GLENDIVE MEDICAL CENTER INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- GLENDIVE MEDICAL CENTER INC (EIN 81-6016016)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-16
- IRS object ID
- 201131369349307043
- Schema version
- 2009v1.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-16T20:41:59-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHMS PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 741 3rd Ave S | AddressLine1 |
| City | Glasgow | City |
| State | MT | State |
| ZIP Code | 59230 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 816016016 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GLENDIVE MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GLEN | NameControl |
| Phone | 4063653306 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 202 PROSPECT DRIVE | AddressLine1 |
| City | GLENDIVE | City |
| State | MT | State |
| ZIP Code | 59330 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BARBARA MARKHAM | Name |
| Title | CFO | Title |
| Phone | 4063653306 | Phone |
| Date Signed | 2011-05-16 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Diana W Mattfeldt CPA | Name |
| Phone | 4062289391 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BARBARA MARKHAM | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 202 PROSPECT DRIVE | AddressLine1 |
| City | GLENDIVE | City |
| State | MT | State |
| ZIP Code | 59330 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 32699104 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.GMC.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1964 | YearFormation |
| State Legal Domicile | MT | StateLegalDomicile |
| Activity Or Mission Description | COMMITTED TO CARING, HEALING, AND A HEALTHIER COMMUNITY THROUGH THE PROCUREMENT OF HEALTH SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 576 | TotalNbrEmployees |
| Total Nbr Volunteers | 260 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 363944 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 161471 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 31479180 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 32287439 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 12312 | InvestmentIncomePriorYear |
| Investment Income Current Year | 219394 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 23650 | OtherRevenuePriorYear |
| Other Revenue Current Year | 30800 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 31879086 | TotalRevenuePriorYear |
| Total Revenue Current Year | 32699104 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 15790783 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 16311283 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 31806 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 15083093 | OtherExpensePriorYear |
| Other Expenses Current Year | 15142385 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 30873876 | TotalExpensesPriorYear |
| Total Expenses Current Year | 31453668 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1005210 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1245436 | RevenuesLessExpensesCY |
| Total Assets BOY | 60184627 | TotalAssetsBOY |
| Total Assets EOY | 59068667 | TotalAssetsEOY |
| Total Liabilities BOY | 37319080 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 34957684 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 22865547 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 24110983 | NetAssetsOrFundBalancesEOY |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 24173876 | Expense |
| Revenue | 32287439 | Revenue |
| Description | REVENUE AND EXPENSES RELATED TO PATIIENT CARE. | Description |
| Total Program Service Expense | 24173876 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 1 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | 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 | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 41 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 576 | 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 |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BARBARA MARKHAM CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4063453301 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 608 REGAL | AddressLine1 |
| City | GLENDIVE | City |
| State | MT | State |
| ZIP Code | 59330 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | OfficerOfficer | Key EmployeeKeyEmployee |
|---|---|---|---|---|---|---|---|---|
| DAVID LINN | ||||||||
| CHAIRPERSON | 2.00 | X | 0 | 0 | 0 | |||
| MAUREEN LUNDMAN | ||||||||
| VICE CHAIRPERSON | 1.00 | X | 0 | 0 | 0 | |||
| LAURA GLUECKERT | ||||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | |||
| TAMMY KANE | ||||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | |||
| ARTHUR K FINK | ||||||||
| CHIEF OF STAFF | 40.00 | X | 256816 | 0 | 65424 | X | ||
| BRUCE BAINBRIDGE | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| MELONIE BEELER | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| SANDRA CARGILL | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| STEVEN RAY | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| KYLE VOSS DVM | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| KEVIN MAXWELL | ||||||||
| PHYSICIAN | 40.00 | X | 569354 | 0 | 135160 | X | ||
| SCOTT DUKE | ||||||||
| CEO | 50.00 | 214292 | 0 | 126906 | X | X | ||
| BARBARA MARKHAM | ||||||||
| CFO | 50.00 | 109867 | 0 | 28070 | X | |||
| JUDY COURTNEY | ||||||||
| VP | 50.00 | 182425 | 0 | 31685 | X | |||
| DALE ADISHIAN | ||||||||
| PHYSICIAN | 40.00 | 621145 | 0 | 64356 | X | |||
| JOSEPH LEAL | ||||||||
| PHYSICIAN | 40.00 | 263406 | 0 | 25346 | X | |||
| SONJA SAMSOONDAR MD | ||||||||
| PHYSICIAN | 40.00 | 251499 | 0 | 31365 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2468804 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 508312 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| HIGH TECH CONSTRUCTION | |||||
