2019-05-10T11:39:27-05:00 2018-06-30 830332861 KOERWITZ MICHEL WRIGHT & ASSOC PC PO BOX 1362 THERMOPOLIS WY 82443 990 2017-07-01 836000182 HOT SPRINGS COUNTY HOSPITAL DIST HOTS 3078643121 150 E ARAPAHOE STREET THERMOPOLIS WY 82443 MARGIE MOLITOR SEE STATEMENT 2 CEO 3078643121 2019-05-06 MICHAEL J WRIGHT P00488529 3078643173 2019-05-10 167.68.16.49 2019-05-10 11:39:27 CD P 73FEBA7905AB37EF9EE18DDCE3A87F8B099E9EBF AFB5F2223C4B292A982AB18322EFE325887FE94D 2017 2019-02-21 02:37:17Z HSC MEMORIAL HOSPITAL MARGIE MOLITOR SEE STATEMENT 2 150 E ARAPAHOE ST THERMOPOLIS WY 82443 21016151 false X WWW.HSCMH.ORG X HOSP. DIST. 1944 WY ACUTE CARE HOSPITAL 5 5 171 0 336392 566435 15927260 19387622 3242 2791 -1725 1040073 16265169 20996921 0 0 6740505 9081797 0 0 9666619 10632353 16407124 19714150 -141955 1282771 11912282 13860563 2987048 3652558 8925234 10208005 X ACUTE CARE HOSPITAL false false 15375385 HOT SPRINGS COUNTY MEMORIAL HOSPITAL, A NOT FOR PROFIT, COMMUNITY HOSPITAL, PROVIDES COMPASSIONATE MEDICAL CARE FOR ALL, REGARDLESS OF THEIR ABILITY TO PAY. HSCMH OFFERS 24/7 EMERGENCY CARE (2,025 VISITS), INPATIENT SERVICES (915 PATIENT DAYS), OUTPATIENT SERVICES (14,374 VISITS), BIG HORN CLINIC RURAL HEALTH SERVICES (4,443 VISITS), AND RED ROCK FAMILY PRACTICE (6,931 VISITS). THE HOSPITAL HAS A FINANCIAL ASSISTANCE PROGRAM UNDER WHICH SERVICES ARE PROVIDED FOR FREE OR AT A REDUCED RATE. CHARITY CARE AWARDED UNDER THE FINANCIAL ASSISTANCE PROGRAM TOTALED 602,772. THE COST OF CHARITY CARE FOR THE YEAR ENDED JUNE 30, 2018 BASED ON DIRECT AND INDIRECT COST OF PROVIDING CHARITY CARE SERVICES WAS 390,529. MANY EMPLOYEES ARE TEACHERS IN THE EDUCATION PROGRAMS OPEN TO THE PUBLIC SUCH AS CERTIFIED NURSING ASSISTANT AND CARDIOPULMONARY RESUSCITATION. EMPLOYEES PROVIDE PHLEBOTOMY SERVICES DURING THE THERMOPOLIS HEALTH FAIR. AN AGREEMENT WITH THE UNIVERSITY OF WYOMING ENCOURAGES NURSING, PHARMACY, AND SOCIAL SERVICES STUDENTS TO INTERN AT HSCMH. REDUCED MAMMOGRAPHY AND BONE DENSITY TESTS ARE OFFERED OCTOBER-DECEMBER. HEALTH INFORMATION LINKS ARE AVAILABLE ON THE HSCMH WEBSITE. USE OF PORTABLE OXYGEN CONCENTRATORS ARE FREE THROUGH CARDIOPULMONARY SERVICES FOR THOSE TRAVELING. COMFORT CARTS AND FREE MEALS ARE AVAILABLE FOR FAMILIES DURING STRESSFUL CONDITIONS. SNACKS ARE OFFERED TO PATIENTS TWICE A DAY. BIG HORN CLINIC, HSCMH'S RURAL FAMILY PRACTICE CLINIC, PROVIDES REDUCED OR FREE EXAMS FOR SCHOOL ATHLETICS, MEDICINE ASSISTANCE, BLOOD PRESSURE SCREENING AND COMMUNITY EDUCATION SEMINARS. HSCMH OFFERS SCHOLARSHIPS TO QUALIFYING EMPLOYEES WANTING TO ADVANCE THEIR EDUCATION TO THE BETTERMENT OF THE HOSPITAL AND COMMUNITY. COMMUNITY RESOURCE TRAINING FOR HIGH SCHOOL STUDENTS AND WWAMI (WASHINGTON, WYOMING, ALASKA MONTANA, IDAHO)MEDICAL EDUCATION PROGRAM, WHICH PROMOTES MEDICAL EDUCATION IN WESTERN STATES, ARE TWO LONG-TIME PROGRAMS IN WHICH HSCMH PARTICIPATES. 