ROUNDUP MEMORIAL HOSPITAL ASSOCIATION: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- ROUNDUP MEMORIAL HOSPITAL ASSOCIATION (EIN 81-0245848)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-07-13
- IRS object ID
- 202031959349302218
- 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 | 2020-07-13T12:46:41-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 EAST FRONT STREET 301 | AddressLine1Txt |
| City | MISSOULA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59802 | 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 | 810245848 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROUNDUP MEMORIAL HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ROUN | BusinessNameControlTxt |
| Phone | 4063232301 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 40 | AddressLine1Txt |
| City | ROUNDUP | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59072 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HOLLY WOLFF | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 4063232301 | PhoneNum |
| Signature | 2020-07-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PHILIP L YASENAK CPA | PreparerPersonNm |
| PTIN | P01248379 | PTIN |
| Phone | 4067281800 | PhoneNum |
| Preparation | 2020-07-06 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 63.235.138.172 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-07-06 | IPDt |
| IP Tm | 12:01:03 | IPTm |
| IP Timezone | MD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BE7A92E7B0152C1C6812F3C99C620D56F411D8FD | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | HOLLY WOLFF | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 40 | AddressLine1Txt |
| City | ROUNDUP | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59072 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,734,529 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.RMHMT.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1979 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HEALTHCARE SERVICES | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 114 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $388,317 | PYContributionsGrantsAmt |
| CY Contributions Grants | $593,386 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,539,636 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,637,623 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,885 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,002 | CYInvestmentIncomeAmt |
| PY Other Revenue | $269,491 | PYOtherRevenueAmt |
| CY Other Revenue | $499,518 | CYOtherRevenueAmt |
| PY Total Revenue | $9,199,329 | PYTotalRevenueAmt |
| CY Total Revenue | $10,734,529 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,203,747 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,487,981 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $225 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,438,337 | PYOtherExpensesAmt |
| CY Other Expenses | $5,098,231 | CYOtherExpensesAmt |
| PY Total Expenses | $8,642,084 | PYTotalExpensesAmt |
| CY Total Expenses | $9,586,212 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $557,245 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,148,317 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,196,278 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,630,190 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,798,578 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,244,840 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,397,700 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,385,350 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | IT IS THE MISSION OF THE ROUNDUP MEMORIAL HOSPITAL TO ACCEPT THE ONGOING CHALLENGE OF PROVIDING FOR THE HEALTHCARE NEEDS OF ALL OF OUR CITIZENS. IT IS OUR SINCERE DESIRE TO HEAL THE SICK AND COMFORT THE SUFFERING WITH ALL THE RESOURCES WE HAVE AVAILABLE. AS GOOD STEWARDS OF THESE INSTITUTIONS, EMPLOYEES WILL HELP ENSURE THE SURVIVAL OF THE HOSPITAL BY BEING COMMITTED TO THE CARE AND WELL-BEING OF THOSE THEY SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,493,302 | ExpenseAmt |
