2019-11-15T10:15:31-06:00 2018-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2018-01-01 810232121 Bozeman Deaconess Health Services BOZE 4064145000 915 Highland Boulevard Bozeman MT 59715 Brad Ludford CFO 4064145000 2019-11-13 1 Kim Hunwardsen CPA P00484560 6122536500 2019-11-13 216.147.181.47 2019-11-13 13:50:50 MS P B1517DAAED479AA3B0236E79C14EA2E11B9BE589 EE7B44BF798B4EF79D5DDE03D0EF16CE53CA0C32 2018 2020-04-17 16:48:07Z Bozeman Health Brad Ludford 915 Highland Boulevard Bozeman MT 59715 104715975 0 X www.bozemanhealth.org X 1911 MT To improve community health and quality of life for residents and visitors of the Bozeman, MT area. 11 10 594 285 -68534 -542661 317090 481565 91618113 101344014 32505 -1509028 126563 94056 92094271 100410607 81000 377000 0 0 60285412 65443442 0 0 0 35039821 43720579 95406233 109541021 -3311962 -9130414 107551674 121251849 57386340 79845082 50165334 41406767 X To improve community health and quality of life. 0 0 38221603 36411982 Bozeman Health Medical Group employs physicians under the Bozeman Health system umbrella. This group of providers compassionately serves the patients of Bozeman Health Deaconess Hospital, Big Sky Medical Center and Bozeman Health Urgent Care. 11210147 7871811 In efforts to reach our community and surrounding area in multiple facets of healthcare, the Bozeman Health system operates additional healthcare facilities which allows more access and levels of care.Big Sky Medical Center had 33 admissions, 13 surgeries and saw over 3,700 patients in the Emergency Room and over 5,100 in the clinic in 2018. The net revenue yield on these operations was only 60.2%, or $486 per equivalent ER visit. With challenging core staffing and related costs, the operating expense (excluding interest, taxes and depreciation) was $816 per equivalent ER visit. This resulted in a $5.2M operating loss for the year. Bozeman Health is committed to providing access and patient care to the Big Sky community in spite of the financial operational challenges the facility continues to face.Bozeman Health also continues to operate our Main Street Urgent Care as an outpatient healthcare access point. With a 51% yield on $4.4M of patient charges and operating costs of $3M, the Urgent Care netted a loss of ($660k) in 2018. 35928064 377000 57060221 Bozeman Health serves as the parent company of the Bozeman Health system. As the corporate parent, management, general and administrative services are centralized here and provided to the operating units caring for our patients. These administrative and support services aim to optimize executive, organizational and financial responsibilities to allow the health system to continue to grow and serve the population. In this past year, Bozeman Health had 19,383 inpatient days, 200,521 outpatient hospital visits, 260,855 outpatient clinic visits, 35,059 emergency room visits and performed 9,103 surgeries. 85359814 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 97 0 1 594 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 1 0 0 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 X Carrie Morasko 4064145039 915 Highland Blvd Bozeman MT 59715 Brian Brown Chair 1.00 1.00 X X 0 0 0 Katie Daughenbaugh 1st Vice Chair 1.00 1.00 X X 0 0 0 Dane Sobek MD 2nd Vice Chair 50.00 1.00 X X 632566 0 41257 Robert Watson Secretary 1.00 1.00 X X 0 0 0 Dennis Munson Treasurer 1.00 1.00 X X 0 0 0 Kerri Brown Director 1.00 1.00 X 0 0 0 Peter Buerhaus Director 1.00 1.00 X 0 0 0 Jerry Cashman Director 1.00 1.00 X 0 0 0 Dave McConnell Director (Jan-Jun) 1.00 1.00 X 0 0 0 Kerry Petitt Director 1.00 1.00 X 0 0 0 Walt Sales Director 1.00 1.00 X 0 0 0 Amy Strader Director (Jul-Dec) 1.00 1.00 X 0 0 0 John Hill CEO 35.00 15.00 X 709521 0 104484 Gordon Davidson CFO (Jan-Apr) 15.00 35.00 X 444410 0 39899 Brad Ludford CFO (Sep-Dec) 15.00 35.00 X 109708 0 20028 Elizabeth Lewis COO 25.00 25.00 X 328129 0 72526 Nathaniel Madsen Cardiology 50.00 0.00 X 637105 0 36619 Andrew Gentry Gastroenterologist 50.00 0.00 X 619003 0 40994 Blair Erb Cardiology 50.00 0.00 X 573721 0 31891 Kleanthis Dendrinos Gastroenterology 50.00 0.00 X 551534 0 18319 Annie Castillo Oncology 50.00 0.00 X 546368 0 38949 John Robbins MD Former Officer 50.00 0.00 X 106451 0 18666 5258516 0 463632 145 1 1 0 Absaroka Emergency Physicians 1184 N 15th Street Suite 1 Bozeman MT 59715 ER Physicians Fee 6106765 Gallatin Valley Anesthesia 3805 Valley Commons Dr Ste 7 Bozeman MT 59718 Anesthesia Services 1428503 Drinker Biddle & Reath LLP One Logan Square Ste 2000 Philadelphia PA 191036996 Legal Services 1405506 Crowley Fleck PLLP PO Box 30441 Billings MT 59107 Legal Services 598441 The