MARCUS DALY MEMORIAL HOSPITAL CORPORATION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- MARCUS DALY MEMORIAL HOSPITAL CORPORATION (EIN 81-0240726)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-06
- IRS object ID
- 201431269349300243
- Schema version
- 2012v2.1
- 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 I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-06T10:13:46-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810240726 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARCUS DALY MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MARC | NameControl |
| Phone | 4063754609 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 WESTWOOD DRIVE | AddressLine1 |
| City | HAMILTON | City |
| State | MT | State |
| ZIP Code | 59840 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN M BARTOS | Name |
| Title | CEO, SECRETARY AND TREASURER | Title |
| Phone | 4063754609 | Phone |
| Date Signed | 2014-05-01 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DARRYN MCGARVEY | Name |
| PTIN | P00958683 | PTIN |
| Phone | 6123764500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JOHN M BARTOS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 WESTWOOD DRIVE | AddressLine1 |
| City | HAMILTON | City |
| State | MT | State |
| ZIP Code | 59840 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 54099514 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MDMH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1938 | YearFormation |
| State Legal Domicile | MT | StateLegalDomicile |
| Activity Or Mission Description | OUR COMMITMENT TO THE BITTERROOT VALLEY IS QUALITY, ACCESSIBLE, PERSONALIZED HEALTHCARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 577 | TotalNbrEmployees |
| Total Nbr Volunteers | 90 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 115352 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 159689 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 51546346 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 53603950 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 15311 | InvestmentIncomePriorYear |
| Investment Income Current Year | -78746 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 194464 | OtherRevenuePriorYear |
| Other Revenue Current Year | 125118 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 51871473 | TotalRevenuePriorYear |
| Total Revenue Current Year | 53810011 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 76726 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 71106 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 28395994 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 31423605 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 216283 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 23871665 | OtherExpensePriorYear |
| Other Expenses Current Year | 23414247 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 52344385 | TotalExpensesPriorYear |
| Total Expenses Current Year | 54908958 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -472912 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1098947 | RevenuesLessExpensesCY |
| Total Assets BOY | 49935753 | TotalAssetsBOY |
| Total Assets EOY | 55319551 | TotalAssetsEOY |
| Total Liabilities BOY | 23861018 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 29790802 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 26074735 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 25528749 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | OUR COMMITMENT TO THE BITTERROOT VALLEY IS QUALITY, ACCESSIBLE, PERSONALIZED HEALTHCARE. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 46190989 | Expense |
| Grants | 71106 | Grants |
| Revenue | 53603950 | Revenue |
| Description | MARCUS DALY MEMORIAL HOSPITAL CORPORATION OWNS AND OPERATES A 48 LICENSED BED ACUTE CARE CRITICAL ACCESS HOSPITAL WITH 25 BEDS SETUP. THE HOSPITAL PROVIDES ACUTE CARE SERVICES TO PATIENTS IN RAVALLI COUNTY. THE SERVICES PROVIDED INCLUDE ACUTE CARE HOSPITAL, RELATED ANCILLARY SERVICES SUCH AS LABORATORY, RADIOLOGY AND THERAPY INPATIENT AND OUTPATIENT SURGERY, EMERGENCY CARE, AMBULANCE, HOME HEALTH, CLINIC, AND INPATIENT AND OUTPATIENT HOSPICE CARE. THE HOSPITAL PROVIDES EMS SERVICES WITH 3 CREWS PROVIDING 911 SERVICE TO THE COUNTY. THE GOAL IS TO RESPOND WITHIN 20 MINUTES OR LESS TO ANY CALL WITHIN THE COUNTY. THE HOSPITAL IS THE ONLY PEDIATRIC REHABILITATION PROVIDER OF PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH THERAPY IN WESTERN MONTANA USING CERTIFIED THERAPISTS. THE HOSPITAL CLINICS SEE ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY AND ENABLE THE COMMUNITY ACCESS TO PRIMARY CARE. | Description |
