2026-03-12T12:45:07-04:00 2025-04-30 272643480 GREEN HEALTH GROUP PC 405 FOURTH AVENUE NORTH GLASGOW MT 59230 990 2024-05-01 810373589 CULBERTSON FROID BAINVILLE HEALTHCARE CORPORATION CULB 4063218660 PO BOX 419 CULBERTSON MT 59218 JAMASON SCHMIDT CEO 4063218660 2026-03-12 true true DANIEL GREEN P01311679 4062632615 2026-03-12 2024 2025-03-06 01:10:19Z ROOSEVELT MEDICAL CENTER JAMASON SCHMIDT PO BOX 419 CULBERTSON MT 59218 10999119 false X ROOSEVELTMEDICAL.ORG X 1976 MT ROOSEVELT MEDICAL CENTER IS DEDICATED TO PROVIDING PATIENTS WITH APPROPRIATE, PERSONALIZED, AND QUALITY HEALTH CARE. 10 10 100 114 0 906463 281237 8251714 9899241 68385 334048 470890 484593 9697452 10999119 0 0 4394622 5508064 0 70095 4709055 4407761 9103677 9915825 593775 1083294 11482274 13312433 2414997 3165574 9067277 10146859 ROOSEVELT MEDICAL CENTER IS DEDICATED TO PROVIDING PATIENTS WITH APPROPRIATE, PERSONALIZED, AND QUALITY HEALTH CARE. false false 8347733 9899241 ROOSEVELT MEDICAL CENTER IS DEDICATED TO 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AND 39.00 PERCENT OF DUES PAID TO AHA, WHICH TOTALED 691, WERE USED FOR LOBBYING EXPENSES BY MHA. 18500 18500 6921522 4161326 2760196 3010749 2471297 539452 114004 114004 3432152 BENEFICIAL INTEREST IN TRUST 1494721 EQUITY IN AIR AMBULANCE CO-OP 206575 EQUITY IN WORKERS' COMP TRUST 65000 1766296 MEDICARE/MEDICAID ESTIMATED PAYABLE 1052733 RESIDENT DEPOSITS PAYABLE 165308 1218041 X 10999119 10999119 10999119 9915825 9915825 9915825 SCHEDULE D, PAGE 3, PART X THE COMPANY BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING THEIR ANNUAL FILING REQUIREMENTS AND, AS SUCH, DO NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. true true true X true X true true true false false 136161 136161 0.01370 136161 136161 0.01370 220620 18058 202562 0.02040 1030047 825498 204549 0.02060 1250667 843556 407111 0.04110 1386828 843556 543272 0.05480 true 3933483 3956301 -22818 X true true 1 1 ROOSEVELT MEDICAL CENTER PO BOX 419 CULBERTSON MT 59218 ROOSEVELTMEDICAL.ORG X X X X ROOSEVELT MEDICAL CENTER 1 false false true X X X X X X X X X X 23 true false true true X ROOSEVELTMEDICAL.ORG X true 23 true ROOSEVELTMEDICAL.ORG false false true X 100.000000000000 200.000000000000 X X X true true X X X X true X WWW.ROOSEVELTMEDICAL.ORG X WWW.ROOSEVELTMEDICAL.ORG X WWW.ROOSEVELTMEDICAL.ORG X X X X true X false X X X X true X X false false FACILITY 1, ROOSEVELT MEDICAL CENTER - PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND ARE IDENTIFIED THROUGH THE CHNA. FACILITY 1, ROOSEVELT MEDICAL CENTER - PART V, LINE 5 THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS PERFORMED IN THE SPRING OF 2023 IN COLLABORATION WITH THE ROOSEVELT