2018-08-15T08:10:45-05:00 2017-09-30 390758449 Wipfli LLP PO Box 12237 Green Bay WI 543072237 990 2016-10-01 810530457 Northern Rockies Medical Center Inc NORT 4068732251 802 Second Street SE Cut Bank MT 59427 Cherie Taylor CEO 4068732251 2018-08-14 1 Terri Rexrode CPA MST P00096513 9206620016 2018-08-14 2016 2022-09-23 18:48:47Z Cherie Taylor 802 Second Street SE Cut Bank MT 59427 9605162 0 X NRMCINC.ORG X 2001 MT NORTHERN ROCKIES MEDICAL CENTER PROVIDES QUALITY HEALTHCARE THAT SERVES OUR COMMUNITIES IN A PRIVATE, SAFE, AND CARING ENVIRONMENT. 10 9 106 10 0 0 102106 38001 8524764 9167050 1863 -4715 373450 394700 9002183 9595036 0 0 0 0 5074764 5676959 0 0 0 4433592 3681877 9508356 9358836 -506173 236200 4029565 4270987 1534829 1540051 2494736 2730936 NORTHERN ROCKIES MEDICAL CENTER PROVIDES QUALITY HEALTHCARE THAT SERVES OUR COMMUNITIES IN A PRIVATE, SAFE, AND CARING ENVIRONMENT. 0 0 7462939 9561750 PROVIDE INPATIENT, OUTPATIENT, AND CLINICAL HEALTHCARE SERVICES TO RESIDENTS OF GLACIER COUNTY AND THE SURROUNDING AREAS. 7462939 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 7 0 1 106 1 0 0 0 0 0 0 0 0 0 0 X 10 9 1 0 0 0 1 1 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X Treasure Berkram 4068732251 802 SECOND STREET NE CUT BANK MT 59427 RICK BILLMAN Board Chairman 1.00 X X 0 0 0 DOUG SHEBLE DIRECTOR 1.00 X 0 0 0 LON PETERSON Board Vice Chairman 1.00 X 0 0 0 WADE JOHNSON DIRECTOR 1.00 X 0 0 0 JOYCE LEWIS Secretary 1.00 X X 0 0 0 DR MICHAEL D'AMBROSE Chief of Staff/MD 40.00 X X 358960 0 8204 Dr Mark Haemig Director 1.00 X 0 0 0 Gail Davis Director 1.00 X 0 0 0 Richard Gannon Director 1.00 X 0 0 0 Linda Luther Director 1.00 X 0 0 0 John Waller Former Board Vice Chair-Termed 1.00 X X 0 0 0 Dr Adron Medley Chief of Staff/MD-Termed 40.00 X X 110095 0 0 CHERIE TAYLOR CEO 40.00 X 101037 0 22196 TREASURE BERKRAM CFO 40.00 X 86379 0 6457 SUZANNAH BEALS CNO 40.00 X 78236 0 12260 NIALL ATKINSON FNP 48.00 X 184389 0 10240 GREGORY COWART CRNA 40.00 X 200827 0 4972 RYNDEE HAMILTON PHARMACIST 40.00 X 122661 0 2263 Mark Hill FNP 48.00 X 145538 0 6016 1388122 0 72608 7 0 1 0 Kalispell Regional Hospital 310 Sunnyview Lane Kalispell MT 59901 Contract Services 468216 Guardian Healthcare Providers 105 W Park Drive Suite 100 Brentwood TN 370275062 Locum Nursing Coverage 262161 Vista Staffing Solutions Inc FILE 50834 Los Angeles CA 900740834 Locum Emergency Room Coverage 221085 Evident 6600 Wall Street Mobile AL 36695 EMR Software Support 167271 Monida 1200 S Reserve Suite H Missoula MT 59801 MRI Imaging Services 152993 9 26107 11894 38001 PATIENT SERVICE REVENU 621110 8199586 8199586 Bed Tax Revenue 621110 781611 781611 OTHER PATIENT REVENUE 621110 163948 163948 RELATED RENTAL 621110 21905 21905 9167050 411 411 5000 10126 -5126 -5126 -5126 COUNTY TAX REVENUE 624100 300000 300000 EHR INCENTIVE PAYMENT 518210 94700 94700 394700 9595036 9561750 0 -4715 X 1054363 835560 218803 3925449 3417967 507482 36410 33137 3273 311460 284442 27018 349277 299677 49600 85335 85335 42962 42962 29989 29989 1379934 1236097 143837 38180 1806 36374 162666 117340 45326 274720 274720 163123 114874 48249 56534 28602 27932 23058 23058 282215 198741 83474 138601 19695 118906 SUPPLIES 423376 423376 REPAIRS AND MAINTENANCE 207291 200989 6302 BAD DEBT EXPENSE 168887 168887 205006 58691 146315 9358836 7462939 1895897 0 581562 863517 0 0 1225992 1095124 530442 0 193987 185361 41636 35847 3793141 2663122 1198899 1130019 257047 961119 4029565 4270987 1037748 877345 496504 662706 577 0 1534829 1540051 X 2494736 2730936 2494736 2730936 4029565 4270987 236200 0 X 0 1 X 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 1 167 167 0 PART II-B, LINE 1, LOBBYING ACTIVITIES: MHA DUES 101008 14153 115161 384684 54396 330288 215423 135715 79708 3077873 2473011 604862 1130019 PATRONAGE CREDITS 101272 INVESTMENT - MHA WORK COMP 74025 CAPITAL CONTRIBUTIONS 250 Bed Tax Receivable 360572 County Taxes Receivable 425000 961119 9426149 -168887 -168887 9595036 0 9595036 9189949 0 9189949 168887 168887 9358836 Part XI, Line 2d - Other Adjustments: Bad Debt Expense -168,887. Part XII, Line 4b - Other Adjustments: Bad debt expense 168,887. 1 1 X 1 X 1 X 1 0 1 1 81299 81299 0.00880 3881270 3521751 359519 0.03910 3962569 3521751 440818 0.04790 245858 22750 223108 0.02430 245858 22750 223108 0.02430 4208427 3544501 663926 0.07220 1 168887 2541268 2596281 -55013 X 1 1 1 1 NORTHERN ROCKIES MEDICAL CENTER INC 802 SECOND STREET NE CUT BANK MT 59427 WWW.NRMCINC.ORG 13337 X X X NORTHERN ROCKIES MEDICAL CENTER INC 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X HTTP://NRMCINC.ORG X 1 15 1 HTTP://NRMCINC.ORG 0 1 X 100.000000000000 200.000000000000 X X 1 1 X X X 1 X HTTP://NRMCINC.ORG/ X HTTP://NRMCINC.ORG/ X http://NRMCINC.ORG/ X X X X X 1 X 0 X X X X 1 X 0 0 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. 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. X X X 0 0 0 0 0 0 0 0 0 DR MICHAEL D'AMBROSE Chief of Staff/MD 303374 0 55586 0 0 0 2156 0 6048 0 367164 0 0 0 NIALL ATKINSON FNP 166389 0 18000 0 0 0 3472 0 6768 0 194629 0 0 0 GREGORY COWART CRNA 200827 0 0 0 0 0 0 0 4972 0 205799 0 0 0 Mark Hill FNP 145538 0 0 0 0 0 0 0 6016 0 151554 0 0 0 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.