| Total Program Service Expense | 46190989 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 72 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 577 | NumberOfEmployees |
| Employment Tax Returns Filed | 0 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
| Other Explain In Sch O | X | OtherExplainInSchO |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DONJA ERDMAN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4063754609 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 WESTWOOD DRIVE | AddressLine1 |
| City | HAMILTON | City |
| State | MT | State |
| ZIP Code | 59840 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| DON LODMELL PHD | ||||||||
| CHAIRMAN | 2.00 | X | X | 0 | 0 | 0 | ||
| BILL BEAN | ||||||||
| VICE CHAIR | 2.00 | X | X | 0 | 0 | 0 | ||
| BARBARA ACKERMAN | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| WALKER ASHCRAFT MD | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | X | 133923 | 0 | 23031 | |||
| GARY BEDEY | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| SUSANNAH BENJAMIN | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| DONNA COONEY | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| FREDERICK ILGENFRITZ MD | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | X | 248881 | 0 | 11800 | |||
| BRIAN KELLEHER MD | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | X | 208876 | 0 | 0 | |||
| JAMES OWINGS CPA | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| RANDY STEWART MD | ||||||||
| BOARD MEMBER/PHYSICIAN | 3.00 | X | 61548 | 0 | 0 | |||
| STEVEN ELLIS MD | ||||||||
| BOARD MEMBER THRU OCT 2010 | 2.00 | X | 0 | 0 | 0 | |||
| SONNY LASALLE | ||||||||
| BOARD CHAIR THRU OCT 2010 | 2.00 | X | X | 0 | 0 | 0 | ||
| JOHN M BARTOS | ||||||||
| CEO/SECRETARY/TREASURER | 39.00 | X | 297133 | 0 | 36347 | 1.00 | ||
| DONJA C ERDMAN | ||||||||
| CFO | 39.00 | X | 123565 | 0 | 26097 | 1.00 | ||
| JOHN MORELAND MD | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | X | 275072 | 0 | 38991 | |||
| JEREMIAH CLINTON MD | ||||||||
| PHYSICIAN | 40.00 | 441891 | 0 | 26567 | X | |||
| FRANK MCHUGH MD | ||||||||
| PHYSICIAN | 40.00 | 316384 | 0 | 17333 | X | |||
| MATTHEW MUNDING MD | ||||||||
| PHYSICIAN | 40.00 | 248261 | 0 | 42109 | X | |||
| JOHN LARAWAY MD | ||||||||
| PHYSICIAN | 40.00 | 271900 | 0 | 16509 | X | |||
| WILLIAM DOYLE MD | ||||||||
| PHYSICIAN | 40.00 | 256284 | 0 | 28019 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2883718 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 266803 | TotalOtherCompensation |
| Number Individuals GT100 K | 31 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| QUALITY CONSTRUCTION INC | |||||
| PO BOX 4746 | MISSOULA | MT | 59806 | GENERAL CONTRACTOR FEES | 781462 |
| OZ ARCHITECTS | |||||
| 5310 NORTH HIGGINS AVE A | MISSOULA | MT | 59806 | ARCHITECTUAL FEES | 557105 |
| ALLIANCE HEALTHCARE SERVICES | |||||
| FILE 55826 | LOS ANGELES | CA | 90074 | MRI IMAGING | 550798 |
| HEALTHCARE OUTSOURCING NETWORK LLC | |||||
| 621 17TH ST 1800 | DENVER | CO | 80293 | BUSINESS SERVICES PROVIDER | 514028 |
| CERNER CORPORATION | |||||
| PO BOX 412072 | KANSAS CITY | MO | 64141 | BUSINESS SERVICES PROVIDER | 387195 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 16 | NumberOfContractorsGT100K |
| All Other Contributions | 159689 | AllOtherContributions |
| Total Contributions | 159689 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621400 | 51565492 | 51565492 |
| HOSPITAL UTILZTN. REV. | 621400 | 1268604 | 1268604 |
| OTHER OPERATING INCOME | 621400 | 769854 | 769854 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 53603950 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12672 | TotalRevenueColumn |
| Exclusion | $12,672 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7234 | TotalRevenueColumn |
| Exclusion | $7,234 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 179766 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 174805 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 4961 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4961 | TotalRevenueColumn |
| Exclusion | $4,961 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 16046 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 114698 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -98652 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -98652 | TotalRevenueColumn |
| Exclusion | -$98,652 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MISCELLEANEOUS | 900099 | 89470 | $89,470 |
| EDUCATION | 900099 | 24639 | $24,639 |
| CAFETERIA/VENDING | 900099 | 6048 | $6,048 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 120157 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 53810011 | TotalRevenueColumn |