| Revenue | $10,137,141 | RevenueAmt |
| Desc | CRITICAL ACCESS HOSPITAL - ROUTINE SERVICE FOR ADULTS, PEDIATRICS, AND SWING BED. RURAL HEALTH CLINIC WITH FOUR PROVIDERS. OTHER SERVICES INCLUDE BUT ARE NOT LIMITED TO ANCILLARIES; CT SCANS; LABORATORY; PHYSICAL, THERAPIES AND REHABILITATION; PHARMACY; EMERGENCY ROOM; X-RAY; CENTRAL SUPPLY; INTRAVENOUS SOLUTIONS; ULTRASOUND; ELECTROCARDIOGRAPHY; OBSERVATION; BLOOD BANK; AND PATHOLOGY. | Desc |
| Total Program Service Expenses | $7,493,302 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 25 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 114 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROUNDUP MEMORIAL HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4063232301 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1202 THIRD STREET WEST | AddressLine1Txt |
| City | ROUNDUP | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59702 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 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 |
|---|---|---|---|---|---|---|---|
| JOHN PFISTER | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARK ROSEBUSH DMD | |||||||
| VICE PRESIDENT | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KEN MOSDAL | |||||||
| TREASURER | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BRYAN ADOLPH | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| THERESA DOUMITT | |||||||
| DIRECTOR | 0.50 | Yes (X) | $69,318 | $0 | $0 | ||
| MARSHALL WHITE MD | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| LEONARD WALL | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| HOLLY WOLFF | |||||||
| CEO | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| BRAD HOWELL | |||||||
| FORMER CEO | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| ANNE MARIE KLOPPEL | |||||||
| CFO | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN CRISWELL | |||||||
| PHYSICAL THERAPIST | 40.00 | $169,571 | $0 | $9,980 | Yes (X) | ||
| BRYNN BIXBY | |||||||
| PA | 40.00 | $155,658 | $0 | $0 | Yes (X) | ||
| VALERI RUSSELL | |||||||
| PA | 40.00 | $130,547 | $0 | $17,490 | Yes (X) | ||
| EMILY SHOUP RN | |||||||
| DIRECTOR OF NURSING SERVICES | 40.00 | $101,802 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $626,896 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $27,470 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BILLINGS CLINIC | |||||
| PO BOX 30357 | BILLINGS | MT | 59107 | MANAGEMENT SERVICES | $1,035,310 |
| PRAIRIE TRAVELERS | |||||
| 130 3RD STREET S 2 | GLASGOW | MT | 59230 | CONTRACT SERVICES | $217,571 |
| YELLOWSTONE VALLEY TRAVELERS | |||||
| PO BOX 51197 | BILLINGS | MT | 59105 | CONTRACT SERVICES | $182,334 |
| WILDERNESS MEDICAL STAFFING | |||||
| 1124 W RIVERSIDE AVE 2 | SPOKANE | WA | 99201 | CONTRACT SERVICES | $138,221 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $62,512 | GovernmentGrantsAmt |
| All Other Contributions | $530,874 | AllOtherContributionsAmt |
| Total Contributions | $593,386 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INPATIENT/OUTPATIENT REVENUE | 621110 | $8,565,313 | $8,565,313 |
| OTHER OPERATING REVENUE | 900099 | $971,142 | $971,142 |
| 340B REVENUE | 446110 | $101,168 | $101,168 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,637,623 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,002 | TotalRevenueColumnAmt |
| Exclusion | $4,002 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,167 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,167 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,167 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,167 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| TAX REVENUE | 900099 | $485,974 | $485,974 |
| REBATES/REFUNDS | 900099 | $10,377 | $10,377 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $496,351 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,734,529 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,137,141 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,002 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,318 | TotalAmt |
| Management And General | $69,318 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,692,815 | TotalAmt |
| Program Services | $3,178,899 | ProgramServicesAmt |
| Management And General | $513,916 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,318 | TotalAmt |
| Management And General | $45,318 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $396,042 | TotalAmt |
| Program Services | $317,361 | ProgramServicesAmt |
| Management And General | $78,681 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $284,488 | TotalAmt |
| Program Services | $198,725 | ProgramServicesAmt |
| Management And General | $85,763 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $844,651 | TotalAmt |
| Program Services | $412,390 | ProgramServicesAmt |
| Management And General | $432,261 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,341 | TotalAmt |
| Management And General | $44,341 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,341 | TotalAmt |
| Management And General | $24,341 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,620,046 | TotalAmt |
| Program Services | $1,421,131 | ProgramServicesAmt |
| Management And General | $198,915 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,994 | TotalAmt |
| Management And General | $40,994 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,357 | TotalAmt |
| Program Services | $11,356 | ProgramServicesAmt |
| Management And General | $38,001 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $246,812 | TotalAmt |
| Program Services | $5,833 | ProgramServicesAmt |
| Management And General | $240,979 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,641 | TotalAmt |
| Program Services | $140,423 | ProgramServicesAmt |
| Management And General | $18,218 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,804 | TotalAmt |
| Program Services | $20,390 | ProgramServicesAmt |
| Management And General | $3,414 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,506 | TotalAmt |
| Program Services | $13,668 | ProgramServicesAmt |
| Management And General | $4,838 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,554 | TotalAmt |
| Management And General | $46,554 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $384,336 | TotalAmt |
| Program Services | $365,084 | ProgramServicesAmt |
| Management And General | $19,252 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,425 | TotalAmt |
| Management And General | $78,425 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $689,921 | $689,921 | |
| BAD DEBT EXPENSE | $318,084 | $318,084 | |
| REPAIRS & MAINTENANCE | $185,985 | $185,615 | $370 |
| OTHER SUPPLIES | $143,790 | $101,262 | $42,528 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,643 | TotalAmt |
| Program Services | $113,160 | ProgramServicesAmt |
| Management And General | $66,258 | ManagementAndGeneralAmt |
| Fundraising | $225 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,586,212 | TotalAmt |
| Program Services | $7,493,302 | ProgramServicesAmt |
| Management And General | $2,092,685 | ManagementAndGeneralAmt |
| Fundraising | $225 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,015 | BOYAmt |
| EOY | $936,813 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $951,634 | BOYAmt |
| EOY | $979,202 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,599,801 | BOYAmt |
| EOY | $1,442,087 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $154,807 | BOYAmt |
| EOY | $120,726 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,260 | BOYAmt |
| EOY | $54,994 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,999,857 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,581,213 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,172,449 | BOYAmt |
| EOY | $3,418,644 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,100 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,312 | BOYAmt |
| EOY | $674,624 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,196,278 | BOYAmt |
| EOY | $7,630,190 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $614,715 | BOYAmt |
| EOY | $1,603,971 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,183,863 | BOYAmt |
| EOY | $1,640,869 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,798,578 | BOYAmt |
| EOY | $3,244,840 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,381,823 | BOYAmt |
| EOY | $4,268,540 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,877 | BOYAmt |
| EOY | $116,810 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,397,700 | BOYAmt |
| EOY | $4,385,350 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,196,278 | BOYAmt |
| EOY | $7,630,190 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,148,317 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$160,667 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | 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 D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,913,795 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,965,562 | DepreciationAmt |
| Book Value | $948,233 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,984,595 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,615,651 | DepreciationAmt |
| Book Value | $2,368,944 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $101,467 | OtherCostOrOtherBasisAmt |
| Book Value | $101,467 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,418,644 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| COST REPORT SETTLEMENT RECEIVABLE | $630,956 |
| BED TAX RECEIVABLE | $43,668 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $674,624 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $10,416,445 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,416,445 | RevenueSubtotalAmt |
| Other Revenues Not Included | $318,084 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $318,084 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $10,734,529 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,268,128 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,268,128 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $318,084 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $318,084 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,586,212 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL IS A TAX-EXEMPT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE TAXES ON RELATED INCOME PURSUANT TO SIMILAR STATE OF MONTANA TAX LAWS. THE HOSPITAL APPLIES GENERALLY ACCEPTED ACCOUNTING PRINCIPLES FOR RECOGNITION OF UNCERTAINTY IN INCOME TAXES AND PRESCRIBING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. IN THE COURSE OF ITS ASSESSMENT, THE HOSPITAL HAS DETERMINED THAT IT IS SUBJECT TO EXAMINATION OF ITS INCOME TAX FILINGS IN THE UNITED STATES AND STATE JURISDICTIONS FOR THE PRIOR THREE TAX YEARS. IN THE EVENT THAT THE HOSPITAL IS ASSESSED PENALTIES AND OR INTEREST, PENALTIES WILL BE CHARGED TO MISCELLANEOUS EXPENSE AND INTEREST WILL BE CHARGED TO INTEREST EXPENSE. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 318,084. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 318,084. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 125.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $86,983 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $86,983 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00940 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,257,655 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,979,143 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $278,512 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03010 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,344,638 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,979,143 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $365,495 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03950 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,648 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,850 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,798 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,250 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $13,250 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,898 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,850 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $19,048 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,368,536 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,983,993 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $384,543 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04150 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $100 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $100 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $100 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $100 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $318,084 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $127,234 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,344,547 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,017,219 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$672,672 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| 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 | ROUNDUP MEMORIAL HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1202 3RD STREET WEST | AddressLine1Txt |
| City | ROUNDUP | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59072 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | RURAL HEALTH CLINIC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROUNDUP MEMORIAL HOSPITAL ASSOC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.RMHMT.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.RMHMT.ORG | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 125.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.RMHMT.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.RMHMT.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| None Made | Yes (X) | NoneMadeInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ROUNDUP MEMORIAL HOSPITAL ASSOC | PART V, SECTION B, LINE 5: A STEERING COMMITTEE WAS CONVENED TO ASSIST ROUNDUP 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 FEBRUARY 2018. THE STEERING COMMITTEE MET TWICE DURING THE CHSD PROCESS; FIRST TO DISCUSS HEALTH CONCERNS IN THE COMMUNITY AND OFFER THEIR PERSPECTIVE IN DESIGNING THE SURVEY INSTRUMENT AND AGAIN TO REVIEW RESULTS OF THE SURVEY AND FOCUS GROUPS AND TO ASSIST IN THE PRIORITIZATION OF HEALTH NEEDS TO ADDRESS. |
| ROUNDUP MEMORIAL HOSPITAL ASSOC | PART V, SECTION B, LINE 6B: THE MONTANA OFFICE OF RURAL HEALTHTHE NATIONAL RURAL HEALTH RESOURCE CENTER |
| ROUNDUP MEMORIAL HOSPITAL ASSOC | PART V, SECTION B, LINE 11: THE FOLLOWING SIGNIFICANT NEEDS WERE IDENTIFIED IN THE CHNA AND ARE BEING ADDRESSED AT THIS TIME: GOAL 1: IMPROVE ACCESS TO HEALTHCARE SERVICES IN MUSSELSHELL COUNTY STRATEGY 1.1: INCREASE ACCESS TO MENTAL HEALTH SERVICES ACTIVITIES: IDENTIFY AND CATALOGUE AVAILABLE MENTAL HEALTH RESOURCES IN THE RMH SERVICE AREA; CREATE A RESOURCE TO EDUCATE PROVIDERS AND COMMUNITY ON AVAILABLE MENTAL HEALTH SERVICES; EXPLORE ALTERNATIVE METHODS TO OFFER/PROVIDE MENTAL HEALTH SERVICES (I.E. TELEHEALTH) STRATEGY 1.2: INCREASE AWARENESS OF AVAILABLE FINANCIAL ASSISTANCE OPTIONS AT RMH ACTIVITIES: EXPLORE NEW MEDIA OUTREACH OPPORTUNITIES TO INFORM RMH SERVICE AREA OF AVAILABLE FINANCIAL ASSISTANCE PROGRAMS; CONTINUE EDUCATING RMH PATIENTS ABOUT FINANCIAL ASSISTANCE PROGRAM AT INTAKE AND DISCHARGE. STRATEGY 1.3: CONTINUE RECRUITMENT AND RETENTION EFFORTS TO ENSURE ACCESS TO HEALTHCARE SERVICES ACTIVITIES: WORK WITH STUDER GROUP TO ENHANCE EMPLOYEE RETENTION AT RMH; EXPLORE OPPORTUNITIES TO EXPAND AVAILABLE SPECIALTY SERVICES (ON-SITE OR VIA TELEHEALTH) AT RMH.GOAL 2: INCREASE AWARENESS OF SERVICES AVAILABLE AT RMH. STRATEGY 2.1: IMPROVE AND EXPAND MARKETING AND ADVERTISING EFFORTS. ACTIVITIES: EXPLORE DEVELOPMENT OF MONTHLY NEWSLETTER (INCLUDING MONTHLY TOPICS, VISITING SPECIALISTS, HEALTH TOPICS); DEVELOP METHOD FOR COMMUNITY MEMBERS TO SIGN UP FOR ELECTRONIC NEWSLETTER AND CREATE MARKETING CAMPAIGN; DEVELOP A MECHANISM TO CAPTURE PATIENT TESTIMONIALS TO SHARE WITH COMMUNITY; CONTINUE WEEKLY CEO COMMUNITY RADIO SHOW/CHAT. STRATEGY 2.2: IMPROVE COMMUNITY COORDINATION OF SERVICES TO ENHANCE AWARENESS OF LOCAL RESOURCES. ACTIVITIES: DETERMINE FEASIBILITY OF FORMING A COMMUNITY HEALTH COALITION TO SHARE AND COORDINATE LOCAL RESOURCES; DETERMINE POTENTIAL PARTNERS AND STAKEHOLDERS WHO WOULD PARTICIPATE IN COMMUNITY HEALTH COALITION (PUBLIC HEALTH, SENIOR CENTER, POLICE, EMS, SCHOOLS, ETC.).GOAL 3: ENHANCE COMMUNITY KNOWLEDGE OF AVAILABLE HEALTH AND WELLNESS PROGRAMS/EFFORTS IN MUSSELSHELL COUNTY. STRATEGY 3.1: CONTINUE PROMOTING HEALTH AND WELLNESS SERVICES AVAILABLE LOCALLY. ACTIVITIES: HOST AND PROMOTE RMH ANNUAL HEALTH FAIR; EXPLORE ADDITIONAL COMMUNITY SPONSORS, BOOTHS, ETC. TO EXPAND EDUCATIONAL AND SERVICE OFFERINGS; SPONSOR A 5K COMMUNITY FUN RUN; CONTINUE OFFERING PREVENTATIVE SCREENINGS, BLOOD DRAWS AND OTHER RESOURCES AT HEALTH FAIR. STRATEGY 3.2: CONTINUE TO PROVIDE CHRONIC DISEASE AND DIABETIC MANAGEMENT PROGRAM AT RMH. ACTIVITIES: CONTINUE TO EDUCATE AND PROMOTE PROGRAM TO POTENTIAL PARTICIPANTS AND COMMUNITY; OBTAIN DIABETIC MANAGEMENT ACCREDITATION. STRATEGY 3.3: CONTINUE TO PROVIDE RMH SUPPORT AND LEADERSHIP IN LOCAL HEALTH AND WELLNESS EFFORTS IN MUSSELSHELL COUNTY. ACTIVITIES: EXPLORE OPPORTUNITIES TO ENHANCE COMMUNITY ENGAGEMENT IN COMMUNITY COALITIONS, WORK GROUPS, ETC. (EX. CHAMBER); CONTINUE RMH STAFF PARTICIPATION IN LAC, MENTAL HEALTH COUNCIL, AND LOCAL EMERGENCY PREPAREDNESS COUNCIL. STRATEGY 3.4: PROMOTE HEALTH AND WELLNESS IN PARTNERSHIP WITH LOCAL SCHOOLS. ACTIVITIES: PROVIDE RMH STAFF AT LOCAL SCHOOLS TO OFFER SPORTS PHYSICALS 1X/YEAR; SUPPORT HEALTH AND SAFETY PROGRAMS FOR LOCAL YOUTH (EX. TEXTING AND DRIVING, DRINKING AND DRIVING, SEATBELT USE)THE FOLLOWING NEEDS ARE NOT BEING ADDRESSED AT THIS TIME:NEED 1: THE COMMUNITY IDENTIFIED A NEED FOR BETTER DRINKING WATER AND FLOOD CONTROL TO IMPROVE THE HEALTH OF THE COMMUNITY. JUSTIFICATION: THIS NEED IS NOT WITHIN OUR MISSION OR ABILITIES. NEED 2: TOP DESIRED LOCAL HEALTHCARE SERVICES IDENTIFIED WERE ALTERNATIVE MEDICINE AND DERMATOLOGY. JUSTIFICATION: ALTERNATIVE MEDICINE IS NOT WITHIN OUR MISSION OR SCOPE AND THERE IS AN INSUFFICIENT DEMAND TO SUPPORT A SPECIALTY CLINIC FOR DERMATOLOGY. LIMITED DERMATOLOGY SERVICES ARE PROVIDED THROUGH THE CLINIC. |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COST-TO-CHARGE RATIO WAS USED TO CALCULATE THE FIGURES IN THE TABLE. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. |
| PART I, LN 7 COL(F): | THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX, LINE 25 HAS BEEN SUBTRACTED FROM TOTAL OPERATING EXPENSES IN THE CALCULATION OF THE COST-TO-CHARGE RATIO FROM WORKSHEET 2. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE COMMUNITY SUPPORT ACTIVITY REPORTED ON PART II WAS THE SPONSORSHIP OF A YOUTH SPORTING CAMP. THE CAMP PROMOTES MAINTAINING AN ACTIVE LIFESTYLE WHICH CONTRIBUTES TO THE OVERALL HEALTH OF THE YOUTH INVOLVED. |
| PART III, LINE 2: | NET BAD DEBT EXPENSE RECORDED IN THE GENERAL LEDGER (EXPENSE LESS RECOVERIES). |
| PART III, LINE 3: | WE ESTIMATE APPROXIMATELY 40% OF TOTAL BAD DEBT IS ATTRIBUTABLE TO PATIENTS THAT WOULD LIKELY BE ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. |
| PART III, LINE 4: | THE FOOTNOTE DESCRIBING BAD DEBT IS ON PAGE 5 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE ENTIRE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. MEDICARE RATES DO NOT ALWAYS ALIGN WITH THE ACTUAL COSTS OF TREATMENT. BY CONTINUING TO TREAT PATIENTS ELIGIBLE UNDER MEDICARE, THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE ORGANIZATION USED AMOUNTS FROM THEIR MEDICARE COST REPORT TO DETERMINE LINE 6. |
