASSESSMENT AND AN EKG FOR 6TH-12TH GRADERS SO THEY CAN PARTICIPATE IN SCHOOL ATHLETICS. CHA WAS THE FIRST HOSPITAL IN MONTANA TO RECEIVE DESIGNATION AS A BABY- FRIENDLY HOSPITAL WHICH INDICATES THEY OFFER AN OPTIMAL LEVEL OF CARE FOR INFANTS, MOTHERS, AND FAMILIES. PINTLER HOME HEALTH THROUGH CHA MAKES IT POSSIBLE FOR PATIENTS TO RECOVER AND/OR MANAGE A HEALTH PROBLEM IN THE COMFORT AND FAMILIARITY OF THEIR HOME. PINTLER HOSPICE SERVES PEOPLE OF ALL AGES WHO ARE EXPERIENCING A SERIOUS ILLNESS. IN JULY OF 2018, CHA OPENED LYNNORES PLACE HOSPICE HOUSE. ANNUALLY, CHA OFFERS A HEALTH FAIR WITH A FULL SPECTRUM OF LAB WORK AT REDUCED COST. PARTICIPANTS RECEIVE INFORMATION ON HOW TO INTERPRET THEIR LAB RESULTS AS WELL AS FREE BLOOD PRESSURE SCREENINGS, FREE BLOOD GLUCOSE TESTING, OXYGEN SATURATION SCREENINGS AND COMPLIMENTARY HEALTH PROMOTION ITEMS. COMMUNITY SERVICES ARE INVITED TO PARTICIPATE TO PROVIDE INFORMATION REGARDING THEIR SERVICE OFFERINGS. THE CHA REHAB THERAPY PROGRAM OFFERS A FALL PREVENTION PROGRAM. THE CERTIFIED DIABETES EDUCATORS AND REGISTERED DIETITIANS OFFER THE DIABETES PREVENTION PROGRAM TWO TIMES PER YEAR. CHA OFFERS TWO FREE FIVE-WEEK PRE-NATAL CLASSES EACH YEAR WHICH COVERS A VARIETY OF TOPICS INCLUDING THE IMPORTANCE OF PRE-NATAL CARE AND FETAL DEVELOPMENT, PREPARING FOR DELIVERY, POSTPARTUM ADJUSTMENTS AND NEWBORN CARE. ANNUALLY, CHA PROVIDES SCHOLARSHIPS TO TWO ANACONDA HIGH SCHOOL STUDENTS PURSUING HIGHER EDUCATION IN THE HEALTHCARE ARENA. CHA HOSTS STUDENTS FOR CAREER SHADOWING PROGRAMS AS PART OF THE HIGH SCHOOL CURRICULUM. CHA SPONSORS LOCAL YOUTH GROUPS SUCH AS YOUTH EMPOWERMENT SERVICES AND BOYS & GIRLS CLUB. CHA SPONSORS VARIOUS LOCAL ARTS AND ENTERTAINMENT EVENTS INCLUDING SHAKESPEARE IN THE PARK, ALIVE AFTER FIVE AND ART IN THE PARK. CHA IS ALSO COMMITTED TO SPONSORING LOCAL FUN RUNS AND WELLNESS EVENTS SUCH AS THE ANNUAL ST. PATRICK DAY RACE AND BICYCLE FEST. IN OCTOBER 2016, CHA HOSTED THE STATES PILOT BEHAVIORAL HEALTH CAMP FOR AREA HIGH SCHOOL STUDENTS. THE CAMP ALLOWED STUDENTS TO EXPLORE A VARIETY OF BEHAVIORAL HEALTH CAREERS AND RECEIVED TRAINING IN YOUTH MENTAL HEALTH FIRST AID, SUICIDE PREVENTION, ANTI-BULLYING AND OTHER TOPICS THAT THEY COULD USE IMMEDIATELY TO BECOME ADVOCATES IN THEIR COMMUNITIES. CHA OFFERED CAMPS IN 2017 AND 2019. STAFF AT CHA PROVIDE FREE BASIC LIFE SUPPORT TRAINING TO LOCAL EMPLOYERS AND HIGH SCHOOL STUDENTS. ANACONDA ADULT LEARNING CENTER PREPARES PEOPLE TO REACH THEIR CAREER GOALS THROUGH ACADEMICS, CAREER COUNSELING, SOFT SKILLS AND DIGITAL LITERACY. ADULT PROTECTIVE SERVICES (APS) INVESTIGATES REPORTS OF ABUSE, NEGLECT, AND EXPLOITATION OF INDIVIDUALS OVER 60 YEARS OF AGE OR DEVELOPMENTALLY DISABLED ADULTS OVER 18 YEARS OF AGE. ANACONDA COMMUNITY FOUNDATION IS A LOCAL PHILANTHROPIC ORGANIZATION WHOSE MISSION IS TO ENHANCE THE QUALITY OF LIFE IN THE LOCAL AREA. ANACONDA COMMUNITY INTERVENTION (ACI) DEVELOPS