| 1201 4 AVENUE NORTH | BILLINGS | MT | 59107 | CONSTRUCTION | 9330685 |
| SODEXO INC | |||||
| 10 EARHART DRIVE | WILLIAMSVILLE | NY | 14221 | DIETARY MANAGEMENT | 895645 |
| MT HEALTH NETWORK | |||||
| 11 SOUTH 7TH STREETSUITE 241 | MILES CITY | MT | 59301 | CONTRACT NURSING | 501496 |
| COMPHEALTH MEDICAL STAFFING | |||||
| 1550 W ROSEDALE ST | DALLAS | TX | 75397 | CRNA CONTRACT LABOR | 363358 |
| JGA ARCHITECTS | |||||
| 3395 GABEL ROAD | BILLINGS | MT | 59102 | ARCHITECTUAL | 229372 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Related Organizations | 112260 | RelatedOrganizations |
| Government Grants | 31076 | GovernmentGrants |
| All Other Contributions | 18135 | AllOtherContributions |
| Total Contributions | 161471 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICES | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 32287439 | TotalRevenueColumn |
| Related Or Exempt Function Income | 32287439 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 32287439 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 219394 | TotalRevenueColumn |
| Related Or Exempt Function Income | 219394 | RelatedOrExemptFunctionIncome |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 30800 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 30800 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 30800 | TotalRevenueColumn |
| Related Or Exempt Function Income | 30800 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 32699104 | TotalRevenueColumn |
| Related Or Exempt Function Income | 32537633 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 494074 | Total |
| Program Services | 187376 | ProgramServices |
| Management And General | 306698 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12580218 | Total |
| Program Services | 9987325 | ProgramServices |
| Management And General | 2592893 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 311231 | Total |
| Program Services | 241152 | ProgramServices |
| Management And General | 70079 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1793407 | Total |
| Program Services | 1399804 | ProgramServices |
| Management And General | 393603 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1132353 | Total |
| Program Services | 881922 | ProgramServices |
| Management And General | 250431 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 757391 | Total |
| Program Services | 393228 | ProgramServices |
| Management And General | 361137 | ManagementAndGeneral |
| Fundraising | 3026 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4855 | Total |
| Management And General | 4855 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2414692 | Total |
| Program Services | 1949875 | ProgramServices |
| Management And General | 461390 | ManagementAndGeneral |
| Fundraising | 3427 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59773 | Total |
| Program Services | 1103 | ProgramServices |
| Management And General | 58329 | ManagementAndGeneral |
| Fundraising | 341 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5323632 | Total |
| Program Services | 4832959 | ProgramServices |
| Management And General | 478753 | ManagementAndGeneral |
| Fundraising | 11920 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1379173 | Total |
| Program Services | 982205 | ProgramServices |
| Management And General | 384668 | ManagementAndGeneral |
| Fundraising | 12300 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 104378 | Total |
| Program Services | 53745 | ProgramServices |
| Management And General | 49841 | ManagementAndGeneral |
| Fundraising | 792 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 502313 | Total |
| Management And General | 502313 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2132649 | Total |
| Program Services | 1990218 | ProgramServices |
| Management And General | 142431 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 354823 | Total |
| Program Services | 327335 | ProgramServices |
| Management And General | 27488 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| BAD DEBTS | 1135538 | 1135538 | |
| TAXES & LICENSES | 501805 | 27539 | 474266 |
| CLINIC BUILDING RENT | 340471 | 340471 | |
| EMPLOYEE RECRUITMENT | 72042 | 72042 | |
| NURSES DORM EXPENSES | 58850 | 58850 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31453668 | Total |
| Program Services | 24173876 | ProgramServices |
| Management And General | 7247986 | ManagementAndGeneral |
| Fundraising | 31806 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1490265 | BOY |
| EOY | 840146 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2214234 | BOY |
| EOY | 5203055 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8233897 | BOY |
| EOY | 8350414 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1880304 | BOY |
| EOY | 2597538 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 285061 | BOY |
| EOY | 240230 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1354970 | BOY |
| EOY | 1517465 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 118899 | BOY |
| EOY | 174011 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 55776654 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 24052470 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23470451 | BOY |
| EOY | 31724184 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1754381 | BOY |
| EOY | 1886010 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14946514 | BOY |
| EOY | 2198045 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4435651 | BOY |
| EOY | 4337569 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60184627 | BOY |
| EOY | 59068667 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7044354 | BOY |
| EOY | 5268313 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30274726 | BOY |