COUNTY HEALTH DEPARTMENT, FORT PECK TRIBES, AND LOVELAND CONSULTING. A DIVERSE GROUP OF STAKEHOLDERS WAS CONVENED TO GUIDE THE PROCESS AND THEY REPRESENTED VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY SUCH AS PUBLIC HEALTH, MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY CITIZENS, SENIORS, YOUTH, AND TRIBAL/AMERICAN INDIANS. ALSO, IN THE SPRING OF 2023, A KEY INFORMANT SURVEY WAS DISTRIBUTED ELECTRONICALLY AND 53 TOTAL RESPONSES WERE RECEIVED. FACILITY 1, ROOSEVELT MEDICAL CENTER - PART V, LINE 6B ROOSEVELT COUNTY HEALTH DEPARTMENT AND FORT PECK TRIBAL HEALTH DEPARTMENT FACILITY 1, ROOSEVELT MEDICAL CENTER - PART V, LINE 11 THE PRIORITIZED HEALTH NEEDS AS DETERMINED THROUGH THE ASSESSMENT PROCESS AND WHICH THE FACILITY WILL BE ADDRESSING RELATES TO THE FOLLOWING HEALTHCARE ISSUES: 1. SENIOR SERVICES 2. HEALTH AND WELLNESS 3. MENTAL AND BEHAVIORAL HEALTH THE FIRST HEALTHCARE ISSUE IS TO ENHANCE SENIOR SERVICES AVAILABLE IN EASTERN ROOSEVELT COUNTY. ONE STRATEGY FOR ADDRESSING THIS ISSUE IS TO EXPAND SERVICES THAT HELP THE LOCAL SENIOR POPULATION TO AGE IN PLACE SUCH AS EXPLORING OFFERING A FOOT CARE CLINIC AND CHECKING IMMUNIZATION STATUS FOR AREA SENIORS, DETERMINING FEASIBILITY OF IMPLEMENTING A COMMUNITY HEALTH WORKER SERVICE OR COMMUNITY PARAMEDICINE MODEL TO ASSIST SENIORS AND COMMUNITY MEMBERS IN THEIR HOMES, AND RMC WILL PROVIDE/SPONSOR LUNCH AND LEARNS IN COLLABORATION WITH AREA SENIOR CENTERS REGARDING VARIOUS HEALTH TOPICS. THE SECOND STRATEGY IS TO IMPROVE AWARENESS AND REACH OF THE CHRONIC CARE MANAGEMENT PROGRAM BY EXPANDING CURRENT EFFORTS BY CONNECTING WITH THE NEW MONTANA HEALTH NETWORK REGIONAL COORDINATOR AND REACHING OUT TO THE LOCAL SENIOR CENTER TO CONDUCT OUTREACH AND EDUCATION RELATED TO THE CHRONIC CARE MANAGEMENT PROGRAM. DUE TO CLINIC STAFFING ISSUES, FOOT CARE CLINICS/IMMUNIZATION STATUS CHECKS WERE NOT FEASIBLE AT THE SENIOR CENTERS. EFFORTS WERE MADE TO PARTNER WITH THE COUNTY'S AGING SERVICES, BUT THEY TOO HAVE A STAFFING/VOLUNTEER ISSUE. HOWEVER, EDUCATIONAL MATERIALS MORE SPECIFIC TO SENIORS SUCH AS THE BENEFITS OF VACCINES, HEALTHY AGING AND SENIOR AGE-RELATED HEALTH CONCERNS AND TOPICS WERE MADE AVAILABLE AT THE SENIOR CENTERS IN THE COMMUNITIES OF CULBERTSON, BAINVILLE AND FROID THROUGHOUT THE YEAR. CONDUCTING ON-SITE LUNCH AND LEARNS AT THE SENIOR CENTERS DURING THEIR SHORT HOURS OF OPERATION DURING THE LUNCH MEAL HAVE NOT BEEN POSSIBLE DUE TO STAFFING ISSUES/SCHEDULES. INSTEAD, AWARENESS BROCHURES, POSTERS AND INFORMATION HAVE BEEN MADE AVAILABLE AT THE SENIOR CENTERS TO COINCIDE WITH MONTHLY HEALTH AWARENESS SPOTLIGHTS. FOR THIS SERVICE, WE PARTNERED WITH THE COUNTY TO ADVERTISE THIS PROGRAM. THE