2018-05-15T11:15:28-05:00 2017-06-30 390758449 Wipfli LLP PO Box 1699 Helena MT 59624 990 2016-07-01 810245848 Roundup Memorial Hospital Association ROUN 4063232301 PO Box 40 Roundup MT 59072 Bradley C Howell CEO 4063232301 2018-05-14 1 Nathan D McCarthy CPA P00368408 4064425520 2018-05-14 2016 2022-09-23 18:48:47Z Bradley C Howell PO Box 40 Roundup MT 59072 7731730 0 X www.rmhmt.org X 1979 MT Provide Healthcare Services 8 8 109 6 0 0 835381 311495 8740407 7041387 954 678 474259 378170 10051001 7731730 0 0 0 0 3922350 4017567 200 0 200 5348956 3475142 9271506 7492709 779495 239021 4190855 4877633 1697302 2037178 2493553 2840455 X IT IS THE MISSION OF THE ROUNDUP MEMORIAL HOSPITAL TO ACCEPT THE ONGOING CHALLENGE OF PROVIDING FOR THE HEALTHCARE NEEDS OF ALL OF OUR CITIZENS. IT IS OUR SINCERE DESIRE TO HEAL THE SICK AND COMFORT THE SUFFERING WITH ALL THE RESOURCES WE HAVE AVAILABLE. AS GOOD STEWARDS OF THESE INSTITUTIONS, EMPLOYEES WILL HELP ENSURE THE SURVIVAL OF THE HOSPITAL BY BEING COMMITTED TO THE CARE AND WELL-BEING OF THOSE THEY SERVE. 0 0 7007226 7419557 Critical access hospital - Routine service for adults, pediatrics, and swing bed. Rural health clinic with four providers. Other services include but are not limited to ancillaries; CT scans; laboratory; physical, speech, and occupational therapies; pharmacy; emergency room; X-ray; central supply; intravenous solutions; ultrasound; electrocardiography; observation; blood bank; and pathology. 7007226 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 23 0 1 109 1 0 0 0 0 0 0 0 0 0 0 X 8 8 1 1 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X Roundup Memorial Hospital Association 4063232301 1202 Third Street West Roundup MT 59702 X John Pfister President 0.50 X X 0 0 0 Mark Rosebush Vice President 0.50 X X 0 0 0 Ken Mosdal Treasurer 0.50 X X 0 0 0 Oliver Odden Director 0.50 X 0 0 0 Bryan Adolph director 0.50 X 0 0 0 Theresa Doumitt director 0.50 X 0 0 0 Marshall White director 0.50 X 0 0 0 Leonard Wall director 0.50 X 0 0 0 Bradley C Howell CEO 40.00 X 0 0 0 Kyle Gee CFO 40.00 X 0 0 0 Brynn Bixby PA 40.00 X 139506 0 0 Kevin Criswell Physical Therapist 40.00 X 113957 0 0 Deb Shields PA 40.00 X 101007 0 0 354470 0 0 3 0 0 0 Billings Clinic PO Box 37000 Billings MT 59107 Management Services 647741 1 102109 209386 311495 Inpatient/outpatient R 621110 6849206 6849206 Other Operating Revenu 900099 104405 104405 340B Revenue 446110 87776 87776 7041387 678 678 550 0 550 550 550 Tax Revenue 900099 363749 363749 Other Non Operating Re 900099 13871 13871 377620 7731730 7419557 0 678 3308192 3161186 147006 394805 347662 47143 314570 233863 80707 647741 555899 91842 56250 56250 26185 26185 665973 648101 17872 22453 14488 7965 33643 31785 1858 213955 213955 145769 145769 32813 28370 4443 31448 27436 4012 26324 26324 378590 378590 96662 96662 Medical Supplies 616874 616874 Bad Debt Expense 295172 295172 Repairs & Maintenance 69479 69479 Other Operating Expense 38814 38814 76997 76797 200 7492709 7007226 485283 200 1434568 868557 1217072 1855048 97437 131233 46703 42856 9886026 7906087 1395075 1979939 4190855 4877633 499425 505431 1010603 1259853 187274 271894 1697302 2037178 X 2477676 2824578 15877 15877 2493553 2840455 4190855 4877633 239021 107881 0 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4343667 3905939 437728 5194888 4000148 1194740 347471 347471 1979939 Cost Report Settlement Payable 271894 271894 Schedule D Part V The endowment fund that had been tracked on Schedule D Part V was incorrectly identified as an endowment in prior years. 1 1 1 X 1 X 1 1 0 0 55372 55372 0.00740 1978960 1831424 147536 0.01970 2034332 1831424 202908 0.02710 17420 3000 14420 0.00190 17420 3000 14420 0.00190 2051752 1834424 217328 0.02900 0 295172 118069 2090085 1771237 318848 X 1 1 1 1 ROUNDUP MEMORIAL HOSPITAL ASSOCIATION 1202 3RD STREET WEST Roundup MT 59072 X X RURAL HEALTH CLINIC ROUNDUP MEMORIAL HOSPITAL ASSOC 1 0 0 1 X X X X X X X X 15 1 0 1 1 X www.rmhmt.org 1 15 1 www.rmhmt.org 0 1 X 100.000000000000 200.000000000000 1 1 X X X 1 X www.rmhmt.org X www.rmhmt.org X X 1 0 X 1 0 0 ROUNDUP MEMORIAL HOSPITAL ASSOC Part V, Section B, Line 6b: The Montana Office of Rural HealthThe National Rural Health Resource Center Part III, Line 9b: POLICY STATES UP FRONT THAT ADMISSIONS REPRESENTATIVE IS TO GIVE FINANCIAL ASSISTANCE PAPERWORK WITH INFORMAION ON CHARITY CARE AT THE TIME OF ADMISSION. FOLLOW UP CONSULTATION IS DONE LATER TO INCLUDE FINANCIAL ASSISTANCE DISCUSSIONS WITH PATIENT. Part VI, Line 2: IN 2014, THE HOSPITAL CONDUCTED A NEEDS ASSESSMENT. STAKEHOLDERS INVOLVED INCLUDED COUNTY COMMISSIONERS, COMMUNITY SERVICE ORGANIZATIONS, SUCH AS ROTARY AND THE LION'S CLUB, AND AREA STATE AGENCIES. IN ADDITION, THE HOSPITAL HELD TWO COMMUNITY MEETINGS AND LED DISCUSSIONS OF HEALTHCARE NEEDS AND DESIRES. Part VI, Line 3: When a patient indicates that a financial hardship exists, the hospital provides information on the hospital charity plan and other state and Federal assistance programs. Part VI, Line 4: Roundup Memorial Healthcare (RMH) is the sole community healthcare provider for Musselshell County, a rural area with a population density of 2.4 per square mile. No other hospitals serve the community and the nearest healthcare facility is located in Billings, 45 miles to the south. Per the 2010 Federal Census, the county population was 4,538; the per capita income in the county is $19,164 and the percentage of persons below the poverty line was 20.5 percent. In 2006, 26.4 percent of Musselshell County was uninsured. The health resources and services administration has designated Musselshell County as an underserved area with a score of 16. Brad Howell Mr. Howell is Roundup Memorial Hospital Association's CEO. MR. Howell 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 Roundup Memorial Hospital Association's CFO. 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 CEO from Billings Clinic, Inc. 0 Form 990, Part VI, Section A, line 2 Leonard Wall and Bryan Adolph - Family Relationship Form 990, Part VI, Section A, line 3 The organization has contracted with Billings Clinic to provide management services. Form 990, Part VI, Section A, line 6 MEMBERS OF HOSPITAL ASSOCIATION 501 (C)(3) Form 990, Part VI, Section B, line 11b The 990 is reviewed by the CEO, CFO and Controller and is distributed to the board before filing. Form 990, Part VI, Section B, line 12c The compliance officer monitors and evaluates conflict of interest issues. Form 990, Part VI, Section B, line 15a The CEO is compensated according to arrangements with the management agreement with Billings Clinic, who recommends the CEO salary to the board for approval. The hospital utilizes the Montana Hospital Association and Associated Employees salary survey to determine salaries of key employees. Form 990, Part VI, Section C, line 19 AVAILABLE UPON REQUSET TO THE CEO.