| EOY | 29689371 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37319080 | BOY |
| EOY | 34957684 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22865547 | BOY |
| EOY | 24110983 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22865547 | BOY |
| EOY | 24110983 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60184627 | BOY |
| EOY | 59068667 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 0 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Political Expenditures | 3114 | PoliticalExpenditures |
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part I-A, Line 1: | Identifier |
| Return Reference | Organizations Direct and Indirect Political Campaign Activities: | ReturnReference |
| Explanation | PORTION OF MHA DUES USED FOR LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 139683 | OtherCostOrOtherBasis |
| Book Value | 139683 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 42214965 | OtherCostOrOtherBasis |
| Depreciation | 12733127 | Depreciation |
| Book Value | 29481838 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13422006 | OtherCostOrOtherBasis |
| Depreciation | 11319343 | Depreciation |
| Book Value | 2102663 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 31724184 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| ACCRUED INTEREST RECEIVABLE | 24714 |
| GABERT MEDICAL SERVICES INVESTMENT | 2150000 |
| HEALTH NET LLC. | 198367 |
| OFF-SITE RESIDENCE | 508427 |
| MEDICARE/MEDICAID RECEIVABLE | 491056 |
| BOND ISSUE COSTS | 965005 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 4337569 | TotalBookValueOtherAssets |
| Total Revenue | 32699104 | TotalRevenue |
| Total Expenses | 31453668 | TotalExpenses |
| Excess Or Deficit For Year | 1245436 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 1245436 | ExcessOrDeficitPerFS |
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 | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 347 | PersonsServed |
| Total Community Benefit Expense | 484746 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 484746 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01600 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 507 | PersonsServed |
| Total Community Benefit Expense | 3348360 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3859152 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -510792 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 854 | PersonsServed |
| Total Community Benefit Expense | 3833106 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3859152 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -26046 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01600 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 11068 | PersonsServed |
| Total Community Benefit Expense | 98833 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5883 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 92950 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00310 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 34 | PersonsServed |
| Total Community Benefit Expense | 43346 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 43346 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00140 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 3862 | PersonsServed |
| Total Community Benefit Expense | 7561689 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5935839 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1625850 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05360 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 262 | PersonsServed |
| Total Community Benefit Expense | 106793 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 106793 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00350 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 16 | NumberOfActivitiesOrPrograms |
| Persons Served | 15226 | PersonsServed |
| Total Community Benefit Expense | 7810661 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5941722 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1868939 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06160 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 16 | NumberOfActivitiesOrPrograms |
| Persons Served | 16080 | PersonsServed |
| Total Community Benefit Expense | 11643767 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9800874 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1842893 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07760 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 14 | PersonsServed |
| Total Community Building Expense | 2980 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2980 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 14 | PersonsServed |
| Total Community Building Expense | 2980 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2980 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $731,404 | BadDebtExpenseAmount |
| Amount Attributable To | 133349 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5285163 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5320207 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -35044 | MedicareSurplusOrShortfall |
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 |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
Form990 Schedule H Part V Form990ScheduleHPartV (6 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | OtherOther | Teaching HospitalTeachingHospital |
|---|---|---|---|---|---|---|---|---|---|
| GLENDIVE MEDICAL CENTER | |||||||||
| 202 PROSPECT DRIVE | GLENDIVE | MT | 59330 | X | X | X | X | ||
| GLENDIVE MEDICAL CENTER NURSING HOME | |||||||||
| 202 PROSPECT DRIVE | GLENDIVE | MT | 59330 | 71 BED SKILLED NURSING HOME | |||||
| GLENDIVE MEDICAL CENTER HOME HEALTH | |||||||||
| 202 PROSPECT DRIVE | GLENDIVE | MT | 59330 | HOME HEALTH FOR DAWSON, WIBAUX, MCCONE AND PRAIRIE | |||||
