LOGAN HEALTH CUT BANK: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- LOGAN HEALTH CUT BANK (EIN 81-0530457)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-08-15
- IRS object ID
- 201842279349300539
- Schema version
- 2016v3.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-15T08:10:45-05:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wipfli LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 12237 | AddressLine1Txt |
| City | Green Bay | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 543072237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810530457 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Rockies Medical Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 4068732251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 802 Second Street SE | AddressLine1Txt |
| City | Cut Bank | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59427 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Cherie Taylor | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 4068732251 | PhoneNum |
| Signature | 2018-08-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Terri Rexrode CPA MST | PreparerPersonNm |
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | PhoneNum |
| Preparation | 2018-08-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Cherie Taylor | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 802 Second Street SE | AddressLine1Txt |
| City | Cut Bank | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59427 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,605,162 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | NRMCINC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | NORTHERN ROCKIES MEDICAL CENTER PROVIDES QUALITY HEALTHCARE THAT SERVES OUR COMMUNITIES IN A PRIVATE, SAFE, AND CARING ENVIRONMENT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 106 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $102,106 | PYContributionsGrantsAmt |
| CY Contributions Grants | $38,001 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,524,764 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,167,050 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,863 | PYInvestmentIncomeAmt |
| CY Investment Income | -$4,715 | CYInvestmentIncomeAmt |
| PY Other Revenue | $373,450 | PYOtherRevenueAmt |
| CY Other Revenue | $394,700 | CYOtherRevenueAmt |
| PY Total Revenue | $9,002,183 | PYTotalRevenueAmt |
| CY Total Revenue | $9,595,036 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,074,764 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,676,959 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,433,592 | PYOtherExpensesAmt |
| CY Other Expenses | $3,681,877 | CYOtherExpensesAmt |
| PY Total Expenses | $9,508,356 | PYTotalExpensesAmt |
| CY Total Expenses | $9,358,836 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$506,173 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $236,200 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,029,565 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,270,987 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,534,829 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,540,051 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,494,736 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,730,936 | NetAssetsOrFundBalancesEOYAmt |
| Mission | NORTHERN ROCKIES MEDICAL CENTER PROVIDES QUALITY HEALTHCARE THAT SERVES OUR COMMUNITIES IN A PRIVATE, SAFE, AND CARING ENVIRONMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,462,939 | ExpenseAmt |
| Revenue | $9,561,750 | RevenueAmt |
| Desc | PROVIDE INPATIENT, OUTPATIENT, AND CLINICAL HEALTHCARE SERVICES TO RESIDENTS OF GLACIER COUNTY AND THE SURROUNDING AREAS. | Desc |
| Total Program Service Expenses | $7,462,939 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 106 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Treasure Berkram | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4068732251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 802 SECOND STREET NE | AddressLine1Txt |
| City | CUT BANK | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59427 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| RICK BILLMAN | |||||||
| Board Chairman | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DOUG SHEBLE | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LON PETERSON | |||||||
| Board Vice Chairman | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WADE JOHNSON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOYCE LEWIS | |||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR MICHAEL D'AMBROSE | |||||||
| Chief of Staff/MD | 40.00 | Yes (X) | Yes (X) | $358,960 | $0 | $8,204 | |
| Dr Mark Haemig | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Gail Davis | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Richard Gannon | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Linda Luther | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| John Waller | |||||||