AN ONGOING EFFORT WITHIN THE COMMUNITY TO RECOGNIZE AND CONSTRUCTIVELY ADDRESS THE COMMUNITYS NEEDS REGARDING DRUG & ALCOHOL ABUSE. ANACONDA FAMILY RESOURCE CENTER ASSURES ALL FAMILIES RECEIVE THE BASIC SKILLS, EDUCATION, SUPPORT, AND ENCOURAGEMENT NECESSARY FOR THE DEVELOPMENT OF HEALTHY FAMILIES. ANACONDA SCHOOL DISTRICT IS AVAILABLE TO PROVIDE LEARNING OPPORTUNITIES TO STUDENTS REGARDING HEALTHY LIVING. ANACONDA-DEER LODGE COUNTY PROVIDES COUNTY GOVERNMENT AND COUNTY SERVICES. ANACONDA-DEER LODGE COUNTY DEPARTMENT OF LAW ENFORCEMENT PROTECTS AND SERVES THE CITY-COUNTY OF ANACONDA-DEER LODGE. ANACONDA-DEER LODGE COUNTY DUI TASKFORCE AND MIP TASKFORCE WORK TO STOP DRUNKEN DRIVERS AND INCREASE AWARENESS OF THE EFFECTS OF UNDERAGE DRINKING. ANACONDA-DEER LODGE COUNTY PUBLIC HEALTH DEPARTMENT ASSURES CONDITIONS IN WHICH PEOPLE CAN BE HEALTHY AND TO PROVIDE LEADERSHIP IN THE PREVENTION OF DISEASE AND INJURY. ANACONDA-DEER LODGE COUNTY VICTIM-WITNESS PROGRAM PROVIDES ASSISTANCE TO PEOPLE WITH PETITIONING THE COURTS FOR ORDERS OF PROTECTION. A.W.A.R.E., INC. PROVIDES YOUTH CASE MANAGEMENT, FAMILY THERAPEUTIC CARE, AND COMMUNITY BASED PSYCHIATRIC REHABILITATIVE SUPPORT FOR YOUTH AND THEIR FAMILIES. BEST BEGINNINGS COALITION FACILITATES COORDINATION AND SUPPORT FOR ALL AGENCIES WHO PROVIDE SERVICES TO FAMILIES AND YOUNG CHILDREN. COPPERHEAD CLUB IS A MONTHLY AFTER SCHOOL PROGRAM FROM GRADES 3-6, OFFERING HOMEWORK HELP, ROBOTICS, SMART MOVES, OR PARTICIPATION IN PHYSICAL ACTIVITY IN THE GYM AND OUTDOORS. COMMUNITY, COUNSELING, AND CORRECTIONAL SERVICES IS A TEAM OF DEDICATED INDIVIDUALS WORKING TO MEET THE SERVICE NEEDS OF YOUTH AND ADULTS TO PROMOTE HEALTHY LIVING THROUGH TREATMENT, TRAINING, AND SUPERVISION. YOUTH EMPOWERMENT SERVICES (YES) PROVIDES MENTORING PROGRAMS AND ACTIVITIES FOR AT RISK YOUTH. THE OFFICE OF PUBLIC ASSISTANCE DEER LODGE COUNTY PROVIDES TEMPORARY FINANCIAL ASSISTANCE. METCALF MEMORIAL SENIOR CITIZEN CENTER STRIVES TO MEET THE NUTRITIONAL NEEDS TO ANACONDAS SENIOR CITIZENS WHILE ALSO PROVIDING ACTIVITIES THAT FACILITATE HEALTHY AND ACTIVE LIFESTYLES. MONTANA STATE HOSPITAL LOCATED IN WARM SPRINGS PROVIDES INPATIENT PSYCHIATRIC TREATMENT FOR ADULTS WITH SERIOUS MENTAL ILLNESS AND IS THE ONLY MENTAL HEALTH HOSPITAL IN THE STATE OF MONTANA. IT IS LOCATED LESS THAN TEN MILES FROM ANACONDA. MONTANA STATE UNIVERSITY DEER LODGE COUNTY EXTENSIONS MISSION IS TO IMPROVE THE LIVES OF MONTANA CITIZENS BY PROVIDING UNBIASED, RESEARCH-BASED EDUCATION AND INFORMATION THAT INTEGRATES LEARNING, DISCOVERY AND ENGAGEMENT TO STRENGTHEN THE SOCIAL, ECONOMIC AND ENVIRONMENTAL WELL-BEING OF INDIVIDUALS, FAMILIES AND COMMUNITIES. PINTLER SUICIDE AWARENESS & PREVENTION (PSAP) IS DEDICATED TO EDUCATING AND SUPPORTING PEOPLE IMPACTED BY SUICIDE WITH THE GOAL OF PREVENTING SUICIDE IN THE COMMUNITY. SOUTHWEST MONTANA PREVENTION IS AN AFFILIATE OF BUTTE CARES AND PROVIDES UNDERAGE DRINKING AND DRUG USE PREVENTION. |
