NORTHEAST MONTANA HEALTH SERVICES INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- NORTHEAST MONTANA HEALTH SERVICES INC (EIN 81-0226578)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-10
- IRS object ID
- 201931309349302993
- Schema version
- 2017v2.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-10T11:20:29-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREEN HEALTH GROUP PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 5TH ST S SUITE 106 | AddressLine1Txt |
| City | GLASGOW | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 592302338 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810226578 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHEAST MONTANA HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 4066536500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 315 KNAPP STREET | AddressLine1Txt |
| City | WOLF POINT | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59201 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARGARET NORGAARD | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 4066536500 | PhoneNum |
| Signature | 2019-05-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DANIEL GREEN | PreparerPersonNm |
| PTIN | P01311679 | PTIN |
| Phone | 4062632615 | PhoneNum |
| Preparation | 2019-05-10 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 52.37.240.203 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-10 | IPDt |
| IP Tm | 11:20:29 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 2FBCB8D7812C079C897CD9009B871BFFB5AA1009 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | AC785BF934A784206A69BEB0C2507B216FA97F7D | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARGARET NORGAARD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 315 KNAPP STREET | AddressLine1Txt |
| City | WOLF POINT | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $29,032,178 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NEMHS.NET | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1948 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | TO DELIVER QUALITY, COST-EFFECTIVE HEALTH CARE TO THE COMMUNITIES THAT WE SERVE FOR IMPROVEMENT OF HUMAN LIFE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 499 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $1,308,667 | TotalGrossUBIAmt |
| PY Contributions Grants | $627,784 | PYContributionsGrantsAmt |
| CY Contributions Grants | $222,309 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $25,465,763 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $28,225,888 | CYProgramServiceRevenueAmt |
| PY Investment Income | $222,666 | PYInvestmentIncomeAmt |
| CY Investment Income | $172,637 | CYInvestmentIncomeAmt |
| PY Other Revenue | $357,597 | PYOtherRevenueAmt |
| CY Other Revenue | $411,344 | CYOtherRevenueAmt |
| PY Total Revenue | $26,673,810 | PYTotalRevenueAmt |
| CY Total Revenue | $29,032,178 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,863,660 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,950,564 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $64,259 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,099,476 | PYOtherExpensesAmt |
| CY Other Expenses | $14,209,545 | CYOtherExpensesAmt |
| PY Total Expenses | $26,963,136 | PYTotalExpensesAmt |
| CY Total Expenses | $30,160,109 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$289,326 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,127,931 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $36,979,769 | TotalAssetsBOYAmt |
| Total Assets EOY | $38,741,981 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $13,452,336 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,350,901 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,527,433 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $22,391,080 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO DELIVER QUALITY, COST-EFFECTIVE HEALTH CARE TO THE COMMUNITIES THAT WE SERVE FOR IMPROVEMENT OF HUMAN LIFE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $22,398,144 | ExpenseAmt |
| Revenue | $28,225,888 | RevenueAmt |
| Desc | PROVIDE QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES TO THE PATIENTS THAT WE SERVE. | Desc |
| Total Program Service Expenses | $22,398,144 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 33 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 499 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEMI WILKINSON | PersonNm |
| Phone | 4066536500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 315 KNAPP ST | AddressLine1Txt |
| City | WOLF POINT | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MARK ZILKOSKI MD | ||||||||
| MEDICAL STAF | 1.00 | 40.00 | Yes (X) | $0 | $237,870 | $103,322 | ||
| SHANE GIBSON | ||||||||
| CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SHARON BRAVARD | ||||||||
| VICE CHAIRWO | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DALLAS O'CONNOR | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RJ DOORNEK | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STEVE HACKLEY | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STEPHANIE MCGOWAN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARGARET NORGAARD | ||||||||
| CEO | 40.00 | $163,998 | $0 | $24,759 | Yes (X) | |||
| RICHARD GOERTZ | ||||||||
| CFO | 40.00 | $161,148 | $0 | $24,658 | Yes (X) | |||
| ROGER FISHER | ||||||||
| COO | 40.00 | $107,354 | $0 | $748 | Yes (X) | |||
| DEMI WILKINSON | ||||||||
| CFO | 40.00 | $86,559 | $0 | $8,928 | Yes (X) | |||
| VICKI HOUSTON | ||||||||
| RN | 40.00 | $170,881 | $0 | $9,561 | Yes (X) | |||
| HANZ ARNSTON | ||||||||
| RN | 40.00 | $143,863 | $0 | $9,358 | Yes (X) | |||
| ELAINE LONG | ||||||||
| RN-VP NURSIN | 40.00 | $136,381 | $0 | $11,007 | Yes (X) | |||
| JO ANN HIBL | ||||||||
| RN-DON | 40.00 | $131,823 | $0 | $12,234 | Yes (X) | |||
| MARK ZYGMOND | ||||||||