| Former Board Vice Chair-Termed | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Dr Adron Medley | |||||||
| Chief of Staff/MD-Termed | 40.00 | Yes (X) | Yes (X) | $110,095 | $0 | $0 | |
| CHERIE TAYLOR | |||||||
| CEO | 40.00 | Yes (X) | $101,037 | $0 | $22,196 | ||
| TREASURE BERKRAM | |||||||
| CFO | 40.00 | Yes (X) | $86,379 | $0 | $6,457 | ||
| SUZANNAH BEALS | |||||||
| CNO | 40.00 | Yes (X) | $78,236 | $0 | $12,260 | ||
| NIALL ATKINSON | |||||||
| FNP | 48.00 | $184,389 | $0 | $10,240 | Yes (X) | ||
| GREGORY COWART | |||||||
| CRNA | 40.00 | $200,827 | $0 | $4,972 | Yes (X) | ||
| RYNDEE HAMILTON | |||||||
| PHARMACIST | 40.00 | $122,661 | $0 | $2,263 | Yes (X) | ||
| Mark Hill | |||||||
| FNP | 48.00 | $145,538 | $0 | $6,016 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,388,122 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $72,608 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Kalispell Regional Hospital | |||||
| 310 Sunnyview Lane | Kalispell | MT | 59901 | Contract Services | $468,216 |
| Guardian Healthcare Providers | |||||
| 105 W Park Drive Suite 100 | Brentwood | TN | 370275062 | Locum Nursing Coverage | $262,161 |
| Vista Staffing Solutions Inc | |||||
| FILE 50834 | Los Angeles | CA | 900740834 | Locum Emergency Room Coverage | $221,085 |
| Evident | |||||
| 6600 Wall Street | Mobile | AL | 36695 | EMR Software Support | $167,271 |
| Monida | |||||
| 1200 S Reserve Suite H | Missoula | MT | 59801 | MRI Imaging Services | $152,993 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $26,107 | GovernmentGrantsAmt |
| All Other Contributions | $11,894 | AllOtherContributionsAmt |
| Total Contributions | $38,001 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENU | 621110 | $8,199,586 | $8,199,586 |
| Bed Tax Revenue | 621110 | $781,611 | $781,611 |
| OTHER PATIENT REVENUE | 621110 | $163,948 | $163,948 |
| RELATED RENTAL | 621110 | $21,905 | $21,905 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,167,050 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $411 | TotalRevenueColumnAmt |
| Exclusion | $411 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $10,126 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$5,126 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$5,126 | TotalRevenueColumnAmt |
| Exclusion | -$5,126 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| COUNTY TAX REVENUE | 624100 | $300,000 | $300,000 |
| EHR INCENTIVE PAYMENT | 518210 | $94,700 | $94,700 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $394,700 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,595,036 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,561,750 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$4,715 | ExclusionAmt |
| 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 | $1,054,363 | TotalAmt |
| Program Services | $835,560 | ProgramServicesAmt |
| Management And General | $218,803 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,925,449 | TotalAmt |
| Program Services | $3,417,967 | ProgramServicesAmt |
| Management And General | $507,482 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,410 | TotalAmt |
| Program Services | $33,137 | ProgramServicesAmt |
| Management And General | $3,273 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,460 | TotalAmt |
| Program Services | $284,442 | ProgramServicesAmt |
| Management And General | $27,018 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,277 | TotalAmt |
| Program Services | $299,677 | ProgramServicesAmt |
| Management And General | $49,600 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,335 | TotalAmt |
| Management And General | $85,335 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,962 | TotalAmt |
| Management And General | $42,962 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,989 | TotalAmt |
| Management And General | $29,989 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,379,934 | TotalAmt |
| Program Services | $1,236,097 | ProgramServicesAmt |
| Management And General | $143,837 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,180 | TotalAmt |
| Program Services | $1,806 | ProgramServicesAmt |
| Management And General | $36,374 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $162,666 | TotalAmt |
| Program Services | $117,340 | ProgramServicesAmt |
| Management And General | $45,326 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,720 | TotalAmt |
| Management And General | $274,720 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,123 | TotalAmt |
| Program Services | $114,874 | ProgramServicesAmt |
| Management And General | $48,249 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,534 | TotalAmt |
| Program Services | $28,602 | ProgramServicesAmt |
| Management And General | $27,932 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,058 | TotalAmt |
| Program Services | $23,058 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $282,215 | TotalAmt |
| Program Services | $198,741 | ProgramServicesAmt |
| Management And General | $83,474 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,601 | TotalAmt |
| Program Services | $19,695 | ProgramServicesAmt |
| Management And General | $118,906 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $423,376 | $423,376 | |
| REPAIRS AND MAINTENANCE | $207,291 | $200,989 | $6,302 |
| BAD DEBT EXPENSE | $168,887 | $168,887 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,006 | TotalAmt |
| Program Services | $58,691 | ProgramServicesAmt |
| Management And General | $146,315 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,358,836 | TotalAmt |
| Program Services | $7,462,939 | ProgramServicesAmt |
| Management And General | $1,895,897 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $581,562 | BOYAmt |
| EOY | $863,517 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,225,992 | BOYAmt |
| EOY | $1,095,124 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $530,442 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,987 | BOYAmt |
| EOY | $185,361 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,636 | BOYAmt |
| EOY | $35,847 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,793,141 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,663,122 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,198,899 | BOYAmt |
| EOY | $1,130,019 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $257,047 | BOYAmt |
| EOY | $961,119 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,029,565 | BOYAmt |
| EOY | $4,270,987 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,037,748 | BOYAmt |
| EOY | $877,345 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $496,504 | BOYAmt |
| EOY | $662,706 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $577 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,534,829 | BOYAmt |
| EOY | $1,540,051 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,494,736 | BOYAmt |
| EOY | $2,730,936 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,494,736 | BOYAmt |
| EOY | $2,730,936 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,029,565 | BOYAmt |
| EOY | $4,270,987 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $236,200 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $167 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $167 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1, LOBBYING ACTIVITIES: | FormAndLineReferenceDesc |
| Explanation | MHA DUES | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $101,008 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $14,153 | OtherCostOrOtherBasisAmt |
| Book Value | $115,161 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $384,684 | OtherCostOrOtherBasisAmt |
| Depreciation | $54,396 | DepreciationAmt |
| Book Value | $330,288 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $215,423 | OtherCostOrOtherBasisAmt |
| Depreciation | $135,715 | DepreciationAmt |
| Book Value | $79,708 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,077,873 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,473,011 | DepreciationAmt |
| Book Value | $604,862 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,130,019 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| PATRONAGE CREDITS | $101,272 |
| INVESTMENT - MHA WORK COMP | $74,025 |
| CAPITAL CONTRIBUTIONS | $250 |
| Bed Tax Receivable | $360,572 |
| County Taxes Receivable | $425,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $961,119 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $9,426,149 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$168,887 | OtherRevenueAmt |
| Revenue Not Reported | -$168,887 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,595,036 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $9,595,036 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,189,949 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,189,949 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $168,887 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $168,887 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,358,836 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part XI, Line 2d - Other Adjustments: | Bad Debt Expense -168,887. |
| Part XII, Line 4b - Other Adjustments: | Bad debt expense 168,887. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $81,299 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $81,299 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00880 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,881,270 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,521,751 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $359,519 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03910 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,962,569 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,521,751 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $440,818 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04790 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $245,858 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,750 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $223,108 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02430 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $245,858 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,750 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $223,108 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02430 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,208,427 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,544,501 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $663,926 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07220 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $168,887 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $2,541,268 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,596,281 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$55,013 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHERN ROCKIES MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 802 SECOND STREET NE | AddressLine1Txt |
| City | CUT BANK | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59427 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.NRMCINC.ORG | WebsiteAddressTxt |
| State License | 13337 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHERN ROCKIES MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://NRMCINC.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://NRMCINC.ORG | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://NRMCINC.ORG/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://NRMCINC.ORG/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://NRMCINC.ORG/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| NORTHERN ROCKIES MEDICAL CENTER, INC. | Part V, Section B, Line 5: A steering committee was convened to assist Northern Rockies Medical Center in conducting a Community Health Needs Assessment. A diverse group of community members representing various organizations and populations within the community. (EX. Public Health, Elderly, Uninsured) came together in June 2016. The group included a member of the Chamber of Commerce, members of the Glacier County Health Department, Glacier County Commissioner, Chief of Police, members of the EMS Ambulance, employees of Northern Rockies Medical Center (CFO, Clinical IT, Community Health Imp Sepecialist, Provider and PT), local pastor, representatives from the school system, etc. |
| NORTHERN ROCKIES MEDICAL CENTER, INC. | Part V, Section B, Line 11: 1. The need for increase in access to behavorial health resources will be addressed by exporing the expansion of mental health resources via telehealth, partnering with the Community Health Center to develop a structured plan for providers, and educate the community on behavorial issues in Glacier County. 2. The need to enhance nutrition and health and wellness opportunities in Glacier County will be addressed by continuing to promote / offer health and wellness programs for the community, explore means of expanding these services, and to improve awareness of existing services. 3. The need for exploring opportunities for programs / services for Glacier County seniors will be addressed by enhancing knowledge of available senior care and home health options and partnering with the senior center to enhand health, wellness, and educational offering. Northern Rockies Medical Center will not be able to address the need for primary care providers. We are currently recruiting additional providers. |
| NORTHERN ROCKIES MEDICAL CENTER, INC. | Part V, Section B, Line 13b: For financial assistance (uninsured) FPG is used. For financial hardship (insured), a debt/income percentage is used. A patient's gross income is compared to their total expenses and a debt/income percentage is calculated. This percentage then determines the amount of discounted or free care that is provided. 100%, 80%, 60%, 40%, and 20% in accordance with the financial assistance table. |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | COMMUNITY BENEFIT EXPENSE IS CALCULATED FROM THE COST-TO-CHARGE RATIO |
| Part I, Ln 7 Col(f): | BAD DEBT EXPENSE OF $168,887 INCLUDED ON FORM 990, PART IX, LINE 25 WAS EXCLUDED FROM THE DENOMINATOR PER INSTRUCTIONS WHEN CALCULATING THE PERCENT TOTAL EXPENSES ON SCHEDULE H. |
| Part II, Community Building Activities: | The organization promotes the community's health by participating in annual health fairs that encompass all areas of wellness including diabetes screening, bone density, and blood pressure checks. Throughout the year, the organiztion does free blood pressure checks and participates in a free physical therapy equipment loan program to assist with rehabilitation at home. |
| Part III, Line 2: | TO DETERMINE THE AMOUNTS USED ON LINE 2, PART III, THE AMOUNTS WRITTEN OFF TO BAD DEBT ARE WHAT ARE LEFT OVER AFTER ANY APPLICABLE DISCOUNTS, INSURANCE, AND PAYMENTS HAVE BEEN APPLIED. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS and a provision for bad debt for expected uncollectible deductibles and copayments BY USING HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. PATIENT RECEIVABLES ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. |
| Part III, Line 4: | IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS and a provision for bad debt for expected uncollectible deductibles and copayments ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. |
| Part III, Line 8: | Medicare allowable cost is based on the Medicare cost report. The medicare cost report is completed based on the rules and regulations set forth by CMS. |
| Part III, Line 9b: | THE FINANCIAL ASSISTANCE POLICY AND MEDICARE BAD DEBT POLICY ARE APPLIED UNIFORMLY ACROSS ALL PATIENTS, REGARDLESS OF PAYOR STATUS. |
| Part VI, Line 2: | A STEERING COMMITTEE WAS CONVENED TO ASSIST NORTHERN ROCKIES MEDICAL CENTER IN CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT. A DIVERSE GROUP OF COMMUNITY MEMBERS REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY. (EX. PUBLIC HEALTH, ELDERLY, UNINSURED) CAME TOGETHER IN JUNE 2016. THE GROUP INCLUDED A MEMBER OF THE CHAMBER OF COMMERCE, MEMBERS OF THE GLACIER COUNTY HEALTH DEPARTMENT, GLACIER COUNTY COMMISSIONER, CHIEF OF POLICE, MEMBERS OF THE EMS AMBULANCE, EMPLOYEES OF NORTHERN ROCKIES MEDICAL CENTER (CFO, CLINICAL IT, COMMUNITY HEALTH IMP SPECIALIST, PROVIDER AND PT), LOCAL PASTOR, REPRESENTATIVES FROM THE SCHOOL SYSTEM, ETC). |
| Part VI, Line 3: | The organization's self pay patient representative works with the patient to determine his/her eligibility for federal, state, or local programs that they may qualify for. They work with the patient one on one to qualify the patient for any eligible charity care program. |
| Part VI, Line 4: | Northern Rockies Medical Center serves Cut Bank and the surrounding Glacier County, which also includes the Blackfeet Indian Reservation. Glacier County is a low-income county. The primary industry in Glacier County is agriculture. |
| Part VI, Line 5: | The organization promotes the community's health by participating in annual health fairs that encompass all areas of wellness including diabetes screening to blood pressure checks to paid screening. The organization does free blood pressure checks and participates in a free physical therapy equipment program to assist with rehabiltation at home. The organization is also participating in a Worksite Wellness pilot program with the Cut Bank School system. This program provided lab draws, wellness profiles, and exercise classes. Results were tracked to monitor results. The organization also participated in Community Wellness, providing a 12 week Lifestyle challenge, exercise classes, and sports physicals. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR MICHAEL D'AMBROSE | ||||||||||||||
| Chief of Staff/MD | $303,374 | $0 | $55,586 | $0 | $0 | $0 | $2,156 | $0 | $6,048 | $0 | $367,164 | $0 | $0 | $0 |
| NIALL ATKINSON | ||||||||||||||
| FNP | $166,389 | $0 | $18,000 | $0 | $0 | $0 | $3,472 | $0 | $6,768 | $0 | $194,629 | $0 | $0 | $0 |
| GREGORY COWART | ||||||||||||||
| CRNA | $200,827 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $4,972 | $0 | $205,799 | $0 | $0 | $0 |
| Mark Hill | ||||||||||||||
| FNP | $145,538 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $6,016 | $0 | $151,554 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | ONE BOARD MEMBER OWNS A FURNITURE AND HARDWARE STORE. NORTHERN ROCKIES MEDICAL CENTER DOES BUSINESS WITH THE STORE AS IT IS THE ONLY STORE IN TOWN. |
| Form 990, Part VI, Section A, line 6 | 1 CLASS OF MEMBER WITH $100 MINIMUM DONATION THAT ALLOWS YOU TO VOTE FOR THE BOARD OF TRUSTEES. |
| Form 990, Part VI, Section A, line 7a | FOR EVERY $100 DONATED, ONE VOTE IS RECEIVED. |
| Form 990, Part VI, Section A, line 8b | COMMITTEES DO NOT HAVE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| Form 990, Part VI, Section B, line 11b | THE FORM 990 IS PREPARED BY THE ORGANIZATION'S INDEPENDENT ACCOUNTANT AND PROVIDED TO THE BOARD FOR REVIEW AND APPROVAL PRIOR TO SUBMITTING TO THE IRS. |
| Form 990, Part VI, Section B, line 12c | THE ORGANIZATION ANNUALLY REVIEWS THE POLICY WITH THE BOARD AND REQUESTS ANY CONFLICTS BE DISCLOSED AT EACH BOARD MEETING. Conflicts of interest are disclosed to administration and safeguards are established to protect all parties. |
| Form 990, Part VI, Section B, line 15 | THE BOARD OF DIRECTORS IS RESPONSIBLE FOR DETERMINING COMPENSATION FOR UPPER LEVEL EMPLOYEES. COMPARATIVE DATA IS COLLECTED AND ANALYZED. THE COMPENSATION PACKAGES ARE APPROVED BY THE BOARD OF DIRECTORS for physicians, CEO, and unions. THE ORGANIZATION'S CEO IS RESPONSIBLE FOR THE HIRING OF ALL OTHER STAFF USING COMPARATIVE DATA TO ENSURE REASONABLE COMPENSATION. |
| Form 990, Part VI, Section C, line 19 | ALL PUBLIC DOCUMENTS ARE AVAILABLE FOR REVIEW AT THE ORGANIZATION'S ADMINISTRATIVE UPON REQUEST. |
| Form 990, Part IX, line 11g | OTHER FEES FOR SERVICES: Program service expenses 1,236,097. Management and general expenses 143,837. Fundraising expenses 0. Total expenses 1,379,934. |