NORTHEAST MONTANA HEALTH SERVICES INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- NORTHEAST MONTANA HEALTH SERVICES INC (EIN 81-0226578)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-13
- IRS object ID
- 201511339349305501
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-13T16:28:54-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREEN HEALTH GROUP PC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 5TH ST S SUITE 106 | AddressLine1 |
| City | GLASGOW | City |
| State | MT | State |
| ZIP Code | 592302338 | 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 | 810226578 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHEAST MONTANA HEALTH SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 4066536500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 315 KNAPP ST | AddressLine1 |
| City | WOLF POINT | City |
| State | MT | State |
| ZIP Code | 59201 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CLEO CAGLE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4066536500 | PhoneNum |
| Signature | 2015-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DANIEL GREEN | PreparerPersonNm |
| PTIN | P01311679 | PTIN |
| Phone | 4062632615 | PhoneNum |
| Preparation | 2015-05-13 | PreparationDt |
| 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 | CLEO CAGLE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 315 KNAPP ST | AddressLine1 |
| City | WOLF POINT | City |
| State | MT | State |
| ZIP Code | 59201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $25,792,521 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NEMHS.NET | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1948 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | TO DELIVER QUALITY, COST-EFFECTIVE HEALTH CARE TO THE COMMUNITIES THAT WE SERVE FOR IMPROVEMENT OF HUMAN LIFE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 514 | TotalEmployeeCnt |
| Total Gross UBI | $2,596,694 | TotalGrossUBIAmt |
| PY Contributions Grants | $232,832 | PYContributionsGrantsAmt |
| CY Contributions Grants | $410,688 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $23,519,444 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,455,946 | CYProgramServiceRevenueAmt |
| PY Investment Income | $293,970 | PYInvestmentIncomeAmt |
| CY Investment Income | $358,951 | CYInvestmentIncomeAmt |
| PY Other Revenue | $374,651 | PYOtherRevenueAmt |
| CY Other Revenue | $566,936 | CYOtherRevenueAmt |
| PY Total Revenue | $24,420,897 | PYTotalRevenueAmt |
| CY Total Revenue | $25,792,521 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,062,307 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,886,598 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $56,990 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,555,671 | PYOtherExpensesAmt |
| CY Other Expenses | $10,867,457 | CYOtherExpensesAmt |
| PY Total Expenses | $22,617,978 | PYTotalExpensesAmt |
| CY Total Expenses | $25,754,055 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,802,919 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $38,466 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $37,572,531 | TotalAssetsBOYAmt |
| Total Assets EOY | $37,160,628 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,312,594 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $13,857,882 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,259,937 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,302,746 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO DELIVER QUALITY, COST-EFFECTIVE HEALTH CARE TO THE COMMUNITIES THAT WE SERVE FOR IMPROVEMENT OF HUMAN LIFE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $19,293,731 | ExpenseAmt |
| Revenue | $24,455,946 | RevenueAmt |
| Desc | TO PROVIDE HEALTH CARE SERVICES TO PATIENTS. | Desc |
| Total Program Service Expenses | $19,293,731 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 514 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CLEO CAGLE | PersonNm |
| Phone | 4066536500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 315 KNAPP ST | AddressLine1 |
| City | WOLF POINT | City |
| State | MT | State |
| ZIP Code | 59201 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MARK ZILKOSKI MD | ||||||||
| MEDICAL STAF | 1.00 | 40.00 | Yes (X) | $0 | $310,237 | $208,931 | ||
| TOM AULT | ||||||||
| CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DALLAS O'CONNOR | ||||||||
| VICE-CHAIRMA | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SHANE GIBSON | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SHARON BRAVARD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RJ DOORNEK | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHELLE ISLE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RICK KIRN | ||||||||
| TRIBAL COUNC | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PEARL HOPKINS | ||||||||
| TRIBAL COUNC | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARGARET NORGAARD | ||||||||
| CEO | 40.00 | $139,984 | $0 | $24,587 | Yes (X) | |||
| CLEO CAGLE | ||||||||
| CFO | 40.00 | $125,152 | $0 | $7,445 | Yes (X) | |||
| VICKI HOUSTON | ||||||||
| RN | 40.00 | $121,524 | $0 | $7,927 | Yes (X) | |||
| MARK ZYGMOND | ||||||||
| CRNA | 20.00 | $110,001 | $0 | $10,710 | Yes (X) | |||
| MARK ROUBIDOUX | ||||||||
| CRNA | 20.00 | $110,001 | $0 | $8,270 | Yes (X) | |||
| NONETTE BROWN | ||||||||
| RN | 40.00 | $108,123 | $0 | $7,770 | Yes (X) | |||
| ELVIRA PADRON | ||||||||
| MT | 40.00 | $103,691 | $0 | $9,422 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $818,476 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $310,237 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $285,062 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BIG SKY LOCUMS | |||||
| PO BOX 50342 | BILLINGS | MT | 59105 | ER PROVIDERS | $263,716 |
| PRAIRIE TRAVELERS INC | |||||
| 130 3RD ST SO SUITE 2 | GLASGOW | MT | 59230 | TRAVEL NURSE | $229,579 |
| COMPHEALTH | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | OB/ER PROVIDERS | $177,461 |
| AMN | |||||
| PO BOX 281939 | ATLANTA | GA | 30384 | LAB TECHS | $168,333 |
| PRACTICAL HEALTHCARE SOLUTIONS INC | |||||
| 2120 S RESERVE ST | MISSOULA | MT | 59801 | ER LOCUM | $110,939 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $44,044 | RelatedOrganizationsAmt |
| Government Grants | $329,246 | GovernmentGrantsAmt |
| All Other Contributions | $37,398 | AllOtherContributionsAmt |
| Total Contributions | $410,688 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT REVENUE | 621500 | $21,859,252 | $21,859,252 | |
| RETAIL PHARMACIES | 446110 | $2,596,694 | $2,596,694 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,455,946 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $358,951 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $358,951 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOSPITAL DISTRICT TAX | 900099 | $411,628 | $411,628 |
| MINERAL LEASE | 532000 | $154,808 | $154,808 |
| GAIN ON SALE OF ASSETS | 900099 | $500 | $500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $566,936 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,792,521 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $22,785,139 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,596,694 | UnrelatedBusinessRevenueAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,551 | TotalAmt |
| Management And General | $279,551 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,323,932 | TotalAmt |
| Program Services | $11,162,872 | ProgramServicesAmt |
| Management And General | $1,113,874 | ManagementAndGeneralAmt |
| Fundraising | $47,186 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,524 | TotalAmt |
| Program Services | $33,940 | ProgramServicesAmt |
| Management And General | $12,413 | ManagementAndGeneralAmt |
| Fundraising | $171 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,252,388 | TotalAmt |
| Program Services | $445,740 | ProgramServicesAmt |
| Management And General | $803,047 | ManagementAndGeneralAmt |
| Fundraising | $3,601 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $984,203 | TotalAmt |
| Program Services | $370,948 | ProgramServicesAmt |
| Management And General | $611,595 | ManagementAndGeneralAmt |
| Fundraising | $1,660 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $662 | TotalAmt |
| Management And General | $662 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,185 | TotalAmt |
| Management And General | $78,185 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,552,127 | TotalAmt |
| Program Services | $1,552,127 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,139 | TotalAmt |
| Program Services | $475 | ProgramServicesAmt |
| Management And General | $27,664 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $706,454 | TotalAmt |
| Program Services | $388,692 | ProgramServicesAmt |
| Management And General | $314,108 | ManagementAndGeneralAmt |
| Fundraising | $3,654 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $320,392 | TotalAmt |
| Management And General | $320,392 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,151 | TotalAmt |
| Program Services | $271,151 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,423 | TotalAmt |
| Program Services | $72,873 | ProgramServicesAmt |
| Management And General | $16,550 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,982 | TotalAmt |
| Program Services | $17,392 | ProgramServicesAmt |
| Management And General | $18,590 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $499,702 | TotalAmt |
| Management And General | $499,702 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,715,220 | TotalAmt |
| Management And General | $1,715,220 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $302,056 | TotalAmt |
| Management And General | $302,056 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $2,126,575 | $2,126,575 | ||
| COGS | $1,738,363 | $1,738,363 | ||
| REPAIRS & MAINTENANCE | $736,084 | $484,369 | $251,715 | |
| FOOD & DIETARY SUPPLIES | $402,191 | $401,473 | $718 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,751 | TotalAmt |
| Program Services | $226,741 | ProgramServicesAmt |
| Management And General | $38,010 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,754,055 | TotalAmt |
| Program Services | $19,293,731 | ProgramServicesAmt |
| Management And General | $6,403,334 | ManagementAndGeneralAmt |
| Fundraising | $56,990 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,664,475 | BOYAmt |
| EOY | $3,412,553 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,439,796 | BOYAmt |
| EOY | $1,487,722 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,029,842 | BOYAmt |
| EOY | $7,374,147 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $959,680 | BOYAmt |
| EOY | $1,086,498 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $622,596 | BOYAmt |
| EOY | $502,549 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $26,340,345 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $15,115,622 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,558,962 | BOYAmt |
| EOY | $11,224,723 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,709,845 | BOYAmt |
| EOY | $3,020,095 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,587,335 | BOYAmt |
| EOY | $9,052,341 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,572,531 | BOYAmt |
| EOY | $37,160,628 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,351,367 | BOYAmt |
| EOY | $3,272,763 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,961,227 | BOYAmt |
| EOY | $10,585,119 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,312,594 | BOYAmt |
| EOY | $13,857,882 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,235,185 | BOYAmt |
| EOY | $23,268,426 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,752 | BOYAmt |
| EOY | $34,320 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,259,937 | BOYAmt |
| EOY | $23,302,746 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,572,531 | BOYAmt |
| EOY | $37,160,628 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $38,466 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $4,343 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $2,060 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,060 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE C, PART II-B, LINE 1 | 0.65 PERCENT OF MHA DUES PAID TO MHA, WHICH WAS 136, 23.65 PERCENT OF DUES PAID TO MHA FOR AHA, WHICH WAS 1891, AND 2.4 PERCENT OF DUES PAID TO MHA FOR LEADING AGE WHICH WAS 33 (2060 COMBINED) WERE USED FOR LOBBYING EXPENSES BY MHA. |
| SCHEDULE C, PART IV | LOBBYING PERCENTAGE OF DUES PAID TO MHA WERE 2060. |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,950 | OtherCostOrOtherBasisAmt |
| Book Value | $28,950 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,102,130 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,742,421 | DepreciationAmt |
| Book Value | $7,359,709 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,209,265 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,373,201 | DepreciationAmt |
| Book Value | $3,836,064 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,224,723 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $1,938,698 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BOND FUNDS | Desc |
| Book Value | $1,081,397 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $3,020,095 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| RECEIVABLE-WOLF POINT CLINIC ASSOC | $5,328,088 |
| RECEIVABLE-RIVERSIDE FAMILY CLINIC | $3,724,253 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $9,052,341 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $25,796,864 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $4,343 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $4,343 | RevenueNotReportedAmt |
| Revenue Subtotal | $25,792,521 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $25,792,521 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $25,754,055 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $25,754,055 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $25,754,055 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | IT IS THE OPINION OF MANAGEMENT THAT THE COMPANY HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT WOULD BE SUBJECT TO CHANGE UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. SEE NORTHEAST MONTANA HEALTH SERVICES, INC. AND AFFILIATES NOTES TO CONSOLIDATED FINANCIAL STATEMENTS JUNE 30, 2014 AND 2013. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,172,040 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,172,040 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04550 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,172,040 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,172,040 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04550 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,530,852 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,934,493 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,596,359 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06200 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,537,852 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,934,493 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,603,359 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06230 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,709,892 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,934,493 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,775,399 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10780 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $51,870 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $51,870 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $51,870 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $51,870 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,733,409 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $3,833,606 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,861,862 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$28,256 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NE MT STAT AIR AMBUL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | AIR AMBULANCE | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.56000 | OrgProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Website AddressWebsiteAddressTxt | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Critical Access HospitalCriticalAccessHospitalInd | Emergency Room24 HrsEmergencyRoom24HrsInd |
|---|---|---|---|---|---|---|---|---|---|
| NEMHS - TRINITY HOSPITAL | |||||||||
| 1 | 315 KNAPP STREET | WOLF POINT | MT | 59201 | WWW.NEMHS.NET | Yes (X) | Yes (X) | Yes (X) | Yes (X) |
| NEMHS - POPLAR COMMUNITY HOSPITAL | |||||||||
| 2 | 211 H STREET EAST | POPLAR | MT | 59255 | WWW.NEMHS.NET | Yes (X) | Yes (X) | Yes (X) | Yes (X) |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)
| FacilityFacilityNum | CHNA ConductedCHNAConductedInd | Community DefinitionCommunityDefinitionInd | Community DemographicsCommunityDemographicsInd | Existing ResourcesExistingResourcesInd | How Data ObtainedHowDataObtainedInd | Community Health NeedsCommunityHealthNeedsInd | Other Health IssuesOtherHealthIssuesInd | Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd | Consulting ProcessConsultingProcessInd | Information GapsInformationGapsInd | OtherOtherInd | CHNA ConductedCHNAConductedYr | Take Into Account Others InputTakeIntoAccountOthersInputInd | CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd | CHNA Report Widely AvailableCHNAReportWidelyAvailableInd | Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd | Own Website URLOwnWebsiteURLTxt | Rpt Available Upon RequestRptAvailableUponRequestInd | Adopt Implementation StrategyAdoptImplementationStrategyInd | Exec Implementation StrategyExecImplementationStrategyInd | All Needs AddressedAllNeedsAddressedInd | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Used Deter Elig Free CareFPGUsedDeterEligFreeCareInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Used Determ Elig Dscnt CareFPGUsedDetermEligDscntCareInd | FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct | Explained BasisExplainedBasisInd | Income LevelIncomeLevelInd | Asset LevelAssetLevelInd | Medical IndigencyMedicalIndigencyInd | Insurance StatusInsuranceStatusInd | Medicaid MedicareMedicaidMedicareInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | Posted On WebsitePostedOnWebsiteInd | Available On RequestAvailableOnRequestInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Collection ActivitiesCollectionActivitiesInd | FAP Notified All PatientsFAPNotifiedAllPatientsInd | Documented Elig DeterminationDocumentedEligDeterminationInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | Other Method UsedOtherMethodUsedInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NEMHS - TRINITY HOSPITAL | |||||||||||||||||||||||||||||||||||||||||||||
| 1 | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 12 | Yes (true) | Yes (true) | Yes (true) | Yes (X) | WWW.NEMHS.NET | Yes (X) | Yes (X) | Yes (X) | false | false | Yes (true) | Yes (true) | 100.000000000000 | Yes (true) | 200.000000000000 | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (true) | Yes (X) | Yes (X) | Yes (true) | false | Yes (X) | Yes (X) | Yes (true) | Yes (X) | false | false |
| NEMHS - POPLAR COMMUNITY HOSPITAL | |||||||||||||||||||||||||||||||||||||||||||||
| 2 | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 12 | Yes (true) | Yes (true) | Yes (true) | Yes (X) | WWW.NEMHS.NET | Yes (X) | Yes (X) | Yes (X) | false | false | Yes (true) | Yes (true) | 100.000000000000 | Yes (true) | 200.000000000000 | Yes (true) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (true) | Yes (true) | Yes (X) | Yes (X) | Yes (true) | false | Yes (X) | Yes (X) | Yes (true) | Yes (X) | false | false |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 3 | A SURVEY WAS MAILED TO A RANDOMLY CHOSEN SAMPLE OF 800 RESIDENTS IN OUR PRIMARY SERVICE AREA TO SOLICIT THEIR INPUT. FOCUS GROUPS WERE HELD IN WOLF POINT AND POPLAR WHICH REPRESENTED VARIOUS CONSUMER GROUPS OF HEALTH CARE INCLUDING SENIOR CITIZENS AND LOCAL COMMUNITY MEMBERS. ALSO, A KEY INFORMANT INTERVIEW WAS CONDUCTED WITH REGIONAL HEALTHCARE ADMINISTRATORS. ADDITIONALLY, NEMHS SOUGHT INPUT FROM VARIOUS GROUPS THROUGHOUT THE COMMUNITY THAT HAVE SPECIAL KNOWLEDGE REGARDING THE NEEDS OF VARIOUS GROUPS WITHIN THE SERVICE AREA. THESE GROUPS WERE CONTACTED AND MEETINGS WERE ESTABLISHED WITH THE STEERING COMMITTEE. THE FOLLOWING CONSTITUTES A LIST OF PARTIES WHICH INCLUDED PUBLIC HEALTH SERVICES, A REPRESENTATIVE FOR THE AMERICAN INDIAN, AND A REPRESENTATIVE FOR SENIOR CITIZENS. |
| FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 4 | NORTHEAST MONTANA HEALTH SERVICES - POPLAR COMMUNITY HOSPITAL |
| FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 7 | 1. DENTAL CARE - PROVIDING THIS SERVICE IS OUTSIDE OF NEMHS CAPACITY AND FINANCIAL RESOURCES. 2. PHYSICAL THERAPY, NUTRITION EDUCATION, DISASTER PLANNING, AND COMMUNITY HOUSING CONCERNS - PROVIDING THESE SERVICES IS BEYOND THE RESOURCE CAPACITY OF NEMHS. 3. HOSPICE, RESPITE CARE, AND HOME HEALTH - THERE ARE ALREADY ORGANIZATIONS THAT EXIST IN THE COMMUNITY THAT HELP PROVIDE RESOURCES FOR SENIOR CITIZENS. NEMHS IS CURRENTLY FOCUSING ON PRIMARY CARE NEEDS OF THE POPULATION. 4. PROGRAMS THAT HELP PEOPLE PAY FOR HEALTH CARE BILLS - THIS IS BEYOND NEMHS' SCOPE OF WORK. THERE ARE ALSO OTHER RESOURCES AVAILABLE IN THE COMMUNITY SUCH AS THE PUBLIC/COUNTY HEALTH DEPARTMENT THAT CAN OFFER ASSISTANCE TO COMMUNITY MEMBERS REGARDING PAYMENT OF HEALTHCARE BILLS. 5. MRI - PROVIDING THIS SERVICE IS OUTSIDE OF NEMHS CAPACITY AND FINANCIAL RESOURCES. |
| FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 20D | ALL PATIENTS ARE INITIALLY CHARGED THE STANDARD RATE. IF A PATIENT APPLIES AND QUALIFIES FOR FINANCIAL ASSISTANCE THEN THEY WOULD RECEIVE A DISCOUNT FROM GROSS CHARGES BASED ON OUR SLIDING SCALE, WHICH WOULD BE AT LEAST A 20% DISCOUNT. THIS RESULTS IN A NET AMOUNT CHARGED THAT IS LESS THAN AMOUNTS GENERALLY BILLED. |
| FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 3 | A SURVEY WAS MAILED TO A RANDOMLY CHOSEN SAMPLE OF 800 RESIDENTS IN OUR PRIMARY SERVICE AREA TO SOLICIT THEIR INPUT. FOCUS GROUPS WERE HELD IN WOLF POINT AND POPLAR WHICH REPRESENTED VARIOUS CONSUMER GROUPS OF HEALTH CARE INCLUDING SENIOR CITIZENS AND LOCAL COMMUNITY MEMBERS. ALSO, A KEY INFORMANT INTERVIEW WAS CONDUCTED WITH REGIONAL HEALTHCARE ADMINISTRATORS. ADDITIONALLY, NEMHS SOUGHT INPUT FROM VARIOUS GROUPS THROUGHOUT THE COMMUNITY THAT HAVE SPECIAL KNOWLEDGE REGARDING THE NEEDS OF VARIOUS GROUPS WITHIN THE SERVICE AREA. THESE GROUPS WERE CONTACTED AND MEETINGS WERE ESTABLISHED WITH THE STEERING COMMITTEE. THE FOLLOWING CONSTITUTES A LIST OF PARTIES WHICH INCLUDED PUBLIC HEALTH SERVICES, A REPRESENTATIVE FOR THE AMERICAN INDIAN, AND A REPRESENTATIVE FOR SENIOR CITIZENS. |
| FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 4 | NORTHEAST MONTANA HEALTH SERVICES - TRINITY HOSPITAL |
| FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 7 | 1. DENTAL CARE - PROVIDING THIS SERVICE IS OUTSIDE OF NEMHS CAPACITY AND FINANCIAL RESOURCES. 2. PHYSICAL THERAPY, NUTRITION EDUCATION, DISASTER PLANNING, AND COMMUNITY HOUSING CONCERNS - PROVIDING THESE SERVICES IS BEYOND THE RESOURCE CAPACITY OF NEMHS. 3. HOSPICE, RESPITE CARE, AND HOME HEALTH - THERE ARE ALREADY ORGANIZATIONS THAT EXIST IN THE COMMUNITY THAT HELP PROVIDE RESOURCES FOR SENIOR CITIZENS. NEMHS IS CURRENTLY FOCUSING ON PRIMARY CARE NEEDS OF THE POPULATION. 4. PROGRAMS THAT HELP PEOPLE PAY FOR HEALTH CARE BILLS - THIS IS BEYOND NEMHS' SCOPE OF WORK. THERE ARE ALSO OTHER RESOURCES AVAILABLE IN THE COMMUNITY SUCH AS THE PUBLIC/COUNTY HEALTH DEPARTMENT THAT CAN OFFER ASSISTANCE TO COMMUNITY MEMBERS REGARDING PAYMENT OF HEALTHCARE BILLS. 5. MRI - PROVIDING THIS SERVICE IS OUTSIDE OF NEMHS CAPACITY AND FINANCIAL RESOURCES. |
| FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 20D | ALL PATIENTS ARE INITIALLY CHARGED THE STANDARD RATE. IF A PATIENT APPLIES AND QUALIFIES FOR FINANCIAL ASSISTANCE THEN THEY WOULD RECEIVE A DISCOUNT FROM GROSS CHARGES BASED ON OUR SLIDING SCALE, WHICH WOULD BE AT LEAST A 20% DISCOUNT. THIS RESULTS IN A NET AMOUNT CHARGED THAT IS LESS THAN AMOUNTS GENERALLY BILLED. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| WOLF POINT CLINIC ASSOCIATION | ||||
| 301 KNAPP STREET | WOLF POINT | MT | 59201 | RURAL HEALTH CLINIC |
| RIVERSIDE FAMILY CLINIC | ||||
| PO BOX 629 | POPLAR | MT | 59255 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION | THE COST OF BAD DEBT REMOVED FROM THE COMMUNITY BENEFIT EXPENSE IN COLUMN C IS 802,743. PHYSICIAN CLINIC COSTS ARE NOT INCLUDED IN SUBSIDIZED HEALTH CARE SERVICES. |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | USED ADJUSTED COST TO CHARGE RATIOS FOR PATIENT CARE FROM THE MEDICARE COST REPORT, ADJUSTED FOR BED TAX AND COMMUNITY BENEFIT. BAD DEBT EXPENSE AND CHARITY CARE ARE ALREADY EXCLUDED FROM THE MEDICARE COST REPORT. |
| PART II - COMMUNITY BUILDING ACTIVITIES | THE STAFF AT NEMHS DESIGNATES TIME FOR THE DEVELOPMENT OF COMMUNITY HEALTH PROGRAMS AND PARTNERSHIPS. THESE ACTIVITIES/INITIATIVES OFTEN TARGET ENVIRONMENTAL STRATEGIES, ECONOMIC DEVELOPMENT AND LEADERSHIP, ADVOCACY AND SUPPORT THAT INDIRECTLY AFFECT THE HEALTH OF THE COMMUNITY. PART II, LINE 8: NEMHS IS LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREA AND SPENT 51,870 TO RECRUIT PHYSICIANS AND OTHER HEALTH PROFESSIONALS NEEDED IN THE COMMUNITY. THE COST IS COMPRISED OF PAYMENTS TO RECRUITING FIRMS, NEWSPAPER AND PERIODICALS ADVERTISING, LEGAL FEES FOR FOREIGN PROFESSIONALS, AND TRAVEL AND LODGING FOR SITE VISITS. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE ORGANIZATION'S PATIENT CARE COST TO CHARGE RATIO, AFTER ELIMINATING BAD DEBT, CHARITY CARE, BED TAX, AND COMMUNITY BENEFIT EXPENSE, IS APPLIED TO GROSS BAD DEBT CHARGES TO ARRIVE AT THE COST OF BAD DEBT. DISCOUNTS REDUCE REVENUE AND ARE NOT RECORDED AS BAD DEBT. PAYMENTS RECEIVED ON PREVIOUSLY WRITTEN OFF ACCOUNTS ARE RECORDED AS RECOVERIES OF BAD DEBT WHICH REDUCE BAD DEBT EXPENSE. NONE OF THE BAD DEBT IS CONSIDERED ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE. BAD DEBTS ARE AN INEVITABLE RESULT OF OPERATING A NON-PROFIT HOSPITAL. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | THE BAD DEBT EXPENSE FOOTNOTE IS ON PAGES 7 & 8 OF THE AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8 - MEDICARE EXPLANATION | THERE IS A MEDICARE SHORTFALL SINCE CRITICAL ACCESS HOSPITALS ARE REIMBURSED 101 PERCENT OF COST FROM MEDICARE, WHICH IS THEN REDUCED BY THE 2% SEQUESTRATION ADJUSTMENT. THE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT SINCE SERVICES ARE PROVIDED TO MEDICARE PATIENTS FOR LESS THAN THE COST. MEDICARE COSTS ON PART III, LINE 6 ARE DIRECTLY FROM THE MEDICARE COST REPORT. MEDICARE REVENUE ON PART III, LINE 5 IS DIRECTLY FROM THE MEDICARE COST REPORT. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | THE ORGANIZATION USES A SLIDING SCALE BASED ON FEDERAL POVERTY GUIDELINES, AND ALSO A MEDICALLY INDIGENT TEST REGARDLESS OF INCOME, TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. THE ORGANIZATION DOES NOT ATTEMPT TO COLLECT CHARGES APPROVED AS CHARITY OR FINANCIAL ASSISTANCE UNLESS THE PATIENT QUALIFIED FOR DISCOUNTED CARE AND THEN DEFAULTS ON THE PAYMENT PLAN ON THE BALANCE OF THE ACCOUNT. THIS IS A SPECIFIC POLICY FOR PATIENTS QUALIFYING FOR FREE OR DISCOUNTED CARE. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | PURSUANT TO THE PROVISIONS OF THE AFFORDABLE CARE ACT, NEMHS ADOPTED A COMMUNITY HEALTH NEEDS ASSESSMENT PLAN AND AN IMPLEMENTATION STRATEGY DURING FISCAL YEAR 2013 (TAX YEAR 2012). THIS IS A CONTINUATION AND EXPANSION OF WHAT WE ARE ALREADY DOING TO BETTER SERVE OUR COMMUNITY. WE ARE DILIGENTLY TRACKING LOCAL TRENDS IN HEALTH CARE NEEDS THROUGH AN AVATAR PATIENT SATISFACTION SURVEY GIVEN TO ALL INPATIENTS AS WELL AS THE USE OF OUR INTERNAL BALANCED SCORE CARD. A SELECTED TEAM OF MANAGERS MEET QUARTERLY TO DISCUSS OUTCOMES FROM OUR SURVEY REPORTS AND BALANCED SCORE CARD FINDINGS. HERE ARE SOME OF OUR PAST FINDINGS: WE RECEIVED COMMENTS FROM PATIENTS THAT EXPRESSED MANY DIETARY ISSUES SO A PROJECT WAS STARTED TO HELP INCREASE THE PATIENTS AND RESIDENTS SATISFACTION ON IMPLEMENTING MENUS. THE CLINICS WERE SHOWING A LARGE NUMBER OF NO-SHOW APPOINTMENTS THAT WERE TRACKED TO SEE IF IT WAS NEGATIVELY IMPACTING REVENUE. RECEPTIONISTS NOW MAKE PHONE CALLS TO THE PATIENTS THE DAY BEFORE THE APPOINTMENT AS A REMINDER. UTILIZING THE BALANCED SCORE CARD, WE TRACKED PATIENT REFERRAL FROM THE CLINICS TO SEE WHICH SERVICES PATIENTS WERE BEING REFERRED TO OTHER AREA CLINICS FOR CARE. IT WAS DISCOVERED THAT THERE WERE A SIGNIFICANT AMOUNT OF PATIENTS BEING REFERRED OUT FOR ECHOCARDIOGRAMS. THE RADIOLOGY DEPARTMENT IS STILL BUDGETING FOR EQUIPMENT AND TRAINING TO BE ABLE TO PROVIDE THESE TESTS LOCALLY. NORTHEAST MONTANA HEALTH SERVICES MAKES INVESTMENTS IN PERSONNEL WITH THE SKILL SETS REQUIRED TO DELIVER THE SERVICES NEEDED IN THE COMMUNITY. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | NORTHEAST MONTANA HEALTH SERVICES EMPLOYS TWO SOCIAL SERVICE EMPLOYEES TO ASSIST PATIENTS WITH THEIR FINANICAL NEEDS AND OPTIONS. COMMUNITY ADVERTISEMENT IS USED TO EDUCATE PATIENTS AND SUPPORT IS GIVEN ON A ONE-ON-ONE BASIS TO ASSIST COMMUNITY MEMBERS. PATIENTS ARE NOTIFIED BY THE BILLING DEPARTMENT OF OUR POLICY FOR FINANCIAL ASSISTANCE AND ARE SENT A SIMPLE APPLICATION. OUR WEBSITE PROVIDES DETAILS OF OUR CHARITY CARE POLICY AND THE FINANCIAL ASSISTANCE AVAILABLE. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | THE ORGANIZATION OPERATES ON THE FORT PECK RESERVATION. GEOGRAPHICALLY THIS IS A REMOTE LOCATION WHERE ACCESS TO OTHER HEALTH FACILITIES IS AT LEAST 50 MILES AWAY. WITH SEVERE WEATHER CONDITIONS OFTEN RESULTING IN BLIZZARDS AND IMPASSABLE ROADS, NORTHEAST MONTANA HEALTH SERVICES IS THE FRONTLINE OF CARE FOR THE COMMUNITY. THE POPULATION OF SIOUX AND ASSINIBOINE TRIBAL MEMBERS MAKE UP OUR HIGHEST CONCENTRATION OF PATIENTS WITH DISPARITIES THAT INCLUDE CULTURAL BARRIERS, LOW HOUSEHOLD INCOME, HIGH UNEMPLOYMENT RATES, HIGHER RATES OF TOBACCO, ALCOHOL AND ILLEGAL DRUG USE, AS WELL AS HIGHER THAN AVERAGE RATES OF HEART DISEASE, DIABETES, FETAL ALCOHOL SYNDROME, AND SUICIDE. AS WE CONTINUE OUR EFFORTS TO SERVE THE PUBLIC THROUGH HEALTHCARE AND EDUCATION, THERE IS PROGRESS BEING MADE TO IMPROVE THE QUALITY OF LIFE FOR COMMUNITY MEMBERS. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | NORTHEAST MONTANA HEALTH SERVICES IS GOVERNED BY A VOLUNTARY BOARD OF COMMUNITY MEMBERS REPRESENTING THE GEOGRAPHICAL AREAS OF OUR PRIMARY SERVICE AREA. OUR HOSPITALS PROVIDE 24/7 EMERGENCY SERVICE COVERAGE TO TREAT PATIENTS, INCLUDING THOSE THAT ARE UNABLE TO PAY. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | TWO AFFILIATED RURAL HEALTH CLINICS, WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC, PROVIDE PROFESSIONAL PHYSICIAN AND OTHER PROVIDER SERVICES WHILE NORTHEAST MONTANA HEALTH SERVICES PROVIDES INPATIENT AND OUTPATIENT HOSPITAL SERVICES AND SKILLED NURSING SERVICES. THE TWO RURAL HEALTH CLINICS ARE OPERATED AND SUBSIDIZED BY NORTHEAST MONTANA HEALTH SERVICES. |
| ADDITIONAL INFORMATION | PART V: WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC ARE RURAL HEALTH CLINICS THAT ARE OPERATED AND SUBSIDIZED BY NORTHEAST MONTANA HEALTH SERVICES. THEIR REVENUE AND EXPENSES ARE NOT INCLUDED ON NORTHEAST MONTANA HEALTH SERVICES' FORM 990. PART I, LINE 7I: NEMHS CONTRIBUTED 7,000 TO RURAL HEALTH DEVELOPMENT, INC TO SUPPORT AND INFLUENCE THE EVOLUTION OF HEALTHCARE ORGANIZATION BY PROVIDING ADDITIONAL FUNDING FOR SMALLER FACILITIES IN CENTRAL AND EASTERN MONTANA FOR CAPITAL PURCHASES, QUALITY IMPROVEMENTS, AND CREATING COST SAVINGS AND OPERATIONAL EFFICIENCIES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|
| MARK ZILKOSKI MD | ||||||
| MEDICAL STAFF REP | $310,237 | $208,931 | $519,168 | |||
| MARGARET NORGAARD | ||||||
| CEO | $139,984 | $24,587 | $164,571 | |||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 4 | MARK ZILKOSKI, MD 0 207,103 0 |
| SCHEDULE J, PART III | THE COMPENSATION OF MARK ZILKOSKI, MD IS AN EXPENSE OF WOLF POINT CLINIC ASSOCIATION, A RELATED PARTY. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MT FACILITY FINANCE AUTHORITY BONDS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 810302402 | BondIssuerEIN |
| CUSIP | 612043EE5 | CUSIPNum |
| Bond Issued | 2007-05-10 | BondIssuedDt |
| Issue Price | $12,444,852 | IssuePriceAmt |
| Purpose | RENOVATIONS TO HOSPITALS | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,890,000 | RetiredAmt |
| Total Proceeds | $12,444,852 | TotalProceedsAmt |
| In Reserve Fund | $863,364 | InReserveFundAmt |
| Capitalized Interest | $743,105 | CapitalizedInterestAmt |
| Issuance Costs From Proceeds | $248,897 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $10,578,875 | CapitalExpendituresAmt |
| Substantial Completion | 2009 | SubstantialCompletionYr |
| Current Refunding | false | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | false | WrittenProcToMonitorReqsInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS REVIEWED AND APPROVED BY THE CEO AND CFO AND IS DISTRIBUTED TO THE GOVERNING BOARD FOR REVIEW PRIOR TO BEING FILED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE MEMBERS OF THE GOVERNING BOARD SIGN CONFLICT OF INTEREST STATEMENTS ANNUALLY IN WHICH THEY ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST. IF A POTENTIAL CONFLICT DOES EXIST, THE BOARD CHAIRMAN WILL REMIND MEMBERS AND ASK THEM TO ABSTAIN FROM VOTING. THESE CONFLICTS ARE DULY NOTED IN THE MINUTES. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD APPROVES THE WAGES OF THE CEO AND OTHER TOP MANAGEMENT OFFICIALS IN THE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE CEO APPROVES THE WAGES OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE AVAILABLE FROM CFO UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| RIVERSIDE FAMILY CLINIC | |||||||||||
| PO BOX 629 | POPLAR | MT | 59255 | 810474760 | CLINIC | MT | 501C3 | 3 | NEMHS | Yes (true) | |
| WOLF POINT CLINIC ASSOCIATION | |||||||||||
| 301 KNAPP STREET | WOLF POINT | MT | 59201 | 810386812 | CLINIC | MT | 501C3 | 3 | NEMHS | Yes (true) | |
| NEMHS CHARITABLE FOUNDATION INC | |||||||||||
| PO BOX 38 | POPLAR | MT | 59255 | 383732814 | SUPPORT | MT | 501C3 | 7 | false | N/A | |
| NE MT STAT AIR AMB COOP | |||||||||||
| 11 SOUTH 7TH ST SUITE 241 | MILES CITY | MT | 59301 | 204748673 | AIR AMBUL | MT | 501C3 | 11B | false | N/A | |
| FAITH LUTHERAN HOME FOUNDATION INC | |||||||||||
| 1000 6TH AVE N | WOLF POINT | MT | 59201 | 810483586 | SUPPORT | MT | 501C3 | PF | false | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| RIVERSIDE FAMILY CLINIC | ||
| R | $841,682 | DECREASE IN RECEIVABLE |
| WOLF POINT CLINIC ASSOCIATION | ||
| S | $306,688 | INCREASE IN RECEIVABLE |
| NEMHS CHARITABLE FOUNDATION | ||
| C | $44,044 | CASH GIFTS |