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ROUNDUP MEMORIAL HOSPITAL ASSOCIATION: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
ROUNDUP MEMORIAL HOSPITAL ASSOCIATION (EIN 81-0245848)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-05-16
IRS object ID
201621379349307867
Schema version
2014v6.0
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)
Return2016-05-16T16:25:57-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 N LAST CHANCE GULCHAddressLine1Txt
CityHELENACityNm
State AbbreviationMTStateAbbreviationCd
ZIP59601ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN810245848EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ROUNDUP MEMORIAL HOSPITAL ASSOCIATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlROUNBusinessNameControlTxt
Phone4062322301PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 40AddressLine1Txt
CityROUNDUPCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59072ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBRAD HOWELLPersonNm
Person TitleCEOPersonTitleTxt
Phone4062322301PhoneNum
Signature2016-05-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNATHAN D MCCARTHY CPAPreparerPersonNm
PTINP00368408PTIN
Phone4064425520PhoneNum
Preparation2016-05-11PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBRAD HOWELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 40AddressLine1Txt
CityROUNDUPCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59072ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$9,305,416GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.RMHMT.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1979FormationYr
Legal Domicile StateMTLegalDomicileStateCd
Activity Or MissionPROVIDE HEALTHCARE SERVICESActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee105TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$26,787PYContributionsGrantsAmt
CY Contributions Grants$192,282CYContributionsGrantsAmt
PY Program Service Revenue$7,439,592PYProgramServiceRevenueAmt
CY Program Service Revenue$8,141,507CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$707,344PYOtherRevenueAmt
CY Other Revenue$971,627CYOtherRevenueAmt
PY Total Revenue$8,173,723PYTotalRevenueAmt
CY Total Revenue$9,305,416CYTotalRevenueAmt
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$3,672,002PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,467,259CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$300CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$300CYTotalFundraisingExpenseAmt
PY Other Expenses$4,610,485PYOtherExpensesAmt
CY Other Expenses$4,918,324CYOtherExpensesAmt
PY Total Expenses$8,282,487PYTotalExpensesAmt
CY Total Expenses$8,385,883CYTotalExpensesAmt
PY Revenues Less Expenses-$108,764PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$919,533CYRevenuesLessExpensesAmt
Total Assets BOY$3,353,963TotalAssetsBOYAmt
Total Assets EOY$3,282,465TotalAssetsEOYAmt
Total Liabilities BOY$2,559,438TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,568,407TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$794,525NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,714,058NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionIT IS THE MISSION OF THE ROUNDUP MEMORIAL HOSPITAL AND MUSSELLSHELL COUNTY MEDICAL CENTER TO ACCEPT THE ONGOING CHALLENGE OF PROVIDING FOR THE HEALTHCARE NEEDS OF ALL OF OUR CITIZENS. IT IS OUR SINCERE DESIRE TO HEAL THE SICK AND COMFORT THE SUFFERING WITH ALL THE RESOURCES WE HAVE AVAILABLE. AS GOOD STEWARDS OF THESE INSTITUTIONS, EMPLOYEES WILL HELP INSURE THE SURVIVAL OF THE HOSPITAL AND CLINIC BY BEING COMMITTED TO THE CARE AND WELL BEING OF THOSE THEY SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$7,692,132ExpenseAmt
Revenue$9,113,134RevenueAmt
DescCRITICAL ACCESS HOSPITAL - ROUTINE SERVICE FOR ADULTS, PEDRIATRICS, AND SWINGBED. RURAL HEALTH CLINIC WITH FOUR PROVIDERS. OTHER SERVICES INCLUDE BUT ARE NOT LIMITED TO ANCILLARIES, CT SCANS, LABRATORY, PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPIES, PHARMACY, EMERGENCY ROOM, X-RAY, CENTRAL SUPPLY, INTRAVENOUS SOLUTIONS, ULTRASOUND, ELECTROCARDIOGRAPHY, OBSERVATION, BLOOD BANK, AND PATHOLOGY.Desc
Total Program Service Expenses$7,692,132TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
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 Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document28IRPDocumentCnt
IRP Document W2 G105IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee105EmployeeCnt
Employment Tax Returns Filed0EmploymentTaxReturnsFiledInd
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
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
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 Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMTStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ROUNDUP MEMORIAL HOSPITAL ASSOCIATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4062322301PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11202 THIRD STREET WESTAddressLine1Txt
CityROUNDUPCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59702ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
JOHN PFISTER
PRESIDENT0.50Yes (X)$0$0$0
MARK ROSEBUSH
VICE PRESIDENT0.50Yes (X)$0$0$0
KEN MOSDAL
TREASURER0.50Yes (X)$0$0$0
OLIVER ODDEN
BOARD MEMBER0.50Yes (X)$0$0$0
LEONARD WALL
BOARD MEMBER0.50Yes (X)$0$0$0
MARSHALL WHITE
BOARD MEMBER0.50Yes (X)$0$0$0
TERRI RUSTAD
BOARD MEMBER0.50Yes (X)$0$0$0
EARNEST SMITH
MD40.00$187,833$0$187,833Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$187,833TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$187,833TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BILLINGS CLINICBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 37000AddressLine1Txt
CityBILLINGSCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59107ZIPCd
FieldValueIRS element (for citing)
ServicesMANAGEMENT SERVICESServicesDesc
Compensation$1,006,946CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Related Organizations$5,000RelatedOrganizationsAmt
All Other Contributions$187,282AllOtherContributionsAmt
Total Contributions$192,282TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescINPATIENT/OUTPATIENT RDesc
Business621110BusinessCd
Total Revenue Column$7,904,016TotalRevenueColumnAmt
Related Or Exempt Func Income$7,904,016RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$237,491TotalRevenueColumnAmt
Related Or Exempt Func Income$237,491RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$8,141,507TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER NON OPERATING REDesc
Business621110BusinessCd
Total Revenue Column$971,627TotalRevenueColumnAmt
Related Or Exempt Func Income$971,627RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$971,627OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,305,416TotalRevenueColumnAmt
Related Or Exempt Func Income$9,113,134RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,823,912TotalAmt
Program Services$2,259,130ProgramServicesAmt
Management And General$564,782ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$355,652TotalAmt
Program Services$284,522ProgramServicesAmt
Management And General$71,130ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$287,695TotalAmt
Program Services$230,156ProgramServicesAmt
Management And General$57,539ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$300TotalAmt
Fundraising$300FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,010,152TotalAmt
Program Services$4,010,152ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$32,060TotalAmt
Program Services$32,060ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$26,301TotalAmt
Program Services$26,301ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$209,523TotalAmt
Program Services$209,523ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$52,212TotalAmt
Program Services$52,212ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$13,854TotalAmt
Program Services$13,854ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$42,820TotalAmt
Program Services$42,820ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$438,458TotalAmt
Program Services$438,458ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$92,944TotalAmt
Program Services$92,944ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,385,883TotalAmt
Program Services$7,692,132ProgramServicesAmt
Management And General$693,451ManagementAndGeneralAmt
Fundraising$300FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$198,355BOYAmt
EOY$262,126EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$893,976BOYAmt
EOY$1,174,837EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$121,136BOYAmt
EOY$113,964EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$16,460BOYAmt
EOY$22,587EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$8,978,284LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,269,333LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,124,036BOYAmt
EOY$1,708,951EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,353,963BOYAmt
EOY$3,282,465EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$951,190BOYAmt
EOY$441,294EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,482,201BOYAmt
EOY$1,094,226EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$126,047BOYAmt
EOY$32,887EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,559,438BOYAmt
EOY$1,568,407EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$794,525BOYAmt
EOY$1,698,181EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
EOY$15,877EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$794,525BOYAmt
EOY$1,714,058EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,353,963BOYAmt
EOY$3,282,465EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$919,533ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
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 D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$47,989BeginningYearBalanceAmt
Contributions$54,125ContributionsAmt
Investment Earnings Or Losses$19InvestmentEarningsOrLossesAmt
Other Expenditures$12,957OtherExpendituresAmt
End Year Balance$89,176EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$106,120BeginningYearBalanceAmt
Contributions$50,703ContributionsAmt
Investment Earnings Or Losses$46InvestmentEarningsOrLossesAmt
Other Expenditures$108,880OtherExpendituresAmt
End Year Balance$47,989EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$89,596BeginningYearBalanceAmt
Contributions$90,416ContributionsAmt
Investment Earnings Or Losses$80InvestmentEarningsOrLossesAmt
Other Expenditures$73,972OtherExpendituresAmt
End Year Balance$106,120EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$52,279BeginningYearBalanceAmt
Contributions$141,459ContributionsAmt
Investment Earnings Or Losses$199InvestmentEarningsOrLossesAmt
Other Expenditures$104,341OtherExpendituresAmt
End Year Balance$89,596EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$15,912BeginningYearBalanceAmt
Contributions$41,345ContributionsAmt
Investment Earnings Or Losses$22InvestmentEarningsOrLossesAmt
Other Expenditures$5,000OtherExpendituresAmt
End Year Balance$52,279EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,343,666OtherCostOrOtherBasisAmt
Depreciation$3,533,581DepreciationAmt
Book Value$810,085BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,634,618OtherCostOrOtherBasisAmt
Depreciation$3,735,752DepreciationAmt
Book Value$898,866BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,708,951TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
Desc3RD PARTY PAYERSDesc
Amt$32,887Amt
FieldValueIRS element (for citing)
Total Liability$32,887TotalLiabilityAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$200,811TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$200,811NetCommunityBenefitExpnsAmt
Total Expense0.02390TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,287,273TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,217,265DirectOffsettingRevenueAmt
Net Community Benefit Expns$70,008NetCommunityBenefitExpnsAmt
Total Expense0.00830TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,488,084TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,217,265DirectOffsettingRevenueAmt
Net Community Benefit Expns$270,819NetCommunityBenefitExpnsAmt
Total Expense0.03220TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,820TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,500DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,320NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,820TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,500DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,320NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,509,904TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,228,765DirectOffsettingRevenueAmt
Net Community Benefit Expns$281,139NetCommunityBenefitExpnsAmt
Total Expense0.03340TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$319,040BadDebtExpenseAmt
Bad Debt Expense Attributable$247,259BadDebtExpenseAttributableAmt
Reimbursed By Medicare$3,088,431ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$1,432,178CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$1,656,253MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdCritical Access HospitalCriticalAccessHospitalIndEmergency Room OtherEmergencyRoomOtherIndOtherOtherDesc
ROUNDUP MEMORIAL HOSPITAL - HOSPITAL
11202 3RD STREET WESTROUNDUPMT59072Yes (X)Yes (X)
ROUNDUP MEMORIAL HOSPITAL - CLINIC
21207 3RD STREET WESTROUNDUPMT59072RURAL HEALTH CLINIC

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ROUNDUP MEMORIAL HOSPITAL ASSOCBusinessNameLine1Txt
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
CHNA Conducted14CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Own Website URLWWW.RMHMT.ORGOwnWebsiteURLTxt
Implementation Strategy Adopt0ImplementationStrategyAdoptInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
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 Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Actions On Nonpayment0FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
Nondis Emergency Care Policy0NondisEmergencyCarePolicyInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, LINE 9B:POLICY STATES UP FRONT THAT ADMISSIONS REPRESENTATIVE IS TO GIVE FINANCIAL ASSISTANCE PAPERWORK WITH INFORMAION ON CHARITY CARE AT THE TIME OF ADMISSION. FOLLOW UP CONSULTATION IS DONE LATER TO INCLUDE FINANCIAL ASSISTANCE.DISCUSSIONS WITH PATIENT
PART VI, LINE 2:IN 2014, THE HOSPITAL CONDUCTED A NEEDS ASSESSMENT. STAKEHOLDERS INVOLVED INCLUDED COUNTY COMMISSIONERS, COMMUNITY SERVICE ORGANIZATIONS, SUCH AS ROTARY AND THE LION'S CLUB, AND AREA STATE AGENCIES. IN ADDITION, THE HOSPITAL HELD TWO COMMUNITY MEETINGS AND LED DISCUSSIONS OF HEALTHCARE NEEDS AND DESIRES.
PART VI, LINE 3:WHEN A PATIENT INDICATES THAT A FINANCIAL HARDSHIP EXISTS, THE HOSPITAL PROVIDES INFORMATION ON THE HOSPITAL CHARITY PLAN AND OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS.
PART VI, LINE 4:ROUNDUP MEMORIAL HEALTHCARE (RMH) IS THE SOLE COMMUNITY HEALTHCARE PROVIDER FOR MUSSELSHELL COUNTY, A RURAL AREA WITH A POPULATION DENSITY OF 2.4 PER SQUARE MILE. NO OTHER HOSPITALS SERVE THE COMMUNITY AND THE NEAREST HEALTHCARE FACILITY IS LOCATED IN BILLINGS, 45 MILES TO THE SOUTH. PER THE 2010 FEDERAL CENSUS, THE COUNTY POPULATION WAS 4,538; THE PER CAPITA INCOME IN THE COUNTY IS $19,164 AND THE PERCENTAGE OF PERSONS BELOW THE POVERTY LINE WAS 20.5 PERCENT. IN 2006, 26.4 PERCENT OF MUSSELSHELL COUNTY WAS UNINSURED. THE HEALTH RESOURCES AND SERVICES ADMINISTRATION HAS DESIGNATED MUSSELSHELL COUNTY AS AN UNDERSERVED AREA WITH A SCORE OF 16.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
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

FieldValueIRS element (for citing)
PersonEARNEST SMITHPersonNm
TitleMDTitleTxt
Base Compensation Filing Org$187,833BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$187,833TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION HAS CONTRACTED WITH A LARGER HOSPITAL FACILITY TO PROVIDE MANAGEMENT DUTIES.
FORM 990, PART VI, SECTION A, LINE 6MEMBERS OF HOSPITAL ASSOCIATION 501 (C)3
FORM 990, PART VI, SECTION B, LINE 11THE 990 IS REVIEWED BY THE CEO, CFO AND CONTROLLER AND IS DISTRIBUTED TO THE BOARD BEFORE FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE COMPLIANCE OFFICER MONITORS AND EVALUATES CONFLICT OF INTEREST ISSUES.
FORM 990, PART VI, SECTION B, LINE 15ACEO COMPENSATED ACCORDING TO ARRANGEMENTS WITH THE MANAGEMENT AGREEMENT WITH BILLINGS CLINIC, WHO RECOMMENDS THE CEO SALARY TO THE BOARD FOR APPROVAL. THE HOSPITAL UTILIZES THE MONTANA HOSPITAL ASSOCIATION AND ASSOCIATED EMPLOYEES SALARY SURVEY TO DETERMINE SALARIES OF KEY EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 19AVAILABLE UPON REQUSET TO THE CEO.
FORM 990, PART IX, LINE 11GDISCOUNTS AND ALLOWANCES: PROGRAM SERVICE EXPENSES 1,686,294. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,686,294. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 552,327. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 552,327. BAD DEBT EXPENSE: PROGRAM SERVICE EXPENSES 319,040. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 319,040. SUPPLIES: PROGRAM SERVICE EXPENSES 587,381. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 587,381. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 319,990. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 319,990. OTHER OPERATING EXPENSES: PROGRAM SERVICE EXPENSES 81,118. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 81,118. UTILITIES: PROGRAM SERVICE EXPENSES 141,183. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 141,183. CHARITY CARE: PROGRAM SERVICE EXPENSES 240,204. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 240,204. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 76,306. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 76,306. LEASES AND RENTALS: PROGRAM SERVICE EXPENSES 6,309. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,309.