15375385 true false false false false false false false false false true false false false true false true false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false true 73 0 true 171 true false false false false false false X 5 5 false true false false false false false true true false false true true true true true true true true false X SHELLY LARSON 3078643121 150 E ARAPAHOE ST THERMOPOLIS WY 824432402 BILL WILLIAMS CHAIRMAN 2.00 X X 0 0 0 DAN HERDT SEC/TREAS 2.00 X X 0 0 0 HEATH OVERFIELD VICE CHAIRMA 2.00 X X 0 0 0 DAVID KOERWITZ DIRECTOR 2.00 X 0 0 0 MELISSA JOHNSON DIRECTOR 2.00 X 0 0 0 SHELLY LARSON CFO 40.00 X 94347 0 4484 MARGIE MOLITOR SEE STATEMENT 2 CEO 40.00 X 0 0 0 CHRISTOPHER PARIS CRNA 40.00 X 182049 0 7936 KEVIN RYAN CRNA 40.00 X 173088 0 6546 BRIDGET TRUEMPLER RN 40.00 X 126647 0 0 KRISTI PHILLIPS-BONNELL PA 40.00 X 117609 0 4761 RANDY JONES PHARMACIST 40.00 X 119891 0 0 ROXANNE ARNETT RN 40.00 X 103506 0 0 917137 23727 6 true true false RED ROCK FAMILY PRACTICE 120 N C STREET THERMOPOLIS WY 82443 PHYS/OP SVCS 773052 HEALTHTECH MGT SER (SEE STATEMENT 3) 5110 MARYLAND WAY STE 2 BRENTWOOD TN 37027 MNGMT/CONTRACT 659831 BILLINGS CLINIC 1020 N 27TH ST BILLINGS MT 59101 IT MAIN/LAB SVC 307439 MORTIMORE AMBULANCE 620 ARAPAHOE ST THERMOPOLIS WY 82443 AMBULANCE SRVS 274420 JASON BROWN 3305 RIVERTON DR RIVERTON WY 82501 DIAGNOSTIC SVCS 233433 6 566435 566435 PATIENT SERVICE REVENUE 18837104 18837104 OTHER OPERATING REVENUE 550518 550518 19387622 2791 2791 35067 19230 15837 15837 15837 SPECIAL PURPOSE TAX 1024236 1024236 1024236 20996921 20430486 X 7438028 6316083 1121945 119336 35403 83933 944717 191906 752811 579716 113383 466333 577117 577117 102873 102873 28600 28600 3915796 3637514 278282 3318472 3184313 134159 926501 686752 239749 130123 94773 35350 58812 58812 1091922 928134 163788 141416 20137 121279 DUES & SUBSCRIPTIONS 232509 65528 166981 RECRUITMENT 92254 85401 6853 LICENSE FEES 15958 16058 -100 19714150 15375385 4338765 0 2541650 1181513 369904 1098777 2570612 3704590 732789 637835 137892 181235 22856517 16462850 5559435 6393667 662946 11912282 13860563 1538454 2030130 68375 23803 1380219 1598625 2987048 3652558 X 8842085 9130131 83149 1077874 8925234 10208005 11912282 13860563 1282771 X false true X true false X 343520 343520 8467230 6021460 2445770 14045767 10441390 3604377 6393667 LONG TERM NOTES PAYABLE 1598625 1598625 20996921 20996921 20996921 19714150 19714150 19714150 true true true X true X true true true false true true 401506 401506 0.02040 1530352 991932 538420 0.02730 1931858 991932 939926 0.04770 174463 42466 131997 0.00670 2453801 2082958 370843 0.01880 2628264 2125424 502840 0.02550 4560122 3117356 1442766 0.07320 false 1294040 388212 8969912 9027473 -57561 true true HEALTHTECH MGMT