DANIELS MEMORIAL HOSPITAL: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- DANIELS MEMORIAL HOSPITAL (EIN 81-6016920)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-15
- IRS object ID
- 201341359349307124
- 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 | 2013-05-15T14:54:56-05:00 | 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 | 816016920 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DANIELS MEMORIAL HOSPITAL ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | DANI | NameControl |
| Phone | 4064875331 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 400 | AddressLine1 |
| City | SCOBEY | City |
| State | MT | State |
| ZIP Code | 59263 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVE HUBBARD | Name |
| Title | ADMINISTRATOR | Title |
| Phone | 4064875331 | Phone |
| Date Signed | 2013-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | DAVE HUBBARD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 400 | AddressLine1 |
| City | SCOBEY | City |
| State | MT | State |
| ZIP Code | 59263 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 6289774 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Association | X | TypeOfOrganizationAssociation |
| Year Formation | 1956 | YearFormation |
| State Legal Domicile | MT | StateLegalDomicile |
| Activity Or Mission Description | TO PROMOTE THE GENERAL HEALTH CARE OF THE COMMUNITY THROUGH PROVIDING HIGH QUALITY HEALTH CARE AND A HOME FOR THE AGED AND INFIRM. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 123 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 955073 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 196001 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5819919 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6025450 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 7391 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1490 | OtherRevenuePriorYear |
| Other Revenue Current Year | 68323 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 6783873 | TotalRevenuePriorYear |
| Total Revenue Current Year | 6289774 | 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 | 3673441 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4006871 | 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 | 2506811 | OtherExpensePriorYear |
| Other Expenses Current Year | 2307084 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6180252 | TotalExpensesPriorYear |
| Total Expenses Current Year | 6313955 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 603621 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -24181 | RevenuesLessExpensesCY |
| Total Assets BOY | 3778115 | TotalAssetsBOY |
| Total Assets EOY | 3467917 | TotalAssetsEOY |
| Total Liabilities BOY | 1218813 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 932796 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2559302 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2535121 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE A HEALTH CARE SYSTEM WITH CLINIC, ACUTE INPATIENT, EMERGENCY, OUTPATIENT, AND LONG-TERM CARE SERVICES | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 4009031 | Expense |
| Revenue | 5470518 | Revenue |
| Description | PROFESSIONAL CARE - PRIMARY, ACUTE AND LONG TERM CARE. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 754158 | Expense |
| Revenue | 750933 | Revenue |
| Description | CLINIC SERVICES FOR OUTPATIENT CLIENTS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 497119 | Expense |
| Description | HOUSEKEEPING, LAUNDRY, LINEN & PLANT SERVICES - PROVIDE FOR THE HOUSEKEEPING AND BUILDING MAINTENANCE OF THE FACILTIY. | Description |
Activity Other ActivityOther (2 entries)
| DescriptionDescription |
|---|
| DIETARY SERVICES FOR ACUTE AND LONG TERM CARE PATIENTS. |
| MEDICAL RECORDS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 5260308 | 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 | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | 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 | 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 | 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 | 2 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 123 | 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 |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | 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 | 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 | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | 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 | DANIELS MEMORIAL HOSPITAL ASSOCIATI | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4064872296 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 105 5TH AVENUE EAST | AddressLine1 |
| City | SCOBEY | City |
| State | MT | State |
| ZIP Code | 59263 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (10 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee |
|---|---|---|---|---|---|---|
| TOM HAGAN | ||||||
| CHAIR | 3.00 | X | 0 | 0 | 0 | |
| BEV LINDSEY | ||||||
| TREASURER | 2.00 | X | 0 | 0 | 0 | |
| PERRY WOLFE | ||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | |
| CARTER JENSEN | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| SCOTT SUSAG | ||||||
| DIRECTOR | 1.50 | X | 0 | 0 | 0 | |
| DERRICK MOTTERN | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| RICHARD HOOD | ||||||
| DIRECTOR | 1.50 | X | 0 | 0 | 0 | |
| KATHY WICOXON | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| ANA BRENDEN | ||||||
| DIRECTOR | 1.50 | X | 0 | 0 | 0 | |
| DR DONALD SAWDEY | ||||||
| DO | 40.00 | 354040 | 0 | 0 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 354040 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 4 | 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 | 2800 10TH AVE NORTH | AddressLine1 |
| City | BILLINGS | City |
| State | MT | State |
| ZIP Code | 59107 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | MANAGEMENT SERVICES | DescriptionOfServices |
| Compensation | 546805 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 196001 | AllOtherContributions |
| Total Contributions | 196001 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REVENU | 623000 | 5882470 | 5882470 |
| OTHER OPERATING REVENU | 623000 | 137093 | 137093 |
| OTHER UNRESTRICTED REV | 623000 | 5887 | 5887 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6025450 | TotalProgramServiceRevenue |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | HOSPITAL DISTRICT TAX | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 68323 | TotalRevenueColumn |
| Related Or Exempt Function Income | 68323 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 68323 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6289774 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6093773 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3038616 | Total |
| Program Services | 2786388 | ProgramServices |
| Management And General | 252228 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35323 | Total |
| Program Services | 32306 | ProgramServices |
| Management And General | 3017 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 689665 | Total |
| Program Services | 581291 | ProgramServices |
| Management And General | 108374 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 243267 | Total |
| Program Services | 206350 | ProgramServices |
| Management And General | 36917 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40085 | Total |
| Program Services | 9733 | ProgramServices |
| Management And General | 30352 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12493 | Total |
| Program Services | 4655 | ProgramServices |
| Management And General | 7838 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42060 | Total |
| Program Services | 37236 | ProgramServices |
| Management And General | 4824 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73945 | Total |
| Program Services | 29011 | ProgramServices |
| Management And General | 44934 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23104 | Total |
| Management And General | 23104 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 269146 | Total |
| Program Services | 269146 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 121400 | Total |
| Program Services | 3113 | ProgramServices |
| Management And General | 118287 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| CONTRACTUAL SERVICES | 567463 | 310801 | 256662 |
| SUPPLIES | 297246 | 267513 | 29733 |
| MEDICAL SUPPLIES AND PH | 264451 | 264451 | |
| REPAIRS AND MAINTENANCE | 177457 | 173261 | 4196 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 418234 | Total |
| Program Services | 285053 | ProgramServices |
| Management And General | 133181 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6313955 | Total |
| Program Services | 5260308 | ProgramServices |
| Management And General | 1053647 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 381580 | BOY |
| EOY | 768400 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 925772 | BOY |
| EOY | 311171 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 772674 | BOY |
| EOY | 624557 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30000 | BOY |
| EOY | 45000 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 156825 | BOY |
| EOY | 175397 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40229 | BOY |
| EOY | 40509 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 5232042 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 3730226 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1469478 | BOY |
| EOY | 1501816 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1557 | BOY |
| EOY | 1067 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3778115 | BOY |
| EOY | 3467917 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 768828 | BOY |
| EOY | 673118 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 448428 | BOY |
| EOY | 258611 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1557 | BOY |
| EOY | 1067 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1218813 | BOY |
| EOY | 932796 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2559302 | BOY |
| EOY | 2535121 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2559302 | BOY |
| EOY | 2535121 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3778115 | BOY |
| EOY | 3467917 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -24181 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| 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
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 34837 | OtherCostOrOtherBasis |
| Book Value | 34837 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3613918 | OtherCostOrOtherBasis |
| Depreciation | 2730080 | Depreciation |
| Book Value | 883838 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1505250 | OtherCostOrOtherBasis |
| Depreciation | 1000146 | Depreciation |
| Book Value | 505104 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 78037 | OtherCostOrOtherBasis |
| Book Value | 78037 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1501816 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | RESIDENT TRUST FUND | Description |
| Amount | $1,067 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1067 | TotalOfAmounts |
| Total Revenue | 6289774 | TotalRevenue |
| Total Expenses | 6313955 | TotalExpenses |
| Excess Or Deficit For Year | -24181 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | -24181 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 5967350 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -52213 | OtherRevenues |
| Revenue Not Rptd F990 | -52213 | RevenueNotRptdF990 |
| Revenue Subtotal | 6019563 | RevenueSubtotal |
| Other Revenues Not Included | 270211 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 270211 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 6289774 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 6261742 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 6261742 | ExpensesSubtotal |
| Other Expenses Not Included | 52213 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 52213 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 6313955 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | THE RECONCILIATION FOR REVENUES AND EXPENSES PER AUDITED FINANCIAL STATMENTS COMPARED TO THE TAX RETURN CONTAINS ADJUSTMENTS DO TO A PROVISION FOR BAD DEBT EXPENSE AND OTHER REVENUES INCLUDING CONTRIBUTION INCOME AND HOSPITAL DISTRICT TAX REVENUES. | Explanation |
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 | 138415 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 138415 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02210 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 138415 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 138415 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02210 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 4059 | PersonsServed |
| Total Community Benefit Expense | 19932 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2400 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 17532 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00280 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 46718 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5190 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 41528 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00660 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 4059 | PersonsServed |
| Total Community Benefit Expense | 66650 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7590 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 59060 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00940 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 4059 | PersonsServed |
| Total Community Benefit Expense | 205065 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7590 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 197475 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03150 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $52,213 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 1868067 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 1868067 | CostOfCareReimbursedByMedicare |
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 | DANIELS MEMORIAL HOSPITAL ASSOCIATION | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 400 | AddressLine1 |
| City | SCOBEY | City |
| State | MT | State |
| ZIP Code | 59263 | 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 |
| Other | LONG-TERM CARE FACILITY; RURAL HEALTH CLINIC; HOME CARE & HOSPICE | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DANIELS MEMORIAL HEALTH CARE CENTER | 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 | 11 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 0 | CHNAWidelyAvailable |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 150.000000000000 | 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 | 0 | 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 Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (8 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 52213. | |
| PART V, SECTION B, LINE 3: THE DANIELS COUNTY PUBLIC NURSE MARY NYPHUS IS THE PERSON WHO REPRESENTED THE COMMUNITY AND WHOM WHICH THE HOSPITAL CONSULTED WITH. A FEW OF THE SURVEY QUESTIONS WERE MODIFIED AND ADDITIONAL QUESTIONS WERE ADDED TO THE COMMUNITY ASSESSMENT THAT PERTAINED TO PUBLIC HEALTH, ISSUES RELATED TO SMOKING, ALCOHOL CONUSMPTION, HEALTHY LIFESTYLES AND CANCER SCREENING. | DANIELS MEMORIAL HEALTH CARE CENTER |
| PART V, SECTION B, LINE 5C: PUBLICIZED IN LOCAL NEWSPAPER. | DANIELS MEMORIAL HEALTH CARE CENTER |
| PART V, SECTION B, LINE 7: THE HOSPITAL IS STILL IN THE PROCESS OF ADDRESSING ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED NEEDS ASSESSMENT. | DANIELS MEMORIAL HEALTH CARE CENTER |
| PART VI, LINE 2: PUBLIC HEALTH NURSING SERVICE REQUESTS ALL PARTICIPANTS: BUSINESS, CIVIC, RELIGIOUS, HEALTHCARE, PUBLIC AND WE IDENTIFY ISSUES THAT MAY ASSIST THE COMMUNITY. I.E. HEALTHCARE, HOUSING, ROADS, INFRASTRUCTURE. | |
| PART VI, LINE 3: WE INFORM THE PUBLIC ABOUT PROGRAMS, I.E. MEDICARE/MEDICAID. ADVERTISEMENT IN PRINT AND RADIO, PHAMPLETS IN THE WAITING ROOM, AND SOCIAL SERVICE VISITS WITH PATIENTS. | |
| PART VI, LINE 4: WE ARE DESIGNATED A FRONTIER CAH, >6 PEOPLE PER SQ MILE, TOWN HAS 960 PEOPLE, COUNTY HAS 1406 PEOPLE, WE ARE 5 HOURS AWAY FROM A TERTIARY HOSPITAL, AND 3 HOURS AWAY FROM A SECONDARY HOSPITAL. | |
| PART VI, LINE 5: THROUGH THE TELEMEDICINE NETWORK, PATIENTS CAN SEE SPECIALISTS 5 HOURS AWAY RIGHT HERE. SEVERAL FREE TELEMEDICINE NETWORK SERVICES ARE OFFERED: CARDIOLOGY, DIABETES, BABY SITTING CLASSES WITH DIPOLMA, MENTAL HEALTH, CHEMICAL DEPENDENCY ARE ALL FREE TO THE PUBLIC AND GROUPS. |
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 | DR DONALD SAWDEY | NamePerson |
| Base Compensation Filing Org | 354040 | 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 | 354040 | 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 (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | DANIELS MEMORIAL HOSPITAL CONTRACTS WITH THE BILLINGS CLINIC FOR MANAGEMENT, IT, AND ACCOUNTING SERVICES. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS AVAILABLE FOR REVIEW BY THE BOARD AFTER APPROVAL BY THE CEO. |
| FORM 990, PART VI, SECTION B, LINE 12C | AT THE ANNUAL MEETING, CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND SIGNED BY ALL TRUSTEES AND THE CEO. THE BOARD CHAIR AND CEO MONITOR THE STATUS OF ALL TRUSTEES THROUGHOUT THE YEAR FOR CHANGES THAT COULD LEAD TO A NEW SITUATION REQUIRING DISCLOSURE. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF TRUSTEES REVIEW AND MAKE DECISIONS ON THE COMPENSATION PACKAGE FOR THE CEO. THE CEO COMPENSATION IS PART OF THE MANAGEMENT CONTRACT PAID TO THE OUTSIDE MANAGEMENT COMPANY. ALL MANAGERS REPORT TO THE CEO AND THE CEO REVIEWS AND MAKES DECISIONS ON THE MANAGERS COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL GOVERNING DOCUMENTS, INCLUDING THE CONFLICT OF INTEREST STATEMENT AND THE FINANCIAL STATEMENTS, ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| THE AUDITED FINANCIAL STATEMENTS ARE REVIEWED BY THE FINANCE COMMITTEE AND THEN REFERRED TO THE OVERALL BOARD. THE BOARD VOTES TO ACCEPT THE AUDITED FINANCIAL STATEMENTS. |