2011-05-16T10:12:31-05:00 2010-06-30 GALUSHA HIGGINS AND GALUSHA PC P O BOX 1530 HAVRE MT 59501 990 2009-07-01 816016920 Daniels Memorial Hospital Association DANI 4064875331 P O Box 400 Scobey MT 59263 Dave Hubbard 4064875331 2011-05-12 1 Thomas M Rygg CPA 4062653201 2009 2016-02-24 21:20:13Z Dave Hubbard P O Box 400 Scobey MT 59263 6346696 0 X n/a X 1956 MT TO PROMOTE THE GENERAL HEALTH CARE OF THE COMMUNITY THROUGH PROVIDING HIGH QUALITY HEALTH CARE AND A HOME FOR THE AGED AND INFIRM. 10 10 0 16 0 0 412976 493847 5189250 5840842 6000 10627 1405 1380 5609631 6346696 0 0 3225584 3449825 0 0 2198890 2347532 5424474 5797357 185157 549339 2992925 3381138 1586583 1425457 1406342 1955681 To provide a health care system with clinic, acute inpatient, emergency, outpatient, and long-term care services 0 0 3336565 5356027 PROFESSIONAL CARE - PRIMARY, ACUTE AND LONG TERM CARE. 752341 484815 CLINIC SERVICES FOR OUTPATIENT CLIENTS. 443821 0 HOUSEKEEPING, LAUNDRY, LINEN & PLANT SERVICES - PROVIDE FOR THE HOUSEKEEPING AND BUILDING MAINTENANCE OF THE FACILTIY. 396555 0 DIETARY SERVICES FOR ACUTE AND LONG TERM CARE PATIENTS. MEDICAL RECORDS 396555 4929282 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3 119 0 1 0 0 0 0 0 0 0 10 10 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 1 0 0 X DANIELS MEMORIAL HOSPITAL ASSOCIATI 4064872296 105 5TH AVENUE EAST Scobey MT 59263 Tom Hagan 3.00 X 0 0 0 Bev Lindsay 2.00 X 0 0 0 Perry Wolfe 2.00 X 0 0 0 Judy States 1.50 X 0 0 0 Carter Jensen 2.00 X 0 0 0 Scott Susag 1.50 X 0 0 0 Derrick Mottern 2.00 X 0 0 0 Richard Hood 1.50 X 0 0 0 Lee Humbert 2.00 X 0 0 0 Ana Brenden 1.50 X 0 0 0 Dr Donald Sawdey 40.00 X X 288936 0 0 Larry Masterson 40.00 X 114352 0 0 403288 0 0 2 1 1 0 Billings Clinic 2800 10th Ave North Billings MT 59107 Management Services 343632 1 493847 493847 Patient Service Revenu 623000 5669543 5669543 Other operating revenu 623000 171299 171299 5840842 10627 10627 1380 1380 1380 1380 6346696 5840842 0 12007 288936 288936 2532696 2403716 128980 35768 34074 1694 389872 361461 28411 202553 180331 22222 148256 148256 39235 39235 29853 11630 18223 27059 13310 13749 8597 3441 5156 62541 62541 37519 35116 2403 46297 28739 17558 39384 39384 143160 143160 115123 1084 114039 Contractual Services 613436 595259 18177 Supplies 552821 530213 22608 Bad Debt 126068 126068 Taxes and Licenses 113952 108419 5533 Repairs and Maintenance 102334 91850 10484 141897 98543 43354 5797357 4929282 868075 0 276254 249329 743404 889993 776927 820307 167000 155429 164999 36390 40253 4282070 3232813 1004521 1049257 2992925 3381138 745608 774562 840975 650895 1586583 1425457 X 1405399 1955681 943 0 1406342 1955681 2992925 3381138 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 13500 13500 3345756 2637869 707887 874315 594944 279371 48499 48499 1049257 6346696 5797357 549339 0 549339 6346696 0 6346696 0 6346696 5797357 0 5797357 0 5797357 1 1 1 X 1 X 1 1 1 0 0 128428 128428 0.02260 1270613 1225514 45099 0.00800 1399041 1225514 173527 0.03060 46296 27658 18638 0.00330 126155 87458 38697 0.00680 172451 115116 57335 0.01010 1571492 1340630 230862 0.04070 0 126068 56731 1552030 1548296 3734 X 1 1 Daniels Memorial Hospital Association

PO Box 400 Scobey MT 59263

X X X X Long-Term care facility; Rural health clinic; Home care & hospice 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 6: 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. 0 0 0 0 0 0 0 0 0 Dr Donald Sawdey 288936 0 0 0 0 0 0 0 0 0 288936 0 0 0 Larry Masterson 114352 0 0 0 0 0 0 0 0 0 114352 0 0 0 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 process by which the audit is reviewed has not changed from the prior year.