CHRONIC CARE MANAGEMENT PROGRAM CONTINUES TO GAIN MOMENTUM WITH SEVERAL DOZEN AREA SENIORS BENEFITING FROM THE PROGRAM. PROVIDING INFORMATION ABOUT THE PROGRAM TO THE COMMUNITY IS ONGOING. THE SECOND HEALTHCARE ISSUE IS TO ENHANCE HEALTH, WELLNESS, AND PREVENTION OUTREACH IN EASTERN ROOSEVELT COUNTY. ONE STRATEGY FOR ADDRESSING THIS ISSUE IS TO CONTINUE RMC'S PROMOTION OF HEALTH AND WELLNESS EFFORTS IN CULBERTSON AND THE SURROUNDING AREA BY OFFERING A COMMUNITY HEALTH FAIR, CONTINUING ANNUAL HEALTH SCREENING LABS, AND CONTINUING TO PROMOTE AND SPONSOR COMMUNITY HEALTH AND WELLNESS ACTIVITIES. THE SECOND STRATEGY IS TO GROW RMC'S PRESENCE IN THE COMMUNITY AS A SOURCE FOR HEALTH EDUCATION, OUTREACH, AND RESOURCES BY ENHANCING EDUCATIONAL RESOURCES AND OUTREACH TO THE COMMUNITY REGARDING HEALTH, WELLNESS, AND PREVENTION SUCH AS PROMOTING MONTHLY WELLNESS TOPICS, PROVIDING EDUCATION MATERIALS AT SCHOOL FUNCTIONS AND COMMUNITY EVENTS, AND SPONSORSHIP OF THE K-12 HEALTH BAGS. THROUGHOUT THE YEAR, MONTHLY NATIONAL AWARENESS CAMPAIGNS WERE HIGHLIGHTED VIA SOCIAL MEDIA AND AWARENESS INFORMATION WAS DISSEMINATED THROUGH THE COMMUNITIES VIA THE LOCAL POST OFFICE/SENIOR CENTERS/AREA BUSINESSES. AS THE COMMUNITY DOES NOT HAVE TRADITIONAL DAILY MEDIA OUTLETS, COMMON PLACES WHERE PEOPLE GATHER ARE UTILIZED TO GET INFORMATION OUT. RMC PARTICIPATED IN A SCHOOL CAREER DAY TO PROMOTE THE OPPORTUNITIES OF PURSUING HEALTH CAREERS WHILE PROVIDING AREA YOUTH WITH HANDS-ON OPPORTUNITIES FOR TRYING TO READ X-RAYS AND IDENTIFY ANATOMY AND CAREER OPPORTUNITIES IN HEALTHCARE. A COMMUNITY HEALTH FAIR WAS HELD IN CONJUNCTION WITH THE ROOSEVELT COUNTY FAIR WITH SEVERAL STAFF IN ATTENDANCE. A SEPARATE EDUCATIONAL BOOTH WAS SET UP TO PROMOTE THE IMPORTANCE OF MENTAL HEALTH AND WELLNESS. A YOUTH HELMET SAFETY DAY TOOK PLACE DURING THE JUNE PARADE AND 50 HELMETS WERE GIVEN AWAY TO YOUTH AND PARENTS. IN AUGUST, A SPORTS INJURY AWARENESS BREAKFEST EVENT TOOK PLACE WITH AREA SCHOOL COACHES AND OUR PHYSICAL THERAPIST. STAFF PARTNERED WITH CULBERTSON SCHOOL FOR THE ANNUAL PACK THE GYM IN PINK BREAST CANCER AWARENESS NIGHT IN OCTOBER. FLU VACCINE COLORING BOOKS WERE DISSEMINATED TO AREA ELEMENTARY SCHOOLS (GRADES K-5) SHOWCASING THE CDC READY WRIGLEY COLORING BOOKS. END-OF-YEAR "HEALTHY SUMMER" BAGS WERE PROVIDED TO AREA STUDENTS. SENIOR GRADUATION HEALTH BAGS WERE PROVIDED TO ALL 12TH GRADE GRADUATES WITH INFORMATION ON HEALTHY LIFESTYLE CHOICES AS THEY MOVED INTO ADULTHOOD AND INDEPENDENT DECISION MAKING. A SPRING INTO SPRING COMMUNITY VENDOR SHOW TOOK PLACE AND RMC HOSTED A HEALTH AND WELLNESS BOOTH WITH INFORMATION AND GIVEAWAYS. A HAUNTED CARNIVAL WAS HOSTED BY STAFF TO PROVIDE AREA YOUTH