| GLENDIVE MEDICAL CENTER HOSPICE | |||||||||
| 202 PROSPECT DRIVE | GLENDIVE | MT | 59330 | HOSPICE FOR DAWSON AND WIBAUX COUNTIES | X | ||||
| EASTERN MONTANA VETERANS HOME | |||||||||
| 2000 MONTANA AVENUE | GLENDIVE | MT | 59330 | 80 BED VETERANS SKILLED NURSING HOME | |||||
| THE HERITAGE ON MERRILL AVENUE | |||||||||
| 1313 NORTH MERRILL AVENUE | GLENDIVE | MT | 59330 | 13 SUITE ASSISTED LIVING CENTER | |||||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Part I, Line 3c: Part 1, Line 3C - N/APart 1, Line 6A - N/A | IncomeBasedCriteria |
| Costing Method Used | Part I, Line 7: Cost to charge ratio was utilized for Charity Care. For subsidized health services actual direct costs and receipts of the departments along with the step down allocation of the annual cost report for 2010 to allocate the correct overhead to the subsidized services since these allocations directly affect the Medicare and Medicaid reimbursement of the cost reimbursed areas(shifting overhead costs to the PPS and non reimbursed areas of the organization) and must be considered when determining the various shortfalls. | CostingMethodUsed |
| Subsidized Health Services Expln | Part I, Line 7g: Subsidized health services line DOES NOT include any costs attributable to a physician clinic. | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | Part I, Line 7f: Bad debt expense was determined by taking the actual dollar balance of each account transferred to collection agencies and bankruptcies which were written off. These were offset by all bad debt recoveries( the total amount the person paid to the collection agencies against their bad debt accounts or paid directly to the medical center). The cost to charge ratio was then applied to the net amount. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: The following is part of Footnote A in GMC's audited financial statement - "Accounts Receivable are carried net of an estimate for uncollectibles and allowances. Accounts which are not considered collectible are written off against the allowance account. Allowances for uncollectible accounts are set based on historical loss rates applied to aged accounts receivable. Bad debts are classified as an operating expense.Line 2, Bad debt expense was determined by taking the actual dollar balance of each account transferred to collection agencies and bankruptcies which were written off. These were offset by all bad debt recoveries( the total amount the person paid to the collection agencies against their bad debt accounts or paid directly to the medical center). The cost to charge ratio was then applied to the net amount. Line 3 - The amount shown to be attributable to patients eligible for Charity Care was primarily applications that were submitted without the necessary information or paperwork to enable the completion of the application even with the collection department aggressively working with the parties through letters, telephone calls and meetings Therefore, as shown in Item 3 below, with the education and assistance provided, the amount reported is appropriate. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: Since this facility is a critical access hospital, and since it is required that only allowable Medicare costs from the Cost Report be reported in Part III, results in the CAH short fall calculated to being zero. The other allowable Medicare costs on this Cost Report, are Home Health, Hospice, and Skilled Nursing Facility. All of those had shortfalls. Therefore, the Medicare shortfall is included in the Subsidized Health Services in Part I, Line 7. Thus Part III line 7, based on the reporting requirements end being zero.As noted in the Schedule H instructions, the cost report does not reflect certain programs which GMC provides Durable Medical Equipment, Medicare Part C, Medicare Part D, and Provider Based Services Emergency Room Providers, Certified Nurse Anesthetists, and Radiologists. Since GMC is in a very rural area, to have 24 hour coverage by these providers for our service area is definitely a quality and safety issue, and therefore, a community benefit.Due to utilizing the allowable Medicare cost from the cost report, Part III does not reflect the fact that there is Medicare shortfall to this facility, due to a number of factors such as the following 1. Any non patient revenue received for reimbursable departments must be offset against expenses. But at the same time, it is not allowed to offset revenue again expenses of non-reimbursable departments. This results in substantial shifting of a substantial amount of administrative expenses to the non reimbursable areas due to allocation of the administrative costs being based on total expense without the offset of revenue on the non reimbursable departments.2. Allocating administrative expense based on the percent of total expense also shifts an excess of costs to areas such as GMCs retail pharmacy due to high cost of drugs again resulting in overstating administrative expenses in a non reimbursable department which in turn lowers reimbursement to Medicare reimbursable departments.3. Medicare Advantage (Part C) plans are creating additional cost and shortfall and are not currently reported in Part III. 4. Medicare Part D - With two nursing homes, being in a very rural area with no other area pharmacies providing Unit Dose dispensing which is required for the safety of our residents, GMC again is seeing a shortfall which is not being reported while providing the necessary services to our local residents and is definitely a benefit to the resident and their families.The following is the calculation of the true shortfall for 2010 from Medicare based on the cost to charge ratio of services provided used for bad debt expense and charity care. This results in all other private pay patients paying