2019-05-15T13:00:19-05:00 2018-06-30 390758449 WIPFLI LLP 101 EAST FRONT STREET 301 MISSOULA MT 59802 990 2017-07-01 810243720 SHERIDAN MEMORIAL HOSPITAL ASSOCIATION SHER 4067653700 440 W LAUREL AVENUE PLENTYWOOD MT 59254 GREG MAURER CEO 4067653700 2019-05-14 1 PHILIP L YASENAK CPA P01248379 4067281800 2019-05-14 65.158.74.97 2019-05-14 11:22:18 MD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 BE7A92E7B0152C1C6812F3C99C620D56F411D8FD 2017 2019-02-21 02:37:17Z GREG MAURER 440 W LAUREL AVENUE PLENTYWOOD MT 59254 11959015 0 X WWW.SHERIDANMEMORIAL.NET X 1920 MT PROVIDE QUALITY CARE TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITY WE SERVE. 7 7 204 68 0 0 306016 351503 11440978 11528758 4853 670 88832 78084 11840679 11959015 0 0 0 0 6735048 6776900 0 0 45845 4984587 5368151 11719635 12145051 121044 -186036 6165298 6168743 1215120 1404601 4950178 4764142 X PROVIDING QUALITY CARE TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITY WE SERVE, REGARDLESS OF THEIR ABILITY TO PAY. 0 0 8943047 11583231 SHERIDAN MEMORIAL HOSPITAL ASSOCIATION OPERATES A 19-BED CRITICAL ACCESS HOSPITAL, A 45-BED LONG-TERM CARE FACILITY, AND A RURAL HEALTH CLINIC THAT BENEFIT THE PEOPLE IN THE SURROUNDING AREA. SMHA IS THE ONLY MEDICAL FACILITY IN SHERIDAN COUNTY, WHICH HAS A POPULATION OF APPROXIMATELY 3,400 RESIDENTS. HIGHLIGHTS OF THE ORGANIZATION'S ACCOMPLISHMENTS DURING FY18 ARE INCLUDED BELOW:THE CRITICAL ACCESS HOSPITAL RECEIVED ACHC SLEEP STUDY ACCREDITATION AND IS NOW ABLE TO PERFORM AND BILL SLEEP STUDIES TO MEDICARE PATIENTS. THE CRITICAL ACCESS HOSPITAL ALSO PURCHASED AND RECEIVED A PHILIPS RESPIRONICS V60 VENTILATOR AND STAFF WILL RECEIVE TRAINING FOR USE OF THE EQUIPMENT EARLY IN FY19.THE EMERGENCY MEDICAL SERVICES DEPARTMENT PROVIDED COMMUNITY CPR CLASSES TO SEVERAL LOCAL BUSINESSES, FIRST RESPONDERS, AND GOVERNMENT OFFICIALS. THE DEPARTMENT CONTINUED OFFERING 1ST AID CLASSES TO LOCAL YOUTH BABY SITTERS. THE DEPARTMENT MADE SEVERAL PURCHASES DURING THE YEAR TO IMPROVE PATIENT CARE AND/OR PROCESSES. PURCHASES INCLUDE A NEW AMBULANCE, A NEW STRYKER STAIR CHAIR, IV SUPPLIES, AND 2 NEW ZOLL AED TRAINERS. THE DEPARTMENT IS ALSO WORKING TO OBTAIN REPLACEMENT VEHICLES. THE NURSING HOME PURCHASED A NEW VITALS MACHINE AND WHEELCHAIR SCALE AND CONTINUED TO INCREASE THE NUMBER OF AIR OVERLAY MATTRESS DEVICES AND GEL WHEELCHAIR CUSHIONS TO PROVIDE PRESSURE RELIEF TO PATIENTS. THE IMMUNIZATION CLINIC HAD 221 APPOINTMENTS DURING THE YEAR. ALSO, 100% OF THE IMMUNIZATIONS GIVEN WERE RECORDED IN IMMTRAX, THE MONTANA IMMUNIZATION RECORDING SYSTEM. 