SRV MANAGEMENT 1 1 HOT SPRINGS COUNTY HOSPITAL DISTRIC 150 E ARAPAHOE THERMOPOLIS WY 82443 X HOT SPRINGS COUNTY HOSPITAL DISTRIC 1 false false true X X X X X X X X X X 16 true false true true X WWW.HSCMH.ORG X true 17 true WWW.HSCMH.ORG false false true X 100.000000000000 300.000000000000 X X X true true X X X true X WWW.HSCMH.ORG X WWW.HSCMH.ORG X WWW.HSCMH.ORG X X X X X X true X false X X X true X false false FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 5 FACILITY 1-PART V, LINE 5 & 6(B) HOSPITAL REPRESENTATIVES, JOHN GIBBEL, MARKETING, AND ROXANNE ARNETTE, PATIENT CARE DIRECTOR,MET WITH COMMUNITY REPRESENTATIVES AS FOLLOWS: BILL MALLOY (FORMER MAYOR OF THERMOPOLIS), JANE NORSKOG (THE H.O.P.E. AGENCY, A NON-PROFIT ORGANIZATION THAT PROVIDES SERVICES TO VICTIMS OF DOMESTIC VIOLENCE, TEEN DATING VIOLENCE, SEXUAL ASSAULT AND STALKING IN HOT SPRINGS COUNTY), MARIE MCDOUGAL, RN & BRENNA HUCKFELDT, RN BSN, CLC (HOT SPRINGS COUNTY PUBLIC HEALTH NURSING SERVICES), FRANK ROBBINS (LANDOWNER, SET FREE CHURCH PASTOR), BECKY MORTIMORE-COMMUNITY PREVENTION PROFESSIONAL (PREVENTION MANAGEMENT ORGANIZATION OF WYOMING, HOT SPRINGS COUNTY OFFICE), ALLEN BRAATEN (HOT SPRINGS COUNTY COUNSELING CENTER), JASON WEYER, DO (RED ROCK FAMILY PRACTICE CLINIC), DR WILLIAM ROBINSON, DDS (PAINTBRUSH DENTAL CLINIC). DATA FROM THE WYOMING HEALTH MATTERS WAS USED AS A GAUGE TO MEASURE HOW HOT SPRINGS COUNTY WAS DOING IN A VARIETY OF LIFESTYLE CHOICES AND TO ASSESS PRIORITY AND FEASIBILITY. FACILITY 1, HOT SPRINGS COUNTY HOSPITAL DISTRIC - PART V, LINE 11 HSCMH ADDRESSED THE UNDER-SERVED POPULATIONS IN HOT SPRINGS COUNTY WITH RESPECT TO ACCESS TO HEALTHCARE AND ACCESS TO HEALTH EDUCATION. THE SPECIFIC AREAS THAT HAVE BEEN IDENTIFIED ARE MOTHERS WHO SMOKED DURING PREGNANCY, BABIES WITH LOW BIRTH WEIGHT AND ADULTS WHO VISIT THE DENTIST/ADULTS 45+ WITH MAJOR TOOTH LOSS. HSCMH IS PARTNERING WITH RED ROCK FAMILY PRACTICE AND PUBLIC HEALTH TO IDENTIFY AT RISK MOTHERS TO PROVIDE EDUCATION ON SMOKING CESSATION AND PRENATAL AND POST-NATAL SERVICES AVAILABLE. HSCMH IS PARTNERING WITH PAINTBRUSH DENTAL AND SUPPORTING THEIR EFFORTS IN THE ELEMENTARY SCHOOL TO EDUCATE YOUTH ON PROPER ORAL HYGIENE TO DEVELOP LIFE LONG SKILLS TO ELIMINATE MAJOR TOOTH LOSS. PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE THE FACILITIES CRITERIA FOR ELIGIBLITY FOR FREE OR DISCOUNTED CARE IS BASED ON THE FEDERAL PROVERTY GUIDELINES, FAMILY SIZE, AND THE PATIENT'S EQUITY RESOURCES (ASSETS LESS MEDICAL DEBT). IN ADDITION, THE PATIENT AND FAMILY MEMBERS MUST RECEIVE A DENIAL FROM MEDICAID OR OTHER PUBLIC ASSISTANCE PROGRAMS. EXTENUATING CIRCUMSTANCES (DEATH, ACTS OF NATURE, ETC.) ARE CONSIDERED IN DETERMINING ELIGIBILTY FOR FINANCIAL ASSISTANCE. PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION THE SUBSIDIZED HEALTH