ROUNDUP MEMORIAL HOSPITAL ASSOCIATION: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: ROUNDUP MEMORIAL HOSPITAL ASSOCIATION (EIN 81-0245848)
Tax period: 2013-07-01 to 2014-06-30
Filed: 2015-05-13
IRS object ID: 201501339349305535
Schema version: 2013v4.0
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-05-13T17:26:42-05:00	ReturnTs
Tax Period End	2014-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	390758449	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	WIPFLI LLP	BusinessNameLine1

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	P O BOX 1530	AddressLine1
City	HAVRE	City
State	MT	State
ZIP Code	59501	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	810245848	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ROUNDUP MEMORIAL HOSPITAL ASSOC	BusinessNameLine1

Field	Value	IRS element (for citing)
Business Name Control	ROUN	BusinessNameControlTxt
Phone	4062322301	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 40	AddressLine1
City	ROUNDUP	City
State	MT	State
ZIP Code	59072	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	BRAD HOWELL	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	4062322301	PhoneNum
Signature	2015-05-13	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	DARCY DEE REUM CPA	PreparerPersonNm
PTIN	P00647883	PTIN
Phone	4062653201	PhoneNum

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	BRAD HOWELL	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 40	AddressLine1
City	ROUNDUP	City
State	MT	State
ZIP Code	59072	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$8,173,723	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.RMHMT.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1979	FormationYr
Legal Domicile State	MT	LegalDomicileStateCd
Activity Or Mission	PROVIDE HEALTH CARE SERVICES	ActivityOrMissionDesc
Voting Members Governing Body	5	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	120	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$224,575	PYContributionsGrantsAmt
CY Contributions Grants	$26,787	CYContributionsGrantsAmt
PY Program Service Revenue	$6,854,085	PYProgramServiceRevenueAmt
CY Program Service Revenue	$7,439,592	CYProgramServiceRevenueAmt
PY Investment Income	$0	PYInvestmentIncomeAmt
CY Investment Income	$0	CYInvestmentIncomeAmt
PY Other Revenue	$131,587	PYOtherRevenueAmt
CY Other Revenue	$707,344	CYOtherRevenueAmt
PY Total Revenue	$7,210,247	PYTotalRevenueAmt
CY Total Revenue	$8,173,723	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$3,143,916	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$3,672,002	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$3,719,185	PYOtherExpensesAmt
CY Other Expenses	$4,610,485	CYOtherExpensesAmt
PY Total Expenses	$6,863,101	PYTotalExpensesAmt
CY Total Expenses	$8,282,487	CYTotalExpensesAmt
PY Revenues Less Expenses	$347,146	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$108,764	CYRevenuesLessExpensesAmt
Total Assets BOY	$2,673,602	TotalAssetsBOYAmt
Total Assets EOY	$3,353,963	TotalAssetsEOYAmt
Total Liabilities BOY	$1,770,313	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$2,559,438	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$903,289	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$794,525	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	IT IS THE MISSION OF THE ROUNDUP MEMORIAL HOSPITAL AND MUSSELLSHELL COUNTY MEDICAL CENTER TO ACCEPT THE ONGOING CHALLENGE OF PROVIDING FOR THE HEALTHCRE 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 Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$7,548,086	ExpenseAmt
Revenue	$8,146,936	RevenueAmt
Desc	CRITICAL 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	$7,548,086	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	20	IRPDocumentCnt
IRP Document W2 G	120	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	120	EmployeeCnt
Employment Tax Returns Filed	0	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	5	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (1)	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	0	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	0	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	0	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	MT	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THE ORGANIZATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Phone	4062322301	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 40	AddressLine1
City	ROUNDUP	City
State	MT	State
ZIP Code	59072	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd
JOHN PFISTER
BOARD PRESIDENT	0.50	Yes (X)	$0	$0	$0
MARK ROSEBUSH
BOARD VICE PRESIDENT	0.50	Yes (X)	$0	$0	$0
KEN MOSDAL
TREASURER	0.50	Yes (X)	$0	$0	$0
BRYAN ADOLPH
BOARD MEMBER	0.50	Yes (X)	$0	$0	$0
BRAD HOWELL
CEO/CFO	40.00		$0	$0	$0	Yes (X)
MARK WARD MD
CHIEF OF STAFF	45.00		$160,181	$0	$0		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$160,181	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BILLINGS CLINIC	BusinessNameLine1

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 37000	AddressLine1
City	BILLINGS	City
State	MT	State
ZIP Code	59107	ZIPCode

Field	Value	IRS element (for citing)
Services	MANAGEMENT SERVICES	ServicesDesc
Compensation	$1,048,582	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
Related Organizations	$26,787	RelatedOrganizationsAmt
Total Contributions	$26,787	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	INPATIENT/OUTPATIENT R	Desc
Business	621110	BusinessCd
Total Revenue Column	$7,229,351	TotalRevenueColumnAmt
Related Or Exempt Func Income	$7,229,351	RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$210,241	TotalRevenueColumnAmt
Related Or Exempt Func Income	$210,241	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$7,439,592	TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	OTHER NON OPERATING RE	Desc
Business	621110	BusinessCd
Total Revenue Column	$707,344	TotalRevenueColumnAmt
Related Or Exempt Func Income	$707,344	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$707,344	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,173,723	TotalRevenueColumnAmt
Related Or Exempt Func Income	$8,146,936	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$2,736,702	TotalAmt
Program Services	$2,189,362	ProgramServicesAmt
Management And General	$547,340	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$647,799	TotalAmt
Program Services	$518,238	ProgramServicesAmt
Management And General	$129,561	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$287,501	TotalAmt
Program Services	$230,001	ProgramServicesAmt
Management And General	$57,500	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$35,336	TotalAmt
Program Services	$35,336	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$258,232	TotalAmt
Program Services	$258,232	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$76,061	TotalAmt
Program Services	$76,061	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
DISCOUNTS AND ALLOWANCE	$1,438,448	$1,438,448
BAD DEBT EXPENSE	$694,724	$694,724
SUPPLIES	$530,445	$530,445
CONTRACT LABOR	$468,964	$468,964

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,108,275	TotalAmt
Program Services	$1,108,275	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$8,282,487	TotalAmt
Program Services	$7,548,086	ProgramServicesAmt
Management And General	$734,401	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$148,113	BOYAmt
EOY	$198,355	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$966,500	BOYAmt
EOY	$893,976	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$33,089	BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$115,808	BOYAmt
EOY	$121,136	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	-$8,850	BOYAmt
EOY	$16,460	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$8,955,302	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$6,831,266	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,404,890	BOYAmt
EOY	$2,124,036	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$14,052	BOYAmt
EOY	$0	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,673,602	BOYAmt
EOY	$3,353,963	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$698,350	BOYAmt
EOY	$951,190	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$918,411	BOYAmt
EOY	$1,482,201	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$153,552	BOYAmt
EOY	$126,047	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,770,313	BOYAmt
EOY	$2,559,438	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$903,289	BOYAmt
EOY	$794,525	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$903,289	BOYAmt
EOY	$794,525	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,673,602	BOYAmt
EOY	$3,353,963	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$108,764	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Cash	Yes (X)	MethodOfAccountingCashInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	0	FSAuditedInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$15,912	BeginningYearBalanceAmt
Contributions	$41,345	ContributionsAmt
Investment Earnings Or Losses	$22	InvestmentEarningsOrLossesAmt
Other Expenditures	$5,000	OtherExpendituresAmt
End Year Balance	$52,279	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Endowments Held Unrelated Org	Yes (1)	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,343,667	OtherCostOrOtherBasisAmt
Depreciation	$3,510,627	DepreciationAmt
Book Value	$833,040	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,966,986	OtherCostOrOtherBasisAmt
Depreciation	$3,320,639	DepreciationAmt
Book Value	$646,347	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$644,649	OtherCostOrOtherBasisAmt
Book Value	$644,649	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$2,124,036	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	3RD PARTY PAYERS	Desc
Amt	$126,047	Amt

Field	Value	IRS element (for citing)
Total Liability	$126,047	TotalLiabilityAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent100	Yes (X)	Percent100Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent200 D	Yes (X)	Percent200DInd
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	0	AnnualCommunityBnftReportInd

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,327,264	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$859,726	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$467,538	NetCommunityBenefitExpnsAmt
Total Expense	0.05640	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,327,264	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$859,726	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$467,538	NetCommunityBenefitExpnsAmt
Total Expense	0.05640	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$30,988	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$24,250	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,738	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$30,988	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$24,250	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,738	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,358,252	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$883,976	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$474,276	NetCommunityBenefitExpnsAmt
Total Expense	0.05720	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Bad Debt Expense	$404,290	BadDebtExpenseAmt
Reimbursed By Medicare	$3,088,431	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$1,432,178	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$1,656,253	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Critical Access HospitalCriticalAccessHospitalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc
ROUNDUP MEMORIAL HOSPITAL - HOSPITAL
1	1202 3RD STREET WEST	ROUNDUP	MT	59072	Yes (X)	Yes (X)	Yes (X)	Yes (X)
ROUNDUP MEMORIAL HOSPITAL - CLINIC
2	1207 3RD STREET WEST	ROUNDUP	MT	59072					RURAL HEALTH CLINIC

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ROUNDUP MEMORIAL HOSPITAL ASSOC	BusinessNameLine1

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
CHNA Conducted	12	CHNAConductedYr
Take Into Account Others Input	0	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	0	CHNAConductedWithOtherFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Own Website URL	WWW.RMHMT.ORG	OwnWebsiteURLTxt
Include Operational Plan	Yes (X)	IncludeOperationalPlanInd
Adopt Budget	Yes (X)	AdoptBudgetInd
Prioritize Services	Yes (X)	PrioritizeServicesInd
All Needs Addressed	Yes (1)	AllNeedsAddressedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Used Deter Elig Free Care	Yes (1)	FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care	100.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt Care	Yes (1)	FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care	200.000000000000	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (1)	ExplainedBasisInd
Income Level	Yes (X)	IncomeLevelInd
Asset Level	Yes (X)	AssetLevelInd
Medical Indigency	Yes (X)	MedicalIndigencyInd
Insurance Status	Yes (X)	InsuranceStatusInd
Uninsured Discount	Yes (X)	UninsuredDiscountInd
Medicaid Medicare	Yes (X)	MedicaidMedicareInd
State Regulation	Yes (X)	StateRegulationInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit Report To Credit Agency	Yes (X)	PermitReportToCreditAgencyInd
Permit Lawsuit	Yes (X)	PermitLawsuitInd
Collection Activities	Yes (1)	CollectionActivitiesInd
Reporting To Credit Agency	Yes (X)	ReportingToCreditAgencyInd
Lawsuit	Yes (X)	LawsuitInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
ROUNDUP MEMORIAL HOSPITAL ASSOC	PART V, SECTION B, LINE 14G: 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.
ROUNDUP MEMORIAL HOSPITAL ASSOC	PART V, SECTION B, LINE 19C: THE FACILITY CHARGES THE SAME TO ALL INDIVIDUALS.

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 2010, THE HOSPITAL CONDUCTED A NEEDS ASSESSMENT IN CONJUNCTION WITH A COMMUNITY MILL LEVY ELECTION. 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 DEFERAL 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

Field	Value	IRS element (for citing)
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

Field	Value	IRS element (for citing)
Person	MARK WARD MD	PersonNm
Title	CHIEF OF STAFF	TitleTxt
Base Compensation Filing Org	$160,181	BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs	$0	CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization	$0	BonusFilingOrganizationAmount
Bonus Related Organizations	$0	BonusRelatedOrganizationsAmt
Other Compensation Filing Org	$0	OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs	$0	OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org	$0	DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs	$0	DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org	$0	NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs	$0	NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org	$160,181	TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs	$0	TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org	$0	CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs	$0	CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3	THE ORGANIZATION HAS CONTRACTED WITH A LARGER HOSPITAL FACILITY TO PROVIDE MANAGEMENT DUTIES.
FORM 990, PART VI, SECTION A, LINE 6	MEMBERS OF HOSPITAL ASSOCIATION 501 (C)3
FORM 990, PART VI, SECTION B, LINE 11	THE 990 IS REVIEWED BY THE CEO AND ACCOUNTING CLERK BEFORE FILING.
FORM 990, PART VI, SECTION B, LINE 12C	THE COMPLIANCE OFFICER MONITORS AND EVALUATES CONFLICT OF INTEREST ISSUES.
FORM 990, PART VI, SECTION B, LINE 15A	CEO COMPENSATED ACCORDING TO ARRANGEMENTS WITH THE MANAGEMETN 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 19	AVAILABLE UPON REQUSET TO THE CEO.
FORM 990, PART IX, LINE 24E	OTHER OPERATING EXPENSES: PROGRAM SERVICE EXPENSES 405,280. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 405,280. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 337,231. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 337,231. CHARITY CARE: PROGRAM SERVICE EXPENSES 179,570. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 179,570. UTILITIES: PROGRAM SERVICE EXPENSES 138,056. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 138,056. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 40,973. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,973. LEASES AND RENTALS: PROGRAM SERVICE EXPENSES 7,165. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,165.