8943047 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 7 0 1 204 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X GREG MAURER 4067653702 440 WEST LAUREL AVENUE PLENTYWOOD MT 59254 X JAKE FLADAGER CHAIRPERSON 1.00 X X 0 0 0 MYRNETTE MILLER VICE CHAIRPERSON 1.00 X X 0 0 0 JESSICA SCHACKELFORD SECRETARY/TREASURER 1.00 X X 0 0 0 NANCY JENSEN DIRECTOR 1.00 X 0 0 0 DON BENSON DIRECTOR 1.00 X 0 0 0 JED WALLER DIRECTOR 1.00 X 0 0 0 JOAN TOMMERUP DIRECTOR 1.00 X 0 0 0 GREG MAURER CEO 40.00 1.00 X 0 0 0 KYLE GEE CFO 10.00 X 0 0 0 CARLOS TREVINO MD 36.00 X 221997 0 6048 ADAM GRAHAM PA 36.00 X 159481 0 11949 LYNNE GRAHAM PA 36.00 X 124902 0 7487 KRISTIN MCCOLLY FNP 36.00 X 104506 0 6520 JENNA THOMAS FNP 36.00 X 113942 0 3804 724828 0 35808 5 0 1 0 BILLINGS CLINIC PO BOX 30357 BILLINGS MT 59107 MANAGEMENT COMPANY 392840 DAKOTA DRUG PO BOX 5009 MINOT ND 58702 PHARMACEUTICALS 249401 MONTANA HEALTH NETWORK 519 PLEASANT ST MILES CITY MT 59301 STAFFING 179125 CERNER CORPORATION PO BOX 959156 ST LOUIS MO 63195 EHR/REVENUE CYCLE 174606 12 126585 206599 18319 351503 PATIENT SERVICE REVENUE 621990 10753299 10753299 OTHER OPERATING REVENUE 900099 345244 345244 340B REVENUE 621990 221557 221557 CONTRACT REVENUE 621990 208658 208658 11528758 670 670 23611 0 23611 23611 23611 BAD DEBT RECOVERY 621990 48392 48392 GIFT SHOP REVENUE 900099 6081 6081 54473 11959015 11583231 0 24281 X 5682003 4765760 899340 16903 680703 440379 238452 1872 414194 350176 62745 1273 337973 337973 3647 3647 24358 23458 900 1806244 1291372 512977 1895 32079 261 25790 6028 289464 10216 279248 13877 6471 7371 35 49265 31920 17345 2647 1597 1050 776768 378802 397966 136511 249 134900 1362 SUPPLIES 994897 926030 67330 1537 REPAIRS AND MAINTENANCE 282290 232932 49358 BAD DEBT 246795 246795 BED TAX 188681 165962 22719 182655 95722 73943 12990 12145051 8943047 3156159 45845 851603 1006448 174852 241417 5000 5390 1210575 1302003 223594 230318 78823 168313 17303045 14518635 3243686 2784410 59884 59914 317281 370530 6165298 6168743 884677 1111504 137606 70687 192837 222410 1215120 1404601 X 4941687 4752315 8491 11827 4950178 4764142 6165298 6168743 -186036 0 X X 0 1 X 1 0 X 103996 143 147 104286 113984 237 10225 103996 113916 68 145 145 113984 113916 64 64 113916 113916 72 72 113916 1.00000 0 1 1 384756 384756 9459299 8562225 897074 7458990 5956410 1502580 2784410 COST REPORT RECEIVABLE 85968 GUARANTEE OF PATIENT LOAN 174838 BED TAX RECEIVABLE 109724 370530 GUARANTEE OF PATIENT LOAN 174838 BED TAXES PAYABLE 47418 OTHER PAYABLES 154 222410 X PART V, LINE 4: THE ENDOWMENT, HELD BY THE SHERIDAN HEALTH CARE FOUNDATION, INC., CONSISTS OF INDIVIDUAL FUNDS ESTABLISHED BY DONORS TO PROVIDE ANNUAL FUNDING FOR SPECIFIC ACTIVITIES AND GENERAL OPERATIONS OF THE HOSPITAL. GIFTS GIVEN TO THE ENDOWMENT FUND AT SHERIDAN HEALTH CARE FOUNDATION ARE INVESTED AND CAREFULLY MANAGED TO PROTECT THE PRINCIPAL; THEY ARE INTENDED TO BE A PART OF THE PERMANENT INVESTMENT RESERVE WHICH WILL REMAIN FOR