SERVICES WERE CALCULATED FOR SERVICES PROVIDED TO PATIENTS WHO ARE TREATED IN THE FACILITIES EMERGENCY ROOM. THIS DOES NOT INCLUDE ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY ACCOUNTS DEEMED TO BE UNCOLLECTIBLE ARE WRITTEN OFF AS ALLOWED BY THE LAWS AND REGULATIONS OF THE STATE OF WYOMING. ACCOUNTS WRITTEN OFF HAVE BEEN FULLY PROVIDED FOR IN THE ALLOWANCE FOR BAD DEBTS. THE FACILITIES ESTIMATE OF BAD DEBT WHICH WOULD QUALIFY FOR FINANCIAL ASSISTANCE IS BASED ON THE STANDARD INDUSTRY BENCHMARK AND THE REVIEW OF BAD DEBT ACCOUNTS AT THE TIME OF WRITE-OFF. NO COMMUNITY BENEFIT IS CLAIMED FOR ANY PORTION OF THE BAD DEBT. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS TEXT OF FINANCIAL STATEMENT FOOTNOTE (SEE PAGE 24, NOTE 3 OF THE AUDITED FINANCIALS). ACCOUNTS DEEMED TO BE UNCOLLECTIBLE ARE WRITTEN OFF AS ALLOWED BY THE LEGISLATION OF THE STATE OF WYOMING. ACCOUNTS WRITTEN OFF HAVE BEEN FULLY PROVIDED FOR IN THE PROVISION FOR BAD DEBT. PART III, LINE 8 - MEDICARE EXPLANATION THE HOSPITAL IS LICENSED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AS A CRITICAL ACCESS HOSPITAL. AS A CRITICAL ACCESS HOSPITAL IT IS REIMBURSED ON 101% OF COSTS LESS THE 2% SEQUESTRATION ADJUSTMENT. THE HOSPTITAL UTILIZED THE ANNUAL COST REPORT FOR FISCAL YEAR JUNE 30, 2018 WHICH IT IS REQUIRED TO SUBMIT TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AS THE SOURCE TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE IN CONNECTION WITH THE REVENUE RECEIVED FROM MEDICARE. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION THE HOSPITAL MAKES EVERY EFFORT TO COMPLETE A FINANCIAL EVALUATION AT THE EARLIST POSSIBLE POINT IN THE REVENUE CYCLE FOR ALL PATIENTS INDICATING AN INABILITY TO MEET THEIR FINANCIAL OBLIGATIONS. A FINANCIAL ASSISTANCE PROGRAM APPLICATION IS COMPLETED ONCE ALL OTHER OPTIONS FOR REIMBURSEMENTS HAVE BEEN EXHAUSTED. X X X false false false false false false false false false CHRISTOPHER PARIS CRNA 182049 7936 189985 KEVIN RYAN CRNA 173088 6546 179634 RANDY JONES PHARMACIST 119891 119891 ROXANNE ARNETT RN 103506 103506 FORM 990, PAGE 2, PART III, LINE 4A NURSING ASSISTANT AND CARDIOPULMONARY RESUSCITATION. EMPLOYEES PROVIDE PHLEBOTOMY SERVICES DURING THE THERMOPOLIS HEALTH FAIR. AN AGREEMENT WITH THE UNIVERSITY OF WYOMING ENCOURAGES NURSING, PHARMACY, AND SOCIAL SERVICES STUDENTS TO INTERN AT HSCMH. REDUCED MAMMOGRAPHY AND BONE DENSITY TESTS ARE OFFERED OCTOBER-DECEMBER. HEALTH INFORMATION LINKS ARE AVAILABLE ON THE HSCMH WEBSITE. USE OF PORTABLE OXYGEN CONCENTRATORS ARE FREE THROUGH CARDIOPULMONARY SERVICES FOR THOSE TRAVELING. COMFORT CARTS AND FREE MEALS ARE AVAILABLE FOR FAMILIES DURING STRESSFUL CONDITIONS. SNACKS ARE OFFERED TO PATIENTS TWICE A DAY. BIG HORN CLINIC, HSCMH'S RURAL FAMILY PRACTICE CLINIC, PROVIDES REDUCED OR FREE EXAMS FOR SCHOOL