| Related Or Exempt Function Income | 53603950 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $46,372 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71106 | Total |
| Program Services | 71106 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1409747 | Total |
| Program Services | 954211 | ProgramServices |
| Management And General | 455536 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23920944 | Total |
| Program Services | 19882650 | ProgramServices |
| Management And General | 3922610 | ManagementAndGeneral |
| Fundraising | 115684 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 886641 | Total |
| Program Services | 739836 | ProgramServices |
| Management And General | 142510 | ManagementAndGeneral |
| Fundraising | 4295 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3520994 | Total |
| Program Services | 2906364 | ProgramServices |
| Management And General | 598418 | ManagementAndGeneral |
| Fundraising | 16212 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1685279 | Total |
| Program Services | 1315374 | ProgramServices |
| Management And General | 361529 | ManagementAndGeneral |
| Fundraising | 8376 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71029 | Total |
| Management And General | 71029 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67832 | Total |
| Management And General | 67832 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3888407 | Total |
| Program Services | 2292479 | ProgramServices |
| Management And General | 1593761 | ManagementAndGeneral |
| Fundraising | 2167 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 119443 | Total |
| Program Services | 119443 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3909728 | Total |
| Program Services | 3577986 | ProgramServices |
| Management And General | 330085 | ManagementAndGeneral |
| Fundraising | 1657 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 756808 | Total |
| Program Services | 580457 | ProgramServices |
| Management And General | 176351 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 333920 | Total |
| Program Services | 318435 | ProgramServices |
| Management And General | 15485 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 166937 | Total |
| Program Services | 116567 | ProgramServices |
| Management And General | 50366 | ManagementAndGeneral |
| Fundraising | 4 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 984171 | Total |
| Program Services | 791338 | ProgramServices |
| Management And General | 154266 | ManagementAndGeneral |
| Fundraising | 38567 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3845520 | Total |
| Program Services | 3667463 | ProgramServices |
| Management And General | 164954 | ManagementAndGeneral |
| Fundraising | 13103 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 886534 | Total |
| Program Services | 886534 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| PROVISION FOR BAD DEBTS | 7180083 | 7180083 | ||
| MAINTENANCE AND REPAIRS | 671266 | 556770 | 112952 | 1544 |
| MISCELLANEOUS EXPENSES | 328013 | 37712 | 275627 | 14674 |
| PHARMACY/ LAB EXPENSES | 169440 | 169440 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35116 | Total |
| Program Services | 26741 | ProgramServices |
| Management And General | 8375 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54908958 | Total |
| Program Services | 46190989 | ProgramServices |
| Management And General | 8501686 | ManagementAndGeneral |
| Fundraising | 216283 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7077081 | BOY |
| EOY | 6073256 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2642542 | BOY |
| EOY | 3398704 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9148211 | BOY |
| EOY | 9154138 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9261 | BOY |
| EOY | -1594 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1198333 | BOY |
| EOY | 1292887 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 371702 | BOY |
| EOY | 422439 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 57660043 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 25141952 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27577068 | BOY |
| EOY | 32518091 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1452688 | BOY |
| EOY | 2032918 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 458867 | BOY |
| EOY | 428712 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49935753 | BOY |
| EOY | 55319551 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6512071 | BOY |
| EOY | 8586884 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 719442 | BOY |
| EOY | 352505 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8085000 | BOY |
| EOY | 7635000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7425464 | BOY |
| EOY | 10894698 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 426904 | BOY |
| EOY | 166521 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 692137 | BOY |
| EOY | 2155194 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23861018 | BOY |
| EOY | 29790802 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24190477 | BOY |
| EOY | 23022484 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 900075 | BOY |
| EOY | 1815208 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 984183 | BOY |
| EOY | 691057 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26074735 | BOY |
| EOY | 25528749 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49935753 | BOY |
| EOY | 55319551 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1098947 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 552961 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 313190 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 2665 | InvestmentEarningsOrLosses |
| Other Expenditures | 2665 | OtherExpenditures |
| End Of Year Balance | 313190 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 313190 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 1997 | InvestmentEarningsOrLosses |
| Other Expenditures | 1997 | OtherExpenditures |
| End Of Year Balance | 313190 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 313190 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 3160 | InvestmentEarningsOrLosses |
| Other Expenditures | 3160 | OtherExpenditures |
| End Of Year Balance | 313190 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 313190 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 4071 | InvestmentEarningsOrLosses |
| Other Expenditures | 4071 | OtherExpenditures |
| End Of Year Balance | 313190 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 313190 | BeginningOfYearBalance |
| End Of Year Balance | 313190 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1637827 | OtherCostOrOtherBasis |
| Book Value | 1637827 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 37163469 | OtherCostOrOtherBasis |
| Depreciation | 13578580 | Depreciation |
| Book Value | 23584889 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 737267 | OtherCostOrOtherBasis |
| Depreciation | 493027 | Depreciation |
| Book Value | 244240 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15898604 | OtherCostOrOtherBasis |
| Depreciation | 11070345 | Depreciation |
| Book Value | 4828259 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2222876 | OtherCostOrOtherBasis |
| Book Value | 2222876 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 32518091 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | THIRD PARTY SETTLEMENT | Description |
| Amount | $2,155,194 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2155194 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 46438684 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -7180083 | OtherRevenues |
| Revenue Not Rptd F990 | -7180083 | RevenueNotRptdF990 |
| Revenue Subtotal | 53618767 | RevenueSubtotal |
| Other Revenues Not Included | 191244 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 191244 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 53810011 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 47880832 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 151957 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 151957 | ExpensesNotRptdF990 |
| Expenses Subtotal | 47728875 | ExpensesSubtotal |
| Other Expenses Not Included | 7180083 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 7180083 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 54908958 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE ENDOWMENT FUND IS DESIGNATED FOR THE PURPOSE OF BUILDING AND CARRYING ON A HOSPITAL IN HAMILTON, MONTANA. THE EVANS ENDOWMENT IS TO BE USED FOR THE CARE AND TREATMENT OF CRIPPLED CHILDREN. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | PER THE AUDITED FINANCIAL STATEMENTS, NOTE 1: THE INTERNAL REVENUE SERVICE (IRS) HAS DETERMINED THAT MARCUS DALY MEMORIAL HOSPITAL IS A TAX-EXEMPT, NOT-FOR-PROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE HOSPITAL FOLLOWS THE GUIDANCE IN THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE HOSPITAL'S FINANCIAL STATEMENTS. THE HOSPITAL'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE INFORMATION TAX RETURNS FOR THE YEARS ENDED 2010 TO 2012 ARE OPEN TO EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PROVISION FOR UNCOLLECTIBLE ACCOUNTS -7,180,083. | |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | INTEREST REVENUE 19,906. UNRESTRICTED CONTRIBUTIONS 36,038. OTHER NONOPERATING REVENUE 163,606. TEMPORARILY RESTRICTED CONTRIBUTIONS 123,651. RENTAL EXPENSES -151,957. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 151,957. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR UNCOLLECTIBLE ACCOUNTS 7,180,083. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 346 | PersonsServed |
