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FALLON MEDICAL COMPLEX INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
FALLON MEDICAL COMPLEX INC (EIN 36-3808993)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-02-15
IRS object ID
201800469349300040
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

FieldValueIRS element (for citing)
Return2018-02-15T12:49:45-06:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN363808993EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Fallon Medical Complex IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFALLBusinessNameControlTxt
Phone4067783331PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 820AddressLine1Txt
CityBakerCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59313ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDavid EspelandPersonNm
Person TitleCEOPersonTitleTxt
Phone4067783331PhoneNum
Signature2018-02-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim C HunwardsenPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2018-02-09PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address199.116.173.11IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-02-09IPDt
IP Tm13:21:03IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdD8A1E5117AA53286D53F57459EBB2DE5C7CA50FCAtSubmissionCreationDeviceId
At Submission Filing Device Id29C631FCBD7EE613918B5A80576D837C30D7D376AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1See Schedule OBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDavid EspelandPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 820AddressLine1Txt
CityBakerCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59313ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$12,109,241GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.fallonmedical.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1991FormationYr
Legal Domicile StateMTLegalDomicileStateCd
Activity Or MissionProviding healthcare servicesActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee138TotalEmployeeCnt
Total Volunteers72TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$434,512PYContributionsGrantsAmt
CY Contributions Grants$444,757CYContributionsGrantsAmt
PY Program Service Revenue$9,808,029PYProgramServiceRevenueAmt
CY Program Service Revenue$10,417,222CYProgramServiceRevenueAmt
PY Investment Income$682PYInvestmentIncomeAmt
CY Investment Income$844CYInvestmentIncomeAmt
PY Other Revenue-$16,192PYOtherRevenueAmt
CY Other Revenue$1,221,485CYOtherRevenueAmt
PY Total Revenue$10,227,031PYTotalRevenueAmt
CY Total Revenue$12,084,308CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,046,151PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,049,343CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,334,815PYOtherExpensesAmt
CY Other Expenses$5,567,649CYOtherExpensesAmt
PY Total Expenses$10,380,966PYTotalExpensesAmt
CY Total Expenses$10,616,992CYTotalExpensesAmt
PY Revenues Less Expenses-$153,935PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,467,316CYRevenuesLessExpensesAmt
Total Assets BOY$16,716,040TotalAssetsBOYAmt
Total Assets EOY$17,585,130TotalAssetsEOYAmt
Total Liabilities BOY$1,642,985TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,004,503TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$15,073,055NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,580,627NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionFallon Medical Complex, in its innovative pursuit of Friends Healing Friends, provides comfort, compassion, and excellence in the promotion of quality of life to all individuals.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
Expense$7,893,963ExpenseAmt
Revenue$10,535,902RevenueAmt
DescFallon Medical Complex (FMC) provides quality health care regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation of FMC, it is recognized that not all individuals possess the ability to purchase these essential services. It is the FMC's mission to serve the surrounding area by providing health care services to all community members.FMC provides medical services to individuals who are determined unable to purchase such services through FMC's Financial Assistance policy and guidelines. In addition to free and/or subsidized care, services are also provided at below cost rates to persons covered by government programs. Recognizing its mission to the community, services are provided to both Medicare and Medicaid patients. The unreimbursed value of providing care to these patients, based on established rates is $46,000 for the year ended June 30, 2017. FMC's Critical Access Hospital provides 24 hour x 7 days a week Emergency Room services, observation, Acute Care, Swing Bed services and onsite ancillary lab and diagnostic imaging services. During fiscal year ended June 30, 2017, FMC provided over 229 days of hospital services, 6,226 days of swing bed care, 1,075 ER visits, and over 7,900 outpatient visits.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,571,337ExpenseAmt
Revenue$1,103,588RevenueAmt
DescFMC Community Clinic (Rural Health Clinic) operates under the same mission as FMC by providing family health care to over 8,400 patient visits per year. The four providers (two physicians and two mid levels) also provide ER coverage 24 hours, 7 days a week.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$19,749ExpenseAmt
Revenue$0RevenueAmt
DescOne of FMC's operating philosophies states that education programs are necessary to enhance the competence of personnel in the healthcare system as well as to assist in the attainment of both personal and organizational goals. To this end, not only does the organization routinely budget $35,000 or more in continuing education for its employees, it also provides job shadowing to area students (typically 3-5 students per year) who may be interested in a healthcare career, in addition to offering routine Certified Nursing Assistant training programs (to about 5-10 prospective aides per year).FMC also hosts numerous college students seeking careers as doctors (1-2 per year), physician assistants (1-2 per year), and various other disciplines, such as radiology & laboratory technology and physical therapy. FMC further believes that it is its responsibility to take a leadership role in informing the public about healthcare subjects of relevance or interest through community education. This objective is supported through a number of channels, which includes routine "Lunch and Learn" sessions provided by medical professionals (about 6 times per year), weekly public service announcements on the local radio station, and an annual health fair which is attended by people from all over the service area.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$9,485,049TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related InvstYes (1)ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document21IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee138EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Marjorie LosingBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4067785103PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 820AddressLine1Txt