| CRNA | 20.00 | $127,825 | $0 | $3,769 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,229,832 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $237,870 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $208,344 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AVENTUS OUTREACH LLC | |||||
| 11301 CORPORATE BLVD BLD 400 STE315 | ORLANDO | FL | 32717 | REF LAB SVCS | $1,265,573 |
| BILLINGS CLINIC | |||||
| PO BOX 30277 | BILLINGS | MT | 59107 | COMPUTER SUPP | $316,521 |
| LOCUM TENENS | |||||
| PO BOX 405547 | ATLANTA | GA | 30384 | LOCUM TENENS | $290,754 |
| BIG SKY LOCUMS | |||||
| 4865 BLUE SPRUCE CIRCLE | BILLINGS | MT | 59103 | LOCUM TENENS | $287,620 |
| DRAGE FAMILY EMERGENCY INC | |||||
| 1912 E HICKORY POINT CIRCLE | SANDY | UT | 84092 | LOCUM TENENS | $249,496 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $34,086 | RelatedOrganizationsAmt |
| All Other Contributions | $188,223 | AllOtherContributionsAmt |
| Total Contributions | $222,309 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT REVENUE | 621500 | $24,997,022 | $24,997,022 | |
| RETAIL PHARMACIES | 446110 | $3,228,866 | $1,920,199 | $1,308,667 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $28,225,888 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $172,637 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $172,637 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOSPITAL DISTRICT TAX | 900099 | $401,709 | $401,709 |
| GAIN ON SALE OF ASSETS | 900099 | $9,635 | $9,635 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $411,344 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,032,178 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,501,202 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,308,667 | UnrelatedBusinessRevenueAmt |
| 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 | $524,563 | TotalAmt |
| Management And General | $524,563 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,073,060 | TotalAmt |
| Program Services | $11,652,103 | ProgramServicesAmt |
| Management And General | $1,369,585 | ManagementAndGeneralAmt |
| Fundraising | $51,372 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,083 | TotalAmt |
| Program Services | $88,480 | ProgramServicesAmt |
| Management And General | $17,265 | ManagementAndGeneralAmt |
| Fundraising | $338 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,150,990 | TotalAmt |
| Program Services | $921,119 | ProgramServicesAmt |
| Management And General | $221,053 | ManagementAndGeneralAmt |
| Fundraising | $8,818 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,095,868 | TotalAmt |
| Program Services | $808,010 | ProgramServicesAmt |
| Management And General | $284,150 | ManagementAndGeneralAmt |
| Fundraising | $3,708 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,434 | TotalAmt |
| Management And General | $1,434 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,058 | TotalAmt |
| Management And General | $77,058 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,272,693 | TotalAmt |
| Program Services | $2,952,770 | ProgramServicesAmt |
| Management And General | $2,319,923 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,312 | TotalAmt |
| Management And General | $24,312 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $759,272 | TotalAmt |
| Program Services | $396,354 | ProgramServicesAmt |
| Management And General | $362,895 | ManagementAndGeneralAmt |
| Fundraising | $23 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $287,354 | TotalAmt |
| Management And General | $287,354 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,119 | TotalAmt |
| Program Services | $274,119 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,512 | TotalAmt |
| Program Services | $84,983 | ProgramServicesAmt |
| Management And General | $20,529 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,565 | TotalAmt |
| Program Services | $21,159 | ProgramServicesAmt |
| Management And General | $5,406 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $308,278 | TotalAmt |
| Program Services | $3,646 | ProgramServicesAmt |
| Management And General | $304,632 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,219,532 | TotalAmt |
| Management And General | $1,219,532 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,484 | TotalAmt |
| Management And General | $311,484 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $3,364,968 | $3,364,968 | |
| COGS | $916,397 | $916,397 | |
| REPAIRS & MAINTENANCE | $633,039 | $333,361 | $299,678 |
| FOOD & DIETARY SUPPLIES | $304,369 | $304,369 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $323,159 | TotalAmt |
| Program Services | $276,306 | ProgramServicesAmt |
| Management And General | $46,853 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,160,109 | TotalAmt |
| Program Services | $22,398,144 | ProgramServicesAmt |
| Management And General | $7,697,706 | ManagementAndGeneralAmt |
| Fundraising | $64,259 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,334,965 | BOYAmt |
| EOY | $5,141,965 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,291,638 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,787,058 | BOYAmt |
| EOY | $6,933,498 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $831,777 | BOYAmt |
| EOY | $963,648 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $313,746 | BOYAmt |
| EOY | $405,231 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $28,594,969 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $20,139,630 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,813,457 | BOYAmt |
| EOY | $8,455,339 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,995,848 | BOYAmt |
| EOY | $6,149,763 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,902,918 | BOYAmt |
| EOY | $9,400,899 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,979,769 | BOYAmt |
| EOY | $38,741,981 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,356,818 | BOYAmt |
| EOY | $6,832,986 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,322,698 | BOYAmt |
| EOY | $8,833,813 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $772,820 | BOYAmt |
| EOY | $684,102 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,452,336 | BOYAmt |
| EOY | $16,350,901 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,891,229 | BOYAmt |
| EOY | $22,243,112 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $636,204 | BOYAmt |
| EOY | $147,968 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,527,433 | BOYAmt |
| EOY | $22,391,080 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,979,769 | BOYAmt |
| EOY | $38,741,981 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,127,931 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$8,422 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $2,336 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,336 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | 1.37 PERCENT OF MHA DUES PAID TO MHA, WHICH WAS 315, 22.98 PERCENT OF DUES PAID TO MHA FOR AHA, WHICH WAS 1,974, AND 3.60 PERCENT OF DUES PAID TO MHA FOR LEADINGAGE WHICH WAS 47 (2336 COMBINED) WERE USED FOR LOBBYING EXPENSES BY MHA. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,950 | OtherCostOrOtherBasisAmt |
| Book Value | $28,950 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,544,012 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,416,473 | DepreciationAmt |
| Book Value | $5,127,539 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,022,007 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,723,157 | DepreciationAmt |
| Book Value | $3,298,850 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,455,339 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $5,145,660 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BOND FUNDS | Desc |
| Book Value | $1,004,103 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $6,149,763 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| RECEIVABLE-WOLF POINT CLINIC ASSOC | $6,415,829 |
| RECEIVABLE-RIVERSIDE FAMILY CLINIC | $2,890,070 |
| WORK COMP TRUST DEPOSIT | $95,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $9,400,899 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $29,023,756 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$8,422 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$8,422 | RevenueNotReportedAmt |
| Revenue Subtotal | $29,032,178 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $29,032,178 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $30,160,109 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $30,160,109 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $30,160,109 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | IT IS THE JUDGMENT OF MANAGEMENT THAT THE COMPANY HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT WOULD BE SUBJECT TO CHANGE UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. SEE PAGE 8 IN THE NORTHEAST MONTANA HEALTH SERVICES, INC. AND AFFILIATES NOTES TO CONSOLIDATED FINANCIAL STATEMENTS JUNE 30, 2018 AND 2017. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $510,682 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $510,682 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01690 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $510,682 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $510,682 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01690 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,586,393 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,245,644 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,340,749 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04450 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,400 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,400 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,594,793 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,245,644 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,349,149 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04470 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,105,475 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,245,644 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,859,831 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06170 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,300 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $63,362 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $63,362 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $65,662 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $65,662 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $382,886 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $4,965,056 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,905,784 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $59,272 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Critical Access HospitalCriticalAccessHospitalInd | Emergency Room24 HrsEmergencyRoom24HrsInd |
|---|---|---|---|---|---|---|---|---|---|
| NEMHS - TRINITY HOSPITAL | |||||||||
| 1 | 315 KNAPP STREET | WOLF POINT | MT | 59201 | WWW.NEMHS.NET | Yes (X) | Yes (X) | Yes (X) | Yes (X) |
| NEMHS - POPLAR COMMUNITY HOSPITAL | |||||||||
| 2 | 211 H STREET EAST | POPLAR | MT | 59255 | WWW.NEMHS.NET | Yes (X) | Yes (X) | Yes (X) | Yes (X) |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)
| FacilityFacilityNum | First Licensed CY Or PYFirstLicensedCYOrPYInd | Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd | CHNA ConductedCHNAConductedInd | Community DefinitionCommunityDefinitionInd | Community DemographicsCommunityDemographicsInd | Existing ResourcesExistingResourcesInd | How Data ObtainedHowDataObtainedInd | Community Health NeedsCommunityHealthNeedsInd | Other Health IssuesOtherHealthIssuesInd | Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd | Consulting ProcessConsultingProcessInd | Prior CHNA ImpactPriorCHNAImpactInd | OtherOtherInd | CHNA ConductedCHNAConductedYr | Take Into Account Others InputTakeIntoAccountOthersInputInd | CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd | CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd | CHNA Report Widely AvailableCHNAReportWidelyAvailableInd | Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd | Own Website URLOwnWebsiteURLTxt | Paper Copy Public InspectionPaperCopyPublicInspectionInd | Rpt Available Thru Other MethodRptAvailableThruOtherMethodInd | Implementation Strategy AdoptImplementationStrategyAdoptInd | Implementation Strategy AdptImplementationStrategyAdptYr | Strategy Posted WebsiteStrategyPostedWebsiteInd | Strategy Website URLStrategyWebsiteURLTxt | Strategy AttachedStrategyAttachedInd | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct | Asset Level CriteriaAssetLevelCriteriaInd | Medical Indigency CriteriaMedicalIndigencyCriteriaInd | Insurance Status CriteriaInsuranceStatusCriteriaInd | Explained BasisExplainedBasisInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Described InfoDescribedInfoInd | Described Suprt DocDescribedSuprtDocInd | Provided Hospital ContactProvidedHospitalContactInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | FAP Available On WebsiteFAPAvailableOnWebsiteInd | FAP Available On Website URLFAPAvailableOnWebsiteURLTxt | FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd | FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt | FAP Summary On WebsiteFAPSummaryOnWebsiteInd | FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt | FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd | FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd | FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd | Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd | Communtity Notified FAPCommuntityNotifiedFAPInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Permit No ActionsPermitNoActionsInd | Collection ActivitiesCollectionActivitiesInd | Provided Written NoticeProvidedWrittenNoticeInd | Made Effort Orally NotifyMadeEffortOrallyNotifyInd | Processed FAP ApplicationProcessedFAPApplicationInd | Made Presumptive Elig DetermMadePresumptiveEligDetermInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | Look Back Medicare PrivateLookBackMedicarePrivateInd | Look Back Medicaid Medcr PrvtLookBackMedicaidMedcrPrvtInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NEMHS - TRINITY HOSPITAL | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | false | false | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 15 | Yes (true) | Yes (true) | false | Yes (true) | Yes (X) | WWW.NEMHS.NET | Yes (X) | Yes (X) | Yes (true) | 15 | Yes (true) | WWW.NEMHS.NET | false | false | Yes (true) | Yes (X) | 100.000000000000 | 200.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | WWW.NEMHS.NET | Yes (X) | WWW.NEMHS.NET | Yes (X) | WWW.NEMHS.NET | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | false | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | Yes (X) | false | false |
| NEMHS - POPLAR COMMUNITY HOSPITAL | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | false | false | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 15 | Yes (true) | Yes (true) | false | Yes (true) | Yes (X) | WWW.NEMHS.NET | Yes (X) | Yes (X) | Yes (true) | 15 | Yes (true) | WWW.NEMHS.NET | false | false | Yes (true) | Yes (X) | 100.000000000000 | 200.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | WWW.NEMHS.NET | Yes (X) | WWW.NEMHS.NET | Yes (X) | WWW.NEMHS.NET | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | false | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (X) | Yes (X) | false | false |
Supplemental Information SupplementalInformationGrp (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 3E | THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND ARE IDENTIFIED THROUGH THE CHNA. |
| FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 5 | IN THE SPRING OF 2016, A SURVEY WAS MAILED TO A RANDOMLY CHOSEN SAMPLE OF 300 RESIDENTS IN THE PRIMARY SERVICE AREA TO SOLICIT THEIR INPUT. THE SURVEY WAS MADE AVAILABLE ONLINE THROUGH SURVEY MONKEY AND ADVERTISED THROUGH FACEBOOK AND BULLETINS POSTED AROUND WOLF POINT AND POPLAR. OF THE 300 SURVEYS SENT, 228 RESULTED IN A RESPONSE. FIVE FOCUS GROUPS WERE HELD IN WOLF POINT AND POPLAR DESIGNED TO REPRESENT VARIOUS CONSUMER GROUPS OF HEALTH CARE INCLUDING SENIOR CITIZENS, MEDICALLY UNDERSERVED, LOW-INCOME, UNDERINSURED, MINORITY CITIZENS, LOCAL COMMUNITY MEMBERS, VARIOUS MEDICAL PROVIDERS, AND AREA CEOS FROM NEIGHBORING HOSPITALS VIA TELECONFERENCING. ALSO, SIX KEY INFORMANT INTERVIEWS WHICH INCLUDED THE PUBLIC HEALTH NURSE WERE CONDUCTED ON BEHALF OF NEMHS BY THE MONTANA OFFICE OF RURAL HEALTH. |
| FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 6A | NORTHEAST MONTANA HEALTH SERVICES - POPLAR COMMUNITY HOSPITAL. |
| FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 7D | THE CHNA IS ALSO AVAILABLE AT THE PUBLIC LIBRARY. |
| FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 11 | NEMHS AND ASSOCIATES IDENTIFIED 14 NEEDS TO ADDRESS. THREE GOALS WITH STRATEGIES AND ACTIVITES WERE DEVELOPED TO ADDRESS A VARIATION OF THOSE 14 NEEDS. NEMHS AND ASSOCIATES IDENTIFIED 4 OF THOSE NEEDS THAT COULD NOT BE ADDRESSED. NEEDS TO BE ADDRESSED: 1. HEALTHY COMMUNITY INCLUDING ACCESS TO HEALTHCARE AND OTHER SERVICES, HEALTHY BEHAVIORS AND LIFESTYLES, AND STRONG FAMILY LIFE. 2. RESPONDENTS DELAYED OR DID NOT GET NEEDED HEALTHCARE SERVICES. 3. DELAYS IN RECEIVING HEALTHCARE INCLUDING TOO LONG TO WAIT FOR AN APPOINTMENT, IT COSTS TOO MUCH, AND COULD NOT GET AN APPOINTMENT. 4. HEALTHCARE WORKFORCE SHORTAGE. 5. MOST COMMUNITY MEMBERS CONSIDER THE COMMUNITY TO BE UNHEALTHY. 6. NEED FOR MORE EXERCISE WITHIN THE COMMUNITY AS 1/3 OF COMMUNITY EXERCISES 20 MINUTES OR LESS ONE TO TWO TIMES A MONTH OR LESS. 7. HEALTH CONCERNS: ALCOHOL/SUBSTANCE ABUSE, CHILD ABUSE/NEGLECT, AND DIABETES. 8. RESPONDENTS REPORTED THEY EXPERIENCED PERIODS OF DEPRESSION FOR AT LEAST THREE MONTHS. 9. NEED FOR GREATER ACCESS TO AND QUALITY MENTAL HEALTH TREATMENT. 10. LACK OF SUBSTANCE ABUSE SERVICES AND THE AMOUNT OF DRUG AND ALCOHOL ABUSE. 11. ADDRESSING CHRONIC DISEASES IN COMMUNITY SUCH AS DIABETES, OBESITY, AND HEART DISEASE. 12. NEED TO REDUCE PERCENTAGE OF DIABETICS IN ROOSEVELT COUNTY AS IT IS DOUBLE THE STATE AVERAGE AND HIGHER THAN THE NATIONAL AVERAGE. 13. NEED FOR LOCAL DENTAL, MRI, AND DERMATOLOGY SERVICES. 14. NEED FOR LOCAL PHYSICAL THERAPY SERVICES. GOALS, STRATEGIES, AND ACTIVITIES TO ADDRESS NEEDS: 1. IMPROVE ACCESS TO HEALTHCARE SERVICES IN NEMHS SERVICE AREA. STRATEGIES FOR IMPLEMENTATION: 1.1 - ENHANCE WORKFORCE DEVELOPMENT OUTREACH THROUGH PIPELINE PROGRAMS, SUCH AS MILES CITY COMMUNITY COLLEGE AND FORT PECK COMMUNITY COLLEGE NURSING PROGRAMS. DURING THE TAX YEAR, NEMHS DID ENHANCE WORKFORCE DEVELOPMENT OUTREACH THROUGH PIPELINE PROGRAMS AND ENTERED INTO A CONTRACT WITH MILES COMMUNITY COLLEGE TO OFFER PRACTICALS TO CURRENT STUDENTS IN THE MCC NURSING PROGRAM. NEMHS WILL PROVIDE TWO YEARS OF CLINICAL TRAINING TO STUDENTS IN THE PROGRAM. 1.2 - EXPAND WORKFORCE RECRUITMENT EFFORTS BY ATTENDING VARIOUS RECRUITMENT FAIRS, CONFERENCES, RESIDENCY PROGRAM "MEET AND GREETS" TO EDUCATE POTENTIAL EMPLOYEES ABOUT NEMHS. THE DIRECTOR OF NURSING HAS BEEN ATTENDING NURSING JOB FAIRS TO RECRUIT NEW GRADUATES TO COME WORK AT NEMHS. ALSO, THE TRINITY EMS DIRECTOR TEACHES CLASSES IN THE FALL TO TRAIN COMMUNITY MEMBERS IN EMERGENCY AID WITH THE GOAL TO RECRUIT MEMBERS TO EMS AFTER THE TRAINING IS COMPLETE. 1.3 - IMPROVE ACCESS TO MENTAL HEALTH SERVICES BY IDENTIFYING LOCAL MENTAL HEALTH PROGRAMS AND STAKEHOLDERS; CATALOGUE AVAILABLE RESOURCES. 2. IMPROVE COMMUNITY HEALTH AND WELLNESS IN ROOSEVELT COUNTY. STRATEGIES FOR IMPLEMENTATION: 2.1 - INCREASE HEALTH AND WELLNESS OPPORTUNITIES AND RESOURCES FOR NEMHS STAFF BY WORKING WITH THE FFCC WELLNESS PROGRAM STAFF. 2.2 - IMPROVE ACCESS TO HEALTH AND WELLNESS OPPORTUNITIES FOR NEMHS COMMUNITY BY SPONSORING/HOLDING COMMUNITY HEALTH EVENTS SUCH AS A COLOR RUN. 2.3 - DURING THE TAX YEAR, NEMHS ENTERED INTO A CONTRACT WITH THE ROOSEVELT COUNTY JAIL TO OFFER CORRECTIONAL HEALTH SERVICES TO INMATES TO PREVENT THE NEED FOR JAILORS TO TRANSPORT INMATES TO THE FACILITY. 3. IMPROVE ACCESS TO PHYSICAL THERAPY SERVICES IN ROOSEVELT COUNTY. STRATEGY FOR IMPLEMENTATION: 3.1 - ENHANCE PHYSICAL THERAPY SERVICES AVAILABLE THROUGH NEMHS BY CONDUCTING A FEASIBILITY STUDY FOR DEVELOPMENT OF PHYSICAL THERAPY SERVICES AT NEMHS - ASSESS FUNDING NEEDS AND POTENTIAL BARRIERS. THIS PROCESS BEGAN IN FY2017 BY INTERVIEWING PHYSICAL THERAPIST CANDIDATES ABOUT STARTING TO OFFER THIS SERVICE IN THE WOLF POINT AREA AND PULLING TOGETHER A COMMITTEE TO IDENTIFY THE BEST LOCATION FOR THE DEPARTMENT. FROM JULY 1, 2017 THROUGH JUNE 30, 2018, NEMHS HAD A FULL TIME PHYSICAL THERAPIST IN PLACE AT FAITH LUTHERAN HOME. 3.2 - DURING THE TAX YEAR, NEMHS EVALUATED THE FEASIBILITY OF ADDING OCCUPATIONAL THERAPY AND EXPANDING THE OUTPATIENT PHYSICAL REHABILITATION THERAPY PROGRAM. NEEDS THAT COULD NOT BE ADDRESSED: 1. STRONG FAMILY LIFE, CHILD ABUSE/NEGLECT, CRIME AND SAFE NEIGHBORHOODS, AND SAFE WALKING TRAILS/PATHS - NEMHS WORKS AND REFERS INCIDENTS TO FAMILY RESOURCES CENTER AND CHILD PROTECTIVE SERVICES BUT IS UNABLE TO PROVIDE HELP ON THE SCOPE THE COMMUNITY WANTS. 2. SURVEY RESPONDENTS DELAYED OR DID NOT RECEIVE NEEDED MEDICAL SERVICES BECAUSE IT COSTS TOO MUCH - NEMHS CURRENTLY OFFERS A SLIDING FEE SCHEDULE AND A FINANCIAL ASSISTANCE PROGRAM TO ASSIST PATIENTS WITHIN THE 200% POVERTY GUIDELINES. AGING SERVICES HAS A REPRESENTATIVE AVAILABLE AT NEMHS TO PROVIDE ASSISTANCE WITH THE INSURANCE EXCHANGE AND BOTH INDIAN HEALTH AND NEMHS HAVE REPRESENTATIVES AVAILABLE TO ASSIST WITH MEDICAID APPLICATIONS. 3. SURVEY RESPONDENTS INDICATED A DESIRE FOR BETTER ACCESS TO DENTAL SERVICES - HP/DP PROVIDES DENTAL SERVICES FOR THOSE TRIBAL COMMUNITY MEMBERS. RECRUITING ADDITIONAL DENTAL PROVIDERS WOULD NOT BE FEASIBLE FOR NEMHS DUE TO FINANCIAL, STAFFING, AND LOGISTICAL BARRIERS. 4. MRI AND DERMATOLOGY WERE TWO SPECIALTY SERVICES IDENTIFIED AS A NEEDED SERVICE BY SURVEY RESPONDENTS - NEMHS HAS BEEN WORKING ON EXPANDING BOTH MRI AND DERMATOLOGY SERVICES. MRI HAS PROVEN TO BE TOO RESOURCE AND STAFF INTENSIVE FOR OUR FACILITY AT THIS TIME. ADDITIONALLY, DERMATOLOGY VIA TELEMEDICINE HAS BEEN ATTEMPTED BUT THUS FAR WE HAVE BEEN UNSUCCESSFUL IN SECURING A DERMATOLOGIST TO PROVIDE SERVICES. |
| FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 3E | THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND ARE IDENTIFIED THROUGH THE CHNA. |
| FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 5 | IN THE SPRING OF 2016, A SURVEY WAS MAILED TO A RANDOMLY CHOSEN SAMPLE OF 300 RESIDENTS IN THE PRIMARY SERVICE AREA TO SOLICIT THEIR INPUT. THE SURVEY WAS MADE AVAILABLE ONLINE THROUGH SURVEY MONKEY AND ADVERTISED THROUGH FACEBOOK AND BULLETINS POSTED AROUND WOLF POINT AND POPLAR. OF THE 300 SURVEYS SENT, 228 RESULTED IN A RESPONSE. FIVE FOCUS GROUPS WERE HELD IN WOLF POINT AND POPLAR DESIGNED TO REPRESENT VARIOUS CONSUMER GROUPS OF HEALTH CARE INCLUDING SENIOR CITIZENS, MEDICALLY UNDERSERVED, LOW-INCOME, UNDERINSURED, MINORITY CITIZENS, LOCAL COMMUNITY MEMBERS, VARIOUS MEDICAL PROVIDERS, AND AREA CEOS FROM NEIGHBORING HOSPITALS VIA TELECONFERENCING. ALSO, SIX KEY INFORMANT INTERVIEWS WHICH INCLUDED THE PUBLIC HEALTH NURSE WERE CONDUCTED ON BEHALF OF NEMHS BY THE MONTANA OFFICE OF RURAL HEALTH. |
| FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 6A | NORTHEAST MONTANA HEALTH SERVICES - TRINITY HOSPITAL |
| FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 7D | THE CHNA IS ALSO AVAILABLE AT THE PUBLIC LIBRARY. |
| FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 11 | NEMHS AND ASSOCIATES IDENTIFIED 14 NEEDS TO ADDRESS. THREE GOALS WITH STRATEGIES AND ACTIVITES WERE DEVELOPED TO ADDRESS A VARIATION OF THOSE 14 NEEDS. NEMHS AND ASSOCIATES IDENTIFIED 4 OF THOSE NEEDS THAT COULD NOT BE ADDRESSED. NEEDS TO BE ADDRESSED: 1. HEALTHY COMMUNITY INCLUDING ACCESS TO HEALTHCARE AND OTHER SERVICES, HEALTHY BEHAVIORS AND LIFESTYLES, AND STRONG FAMILY LIFE. 2. RESPONDENTS DELAYED OR DID NOT GET NEEDED HEALTHCARE SERVICES. 3. DELAYS IN RECEIVING HEALTHCARE INCLUDING TOO LONG TO WAIT FOR AN APPOINTMENT, IT COSTS TOO MUCH, AND COULD NOT GET AN APPOINTMENT. 4. HEALTHCARE WORKFORCE SHORTAGE. 5. MOST COMMUNITY MEMBERS CONSIDER THE COMMUNITY TO BE UNHEALTHY. 6. NEED FOR MORE EXERCISE WITHIN THE COMMUNITY AS 1/3 OF COMMUNITY EXERCISES 20 MINUTES OR LESS ONE TO TWO TIMES A MONTH OR LESS. 7. HEALTH CONCERNS: ALCOHOL/SUBSTANCE ABUSE, CHILD ABUSE/NEGLECT, AND DIABETES. 8. RESPONDENTS REPORTED THEY EXPERIENCED PERIODS OF DEPRESSION FOR AT LEAST THREE MONTHS. 9. NEED FOR GREATER ACCESS TO AND QUALITY OF MENTAL HEALTH TREATMENT. 10. LACK OF SUBSTANCE ABUSE SERVICES AND THE AMOUNT OF DRUG AND ALCOHOL ABUSE. 11. ADDRESSING CHRONIC DISEASES IN COMMUNITY SUCH AS DIABETES, OBESITY, AND HEART DISEASE. 12. NEED TO REDUCE PERCENTAGE OF DIABETICS IN ROOSEVELT COUNTY AS IT IS DOUBLE THE STATE AVERAGE AND HIGHER THAN THE NATIONAL AVERAGE. 13. NEED FOR LOCAL DENTAL, MRI, AND DERMATOLOGY SERVICES. 14. NEED FOR LOCAL PHYSICAL THERAPY SERVICES. GOALS, STRATEGIES, AND ACTIVITIES TO ADDRESS NEEDS: 1. IMPROVE ACCESS TO HEALTHCARE SERVICES IN NEMHS SERVICE AREA. STRATEGIES FOR IMPLEMENTATION: 1.1 - ENHANCE WORKFORCE DEVELOPMENT OUTREACH THROUGH PIPELINE PROGRAMS, SUCH AS MILES CITY COMMUNITY COLLEGE AND FORT PECK COMMUNITY COLLEGE NURSING PROGRAMS. DURING THE TAX YEAR, NEMHS DID ENHANCE WORKFORCE DEVELOPMENT OUTREACH THROUGH PIPELINE PROGRAMS AND ENTERED INTO A CONTRACT WITH MILES COMMUNITY COLLEGE TO OFFER PRACTICALS TO CURRENT STUDENTS IN THE MCC NURSING PROGRAM. NEMHS WILL PROVIDE TWO YEARS OF CLINICAL TRAINING TO STUDENTS IN THE PROGRAM. 1.2 - EXPAND WORKFORCE RECRUITMENT EFFORTS BY ATTENDING VARIOUS RECRUITMENT FAIRS, CONFERENCES, RESIDENCY PROGRAM "MEET AND GREETS" TO EDUCATE POTENTIAL EMPLOYEES ABOUT NEMHS. THE DIRECTOR OF NURSING HAS BEEN ATTENDING NURSING JOB FAIRS TO RECRUIT NEW GRADUATES TO COME WORK AT NEMHS. 1.3 - IMPROVE ACCESS TO MENTAL HEALTH SERVICES BY IDENTIFYING LOCAL MENTAL HEALTH PROGRAMS AND STAKEHOLDERS; CATALOGUE AVAILABLE RESOURCES. 2. IMPROVE COMMUNITY HEALTH AND WELLNESS IN ROOSEVELT COUNTY. STRATEGIES FOR IMPLEMENTATION: 2.1 - INCREASE HEALTH AND WELLNESS OPPORTUNITES AND RESOURCES FOR NEMHS STAFF BY WORKING WITH THE FFCC WELLNESS PROGRAM STAFF. 2.2 - IMPROVE ACCESS TO HEALTH AND WELLNESS OPPORTUNITIES FOR NEMHS COMMUNITY BY SPONSORING/HOLDING COMMUNITY HEALTH EVENTS SUCH AS A COLOR RUN. POPLAR COMMUNITY HOSPITAL HOLDS A COLOR RUN IN JUNE TO ADVOCATE EXERCISE TO CHILDREN AND THEIR FAMILY MEMBERS. 2.3 - DURING THE TAX YEAR, NEMHS ENTERED INTO A CONTRACT WITH THE ROOSEVELT COUNTY JAIL TO OFFER CORRECTIONAL HEALTH SERVICES TO INMATES TO PREVENT THE NEED FOR JAILORS TO TRANSPORT INMATES TO THE FACLITY. 3. IMPROVE ACCESS TO PHYSICAL THERAPY SERVICES IN ROOSEVELT COUNTY. STRATEGY FOR IMPLEMENTATION: 3.1 - ENHANCE PHYSICAL THERAPY SERVICES AVAILABLE THROUGH NEMHS BY CONDUCTING A FEASIBILITY STUDY FOR DEVELOPMENT OF PHYSICAL THERAPY SERVICES AT NEMHS - ACCESS FUNDING NEEDS AND POTENTIAL BARRIERS. THIS PROCESS BEGAN IN FY2017 BY INTERVIEWING PHYSICAL THERAPIST CANDIDATES ABOUT STARTING TO OFFER THIS SERVICE AT THE POPLAR HOSPITAL FOR THE SWING BED UNIT AND OTHER COMMUNITY MEMBERS. FROM DECEMBER 1, 2017 THROUGH JUNE 30, 2018, POPLAR HOSPITAL HAD A PHYSICAL THERAPIST IN THE FACILITY FOUR TIMES A WEEK FOR THREE HOURS TO PROVIDE SERVICES TO SWING BED PATIENTS. 3.2 - DURING THE TAX YEAR, NEMHS EVALUATED THE FEASIBILITY OF ADDING OCCUPATIONAL THERAPY AND EXPANDING THE OUTPATIENT PHYSICAL REHABILITATION THERAPY PROGRAM. NEEDS THAT COULD NOT BE ADDRESSED: 1. STRONG FAMILY LIFE, CHILD ABUSE/NEGLECT, CRIME AND SAFE NEIGHBORHOODS, AND SAFE WALKING TRAILS/PATHS - NEMHS WORKS AND REFERS INCIDENTS TO FAMILY RESOURCES CENTER AND CHILD PROTECTIVE SERVICES BUT IS UNABLE TO PROVIDE HELP ON THE SCOPE THE COMMUNITY WANTS. 2. SURVEY RESPONDENTS DELAYED OR DID NOT RECEIVE NEEDED MEDICAL SERVICES BECAUSE IT COSTS TOO MUCH - NEMHS CURRENTLY OFFERS A SLIDING FEE SCHEDULE AND A FINANCIAL ASSISTANCE PROGRAM TO ASSIST PATIENTS WITHIN THE 200% POVERTY GUIDELINES. AGING SERVICES HAS A REPRESENTATIVE AVAILABLE AT NEMHS TO PROVIDE ASSISTANCE WITH THE INSURANCE EXCHANGE AND BOTH INDIAN HEALTH AND NEMHS HAVE REPRESENTATIVES AVAILABLE TO ASSIST WITH MEDICAID APPLICATIONS. 3. SURVEY RESPONDENTS INDICATED A DESIRE FOR BETTER ACCESS TO DENTAL SERVICES - HP/DP PROVIDES DENTAL SERVICES FOR THOSE TRIBAL COMMUNITY MEMBERS. RECRUITING ADDITIONAL DENTAL PROVIDERS WOULD NOT BE FEASIBLE FOR NEMHS DUE TO FINANCIAL, STAFFING, AND LOGISTICAL BARRIERS. 4. MRI AND DERMATOLOGY WERE TWO SPECIALTY SERVICES IDENTIFIED AS A NEEDED SERVICE BY SURVEY RESPONDENTS - NEMHS HAS BEEN WORKING ON EXPANDING BOTH MRI AND DERMATOLOGY SERVICES. MRI HAS PROVEN TO BE TOO RESOURCE AND STAFF INTENSIVE FOR OUR FACILITY AT THIS TIME. ADDITIONALLY, DERMATOLOGY VIA TELEMEDICINE HAS BEEN ATTEMPTED BUT THUS FAR WE HAVE BEEN UNSUCCESSFUL IN SECURING A DERMATOLOGIST TO PROVIDE SERVICES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| WOLF POINT CLINIC ASSOCIATION | ||||
| 301 KNAPP STREET | WOLF POINT | MT | 59201 | RURAL HEALTH CLINIC |
| RIVERSIDE FAMILY CLINIC | ||||
| PO BOX 629 | POPLAR | MT | 59255 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION | THE COST OF BAD DEBT REMOVED FROM THE COMMUNITY BENEFIT EXPENSE IN COLUMN C IS 123,544. PHYSICIAN CLINIC COSTS ARE NOT INCLUDED IN SUBSIDIZED HEALTH CARE SERVICES. |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | USED ADJUSTED COST TO CHARGE RATIOS FOR PATIENT CARE FROM THE MEDICARE COST REPORT, ADJUSTED FOR BED TAX, COMMUNITY BENEFIT, LEADERSHIP DEVELOPMENT/TRAINING, AND WORKFORCE DEVELOPMENT EXPENSE. BAD DEBT EXPENSE AND FINANCIAL ASSISTANCE ARE ALREADY EXCLUDED FROM THE MEDICARE COST REPORT. |
| PART II - COMMUNITY BUILDING ACTIVITIES | THE STAFF AT NEMHS DESIGNATES TIME FOR THE DEVELOPMENT OF COMMUNITY HEALTH PROGRAMS AND PARTNERSHIPS. THESE ACTIVITIES/INITIATIVES OFTEN TARGET ENVIRONMENTAL STRATEGIES, ECONOMIC DEVELOPMENT AND LEADERSHIP, ADVOCACY AND SUPPORT THAT INDIRECTLY AFFECT THE HEALTH OF THE COMMUNITY. PART II, LINE 5: NEMHS SPENT 2,300 ON LEADERSHIP DEVELOPMENT AND TRAINING. THE FACILITY BROUGHT IN A LEADERSHIP SPEAKER FOR A ONE DAY TRAINING; TRAINING WAS OPEN TO MEMBERS OF THE COMMUNITY. PART II, LINE 8: NEMHS IS LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREA AND SPENT 63,362 TO RECRUIT PHYSICIANS AND OTHER HEALTH PROFESSIONALS NEEDED IN THE COMMUNITY. THE COST IS COMPRISED OF PAYMENTS TO RECRUITING FIRMS, NEWSPAPER AND PERIODICALS ADVERTISING, LEGAL FEES FOR FOREIGN PROFESSIONALS, AND TRAVEL AND LODGING FOR SITE VISITS. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE ORGANIZATION'S PATIENT CARE COST TO CHARGE RATIO, AFTER ELIMINATING BAD DEBT, FINANCIAL ASSISTANCE, BED TAX, AND COMMUNITY BENEFIT EXPENSE, IS APPLIED TO GROSS BAD DEBT CHARGES TO ARRIVE AT THE COST OF BAD DEBT. DISCOUNTS REDUCE REVENUE AND ARE NOT RECORDED AS BAD DEBT. PAYMENTS RECEIVED ON PREVIOUSLY WRITTEN OFF ACCOUNTS ARE RECORDED AS RECOVERIES OF BAD DEBT WHICH REDUCE BAD DEBT EXPENSE. NONE OF THE BAD DEBT IS CONSIDERED ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE. BAD DEBTS ARE AN INEVITABLE RESULT OF OPERATING A NON-PROFIT HOSPITAL. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | THE BAD DEBT EXPENSE FOOTNOTE IS ON PAGE 7 OF THE AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8 - MEDICARE EXPLANATION | THERE IS NO MEDICARE SHORTFALL. MEDICARE COSTS ON PART III, LINE 6 ARE DIRECTLY FROM THE MEDICARE COST REPORT, PLUS AMBULANCE MEDICARE COSTS BASED ON THE AMBULANCE COST-TO-CHARGE RATIO ON THE COST REPORT. MEDICARE REVENUE ON PART III, LINE 5 IS DIRECTLY FROM THE MEDICARE COST REPORT, PLUS AMBULANCE MEDICARE REVENUE FROM THE MEDICARE PS&R REPORT. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | THE ORGANIZATION USES A SLIDING SCALE BASED ON FEDERAL POVERTY GUIDELINES, AND ALSO A MEDICALLY INDIGENT TEST REGARDLESS OF INCOME, TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. THE ORGANIZATION DOES NOT ATTEMPT TO COLLECT CHARGES APPROVED AS FINANCIAL ASSISTANCE UNLESS THE PATIENT QUALIFIES FOR DISCOUNTED CARE AND THEN DEFAULTS ON THE PAYMENT PLAN ON THE BALANCE OF THE ACCOUNT. THIS IS A SPECIFIC POLICY FOR PATIENTS QUALIFYING FOR FREE OR DISCOUNTED CARE. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | PURSUANT TO THE PROVISIONS OF THE AFFORDABLE CARE ACT, NEMHS ADOPTED A COMMUNITY HEALTH NEEDS ASSESSMENT PLAN AND AN IMPLEMENTATION STRATEGY DURING FISCAL YEARS 2016 AND 2013 (TAX YEARS 2015 AND 2012). THESE ARE A CONTINUATION AND EXPANSION OF WHAT WE ARE ALREADY DOING TO BETTER SERVE OUR COMMUNITY. WE ARE DILIGENTLY TRACKING LOCAL TRENDS IN HEALTH CARE NEEDS THROUGH AN CUSTOM SURVEY SOLUTIONS PATIENT SATISFACTION SURVEY GIVEN TO ALL INPATIENTS AS WELL AS THE USE OF OUR INTERNAL BALANCED SCORE CARD. A SELECTED TEAM OF MANAGERS MEET QUARTERLY TO DISCUSS OUTCOMES FROM OUR SURVEY REPORTS AND BALANCED SCORE CARD FINDINGS. HERE IS ONE OF OUR PAST FINDINGS: PATIENTS EXPRESSED THEIR DISSATISFACTION WITH HAVING TO TRAVEL OVER 50 MILES TO RECEIVE PHYSICAL THERAPY SERVICES. SOME PATIENTS EXPRESSED FRUSTRATION WITH HAVING TO PLAN EXTENDED STAYS IN BILLINGS AFTER MAJOR SURGERIES THAT REQUIRE PHYSICAL THERAPY FOLLOWUP BECAUSE THE SERVICES WERE NOT OFFERED LOCALLY. A GROUP OF MANAGERS WAS BROUGHT TOGETHER TO PLAN A FEASIBILITY STUDY IN BRINGING PHYSICAL THERAPY SERVICES TO NEMHS, AND SEVERAL PLANS WERE MADE. A PHYSICAL THERAPIST FROM A NEIGHBORING COMMUNITY WAS ABLE TO MAKE A COMMITMENT TO COME ON AS AN EMPLOYEE FOR A YEAR. AS THERE WAS NO SPACE AVAILABLE IN A HOSPITAL WING, A SPACE WAS EMPTIED AND DESIGNATED FOR PHYSICAL THERAPY IN THE LONG TERM CARE CENTER. PHYSICAL THERAPY SERVICES WAS TO BE OFFERED FOR BOTH INPATIENTS AND OUTPATIENTS WITH OUTSIDE REFERRALS BEING ACCEPTED FOUR DAYS A WEEK. THIS WAS TO BE A TEST TO MAKE SURE PHYSICAL THERAPY SERVICES COULD BE FEASIBLY OFFERED IN THE LONG TERM AT NEMHS. NEMHS MADE THE INVESTMENT TO DELIVER THE SERVICES NEEDED IN THE COMMUNITY. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | NORTHEAST MONTANA HEALTH SERVICES EMPLOYS TWO SOCIAL SERVICE EMPLOYEES TO ASSIST PATIENTS WITH THEIR FINANICAL NEEDS AND OPTIONS. COMMUNITY ADVERTISEMENT IS USED TO EDUCATE PATIENTS AND SUPPORT IS GIVEN ON A ONE-ON-ONE BASIS TO ASSIST COMMUNITY MEMBERS. PATIENTS ARE NOTIFIED BY THE BILLING DEPARTMENT OF OUR POLICY FOR FINANCIAL ASSISTANCE AND ARE SENT A SIMPLE APPLICATION. OUR WEBSITE PROVIDES DETAILS OF OUR FINANCIAL ASSISTANCE POLICY AND THE FINANCIAL ASSISTANCE AVAILABLE. THE PATIENT INVOICES INCLUDE A STATEMENT ABOUT THE FINANCIAL ASSISTANCE POLICY AND HOW TO FIND FURTHER INFORMATION. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | THE ORGANIZATION OPERATES ON THE FORT PECK RESERVATION. GEOGRAPHICALLY THIS IS A REMOTE LOCATION WHERE ACCESS TO OTHER HEALTH FACILITIES IS AT LEAST 50 MILES AWAY. WITH SEVERE WEATHER CONDITIONS OFTEN RESULTING IN BLIZZARDS AND IMPASSABLE ROADS, NORTHEAST MONTANA HEALTH SERVICES IS THE FRONTLINE OF CARE FOR THE COMMUNITY. THE POPULATION OF SIOUX AND ASSINIBOINE TRIBAL MEMBERS MAKE UP OUR HIGHEST CONCENTRATION OF PATIENTS WITH DISPARITIES THAT INCLUDE CULTURAL BARRIERS, LOW HOUSEHOLD INCOME, HIGH UNEMPLOYMENT RATES, HIGHER RATES OF TOBACCO, ALCOHOL AND ILLEGAL DRUG USE, AS WELL AS HIGHER THAN AVERAGE RATES OF HEART DISEASE, DIABETES, FETAL ALCOHOL SYNDROME, AND SUICIDE. AS WE CONTINUE OUR EFFORTS TO SERVE THE PUBLIC THROUGH HEALTHCARE AND EDUCATION, THERE IS PROGRESS BEING MADE TO IMPROVE THE QUALITY OF LIFE FOR COMMUNITY MEMBERS. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | NORTHEAST MONTANA HEALTH SERVICES IS GOVERNED BY A VOLUNTARY BOARD OF COMMUNITY MEMBERS REPRESENTING THE GEOGRAPHICAL AREAS OF OUR PRIMARY SERVICE AREA. OUR HOSPITALS PROVIDE 24/7 EMERGENCY SERVICE COVERAGE TO TREAT PATIENTS, INCLUDING THOSE THAT ARE UNABLE TO PAY. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | TWO AFFILIATED RURAL HEALTH CLINICS, WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC, PROVIDE PROFESSIONAL PHYSICIAN AND OTHER PROVIDER SERVICES WHILE NORTHEAST MONTANA HEALTH SERVICES PROVIDES INPATIENT AND OUTPATIENT HOSPITAL SERVICES AND SKILLED NURSING SERVICES. THE TWO RURAL HEALTH CLINICS ARE OPERATED, AND SUBSIDIZED IF NEEDED, BY NORTHEAST MONTANA HEALTH SERVICES. |
| ADDITIONAL INFORMATION | PART V: WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC ARE RURAL HEALTH CLINICS THAT ARE OPERATED AND SUBSIDIZED BY NORTHEAST MONTANA HEALTH SERVICES. THEIR REVENUE AND EXPENSES ARE NOT INCLUDED ON NORTHEAST MONTANA HEALTH SERVICES' FORM 990. PART I, LINE 7I: NEMHS CONTRIBUTED 8,400 TO RURAL HEALTH DEVELOPMENT, INC. TO SUPPORT AND INFLUENCE THE EVOLUTION OF HEALTHCARE ORGANIZATION BY PROVIDING ADDITIONAL FUNDING FOR SMALLER FACILITIES IN CENTRAL AND EASTERN MONTANA FOR CAPITAL PURCHASES, QUALITY IMPROVEMENTS, AND CREATING COST SAVINGS AND OPERATIONAL EFFICIENCIES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|---|
| MARK ZILKOSKI MD | |||||||
| MEDICAL STAFF REP | $237,870 | $103,322 | $341,192 | ||||
| MARGARET NORGAARD | |||||||
| CEO | $163,998 | $2,763 | $21,996 | $188,757 | |||
| RICHARD GOERTZ | |||||||
| CFO | $161,148 | $646 | $24,012 | $185,806 | |||
| VICKI HOUSTON | |||||||
| RN | $170,881 | $1,282 | $8,279 | $180,442 | |||
| HANZ ARNSTON | |||||||
| RN | $143,863 | $1,079 | $8,279 | $153,221 | |||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 4 | MARK ZILKOSKI, MD 0 100,943 0 |
| SCHEDULE J, PART III | THE COMPENSATION OF MARK ZILKOSKI, MD IS AN EXPENSE OF WOLF POINT CLINIC ASSOCIATION, A RELATED PARTY. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MT FACILITY FINANCE AUTHORITY BONDS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 364615155 | BondIssuerEIN |
| Bond Issued | 2017-01-31 | BondIssuedDt |
| Issue Price | $9,820,000 | IssuePriceAmt |
| Purpose | REFUNDING OF 2007B REVENUE BONDS | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $9,820,000 | TotalProceedsAmt |
| In Reserve Fund | $794,798 | InReserveFundAmt |
| Refunding Escrow | $8,827,353 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $196,400 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $1,449 | OtherSpentProceedsAmt |
| Substantial Completion | 2017 | SubstantialCompletionYr |
| Current Refunding | Yes (true) | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | false | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | false | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS REVIEWED AND APPROVED BY THE CEO AND CFO AND IS DISTRIBUTED TO THE GOVERNING BOARD FOR REVIEW PRIOR TO BEING FILED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE MEMBERS OF THE GOVERNING BOARD SIGN CONFLICT OF INTEREST STATEMENTS ANNUALLY IN WHICH THEY ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST. IF A POTENTIAL CONFLICT DOES EXIST, THE BOARD CHAIRMAN WILL REMIND MEMBERS AND ASK THEM TO ABSTAIN FROM VOTING. THESE CONFLICTS ARE DULY NOTED IN THE MINUTES. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD APPROVES THE WAGES OF THE CEO AND OTHER TOP MANAGEMENT OFFICIALS IN THE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE CEO APPROVES THE WAGES OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE AVAILABLE FROM CFO UPON REQUEST. |
| FORM 990, PART VII | THE MEDICAL STAFF REPRESENTATIVE ON THE GOVERNING BOARD, MARK ZILKOSKI, M.D., IS EMPLOYED BY WOLF POINT CLINIC ASSOCIATION, A RELATED PARTY, AS A FULL TIME PHYSICIAN WHICH IS INCLUDED AT 40 HOURS PER WEEK. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES & LOCUMS 1,800,567 0 0 REFERENCE LAB CONTRACT SERVIC 0 2,319,923 0 CONTRACT NURSING STAFF 803,166 0 0 CONTRACT LABORATORY STAFF 349,037 0 0 TOTAL 2,952,770 2,319,923 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| RIVERSIDE FAMILY CLINIC | |||||||||||
| PO BOX 629 | POPLAR | MT | 59255 | 810474760 | CLINIC | MT | 501C3 | 3 | NEMHS | Yes (true) | |
| WOLF POINT CLINIC ASSOCIATION | |||||||||||
| 301 KNAPP STREET | WOLF POINT | MT | 59201 | 810386812 | CLINIC | MT | 501C3 | 3 | NEMHS | Yes (true) | |
| NEMHS CHARITABLE FOUNDATION INC | |||||||||||
| PO BOX 341 | POPLAR | MT | 59255 | 383732814 | SUPPORT | MT | 501C3 | 7 | false | N/A | |
| NE MT STAT AIR AMB COOP | |||||||||||
| 519 PLEASANT STREET | MILES CITY | MT | 59301 | 204748673 | AIR AMBUL | MT | 501C3 | 12B | false | N/A | |
| FAITH LUTHERAN HOME FOUNDATION INC | |||||||||||
| 1000 6TH AVE N | WOLF POINT | MT | 59201 | 810483586 | SUPPORT | MT | 501C3 | PF | false | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| NEMHS CHARITABLE FOUNDATION | ||
| C | $25,189 | CASH GIFTS |
| NEMHS CHARITABLE FOUNDATION | ||
| O | $60,606 | DIRECT EXPENSE |
| FAITH LUTHERAN HOME FOUNDATION | ||
| C | $8,897 | CASH GIFTS |
| RIVERSIDE FAMILY CLINIC | ||
| S | $618,780 | DECREASE IN RECEIVABLE |
| WOLF POINT CLINIC ASSOCIATION | ||
| R | $101,761 | INCREASE IN RECEIVABLE |