A SAFE PLACE TO CELEBRATE HALLOWEEN. THERE, GAMES AND ACTIVITIES TOOK PLACE AND SAFETY/WELLNESS AWARENESS WAS PROMOTED. STAFF PARTICIPATED IN THE ANNUAL WINTER SHOWCASE WHERE WINTER AND RESPIRATORY ILLNESS HEALTH TIPS WERE PROMOTED THROUGH EDUCATION AND GIVEAWAYS. STAFF ALSO SHOWCASED PARADE FLOATS THROUGH SUMMER/WINTER CELEBRATIONS TO PROMOTE HEALTH AND WELLNESS. SEPARATELY, EMS HAS HOSTED CPR TRAINING FOR SCHOOL COACHES AND BUS DRIVERS. EMS PROVIDES STAND-BY AMBULANCES AT ALL HOME VARSITY FOOTBALL GAMES AND SUMMER EVENTS SUCH AS RODEOS AND STREET DANCES. EMS ALSO VISITS LOCAL DAYCARE FACILITIES FOR AWARENESS ABOUT WHEN TO CALL 9-1-1 AND PROVIDES AMBULANCE TOURS. TWICE ANNUALLY, THE LABORATORY PROVIDES WELLNESS LABS SCREENINGS TO THE COMMUNITY. STAFF SERVE AS ACTIVE MEMBERS OF THE CHAMBER OF COMMERCE, LOCAL EMERGENCY PLANNING COMMITTEE, COUNTY EPIDEMIOLOGY COMMITTEE, AND THE CITY'S AIRPORT BOARD. "WELCOME TO TOWN" KITS ARE PROVIDED BY RMC TO AREA TOWN HALLS TO PROMOTE HEALTH AND WELLNESS IN THE AREA TO NEW RESIDENTS. THE THIRD HEALTHCARE ISSUE IS TO IMPROVE ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES IN EASTERN ROOSEVELT COUNTY. THE FIRST STRATEGY FOR ADDRESSING THIS ISSUE IS TO INCREASE COMMUNITY AWARENESS OF NEW AND ENHANCED MENTAL AND BEHAVIORAL HEALTH SERVICES IN THE AREA BY PROVIDING OUTREACH TO THE COMMUNITY ON BEHAVIORAL HEALTH PARTNERSHIPS AND AVAILABILITY OF TELE-MENTAL HEALTH CAPABILITIES AT RMC AND PROMOTING MENTAL HEALTH SERVICES OFFERED THROUGH THE LICENSED SOCIAL WORKER CANDIDATE AT RMC. THE SECOND STRATEGY IS TO EXPLORE NEW TRAINING OPPORTUNITIES AND PARTNERSHIPS TO ENHANCE THE COMMUNITY'S ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES BY PROMOTING MORH/AHEC'S BEHAVIORAL HEALTH TRAININGS TO RMC STAFF AND AREA PHYSICIANS/PRACTITIONERS TO ENHANCE MENTAL AND BEHAVIORAL HEALTH SKILLS, KNOWLEDGE, AND TRAINING AND EXPLORING OPPORTUNITIES TO PARTNER WITH LOCAL SCHOOLS, EMS, POLICE, ETC. TO DELIVER HEALTHY LIFESTYLE/RESILIENCE EDUCATION AND PROGRAMMING/EVENTS SUCH AS ENGAGING WITH LOCAL YOUTH ON PEER-SUPPORT. OTHER ACTIVITIES FOR THE THIRD STRATEGY MAY INCLUDE PARTNERING AND PARTICIPATING IN THE FORT PECK CRISES COALITION COMMITTEE WITH AREA AGENCIES AND CONNECTING WITH THE LOCAL TOBACCO PREVENTION SPECIALIST TO DEVELOP AND ENHANCE PARTNERSHIP AND EDUCATIONAL OPPORTUNITIES/RESOURCES OFFERED TO THE EAST SIDE OF THE COUNTY. ROOSEVELT MEDICAL CENTER APPLIED FOR THE MONTANA SCHOOL-BASED BEHAVIORAL HEALTH GRANT AND RECEIVED IT. THE GRANT HAS ENABLED RMC TO PROVIDE A LICENSED PROFESSIONAL COUNSELOR ON THE SCHOOL CAMPUS TO DELIVER ON-SITE AND VIRTUAL COUNSELING TO STUDENTS ONE DAY A WEEK. THE PARTNERSHIP ENABLES OUR CLINIC AND THE SCHOOL TO BETTER COLLABORATE AND PROVIDE SEAMLESS CARE TO STUDENTS WHO MAY NOT HAVE THE OPPORTUNITY TO BE SEEN IN THE CLINIC SETTING. BY INTEGRATING THE CLINIC'S EXPERTISE WITH THE SCHOOL'S EDUCATIONAL ENVIRONMENT, WE HAVE CREATED A MORE INFORMED, SUPPORTIVE FRAMEWORK THAT PROMOTES EMOTIONAL RESILIENCE, MENTAL HEALTH AWARENESS, AND OVERALL WELLNESS. THIS HAS ENHANCED OUR GOAL OF ADDRESSING THE GROWING NEED FOR BEHAVIORAL HEALTH SUPPORT AMONG STUDENTS AND HELPED PROVIDE TEACHERS WITH THE PROFESSIONAL SUPPORT NEEDED FOR WORKING WITH STUDENTS EXHIBITING BEHAVIORAL ISSUES. RMC CONTINUES TO PROVIDE MENTAL HEALTH SERVICES THROUGH ITS OWN LICENSED STAFF SOCIAL WORKER. NUMEROUS SERVICE CAMPAIGNS HAVE OCCURED THROUGHOUT THE YEAR. SERVICES FOCUS ON INDIVIDUAL ADULTS, YOUTH, AND FAMILY COUNSELING. CURRENTLY, STAFF MEMBERS ARE PART OF THE ROOSEVELT COUNTY/FORT PECK TRIBES CRISES COALITION WHICH MEETS MONTHLY WITH STAKEHOLDERS TO PROMOTE/TACKLE THE ISSUES FACING THE REGION PERTAINING TO THE MENTAL HEALTH AND ADDICTION CRISES. TOGETHER, WE ARE DEVISING PLANS OF ACTION THAT CAN BENEFIT MORE PEOPLE AND GET THEM THE HELP THEY NEED TO LIVE A HEALTHY LIFE. PLANS ARE FOCUSED ON KEEPING PEOPLE OUT OF THE JAIL SYSTEM AND OUT OF PERPETUAL CYCLES OF ADDICTION AND RELAPSES, WHILE ALSO FOCUSING ON SUICIDE PREVENTION. THE GROUP IS WORKING TO CREATE MULTI-AGENCY, COHESIVE, HAND-OFF PLANS THAT TAKE A PERSON THROUGHOUT THE HELP PROCESS. RMC CONTINUES A FREE, TWICE-MONTHLY SNACKS AND CHATS PROGRAM FOR YOUTH IN JUNIOR HIGH AND HIGH SCHOOL. IT IS A PROGRAM THAT CREATES A 1 ROOSEVELT MEDICAL CLINIC 818 2ND AVE E CULBERTSON MT 59218 RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 7G THERE IS NO COST OF BAD DEBT TO REMOVE FROM THE COMMUNITY BENEFIT EXPENSE IN COLUMN C. PHYSICIAN/PRACTITIONER PROFESSIONAL SERVICES MAKE UP 246,973 OF COLUMN C, 160,168 OF COLUMN D, AND 86,804 OF COLUMN E. ROOSEVELT MEDICAL CENTER'S EFFORTS TO RECRUIT AND RETAIN PHYSICIANS/PRACTITIONERS ARE DEPENDENT ON OUR ABILITY TO COMPETE WITH ALL OTHER COMMUNITIES THAT ARE RECRUITING SIMILAR PHYSICIANS/PRACTITIONERS. BECAUSE OF OUR SMALL COMMUNITY SIZE AND REMOTE LOCATION FAR REMOVED FROM MEDICAL COMMUNITIES OF GREATER SCOPE, WE EMPLOY PHYSICIANS/PRACTITIONERS AND SUBSIDIZE THEIR PRACTICES TO OFFER APPROPRIATELY COMPETITIVE SALARIES AND PRACTICE ENVIRONMENTS, INCLUDING REASONABLE CALL SCHEDULES. WE BELIEVE OUR ABILITY TO OFFER CORE NECESSARY PRIMARY CARE AND EMERGENCY SERVICES IS DEPENDENT ON SUBSIDIZATION OF PHYSICIAN/PRACTITIONER PRACTICES DUE TO LOW VOLUMES IN THE ER RESULTING IN LOW REVENUES, BUT HIGH EXPENSES FROM HAVING TO STAFF A PHYSICIAN/PRACTITIONER 24 HOURS PER DAY. SCHEDULE H, PART I, LINE 7 