CityBakerCityNm
State AbbreviationMTStateAbbreviationCd
ZIP593130820ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Betty Mueller
President0.500.00Yes (X)Yes (X)$0$0$0
Doug Varner
Vice President0.500.50Yes (X)Yes (X)$0$0$0
Richard Menger
Secretary0.500.00Yes (X)Yes (X)$0$0$0
Merri Burns
Trustee0.500.00Yes (X)$0$0$0
Shane Bettenhausen
Trustee0.500.00Yes (X)$0$0$0
Bryant Steen
Trustee0.500.00Yes (X)$0$0$0
Alice Key Schweigert
Trustee (as of Jan 2017)0.500.00Yes (X)$0$0$0
David Espeland
Chief Executive Officer40.000.00Yes (X)$126,781$0$20,335
Selena NelsonChief
Financial Officer (thru Mar 2017)40.000.00Yes (X)$100,625$0$12,162
Marjorie LosingChief
Financial Officer (as of Mar 2017)40.000.00Yes (X)$28,250$0$0
Darryl Espeland
DO, Chief of Staff40.000.00$198,824$0$32,352Yes (X)
Dominick Trivisonno
MD40.000.00$210,065$0$17,811Yes (X)
Leanne R Breihahn
NP40.000.00$108,566$0$2,618Yes (X)
Travis Allen
Physician Assistant40.000.00$100,595$0$5,069Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$873,706TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$90,347TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MT Health Network Inc
111 South 7th Street Suite 241Miles CityMT59301Contract Nursing and Xray Services$593,398
Prairie Travelers Inc
130 3rd Street S 2GlasgowMT59230Contract Nursing Services$186,194
Rural Medical Partners
4956 Curran CourtGrand ForksND58201Locum Physician$184,720
Healthland Inc
PO Box 856554MinneapolisMN55485Software & Maintenance$171,188
NXC Imaging
2118 4th Ave SMinneapolisMN55485Software & Maintenance$154,403
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Related Organizations$42,679RelatedOrganizationsAmt
Government Grants$60,751GovernmentGrantsAmt
All Other Contributions$341,327AllOtherContributionsAmt
Total Contributions$444,757TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Service Revenue622110$9,237,464$9,237,464
County Subsidy900099$923,083$923,083
Miscellaneous900099$174,850$174,850
Meals on Wheels722212$59,949$59,949
Cafeteria722212$21,876$21,876
FieldValueIRS element (for citing)
Total Program Service Revenue$10,417,222TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$639TotalRevenueColumnAmt
Exclusion$639ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$24,150RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$24,933RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$783RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$783TotalRevenueColumnAmt
Exclusion-$783ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$205OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$205OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$205TotalRevenueColumnAmt
Exclusion$205ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescGain on Insurance SettlementDesc
Business900099BusinessCd
Total Revenue Column$1,222,268TotalRevenueColumnAmt
Related Or Exempt Func Income$1,222,268RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,222,268OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,084,308TotalRevenueColumnAmt
Related Or Exempt Func Income$11,639,490RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$61ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$453,962TotalAmt
Program Services$120,009ProgramServicesAmt
Management And General$333,953ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,807,063TotalAmt
Program Services$3,387,794ProgramServicesAmt
Management And General$419,269ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$45,784TotalAmt
Program Services$45,784ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$369,041TotalAmt
Program Services$311,003ProgramServicesAmt
Management And General$58,038ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$373,493TotalAmt
Program Services$308,692ProgramServicesAmt
Management And General$64,801ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$930TotalAmt
Management And General$930ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,503,196TotalAmt
Program Services$2,468,271ProgramServicesAmt
Management And General$34,925ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$24,945TotalAmt
Program Services$21,649ProgramServicesAmt
Management And General$3,296ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$658,756TotalAmt
Program Services$635,572ProgramServicesAmt
Management And General$23,184ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$141,656TotalAmt
Program Services$141,656ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$7,277TotalAmt
Program Services$6,856ProgramServicesAmt
Management And General$421ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$18,769TotalAmt
Program Services$14,594ProgramServicesAmt
Management And General$4,175ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$780TotalAmt
Program Services$4,713ProgramServicesAmt
Management And General-$3,933ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,134,602TotalAmt
Program Services$1,077,872ProgramServicesAmt
Management And General$56,730ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$122,493TotalAmt
Program Services$63,225ProgramServicesAmt
Management And General$59,268ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Equipment Rental$482,087$449,610$32,477
Bad Debt$387,568$387,568
Taxes & Licenses$21,038$19,219$1,819

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$63,552TotalAmt
Program Services$20,962ProgramServicesAmt
Management And General$42,590ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$10,616,992TotalAmt
Program Services$9,485,049ProgramServicesAmt
Management And General$1,131,943ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,373,293BOYAmt
EOY$3,382,318EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,467,775BOYAmt
EOY$1,477,017EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$177,369BOYAmt
EOY$202,812EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$4,067BOYAmt
EOY$64,333EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$20,618,608LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$10,524,250LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$9,713,821BOYAmt
EOY$10,094,358EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$73,574BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,174,036BOYAmt
