ROUNDUP MEMORIAL HOSPITAL ASSOCIATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ROUNDUP MEMORIAL HOSPITAL ASSOCIATION (EIN 81-0245848)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-15
- IRS object ID
- 201341359349300769
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-15T09:42:58-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810272932 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GALUSHA HIGGINS AND GALUSHA PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 1530 | AddressLine1 |
| City | HAVRE | City |
| State | MT | State |
| ZIP Code | 59501 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810245848 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROUNDUP MEMORIAL HOSPITAL ASSOC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ROUN | NameControl |
| Phone | 4062322301 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 40 | AddressLine1 |
| City | ROUNDUP | City |
| State | MT | State |
| ZIP Code | 59072 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRAD HOWELL | Name |
| Title | CEO | Title |
| Phone | 4062322301 | Phone |
| Date Signed | 2013-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DARCY DEE REUM CPA | Name |
| PTIN | P00647883 | PTIN |
| Phone | 4062653201 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BRAD HOWELL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 40 | AddressLine1 |
| City | ROUNDUP | City |
| State | MT | State |
| ZIP Code | 59072 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 6784484 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.RMHMT.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1979 | YearFormation |
| State Legal Domicile | MT | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE HEALTH CARE SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 110 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 998700 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 558068 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4291217 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5815741 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 266 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 410675 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5290183 | TotalRevenuePriorYear |
| Total Revenue Current Year | 6784484 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 1941960 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2913391 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5207420 | OtherExpensePriorYear |
| Other Expenses Current Year | 3269789 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 7149380 | TotalExpensesPriorYear |
| Total Expenses Current Year | 6183180 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1859197 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 601304 | RevenuesLessExpensesCY |
| Total Assets BOY | 2766674 | TotalAssetsBOY |
| Total Assets EOY | 2629486 | TotalAssetsEOY |
| Total Liabilities BOY | 2811835 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2073343 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -45161 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 556143 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | IT IS THE MISSION OF THE ROUNDUP MEMORIAL HOSPITAL AND MUSSELLSHELL COUNTY MEDICAL CENTER TO ACCEPT THE ONGOING CHALLENGE OF PROVIDING FOR THE HEALTHCRE NEEDS OF ALL OF OUR CITIZENS. IT IS OUR SINCERE DESIRE TO HEAL THE SICK AND COMFORT THE SUFFERING WITH ALL THE RESOURCES WE HAVE AVAILABLE. AS GOOD STEWARDS OF THESE INSTITUTIONS, EMPLOYEES WILL HELP INSURE THE SURVIVAL OF THE HOSPITAL AND CLINIC BY BEING COMMITTED TO THE CARE AND WELL BEING OF THOSE THEY SERVE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 2597683 | Expense |
| Revenue | 2828429 | Revenue |
| Description | CRITICAL ACCESS HOSPITAL - ROUTINE SERVICE FOR ADULTS, PEDRIATRICS, AND SWINGBED. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 803466 | Expense |
| Revenue | 569558 | Revenue |
| Description | RURAL HEALTH CLINIC - 4 PROVIDERS | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2597683 | Expense |
| Revenue | 2828429 | Revenue |
| Description | OTHER SERVICES INCLUDE BUT ARE NOT LIMITED TO ANCILLARIES, CT SCANS, LABRATORY, PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPIES, PHARMACY, EMERGENCY ROOM, X-RAY, CENTRAL SUPPLY, INTRAVENOUS SOLUTIONS, ULTRASOUND, ELECTROCARDIOGRAPHY, OBSERVATION, BLOOD BANK, AND PATHOLOGY. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 5998832 | 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 | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | 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 | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| 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 | 0 | 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 | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 16 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 110 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | 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 |
| Premiums Paid | 0 | PremiumsPaid |
| Form8899 Filed | 0 | Form8899Filed |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | 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 | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 0 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MT | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4062322301 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 40 | AddressLine1 |
| City | ROUNDUP | City |
| State | MT | State |
| ZIP Code | 59072 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (9 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee |
|---|---|---|---|---|---|---|---|
| JOHN PHISTER | |||||||
| BOARD PRESIDENT | 0.50 | X | 0 | 0 | 0 | ||
| MARK ROSEBUSH | |||||||
| BOARD VICE PRESIDENT | 0.50 | X | 0 | 0 | 0 | ||
| KEN MOSDAL | |||||||
| TREASURER | 0.50 | X | 0 | 0 | 0 | ||
| OLIVER ODDEN | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| TERRI RUSTAD | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| LEONARD WALL | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| MARSHALL WHITE MD | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| GARY BOSTROM | |||||||
| CEO/CFO | 40.00 | 0 | 0 | 0 | X | ||
| TERRY JONES MD | |||||||
| CHIEF OF STAFF | 45.00 | 186164 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 186164 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BILLINGS CLINIC | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 37000 | AddressLine1 |
| City | BILLINGS | City |
| State | MT | State |
| ZIP Code | 59107 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | MANAGEMENT SERVICES | DescriptionOfServices |
| Compensation | 640464 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Related Organizations | 558068 | RelatedOrganizations |
| Total Contributions | 558068 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INPATIENT/OUTPATIENT R | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 5765237 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5765237 | RelatedOrExemptFunctionIncome |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 50504 | TotalRevenueColumn |
| Related Or Exempt Function Income | 50504 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5815741 | TotalProgramServiceRevenue |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER NON OPERATING RE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 410675 | TotalRevenueColumn |
| Related Or Exempt Function Income | 410675 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 410675 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6784484 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6226416 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2331211 | Total |
| Program Services | 2226718 | ProgramServices |
| Management And General | 104493 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27805 | Total |
| Program Services | 26554 | ProgramServices |
| Management And General | 1251 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 281737 | Total |
| Program Services | 269059 | ProgramServices |
| Management And General | 12678 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 272638 | Total |
| Program Services | 260369 | ProgramServices |
| Management And General | 12269 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53657 | Total |
| Management And General | 53657 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 302662 | Total |
| Program Services | 302662 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61300 | Total |
| Program Services | 61300 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| DISCOUNTS AND ALLOWANCE | 607306 | 607306 |
| CONTRACT LABOR | 594117 | 594117 |
| SUPPLIES | 505127 | 505127 |
| BAD DEBT EXPENSE | 418061 | 418061 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 727559 | Total |
| Program Services | 727559 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6183180 | Total |
| Program Services | 5998832 | ProgramServices |
| Management And General | 184348 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60118 | BOY |
| EOY | 147777 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 795087 | BOY |
| EOY | 649142 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33089 | BOY |
| EOY | 33089 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 119394 | BOY |
| EOY | 107757 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7740 | BOY |
| EOY | 33713 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7935116 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6291160 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1737194 | BOY |
| EOY | 1643956 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14052 | BOY |
| EOY | 14052 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2766674 | BOY |
| EOY | 2629486 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1222902 | BOY |
| EOY | 917197 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1370849 | BOY |
| EOY | 945062 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 218084 | BOY |
| EOY | 211084 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2811835 | BOY |
| EOY | 2073343 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -45161 | BOY |
| EOY | 556143 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -45161 | BOY |
| EOY | 556143 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2766674 | BOY |
| EOY | 2629486 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 601304 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
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 | 52279 | BeginningOfYearBalance |
| Contributions | 141459 | Contributions |
| Investment Earnings Or Losses | 199 | InvestmentEarningsOrLosses |
| Other Expenditures | 104341 | OtherExpenditures |
| End Of Year Balance | 89596 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 15912 | BeginningOfYearBalance |
| Contributions | 41345 | Contributions |
| Investment Earnings Or Losses | 22 | InvestmentEarningsOrLosses |
| Other Expenditures | 5000 | OtherExpenditures |
| End Of Year Balance | 52279 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4054478 | OtherCostOrOtherBasis |
| Depreciation | 3425934 | Depreciation |
| Book Value | 628544 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3880638 | OtherCostOrOtherBasis |
| Depreciation | 2865226 | Depreciation |
| Book Value | 1015412 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1643956 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | 3RD PARTY PAYERS | Description |
| Amount | $211,084 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 211084 | TotalOfAmounts |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| 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 | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 128706 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 128706 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02080 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 982070 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 853356 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 128714 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02080 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1110776 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 853356 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 257420 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04160 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9291 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 9291 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9291 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 9291 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1120067 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 853356 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 266711 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04310 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense | $418,061 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 1080894 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 1080894 | CostOfCareReimbursedByMedicare |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 2 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|---|
| ROUNDUP MEMORIAL HOSPITAL - HOSPITAL | |||||||||
| 1 | 1202 3RD STREET WEST | ROUNDUP | MT | 59072 | X | X | X | X | |
| ROUNDUP MEMORIAL HOSPITAL - CLINIC | |||||||||
| 2 | 1207 3RD STREET WEST | ROUNDUP | MT | 59072 | RURAL HEALTH CLINIC | ||||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROUNDUP MEMORIAL HOSPITAL ASSOC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| 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 |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Notify Upon Admission | X | NotifyUponAdmission |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (6 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART III, LINE 9B: POLICY STATES UP FRONT THAT ADMISSIONS REPRESENTATIVE IS TO GIVE FINANCIAL ASSISTANCE PAPERWORK WITH INFORMAION ON CHARITY CARE AT THE TIME OF ADMISSION. FOLLOW UP CONSULTATION IS DONE LATER TO INCLUDE FINANCIAL ASSISTANCE.DISCUSSIONS WITH PATIENT | |
| PART V, SECTION B, LINE 13G: WHEN A PATIENT INDICATES THAT A FINANCIAL HARDSHIP EXISTS, THE HOSPITAL PROVIDES INFORMATION ON THE HOSPITAL CHARITY PLAN AND OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS. | ROUNDUP MEMORIAL HOSPITAL ASSOC |
| PART V, SECTION B, LINE 18C: THE FACILITY CHARGES THE SAME TO ALL INDIVIDUALS. | ROUNDUP MEMORIAL HOSPITAL ASSOC |
| PART VI, LINE 2: IN 2010, THE HOSPITAL CONDUCTED A NEEDS ASSESSMENT IN CONJUNCTION WITH A COMMUNITY MILL LEVY ELECTION. STAKEHOLDERS INVOLVED INCLUDED COUNTY COMMISSIONERS, COMMUNITY SERVICE ORGANIZATIONS, SUCH AS ROTARY AND THE LION'S CLUB, AND AREA STATE AGENCIES. IN ADDITION, THE HOSPITAL HELD TWO COMMUNITY MEETINGS AND LED DISCUSSIONS OF HEALTHCARE NEEDS AND DESIRES. | |
| PART VI, LINE 3: WHEN A PATIENT INDICATES THAT A FINANCIAL HARDSHIP EXISTS, THE HOSPITAL PROVIDES INFORMATION ON THE HOSPITAL CHARITY PLAN AND OTHER STATE AND DEFERAL ASSISTANCE PROGRAMS. | |
| PART VI, LINE 4: ROUNDUP MEMORIAL HEALTHCARE (RMH) IS THE SOLE COMMUNITY HEALTHCARE PROVIDER FOR MUSSELSHELL COUNTY, A RURAL AREA WITH A POPULATION DENSITY OF 2.4 PER SQUARE MILE. NO OTHER HOSPITALS SERVE THE COMMUNITY AND THE NEAREST HEALTHCARE FACILITY IS LOCATED IN BILLINGS, 45 MILES TO THE SOUTH. PER THE 2010 FEDERAL CENSUS, THE COUNTY POPULATION WAS 4,538; THE PER CAPITA INCOME IN THE COUNTY IS $19,164 AND THE PERCENTAGE OF PERSONS BELOW THE POVERTY LINE WAS 20.5 PERCENT. IN 2006, 26.4 PERCENT OF MUSSELSHELL COUNTY WAS UNINSURED. THE HEALTH RESOURCES AND SERVICES ADMINISTRATION HAS DESIGNATED MUSSELSHELL COUNTY AS AN UNDERSERVED AREA WITH A SCORE OF 16. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | TERRY JONES MD | NamePerson |
| Base Compensation Filing Org | 186164 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 0 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 186164 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION HAS CONTRACTED WITH A LARGER HOSPITAL FACILITY TO PROVIDE MANAGEMENT DUTIES. | |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS OF HOSPITAL ASSOCIATION 501 (C)3 | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS REVIEWED BY THE CEO AND ACCOUNTING CLERK BEFORE FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE COMPLIANCE OFFICER MONITORS AND EVALUATES CONFLICT OF INTEREST ISSUES. | |
| FORM 990, PART VI, SECTION B, LINE 15A | CEO COMPENSATED ACCORDING TO ARRANGEMENTS WITH THE MANAGEMETN AGREEMENT WITH BILLINGS CLINIC, WHO RECOMMENDS THE CEO SALARY TO THE BOARD FOR APPROVAL. THE HOSPITAL UTILIZES THE MONTANA HOSPITAL ASSOCIATION AND ASSOCIATED EMPLOYEES SALARY SURVEY TO DETERMINE SALARIES OF KEY EMPLOYEES. | |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABLE UPON REQUSET TO THE CEO. | |
| THE ORGANIZATION WILL PROVIDE A COPY OF FORM 990 TO THE GOVERNING BODY. | ||
| FORM 990, PART X, LINE 24E | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 402,523. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 402,523. OTHER OPERATING EXPENSES: PROGRAM SERVICE EXPENSES 187,253. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 187,253. UTILITIES: PROGRAM SERVICE EXPENSES 133,574. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 133,574. CHARITY CARE: PROGRAM SERVICE EXPENSES 129,450. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 129,450. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 20,518. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,518. LEASES AND RENTALS: PROGRAM SERVICE EXPENSES 9,408. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,408. PRIOR YEAR SETTLEMENTS: PROGRAM SERVICE EXPENSES -155,167. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -155,167. | ALL OTHER FUNCTIONAL EXPENSES |