USED ADJUSTED COST TO CHARGE RATIOS FOR PATIENT CARE FROM THE MEDICARE COST REPORT, ADJUSTED FOR BED TAX AND COMMUNITY BENEFIT. BAD DEBT EXPENSE AND FINANCIAL ASSISTANCE ARE ALREADY EXCLUDED FROM THE MEDICARE COST REPORT. SCHEDULE H, PART III, LINE 2 THE ORGANIZATION'S PATIENT CARE COST TO CHARGE RATIO, AFTER ELIMINATING BAD DEBT EXPENSE, FINANCIAL ASSISTANCE, BED TAX, AND COMMUNITY BENEFIT EXPENSE, IS APPLIED TO GROSS BAD DEBT CHARGES, NOT INCLUDING IMPLICIT PRICE CONCESSIONS, TO ARRIVE AT THE COST OF BAD DEBT. DISCOUNTS AND IMPLICIT PRICE CONCESSIONS REDUCE REVENUE AND ARE NOT RECORDED AS BAD DEBT. PAYMENTS RECEIVED ON PREVIOUSLY WRITTEN OFF ACCOUNTS ARE RECORDED AS RECOVERIES OF IMPLICIT PRICE CONCESSIONS OR BAD DEBT, WHICH REDUCE IMPLICIT PRICE CONCESSIONS OR BAD DEBT EXPENSE. PATIENT OBLIGATIONS WHICH QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT RECORDED AS IMPLICIT PRICE CONCESSIONS OR BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 4 THERE WERE NO BAD DEBT EXPENSES RECORDED AND THEREFORE NO RELATED FOOTNOTE AFTER ADOPTING THE NEW REVENUE RECOGNITION GUIDANCE IN FASB ASU 2014-09. MOST TRANSACTIONS WHICH PREVIOUSLY WOULD HAVE BEEN RECORDED AS BAD DEBT EXPENSE ARE CLASSIFIED AS IMPLICIT PRICE CONCESSIONS WHICH ARE RECORDED AS REDUCTIONS IN REVENUE VERSUS BAD DEBT EXPENSE. NOTE 10 TO THE CONSOLIDATED FINANCIAL STATEMENTS DISCUSSES IMPLICIT PRICE CONCESSIONS ON PAGES 17, 18, 19, AND 20. SCHEDULE H, PART III, LINE 8 THERE IS A MEDICARE SHORTFALL SINCE CRITICAL ACCESS HOSPITALS ARE REIMBURSED 101 PERCENT OF COST FROM MEDICARE FOR MOST SERVICES, LESS THE 2% SEQUESTRATION ADJUSTMENT, AND SOME SERVICES ARE PAID BASED ON FEE SCHEDULES WHICH ARE OFTEN LESS THAN COST. MEDICARE COSTS ON PART III, LINE 6 ARE DIRECTLY FROM THE MEDICARE COST REPORT. MEDICARE REVENUE ON PART III, LINE 5 IS DIRECTLY FROM THE MEDICARE COST REPORT AND THE MEDICARE PROVIDER SUMMARY REPORT. SCHEDULE H, PART III, LINE 9B IF APPROVED FOR FINANCIAL ASSISTANCE UNDER THE PROVISIONS OF THE FINANCIAL ASSISTANCE POLICY (FAP), THE PATIENT WILL RECEIVE NOTIFICATIONS THAT INCLUDE: A. THE DISCOUNT OF GROSS CHARGES TO THE AGB. THEN FINANCIAL ASSISTANCE DISCOUNTS WILL BE APPLIED TO THE AGB IN ACCORDANCE WITH THE DISCOUNT OF AGB CHARGES SCHEDULE DESCRIBED IN THE "DISCOUNT" SECTION OF THE FAP. B. PROVIDING THE PATIENT WITH A BILLING STATEMENT THAT INDICATES THE AMOUNT THE PATIENT OWES, IF THEY ARE NOT ELIGIBLE FOR FREE CARE. C. REFUNDING ANY EXCESS PAYMENTS MADE BY THE INDIVIDUAL BEYOND THE AGB ON ELIGIBLE ACCOUNTS IF NECESSARY. D. TAKING ALL REASONABLY AVAILABLE MEASURES TO REVERSE EXTRAORDINARY COLLECTION ACTIONS THAT OCCURRED. SCHEDULE H, PART VI, LINE 2 WE SEND OUT PATIENT SATISFACTION SURVEYS TO OUR PATIENTS. SCHEDULE H, PART VI, LINE 3 RMC WILL MAKE ALL REASONABLE EFFORTS TO NOTIFY A PATIENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THIS POLICY BY: 1. ATTEMPTING TO DETERMINE WHETHER A PATIENT HAS THIRD-PARTY COVERAGE FOR ANY PART OF THE EMERGENCY OR MEDICALLY NECESSARY HEALTH CARE SERVICE PROVIDED. IF A PATIENT DOES NOT HAVE OR QUALIFY FOR THIRD-PARTY FUNDING, THE BUSINESS OFFICE STAFF WILL EXPLAIN THE FINANCIAL ASSISTANCE POLICY, PROVIDE AN APPLICATION FOR FINANCIAL ASSISTANCE AND PROVIDE ASSISTANCE WITH COMPLETING THE APPLICATION, IF DESIRED. 2. OFFERING THE PATIENT A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE AVAILABLE UNDER THIS POLICY AT THE TIME OF ADMISSION OR BEFORE DISCHARGE FROM RMC. 3. PROVIDING THE INFORMATION DURING THE NOTIFICATION PERIOD ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE ON AT LEAST THREE (3) BILLING STATEMENTS AND IN ALL OTHER WRITTEN COMMUNICATIONS IN REFERENCE TO FINANCIAL RECORDS TO THE PATIENT; 4. INFORMING PATIENTS DURING THE NOTIFICATION PERIOD ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE DURING ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE CARE THAT OCCURRED; 5. PROVIDING THE PATIENT WITH AT LEAST ONE WRITTEN NOTICE INFORMING THE PATIENT ABOUT THE EXTRAORDINARY COLLECTION ACTIONS THAT RMC MAY TAKE IF THE PATIENT DOES NOT SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE OR PAY THE AMOUNT DUE BY AT LEAST THIRTY DAYS FOLLOWING THE DATE OF THE NOTICE. THE NOTICE WILL NOT BE MAILED OR DELIVERED TO A PATIENT EARLIER THAN 30 DAYS PRIOR TO THE END OF THE NOTIFICATION PERIOD; AND 6. RMC WILL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS AGAINST A PATIENT UNTIL SUCH TIME AS IT DETERMINES THE PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER THIS POLICY DURING THE 120 DAY NOTIFICATION PERIOD AND HAS PROVIDED THE PATIENT WITH THE NOTICE AS DESCRIBED ABOVE. SCHEDULE H, PART VI, LINE 4 WE PROVIDE SERVICE TO THE POPULATION IN EASTERN ROOSEVELT COUNTY, SOUTHERN SHERIDAN COUNTY, AND NORTHERN RICHLAND COUNTY. SCHEDULE H, PART VI, LINE 5 THE CEO AND MARKETING DIRECTOR OF ROOSEVELT MEDICAL CENTER PARTICIPATE IN THE LOCAL CHAMBER OF COMMERCE. THE MARKETING DIRECTOR WRITES ARTICLES FOR THE LOCAL NEWSPAPER TO PROMOTE THE FACILITY AND DOES PUBLIC SERVICE ANNOUNCEMENTS THROUGH PRINTED MEDIA AND SOCIAL MEDIA (FACEBOOK). X X X false false false false false false false false false DANIELLE CHRISTENSEN RN 188883 5688 10493 205064 ZOE FUGERE FNP 187651 6207 10710 204568 CARLOS TREVINO MD 178014 2762 5 180781 FORM 990, PAGE 1, PART I, LINE 6 THE VOLUNTEERS ARE BOARD MEMBERS, MINISTERS AND INDIVIDUALS/GROUPS COMING IN TO HOST THE SOCIAL HOURS AND ACTIVITIES. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS REVIEWED BY THE CEO, CFO, AND BOARD OF DIRECTORS BEFORE IT IS FILED. FORM 990, PAGE 6, PART VI, LINE 12C COMPLIANCE IS REVIEWED ANNUALLY. FORM 990, PAGE 6, PART VI, LINE 15A THE CEO'S COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS WHICH IS USUALLY BASED ON THE AMOUNT/PERCENTAGE OF RAISE THE REST OF THE EMPLOYEES ARE GOING TO RECEIVE. FORM 990, PAGE 6, PART VI, LINE 15B THE CFO COMPILES INFORMATION FROM THE ANNUAL MHA SALARY SURVEY REGARDING AVERAGE WAGE BEING PAID FOR EACH JOB DESCRIPTION BASED ON PEER GROUP, CRITICAL ACCESS HOSPITALS, OR MHA REGION. THE CFO AND CEO COMPARE AVERAGES BEING PAID TO THE CURRENT ROOSEVELT MEDICAL CENTER SALARY SCALE TO SEE IF ADJUSTMENTS NEED TO BE MADE TO KEEP EACH JOB COMPETITIVE WITHIN THE INDUSTRY. RECOMMENDATIONS FOR SALARY INCREASES ARE MADE TO THE BOARD OF DIRECTORS FOR APPROVAL OR DISAPPROVAL WHICH IS RECORDED IN THE BOARD MINUTES. FORM 990, PAGE 6, PART VI, LINE 19 DOCUMENTS RELATING TO ROOSEVELT MEDICAL CENTER ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G ADMIN PROF FEES 0 53,475 0 ADMIN PURCHASED SERVICES 0 19,056 0 CLINIC PROF FEES 55,906 0 0 DIETARY PURCHASED SERVICES 396,504 93,309 0 LAB PROF FEES 14,920 0 0 LAB PURCHASED SERVICES 100,955 0 0 MAINT PURCHASED SERVICES 30,124 7,177 101 MEDICAL & SURGICAL PROF FEES 238,516 0 0 MEDICAL & SURGICAL PURCH SVCS 6,691 0 0 MEDICAL RECORDS PURCH SVCS 0 330 0 AMBULANCE PURCHASED SERVICES 2,779 0 0 RADIOLOLGY PURCHASED SERVICES 138,688 0 0 SWING BED PROF FEES 772,295 0 0 RADIOLOGY PROF FEES 30,390 0 0 PHARMACY PURCHASED SVCS 72,755 0 0 BUSINESS OFFICE PURCH SVCS 0 72 0 CLINIC PURCHASED SERVICES 11,384 0 0 ER PURCHASED SERVICES 121 0 0 ADMIN COLLECTION FEE 0 3,182 0 INFO SYSTEMS-PURCHASED SVCS 24,595 6,593 344 TELEMEDICINE-PURCHASED SVCS 2,900 0 0 PURCHASING-PURCHASED SERVICES 2,627 373 0 TOTAL 1,902,150 183,567 445 FORM 990, PART XI, LINE 9 CHANGE IN VALUE OF INTEREST IN TRUST -3,712 ROOSEVELT MEMORIAL HEALTHCARE FOUND PO BOX 419 CULBERTSON MT 59218 810529284 SUPPORT OR MT 501C3 7 N/A false NE MT STAT AIR AMB COOP 81 AIRPORT ROAD GLASGOW MT 59230 204748673 AIR AMBUL MT 501C3 12B NA N/A false MONIDA SHARED IMAGING LLC 1200 S RESERVE ST STE H MISSOULA MT 59801 205410131 MOBILE MRI MT N/A RELATED 1100 81290 false false 0.03000 false true true false false false false false false false true false false true true false false false false ROOSEVELT MEMORIAL HEALTHCARE FOUND C 122543 SUPPORT ROOSEVELT MEMORIAL HEALTHCARE FOUND O 65865 PAYROLL ROOSEVELT MEMORIAL HEALTHCARE FOUND N 4230 OCCUPANCY MONIDA SHARED IMAGING LLC B 9000 CONTRIBUTED CAPITAL MONIDA SHARED IMAGING LLC K 43237 MOBILE MRI SERVICES