PERPETUITY. INTEREST FROM ENDOWMENTS WILL GO TOWARDS SHERIDAN HEALTH CARE FOUNDATION'S UNRESTRICTED FUND TO ALLOW FOR ADDITONAL REVENUE TO ENSURE THE FUTURE OF THE FOUNDATION AND SHERIDAN MEMORIAL HOSPITAL ASSOCIATION UNLESS OTHERWISE STIPULATED BY THE DONOR. PART X, LINE 2: THE HOSPITAL AND FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL AND FOUNDATION ARE ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. FEDERAL AND STATE INCOME TAXES ARE PAID ON NONEXEMPT UNRELATED BUSINESS INCOME IN ACCORDANCE WITH THE CODE. CURRENT ACCOUNTING GUIDELINES REQUIRE AN ORGANIZATION TO DETERMINE WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED ON THE FINANCIAL STATEMENTS. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. FEDERAL RETURNS FOR TAX YEARS 2014 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. 1 1 X 1 X 1 X 1 1 1 0 0 211127 211127 0.01740 1760611 1760611 0.14500 1971738 1971738 0.16240 340391 340391 0.02800 465650 204716 260934 0.02150 806041 204716 601325 0.04950 2777779 204716 2573063 0.21190 1 196449 5689489 6167170 -477681 X 1 1 1 1 SHERIDAN MEMORIAL HOSPITAL ASSOCIATION 440 W LAUREL AVE PLENTYWOOD MT 59254 WWW.SHERIDANMEMORIAL.NET 13547 X X X RURAL HEALTH CLINIC, LONG-TERM CARE FACILITY SHERIDAN MEMORIAL HOSPITAL ASSOCIATION 1 0 0 1 X X X X X X X X X 15 1 0 1 1 X WWW.SHERIDANMEMORIAL.NET X X 1 15 1 WWW.SHERIDANMEMORIAL.NET 0 1 X 100.000000000000 400.000000000000 X 1 1 X X X 1 X WWW.SHERIDANMEMORIAL.NET X WWW.SHERIDANMEMORIAL.NET X WWW.SHERIDANMEMORIAL.NET X X X X X 1 X 0 X 1 X 0 1 SHERIDAN MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: THREE FOCUS GROUPS WERE HELD IN MAY 2016. THE MEETINGS WERE HELD IN PLENTYWOOD, WESTBY AND MEDICINE LAKE, MONTANA. FOCUS GROUP PARTICIPANTS WERE IDENTIFIED AS PEOPLE LIVING IN SHERIDAN MEMORIAL HOSPITAL'S SERVICE AREA. ADDITIONALLY, FOUR KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH THE ASSISTANCE FROM THE MONTANA OFFICE OF RURAL HEALTH. SHERIDAN MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6B: SHERIDAN COUNTY SHERIFF'S OFFICESHERIDAN COUNTY OFFICE OF PUBLIC HEALTHSHERIDAN COUNTY MENTAL HEALTH COUNSELORPIONEER MANOR RETIREMENT HOMESHERIDAN COUNTY CHILD AND FAMILY SERVICES SHERIDAN MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 7D: THE FULL CHNA IS AVAILABLE UPON REQUEST. IT IS ALSO POSTED IN A COUPLE PLACES IN THE HOSPITAL. SHERIDAN MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 11: THE FOLLOWING NEEDS WERE IDENTIFIED IN THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT:1. IMPROVING LOCAL ACCESS TO WELLNESS OPPORTUNITIES AND HEALTH CARE SERVICES BY OPTIMIZING FACILITY SPACE AND RECRUITING/RETAINING STAFF TO SUPPORT COMMUNITY HEALTH NEEDS.2. IMPROVING LOCAL ACCESS TO WELLNESS OPPORTUNITIES BY PROVIDING HEALTH EDUCATION AND COMMUNITY