| Total Community Benefit Expense | 737080 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 737080 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01540 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4492557 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3067240 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1425317 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02990 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 346 | PersonsServed |
| Total Community Benefit Expense | 5229637 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3067240 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2162397 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04530 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 431921 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 431921 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00900 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 137727 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 137727 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2884532 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1650817 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1233715 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02580 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 66784 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 66784 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00140 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3520964 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1650817 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1870147 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03910 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 346 | PersonsServed |
| Total Community Benefit Expense | 8750601 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4718057 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4032544 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08440 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 7030 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 7030 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1448 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1448 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 201660 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 201660 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00420 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 210138 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 210138 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00430 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $7,180,083 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 15392126 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 16115432 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -723306 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARCUS DALY MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 WESTWOOD DRIVE | AddressLine1 |
| City | HAMILTON | City |
| State | MT | State |
| ZIP Code | 59840 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARCUS DALY MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 5 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (5 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| CORVALLIS FAMILY MEDICINE CLINIC | ||||
| 1037 MAIN STREET | CORVALLIS | MT | 59828 | FAMILY PRACTICE CLINIC |
| BITTERROOT VALLEY EYE ASSOCIATES | ||||
| 300 N 10TH STREET | HAMILTON | MT | 59840 | OPTICAL SPECIALTY CLINIC |
| BITTERROOT CLINIC | ||||
| 1224 MAIN STREET | HAMILTON | MT | 59840 | FAMILY PRACTICE CLINIC |
| BITTERROOT VALLEY EYE ASSOCIATES | ||||
| 401 MAIN STREET | STEVENSVILLE | MT | 59870 | OPTICAL SPECIALTY CLINIC |
| RAVALLI UROLOGY | ||||
| 1224 MAIN STREET | HAMILTON | MT | 59840 | UROLOGY SPECIALTY CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (21 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: A FAMILY MAY NOT OWN NET ASSETS IN EXCESS OF $10,000 CURRENT VALUE, INCLUDING A HOME AND ONE OR TWO CARS (IF TWO ADULTS IN FAMILY). OWNERSHIP IN LIVESTOCK, RECREATIONAL VEHICLES AND SIMILAR TYPE ITEMS WILL DISQUALIFY THE FAMILY FROM CHARITY CARE (UNLESS RELATED TO PRIMARY SOURCE OF INCOME AND INCLUDED ON MOST RECENT FEDERAL TAX FILING). A FAMILY MAY NOT OWN GROSS ASSETS (WITHOUT CONSIDERATION OF MORTGAGE OR OTHER LOANS ON PROPERTY) IN EXCESS OF $200,000. | ||
| PART I, LINE 6A: A COMMUNITY BENEFIT REPORT FOR FISCAL YEAR 2012 WAS IN THE SPRING 2013 EDITION OF HEALTHLINES, THE NEWSLETTER OF MARCUS DALY MEMORIAL HOSPITAL. THE NEWSLETTER WAS DELIVERED TO EVERY MAILING ADDRESS IN RAVALLI COUNTY COVERING APPROXIMATELY 14,300 HOUSEHOLDS. AN ADDITIONAL 1,000 COPIES OF THE NEWSLETTER WERE PRINTED FOR GENERAL CIRCULATION. | ||
| PART I, LINE 7: EXPLANATION OF COSTING METHOD:COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONAL EDUCATION, AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS ARE REPORTED AT COST. GENERAL SUBSIDIZED SERVICES ARE COMPUTED USING THE IRS GUIDELINES OF COST ADJUSTED NET OF PAYMENTS RECEIVED. THE MEDICARE COST REPORT WAS USED TO DETERMINE THE TOTAL SUBSIDY FOR THE HOME HEALTH/HOSPICE DEPARTMENTS. | ||
| PART I, LINE 7G: INCLUDED IN THE SUBSIDIZED HEALTH SERVICES ARE THE FOLLOWING DEPARTMENTS:AMBULANCE, HOME HEALTH, HOSPICE CENTER AND HOSPICE OUTPATIENT, HOSPITALIST PROGRAM, AND THE ROCKY MOUNTAIN NEUROLOGY SURGERY CLINIC. | ||
| PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSES THAT WAS EXCLUDED FROM THE CALCULATION TO DETERMINE THE NET COMMUNITY BENEFIT EXPENSES AS A PERCENT OF TOTAL EXPENSES WAS $7,180,083. | ||
| PART II: THE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY BY PARTICIPATION IN BOTH ECONOMIC AND COALITION BUILDING EVENTS. THE HOSPITAL PARTNERS WITH LOCAL HIGH SCHOOLS WITH A "JOB SHADOW" PROGRAM. THE GOAL IS TO EXPOSE AND PROMOTE THE HEALTH CARE PROFESSION TO AREA YOUTH. THE HOSPITAL IS ALSO ACTIVELY INVOLVED IN NUMEROUS COMMUNITY SUPPORT ORGANIZATIONS. | ||
| PART III, LINE 4: THE FOLLOWING IS FROM THE "PATIENT RECEIVABLES" PARAGRAPH IN NOTE 1 TO THE HOSPITAL'S FINANCIAL STATEMENTS:"PATIENT AND RESIDENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT AND RESIDENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATESIF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS."THE AMOUNT OF BAD DEBT EXPENSE REPORTED IN PART III, LINE 2 IS CALCULATED AS FOLLOWS: PAYMENT ARRANGEMENT INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. | ||
| PART III, LINE 8: MDMH HAS A MEDICARE SHORTFALL IN EXCESS OF APPROXIMATELY $723,000. THE HOSPITAL HAS CRITICAL ACCESS HOSPITAL STATUS AND IS REIMBURSED BY MEDICARE FOR INPATIENT AND OUTPATIENT SERVICES ON A COST BASIS AS DEFINED AND LIMITED BY THE MEDICARE PROGRAM. MDMH PROVIDES A SIGNIFICANT RURAL LINK FOR BOTH THE HEALTH AND WELL-BEING OF RAVALLI COUNTY RESIDENTS. WE ARE COMMITTED TO LOCAL HEALTHCARE CLOSE TO HOME AND WORK HARD TO EARN AND KEEP THE TRUST OF THE LOCAL COMMUNITY. TO ENSURE THAT A VARIETY OF CLINIC, HOSPITAL AND EMERGENCY SERVICES ARE OPEN AND AVAILABLE TO ALL THOSE WITHIN OUR SERVICE AREA WE STRIVE TO OPERATE AT THE HIGHEST LEVEL OF FISCAL RESPONSIBILITY AND TO BE A GOOD STEWARD OF OUR RESOURCES. THE MEDICARE ALLOWABLE COSTS INCLUDED IN PART III, LINE 6 WAS DERIVED USING THE 2013 FILED MEDICARE COST REPORT. | ||
| PART III, LINE 9B: IF A PATIENT IS PRESUMED TO BE FINANCIALLY INDIGENT, THE PATIENT REPRESENTATIVE WILL OFFER A PATIENT FINANCIAL STATEMENT (PFS) TO BE FILLED OUT. THE PFS WILL BE FORWARDED TO THE PATIENT FINANCIAL ASSISTANCE COMMITTEE FOR REVIEW AND DETERMINATION OF PATIENT FINANCIAL ASSISTANCE STATUS. A PATIENT MAY REQUEST A MONTHLY PAYMENT ARRANGMENT. A MINIMUM PAYMENT OF $50 MUST BE PAID MONTHLY, WITH THE BALANCE PAID IN FULL WITHIN 5 YEARS. ACCOUNTS THAT CANNOT BE COLLECTED AFTER NORMAL IN-HOUSE COLLECTION PROCEDURES MAY BE REFERRED TO A COLLECTION AGENCY, MAGISTRATE OR ATTORNEY FOR FURTHER COLLECTION ACTION. | ||
| PART V, SECTION B, LINE 3: THOSE ZIP CODES WITH THE GREATEST NUMBER OF ADMISSIONS WERE SELECTED TO BE INCLUDED IN THE SURVEY. A RANDOM LIST OF 800 RESIDENTS WAS SELECTED FROM PRIME NET DATA SOURCE. ADDITIONALLY, THREE FOCUS GROUPS WERE HELD TO IDENTIFY THE MOTIVES OF LOCAL RESIDENTS WHEN SELECTING HEALTH CARE PROVIDERS. NOTICE OF THE SURVEY WAS PLACED IN THE LOCAL NEWSPAPER. | MARCUS DALY MEMORIAL HOSPITAL | |
| PART V, SECTION B, LINE 5C: MDMH'S COMMUNITY HEALTH NEEDS ASSESSMENT WAS AVAILABLE ON THEIR WEBSITE AS OF JANUARY 1, 2104 AT: HTTP://WWW.MDMH.ORG/DOCS/COMMUNITY_HEALTH_NEEDS_ASSESSMENT_REPORT_2012.PDF?SUB=PATIENT%20INFO | MARCUS DALY MEMORIAL HOSPITAL | |
| PART V, SECTION B, LINE 10: ELIGIBILITY FOR PATIENT ASSISTANCE IS MADE REGARDLESS OF RACE, COLOR, CREED, OR AGE. COSMETIC OR EXPERIMENTAL PROCEDURES AND CHARGES ARE NOT ELIGIBLE FOR PATIENT FINANCIAL ASSISTANCE. FULL TO PARTIAL PATIENT ASSISTANCE MAY BE PROVIDED TO PATIENTS WITH GROSS FAMILY INCOME BELOW 100% OF THE FPG AS ADJUSTED FOR FAMILY SIZE. THE FAMILY MAY NOT OWN NET ASSETS IN EXCESS OF $10,000 OR GROSS ASSETS OVER $200,000. OTHER CONSIDERATIONS MAY BE A PATIENT'S HEALTHINESS AND THEIR ABLILTY TO SEEK OR HOLD EMPLOYEMENT. SEE PATIENT FINANCIAL ASSISTANCE POLICY FOR DETAILS. | MARCUS DALY MEMORIAL HOSPITAL | |
| PART V, SECTION B, LINE 11: ELIGIBILITY FOR PATIENT ASSISTANCE IS MADE REGARDLESS OF RACE, COLOR, CREED OR AGE. COSMETIC OR EXPERIMENTAL PROCEDURES AND CHARGES ARE NOT ELIGIBLE FOR CHARITY ASSISTANCE. FULL TO PARTIAL PATIENT ASSISTANCE MAY BE PROVIDED TO PATIENTS WITH GROSS FAMILY INCOME BELOW 100% OF THE FPG AS ADJUSTED FOR FAMILY SIZE. THE FAMILY MAY NOT OWN NET ASSETS IN EXCESS OF $10,000 OR GROSS ASSETS OVER $200,000. SEE CHARITY CARE POLICY FOR DETAILS. | MARCUS DALY MEMORIAL HOSPITAL | |
| PART V, SECTION B, LINE 14G: AS OF JANUARY 1, 2014, THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY WAS ALSO POSTED ON THEIR WEBSITE AT HTTP://WWW.MDMH.ORG/DOCS/CHARITYCAREPOLICY.PDF?SUB=PATIENT%20INFO. | MARCUS DALY MEMORIAL HOSPITAL | |
| PART V, SECTION B, LINE 20D: MDMH DETERMINES AMOUNTS GENERALLY BILLED ("AGB") BASED ON COMMERCIAL PAYORS. THE LARGEST COMMERCIAL PAYOR DISCOUNT WAS 20% FOR THE YEAR ENDED JUNE 30, 2013. PATIENT FINANCIAL ASSISTANCE DISCOUNTS RANGE FROM 30% TO 100%, DEPENDING UPON PATIENT ELIGIBILITY. | MARCUS DALY MEMORIAL HOSPITAL | |
| PART VI, LINE 2: MARCUS DALY MEMORIAL HOSPITAL PARTICIPATED IN THE COMMUNITY HEALTH SERVICES DEVELOPMENT (CHSD) PROJECT ADMINISTRATED BY THE MONTANA OFFICE OF RURAL HEALTH AND THE NATIONAL RURAL HEALTH RESOURCE CENTER (NRHRC) IN DULUTH, MINNESOTA. | ||
| PART VI, LINE 3: BILLING AND COLLECTION INFORMATION IS LOCATED ON THE BACK OF THE STATEMENT SENT TO PATIENTS ON A MONTHLY BASIS, WE CONTACT BY PHONE REQUESTING PAYMENT AND MAY EXPLAIN POLICIES AT THAT TIME. WE UTILIZE THE MASH PROGRAM TO SCREEN PRIVATE PAY PATIENTS TO QUALIFY FOR OTHER PROGRAMS SUCH AS MEDICAID AND DISABILITY. | ||
| PART VI, LINE 4: THE HOSPITAL SERVES A RURAL POPULATION WHERE THE HOUSEHOLD MEDIAN INCOME IS ABOUT $28,000. THE PAYER MIX IS 55% MEDICARE, 9% MEDICAID, 12% SELF PAY, NO INSURANCE, WITH THE BALANCE AT OTHER COMMERCIAL PAYORS. THE PERIOD UNEMPLOYMENT RATE HAS RANGED BETWEEN 9 AND 10.2% | ||
| PART VI, LINE 5: THE HOSPITAL IS PROUD OF IT'S EFFORTS TO PROMOTE COMMUNITY HEALTH AND WELLNESS. THIS YEAR THE FOCUS WAS ON THE "SPRINKLE PINK" PROGRAM WHICH PROMOTED COMMUNITY AWARENESS AS TO THE IMPORTANCE OF MAMMOGRAPHY SCREENING. THE HOSPITAL SPONSORS AN ANNUAL SPORTS PHYSICAL CLINIC TO SUPPORT AND ENCOURAGE AREA YOUTH TO PARTICIPATE IN PHYSICIAL ACTIVITIES. OTHER COMMUNITY CLINICS OR SCREENINGS INCLUDED BLOOD PRESSURE TESTING AT AREA SENIOR CENTERS, AND LIPID PROFILES AND CHOLESTEROL TESTS PROVIDED TO THE COMMUNITY FREE OF CHARGE. A VARIETY OF HEALTH EDUCATION CLASSES WERE CONDUCTED INCLUDING A ONE-DAY WORKSHOP FOCUSED ON WOMEN'S HEART HEALTH. | ||
| PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. | ||
| MT | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| HAMILTON SCHOOL DISTRICT | |||||||
| 217 DALY AVENUE | HAMILTON | MT | 59840 | 816000830 | GOVERNMENTAL | 9700 | SUPPORT FOR SCHOOL RN PROGRAM AND STUDENT ATHLETICS. |
| CORVALLIS SCHOOL DISTRICT | |||||||
| PO BOX 700 1045 MAIN STREET | CORVALLIS | MT | 59828 | 816000828 | GOVERNMENTAL | 8950 | SUPPORT FOR SCHOOL RN PROGRAM AND STUDENT ATHLETICS. |
| STEVENSVILLE SCHOOL DISTRICT | |||||||
| 300 PARK STREET | STEVENSVILLE | MT | 59870 | 816000829 | GOVERNMENTAL | 6500 | SUPPORT FOR SCHOOL RN PROGRAM. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: THE HOSPITAL IS COMMITTED TO SUPPORT THE HEALTH AND WELL-BEING OF AREA SCHOOL AGED CHILDREN BY PROVIDING FUNDING GRANTS RESTRICTED TO THE DISTRICT'S SCHOOL NURSE PROGRAM. THE HOSPITAL HAS ALSO COMMITTED TO SUPPORT STUDENT ATHLETICS BY PROVIDING A VOLUNTEER BASED, LOW-COST SPORTS PHYSICAL CLINIC DURING THE SUMMER. THE PROCEEDS ARE GIVEN TO THE PARTICIPATING STUDENTS' HOME DISTRICT TO SUPPORT THE DISTRICT'S ATHLETIC PROGRAMS. OTHER COMMUNITY ORGANIZATIONS MAY SUBMIT A GRANT PROPOSAL DIRECTLY TO THE HOSPITAL CEO FOR CONSIDERATION. THE REQUESTS ARE EVALUATED BASED UPON BROAD BASED COMMUNITY SUPPORT AND THE URGENCY OF NEED. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Written Policy Re T And E Expenses | 0 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 0 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WALKER ASHCRAFT MD | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | 133923 | 0 | 0 | 0 | 0 | 0 | 15984 | 0 | 7047 | 0 | 156954 | 0 | 0 | 0 |
| FREDERICK ILGENFRITZ MD | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | 248881 | 0 | 0 | 0 | 0 | 0 | 10800 | 0 | 1000 | 0 | 260681 | 0 | 0 | 0 |
| BRIAN KELLEHER MD | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | 208876 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 208876 | 0 | 0 | 0 |
| JOHN M BARTOS | ||||||||||||||
| CEO/SECRETARY/TREASURER | 292333 | 0 | 0 | 0 | 4800 | 0 | 22500 | 0 | 13847 | 0 | 333480 | 0 | 0 | 0 |
| JOHN MORELAND MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | 275072 | 0 | 0 | 0 | 0 | 0 | 38991 | 0 | 0 | 0 | 314063 | 0 | 0 | 0 |
| JEREMIAH CLINTON MD | ||||||||||||||
| PHYSICIAN | 441891 | 0 | 0 | 0 | 0 | 0 | 18458 | 0 | 8109 | 0 | 468458 | 0 | 0 | 0 |
| FRANK MCHUGH MD | ||||||||||||||
| PHYSICIAN | 316384 | 0 | 0 | 0 | 0 | 0 | 17000 | 0 | 333 | 0 | 333717 | 0 | 0 | 0 |
| MATTHEW MUNDING MD | ||||||||||||||
| PHYSICIAN | 248261 | 0 | 0 | 0 | 0 | 0 | 34000 | 0 | 8109 | 0 | 290370 | 0 | 0 | 0 |
| JOHN LARAWAY MD | ||||||||||||||
| PHYSICIAN | 271900 | 0 | 0 | 0 | 0 | 0 | 8400 | 0 | 8109 | 0 | 288409 | 0 | 0 | 0 |
| WILLIAM DOYLE MD | ||||||||||||||
| PHYSICIAN | 256284 | 0 | 0 | 0 | 0 | 0 | 19045 | 0 | 8974 | 0 | 284303 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 1B | ReturnReference |
| Explanation | THE CEO HAS BEEN APPROVED BY THE BOARD OF DIRECTORS TO RECEIVE A MONTHLY $400 VEHICLE ALLOWANCE. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MT HEALTH FACILITY AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 810302402 | IssuerEIN |
| CUSIP Number | 612043ED7 | CUSIPNumber |
| Date Issued | 2007-01-31 | DateIssued |
| Issue Price | 7068924 | IssuePrice |
| Description Of Purpose | CONSTRUCTION OF A NEW EMERGENCY DEPARTMENT | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 1300000 | AmountRetired |
| Total Proceeds | 7135000 | TotalProceeds |
| Amount In Reserve Fund | 1006262 | AmountInReserveFund |
| Issuance Costs From Proceeds | 155264 | IssuanceCostsFromProceeds |
| Capital Expenditures | 5973474 | CapitalExpenditures |
| Year Of Subst Completion | 2008 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 0 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 1 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | 1 | ProcToUndertkCorrectiveAction |
Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SCHEDULE K PART IV, ARBITRAGE, LINE 2C | DATE REBATE COMPUTATION PERFORMED | ISSUER NAME: MT HEALTH FACILITY AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 08/01/2011 |
| PART II, LINE 3, PROCEEDS OF ISSUE | THE ISSUE PRICE OF $7,068,924 (PART I, COLUMN E) DOES NOT EQUAL THE TOTAL PROCEEDS OF ISSUE OF $7,135,000 (PART II, LINE 3) BECAUSE OF A $66,076 ORIGINAL ISSUE DISCOUNT. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KATHLEEN OWINGS | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | SPOUSE OF BOARD MEMBER | Relationship |
| Amount Of Transaction | 105746 | AmountOfTransaction |
| Description Of Transaction | EMPLOYMENT | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| NEW PROGRAM SERVICES | FORM 990, PART III, LINE 2 | ADDED NEURO SURGERY CLINIC |
| FORM 990, PART VI, SECTION B, LINE 11 | A REPRESENTATIVE FROM CLIFTONLARSONALLEN WILL BE RESPONSIBLE TO PRESENT THE FORM 990 TO THE HOSPITAL FINANCE COMMITTE. UPON APPROVAL THE FORM 990 WILL BE PRESENTED TO THE ENTIRE BOARD OF DIRECTORS FOR ACCEPTANCE AND APPROVAL. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE HOSPITAL ATTORNEY ATTENDS ALL BOARD MEETINGS AND HE IS GIVEN THE AUTHORITY TO QUESTION, PRIOR TO DISCUSSION, A POTENTIAL CONFLICT OF INTEREST FOR ANY DIRECTOR. THE CEO RAISES A QUESTION REGARDING CONFLICT OF INTEREST. THE HOSPITAL BOARD ASKS THE DIRECTOR TO STEP OUT OF THE ROOM DURING DISCUSSION OF CONFLICT. THE DIRECTOR IS EXCUSED FOR THE DISCUSSION ONCE A CONFLICT HAS BEEN DETERMINED OR IS INVITED BACK INTO THE ROOM IF NO CONFLICT IS DETERMINED TO EXIST. | |
| FORM 990, PART VI, SECTION B, LINE 15 | CEO - OCCURS ANNUALLY WITH ANNUAL COMPENSATION COMMITTEE OF THE BOARD. THE COMMITTEE REVIEWS SURVEYS FOR COMPARABLE PAY AND BENEFITS. THIS COMMITTEE ALSO CONDUCTS THE ANNUAL EVALUATION OF THE CFO. | |
| FORM 990, PART VI, SECTION C, LINE 18 | IN ADDITION TO BEING AVAILABLE UPON REQUEST, A COPY OF THE FORM 990 IS ALSO AVAILABLE AT WWW.GUIDESTAR.ORG. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF DALY HOSPITAL FOUNDATION 580,230. AUXILIARY -27,269. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DALY HOSPITAL FOUNDATIONINC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 WESTWOOD DRIVE | AddressLine1 |
| City | HAMILTON | City |
| State | MT | State |
| ZIP Code | 59840 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363766000 | EIN |
| Primary Activities | CHARITABLE SERVICES | PrimaryActivities |
| Legal Domicile State | MT | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11-TYPE 2 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |