2015-05-13T17:26:42-05:00 2014-06-30 390758449 WIPFLI LLP P O BOX 1530 HAVRE MT 59501 990 2013-07-01 810245848 ROUNDUP MEMORIAL HOSPITAL ASSOC ROUN 4062322301 PO BOX 40 ROUNDUP MT 59072 BRAD HOWELL CEO 4062322301 2015-05-13 1 DARCY DEE REUM CPA P00647883 4062653201 2013 2016-02-25 16:41:14Z BRAD HOWELL PO BOX 40 ROUNDUP MT 59072 8173723 0 X WWW.RMHMT.ORG X 1979 MT PROVIDE HEALTH CARE SERVICES 5 5 120 0 0 0 224575 26787 6854085 7439592 0 0 131587 707344 7210247 8173723 0 0 0 0 3143916 3672002 0 0 0 3719185 4610485 6863101 8282487 347146 -108764 2673602 3353963 1770313 2559438 903289 794525 X 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. 0 0 7548086 8146936 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. 7548086 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 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 20 120 1 120 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 1 0 0 1 1 0 0 0 1 0 1 1 0 1 0 0 MT X THE ORGANIZATION 4062322301 PO BOX 40 ROUNDUP MT 59072 JOHN PFISTER BOARD PRESIDENT 0.50 X 0 0 0 MARK ROSEBUSH BOARD VICE PRESIDENT 0.50 X 0 0 0 KEN MOSDAL TREASURER 0.50 X 0 0 0 BRYAN ADOLPH BOARD MEMBER 0.50 X 0 0 0 BRAD HOWELL CEO/CFO 40.00 X 0 0 0 MARK WARD MD CHIEF OF STAFF 45.00 X 160181 0 0 160181 0 0 2 0 1 0 BILLINGS CLINIC PO BOX 37000 BILLINGS MT 59107 MANAGEMENT SERVICES 1048582 1 26787 26787 INPATIENT/OUTPATIENT R 621110 7229351 7229351 210241 210241 7439592 OTHER NON OPERATING RE 621110 707344 707344 707344 8173723 8146936 0 0 X 2736702 2189362 547340 647799 518238 129561 287501 230001 57500 35336 35336 258232 258232 76061 76061 DISCOUNTS AND ALLOWANCE 1438448 1438448 BAD DEBT EXPENSE 694724 694724 SUPPLIES 530445 530445 CONTRACT LABOR 468964 468964 1108275 1108275 8282487 7548086 734401 0 148113 198355 966500 893976 33089 115808 121136 -8850 16460 8955302 6831266 1404890 2124036 14052 0 2673602 3353963 698350 951190 918411 1482201 153552 126047 1770313 2559438 X 903289 794525 903289 794525 2673602 3353963 -108764 0 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 106120 50703 46 108880 47989 89596 90416 80 73972 106120 52279 141459 199 104341 89596 15912 41345 22 5000 52279 1 0 4343667 3510627 833040 3966986 3320639 646347 644649 644649 2124036 3RD PARTY PAYERS 126047 126047 1 1 1 X 1 X 1 1 1 0 0 1327264 859726 467538 0.05640 1327264 859726 467538 0.05640 30988 24250 6738 0.00080 30988 24250 6738 0.00080 1358252 883976 474276 0.05720 0 404290 3088431 1432178 1656253 X 1 1 2 1 ROUNDUP MEMORIAL HOSPITAL - HOSPITAL 1202 3RD STREET WEST ROUNDUP MT 59072 X X X X 2 ROUNDUP MEMORIAL HOSPITAL - CLINIC 1207 3RD STREET WEST ROUNDUP MT 59072 RURAL HEALTH CLINIC ROUNDUP MEMORIAL HOSPITAL ASSOC 1 1 X X X X X 12 0 0 1 WWW.RMHMT.ORG X X X 1 0 1 1 100.000000000000 1 200.000000000000 1 X X X X X X X 1 1 1 X X 1 X X X X 1 0 0 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. 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. X X 0 0 0 0 0 0 0 0 0 MARK WARD MD CHIEF OF STAFF 160181 0 0 0 0 0 0 0 0 0 160181 0 0 0 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.