more to cover this Medicare shortfall since GMC does not receive any tax support or outside funding.Medicare Total Charges for all services - $14,530,824Cost to Charge ratio of 0.661 - Cost - $9,604,874Medicare Revenue - $8,736,360Shortfall - $868,514 | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: Bad Debt Policy -PROCEDURES: All accounts, including Medicare and Medicaid, will be processed in a consistent manner before transferring said accounts to a collection agency.1.Statements on self pay balances will be sent monthly.2.Uncompensated Care information will be provided to all patients.3.A final notice stating the account will be turned over to a collection agency within ten days will be sent after the designated number of statements, set in the billing parameters of the Information System, has been sent showing that no payments have been received.4.Accounts can be returned from the collection agency if it has been determined the account qualifies for uncompensated care.5.After twelve months, if no payments have been received by the collection agency, accounts may be returned to GMC. | DebtCollectionPolicy |
| Needs Assessment | Part VI, Line 2: Needs Assessment - 1. Over the past years, Glendive Medical Center has identified and prioritized community needs through a variety of community surveys in collaboration with various organizations including the City of Glendive and Dawson County. 2. Public meetings were held by Glendive Medicare Center at various times to receive Community input. 3. Strategic Planning sessions are held by GMC to plan and prioritize the needs of the Community on an annual basis. These sessions include the Board of Directors, Foundation Board of Directors, Physicians and other Medical Providers and the Administration of GMC. Over the past years, areas identified and services implemented from the community's surveys included the need for Hospice, Assisted Living and Behavior Health Services. 4. Another Community Survey is planned during calendar year 2011. Community leaders from the medical center, public health, schools, economic development committee, and city and county governments are currently meeting concerning this assessment. They will jointly plan and conduct a community based assessment. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: Patient Education of eligibility for assistance -Glendive Medical Center(GMC) provides information and education concerning assistance through various programs and the organizations charity care policy in a variety of ways. Some of those are:1. Through our social services department, patient financial services and other areas, assistance is offered and given to all patients and their families about available programs.2. GMC's website, www.gmc.org, provides charity care and other financial assistance policies and procedures including applications.3. Signage is posted in the various admission areas in the facilities providing information concerning charity care and other financial assistance available through GMC.4. A Guest Information Book for the patient and their familys use is in each patients room and other areas providing various information including financial assistance information that is available which includes charity care and the appropriate personnel to contact if they have not been contacted. Contact information for our social services department if the person needs assistance or has questions about the various government and other programs available in the area is also provided in the information book.5. GMC's monthly statement provides information of the person(s) to contact if financial assistance is needed. At the same time, with all collection letters, our credit and collection department mails financial assistance information which includes an application and the contact person at GMC who can assist them.6. GMC employees are aware of the financial assistance programs and are able to provide direction to patients or their families in their departments concerning charity care. Quarterly at the CEO forums, the employees are provided with the amount of charity care provided by the facility while expressing the importance of providing the free care for people that are in need. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: 4. Community Information -GMC's primary service area is Dawson County on the eastern edge of Montana. GMCs secondary service areas are surrounding counties, McCone, Richland, Fallon, Prairie and Wibaux. Projections by the National Planning Association Data Services, Inc. show that Dawson County will experience a decrease in population from the 2000 Census until after 2020 when a slow and steady growth pattern is projected. The population aged 65 and over in Dawson County decreased by 4.4% from the 2000 census to 2006 but is projected to increase approximately 10% by 2010 and an additional 20% by 2020. The population of Dawson County was estimated to be 8,520 in 2010. Approximately 12,000 persons are in the total area GMC serves. The projected increase in population and area health care services is related to the increase in the senior population and energy-related services in the area.Glendive is a medical, retail and agricultural trade center for the county and the surrounding communities within a 30-60 mile radius. Glendives economic base is closely tied to agriculture and the transportation industry, particularly rail services. GMC is the largest employer in Glendive. Other significant employers in the GMCs service area are state, county and city governments, Burlington Northern Santa Fe Railway, Glendive Public Schools, Dawson County Community College and Williston Basin Interstate Pipeline.Dawson County is designated as a Health Professional Shortage Area (HPSA) with shortages of primary medical care and mental