Eleva Group 1037 NE 65th ST 80522 Seattle WA 98115 Consulting Services 491373 17 481565 481565 Hlth System Corp Servi 900099 56421695 56421695 Hlth System Physician 622110 36411983 36411983 Patient Service Revenu 622110 9261716 9261716 Pharmacy Revenue 446110 41802 110336 -68534 -793182 -793182 101344014 103317 103317 94056 0 94056 94056 94056 2693023 4305368 -1612345 -1612345 -1612345 100410607 101412548 -68534 -1414972 X 377000 377000 2584399 703257 1881142 52262453 49623818 2638635 2138731 2137149 1582 5710723 4791689 919034 2747136 2484444 262692 8136353 170524 7965829 139756 139756 60569 60569 11616829 5769375 5847454 1547807 1456191 91616 315931 263366 52565 1425636 1097159 328477 252448 145282 107166 168298 96854 71444 1489759 1489759 4861489 4861489 1897842 80595 1817247 Equipment Rent & Mainte 6498663 6326336 172327 Provision for Bad Debts 1527536 1527536 Goodwill Impairment 1125000 1125000 Medical Supplies 944715 954818 -10103 1711948 863417 848531 109541021 85359814 24181207 0 15202322 37580431 4961259 3321552 165849 472337 251595 279288 991157 3598979 80201412 28167281 53219549 52034131 6093851 5936218 12007327 7606008 8695493 8695493 5963272 1727412 107551674 121251849 19594578 18181593 21784590 21491088 8884748 9572467 7122424 30599934 57386340 79845082 X 49045737 39915322 1119597 1491445 50165334 41406767 107551674 121251849 X -9130414 371847 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 56400 0 1 504169 560569 0 Part II-B, Line 1: Hired consultant to provide lobbying services in connection with governmental affairs representation to ensure hospital, community, and employee interests and needs are represented. Bozeman Deaconess Health Services reimburses certain professional membership dues of employees, a portion of such membership dues are used by the professional associations for lobbying activities. The dues for MHA and AHA were $4,169. Bozeman Deaconess Health Services contributed $500,000 to the Montana Hospital Association in support of the Montana I-185 initiative to increase taxes on tobacco products to fund health care programs. 16828400 335927 -723008 169014 16272305 14747913 223082 2235283 377878 16828400 13928221 122889 843418 146615 14747913 13788550 99933 216493 176755 13928221 12396438 785403 619492 12783 13788550 0.71630 0.16770 0.11600 0 1 1 8653091 8653091 27585372 2614653 24970719 41015020 25552628 15462392 2947929 2947929 52034131 Investment in Affiliated Organizations 7606008 F 7606008 Deposits 7988 Capitalized Lease Obligation 6147166 Due To Affliates 24444780 30599934 X Part V, Line 4: Each endowment fund is privy to a separate agreement. Donations made for each purpose shall be received, held, and invested by the Bozeman Deaconess Foundation according to established policies governing gift acceptance, investment, and distribution. The principal of the fund shall be retained in perpetuity. The interest income is utilized for the greatest needs of the designated department. Policy says the organization can use a portion of interest for operations. The endowment fund reported in Line 1 is currently being held by a related organization, Bozeman Health Foundation, and benefits Bozeman Health and related system entities. Due to this relationship the endowment fund is being reported all the Form 990, Schedule D, Part V for all three related entities. Part X, Line 2: The Organization consists of Montana nonprofit organizations and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Organization is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Organization is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Organization files an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report its unrelated business taxable income. The Organization believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 1 1 0 0 454933 2765 452168 0.00420 2306562 866730 1439832 0.01330 2761495 869495 1892000 0.01750 569041 130523 438518 0.00410 15754 15754 0.00010 2802325 2235840 566485 0.00520 410600 410600 0.00380 3797720 2366363 1431357 0.01320 6559215 3235858 3323357 0.03070 1 1527536 0 2225875 6800482 -4574607 X 1 1 1 Rocky Mountain Surgical Center LLC Outpatient Surgical Center 0.50780 0.00000 0.48990 2 Deaconess Intercity Imaging LLC Radiology 0.77500 0.00000 0.22500 3 Spanish Peaks Plaza LLC Real Estate 0.69940 0.00000 0.30060 1 1 Big Sky Medical Center 334 Town Center Ave Big Sky MT 59716 www.bigskymedicalcenter.com 13563 X X X Big Sky Medical Center LLC 1 0 0 1 X X X X X X X X X 17 1 1 1 1 X See Part V, Section B, Line 7d X 1 17 1 https://www.bigskymedicalcenter.org/For-Community.aspx 0 1 X 150.000000000000 250.000000000000 X X X X 1 1 X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X X 1 X 0 X X X X 1 X 0 1 Big Sky Medical Center, LLC Part V, Section B, Line 5: To solicit feedback from key community stakeholders, we utilized an Online Key Informant Survey and collected responses in March and April of 2017. We asked the Key Informants to rate the degree to which various health issues are a problem in their community. Follow-up questions asked them to describe why they identify problem areas as such, and how theses might be better addressed. In total, we invited 68 Key Informants via email including physicians and advanced practice clinicians, public and community health representatives, health professionals, social service providers, and community leaders to participate. Of the 68 invited, 40 participated. Input was gathered from several individuals whose organizations work with low-income, minority populations, or other medically underserved populations. These populations include: African-Americans, domestic violence victims, elderly, English as a second language, foreign visitors to Yellowstone, those with geographic barriers, Hispanic, homeless, immigrants, LGBTQ, low-income, Medicare/Medicaid recipients, mentally ill, Native Americans, non-English speaking, seasonal workers, undocumented immigrants, uninsured/underinsured, veterans, women and children Big Sky Medical Center, LLC Part V, Section B, Line 6a: Bozeman Health Deaconess Hospital Big Sky Medical Center, LLC Part V, Section B, Line 6b: Community Health Partners Gallatin City-County Health Department Big Sky Medical Center, LLC Part V, Section B, Line 7d: Hospital Website: https://www.bigskymedicalcenter.org/For-Community.aspx Big Sky Medical Center, LLC Part V, Section B, Line 11: Based on the CHNA and community / stakeholder input, Big Sky Medical Center, LLC (BSMC) adopted the following priority areas:1. Behavioral Health (Mental Health + Substance Abuse)2. Access to Health Services 3. Healthy Lifestyles (Nutrition, Physical Activity & Weight + Heart Disease & Stroke)4. Injury & Violence During 2018, BSMC worked in a couple of the priority areas:1.Behavioral Health * Community Collaboration o We convened a working group to discuss the needs and possible strategies to address behavioral health in the Big Sky Area. * Tobacco Free Initiatives o We supported the amendment of the Clean Indoor Air Act to include electronic smoking devices to limit the use of and exposure to tobacco in the Big Sky Area.2. Access to Health Services * HealthCare Connections o We continued to operate our mobile screening program, HealthCare Connections, and served nearly 300 community members in the Big Sky Area.3. Healthy Lifestyles * Nutrition and Physical Activity Opportunities o We generated thousands of minutes of physical activity in the school setting for middle school youth in the Big Sky Area through our continued partnership with GoNoodle. * Community Initiatives o We convened and facilitated the Nutrition and Physical Activity coalition.Rationale for Unaddressed Needs: Several of the needs identified in the 2017 CHNA were not selected as BSMC priority areas. In order to best impact health outcomes, BSMC focused on prioritizing health issues for which there are existing internal and/or external resources and feasibility to affect change. Additionally, in recognition of comorbidities, and in a strategic effort to consolidate, many of the community-prioritized needs will be addressed thorough BSMC priority area strategies, programs, and efforts: Diabetes: decreasing both incidence and prevalence will be addressed under the area of Healthy Lifestyles Cancer: screenings for certain cancers will remain a key strategy under the area of Access to Health ServicesTobacco Use: decreasing tobacco use will be a focus under the area of Behavioral Health Potentially Disabling Conditions: many disabling conditions occur with other chronic conditions such as diabetes, heart disease, and obesity. As such, strategies addressing these conditions will appear under the area of Healthy Lifestyles. Respiratory Disease: BSMC providers are currently engaged in providing care in this area. We will continually assess and be responsive to opportunities to expand programming and/or outreach. Big Sky Medical Center, LLC Part V, Section B, Line 13h: Any individual and their dependents who are at 150% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but they must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Big Sky Medical Center, LLC Part V, Section B, Line 16j: Medical Advocacy Services in Healthcare (MASH) will give out our financial application after determining patient is ineligible for federal and state programs. A summary of the financial assistance policy is attached to billing invoices, posted in patient admissions area, and provided to patient on admission to the hospital facility. Big Sky Medical Center, LLC Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be billed gross charges on elective procedures. Schedule H, Part V, Section B, Line 16a-16c: https://www.bozemanhealth.org/patients-and-visitors/financial-services/ financial-assistance/ 6 1 - Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Imaging Center 2 - Rocky Mountain Surgery Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 Outpatient Surgical Center 3 - Hospice of Southwest Montana LLC 3810 Valley Commons Dr Ste 1 Bozeman MT 59715 Hospice Services 4 - Bozeman Health Urgent Cares LLC 106 W Main Bozeman MT 59715 Outpatient Health Care 5 - Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 Contracted Physician Services 6 - Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Health Care Part I, Line 3c: Any individual and their dependents who are at 150% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but they must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Part I, Line 7: The cost to charge ratio from Worksheet 2 was used to obtain the costs related to Charity Care and Medicaid. All net benefit expenses were calculated using direct costs and revenue with reasonable indirect overhead allocation methods. Benefits are allocated at 23% of payroll dollars. For Subsidized Services, other indirect overhead costs are allocated based on historical reasonableness of 15% of total expenses. Our internal system does record patient revenues based on type (inpatient vs. outpatient vs. emergency) and payor (Medicaid, Medicare, Commercial, Self-Pay, etc.). Related costs are then determined based on the pro-rated share as a percentage of the total. For example, if Medicaid comprises 7% of a department's revenue, Medicaid expenses are calculated at 7% of the total as well.Lines 7e, 7f, 7i are based on actual expenses. Part I, Line 7g: Amount of cost attributable to a physician clinic is $2,802,325. The Urgent Care disregarded entity was reported as a subsidized services, pulling out the financial assistance and Medicaid to report separately as appropriate. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 1,527,536. Part III, Line 2: Bad debt is reported at charges as recorded by the organization and included joint ventures. Bad debt is reported based upon actual bad debt expense net of discounts and contractual adjustments, less recoveries. Part III, Line 4: The footnote to the organization's financial statements that describes bad debt expenses is located in Footnote 1 on page nine of the attached financial statements. Part III, Line 8: The entire amount of shortfall should be considered a community benefit.The Medicare shortfall represents a cost absorbed by the Hospital as a result of providing care to Medicare patients. The contract driving this loss is a nondiscretionary contract, as is providing the services to this population of individuals. The cost of providing this benefit to the community should be reportable as such. Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.For the Joint Ventures, Net Medicare Revenue was used as the revenue received, and that percentage of total revenues was applied against operating expenses to determine related costs. The Joint Venture portion of the shortfall is $3,662,419. Part III, Line 9b: Bozeman Health's Financial Assistance Policy explains the patient notification practice that includes providing the patient, either directly or through its contracted collection agency with at least one written notice informing the patient about the Extraordinary Collection Actions that we intend to take if the patient does not submit an Application for Financial Assistance or pay the amount due by at least thirty days following the date of the notice. The notice will include a copy of the plain language summary and will not be mailed or delivered to a patient earlier than 30 days prior to the end of the Notification Period. No Extraordinary Collection Actions will be undertaken during the 120 day Notification Period, during which time we will take reasonable efforts to determine whether the patient is eligible for Financial Assistance. After the 120 day Notification Period, an Extraordinary Collection Action will be undertaken only if the patient has received the 30 day written notice described above. Extraordinary Collection Actions are defined as those actions that may be taken in the event of non-payment following the expiration of the notification period. These may include the reporting of adverse information about the individual to consumer credit reporting agencies or credit bureaus, garnishment of an individual's wages, and/or commencement of a legal civil action against an individual. As part of Bozeman Health collection practices, any patient account placed in collections will be pulled back from collections should that patient apply for financial assistance within 240 days of receiving their initial patient statement. Part VI, Line 2: In addition to the CHNA, Bozeman Health Big Sky Medical Center (BSMC) assesses community health care needs in a number of ways. The hospital sends representatives to community meetings and conversations related to health and heath care to hear directly from community members - patients, clients, stakeholders, etc. - about their needs. In a related fashion, the hospital also convenes community members - patients, clients, stakeholders, etc. - to solicit feedback about health and health care needs. Finally, the hospital looks at and considers 3rd party projections about health care needs and available local and national trend data when making health care delivery and health improvement decisions. Part VI, Line 3: Bozeman Health is deeply committed to providing financial assistance to patients needing, but unable to afford, medically necessary health care services. As a hospital operating in the Bozeman Health system, Big Sky Medical Center (BSMC) posts notice of its Financial Assistance Policy in all admitting areas, as well as on the website. At the earliest feasible time, BSMC will attempt to determine whether a patient has third party coverage for any part of the hospital services provided. If a patient does not have third party coverage, a patient advocate from the MASH program will screen all inpatient cases and any outpatient cases exceeding $1,000 in total charges to determine if the patient qualifies for third party funding. If not, the patient advocate will explain the Financial Assistance Policy and give the patient an application if desired. In circumstances where payment in full will cause financial hardship that will significantly harm the patient or patient's family, the applicant may be asked to visit with Consumer Credit Counseling Services to further review their financial situations. Upon request, patients may be asked to complete an application for Medicaid participation or for coverage by other governmental payment programs. Patient bills also contain billing information explaining financial options and provide contact information to the appropriate resources. Part VI, Line 4: BH Big Sky Medical Center (BSMC) primarily serves a three zip code region in Gallatin County Montana: 59716 Big Sky, 59730 Gallatin Gateway, and 59758 West Yellowstone (note in certain zip code boundary definitions, 59716 Big Sky is in both Gallatin and Madison County-although the most populous area is in Gallatin County). These 3 communities account for more than 74% of clinic visits at BSMC Big Sky Clinic in 2018. In addition, these same communities account for 24.2% of BSMC's inpatient admissions while 75.8% were of patients originating outside Montana-likely driven by the Big Sky area being a popular tourist destination.The population of the tri-zip code area was an estimated 6,523 (59716: 2,208, 59730: 2,065, and 59758: 2,250) in 2018 (IBM Watson Health). The average median household income (weighted by number of households) in the combined communities was an estimated $59,770 and 12.5% of the population was estimated to be in poverty in 2017 (ACS 5yr estimates, 2017). 2018 estimates suggest that 12.7% of the population in the tri-zip code area are covered by Medicaid, 6.6% are uninsured, and 15.5% are insured under Medicare (IBM Watson Health, 2018). Bozeman Health Big Sky Medical Center is the only hospital in the BSMC three zip code service area, and is one of two hospitals in Gallatin County (BH BSMC and BH Deaconess Hospital). The low income population within Gallatin County is designated as a Primary Care HPSA and the total geographic population of Gallatin County is designated as a Mental Health Professional Shortage (HPSA) Geographic Area HPSA based on 2019 HPSA data.(https://dphhs.mt.gov/publichealth/primarycare/-shortage-area-designations). Part VI, Line 5: The governing body of BSMC is comprised of individuals who represent our community and live in our primary service area, most of whom are independent of the organization. To ensure immediate access to care, BSMC has an open medical staff and requires each medical staff member to care for anyone presenting in the Emergency Department. As an organization, we devote a significant amount of surplus funds into maintaining a high level of patient care through quality initiatives as well as technology and community investments.Various employees, physicians, administrators, and board members of the Hospital are actively involved in volunteer roles including community board positions in numerous other activities, groups, and organizations that actively promote the health of the community.In 2017, Bozeman Health hired a FTE dedicated to community involvement. The System Program Manager for Community Health Improvement and Partnerships works to align Bozeman Health Deaconess Hospital health improvement initiatives with the needs and desires of the communities served by BHDH. This includes, among other things, representing BHDH at community meetings, and planning and implementing programs with community partners to address needs highlighted in the CHNA. Part VI, Line 6: Bozeman Deaconess Health Services owned a majority interest in Deaconess Intercity Imaging, LLC and Rocky Mountain Surgery Center in the current tax year. Although these joint ventures are not licensed hospitals, these organizations hold similar policies regarding providing care to all members of the community and offering financial assistance as determined by ability to pay. 1 Greater Gallatin United Way 945 Technology Blvd 101F Bozeman MT 59718 810384820 501(c)(3) 50000 Support human service needs within our service area Western Montana Mental Health 140 N Russell Missoula MT 59801 810307814 501(c)(3) 300000 Support mental health needs within our service area 2 0 Part I, Line 2: Recipients of grants and assistance prepare informational reports substantiating the use of the funds that were earmarked to support community health programs. Involvement of Bozeman Deaconess Health Services staff and/or administration as volunteers in the activities being supported also ensures proper usage of funds. X X X 1 1 0 0 0 0 0 0 0 Dane Sobek MD 2nd Vice Chair 571538 0 60000 0 1028 0 16500 0 25732 0 674798 0 0 0 John Hill CEO 539749 0 159902 0 9870 0 80371 0 25493 0 815385 0 0 0 Gordon Davidson CFO (Jan-Apr) 178884 0 55884 0 209642 0 33159 0 7146 0 484715 0 0 0 Elizabeth Lewis COO 274819 0 49536 0 3774 0 54650 0 18851 0 401630 0 0 0 Nathaniel Madsen Cardiology 576420 0 60000 0 685 0 16500 0 21094 0 674699 0 0 0 Andrew Gentry Gastroenterologist 605971 0 11725 0 1307 0 16500 0 25217 0 660720 0 0 0 Blair Erb Cardiology 509887 0 60000 0 3834 0 16500 0 16366 0 606587 0 0 0 Kleanthis Dendrinos Gastroenterology 502249 0 49285 0 0 0 0 0 19294 0 570828 0 0 0 Annie Castillo Oncology 485128 0 57755 0 3485 0 16500 0 23424 0 586292 0 0 0 John Robbins MD Former Officer 94320 0 11625 0 506 0 6571 0 12715 0 125737 0 0 0 Part I, Lines 4a-b Line 4a: Gordon Davidson received severance payments in the amount of $207,441 in 2018. Line 4b: Schedule J, Part II, column (c) reflects payments received by individuals from a 457(f) plan. The following individuals received payments in 2018. John Hill: $71,761 Brad Ludford: $16,152 Elizabeth Lewis: $22,848 A Montana Facility Finance Authority 364615155 61240MBM8 2014-11-05 23005852 Refinance 2004 bond issued 3/4/2004; fund add'n of Big Sky Medical Facility 0 0 0 B Montana Facility Finance Authority 364615155 2015-01-09 6300000 Portion for Big Sky Medical Facility 0 0 0 A 1170569 23008884 3032 377976 17500000 5127876 2015 1 0 0 1 B 276784 6300000 15123 6284877 2016 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 A 1 B 1 Schedule K, Part I, Line A(e): Part I issue price and Part II Line 3 bond proceeds differ due to interest earned on the proceeds. Form 990, Part VI, Section A, line 4 The Bylaws were amended in 2018. Significant changes indicate no fewer than nine board members will serve on the Board. The total time a board member can serve cannot exceed 11 years. Form 990, Part VI, Section A, line 7a The Yellowstone Conference of the Methodist Church confirms the Board Members and has authority to appoint the clergy member of the board. Form 990, Part VI, Section A, line 7b Changing the Articles of Incorporation in relationship to the process of selecting board membership must be approved by the Yellowstone Conference of the United Methodist Church. Form 990, Part VI, Section A, line 8b The organization does not have any committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b A copy of the 990 is provided to both the Planning and Finance Committee as well as the Board of Directors prior to filing. The Finance Team will review Form 990 in detail with the Planning and Finance Committee. Form 990, Part VI, Section B, line 12c Annual Disclosure Statement is obtained from the Board, Operating Committee, and Executive Team Members. Disclosures are reviewed with the Conflict of Interest (COI) Panel (Compliance Officer, Board Compliance Committee Chair, Chief Executive Officer, & Chief Legal Officer). The COI Panel assesses the disclosure, develops an acknowledgement and management plan. The management plan is reviewed with the affected member, if the COI Panel and the member are unable to resolve the disclosure, the disclosure is reported to the Board Compliance Committee for further review. Conflicts are addressed annually in writing and verbally during meetings. If a COI exists, the member shall not participate in any deliberations or vote regarding the transaction or arrangement at issue, and shall not be present in the meeting room for any part of the deliberations or vote relating to the transaction or arrangement. Form 990, Part VI, Section B, line 15 The Executive Compensation Committee receives a formal presentation by an independent compensation consultant (as selected by the Board) qualified to perform compensation reviews including usage of comparability data. This person presents recommendations to the Compensation Committee of the Board. The Compensation Committee makes recommendations to the full Board on an annual basis for Officers and Senior Administration. This annual process was performed in fall 2017 to determine 2018 compensation. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy, and all tax related information required to be available for public inspection are available via walk-in, telephone call, e-mail, and/or mail-in request. The audited financial statements are required to be attached to the Form 990 and provided to the Municipal Securities Rulemaking Board, which is our tax-exempt bonds trustee, via an on-line, central filing location called Electronic Municipal Market Access (EMMA). The financial statements can be obtained by the general public at the EMMA website. Form 990, Part IX, line 11g Other Fees: Program service expenses 5,769,375. Management and general expenses 5,847,454. Fundraising expenses 0. Total expenses 11,616,829. Form 990, Part XI, line 9: Change in Temp Restricted Investment of Foundation 371,847. Big Sky Medical Center LLC 334 Town Center Ave Big Sky MT 59716 474718253 Healthcare - Inpatient and Outpatient Servcies MT 6190599 28473269 Bozeman Deaconess Health Services Bozeman Health Urgent Cares LLC 915 Highland Blvd Bozeman MT 59715 465318746 Healthcare - Physician Outpatient Care MT 2261973 1243462 Bozeman Deaconess Health Services Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 475126599 Physician Employment & Contract to Bozeman Health System MT 38388743 2728844 Bozeman Deaconess Health Services Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 822848277 Healthcare-Ambulatory Clinic Outpatient Care MT 227536 1393550 Bozeman Deaconess Health Services Bozeman Deaconess Foundation dba Bozeman Health Foundation 931 Highland Blvd Suite 3200 Bozeman MT 59715 841407943 Raise funds to support Bozeman Deaconess Health Services MT 501(c)(3) Line 7 Bozeman Deaconess Health Services 1 Bozeman Health Deaconess Hospital 915 Highland Blvd Bozeman MT 59715 474717998 Healthcare - Inpatient and Outpatient Services MT 501(c)(3) Line 3 Bozeman Deaconess Health Services 1 Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 810666871 Healthcare - Imaging Services MT Bozeman Deaconess Health Services Related -3773654 2194199 0 1 0.77500 Rocky Mountain Surgical Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 364462300 Healthcare - Surgical Services MT Bozeman Deaconess Health Services Related 3378377 4303763 0 0 0.50780 Spanish Peaks Plaza LLC 120 N 19th Ave Suite A Bozeman MT 59718 810539803 Rental Real Estate for VA Med Clinic & Chiro MT Bozeman Deaconess Health Services Related 17550 265952 0 1 0.69940 Bozeman Deaconess Real Estate Development Corp PO Box 10490 Bozeman MT 59719 205496567 Sale of real estate property and residences to seniors MT Bozeman Deaconess Health Services C 147200 9958525 1.00000 1 0 1 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1 1 Deaconess Intercity Imaging LLC M 87826 General ledger and corp. records Deaconess Intercity Imaging LLC S 499875 General ledger and corp. records Bozeman Deaconess Foundation C 481565 General ledger and corp. records Bozeman Deaconess Foundation Q 72039 General ledger and corp. records Rocky Mountain Surgical Center LLC S 3340612 General ledger and corp. records Bozeman Health Deaconess Hospital L 92817782 General ledger and corp. records Deaconess Intercity Imaging LLC B 919368 General ledger and corp. records