OUTREACH ACTIVITIES.A COMMUNITY HEALTH OUTREACH PROGRAM IS TENTATIVELY PLANNED FOR THE TOWN OF WESTBY. ADMINISTRATION HAS MET WITH RESIDENTS OF WESTBY TO ASSESS HEALTH NEEDS AND DEVELOP A PLAN. WESTBY WILL BE OUR "PILOT PROGRAM" FOR STARTING A COMMUNITY HEALTH NEEDS PROGRAM. CURRENTLY, THE FACILITY IS WORKING ON A PLAN AND WILL BE SEEKING GRANT FUNDING TO BRING THE PLAN TO FRUITION. A WESTBY HEALTH STEERING COMMITTEE HAS MET A NUMBER OF TIMES AND IS RECOMMENDING THE DEVELOPMENT OF A COMMUNITY HEALTH WORKER PROGRAM. FUNDING AND TRAINING OPTIONS ARE BEING EXPLORED. RECENTLY, THE PROGRAM COORDINATOR RETIRED AND A REPLACEMENT IS BEING RECRUITED. SHERIDAN MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 13H: IN ADDITION TO FAMILY SIZE AND FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY WILL CONSIDER SPECIAL HARDSHIPS OR UNUSUAL CIRCUMSTANCES IN DETERMINING FINANCIAL ASSISTANCE. SHERIDAN MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 20E: THE PATIENT RECEIVES UP TO 240 DAYS TO PROPERLY SUBMIT A FINANCIAL ASSISTANCE APPLICATION. SHERIDAN MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 24: ALL INDIVIDUALS ELIGIBLE UNDER THE HOSPITAL FINANCIAL ASSISTANCE POLICY ARE PROVIDED A DISCOUNT FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE. THE FINANCIAL ASSISTANCE POLICY DOES NOT APPLY TO ELECTIVE PROCEDURES. THEREFORE, FAP-ELIGIBLE PATIENTS WITHOUT INSURANCE MAY BE CHARGED GROSS CHARGES ON ELECTIVE PROCEDURES. PART I, LINE 3C: IN ADDITION TO FAMILY SIZE AND FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY WILL CONSIDER SPECIAL HARDSHIPS OR UNUSUAL CIRCUMSTANCES IN DETERMINING FINANCIAL ASSISTANCE. PART I, LINE 7: LINE 7A: CHARITY CARE WAS CALCULATED BY MULTIPLYING THE RATIO OF COST TO GROSS CHARGES BY THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CHARITY CARE TO PATIENTS.LINE 7B: THE MEDICAID CALCULATION IS BASED ON THE RATIO OF PATIENT CARE COST TO CHARGES.LINE 7E: ACTUAL COSTS WERE USED TO REPORT COMMUNITY HEALTH IMPROVEMENT SERVICES. PART I, LINE 7G: A COMBINATION OF ACTUAL COSTS AND COSTS BASED ON THE COST REPORT WERE USED TO REPORT SUBSIDIZED HEALTH SERVICES. PART III, LINE 2: ACCOUNTS ARE WRITTEN OFF AS DETERMINED. THE ALLOWANCE IS ADJUSTED UP OR DOWN BASED ON THE CHANGE IN SELF PAY AGED OUTSTANDING BALANCE. PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE IS FOUND ON PAGE 11 OF THE ATTACHED AUDIT REPORT. PART III, LINE 8: THE COST TO CHARGE RATIO IS USED TO DETERMINE COMMUNITY BENEFIT. THIS IS DONE BY APPLYING THE RATIO TO THE TOTAL MEDICARE REVENUE. A SHORTFALL OR OVERAGE IN ANY GIVEN YEAR IS A RESULT OF THE TIMING OF PAYMENTS FROM MEDICARE ON AN INTERIM BASIS AND WHEN FINAL SETTLEMENT IS MADE. MANAGEMENT USES ESTIMATES TO CALCULATE SUCH SETTLEMENTS BUT ACTUAL RESULTS VARY FROM THOSE ESTIMATES. ADDITIONALLY, SHORTFALLS CAN RESULT FROM VARIOUS EXPENSES THAT ARE INCURRED BY THE FACILITY WHICH ARE CONSIDERED NON-REIMBURSABLE BY MEDICARE. SINCE PART OF THE COSTS ARE NOT REIMBURSED IT IS ONLY PRUDENT TO CONSIDER THIS SHORTFALL TO BE A BENEFIT TO THE COMMUNITY. ALSO MEDICARE RECIPIENTS ARE PART OF A CHARITABLE CLASS AND SO THE PROVISION OF MEDICAL CARE FURTHERS THIS CHARITABLE CLASS. PART III, LINE 9B: SHERIDAN MEMORIAL FOLLOWS THE COLLECTION AND FINANCIAL ASSISTANCE PRACTICES MANDATED IN 501R. ONCE A FINANCIAL ASSISTANCE APPLICATION IS RECEIVED IT IS REVIEWED TO ENSURE ALL AREAS ARE COMPLETED AND ALL REQUESTED DOCUMENTS ARE PROVIDED. AT THIS TIME ALL COLLECTION ACTION IS SUSPENDED UNTIL A DECISION CAN BE MADE ON THE APPLICANT'S FINANCIAL ASSISTANCE REQUEST. IF THE PATIENT QUALIFIES FOR ASSISTANCE IN ACCORDANCE TO THE SLIDING FEE SCHEDULE AND THE FEDERAL POVERTY GUIDELINES, A PATIENT FINANCIAL REPRESENTATIVE THEN LOOKS BACK 240 DAYS FROM THE DATE THE APPLICATION WAS RECEIVED AND APPLIES THAT PERCENTAGE OF DISCOUNT TO ALL ACCOUNTS. SOME ACCOUNTS AT THIS POINT MAY HAVE ALREADY BEEN TURNED OVER TO A COLLECTION AGENCY. THOSE ACCOUNTS ARE PULLED BACK FROM THE COLLECTION AGENCY AND THE SAME DISCOUNT IS APPLIED. ONCE ALL DISCOUNTS ARE APPLIED, COLLECTION ACTION IS PROCEEDED AS NORMAL. PART VI, LINE 2: SHERIDAN MEMORIAL HOSPITAL CONDUCTED A THOROUGH SECONDARY DATA ANALYSIS TO IDENTIFY HEALTH CONCERNS IN PLENTYWOOD AND SHERIDAN COUNTY. ADDITIONALLY, A DIVERSE GROUP OF COMMUNITY MEMEBERS REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY (EX. PUBLIC HEALTH, ELDERLY, UNINSURED) CAME TOGETHER FOR KEY INFORMANT INTERVIEWS AND FOCUS GROUPS TO BETTER UNDERSTAND THE COMMUNITY'S PERCEPTION OF HEALTH AND HEALTH CONCERNS IN THE AREA. THE INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED IN MAY 2016. PART VI, LINE 3: SHERIDAN MEMORIAL ENSURES ALL PATIENTS ARE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AT EVERY ADMISSION. AT ADMISSION, THE PATIENT SIGNS A CONDITION OF ADMISSION WHICH STATES THAT ASSISTANCE IS AVAILABLE. IN ADDITION, FINANCIAL ASSISTANCE PACKETS ARE HANDED OUT BY THE ADMISSION'S CLERK TO THOSE WHO ARE UNDERINSURED/UNINSURED OR EXPRESS NEED FOR ASSISTANCE. THIS PACKET INCLUDES ALL PAYMENT OPTIONS, MEDICAID INFORMATION AND FINANCIAL ASSISTANCE APPLICATION. IN ADDITION THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE POSTED ON THE SHERIDAN MEMORIAL WEBSITE WWW.SHERIDANMEMORIAL.NET AND POSTERS ARE PLACED AROUND THE FACILITY EXPLAINING PAYMENT OPTIONS. EACH STATEMENT SENT OUT TO THE PATIENT STATES THAT FINANCIAL ASSISTANCE IS AVAILABLE. THE BUSINESS OFFICE STAFF ALSO COVERS THIS INFORMATION WITH SELF-PAY PATIENTS WHEN MAKING COLLECTION/PAYMENT PLAN CALLS. PART VI, LINE 4: SHERIDAN COUNTY IS