EOY$1,214,292EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$732,105BOYAmt
EOY$1,150,000EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$16,716,040BOYAmt
EOY$17,585,130EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$871,718BOYAmt
EOY$458,348EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$529,105BOYAmt
EOY$157,968EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$1,898BOYAmt
EOY$1,940EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$34,600BOYAmt
EOY$16,202EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$205,664BOYAmt
EOY$370,045EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,642,985BOYAmt
EOY$1,004,503EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,746,357BOYAmt
EOY$16,248,938EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$143,649BOYAmt
EOY$148,640EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$183,049BOYAmt
EOY$183,049EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,073,055BOYAmt
EOY$16,580,627EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,716,040BOYAmt
EOY$17,585,130EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,467,316ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$40,256OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$29OtherActivitiesAmt
Total Lobbying Expenditures$29TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationFallon Medical Complex reimburses certain professional membership dues of employees. A portion of such membership dues are used by the professional association for lobbying activities. FMC also pays for dues to the Montana Hospital Association and Montana Health Care Association and a percentage of those dues are also used by the professional association for lobbying activities.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$243,034BeginningYearBalanceAmt
Investment Earnings Or Losses$681InvestmentEarningsOrLossesAmt
End Year Balance$243,715EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$230,502BeginningYearBalanceAmt
Contributions$10,000ContributionsAmt
Investment Earnings Or Losses$2,532InvestmentEarningsOrLossesAmt
End Year Balance$243,034EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$208,676BeginningYearBalanceAmt
Contributions$21,794ContributionsAmt
Investment Earnings Or Losses$1,032InvestmentEarningsOrLossesAmt
Grants Or Scholarships$1,000GrantsOrScholarshipsAmt
End Year Balance$230,502EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$190,592BeginningYearBalanceAmt
Contributions$20,000ContributionsAmt
Investment Earnings Or Losses$1,084InvestmentEarningsOrLossesAmt
Grants Or Scholarships$3,000GrantsOrScholarshipsAmt
End Year Balance$208,676EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$172,588BeginningYearBalanceAmt
Contributions$21,012ContributionsAmt
Investment Earnings Or Losses$992InvestmentEarningsOrLossesAmt
Grants Or Scholarships$4,000GrantsOrScholarshipsAmt
End Year Balance$190,592EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.17250BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.75110PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.07640TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$96,521OtherCostOrOtherBasisAmt
Book Value$96,521BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$17,253,374OtherCostOrOtherBasisAmt
Depreciation$8,129,561DepreciationAmt
Book Value$9,123,813BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,962,457OtherCostOrOtherBasisAmt
Depreciation$2,241,163DepreciationAmt
Book Value$721,294BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$306,256OtherCostOrOtherBasisAmt
Depreciation$153,526DepreciationAmt
Book Value$152,730BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$10,094,358TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescInvestment in FoundationDesc
Book Value$1,214,292BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$1,214,292TotalBookValueProgramRltdAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescEstimated Third Party Payor SettlementsDesc
Book Value$1,150,000BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,150,000TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDue to CountyDesc
Amt$370,045Amt
FieldValueIRS element (for citing)
Total Liability$370,045TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$11,626,253TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$143,737OtherRevenueAmt
Revenue Not Reported-$143,737RevenueNotReportedAmt
Revenue Subtotal$11,769,990RevenueSubtotalAmt
Other Revenues Not Included$314,318OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$314,318RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$12,084,308TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$10,254,357TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$24,933OtherExpensesIncludedAmt
Expenses Not Reported$24,933ExpensesNotReportedAmt
Expenses Subtotal$10,229,424ExpensesSubtotalAmt
Other Expenses Not Included$387,568OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$387,568ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$10,616,992TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part IV, Line 2b:The complex acts as a custodian for the funds of some residents. Resident funds totaled $1,940 and $1,898 at June 30, 2017 and 2016, respectively.
Part V, Line 4:Friends of FMC Foundation, Inc. holds the permanently restricted funds to provide a source of income to be used for Long Term Care, and/or equipment purchases on behalf of Fallon Medical Complex, and for scholarships. The principal has been invested and the generated income (temporarily restricted) is used for said purpose.
Part X, Line 2:The Complex is organized as a nonprofit organization and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. The Complex is also exempt from state income taxes. The Complex is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Complex is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Complex has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS. The Complex believes it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Complex would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.
Part XI, Line 2d - Other Adjustments:Equity in Earnings of Affiliate recorded in revenue for financial statements 40,256. Provision for Bad Debts -387,568. Net assets released from restrictions in revenue for finanical statements 203,575.
Part XI, Line 4b - Other Adjustments:Rental Expenses recorded in revenue for Form 990 -24,933. Contributions recorded in fund balanace for financial statements 339,251.
Part XII, Line 2d - Other Adjustments:Rental Expenses recorded in revenue for Form 990 24,933.
Part XII, Line 4b - Other Adjustments:Provision for Bad Debts 387,568.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent250Yes (X)Percent250Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served14PersonsServedCnt
Total Community Benefit Expns$54,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$54,000NetCommunityBenefitExpnsAmt
Total Expense0.00530TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,316,402TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$885,365DirectOffsettingRevenueAmt
Net Community Benefit Expns$431,037NetCommunityBenefitExpnsAmt
Total Expense0.04210TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,592TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,126DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,466NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served14PersonsServedCnt
Total Community Benefit Expns$1,382,994TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$894,491DirectOffsettingRevenueAmt
Net Community Benefit Expns$488,503NetCommunityBenefitExpnsAmt
Total Expense0.04770TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$112,087TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$59,505DirectOffsettingRevenueAmt
Net Community Benefit Expns$52,582NetCommunityBenefitExpnsAmt
Total Expense0.00510TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Persons Served2PersonsServedCnt
Total Community Benefit Expns$217,448TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$217,448NetCommunityBenefitExpnsAmt
Total Expense0.02130TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,018,187TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,417,005DirectOffsettingRevenueAmt
Net Community Benefit Expns$601,182NetCommunityBenefitExpnsAmt
Total Expense0.05880TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Persons Served9PersonsServedCnt
Total Community Benefit Expns$3,546TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,546NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Persons Served11PersonsServedCnt
Total Community Benefit Expns$2,351,268TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,476,510DirectOffsettingRevenueAmt
Net Community Benefit Expns$874,758NetCommunityBenefitExpnsAmt
Total Expense0.08550TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served25PersonsServedCnt
Total Community Benefit Expns$3,734,262TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,371,001DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,363,261NetCommunityBenefitExpnsAmt
Total Expense0.13320TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$973TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$973NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$379TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$379NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Total Community Benefit Expns$415TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$415NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$850TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$850NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served6643PersonsServedCnt
Total Community Benefit Expns$162,393TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$59,949DirectOffsettingRevenueAmt
Net Community Benefit Expns$102,444NetCommunityBenefitExpnsAmt
Total Expense0.01000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Total Community Benefit Expns$594TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$594NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs8ActivitiesOrProgramsCnt
Persons Served6643PersonsServedCnt
Total Community Benefit Expns$165,604TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$59,949DirectOffsettingRevenueAmt
Net Community Benefit Expns$105,655NetCommunityBenefitExpnsAmt
Total Expense0.01030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$387,568BadDebtExpenseAmt
Bad Debt Expense Attributable$29,843BadDebtExpenseAttributableAmt
Reimbursed By Medicare$3,782,121ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$3,814,084CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$31,963MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Fallon Medical Complex IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1202 South 4th Street WestAddressLine1Txt
CityBakerCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59313ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.fallonmedical.orgWebsiteAddressTxt
State License13128StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherOutpatient Clinic - RHCOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Fallon Medical Complex IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://www.fallonmedical.org/OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttp://www.fallonmedical.org/StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care250.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLwww.fallonmedical.orgFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLwww.fallonmedical.orgFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.fallonmedical.orgFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Fallon Medical Complex, Inc.Part V, Section B, Line 5: During the Community Health Services Development Process, Fallon Medical Complex conducted three focus group meetings that were open to the public. Steering committee participants were selected based on their involvement with community development and healthcare services, including: local business men and women, Fallon County commissioners, healthcare personnel, and representatives from the Council on Aging and the South Eastern Montana Area Revitalization Team (SMART).
Fallon Medical Complex, Inc.Part V, Section B, Line 7d: Available in FMC's Quality Improvement Department
Fallon Medical Complex, Inc.Part V, Section B, Line 11: Fallon Medical Complex (FMC) conducted a Community Health Needs Assessment (CHNA) during FY2016 in order to develop a new implementation plan for FY2017 beginning July 1, 2016. That plan was adopted by our Board of Trustees on November 2, 2016.Our new plan identified four prioritized health needs as determined by the assessment process: 1) outreach and education, 2) primary care, 3) specialty care, 4) smoking prevalence. For the most part, our implementation plan largely addressed the formation of a framework for providing these services using our existing staff. We identified the most substantial barrier to be "resource limitations," which has been the case.This past fiscal year was one of our worst, prompting both a wage freeze and a hiring freeze, resulting in a 10% reduction in our workforce. For this reason, we could not work on many of the goals and strategies identified in the implementation plan, especially as it relates to outreach and education. Nonetheless, we did achieve a handful of accomplishments under each identified health need:1) Outreach & Education: Our PR Coordinator has been evaluating alternative modalities to share information (radio, newspaper, websites, social media), trying to determine which is the most effective and reasonably priced. In particular, she has been trying to enhance our presence on FaceBook, which seems to be viewed the most. In addition, we have continued to actively sponsor and participate in our local health fair, holding mini-health fairs throughout the year for major employers. In light of recent retirements, we have been educating the community on our plan for the staffing of our providers in the clinic. Lastly, we did implement the 340B program in November 2016 to provide reasonably priced medications to low income individuals. 2) Primary Care: We did extend our clinic scheduling from one month in advance to six months in advance, and we are currently working on a one-year schedule. We publish a color copy of our monthly staffing in the local newspaper, so that our patients can see who is available on each day. We continue to offer student camps, job shadow opportunities and rural clinical rotation experiences for medical students.3) Specialty Care: We are continuing to offer Lunch-and-Learn programs during the winter months (summer months are not well-attended), which have included sessions on telemedicine and eEmergency.4) Smoking Prevalence: We embraced the process of evaluating the concept of a Smoke Free Medical Campus and developed a working policy and implementation plan. We provided the appropriate education and notification, in addition to posting signage throughout our campus. We also worked with our health insurance plan to create smoking cessation funding. All in all, this need was fully implemented and completed on September 1, 2016.During the CHNA process, a handful of needs were identified that we are not able to address:a) Offering optometry in our facility: For a number of years, we rented space to an out-of-town optometrist who offered his services once a week. When he retired, he was unable to convince the buyer of his practice to come to our town. We have been continuously searching for a replacement with no success. That type of service cannot be sustained 5-days a week in this community, so a new optometrist will need to provide outreach from a neighboring town.b) Offering additional programs in alcohol & substance abuse: A large number of CHNA participants identified this as a significant issue. While we can heighten people's awareness of alcohol and substance abuse through education, we do not have the population base to support a formal program. Even towns five times bigger than ours cannot seem to sustain such a program, so our providers routinely refer patients to programs in larger cities. Nevertheless, we offer alcohol and drug counseling over telemedicine with the Eastern MT Mental Health Center in Miles City, MT.c) Reducing the burden of traveling long distances to receive specialty services: Unfortunately, we do not have the population base to support specialty services. We have collaborated with neighboring facilities to offer routine 1-day clinics in our facility, but inevitably the providers find it too burdensome to sustain. We are, however, offering specialty consultations over telemedicine which has been very successful, greatly reducing the travel burden.d) Addressing the shortage of mental health resources and providers: It is widely recognized by healthcare providers statewide that there is a significant need to provide better mental health services. After studying this issue in collaboration with our peers in the Montana Health Network, we have identified two sizeable barriers: 1) there are no mental health professionals available to service our communities, and 2) there is no insurance reimbursement available to pay for the services. This is an ongoing topic that is discussed frequently in larger circles, but too substantial for us to solve on our own.
Fallon Medical Complex, Inc.Part V, Section B, Line 16j: FMC provides a summary of the financial assistance policy to patients upon admission. FMC also attaches a summary of the policy to billing invoices and posts a plain language summary in the facility's emergency and waiting rooms, admissions offices, public health, courthouse, and senior citizen center.
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
2 - Community Clinic
202 South 4th Street WestBakerMT59313Outpatient Clinic - RHC
3 - Wibaux Clinic
710 Drake StreetWibauxMT59353Outpatient Clinic

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:We do include an asset & liability test for those who qualify between 200-250%. Anyone at or below 150% qualifies for free care. Anyone who does not qualify for free care, with income between 151% and 250% qualifies for discounted care. Because the test of discounted care considers net assets and the patient's medical bills are included in liabilities, a medically indigent could qualify for discounted care under this program.
Part I, Line 7:Charity care expense was converted to cost based on an overallcost-to-charge ratio addressing all patient segments. Community health improvement services and community benefit operations, health professions education and cash and in-kind contributions to community groups are based on costs recorded in the general ledger and estimated costs. Medicaid and Subsidized health services are determined based on costing methods used to prepare the cost report. Costs of other means-tested government programs was determined using worksheet 2.
Part I, Ln 7 Col(f):The amount of bad debt expense removed from the denominator of the calculation was $387,568.
Part II, Community Building Activities:FMC participates in a number of community building activities to improve our community. Our Foundation Coordinator has been a member of the local housing board, searching for ways to address our community's chronic housing shortage by facilitating the construction of new housing and the renovation of existing housing. In addition, FMC manages a senior independent living complex for Fallon County. Although the county does reimburse direct expenses for maintenance, one of our employees act as a "property manager," coordinating tenant turnover, fielding questions or concerns, calling for property services, etc., at no cost to the County.From an economic development standpoint, our Foundation Director has also been a board member of our local Southeastern Montana Revitalization Team which is dedicated to revitalizing the economic climate in the area. They are focused on building community infrastructure, as well as attracting new businesses and finding ways to provide housing for incoming workers and their families. In addition, in an effort to help keep local commerce alive, our Foundation Coordinator actively participates in Baker Chamber of Commerce meetings and events, including hosting their monthly meeting on a rotating basis. One of the Chamber's primary events, the Fall Festival, is coordinated by FMC staff, who also participate in the Chili Cook-off event every year during the Fall Festival.To further support the community, a number of FMC employees frequently participate in disaster preparedness meetings and events through the Fallon County Local Emergency Preparedness Committee (LEPC). This group meets regularly to discuss disaster preparedness activities, to review the response of similar groups to disasters across the nation, to determine ways to enhance the effectiveness of disaster response in our area and to conduct table top exercises that simulate potential local disasters. We have also dedicated staff time and resources to acquiring knowledge in the Hospital Emergency Incident Command System (HEICS), a nationally recognized and practice program in incident management.In an effort to assist with leadership development, two staff members routinely provide assistance with youth leadership programs. For instance, one of our Physical Therapists has acted as a 4H leader for a number of years, participating in youth developmental programs that provide hands-on learning activities to youth. In addition, our CEO provides coaching and judging for our local Business Professionals of America (BPA) chapter, which teaches basic and advanced business skills to high school students. Our CEO has also acted as a judge for local Speech and Drama events, which helps high school students gain valuable skills in public speaking and performing.FMC participates in coalition building by contributing to collaborative efforts that address health and safety issues, including LEPC and HEICS mentioned earlier, with other healthcare entities and emergency service providers. To further provide continuity across our service area, our Chief of the Medical Staff is the County Health Officer for Carter, Fallon, and Wibaux Counties, routinely attending their meeting and providing medical control and guidance on relevant issues.One of our larger efforts to assist with community health improvement is to take an active role in offering, serving and significantly subsidizing noon meals to seniors. FMC collaborates with our local Council on Aging to serve 4,186 meals each year to seniors in our facility dining room as well as an additional 2,457 meals through Meals on Wheels. This program promotes health and well-being of our seniors by providing nutritious meals to those who might otherwise not receive them, especially those who are home bound.FMC's workforce development support is largely focused on healthcare careers. We annually work with the local school system to offer "Medical Explorers," which allows students to ask medical professionals questions about their job and learn about the myriad of healthcare careers. Some years we are able to secure a patient simulator to give students a real life experience. Additionally, we allow students of all levels to request an opportunity to job shadow a healthcare professional. In the past, students have observed lab techs, radiology techs, nurses, doctors and mid-levels in their daily activities of providing care for patients. Our CEO and Foundation Director serve on two Montana healthcare-related scholarship committees. Their participation on these committees promotes healthcare-related careers by helping to fund college educations.
Part III, Line 2:Bad debt expense is reported as charges at gross charges recorded by the organization.Bad debts are expensed when accounts are determined uncollectible (charges less any payments or insurer discounts) and any payments toward bad debt are booked as bad debt recovery.
Part III, Line 3:The estimated amount of bad debt expense attributable to patients eligible under the organization's charity care policy is 7.7% (based upon US Census Bureau Quickfacts for percent of citizens below the poverty level in Fallon County). Fallon Medical Complex is estimating the amount of bad debt to be charity care based on the percentage of demographics below charity care income/asset levels. This identifies a reasonable percentage of individuals who potentially qualify for charity care but may not have applied and therefore were written off to bad debt.
Part III, Line 4:The footnote to the Organization's financial statements can be found on page 8 of the attached audited financial statements.
Part III, Line 8:Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.All of the Medicare shortfall should be treated as a community benefit. The Organzation treats individuals regardless of the ability to pay. Most of the Medicare shortfall comes from the rural health clinic. It is a community benefit to be able to treat all individuals at the local clinic.
Part III, Line 9b:Once a patient has been determined by FMC to be eligible for financial assistance, that patient shall not receive any future bills based upon undiscounted gross charges on approved account balances. Requests for financial assistance shall be processed promptly. FMC shall notify the patient in writing within 30 days of receipt of a completed application. Collection activity will be suspended while a financial assistance application is under review. Normal collection efforts will resume if the application is not returned in a timely fashion or after the write-off is complete and the patient owes a balance.
Part VI, Line 2:We have traditionally received input about unmet community health care needs from a number of sources: a) citizens, board members, patients, and residents expressing an idea or a concern, b) suggestions from consultants who were hired to provide a study of our operations, c) the county or state health department providing observations or data regarding the health status of our specific population, d) staff members gleaning information from an education program or from reviewing professional journals and periodicals regarding the latest equipment or trends in patient and resident care, e) suggestions from the public posted on our website, etc. We have completed a formal Community Health Services Development assessment through Montana State University, the result of which is available on our website, www.fallonmedical.org. Subsequent to the CHNA, we developed a 3 year implementation plan to address the most important health needs in our community. This plan is also published on our website. Information from all of these sources is analyzed on a case by case basis by the department manager who would be responsible for implementing the program. The manager determines the program's merit relative to our stated mission as well as what resources would be necessary to implement the program. The manager submits the analysis to our internal Operational Review Committee, which looks at its impact facility-wide and its feasibility. If it progresses past this committee, it is then evaluated by our management team, who analyzes the finer details. Ultimately, it is discussed at the Board of Trustees level to seek their input and approval, if necessary.
Part VI, Line 3:We notify our patients of our financial assistance program through a number of methods; (1) we post the charity care policy, or a summary thereof, and financial assistance contact information in admissions areas, emergency rooms, facility website, other areas of our facility in which eligible patients are likely to be present, public health department, senior citizen center and courthouse; (2) we make available a copy of the policy, or a summary thereof, and financial assistance contact information to patients as part of the intake process; (3) we provide a copy of the policy, or a summary thereof, and financial assistance contact information to patients with discharge materials; (4) we include the policy, or a summary thereof, along with financial assistance contact information, in patient bills; and/or (5) we discuss with the patient the availability of various government benefits, such as Medicaid or state programs, and assist the patient with qualification for such programs, where applicable. In addition, we offer the free services of a certified "Navigator" who can assist the public while evaluating health insurance choices offered in the ACA Marketplace.
Part VI, Line 4:Fallon Medical Complex (FMC) is a sole community health care provider for a rural population in excess of 7,200 people spread over seven counties. In addition to serving Fallon County, located in southeastern Montana, FMC also provides health care for three bordering Montana counties (Carter, Wibaux, and part of Custer) and three adjacent North Dakota counties (Slope, Golden Valley, and part of Bowman). Considered "frontier" by the Montana Department of Public Health and Human Services, this region boasts less than two residents per square mile. FMC operates a critical access hospital, a rural health clinic, and a home care and personal services agency. Although Carter County operates a Critical Access Hospital and a Rural Health Clinic in Ekalaka, MT (35 miles to the south), facilities offering the next highest level of care are over 80 miles from Baker, necessitating a drive of nearly two hours in inclement weather. Two primary care physicians and two mid levels (physician assistants and/or family nurse practitioners) practice full time in Baker and see patients two days a week in our satellite clinic in Wibaux, MT. In addition, FMC's physicians supervise physician assistants in Ekalaka, MT and in Wibaux, MT. All in all, the DHHS Bureau of Primary Health Care has designated FMC's service area as a Health Professional Shortage Area (HPSA) due to: a) a high population-to-physician ratio (greater than 3,500:1), b) the extreme remoteness of this facility, c) sparseness of our service area, and d) excessive distances to alternative providers.The majority of patients in FMC's service area are Caucasian (96%), older than age 45 (52%) and have graduated from high school (96.2%). The per capita income is about $35,405 per year (compared to $33,225 for all of Montana) and the unemployment rate is 2.3% (compared to 4.5%). About 6.9% of the population is below the Federal Poverty Level and roughly 15% of the population does not have health insurance. Of those with health insurance, 22% are covered by Medicare, and 6% are covered by Medicaid. Of those people on Medicaid, 21% receive mental health services. In all, according to a Robert Wood Johnson Foundation study, Fallon County is ranked 3 out of 47 for "health factors," based on health behaviors, clinical care, social and economic factors, and physical environment.Like most rural Montana areas, FMC's service area economy is largely based on agriculture. Wheat and barley are major farm crops and cattle and sheep dominate the local livestock production. The other major contributor towards the local economy is oil and gas exploration and extraction. Many residents are employed by large energy exploration and drilling companies or smaller energy-related service companies. The area recently entered the alternative energy arena when wind farms began cropping up across the wind-swept prairie.
Part VI, Line 5:All members of the Board of Trustees reside in our primary service area and are neither employees, contractors, nor family members of FMC. They are not compensated for their participation on the board and must be interested in, and willing to work towards, the best interests of health care in our service area. The board strives to find trustee candidates from all corners of FMC's service area, as well as diversity in gender and occupations. The Board is comprised of individuals who work as educators, ranchers, small business owners, retirees, and oil company managers.One of the board's responsibilities is to maintain and oversee FMC's Medical Staff. As such, they are responsible for granting privileges to qualified physicians and mid-levels (providers) based on education and skills confirmed through a structured credentialing process. The board extends medical staff privileges to all qualified providers that have an interest in providing services to our patients and who complete our formal application process. This process includes conducting due diligence through background checks, verification of education and credentials, and personal and professional reference checks. Providers may offer their services directly in our community or remotely via telemedicine systems.Given the isolated rural location of FMC as well as its limited service area population, the facility typically does not generate surplus funds from operations. A delicate balance exists between forecasting an anticipated revenue stream and attempting to match up operational expenses. Given that no revenue is guaranteed, adjustments must be made throughout each fiscal year to ensure the facility's ongoing solvency. Accordingly, FMC has not realized a net profit from operations for over 20 years.Most "surplus" funds are derived from gifts, grants, and fundraising efforts, all of which are generally focused on acquiring capital for the acquisition of patient care equipment. Some of these purchases are meant to upgrade equipment that has reached the end of its useful life cycle, in which case we strive to leverage design or technology improvements to provide greater comfort and effectiveness for the benefit of our patients. And in some cases, we use the funding to start a new service which was identified through our various needs assessments.FMC is predominantly a sole community "primary care" provider for its service area. Its system, or complex, of health care services was created out of necessity due to its remoteness. FMC lacks the resources and service area population to offer specialized medical services and/or conduct formal medical education and medical research. For the most part, we have striven to incrementally improve and enhance our core service offerings in an effort to increase the overall health status of our patients and residents. Accordingly, we strive to excel at primary care, offering family practice and preventative health outpatient services, routine hospital and fully digital diagnostic services, 24-hour emergency care (available to all regardless of ability to pay), long-term care, home-based skilled and personal care, and physical and occupational therapy.In an effort to provide comprehensive medical care to the community, various providers from neighboring communities routinely offer services to patients at FMC. For instance, chiropractic, dental, and hearing aid clinics are held regularly in Baker. In addition, FMC's primary medical care is augmented by visiting physicians such as Obstetricians and Pediatricians.In addition, our Telemedicine system is routinely used by participants in a Chemical Dependency (CD) support, education, and life skill class, allowing participants to interact with other participants and counselors in neighboring communities without having to drive for more than an hour each way multiple times each month. It is also used to conduct Healthy Lifestyles classes in conjunction with Holy Rosary Healthcare in Miles City, MT and to connect our patients with specialists located at Billings Clinic. Although we are not a formal teaching facility, we do host multiple students annually who are seeking careers in healthcare related disciplines. This includes high school students who would like to job shadow, to medical students who are completing a primary care rural rotation. We have a number of cooperative agreements with colleges and universities across the nation that allow students a variety of clinical experiences, from observation of care by a trained professional to providing limited patient services under direct supervision. In the past few years, we have hosted students pursuing careers as nurses, lab techs, radiology techs, physician assistants, physical therapists and physicians, coming from Pennsylvania, Washington State, Florida, Utah and Montana.In addition, FMC's Hospital Helpers organization has 30 members who volunteer their time by fundraising for various projects, working in our long term care area -- operating a beauty shop, visiting with residents, and providing assistance with activities -- and managing a small gift shop in the hospital. All of the money raised by this group is gifted to the facility for the purchase of essential furniture, fixtures, and equipment. The community also provides 36 specialty volunteers who offer their talents to our facility. For example, various music groups provide events throughout the year and clergy from surrounding churches hold regular church services and help with special needs. Volunteers also read newspapers and books, hold bible study classes, and decorate rooms and hallways for our residents.FMC operates a foundation that exists solely to attract and manage funds from donors who would like to provide financial support in the furtherance of FMC's mission. This separate non-profit entity is governed by its own Board of Directors, which raises the funds, manages the investments, and determines how the funds should be spent. One of their most actively managed efforts is the awarding of scholarships to students from our service area seeking healthcare careers.We also encourage our staff to be involved in community-related boards and programs. For instance, our Foundation Coordinator has been a member of a local housing board, searching for ways to address our community's chronic housing shortage, as well as a county-supported economic revitalization team, and the local chamber of commerce. Furthermore, a number of employees participate in disaster preparedness meetings through the Local Emergency Preparedness Committee and provide leadership roles in Boy Scouts, 4H, Business Professionals of America, Medical Explorers and Speech and Drama.Lastly, FMC participates in many government-sponsored health care programs, including Medicare, Medicaid, Champus/Tricare, CHIP, and VA Choice. Plus, we recently agreed to participate in the newly expanded Medicaid program (HELP) offered in Montana. We have also embraced participation in a number of voluntary government-sponsored programs that focus on quality assurance and process improvement, both independently, as well as through collaborative efforts with other Montana hospitals and associations (such as the Montana Health Network, the Montana Hospital Association, the Mountain-Pacific Quality Health Foundation and the Hospital Improvement Innovation Network).