ATHLETICS, MEDICINE ASSISTANCE, BLOOD PRESSURE SCREENING AND COMMUNITY EDUCATION SEMINARS. HSCMH OFFERS SCHOLARSHIPS TO QUALIFYING EMPLOYEES WANTING TO ADVANCE THEIR EDUCATION TO THE BETTERMENT OF THE HOSPITAL AND COMMUNITY. COMMUNITY RESOURCE TRAINING FOR HIGH SCHOOL STUDENTS AND WWAMI (WASHINGTON, WYOMING, ALASKA MONTANA, IDAHO)MEDICAL EDUCATION PROGRAM, WHICH PROMOTES MEDICAL EDUCATION IN WESTERN STATES, ARE TWO LONG-TIME PROGRAMS IN WHICH HSCMH PARTICIPATES. FORM 990, PAGE 6, PART VI, LINE 3 HSCMH CONTRACTS WITH HEALTHTECH MANAGEMENT SERVICES, INC. FOR MANAGEMENT SERVICES INCLUDING THE CEO POSITION. THE CEO IS EMPLOYED BY HEALTHTECH MANAGEMENT SERVICES, INC. FORM 990, PAGE 6, PART VI, LINE 11B THE CURRENT FISCAL YEAR 6/30/18 FORM 990 WAS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES FOR DISCUSSION AND REVIEW. THE ENTIRE BOARD OF DIRECTORS APPROVED THE CURRENT FISCAL YEAR 6/30/18 FORM 990 AT A REGULARLY SCHEDULED BOARD MEETING. FORM 990, PAGE 6, PART VI, LINE 12C THE HOSPITAL HAS A FORMAL CONFLICT OF INTEREST POLICY WHICH REQUIRES EMPLOYEES TO MAKE A PROMPT WRITTEN FULL DISCLOSURE OF ANY POTENTIAL SITUATION WHICH MAY INVOLVE A CONFLICT OF INTEREST. THE POLICY PROVIDES A LIST OF POTENTIAL CONFLICTS. EMPLOYEES WHO VIOLATE THE POLICY ARE SUBJECT TO DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION. THE POLICY IS REVIEWED AT LEAST 2 TIMES A YEAR WITH EMPLOYEES; THE ANNUAL SKILLS FAIR AND THE ANNUAL EMPLOYEE EVALUATION. THE EMPLOYEE COMPLETES AND SIGNS A NEW DISCLOSURE AT THE TIME OF THEIR EVALUATION. THE HOSPITAL DOES REQUIRE GOVERNING BOARD MEMBERS, OFFICERS, MANAGERS, AND MEDICAL REPRESENTATIVES WITH ADMINISTRATIVE RESPONSIBILITY TO DISCLOSE IN WRITING ALL POTENTAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS AS WELL. FORM 990, PAGE 6, PART VI, LINE 15A THE ORGANIZATION'S CEO IS A LEASED-EMPLOYEE, WHO CONDUCTS THE EVALUATION AND COMPARABILITY OF SALARY DATA. FORM 990, PAGE 6, PART VI, LINE 15B THE ORGANIZATION COMPLETES AN ANNUAL REVIEW OF OTHER KEY EMPLOYEES AND COMPLETES A COMPARISON OF SALARIES WITH WYOMING HOSPITAL ASSOCIATION SALARY SURVEY DATA. THE ANNUAL REVIEW IS COMPLETED BY THE CEO. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION IS A GOVERNMENTAL ENTITY, ALL BOARD OF TRUSTEE MEETINGS ARE PUBLIC MEETINGS. ALL REPORTS (NOT CONSIDERED CONFIDENTIAL) ARE SUBJECT TO THE OPEN MEETING LAWS UNDER STATE OF WYOMING LAWS. IN ADDITION THESE DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION IN ACCORDANCE WITH FEDERAL AND STATE LAW. FORM 990, PART IX, LINE 11G COLLECTION FEES 0 164,589 0 CONSULTING FEES 57,548 59,618 0 PHYSICIAN FEES 1,677,505 0 0 STAFFING AGENCY FEES 1,292,127 0 0 CONTRACT AND PURCH SERVICES 330,436 11,027 0 PUBLIC RELATIONS/ADVERTISING 8,483 32,298 0 AMBULANCE SERVICES 271,415 0 0 COST REPORT 0 10,750 0 TOTAL 3,637,514 278,282 0