LOCATED IN THE NORTHEAST CORNER OF MONTANA AND COVERS THE GEOGRAPHIC AREA OF 1,706 SQUARE MILES. POPULATION OF THE COUNTY IS 3,668 (BASED ON THE 2013 CENSUS). THE COMMUNITY IS RURAL AND PRIMARILY A FARMING AND RANCHING AREA. PART VI, LINE 5: SHERIDAN MEMORIAL HAS EXPANDED MEDICAL STAFF PRIVILEGES TO AN MD WHO HAS HIS OWN PRIVATE CLINIC IN THE AREA. MEDICAL PRIVILEGES ARE ALSO EXTENDED TO QUALIFIED PHYSICIANS IN THE COMMUNITY AND PROVIDERS WILLING TO SEE SHERIDAN MEMORIAL PATIENTS VIA TELE-MED/VIDEO CONFERENCE. THE BOARD OF DIRECTORS IS MADE UP OF VOLUNTEERS FROM THE COMMUNITY. WE TRY TO HAVE REPRESENTATION OF THE BOARD FROM INDIVIDUALS THROUGHOUT THE COUNTY AND NOT JUST OF THOSE LIVING IN PLENTYWOOD. SURPLUS FUNDS ARE APPLIED BACK TO PATIENT CARE AND EDUCATION. WE OFFER MANY SERVICES WHICH ARE A COMMUNITY BENEFIT TO THE COMMUNITIES WE SERVE WHICH INCLUDE THE FOLLOWING: * ALZHEIMER'S SUPPORT GROUP* GRIEF COUNSELOR* USE OF TELE-MED EQUIPMENT IS OPEN TO THE COMMUNITY FOR MENTAL HEALTH VISITS, BEHAVIORAL HEALTH CLASSES, MIP CLASSES, COMMUNITY GENERAL HEALTH EDUCATION AS WELL AS LIFESTYLE BALANCE CLASSES. CONTINUING EDUCATION OPPORTUNITIES ARE ALSO AVAILABLE VIA TELE-VIDEO FOR EMPLOYEES AND OTHER MEDICAL PERSONNEL OUTSIDE OF SHERIDAN MEMORIAL. ALL OF THE TELE-VIDEO OPPORTUNITIES ARE FREE OF CHARGE* ER IS OPEN 24 HOURS REGARDLESS OF ABILITY TO PAY* EDUCATION OF HEALTHCARE PROFESSIONALS* PARTICIPATION IN GOVERNMENT SPONSORED HEALTH PROGRAMS* SHERIDAN MEMORIAL IS INVOLVED IN COMMUNITY OUTREACH THROUGH THE SHERIDAN COUNTY CHAMBER, COUNCIL ON AGING, AND COUNTY HEALTH* ASSIST COMMUNITY MEMBERS IN APPLYING FOR STATE MEDICAID ASSISTANCE AND SSDI. APPLICATIONS CAN BE CONFUSING AND THE PROCESS FRUSTRATING THUS SHERIDAN MEMORIAL OFFERS ANY HELP WITH THESE PROCESSES* SOLE COMMUNITY PROVIDER OF MOST SERVICE LINES* OFFERS VOLUNTEER OPPORTUNITIES TO COMMUNITY THROUGH HOSPICE, EMS, ACTIVITIES, BEAUTY SHOP, PINK LADY PROGRAM AS WELL AS GIFT SHOP STAFFING* HAS A FOUNDATION THAT SERVES AS A VEHICLE FOR ATTRACTING AND EFFECTIVELY USING DONATED FUNDS* HAS THE SUPPORT OF AN AUXILIARY THAT HOSTS EVENTS THROUGHOUT THE YEAR TO RAISE FUNDS FOR THE HEALTH CARE FACILITY* EMERGENCY STANDBY COVERAGE FOR COMMUNITY EVENTS AT NO COST TO THE COMMUNITY* PARTICIPATION IN THE COUNTY FAIR AND PARADES* OFFERS COMMUNITY CPR AND FIRST AID CLASSES* OFFERS A COMMUNITY HEALTH FAIR* PARTICIPATES IN THE KID'S SAFETY FAIR* PROMOTES A COMMUNITY HEALTH PANEL X 0 0 0 0 0 0 0 0 0 0 0 CARLOS TREVINO MD 215308 0 6689 0 0 0 0 0 6048 0 228045 0 0 0 ADAM GRAHAM PA 159430 0 51 0 0 0 0 0 11949 0 171430 0 0 0 PART I, LINE 1A A HOUSING ALLOWANCE WAS PROVIDED FOR THE HIGHEST COMPENSATED EMPLOYEES ADAM AND LYNN GRAHAM. THIS WAS INCLUDED AS COMPENSATION ON THEIR FORM W-2. GREG MAURER MR. MAURER IS SHERIDAN MEMORIAL HOSPITAL ASSOCIATION'S CEO. 0 MR. MAURER IS AN EMPLOYEE OF THE BILLINGS CLINIC, INC., THE INDEPENDENT CONTRACTOR HIRED TO MANAGE THE HOSPITAL, AND RECEIVED ALL COMPENSATION FOR HIS SERVICES AS CEO FROM BILLINGS CLINIC, INC. 0 KYLE GEE MR. GEE IS SHERIDAN MEMORIAL HOSPITAL ASSOCIATION'S CFO. 0 MR. GEE IS AN EMPLOYEE OF THE BILLINGS CLINIC, INC., THE INDEPENDENT CONTRACTOR HIRED TO MANAGE THE HOSPITAL, AND RECEIVED ALL COMPENSATION FOR HIS SERVICES AS CFO FROM BILLINGS CLINIC, INC. 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT, AS CHAIRMAN, THE VICE CHAIRPERSON AND THE SECRETARY/TREASURER. THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 3 THE HOSPITAL HAS A MANAGEMENT AGREEMENT WITH BILLINGS CLINIC. THEY PROVIDE GENERAL ACCOUNTING, HR, AND BUSINESS SUPPORT SERVICES. GREG MAURER, CEO, IS AN EMPLOYEE OF BILLINGS CLINIC AND IS COMPENSATED BY BILLING CLINIC. KYLE GEE, CFO, IS ALSO COMPENSATED BY BILLINGS CLINIC. FORM 990, PART VI, SECTION A, LINE 6 SHERIDAN MEMORIAL HOSPITAL ASSOCIATION HAS 789 LIFETIME VOTING MEMBERS. THESE MEMBERS ARE GRANTED VOTING PRIVILEGES IN ELECTING/RE-ELECTING ASSOCIATION BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A SHERIDAN MEMORIAL HOSPITAL ASSOCIATION HAS 789 LIFETIME VOTING MEMBERS. THESE MEMBERS ARE GRANTED VOTING PRIVILEGES IN ELECTING/RE-ELECTING ASSOCIATION BOARD MEMBERS DURING THE ANNUAL MEETING HELD THE THIRD TUESDAY OF FEBRUARY EVERY YEAR. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD REVIEWS AN ELECTRONIC COPY OF THE FORM 990 BEFORE THE FINAL COPY IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS, CEO, AND MEETING SECRETARY ARE ANNUALLY REQUIRED TO SIGN THE CONFLICT OF INTEREST POLICY. THE BOARD MEMBERS REVIEW ANY POTENTIAL CONFLICTS TO DETERMINE IF A CONFLICT EXISTS. IF THERE IS A CONFLICT OF INTEREST, THE CONFLICTED BOARD MEMBER IS NOT INCLUDED IN THE VOTE ON THE PARTICULAR MATTER. IF THE TRANSACTION IS RELATING TO A PARTICULARLY SENSITIVE TOPIC, THE CONFLICTED BOARD MEMEBER MAY BE ASKED TO EXCUSE THEMSELVES FROM BOTH THE DISCUSSION AND THE VOTE. FORM 990, PART VI, SECTION B, LINE 15 BILLINGS CLINIC, ALONG WITH THE INPUT FROM THE SHERIDAN MEMORIAL HOSPITAL BOARD OF DIRECTORS, DETERMINES COMPENSATION FOR THE CEO. THE BILLINGS CLINIC REVIEWS COMPARABILITY DATA TO ASSIST IN THIS PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,291,372. MANAGEMENT AND GENERAL EXPENSES 512,977. FUNDRAISING EXPENSES 1,895. TOTAL EXPENSES 1,806,244. PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SHERIDAN HEALTH CARE FOUNDATION INC 440 W LAUREL AVENUE PLENTYWOOD MT 59254 810496987 SUPPORT ACTIVITIES OF SHERIDAN MEMORIAL HOSPITAL ASSOCIATION MT 501(C)(3) LINE 7 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 SHERIDAN HEALTH CARE FOUNDATION INC C 126585