| SCHEDULE H, PART III, LINE 2 | THE HOSPITAL USED THE COST TO CHARGE RATIO OF PATIENT CARE TO DETERMINE THE COST OF BAD DEBT EXPENSE. |
| SCHEDULE H, PART III, LINE 3 | THE HOSPITAL DID NOT TRACK THE AMOUNT OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY BUT FOR WHOM SUFFICIENT INFORMATION WAS NOT OBTAINED TO MAKE DETERMINATION OF THEIR ELIGIBILITY DURING THE YEAR. |
| SCHEDULE H, PART III, LINE 4 | THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 5 ON PAGE 14 OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 11 ON PAGE 19 OF THE AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, LINE 8 | ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. |
| SCHEDULE H, PART III, LINE 9B | IF A PATIENT CANNOT PAY THE ENTIRE BILL WITHIN THE TIMELINE SPECIFIED IN THE BILLING/COLLECTION POLICY, AN INTERVIEW WITH THE PATIENT IS CONDUCTED TO DETERMINE THEIR FINANCIAL STATUS. IF THEY ARE SELF PAY WITHOUT INSURANCE AND DO NOT QUALIFY FOR ANY GOVERNMENT PROGRAMS SUCH AS MEDICAID, MEDICARE, SSI, ETC, WE DETERMINE IF THEY ARE ELIGIBLE FOR OUR FINANCIAL ASSISTANCE PROGRAM. PART OF THE FINANCIAL ASSISTANCE PROGRAM IS A REDUCED PAYMENT PLAN THAT CAN BE APPROVED EVEN IF THE PATIENT DOES NOT QUALIFY FOR FULL FINANCIAL ASSISTANCE. IF THE PATIENT HAS INSURANCE, THE PROCEDURE TO DETERMINE IF THEY QUALITY FOR OUR FINANCIAL ASSISTANCE PROGRAM IS ALSO FOLLOWED. ANOTHER PROVISION IN THE CREDIT AND COLLECTIONS POLICY ALLOWS THE PATIENT ACCOUNT REPRESENTATIVE TO APPROVE A LESSER PAYMENT ARRANGEMENT IF THE ARRANGEMENT IS IN THE BEST INTEREST OF THE HOSPITAL AND THE PATIENT. AN EXAMPLE OF THIS WOULD BE IF A PATIENT IS IN A TEMPORARY SITUATION THAT PREVENTS MEETING A HIGHER PAYMENT, CHA WILL APPROVE THE LOWER PAYMENT PLAN WITH A DATE TO REEVALUATE WHEN THAT SITUATION IS RESOLVED. CHA WORKS WITH PATIENTS TO ACCOMMODATE THEIR FINANCIAL SITUATION. THE FACT THAT THEY CANNOT MEET THE GUIDELINES UNDER THE FINANCIAL POLICY DOES NOT MEAN THEY ARE SENT DIRECTLY TO COLLECTIONS. PARTIAL OR FULL PAYMENT MAY BE REQUIRED PRIOR TO SERVICE IN SOME SITUATIONS. ALL NON-EMERGENT PATIENTS REQUIRING A SURGICAL PROCEDURE THAT TO NOT HAVE INSURANCE COVERAGE MUST MEET WITH A PATIENT ACCOUNT REPRESENTATIVE PRIOR TO HAVING THEIR SERVICE PROVIDED. AN INTERVIEW IS CONDUCTED TO DETERMINE THEIR FINANCIAL STATUS. BASED ON THE PROCEDURE BEING PERFORMED AND THE FINANCIAL STATUS OF THE PATIENT, A PARTIAL OR FULL PAYMENT MAY BE REQUIRED. IF THE PATIENT IS UNABLE TO MAKE A PARTIAL OR FULL PAYMENT, WE TRY TO DETERMINE IF THE PATIENT QUALIFIES FOR ANY GOVERNMENT PROGRAMS. FOR ANY PATIENT THAT DOES NOT QUALIFY FOR ANY GOVERNMENT PROGRAM, AN APPLICATION FOR FINANCIAL ASSISTANCE IS OFFERED PRIOR TO THE SERVICE BEING PERFORMED. BASED ON THE RESULTS OF THE FINANCIAL ASSISTANCE APPLICATION, THE BALANCE OF THE ACCOUNT AND THE PATIENT'S ABILITY TO PAY, A PARTIAL (PAYMENT PLAN) OR FULL PAYMENT IS REQUIRED. IF THE PATIENT DOES NOT HAVE THE ABILITY TO PAY, THE ACCOUNT IS RELIVED UNDER THE PATIENT FINANCIAL ASSISTANCE PROGRAM. |
| SCHEDULE H, PART VI, LINE 2 | COMMUNITY HOSPITAL OF ANACONDA COMPLETED A COMMUNITY NEEDS ASSESSMENT IN 2019. THE LAST ASSESSMENT WAS COMPLETED IN 2016. THE ASSESSMENT WAS COMPLETED WITH ASSISTANCE FROM THE MONTANA OFFICE OF RURAL HEALTH, WITH DATA COLLECTED BY STEERING COMMITTEE MEETINGS, KEY INFORMANT INTERVIEWS, FOCUS GROUPS AND A SURVEY MAILED TO 800 RANDOM HOUSEHOLDS IN OUR SERVICE AREA. THE SURVEY RESULTED IN A 17.4% RESPONSE RATE, WHICH IS DEEMED STATISTICALLY SIGNIFICANT. THE TOP FOUR ISSUES/OPPORTUNITIES WERE IDENTIFIED: 1. BEHAVIORAL HEALTH 2. ACCESS TO HEALTHCARE SERVICES 3. HEALTH, WELLNESS AND HEALTHY LIFESTYLES 4. FAMILY AND COMMUNITY SERVICES THE CHA BOARD OF TRUSTEES APPROVED THE NEEDS ASSESSMENT IMPLEMENTATION PLAN ON FEBRUARY 2020. THE PLAN ESTABLISHES GOALS, STRATEGIES FOR EACH GOAL, ANTICIPATED IMPACT, PLAN TO EVALUATE IMPACT AND MEASURE OF SUCCESS. ACTIVITIES AND STRATEGIES WERE DEVELOPED FOR EACH GOAL WITH A CORRESPONDING IMPLEMENTATION GRID. THE FOLLOWING GOALS AND STRATEGIES WERE APPROVED: GOAL 1: IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES, RESOURCES, & INFORMATION IN ANACONDA - DEER LODGE COUNTY STRATEGY 1: EXPAND ACCESS TO BEHAVIORAL HEALTH SERVICES THROUGH CHA STRATEGY 2: COLLABORATE AND ENGAGE WITH COMMUNITY PARTNERS TO IMPROVE ACCESS AND AWARENESS OF BEHAVIORAL HEALTH SERVICES PROGRESS: REACH OUT AND CONVENE COMMUNITY STAKEHOLDER GROUP (VA, SWMTCHC, PUBLIC HEALTH, SCHOOLS, ETC.) TO REVIEW AVAILABLE BEHAVIORAL HEALTH SERVICES AND IDENTIFY GAPS EXPLORE FEASIBILITY/GAUGE COMMUNITY INTEREST IN DEVELOPMENT OF A LOCAL MENTAL HEALTH ADVISORY COUNCIL SPONSOR SUBSTANCE USE/ABUSE PREVENTION SPECIALIST FOR PRESENTATION AT LOCAL SCHOOLS REVIEW AND UPDATE BEHAVIORAL HEALTH MARKETING AND RESOURCE OPPORTUNITIES ON WEBSITE/OTHER GOAL 2: IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES, RESOURCES, AND INFORMATION IN THE STRATEGY 1: EXPAND ACCESS TO PRIMARY AND SPECIALTY SERVICES AT CHA PROGRESS: RESEARCH ALTERNATIVE STAFFING/HOUR MODELS AND INTERNAL PROCESSES (PHONE SYSTEM, REGISTRATION, ETC.) TO EXPAND ACCESS TO PRIMARY CARE SERVICES EXPLORE FEASIBILITY OF EXPANDING SCHEDULING OPPORTUNITIES VIA ONLINE/MYCHART APP EXPLORE OPPORTUNITIES TO EXPAND SPECIALTY SERVICES ONSITE OR VIA TELEHEALTH (DERMATOLOGY, PSYCH, STROKE) DETERMINE BEST PRACTICES FOR PATIENT CARE FOLLOW-UP AND COORDINATION AND IMPLEMENT NEW FOLLOW-UP PROTOCOLS FOR CLINIC AND OUTPATIENT SERVICES GOAL 3: ENHANCE ACCESS TO CHA SERVICES THAT PROMOTE HEALTH, WELLNESS & HEALTHY LIFESTYLES STRATEGY 1: PROMOTE HEALTH, WELLNESS, PREVENTION, RESOURCES AND SERVICES AT CHA STRATEGY 2: ENHANCE COMMUNITY ACCESS TO PREVENTATIVE SERVICES AND SCREENINGS PROGRESS: CHA CURRENTLY OFFERS THE DIABETES PREVENTION PROGRAM; ANNUAL HEALTH FAIR; AND SPORTS PHYSICALS. ADDITIONAL DIABETES PREVENTION PROGRAM CLASSES HAVE BEEN MADE AVAILABLE TO CHA STAFF AND WORKING COMMUNITY MEMBERS, WITH EACH CLASS AVERAGING 40 PARTICIPANTS. DIFFERENT AVENUES OF MARKETING TOUCHPOINTS (RADIO, SOCIAL MEDIA, TRADITIONAL PRINT ADVERTISING) HAVE BEEN IMPLEMENTED TO CAPTURE A LARGER MARKET SHARE AND AUDIENCES THAT OTHERWISE MAY NOT HAVE BEEN CAPTURED WITH PAST EFFORTS. THE 2018 HEALTH FAIR WAS REVAMPED AND HOSTED AT AN ALTERNATE LOCATION WITH BETTER COMMUNITY INVOLVEMENT THAN IN PAST YEARS. A PAMPHLET IS AVAILABLE FOR MENTAL HEALTH RESOURCES (COUNSELING AND MENTAL HEALTH SERVICES) AND A PAMPHLET FOR CARE COORDINATION SERVICES (I.E., WHAT IT IS, FOR CHRONIC DISEASE MANAGEMENT, ETC.) HAS BEEN MADE AVAILABLE TO PATIENTS. CHA WILL CONTINUE TO ASSESS HEALTH EDUCATION OFFERINGS.. GOAL 4: ENHANCE FAMILY & COMMUNITY SERVICES AVAILABLE IN ANACONDA-DEER LODGE COUNTY STRATEGY 1: SUPPORT AND EXPAND COMMUNITY SERVICES AND RESOURCES FOR AREA YOUTH STRATEGY 2: SUPPORT AND EXPAND COMMUNITY SERVICES AND RESOURCES FOR AREA FAMILIES STRATEGY 3: SUPPORT AND EXPAND COMMUNITY SERVICES AND RESOURCES FOR AREA SENIORS PROGRESS: MEET WITH METCALF SENIOR CENTER TO EXPLORE OPPORTUNITIES TO EXPAND FOOD SERVICES (COORDINATION, DELIVERY, OTHER SUPPORT) FOR AREA SENIORS IN NEED ASSESS INTEREST IN THE DEVELOPMENT OF A CARE GIVER SUPPORT GROUP EVALUATE FEASIBILITY OF OFFERING RESPITE SUPPORT FOR CARE GIVERS CREATE EDUCATIONAL PRESENTATIONS FOR SENIORS/CARE GIVERS (MEDICATION ASSISTANCE, MEDICARE, DEMENTIA, ALZHEIMERS, SOCIAL ISOLATION, ETC.) PARTNER WITH METCALF SENIOR CENTER TO CREATE A SENIOR RELATED RESOURCE SPECIFYING WHAT ASSISTANCE PROGRAMS ARE AVAILABLE TO ASSIST AREA SENIORS TO AGE IN PLACE (MEDICARE BENEFITS, ELECTRICITY SERVICES, PAYMENT ASSISTANCE, FOOD ACCESS, TRANSPORTATION, ETC.) COMMUNITY HOSPITAL OF ANACONDA (CHA) DISSEMINATED THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION PLAN BY POSTING BOTH DOCUMENTS CONSPICUOUSLY ON CHA'S WEBSITE (WWW.COMMUNITYHOSPITALOFANACONDA.ORG) AS WELL AS HAVING COPIES AVAILABLE AT THE FACILITY SHOULD COMMUNITY MEMBERS REQUEST TO VIEW THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) OR THE IMPLEMENTATION PLANNING DOCUMENTS. THE STEERING COMMITTEE, WHICH WAS FORMED SPECIFICALLY AS A RESULT OF THE CHNA PROCESS IN ORDER TO INTRODUCE THE COMMUNITY TO THE ASSESSMENT PROCESS, WAS INFORMED OF THE IMPLEMENTATION PLAN TO SEE THE VALUE OF THEIR INPUT AND TIME IN THE CHNA PROCESS, AS WELL AS HOW COMMUNITY HOSPITAL OF ANACONDA IS UTILIZING THEIR INPUT. THE STEERING COMMITTEE, AS WELL AS THE BOARD OF DIRECTORS, WILL BE ENCOURAGED TO ACT AS ADVOCATES IN DEER LODGE COUNTY AS THE FACILITY SEEKS TO ADDRESS THE HEALTH CARE NEEDS OF THEIR COMMUNITY. CHA WILL CONDUCT ANOTHER COMMUNITY NEEDS ASSESSMENT IN 2022. COPIES ARE AVAILABLE AT THE HOSPITAL UPON REQUEST OF THE MOST RECENTLY ADOPTED COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY OR A COPY CAN BE FOUND AT THE HOSPITAL'S WEBSITE AT THE FOLLOWING URL: HTTP://WWW.COMMUNITYHOSPITALOFANACONDA.ORG/DOCS/CHA_CHNA_FINAL_REPORT_2019. PDF HTTP://WWW.COMMUNITYHOSPITALOFANACONDA.ORG/DOCS/CHA_DRAFT_IMPLEMENTATION_PL AN_REPORT_FINAL_EDITS_%28002%29.PDF |
| SCHEDULE H, PART VI, LINE 3 | IN COMPLIANCE WITH THE COLLECTION POLICIES OF CHA, AN ANNUAL REVIEW IS PERFORMED OF ALL CREDIT/COLLECTION AND FINANCIAL ASSISTANCE POLICIES. ONCE REVIEWED AND REVISED, THE INFORMATION IS DISTRIBUTED TO THE COMMUNITY IN A VARIETY OF WAYS. THE FACILITY PUBLISHED A BROCHURE THAT IS PLACED IN PUBLIC AREAS OF ALL THE CHA FACILITIES, AS WELL AS INCLUDED IN ALL FORMAL ADMISSION PACKETS TO PATIENTS. THE PATIENT ACCOUNT REPRESENTATIVES HAND OUT THE INFORMATION DURING PATIENT CONSULTS AS WELL. THE INFORMATION IS ALSO AVAILABLE ON THE CHA WEBSITE AND IS MADE AVAILABLE TO LOCAL AGENCIES THAT ASSIST WITH LOW INCOME POPULATIONS. A COPY OF THE LATEST FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT THE HOSPITAL'S WEBSITE AT THE FOLLOWING URL: HTTP://WWW.COMMUNITYHOSPITALOFANACONDA.ORG/GETPAGE.PHP?NAME=CHARITY |
| SCHEDULE H, PART VI, LINE 4 | ANACONDA-DEER LODGE COUNTY (ADLC) COVERS 737 SQUARE MILES OF SOUTHWESTERN MONTANA, WITH 12.6 PERSONS PER SQUARE MILE, MAKING IT A RURAL COUNTY WITH RURAL URBAN CONTINUUM CODE OF 7 (RUCC 1 = MOST URBAN, 10= MOST RURAL). ANACONDA DEER LODGE COUNTY IS A DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA (HPSA, ID1309993042). THE 2017 POPULATION WAS 9,106 COMPARED TO A 2000 POPULATION OF 9,417, REPRESENTING A POPULATION LOSS OF 3.3% SINCE 2000. THE MAJOR COMMUNITY IN ANACONDA-DEER LODGE COUNTY IS ANACONDA, WITH A MEDIAN AGE OF 47.3 YEARS. 20.8% OF THE PEOPLE IN THE COUNTY LIVE BELOW THE POVERTY LINE COMPARED TO THE NATIONAL AVERAGE OF 14%. COMMUNITY HOSPITAL OF ANACONDA (CHA) HAS BEEN SERVING THE HEALTHCARE NEEDS OF ANACONDA-DEER LODGE COUNTY (ADLC) SINCE 1889. THE HOSPITAL IS A PRIVATELY OWNED, NON-PROFIT, TWENTY-FIVE BED CRITICAL ACCESS FACILITY BUILT IN 1981. CHA OFFERS A FULL CONTINUUM OF CARE INCLUDING INPATIENT HOSPITAL SERVICES, OUTPATIENT SERVICES, FOUR AMBULATORY CARE CLINICS INCLUDING INTERNAL/FAMILY MEDICINE, SURGICAL, PEDIATRICS AND ONCOLOGY, A LONG-TERM CARE FACILITY, AND HOSPICE/HOME HEALTH SERVICES. CHA EMPLOYS OVER 425 INDIVIDUALS, WITH AN ANNUAL PAYROLL IN EXCESS OF 30 MILLION. |
| SCHEDULE H, PART VI, LINE 5 | COMMUNITY HOSPITAL OF ANACONDA'S BOARD OF TRUSTEES IS COMPRISED OF COMMUNITY MEMBERS REPRESENTING MULTIPLE FACETS OF OUR COMMUNITY FROM THE FINANCIAL SECTOR TO SMALL BUSINESS OWNERS TO RETIREES AND SCHOOL DISTRICT EMPLOYEES. THIS VOLUNTEER BOARD HAS DEDICATED THEIR TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. MEDICAL STAFF PRIVILEGES AT CHA ARE OPEN TO ALL MEDICAL PROVIDERS WITH ACTIVE LICENSURE. WHILE WE HAVE INSTITUTED AN ARDUOUS CREDENTIALING PROCESS TO ENSURE PRACTITIONERS OF THE HIGHEST CALIBER ARE PRIVILEGED, WE ENCOURAGE PRACTITIONERS FROM NUMEROUS SPECIALTIES TO MEET THE EVER EXPANDING HEALTHCARE NEEDS OF THE COMMUNITY. AS A NON-PROFIT CORPORATION, WE DO NOT HAVE SHAREHOLDERS. THEREFORE, SURPLUS FUNDS ARE REINVESTED INTO OUR FACILITIES, EQUIPMENT AND EMPLOYEE EDUCATION. THE ABSENCE OF SHAREHOLDERS ELIMINATES THE POTENTIAL FOR CONFLICTS OF INTEREST RELATED TO ATTAINING INFLATED PROFIT MARGINS AND ALLOWS COMMUNITY HOSPITAL OF ANACONDA TO FOCUS ON WHAT IS IMPORTANT; MEETING THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. |
| SCHEDULE H, PART VI, LINE 6 | N/A |
| SCHEDULE H, PART VI, LINE 7 | MONTANA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|
| FREDERICK BARTOLETTI | |||
| TRUSTEE/PHYSICIAN | $394,753 | $22,390 | $417,143 |
| JOELLEN VILLA | |||
| CEO | $252,735 | $14,237 | $266,972 |
| MARGARET HICKEY-BOYNTON | |||
| CFO | $194,917 | $13,074 | $207,991 |
| GUS VARNAVUS | |||
| PHYSICIAN | $945,427 | $15,940 | $961,367 |
| CARL SCHILLHAMMER | |||
| PHYSICIAN | $575,049 | $15,940 | $590,989 |
| BERTRAND JONES | |||
| PHYSICIAN | $550,014 | $15,940 | $565,954 |
| JAMES HUEFTLE | |||
| PHYSICIAN | $533,956 | $19,405 | $553,361 |
| GLENN MCLAUGHLIN | |||
| PHYSICIAN | $511,981 | $5,600 | $517,581 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| FREDRICK BARTOLETTI MD | |||
| TRUSTEE | $394,753 | EMPLOYMENT | false |
| LBR GROUP PC | |||
| OWNED BY FORMER | $1,464,897 | CONSULTING | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | LB&R GROUP, PC DBA CAH SOLUTIONS GROUP IS AN ENTITY MORE THAN 35% OWNED BY JOHN MCNEECE, FORMER PRESIDENT AND LAURA AUSTIN, FORMER SENIOR VP. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 2 | LEE ANN BARTOLETTI FREDRICK BARTOLETTI, MD TRUSTEE PHYSICIAN FAMILY RELATIONSHIP |
| FORM 990, PAGE 6, PART VI, LINE 6 | WHEN THE HOSPITAL WAS FORMED IN 1969, SOME COMMUNITY MEMBERS PURCHASED THE HOSPITAL FROM SISTERS OF CHARITY. AS THESE ORIGINAL MEMBERS DECEASE, THEIR MEMBERSHIP IS LOST. AN ANNUAL MEETING IS SCHEDULED IN SEPTEMBER OF EACH YEAR WITH A PUBLIC NOTICE POSTED IN THE LOCAL PAPER. THE REMAINING ORIGINAL MEMBERS MAY ATTEND THE MEETING; HOWEVER, THEY ARE NOT ACTIVE MEMBERS AND DO NOT HAVE VOTING RIGHTS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE 990 IS PROVIDED TO THE CFO WHO REVIEWS THE FORM, SCHEDULES, AND RELATED ATTACHMENTS. THE FINANCE COMMITTEE IS DESIGNATED BY THE BOARD OF TRUSTEES TO ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE 990 AND IS ALSO PART OF THE REVIEW PROCESS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL APPROVAL IS GIVEN TO THE PREPARER BEFORE FINALIZING. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CFO SIGNS FORM 8879-EO AUTHORIZING THE PREPARER TO E-FILE THE RETURN. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ARTICLE II OF THE BYLAWS STATES THAT, AT A MINIMUM, EACH MEMBER OF THE BOARD WILL EXECUTE THE CONFLICT OF INTEREST FORM AT THE COMMENCEMENT OF THE TERM OR IN THE EVENT OF ANY CHANGE THAT MAY DEVELOP. THE CONFLICT OF INTEREST GUIDELINES ARE MONITORED BY THE CHA CORPORATE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER ATTENDS NEW EMPLOYEE ORIENTATION AND PRESENTS THE POLICY AS PART OF THE OVERALL CORPORATE LEGAL COMPLIANCE PROGRAM. EACH EMPLOYEE IS PRESENTED WITH A CONFLICT OF INTEREST STATEMENT. ALL POTENTIAL CONFLICTS ARE DISCLOSED. IF ANY POTENTIAL CONFLICTS ARE IDENTIFIED, THE COMPLIANCE OFFICER WILL MEET WITH THE EMPLOYEE'S SUPERVISOR AND ADMINISTRATION TO DETERMINE IF A CONFLICT EXISTS. ON AN ANNUAL BASIS, ALL EMPLOYEES AND THE BOARD OF DIRECTORS ARE REQUIRED TO READ AND SIGN THE CONFLICT OF INTEREST STATEMENT. THE CORPORATE COMPLIANCE OFFICER TRACKS THE RECEIPT AND COMPLETION OF THE CONFLICT OF INTEREST STATEMENTS. THE PROCESS IS A PART OF THE ANNUAL EMPLOYEE REQUIREMENTS MANDATED FOR CONTINUED EMPLOYMENT. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE SOURCES UTILIZED BY CHA IN REGARD TO FAIR MARKET VALUE IN SALARIES ARE SALARY DATA PUBLISHED BY THE ECONOMIC RESEARCH INSTITUTE (ERI), THE MONTANA HOSPITAL ASSOCIATION (MHA) ANNUAL SALARY SURVEY AND EXECUTIVE COMPENSATION SURVEYS PUBLISHED BY CRITICAL DATA, INC. THESE SURVEYS ARE UTILIZED FOR SETTING THE SALARY LEVELS OF EMPLOYEES AT CHA. THE MHA SURVEY ITEMIZES ALL HOSPITALS AS A GROUP, CAH HOSPITALS AND HOSPITALS BY REGION. ERI CALCULATES BASED ON POSITION AND LOCATION. CHALLENGES EXIST WHEN CHA JOB DESCRIPTIONS ARE UNIQUE AND THEREFORE, MAY NOT BE LISTED AS A JOB CATEGORY IN THE MHA SURVEY. IN REGARD TO SETTING THE SALARY LEVELS OF PHYSICIANS, CHA UTILIZES THE MGMA PHYSICIAN COMPENSATION AND PRODUCTION SURVEY. THIS SURVEY ITEMIZES SALARIES AND PRODUCTIVITY BY PHYSICIAN SPECIALTY, YEARS IN PRACTICE, GEOGRAPHIC REGION AND OTHER CATEGORIES. CHA STRIVES TO PAY MARKET LEVEL SALARIES TO ALL EMPLOYEES OF THE ORGANIZATION. IT IS OUR GOAL TO RECRUIT AND RETAIN TOP TALENT IN EVERY VENUE, WHILE CONTROLLING SALARY AND BENEFITS COSTS WITHIN ESTABLISHED TARGETS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SEE FORM 990, PART VI, LINE 15A. |
| FORM 990, PAGE 6, PART VI, LINE 19 | CHA MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | LOSS ON DISPOSAL OF ASSETS 49,452 LOSS ON DISPOSAL OF ASSETS -49,452 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHANHA FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1245 | AddressLine1Txt |
| City | ANACONDA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59711 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810504127 | EIN |
| Primary Activities | SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Exempt Code Section | 501C3 | ExemptCodeSectionTxt |
| Public Charity Status | 12B | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNTIY | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL OF ANACONDA | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |