2017-04-11T20:01:45-05:00 2016-06-30 390758449 Wipfli LLP PO Box 1699 Helena MT 59624 990 2015-07-01 816016920 Daniels Memorial Hospital dba Daniels Memorial Healthcare Center DANI 4064875331 P O Box 400 Scobey MT 59263 Dave Ryerse CEO 4064875331 2017-04-11 1 Nathan D McCarthy CPA P00368408 4064425520 2017-04-11 2015 2021-01-29 14:40:06Z Dave Ryerse P O Box 400 Scobey MT 59263 7267468 0 X www.danielsmemorialhealthcare.org X 1956 MT TO PROMOTE THE GENERAL HEALTH CARE OF THE COMMUNITY THROUGH PROVIDING HIGH QUALITY HEALTH CARE AND A HOME FOR THE AGED AND INFIRM. 12 12 111 6 0 0 569624 343011 6178536 6444336 0 635 165581 479486 6913741 7267468 0 0 0 0 4233451 4173463 0 0 0 3054973 3568543 7288424 7742006 -374683 -474538 3076835 3119674 785614 1302993 2291221 1816681 X To provide a health care system with clinic, acute inpatient, emergency, outpatient, and long-term care services 0 0 4465898 4771432 PROFESSIONAL CARE - PRIMARY, ACUTE AND LONG TERM CARE. 1101731 945019 CLINIC SERVICES FOR OUTPATIENT CLIENTS. 277707 0 HOUSEKEEPING, LAUNDRY, LINEN & PLANT SERVICES - PROVIDE FOR THE HOUSEKEEPING AND BUILDING MAINTENANCE OF THE FACILTIY. 562139 727885 DIETARY SERVICES FOR ACUTE AND LONG TERM CARE PATIENTS. Other Unrestricted 562139 727885 6407475 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 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 6 0 1 111 0 0 0 0 0 0 0 0 0 X 12 12 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 1 0 0 MT X DANIELS MEMORIAL HOSPITAL 4064872296 105 5TH AVENUE EAST Scobey MT 59263 X Mike BJARKO Chair 2.00 X 0 0 0 Paul Kanning Vice Chair 2.00 X 0 0 0 Perry Wolfe Secretary 2.00 X 0 0 0 Nancy Lund Treasurer 2.00 X 0 0 0 Kathy Wilcoxon Director 2.00 X 0 0 0 Larry Henderson Director 2.00 X 0 0 0 Karen TANDE Director 2.00 X 0 0 0 Susan Ferestad Director 2.00 X 0 0 0 Jedda Barron Director 2.00 X 0 0 0 JR Maldonado Director 2.00 X 0 0 0 brian hagan director 2.00 X 0 0 0 liana handran director 2.00 X 0 0 0 Dr Donald Sawdey DO 40.00 X 368090 0 0 Zoe McCarty Fugere FNP 40.00 X 137669 0 0 Shirley Reller PT 40.00 X 116202 0 0 Linda Wolford Lab/Radiology Manager 40.00 X 100344 0 0 Kim Wolfe Director of Nursing 40.00 X 100285 0 0 822590 0 0 5 0 1 0 Billings Clinic 2800 10th Ave North Billings MT 59107 Management Services 596826 1 343011 343011 Professional Care Reve 623000 5499317 5499317 Clinic Revenue 623000 945019 945019 6444336 635 635 Hosplital Tax district 623000 300206 300206 Income/Loss from Insur 623000 -28383 -28383 207663 207663 479486 7267468 6924457 0 0 3167123 2893734 273389 767094 687328 79766 239246 218892 20354 29305 1209 28096 33409 17157 16252 52233 45850 6383 59346 34352 24994 1129 1129 279861 279861 118351 872 117479 Contractual Services 992369 756446 235923 Professional Fees 862776 411608 451168 MEDICAL SUPPLIES AND PH 439837 439837 0 Supplies 258803 239405 19398 441124 380924 60200 7742006 6407475 1334531 0 221133 651524 462527 32000 551461 884276 90000 0 196464 207406 54793 50261 5817072 4731203 1264036 1085869 236421 208338 3076835 3119674 743143 1302673 42451 0 20 320 785614 1302993 X 2291221 1816681 2291221 1816681 3076835 3119674 -474538 0 X X 1 X 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 13500 13500 3622462 3286895 335567 2149778 1422381 727397 31332 21927 9405 1085869 Resident Cash 320 Subscribers equity in insurance cap 208018 208338 Resident Trust Fund 320 320 6649299 0 6649299 618169 618169 7267468 7742006 0 7742006 0 7742006 Part XI, Line 4b - Other Adjustments: OTHER REVENUES 1 1 1 X 1 X 1 1 1 0 1 1 36434 36434 0.00470 36434 36434 0.00470 101486 101486 0.01310 0 101486 101486 0.01310 137920 137920 0.01780 0 225526 169145 2156797 2156797 X 1 1 1 1 Daniels Memorial Hospital PO Box 400 Scobey MT 59263 www.danielsmemorialhealthcare.org X X X X Long-Term care facility; Rural health clinic; Daniels Memorial Healthcare Center 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X www.danielsmemorialhealthcare.org X X 1 16 1 www.danielsmemorialhealthcare.org 0 0 1 X 100.000000000000 200.000000000000 X X X X X 1 1 X X X 1 X X X X 1 X X 1 X X X X 1 0 0 Daniels Memorial Healthcare Center Part V, Section B, Line 5: A FEW OF THE SURVEY QUESTIONS WERE MODIFIED AND ADDITIONAL QUESTIONS WERE ADDED TO THE COMMUNITY ASSESSMENT THAT PERTAINED TO PUBLIC HEALTH, ISSUES RELATED TO SMOKING, ALCOHOL CONUSMPTION, HEALTHY LIFESTYLES AND CANCER SCREENING. Daniels Memorial Healthcare Center Part V, Section B, Line 7d: Publicized in local newspaper. Daniels Memorial Healthcare Center Part V, Section B, Line 11: The hospital is still in the process of addressing all of the needs identified in its most recently conducted needs assessment. Part VI, Line 2: Public Health Nursing service requests all participants: business, civic, religious, healthcare, public and we identify issues that may assist the community. i.e. healthcare, housing, roads, infrastructure. Part VI, Line 3: We inform the public about programs, i.e. Medicare/Medicaid. Advertisement in print and radio, phamplets in the waiting room, and social service visits with patients. Part VI, Line 4: We are designated a frontier CAH, >6 people per sq mile, town has 960 people, county has 1406 people, we are 5 hours away from a tertiary hospital, and 3 hours away from a secondary hospital. Part VI, Line 5: Through the Telemedicine Network, patients can see specialists 5 hours away right here. Several free telemedicine network services are offered: cardiology, diabetes, baby sitting classes with dipolma, mental health, chemical dependency are all free to the public and groups. X X 0 0 0 0 0 0 0 0 0 Dr Donald Sawdey DO 368090 0 0 0 0 0 0 0 0 0 368090 0 0 0 Form 990, Part VI, Section A, line 3 Daniels Memorial Hospital contracts with the Billings Clinic for management, IT, and accounting services. Form 990, Part VI, Section B, line 11 The 990 is available for review by the Board after approval by the CEO. Form 990, Part VI, Section B, line 12c At the annual meeting, conflict of interest statements are reviewed and signed by all trustees and the CEO. The board chair and CEO monitor the status of all trustees throughout the year for changes that could lead to a new situation requiring disclosure. Form 990, Part VI, Section B, line 15a The board of trustees review and make decisions on the compensation package for the CEO. The CEO compensation is part of the management contract paid to the outside management company. All managers report to the CEO and the CEO reviews and makes decisions on the managers compensation. Form 990, Part VI, Section C, line 19 All governing documents, including the conflict of interest statement and the financial statements, are available to the public upon request. Form 990 Line 2c The Board reviews the financial statements