HOT SPRINGS COUNTY HOSPITAL DIST: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- HOT SPRINGS COUNTY HOSPITAL DIST (EIN 83-6000182)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-05-07
- IRS object ID
- 202031289349301663
- Schema version
- 2018v3.2
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-05-07T17:37:04-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 830332861 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KOERWITZ MICHEL WRIGHT & ASSOC PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1362 | AddressLine1Txt |
| City | THERMOPOLIS | CityNm |
| State Abbreviation | WY | StateAbbreviationCd |
| ZIP | 82443 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 836000182 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOT SPRINGS COUNTY HOSPITAL DIST | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOTS | BusinessNameControlTxt |
| Phone | 3078643121 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 E ARAPAHOE STREET | AddressLine1Txt |
| City | THERMOPOLIS | CityNm |
| State Abbreviation | WY | StateAbbreviationCd |
| ZIP | 82443 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHELLY LARSON | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3078643121 | PhoneNum |
| Signature | 2020-05-05 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J WRIGHT | PreparerPersonNm |
| PTIN | P00488529 | PTIN |
| Phone | 3078643173 | PhoneNum |
| Preparation | 2020-05-07 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 52.37.240.203 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-05-07 | IPDt |
| IP Tm | 17:37:04 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | C2D4B6A860A7B788766D3BCA412E976E5595A016 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | D88880BABF433658D8E12CBC5853A2924AADC488 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HSC MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARGIE MOLITOR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 E ARAPAHOE ST | AddressLine1Txt |
| City | THERMOPOLIS | CityNm |
| State Abbreviation | WY | StateAbbreviationCd |
| ZIP | 82443 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $26,034,157 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HSCMH.ORG | WebsiteAddressTxt |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Other Organization Dsc | HOSP. DIST. | OtherOrganizationDsc |
| Formation | 1944 | FormationYr |
| Legal Domicile State | WY | LegalDomicileStateCd |
| Activity Or Mission | ACUTE CARE HOSPITAL | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 201 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $566,435 | PYContributionsGrantsAmt |
| CY Contributions Grants | $447,508 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,387,622 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,020,554 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,791 | PYInvestmentIncomeAmt |
| CY Investment Income | $11,829 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,040,073 | PYOtherRevenueAmt |
| CY Other Revenue | $1,551,556 | CYOtherRevenueAmt |
| PY Total Revenue | $20,996,921 | PYTotalRevenueAmt |
| CY Total Revenue | $26,031,447 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,081,797 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,090,072 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,632,353 | PYOtherExpensesAmt |
| CY Other Expenses | $11,604,401 | CYOtherExpensesAmt |
| PY Total Expenses | $19,714,150 | PYTotalExpensesAmt |
| CY Total Expenses | $23,694,473 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,282,771 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,336,974 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,860,563 | TotalAssetsBOYAmt |
| Total Assets EOY | $21,266,966 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,652,558 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,721,987 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,208,005 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,544,979 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ACUTE CARE HOSPITAL | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $18,765,303 | ExpenseAmt |
| Desc | HOT SPRINGS COUNTY MEMORIAL HOSPITAL, A NOT FOR PROFIT, COMMUNITY HOSPITAL, PROVIDES COMPASSIONATE MEDICAL CARE FOR ALL, REGARDLESS OF THEIR ABILITY TO PAY. HSCMH OFFERS 24/7 EMERGENCY CARE (2,086 VISITS), INPATIENT SERVICES (1,587 PATIENT DAYS), OUTPATIENT SERVICES (14,949 VISITS), BIG HORN CLINIC RURAL HEALTH CLINIC (4,381 VISITS), AND RED ROCK FAMILY PRACTICE CLINIC (13,390 VISITS). THE HOSPITAL HAS A FINANCIAL ASSISTANCE PROGRAM UNDER WHICH SERVICES ARE PROVIDED FOR FREE OR AT A REDUCED RATE. CHARITY CARE AWARDED UNDER THE FINANCIAL ASSISTANCE PROGRAM TOTALED 434,635. THE COST OF CHARITY CARE FOR THE YEAR ENDED JUNE 30, 2019 BASED ON DIRECT AND INDIRECT COST OF PROVIDING CHARITY CARE SERVICES WAS 252,271. MANY EMPLOYEES ARE TEACHERS IN THE EDUCATION PROGRAMS OPEN TO THE PUBLIC SUCH AS CERTIFIED NURSING ASSISTANT AND CARDIOPULMONARY RESUSCITATION. AN AGREEMENT WITH THE UNIVERSITY OF WYOMING ENCOURAGES NURSING, PHARMACY, AND SOCIAL SERVICES STUDENTS TO INTERN AT HSCMH. REDUCED MAMMOGRAPHY AND BONE DENSITY TESTS ARE OFFERED OCTOBER-DECEMBER. HEALTH INFORMATION LINKS ARE AVAILABLE ON THE HSCMH WEBSITE. USE OF PORTABLE OXYGEN CONCENTRATORS ARE FREE THROUGH CARDIOPULMONARY SERVICES FOR THOSE TRAVELING. COMFORT CARTS AND FREE MEALS ARE AVAILABLE FOR FAMILIES DURING STRESSFUL CONDITIONS. SNACKS ARE OFFERED TO PATIENTS TWICE A DAY. BIG HORN CLINIC, AND RED ROCK FAMILY PRACTIC CLINIC PROVIDES REDUCED OR FREE EXAMS FOR SCHOOL ATHLETICS, MEDICINE ASSISTANCE, BLOOD PRESSURE SCREENING AND COMMUNITY EDUCATION SEMINARS. HSCMH OFFERS SCHOLARSHIPS TO QUALIFYING EMPLOYEES WANTING TO ADVANCE THEIR EDUCATION TO THE BETTERMENT OF THE HOSPITAL AND COMMUNITY. COMMUNITY RESOURCE TRAINING FOR HIGH SCHOOL STUDENTS AND WWAMI (WASHINGTON, WYOMING, ALASKA MONTANA, IDAHO)MEDICAL EDUCATION PROGRAM, WHICH PROMOTES MEDICAL EDUCATION IN WESTERN STATES, ARE TWO LONG-TIME PROGRAMS IN WHICH HSCMH PARTICIPATES. | Desc |
| Total Program Service Expenses | $18,765,303 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | 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 |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | 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 | Yes (true) | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 77 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 201 | 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 |
| 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | 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 | SHELLY LARSON | PersonNm |
| Phone | 3078643121 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 E ARAPAHOE ST | AddressLine1Txt |
| City | THERMOPOLIS | CityNm |
| State Abbreviation | WY | StateAbbreviationCd |
| ZIP | 824432402 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 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 |
|---|---|---|---|---|---|---|---|
| BILL WILLIAMS | |||||||
| CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAN HERDT | |||||||
| SEC/TREAS | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| HEATH OVERFIELD | |||||||
| VICE CHAIRMA | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVID KOERWITZ | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MELISSA JOHNSON | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SHELLY LARSON | |||||||
| CFO | 40.00 | Yes (X) | $121,025 | $0 | $5,639 | ||
| MARGIE MOLITOR | |||||||
| CEO | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| JASON WEYER | |||||||
| PHYSICIAN | 40.00 | $508,832 | $0 | $10,387 | Yes (X) | ||
| WADE BOMENGEN | |||||||
| PHYSICIAN | 40.00 | $496,184 | $0 | $11,006 | Yes (X) | ||
| HALLIE BISCHOFF | |||||||
| PHYSICIAN | 40.00 | $419,844 | $0 | $0 | Yes (X) | ||
| CHRISTOPHER PARIS | |||||||
| CRNA | 40.00 | $188,003 | $0 | $8,166 | Yes (X) | ||
| DANIEL HERMANN | |||||||
| PHARMACIST | 40.00 | $175,713 | $0 | $3,285 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,909,601 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $38,483 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | 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 |
|---|---|---|---|---|---|
| HEALTHTECH MGT SER (SEE STATEMENT 3) | |||||
| 5110 MARYLAND WAY STE 2 | BRENTWOOD | TN | 37027 | MNGMT/CONTRACT | $668,052 |
| HOLISTIC PAIN MANAGEMENT | |||||
| PO BOX 1476 | LOVELAND | CO | 80539 | AGENCY STAFF | $562,980 |
| BILLINGS CLINIC | |||||
| 1020 N 27TH ST | BILLINGS | MT | 59101 | IT MAIN/LAB SVC | $329,358 |
| MORTIMORE AMBULANCE | |||||
| 620 ARAPAHOE ST | THERMOPOLIS | WY | 82443 | AMBULANCE SRVS | $302,823 |
| AMEDISTAF LLC | |||||
| PO BOX 595 | TONITOWN | AR | 72770 | TRAVEL STAFF | $272,084 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $447,508 | AllOtherContributionsAmt |
| Total Contributions | $447,508 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| PATIENT SERVICE REVENUE | $23,129,305 | $23,129,305 |
| OTHER OPERATING REVENUE | $891,249 | $891,249 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,020,554 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,829 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,829 | RelatedOrExemptFuncIncomeAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $19,800 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,710 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $17,090 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,090 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,090 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| SPECIAL PURPOSE TAX | $1,044,022 | $1,044,022 |
| PROPERTY TAX | $490,444 | $490,444 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,534,466 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,031,447 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,583,939 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,073,461 | TotalAmt |
| Program Services | $8,296,324 | ProgramServicesAmt |
| Management And General | $1,777,137 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,848 | TotalAmt |
| Program Services | $149,399 | ProgramServicesAmt |
| Management And General | $20,449 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,127,010 | TotalAmt |
| Program Services | $854,626 | ProgramServicesAmt |
| Management And General | $272,384 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $719,753 | TotalAmt |
| Program Services | $625,571 | ProgramServicesAmt |
| Management And General | $94,182 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $562,336 | TotalAmt |
| Management And General | $562,336 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,106 | TotalAmt |
| Management And General | $85,106 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,750 | TotalAmt |
| Management And General | $31,750 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,906,974 | TotalAmt |
| Program Services | $3,494,190 | ProgramServicesAmt |
| Management And General | $412,784 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,572,187 | TotalAmt |
| Program Services | $3,358,970 | ProgramServicesAmt |
| Management And General | $213,217 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,019,800 | TotalAmt |
| Program Services | $709,123 | ProgramServicesAmt |
| Management And General | $310,677 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,776 | TotalAmt |
| Program Services | $139,116 | ProgramServicesAmt |
| Management And General | $54,660 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,179 | TotalAmt |
| Management And General | $41,179 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,146,846 | TotalAmt |
| Program Services | $974,819 | ProgramServicesAmt |
| Management And General | $172,027 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,850 | TotalAmt |
| Program Services | $12,615 | ProgramServicesAmt |
| Management And General | $140,235 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| BOND ISSUANCE COST | $581,285 | $581,285 | |
| DUES & SUBSCRIPTIONS | $246,137 | $144,754 | $101,383 |
| RECRUITMENT | $41,946 | $13,217 | $28,729 |
| LICENSE FEES | $22,229 | $1,791 | $20,438 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,694,473 | TotalAmt |
| Program Services | $18,765,303 | ProgramServicesAmt |
| Management And General | $4,929,170 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,181,513 | BOYAmt |
| EOY | $2,294,770 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,098,777 | BOYAmt |
| EOY | $3,533,348 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,683,340 | BOYAmt |
| EOY | $4,355,271 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,250 | BOYAmt |
| EOY | $11,215 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $637,835 | BOYAmt |
| EOY | $740,239 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $181,235 | BOYAmt |
| EOY | $180,212 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $27,097,204 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $17,535,873 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,393,667 | BOYAmt |
| EOY | $9,561,331 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $662,946 | BOYAmt |
| EOY | $590,580 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,860,563 | BOYAmt |
| EOY | $21,266,966 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,030,130 | BOYAmt |
| EOY | $3,035,524 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,803 | BOYAmt |
| EOY | $9,339 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,598,625 | BOYAmt |
| EOY | $5,677,124 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,652,558 | BOYAmt |
| EOY | $8,721,987 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,130,131 | BOYAmt |
| EOY | $9,032,628 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,077,874 | BOYAmt |
| EOY | $3,512,351 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,208,005 | BOYAmt |
| EOY | $12,544,979 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,860,563 | BOYAmt |
| EOY | $21,266,966 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,336,974 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (true) | 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 | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $614,079 | OtherCostOrOtherBasisAmt |
| Book Value | $614,079 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,313,696 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,143,616 | DepreciationAmt |
| Book Value | $5,170,080 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,169,429 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,392,257 | DepreciationAmt |
| Book Value | $3,777,172 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,561,331 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LONG TERM NOTES PAYABLE | Desc |
| Amt | $5,677,124 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,677,124 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $26,031,447 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $26,031,447 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $26,031,447 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $23,694,473 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $23,694,473 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $23,694,473 | TotalExpensesPerForm990Amt |
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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| 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 | $263,650 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $263,650 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01110 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,814,949 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,353,835 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $461,114 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01950 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,078,599 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,353,835 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $724,764 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03060 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $170,760 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $48,795 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $121,965 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00510 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,597,587 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,364,156 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $233,431 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00990 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,768,347 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,412,951 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $355,396 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01500 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,846,946 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,766,786 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,080,160 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04560 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,812,080 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $543,624 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,710,504 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,574,826 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $135,678 | MedicareSurplusOrShortfallAmt |
| 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 | HEALTHTECH MGMT SRV | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | MANAGEMENT | PrimaryActivitiesTxt |
| 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 | HOT SPRINGS COUNTY HOSPITAL DISTRIC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 E ARAPAHOE | AddressLine1Txt |
| City | THERMOPOLIS | CityNm |
| State Abbreviation | WY | StateAbbreviationCd |
| ZIP | 82443 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOT SPRINGS COUNTY HOSPITAL DISTRIC | 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 |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 16 | 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.HSCMH.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.HSCMH.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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.HSCMH.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.HSCMH.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.HSCMH.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 |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 3E | PROVIDES SIGNIFICANT HEALTH NEEDS FOR THE COMMUNITY |
| FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 5 | FACILITY 1-PART V, LINE 5 & 6(B) HOSPITAL REPRESENTATIVES, JOHN GIBBEL, MARKETING, AND ROXANNE ARNETTE, PATIENT CARE DIRECTOR,MET WITH COMMUNITY REPRESENTATIVES AS FOLLOWS: BILL MALLOY (FORMER MAYOR OF THERMOPOLIS), JANE NORSKOG (THE H.O.P.E. AGENCY, A NON-PROFIT ORGANIZATION THAT PROVIDES SERVICES TO VICTIMS OF DOMESTIC VIOLENCE, TEEN DATING VIOLENCE, SEXUAL ASSAULT AND STALKING IN HOT SPRINGS COUNTY), MARIE MCDOUGAL, RN & BRENNA HUCKFELDT, RN BSN, CLC (HOT SPRINGS COUNTY PUBLIC HEALTH NURSING SERVICES), FRANK ROBBINS (LANDOWNER, SET FREE CHURCH PASTOR), BECKY MORTIMORE-COMMUNITY PREVENTION PROFESSIONAL (PREVENTION MANAGEMENT ORGANIZATION OF WYOMING, HOT SPRINGS COUNTY OFFICE), ALLEN BRAATEN (HOT SPRINGS COUNTY COUNSELING CENTER), JASON WEYER, DO (RED ROCK FAMILY PRACTICE CLINIC), DR WILLIAM ROBINSON, DDS (PAINTBRUSH DENTAL CLINIC). DATA FROM THE WYOMING HEALTH MATTERS WAS USED AS A GAUGE TO MEASURE HOW HOT SPRINGS COUNTY WAS DOING IN A VARIETY OF LIFESTYLE CHOICES AND TO ASSESS PRIORITY AND FEASIBILITY. |
| FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 6B | REFER TO FACILITY 1- PART V, LINE 5, SEE ABOVE |
| FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 11 | HSCMH ADDRESSED THE UNDER-SERVED POPULATIONS IN HOT SPRINGS COUNTY WITH RESPECT TO ACCESS TO HEALTHCARE AND ACCESS TO HEALTH EDUCATION. THE SPECIFIC AREAS THAT HAVE BEEN IDENTIFIED ARE MOTHERS WHO SMOKED DURING PREGNANCY, BABIES WITH LOW BIRTH WEIGHT AND ADULTS WHO VISIT THE DENTIST/ADULTS 45+ WITH MAJOR TOOTH LOSS. HSCMH IS PARTNERING WITH RED ROCK FAMILY PRACTICE AND PUBLIC HEALTH TO IDENTIFY AT RISK MOTHERS TO PROVIDE EDUCATION ON SMOKING CESSATION AND PRENATAL AND POST-NATAL SERVICES AVAILABLE. HSCMH IS PARTNERING WITH PAINTBRUSH DENTAL AND SUPPORTING THEIR EFFORTS IN THE ELEMENTARY SCHOOL TO EDUCATE YOUTH ON PROPER ORAL HYGIENE TO DEVELOP LIFE LONG SKILLS TO ELIMINATE MAJOR TOOTH LOSS. |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE | THE FACILITIES CRITERIA FOR ELIGIBLITY FOR FREE OR DISCOUNTED CARE IS BASED ON THE FEDERAL PROVERTY GUIDELINES, FAMILY SIZE, AND THE PATIENT'S EQUITY RESOURCES (ASSETS LESS MEDICAL DEBT). IN ADDITION, THE PATIENT AND FAMILY MEMBERS MUST RECEIVE A DENIAL FROM MEDICAID OR OTHER PUBLIC ASSISTANCE PROGRAMS. EXTENUATING CIRCUMSTANCES (DEATH, ACTS OF NATURE, ETC.) ARE CONSIDERED IN DETERMINING ELIGIBILTY FOR FINANCIAL ASSISTANCE. |
| PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION | THE SUBSIDIZED HEALTH SERVICES WERE CALCULATED FOR SERVICES PROVIDED TO PATIENTS WHO ARE TREATED IN THE FACILITIES EMERGENCY ROOM. THIS DOES NOT INCLUDE ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | ACCOUNTS DEEMED TO BE UNCOLLECTIBLE ARE WRITTEN OFF AS ALLOWED BY THE LAWS AND REGULATIONS OF THE STATE OF WYOMING. ACCOUNTS WRITTEN OFF HAVE BEEN FULLY PROVIDED FOR IN THE ALLOWANCE FOR BAD DEBTS. THE FACILITIES ESTIMATE OF BAD DEBT WHICH WOULD QUALIFY FOR FINANCIAL ASSISTANCE IS BASED ON THE STANDARD INDUSTRY BENCHMARK AND THE REVIEW OF BAD DEBT ACCOUNTS AT THE TIME OF WRITE-OFF. NO COMMUNITY BENEFIT IS CLAIMED FOR ANY PORTION OF THE BAD DEBT. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | TEXT OF FINANCIAL STATEMENT FOOTNOTE (SEE PAGE 24, NOTE 3 OF THE AUDITED FINANCIALS). ACCOUNTS DEEMED TO BE UNCOLLECTIBLE ARE WRITTEN OFF AS ALLOWED BY THE LEGISLATION OF THE STATE OF WYOMING. ACCOUNTS WRITTEN OFF HAVE BEEN FULLY PROVIDED FOR IN THE PROVISION FOR BAD DEBT. |
| PART III, LINE 8 - MEDICARE EXPLANATION | THE HOSPITAL IS LICENSED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AS A CRITICAL ACCESS HOSPITAL. AS A CRITICAL ACCESS HOSPITAL IT IS REIMBURSED ON 101% OF COSTS LESS THE 2% SEQUESTRATION ADJUSTMENT. THE HOSPTITAL UTILIZED THE ANNUAL COST REPORT FOR FISCAL YEAR JUNE 30, 2018 WHICH IT IS REQUIRED TO SUBMIT TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AS THE SOURCE TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE IN CONNECTION WITH THE REVENUE RECEIVED FROM MEDICARE. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | THE HOSPITAL MAKES EVERY EFFORT TO COMPLETE A FINANCIAL EVALUATION AT THE EARLIST POSSIBLE POINT IN THE REVENUE CYCLE FOR ALL PATIENTS INDICATING AN INABILITY TO MEET THEIR FINANCIAL OBLIGATIONS. A FINANCIAL ASSISTANCE PROGRAM APPLICATION IS COMPLETED ONCE ALL OTHER OPTIONS FOR REIMBURSEMENTS HAVE BEEN EXHAUSTED. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|
| JASON WEYER | |||
| PHYSICIAN | $508,832 | $10,387 | $519,219 |
| WADE BOMENGEN | |||
| PHYSICIAN | $496,184 | $11,006 | $507,190 |
| HALLIE BISCHOFF | |||
| PHYSICIAN | $419,844 | $419,844 | |
| CHRISTOPHER PARIS | |||
| CRNA | $188,003 | $8,166 | $196,169 |
| DANIEL HERMANN | |||
| PHARMACIST | $175,713 | $3,285 | $178,998 |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR BISCHOFF | PersonNm |
| Relationship With Org | EMPLOYEE | RelationshipWithOrgTxt |
| Loan Purpose | RECRUITMENT | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $25,000 | OriginalPrincipalAmt |
| Balance Due | $11,215 | BalanceDueAmt |
| Default | false | DefaultInd |
| Board Or Committee Approval | Yes (true) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (true) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $11,215 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4A | HOT SPRINGS COUNTY MEMORIAL HOSPITAL, A NOT FOR PROFIT, COMMUNITY HOSPITAL, PROVIDES COMPASSIONATE MEDICAL CARE FOR ALL, REGARDLESS OF THEIR ABILITY TO PAY. HSCMH OFFERS 24/7 EMERGENCY CARE (2,086 VISITS), INPATIENT SERVICES (1,587 PATIENT DAYS), OUTPATIENT SERVICES (14,949 VISITS), BIG HORN CLINIC RURAL HEALTH CLINIC (4,381 VISITS), AND RED ROCK FAMILY PRACTICE CLINIC (13,390 VISITS). THE HOSPITAL HAS A FINANCIAL ASSISTANCE PROGRAM UNDER WHICH SERVICES ARE PROVIDED FOR FREE OR AT A REDUCED RATE. CHARITY CARE AWARDED UNDER THE FINANCIAL ASSISTANCE PROGRAM TOTALED 434,635. THE COST OF CHARITY CARE FOR THE YEAR ENDED JUNE 30, 2019 BASED ON DIRECT AND INDIRECT COST OF PROVIDING CHARITY CARE SERVICES WAS 252,271. MANY EMPLOYEES ARE TEACHERS IN THE EDUCATION PROGRAMS OPEN TO THE PUBLIC SUCH AS CERTIFIED NURSING ASSISTANT AND CARDIOPULMONARY RESUSCITATION. AN AGREEMENT WITH THE UNIVERSITY OF WYOMING ENCOURAGES NURSING, PHARMACY, AND SOCIAL SERVICES STUDENTS TO INTERN AT HSCMH. REDUCED MAMMOGRAPHY AND BONE DENSITY TESTS ARE OFFERED OCTOBER-DECEMBER. HEALTH INFORMATION LINKS ARE AVAILABLE ON THE HSCMH WEBSITE. USE OF PORTABLE OXYGEN CONCENTRATORS ARE FREE THROUGH CARDIOPULMONARY SERVICES FOR THOSE TRAVELING. COMFORT CARTS AND FREE MEALS ARE AVAILABLE FOR FAMILIES DURING STRESSFUL CONDITIONS. SNACKS ARE OFFERED TO PATIENTS TWICE A DAY. BIG HORN CLINIC, AND RED ROCK FAMILY PRACTIC CLINIC PROVIDES REDUCED OR FREE EXAMS FOR SCHOOL ATHLETICS, MEDICINE ASSISTANCE, BLOOD PRESSURE SCREENING AND COMMUNITY EDUCATION SEMINARS. HSCMH OFFERS SCHOLARSHIPS TO QUALIFYING EMPLOYEES WANTING TO ADVANCE THEIR EDUCATION TO THE BETTERMENT OF THE HOSPITAL AND COMMUNITY. COMMUNITY RESOURCE TRAINING FOR HIGH SCHOOL STUDENTS AND WWAMI (WASHINGTON, WYOMING, ALASKA MONTANA, IDAHO)MEDICAL EDUCATION PROGRAM, WHICH PROMOTES MEDICAL EDUCATION IN WESTERN STATES, ARE TWO LONG-TIME PROGRAMS IN WHICH HSCMH PARTICIPATES. |
| FORM 990, PAGE 6, PART VI, LINE 3 | HSCMH CONTRACTS WITH HEALTHTECH MANAGEMENT SERVICES, INC. FOR MANAGEMENT SERVICES INCLUDING THE CEO POSITION. THE CEO IS EMPLOYED BY HEALTHTECH MANAGEMENT SERVICES, INC. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE CURRENT FISCAL YEAR 6/30/19 FORM 990 WAS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES FOR DISCUSSION AND REVIEW. THE ENTIRE BOARD OF DIRECTORS APPROVED THE CURRENT FISCAL YEAR 6/30/19 FORM 990 AT A REGULARLY SCHEDULED BOARD MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE HOSPITAL HAS A FORMAL CONFLICT OF INTEREST POLICY WHICH REQUIRES EMPLOYEES TO MAKE A PROMPT WRITTEN FULL DISCLOSURE OF ANY POTENTIAL SITUATION WHICH MAY INVOLVE A CONFLICT OF INTEREST. THE POLICY PROVIDES A LIST OF POTENTIAL CONFLICTS. EMPLOYEES WHO VIOLATE THE POLICY ARE SUBJECT TO DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION. THE POLICY IS REVIEWED AT LEAST 2 TIMES A YEAR WITH EMPLOYEES; THE ANNUAL SKILLS FAIR AND THE ANNUAL EMPLOYEE EVALUATION. THE EMPLOYEE COMPLETES AND SIGNS A NEW DISCLOSURE AT THE TIME OF THEIR EVALUATION. THE HOSPITAL DOES REQUIRE GOVERNING BOARD MEMBERS, OFFICERS, MANAGERS, AND MEDICAL REPRESENTATIVES WITH ADMINISTRATIVE RESPONSIBILITY TO DISCLOSE IN WRITING ALL POTENTAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS AS WELL. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE ORGANIZATION'S CEO IS A LEASED-EMPLOYEE, WHO CONDUCTS THE EVALUATION AND COMPARABILITY OF SALARY DATA. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE ORGANIZATION COMPLETES AN ANNUAL REVIEW OF OTHER KEY EMPLOYEES AND COMPLETES A COMPARISON OF SALARIES WITH WYOMING HOSPITAL ASSOCIATION SALARY SURVEY DATA. THE ANNUAL REVIEW IS COMPLETED BY THE CEO. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION IS A GOVERNMENTAL ENTITY, ALL BOARD OF TRUSTEE MEETINGS ARE PUBLIC MEETINGS. ALL REPORTS (NOT CONSIDERED CONFIDENTIAL) ARE SUBJECT TO THE OPEN MEETING LAWS UNDER STATE OF WYOMING LAWS. IN ADDITION THESE DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION IN ACCORDANCE WITH FEDERAL AND STATE LAW. |
| FORM 990, PART IX, LINE 11G | AMBULANCE SERVICES 310,675 0 0 COLLECTION FEES 0 190,516 0 CONSULTING FEES 74,370 51,619 0 CONTRACT AND PURCH SERVICES 390,377 89,445 0 COST REPORT 0 14,629 0 PHYSICIAN FEES 1,409,812 0 0 PUBLIC RELATIONS/ADVERTISING 13,574 26,603 0 STAFFING AGENCY FEES 1,295,382 39,972 0 TOTAL 3,494,190 412,784 0 |