| PART III, LINE 9B: | POLICY STATES UP FRONT THAT ADMISSIONS REPRESENTATIVE IS TO GIVE FINANCIAL ASSISTANCE PAPERWORK WITH INFORMAION ON CHARITY CARE AT THE TIME OF ADMISSION. FOLLOW UP CONSULTATION IS DONE LATER TO INCLUDE FINANCIAL ASSISTANCE DISCUSSIONS WITH PATIENT. |
| PART VI, LINE 2: | IN 2018, THE HOSPITAL CONDUCTED A NEEDS ASSESSMENT. THE STEERING COMMITTEE INCLUDED REPRESENTATIVES FROM THE LOCAL MEDIA, EMS, PUBLIC HEALTH, THE SCHOOL SYSTEM, AGENCY ON AGING, AND MENTAL HEALTH IN ADDITION TO THE HOSPITAL CLINICAL AND ADMINISTRATIVE STAFF. ONE FOCUS GROUP AND FIVE KEY INFORMANT MEETINGS WERE HELD TO GATHER INFORMATION ON HEALTHCARE NEEDS AND DESIRES. |
| PART VI, LINE 3: | WHEN A PATIENT INDICATES THAT A FINANCIAL HARDSHIP EXISTS, THE HOSPITAL PROVIDES INFORMATION ON THE HOSPITAL CHARITY PLAN AND OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS. |
| PART VI, LINE 4: | ROUNDUP MEMORIAL HEALTHCARE (RMH) IS THE SOLE COMMUNITY HEALTHCARE PROVIDER FOR MUSSELSHELL COUNTY, A RURAL AREA WITH A POPULATION DENSITY OF 2.4 PER SQUARE MILE. NO OTHER HOSPITALS SERVE THE COMMUNITY AND THE NEAREST HEALTHCARE FACILITY IS LOCATED IN BILLINGS, 45 MILES TO THE SOUTH. PER THE 2010 FEDERAL CENSUS, THE COUNTY POPULATION WAS 4,538; THE PER CAPITA INCOME IN THE COUNTY IS $19,164 AND THE PERCENTAGE OF PERSONS BELOW THE POVERTY LINE WAS 20.5 PERCENT. IN 2006, 26.4 PERCENT OF MUSSELSHELL COUNTY WAS UNINSURED. THE HEALTH RESOURCES AND SERVICES ADMINISTRATION HAS DESIGNATED MUSSELSHELL COUNTY AS AN UNDERSERVED AREA WITH A SCORE OF 16. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN CRISWELL | ||||||||||||||
| PHYSICAL THERAPIST | $169,571 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $9,980 | $0 | $179,551 | $0 | $0 | $0 |
| BRYNN BIXBY | ||||||||||||||
| PA | $155,658 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $155,658 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BILLINGS CLINIC INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | ORGANIZATION'S CEO & CFO ARE EMPLOYEES OF BILLINGS CLINIC | RelationshipDescriptionTxt |
| Transaction | $1,035,310 | TransactionAmt |
| Transaction | HOLLY WOLFF, CEO, AND ANNE MARIE KLOPPEL, CFO, ARE EMPLOYEES OF THE BILLINGS CLINIC, INC., THE INDEPENDENT CONTRACTOR HIRED TO MANAGE THE HOSPITAL, AND RECEIVED ALL COMPENSATION FOR THEIR SERVICES AS CEO AND CFO, RESPECTIVELY, FROM BILLINGS CLINIC, INC. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | LEONARD WALL AND BRYAN ADOLPH - FAMILY RELATIONSHIP |
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION HAS CONTRACTED WITH BILLINGS CLINIC TO PROVIDE MANAGEMENT SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS OF HOSPITAL ASSOCIATION 501 (C)(3) |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS REVIEWED BY THE CEO, CFO, AND CONTROLLER AND IS DISTRIBUTED TO THE BOARD BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE COMPLIANCE OFFICER MONITORS AND EVALUATES CONFLICT OF INTEREST ISSUES. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE CEO IS COMPENSATED ACCORDING TO ARRANGEMENTS WITH THE MANAGEMENT AGREEMENT WITH BILLINGS CLINIC, WHO RECOMMENDS THE CEO SALARY TO THE BOARD FOR APPROVAL. THE HOSPITAL UTILIZES THE MONTANA HOSPITAL ASSOCIATION AND ASSOCIATED EMPLOYEES SALARY SURVEY TO DETERMINE SALARIES OF KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABLE UPON REQUSET TO THE CEO. |
| FORM 990, PART IX, LINE 11G | OTHER FEES & CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,421,131. MANAGEMENT AND GENERAL EXPENSES 198,915. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,620,046. |
| FORM 990, PART XII, LINE 2C: | THERE IS NO SEPARATE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT. THE BOARD OF DIRECTORS ASSUMES THIS OVERSIGHT RESPONSIBILITY. THE BOARD HIRES THE AUDIT FIRM AND MEETS WITH THE AUDIT TEAM AT THE CONCLUSION OF THE AUDIT. THE BOARD IS ALSO AVAILABLE FOR ANY QUESTIONS THAT ARISE THROUGHOUT THE AUDIT. |