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Darryl Espeland
DO, Chief of Staff$198,824$0$0$0$0$0$17,136$0$15,227$0$231,187$0$0$0
Dominick Trivisonno
MD$210,065$0$0$0$0$0$2,810$0$15,012$0$227,887$0$0$0

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Darryl Espeland DO Chief of Staff
Employee and brother of CEO$122,458Wages and Benefits0
David Espeland CEO
Employee and brother of DO, Chief of Staff$154,328Wages and Benefits0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, line 2Our 340B Program and Avera ePharmacy went live December 14, 2016. Bone Densitometry was implemented March 30, 2017.
Form 990, Part III, line 3We decertified our Skilled Nursing Facility as of July 1, 2016.
Form 990, Part VI, Section A, line 2David Espeland and Darryl Espeland have a family relationship.
Form 990, Part VI, Section A, line 6The members of the Corporation shall consist of all trustees and those individuals who apply for membership and fulfill the qualifications for membership which are established by the Board of Trustees.
Form 990, Part VI, Section A, line 7aElections for Trustees shall be held at the annual membership meeting, or by written ballot if authorized by the Board of Trustees. Any vacancy occurring on the Board of Trustees may be filled by appointment by the President of the Board of Trustees subject to confirmation by a majority of the members of the Board present at the next regular meeting of the Board following such appointment. The person so appointed shall serve for the remainder of the term of the Trustee for whom he or she was appointed. In the event that the election date set forth above falls on a legal holiday, the Board may by resolution adopted at any regular or special meeting preceding said date, postpone said election to the next business day following such date.
Form 990, Part VI, Section A, line 8bThe organization does not have a committee that acts on behalf of the governing board.
Form 990, Part VI, Section B, line 11bThe Form 990 is emailed to the Board of Trustees for their review and they are allowed to comment prior to filing.
Form 990, Part VI, Section B, line 12cThe organization's policy requires a duty to disclose any conflicts annually as well as during discussions. The conflict of interest policy covers all members of the board, officers and employees. Board Members, officers and employees complete a questionnaire annually addressing potential areas of conflicts. Conflicts are determined by each individual. Conflicts are determined by each individual, but reviewed at the board level. If a conflict arises, the board member abstains from voting on matters that gave rise to the conflict.
Form 990, Part VI, Section B, line 15The Montana Hospital Association (MHA) publishes its compensation data for all classifications of healthcare workers annually. The data pertaining to facilities comparable in size is used to determine executive and officer compensation. The Board may also choose to call their peers in other facilities to substantiate the MHA data and to confirm the appropriateness of any proposed compensation. The board votes and approves the compensation for officers such as the CEO and CFO. The decisions are documented on an annual basis when salaries are approved. This process last took place at the end of fiscal year 06/30/17, with board approval of the budget for FY 2017 at the 06/21/17 board meeting.
Form 990, Part VI, Section C, line 19The organization's governing documents, conflict of interest policy and financial statements are available for inspection at the corporation's place of business upon request.
Form 990, Part IX, line 11gProfessional Fees: Program service expenses 933,045. Management and general expenses 34,925. Fundraising expenses 0. Total expenses 967,970. Contract Services: Program service expenses 1,444,792. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,444,792. Purchased PT Testing: Program service expenses 90,434. Management and general expenses 0. Fundraising expenses 0. Total expenses 90,434.
Form 990, Part XI, line 9:Equity in Earnings of Affiliate recorded in Revenue for Financial Statement 40,256.
Form 990, Page 1, Line C:Fallon Medical Complex, Inc. is doing business under the following names: Community Clinic, Home Care Services, Fallon Memorial Hospital, and Wibaux Clinic.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Friends of FMC FoundationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1202 S 4th St WAddressLine1Txt
CityBakerCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59313ZIPCd
FieldValueIRS element (for citing)
EIN431975486EIN
Primary ActivitiesFoundation/FundraisingPrimaryActivitiesTxt
Legal Domicile StateMTLegalDomicileStateCd
Exempt Code Section501(c)(3)ExemptCodeSectionTxt
Public Charity StatusLine 7PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd