2020-11-16T17:30:23-06:00 2019-12-31 390758449 WIPFLI LLP 101 EAST FRONT STREET 301 MISSOULA MT 59802 990 2019-01-01 810392231 WHEATLAND MEMORIAL HEALTHCARE WHEA 4066324351 PO BOX 287 HARLOWTON MT 59036 RICK POSS CEO 4066324351 2020-11-11 1 PHILIP L YASENAK CPA P01248379 4067281800 2020-11-11 72.174.136.45 2020-11-11 16:10:00 MS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 BE7A92E7B0152C1C6812F3C99C620D56F411D8FD 2019 2021-01-29 14:40:06Z RICK POSS PO BOX 287 HARLOWTON MT 59036 8186475 0 X WWW.WHEATLANDMEMORIAL.ORG X 1951 MT TO PROVIDE HEALTHCARE SERVICES TO THE SURROUNDING COMMUNITY. 6 6 115 10 0 0 409633 154276 7499667 7784926 62455 41571 9572 23157 7981327 8003930 2436 3430 0 0 4154902 4595274 0 0 0 3558304 3406479 7715642 8005183 265685 -1253 6385560 6283909 2026946 1650015 4358614 4633894 X RESPONSIVE TO THE COMMUNITIES WE SERVE, WHEATLAND MEMORIAL HEALTHCARE IS DEDICATED TO PROVIDING SUSTAINABLE QUALITY CARE WITH RESPECT, COMPASSION, AND TEAMWORK. 0 0 6700157 3430 7784926 AS A CRITICAL ACCESS HOSPITAL, WHEATLAND MEMORIAL HEALTHCARE PROVIDES A BROAD RANGE OF PRIMARY CARE SERVICES TO THE LOCAL COMMUNITY REGARDLESS OF ABILITY TO PAY. THE OBJECTIVE FOR OPERATING THE HOSPITAL AND ITS VARIOUS DEPARTMENTS IS TO MEET THE MISSION OF BEING RESPONSIVE TO THE COMMUNITIES WE SERVE AND PROVIDING SUSTAINABLE QUALITY HEALTH CARE WITH RESPECT, COMPASSION, AND TEAMWORK.THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. THE AMOUNTS OF CHARGES FOREGONE WERE $15,510, FOR THE YEAR ENDED DECEMBER 31, 2019. THE ESTIMATED COST OF PROVIDING THESE SERVICES WAS APPROXIMATELY $13,030 FOR THE YEAR ENDED DECEMBER 31, 2019, CALCULATED BY MULTIPLYING THE RATIO OF COST TO GROSS CHARGES FOR THE HOSPITAL BY THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CHARITY CARE TO ITS PATIENTS.IN 2019, THE HOSPITAL STARTED A SLEEP STUDY PROGRAM. 6700157 1 1 0 0 0 0 0 0 1 1 1 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 16 0 1 115 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 X PATRICK MCCONNELL 4066573821 PO BOX 37000 BILLINGS MT 59701 X AUBREY MILLER CHAIRPERSON 1.00 0.00 X X 0 0 0 KATIE REIN VICE CHAIRPERSON 0.50 0.00 X X 0 0 0 DON AMUNDSON SECRETARY/TREASURER 0.20 0.20 X X 0 0 0 JENNY PETERS TRUSTEE 0.20 0.00 X 0 0 0 RICHARD MOE TRUSTEE 0.20 0.00 X 0 0 0 JUNE VOLDSETH TRUSTEE 0.20 0.00 X 0 0 0 RICK POSS CEO 40.00 0.00 X 0 0 0 PATRICK MCCONNELL CFO 40.00 0.00 X 0 0 0 REBECCA STURDEVANT NP 40.00 0.00 X 181416 0 7257 HANNAH SEXTON PA 40.00 0.00 X 148767 0 13576 JAMIE GOLDBERG NP 40.00 0.00 X 141415 0 10997 PATRICIA MORRIS RADIOLOGIST 40.00 0.00 X 108274 0 4403 KAREN TOMLINSON LABORATORY TECH 40.00 0.00 X 105645 0 4226 685517 0 40459 6 0 1 0 BILLINGS CLINIC PO BOX 30357 BILLINGS MT 59036 MANAGEMENT & CONSULTING 441658 EIDE BAILLY PO BOX 7112 BILLINGS MT 59103 ACCOUNTING 151205 2 11035 10968 132273 154276 PATIENT SERVICE REVENU 621110 7620501 7620501 OTHER PROGRAM INCOME 900099 164425 164425 7784926 40259 40259 23157 0 23157 23157 23157 183857 182545 1312 1312 1312 8003930 7784926 0 64728 X 1430 1430 2000 2000 3797836 3651656 146180 94577 87006 7571 398573 309558 89015 304288 290285 14003 441658 441658 17945 17945 63509 63509 9048 9048 918872 667988 250884 7804 4331 3473 99798 32907 66891 11886 8708 3178 167013 146343 20670 20823 11793 9030 22710 12860 9850 55879 55879 449154 449154 36234 771 35463 SUPPLIES 440468 388153 52315 BAD DEBT EXPENSE 283597 283597 REPAIRS & MAINTENANCE 167215 164971 2244 FOOD 89013 89013 103853 41754 62099 8005183 6700157 1305026 0 75 110 683336 563899 1439757 1396002 174860 128113 32357 12948 7915159 6220287 2026407 1694872 1499885 1772575 303883 320925 225000 394465 6385560 6283909 949618 763189 2437 1856 1074891 884970 2026946 1650015 X 3889330 4224161 469284 409733 4358614 4633894 6385560 6283909 -1253 266192 10341 0 X 0 1 X 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 123788 100000 13397 237185 129503 700 -6415 123788 0.12240 0.87760 0 1 1 60308 60308 2902765 2478200 424565 4952086 3742087 1209999 1694872 INSURANCE CAPTIVE INVESTMENT 320925 C 320925 COST REPORT RECEIVABLE, NET 394465 394465 X PART IV, LINE 2B: THE HOSPITAL ACTS AS CUSTODIAN FOR FUNDS OF CERTAIN SWING BED PATIENTS. THESE FUNDS ARE INCLUDED IN ASSETS LIMITED AS TO USE AND ACCOUNTS PAYABLE IN THE FINANCIAL STATEMENTS. SWING BED PATIENT TRUST FUNDS TOTALED $1,856 AND $2,437 AT DECEMBER 31, 2019 AND 2018, RESPECTIVELY. PART V, LINE 4: THE WHEATLAND MEMORIAL HEALTHCARE FOUNDATION'S ENDOWMENT (THE ENDOWMENT) CONSISTS OF INDIVIDUAL FUNDS ESTABLISHED BY DONORS TO PROVIDE ANNUAL FUNDING FOR SPECIFIC ACTIVITIES AND GENERAL OPERATIONS. THE ENDOWMENT MAY ALSO INCLUDE CERTAIN NET ASSETS WITHOUT DONOR RESTRICTIONS DESIGNATED FOR QUASI-ENDOWMENT BY THE BOARD OF DIRECTORS. PART X, LINE 2: THE HOSPITAL IS ORGANIZED AS A MONTANA NON-PROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOSPITAL IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE HOSPITAL IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE, IF APPLICABLE. THE ORGANIZATION HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS. THE HOSPITAL BELIEVES 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 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. PART V, ENDOWMENT FUND: THE WHEATLAND MEMORIAL HEALTHCARE FOUNDATION ESTABLISHED THIS ENDOWMENT FUND FOR THE BENEFIT OF THE HOSPITAL. THE FOUNDATION IS ONLY REQUIRED TO FILE A 990-EZ AND AS SUCH IS NOT REQUIRED TO COMPLETE SCHEDULE D. THE PRIOR ACCOUNTANT DID NOT DISCLOSE THE ENDOWMENT FUND ON THE HOSPITAL RETURN IN PRIOR YEARS. AS SUCH, WE HAVE ONLY TWO YEARS OF ENDOWMENT FUND DATA REPORTED. 1 1 1 X 125.000000000000 1 X 1 1 0 1 1 13041 13041 0.00170 2037967 2019571 18396 0.00240 2051008 2019571 31437 0.00410 62849 17552 45297 0.00590 62849 17552 45297 0.00590 2113857 2037123 76734 0.01000 0 283597 56152 3168311 3230267 -61956 X 1 1 1 1 WHEATLAND MEMORIAL HEALTHCARE PO BOX 287 HARLOWTON MT 59036 WWW.WHEATLANDMEMORIAL.ORG 13546 X X X X RURAL HEALTH CLINIC WHEATLAND MEMORIAL HEALTHCARE 1 0 0 1 X X X X X X X X X 19 1 0 1 1 X WWW.WHEATLANDMEMORIAL.ORG/RESOURCES X 1 19 1 WWW.WHEATLANDMEMORIAL.ORG/RESOURCES 0 1 X 125.000000000000 200.000000000000 X X X 1 1 X X X X 1 X WWW.WHEATLANDMEMORIAL.ORG/RESOURCES/COMPASSIONATE-CARE/ X WWW.WHEATLANDMEMORIAL.ORG/RESOURCES/COMPASSIONATE-CARE/ X WWW.WHEATLANDMEMORIAL.ORG/RESOURCES/COMPASSIONATE-CARE/ X X X X X X 1 X 0 X X X X 1 X 0 1 WHEATLAND MEMORIAL HEALTHCARE PART V, SECTION B, LINE 5: A STEERING COMMITTEE WAS CONVENED TO ASSIST WHEATLAND MEMORIAL HEALTHCARE IN CONDUCTING CHSD. A DIVERSE GROUP OF COMMUNITY MEMBERS REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY (EX. PUBLIC HEALTH, ELDERLY, UNINSURED) CAME TOGETHER IN JULY 2019. WHEATLAND MEMORIAL HEALTHCARE PART V, SECTION B, LINE 6B: WHEATLAND MEMORIAL HEALTHCARE PARTICIPATED IN THE COMMUNITY HEALTH SERVICES DEVELOPMENT (CHSD) PROJECT ADMINISTRATED BY THE MONTANA OFFICE OF RURAL HEALTH. WHEATLAND MEMORIAL HEALTHCARE PART V, SECTION B, LINE 11: SIGNIFICANT NEED 1: ENHANCE ACCESS TO HEALTHCARE SERVICES IN THE WHEATLAND MEMORIAL HEALTHCARE SERVICE AREA STRATEGY 1.1: INCREASE ACCESS TO PRIMARY CARE AND EMERGENCY SERVICES ACTIVITIES: CONTINUE TO ACTIVELY RECRUIT FOR A STABLE, COMMUNITY-BASED PROVIDER; CREATE A COMMUNITY EDUCATION CAMPAIGN TO ENGAGE COMMUNITY IN RECRUITMENT EFFORTS, BARRIERS, AND TO EDUCATE ABOUT PROVIDER SCOPE OF WORK; COLLABORATE WITH REGIONAL PARTNERS TO REDUCE TRANSPORT EXPENSES, ENHANCE AND STABILIZE EMS WORKFORCE, AND IMPROVE ACCESS TO CARE; CONTINUE EFFORTS TO PROMOTE HEALTHCARE CAREERS AND EXPLORE OPPORTUNITIES TO ENHANCE PIPELINE EFFORTS (REACH CAMP, CNA, AND EMS COURSES) AND SHADOWING EXPERIENCES. STRATEGY 1.2: EXPLORE OPPORTUNITIES TO EXPAND ACCESS TO SPECIALTY CARE SERVICES AT WMH ACTIVITIES: EXPLORE FEASIBILITY OF EXPANDING TELEHEALTH OFFERINGS WITH REGIONAL OR STATE PARTNERS; EXPLORE FEASIBILITY OF EXPANDING ON-SITE SPECIALTY SERVICES (SLEEP STUDIES, COLONOSCOPY, OTHER). STRATEGY 1.3: ENHANCE ACCESS AND KNOWLEDGE OF MENTAL AND BEHAVIORAL HEALTH SERVICES ACTIVITIES: CONDUCT ENVIRONMENTAL SCAN OF AVAILABLE LOCAL MENTAL AND BEHAVIORAL HEALTH PROVIDERS AND SERVICES; REACH OUT TO LOCAL PARTNERS (PUBLIC HEALTH, M/BH PROVIDERS, EMS, POLICE, SCHOOLS, EXTENSION, ETC.) AND GAUGE INTEREST IN DEVELOPMENT OF A LOCAL MENTAL HEALTH ADVISORY COMMITTEE; DEVELOP STANDARDIZED SCREENING PROTOCOLS FOR BEHAVIORAL RISK ASSESSMENT AND IMPLEMENT FACILITY WIDE. GOAL 2: ENHANCE CHRONIC DISEASE PREVENTION AND CARE COORDINATION AT WMH STRATEGY 2.1: ENHANCE PREVENTATIVE PROGRAMS AND RESOURCES AVAILABLE THROUGH WMH ACTIVITIES: DEVELOP A COMMUNITY HEALTH FAIR TO ENHANCE ACCESS TO PREVENTATIVE SCREENINGS AND EDUCATION; REACH OUT TO COMMUNITY AND REGIONAL PARTNERS TO SUPPORT AND ENHANCE THE HEALTH FAIR'S REACH AND SUSTAINABILITY; CONDUCT ENVIRONMENTAL SCAN TO ASSESS LOCAL PROGRAMS AND RESOURCES AVAILABLE THAT ENHANCE AND PROMOTE HEALTHY LIFESTYLES (FITNESS CENTER, HEAD START, EXTENSION, SCHOOLS, ETC.); EXPLORE OPPORTUNITIES TO SUPPORT AND PROMOTE HEALTHY BEHAVIORS AND ACTIVITIES LOCALLY (FUN RUNS, HEALTH CHALLENGES); EXPLORE DEVELOPING NUTRITIONAL COOKING AND DIETARY EDUCATION THROUGH WMH AND IN COLLABORATION WITH REGIONAL PARTNERS. STRATEGY 2.2: ENHANCE CARE COORDINATION PROGRAMS AND RESOURCES AT WMH ACTIVITIES: RESEARCH AND DETERMINE FEASIBILITY OF IMPLEMENTING A CARE COORDINATION PROGRAM AT WMH OR IN PARTNERSHIP WITH REGIONAL PARTNERS (IF FOUND TO BE FEASIBLE: DETERMINE STAFFING NEEDS (FTE)); EXPLORE OPPORTUNITIES TO EXPAND COMMUNITY CARE COORDINATION STAFF (COMMUNITY CARE COORDINATOR, COMMUNITY HEALTH WORKER); DETERMINE WHM PROVIDER AND CLINICAL SERVICES CHAMPION FOR PROGRAM IMPLEMENTATION; EDUCATE STAFF AND PROVIDERS ON NEW COMMUNITY CARE COORDINATION PROGRAM; CREATE EDUCATION AND OUTREACH MATERIALS TO EDUCATE COMMUNITY ON NEW PROGRAM. GOAL 3: ENGAGE IN EFFORTS TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH IN WHEATLAND COUNTY STRATEGY 3.1: ENHANCE WMH EFFORTS IN INFLUENCING SOCIAL DETERMINANTS OF HEALTH ACTIVITIES: EXPLORE OPPORTUNITIES TO PARTNER WITH SCHOOLS ON ADULT EDUCATION AND SKILLS TRAINING TO PROMOTE LITERACY AND G.E.D ATTAINMENT; CONTINUE TO OFFER CNA OTHER HEALTH SKILLS TRAININGS. EXPLORE OPPORTUNITIES TO SUPPORT AND INCENTIVIZE LOCAL LEARNERS; MEET WITH COUNTY COMMISSIONERS TO DISCUSS HOUSING NEEDS AND OPPORTUNITIES; EXPLORE STATE AND FEDERAL RESOURCES, FUNDING, AND RELEVANT DATA; EXPLORE REVIEW OF ELECTRONIC MEDICAL RECORD PATIENT DISCHARGE INFORMATION TO ASSESS LITERACY LEVEL AND UPDATE AS APPROPRIATE TO ENHANCE PATIENT UNDERSTANDING; CREATE AND MARKET AN "INSURANCE PAYOR 101" RESOURCE(S) TO ASSIST COMMUNITY IN ACCESSING AND UNDERSTANDING BENEFITS; ESTABLISH A PATIENT ASSISTANCE REPRESENTATIVE AT WMH TO SUPPORT NAVIGATION OF HEALTHCARE SYSTEM AND LEARN OF AVAILABLE LOCAL, STATE AND FEDERAL COST ASSISTANCE RESOURCES. IDENTIFIED HEALTH NEEDS UNABLE TO ADDRESS BY WMH: 1. 13% OF SURVEY RESPONDENTS INDICATED COST HAD PREVENTED THEM FROM GETTING OF TAKING THEIR MEDICATIONS REGULARLY. WMH EXPLORED POTENTIAL 340B PLAN TO LOWER COST OF MEDICATIONS. LOCAL PHARMACY NOT INTERESTED AT THIS TIME. WILL CONTINUE TO EXPLORE AND DISCUSS WITH LOCAL PARTNERS.2. WHEATLAND COUNTY'S UNINTENTIONAL INJURY DEATH RATE IS 50.5 PER 100,000 PEOPLE COMPARED TO 41.3 FOR THE US AND MONTANA. WMH DOES NOT WANT TO DUPLICATE TRAUMA EDUCATION IN COMMUNITY. SUPPORTING EFFORTS OF TRAUMA COORDINATION IN COMMUNITY. WHEATLAND MEMORIAL HEALTHCARE PART V, SECTION B, LINE 16J: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND INFORMATION ON HOW TO OBTAIN AN APPLICATION OR VIEW THE ENTIRE POLICY IS POSTED IN THE EMERGENCY ROOM, WAITING ROOMS, AND ADMISSION AREAS OF THE HOSPITAL. A SUMMARY IS ALSO AVAILABLE ON THE HOSPITAL'S WEBSITE. THE FINANCIAL ASSISTANCE POLICY IS ALSO PROVIDED WITH THE INITIAL COLLECTION EFFORT NOTICES. WHEATLAND MEMORIAL HEALTHCARE 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 CHARGED GROSS CHARGES ON ELECTIVE PROCEDURES. HOWEVER PATIENT PAYMENTS ARE ELIGIBLE FOR OTHER DISCOUNTS FROM GROSS CHARGES. PART I, LINE 7: CHARITY CARE WAS RECORDED AT COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID ON LINE 7B WAS CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. PART I, LINE 7G: THE COST FOR SUBSIDIZED HEALTH SERVICES ON LINE 7G WAS DETERMINED USING THE MEDICARE COST REPORT. PART I, LN 7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES TO DETERMINE THE PERCENTAGE WAS $283,597. PART I, LINE 6B WMH'S ANNUAL COMMUNITY BENEFIT REPORT CAN BE FOUND ON THEIR WEBSITE. PART III, LINE 2: PATIENT ACCOUNTS ARE NOT CLASSIFIED AS BAD DEBT UNTIL EVERY EFFORT IS MADE TO COLLECT ON THE ACCOUNT, INSURANCE IS FILED, AND ALL PAYMENTS ARE APPLIED INCLUDING CONTRACTUAL ALLOWANCES AND DISCOUNTS. ANY PAYMENT ON AN ACCOUNT THAT WAS WRITTEN OFF TO BAD DEBT REDUCES BAD DEBT EXPENSE IN THE CURRENT YEAR. BAD DEBT EXPENSE ON LINE 2 IS REPORTED AT CHARGES AS PRESENTED ON THE FINANCIAL STATEMENTS. PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BY USING THE PERCENTAGE OF INDIVIDUALS WITHIN THE COMMUNITY WHO ARE BELOW THE FEDERAL POVERTY LEVEL AT 19.8%. PART III, LINE 4: BAD DEBT EXPENSE IS DESCRIBED IN FOOTNOTE 1 WHICH BEGINS ON PAGE 9 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: WHEATLAND MEMORIAL HEALTHCARE IS A CRITICAL ACCESS HOSPITAL. THE HOSPITAL PROVIDES SERVICES TO PATIENTS BECAUSE ACCESS TO HEALTHCARE AND INDIVIDUAL'S HEALTH IS IMPORTANT TO THE HOSPITAL. THEREFORE, THE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT.TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. PART III, LINE 9B: THE HOSPITAL IS AWARE OF PATIENTS WHO ARE IN THE PROCESS OF APPLYING FOR FINANCIAL ASSISTANCE AND THESE ACCOUNTS ARE NOT SENT TO COLLECTIONS. IF A PATIENT DOES NOT COOPERATE OR IS NOT IN COMPLIANCE WITH THEIR PAYMENT ARRANGEMENT THE ACCOUNT IS TURNED OVER TO A COLLECTION AGENCY.COLLECTION EFFORTS CEASE WHILE A PATIENT IS UNDER REVIEW FOR CHARITY CARE OR WHILE A PATIENT IS IN COMPLIANCE WITH A PAYMENT ARRANGEMENT. AFTER FINANCIAL ASSISTANCE IS AWARDED, ANY PERSONAL PORTION DUE FOLLOWS THE SAME COLLECTION PROCEDURE AS OTHER ACCOUNTS. PART VI, LINE 2: WHEATLAND MEMORIAL HEALTHCARE ASSESSES THE NEEDS OF THE COMMUNITY THROUGH PATIENT SURVEYS, GENERAL PUBLIC SURVEYS, AND COMMUNITY MEETINGS.A STEERING COMMITTEE WAS CONVENED TO ASSIST WHEATLAND MEMORIAL HEALTHCARE IN CONDUCTING ITS CHNA. THE HOSPITAL USED A DIVERSE GROUP OF COMMUNITY MEMBERS REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY. THE 12/31/2019 NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY IS POSTED TO THE HOSPITAL WEBSITE. PART VI, LINE 3: WHEATLAND MEMORIAL HEALTHCARE TRIES TO DETERMINE IF PATIENTS QUALIFY OR POSSIBLY QUALIFY FOR ANY FINANCIAL ASSISTANCE EITHER AT REGISTRATION OR DISCHARGE. WE NOTIFY PATIENTS OF OUR PROGRAMS BY MAKING AVAILABLE FINANCIAL ASSISTANCE BROCHURES IN WAITING ROOMS, EMERGENCY ROOM AREAS, AND OTHER PATIENT ACCESS AREAS AND LOCAL NEWSPAPER ADS. FINANCIAL ASSISTANCE INFORMATION IS PROVIDED IN ALL CORRESPONDENCE REGARDING PATIENT BILLS. WE ALSO HAVE STAFF AVAILABLE TO ASSIST IN APPLICATIONS FOR STATE AID. PART VI, LINE 4: WHEATLAND MEMORIAL HEALTHCARE (WMH) IS A 25-BED CRITICAL ACCESS HOSPITAL AND RURAL HEALTH CLINIC LOCATED IN HARLOWTON, MONTANA. HARLOWTON IS A RANCHING COMMUNITY IN CENTRAL MONTANA WITH APPROXIMATELY 1.6 PEOPLE PER SQUARE MILE. THE POPULATION OF HARLOWTON WAS 992 AND WHEATLAND COUNTY WAS 2,108. WMH SERVES RESIDENTS OF WHEATLAND, GOLDEN VALLEY, JUDITH BASIN AND PORTIONS OF SWEET GRASS AND MEAGHER COUNTIES. THE MOST COMMON INDUSTRIES ARE MANAGEMENT, FARMING, FISHING, AND CONSTRUCTION. THE NEAREST TERTIARY CARE FACILITY IS 93 MILES SOUTH EAST OF HARLOWTON, IN BILLINGS, MT. THE NEXT CLOSEST TERTIARY CARE FACILITY IS 130 MILES NORTH WEST OF HARLOWTON, IN GREAT FALLS, MT. LEWISTOWN WHICH IS 60 MILES NORTH FROM WMH, HAS A SECONDARY CARE FACILITY.THE MEDIAN HOUSEHOLD INCOME IN WHEATLAND COUNTY WAS $37,222, AND INDIVIDUALS LIVING BELOW THE FEDERAL POVERTY LEVEL IN WAS 19.8%. PART VI, LINE 5: OUR BOARD IS COMPRISED OF MEMBERS WITHIN OUR LOCAL AND OUTLYING SERVICE AREA. THESE MEMBERS ARE NOT EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION. AT THIS TIME THE ORGANIZATION HAS LACKED EXCESS FUNDS FROM OPERATIONS BUT HAS PURSUED GRANTS AGGRESSIVELY IN ORDER TO REPLACE AGING EQUIPMENT AND ESTABLISH COMMUNITY HEALTH PROGRAMS THAT WILL ALLOW US TO CONTINUE SERVING THE HEALTH CARE NEEDS OF OUR COMMUNITY DURING THESE CHALLENGING ECONOMIC TIMES. OUR EMERGENCY ROOM IS AVAILABLE 24/7 AND SERVES ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. WE EXTEND PRIVILEGES TO MEDICAL STAFF THAT ARE LICENSED AND QUALIFIED.THE HOSPITAL PROVIDES SPACE FOR IMMUNIZATION CLINICS TO ENSURE CHILDREN IN THE COMMUNITY RECEIVE RECOMMENDED IMMUNIZATIONS. WE ALSO PROVIDE SPACE FOR THE REGIONAL WIC (WOMEN, INFANTS AND CHILDREN) CLINIC TO PROMOTE THE SERVICES OFFERED BY THAT ORGANIZATION. THE HOSPITAL HAS ESTABLISHED A STRONG WORKING RELATIONSHIP WITH THE CHAPLAINS OF SEVERAL CHURCHES WHO PROVIDE SUPPORT TO PATIENTS AND FAMILIES OF THE FACILITY AND PARTICIPATE IN CARE PLANNING AND REGULAR MEETINGS. THE CEO REGULARLY ATTENDS COUNTY COMMISSIONER MEETINGS TO PROVIDE THE COMMUNITY WITH AN UPDATE OF THE EVENTS GOING ON AT THE HOSPITAL. BOARD MEMBERS ALSO FREQUENTLY ATTEND THESE COMMISSIONER MEETINGS. THE HOSPITAL AND ITS ATTACHED RURAL HEALTH CLINIC IS THE SOLE PROVIDER OF HEALTH CARE SERVICES WITHIN THE COMMUNITY. 0 0 0 0 0 0 0 0 0 REBECCA STURDEVANT NP 181416 0 0 0 0 0 7257 0 0 0 188673 0 0 0 HANNAH SEXTON PA 148767 0 0 0 0 0 1564 0 12012 0 162343 0 0 0 JAMIE GOLDBERG NP 141415 0 0 0 0 0 987 0 10010 0 152412 0 0 0 PART I, LINE 3 WHEATLAND MEMORIAL HEALTHCARE DOES NOT PAY COMPENSATION TO THE CEO OR CFO DIRECTLY. THE CEO AND CFO ARE COMMON LAW EMPLOYEES OF BILLINGS CLINIC AND ARE COMPENSATED BY BILLINGS CLINIC. BILLINGS CLINIC DETERMINES COMPENSATION BASED ON THE PROCESSES DESCRIBED IN PART I, QUESTION 3 AND OTHER METHODS THEY HAVE ESTABLISHED. FORM 990, PART VI, SECTION A, LINE 3 WHEATLAND MEMORIAL HEALTHCARE HAS CONTRACTED WITH BILLINGS CLINIC TO PROVIDE MANAGEMENT SERVICES. THE CEO AND CFO POSITIONS AT WHEATLAND MEMORIAL HEALTHCARE ARE CONSIDERED COMMON LAW EMPLOYEES OF BILLINGS CLINIC. BILLINGS CLINIC MAY, IN ITS DISCRETION AT ANY TIME, REMOVE AND REPLACE THE CEO AND CFO. THE CEO HAS THE RESPONSIBILITY OF SUPERVISING MANAGEMENT AND ADMINISTRATING THE OPERATION OF WHEATLAND MEMORIAL HEALTHCARE. THE CFO HAS THE RESPONSIBILITY OF MANAGING THE ORGANIZATION'S FINANCES. THE AMOUNTS BELOW WERE PAID TO EACH INDIVIDUAL BASED ON AN HOURLY RATE. RICK POSS, CEO SALARY $120,000 PATRICK MCCONNELL, CFO SALARY $16,244 FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE COMPLETED FORM 990 IS PROVIDED TO THE BOARD MEMBERS BEFORE IT IS FILED. THE CEO AND THE CFO REVIEW THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED UPON HIRE AND AT LEAST ANNUALLY THEREAFTER, TO DISCLOSE ANY CONFLICTS OR POTENTIAL CONFLICTS AND SIGN A CONFLICT OF INTEREST POLICY. A CONFLICT OF INTEREST CAN BE CONSIDERED TO EXIST IN ANY INSTANCE WHERE THE ACTIONS OR ACTIVITIES OF AN INDIVIDUAL ON BEHALF OF WHEATLAND MEMORIAL ALSO INVOLVE THE OBTAINING OF AN IMPROPER GAIN OR ADVANTAGE, OR ADVERSE EFFECT ON THE INTERESTS OF WHEATLAND MEMORIAL. THE CEO REVIEWS THE STATEMENTS AND INVESTIGATES ALL DISCLOSURES OF POSSIBLE CONFLICTS OF INTEREST. THE CEO PREPARES A REPORT FOR THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE IS RESPONSIBLE FOR FINAL REVIEW AND INVESTIGATION OF POTENTIAL CONFLICTS OF INTEREST AND PRESENTATION OF ITS FINDINGS TO THE WHEATLAND MEMORIAL BOARD OF DIRECTORS ON AN ANNUAL BASIS. UPON DISCLOSURE OF A POSSIBLE CONFLICT OF INTEREST, BOARD MEMBERS WILL REFRAIN FROM DELIBERATING ON THE MATTER UNTIL ALL RELEVANT AND PERTINENT FACTS AND CIRCUMSTANCES HAVE BEEN DISCLOSED AND ANY POTENTIAL CONFLICT HAS BEEN AVOIDED OR RESOLVED. THE INDIVIDUAL WITH A CONFLICT IS NOT ALLOWED TO BE PRESENT WHEN THE MATTER IS DISCUSSED OR VOTED UPON. ALL MATTERS OF DISCUSSION ARE DOCUMENTED. FORM 990, PART VI, SECTION B, LINE 15A THE CEO AND CFO ARE COMMON LAW EMPLOYEES OF BILLINGS CLINIC. BILLINGS CLINIC DETERMINES COMPENSATION BASED ON METHODS THEY HAVE ESTABLISHED. THE BOARD OF DIRECTORS APPROVES THE MANAGEMENT RELATIONSHIP WITH BILLINGS CLINIC. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THE FORM 990. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 551,464. MANAGEMENT AND GENERAL EXPENSES 214,238. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 765,702. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 108,711. MANAGEMENT AND GENERAL EXPENSES 36,162. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 144,873. RECRUITMENT: PROGRAM SERVICE EXPENSES 7,813. MANAGEMENT AND GENERAL EXPENSES 484. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,297. WHEATLAND MEMORIAL HEALTHCARE FOUNDATION PO BOX 287 HARLOWTON MT 59036 454035841 SUPPORT WHEATLAND MEMORIAL HEALTHCARE MT 501(C)(3) LINE 12A, I WHEATLAND MEMORIAL HEALTHCARE 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0