health providers. Beginning July, 2010 GMC has a psychiatrist on staff, the only one east of Billings, MT, 200 miles to the West. The Behavior Care Unit opened in July, 2010 as part of the Critical Access Hospital to provide a needed service throughout Eastern Montana and Western North Dakota.The service area residents see GMC and their providers as someone they can come to receive treatment, without regard to whether they have insurance or are uninsured, knowing they will be treated and cared for in a respectful and caring manner,GMC also provides outreach in various ways to the very small critical access frontier facilities as small as one bed facilities in neighboring counties and to four counties in the service area for home care services in sparsely populated areas.There are no other providers in the GMCs primary service area. Sidney Health Center, a critical access hospital located 50 miles north of Glendive, and Holy Rosary Medical Center, a critical access hospital located 70 miles south of Glendive, are the closest facilities. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: Community Building Activities -The amount reported in Part II for Community Building Activities provided assistance by GMC leaders to develop and maintain an active Economic Development Committee formed to assist in projects to enhance the health, safety and well being of the community of Glendive. The initial activity of this committee during the past several years was obtaining funds and building low income housing for seniors in the community which has been completed. This was a community benefit providing safe housing for those seniors in an area of housing shortages.This committee is made up of community leaders and has the support of this community. It is currently working to bring new businesses that are needed in the area which will create additional employment opportunities for the areas population. Also, these new businesses will provide additional services to the area which will enhance the ability to recruit healthcare providers and professionals to this community. Due to Glendives setting in a remote rural area, this is always a challenge as shown by the Dawson Countys designation as a HSPA area which was discussed in Item 4. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: Other information -GMC Board of DirectorsThe governing body of the GMC is its Board of Directors (the Board), which consists of eleven members. The Board includes the Chief of the Medical Staff and one member of GMCs active medical staff. Other members are selected to promote a representative composition of the Board by gender, rural/urban, professional/non-professional and geography. Board members are selected from the GMCs service area by the Boards nominating committee and approved by the existing Board members. The members of the Board serve in a voluntary capacity and receive no compensation for their services.Members of the Board have various relationships with services or products, who may, from time to time, have dealings with the GMC, but these relationships are not considered to be material. The Chief of Staff and member of the medical staff are employed by the GMC as physicians and medical advisors. The Board has an established conflict of interest policy to detect and manage such relationships.GMC Medical StaffThe active medical staff of GMC is comprised of eleven (11) physicians and thirteen (13) allied health professionals. These providers are all employed by GMC and provide services at all of GMC facilities including the attached Clinic and two of the frontier critical access hospitals in McCone and Prairie County.. Ten (10) of the eleven (11) physicians who are members of the active medical staff are board certified. A Specialty Clinic at GMC is utilized by physicians from Billings, MT. and Bismarck ND to provide services that are not available by the GMC Medical Staff. The patients are able to stay at home in Glendive and have the services provided by the out of town physician locally without traveling great distances. GMC extends medical staff privileges to all qualified physicians in the area who at this time are all employees of GMC. GMC also extends those privileges to the qualified specialty physicians who provide services through the Specialty Clinic.GMC Surplus FundsAll funds in excess of expenses are utilized in the following ways: 1. Utilized for the facilities debt service payments on the 2008 $30,000,000 bond issue obtained to provide a much needed expansion and renovation of the Surgery Suite, an additional nursing home wing and expansion and renovation of the emergency department. 2. A substantial amount of funds are needed each year and utilized for the ongoing capital needs of the facility to insure the appropriate equipment is available to meet the needs of our community. All departments have a three to five year plan in place to forecast these needs.3. Continued assistance to providers and professional staff for education to maintain GMCs standards to provide the care needed to our community.4. To increase reserve funds to insure the ability to continue meeting the above obligations in future years when surplus funds are not available. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: Affiliated Health Care System N/A | AffiliatedHealthCareSystem |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ARTHUR K FINK | |||||||||||||
| 256816 | 0 | 0 | 0 | 0 | 0 | 35878 | 0 | 29546 | 0 | 322240 | 0 | 315312 | 0 |
| KEVIN MAXWELL | |||||||||||||
| 569354 | 0 | 0 | 0 | 0 | 0 | 89347 | 0 | 45813 | 0 | 704514 | 0 | 247319 | 0 |
| SCOTT DUKE | |||||||||||||
| 214292 | 0 | 0 | 0 | 0 | 0 | 99950 | 0 | 26956 | 0 | 341198 | 0 | 278938 | 0 |
| JUDY COURTNEY | |||||||||||||
| 182425 | 0 | 0 | 0 | 0 | 0 | 6917 | 0 | 24768 | 0 | 214110 | 0 | 0 | 0 |
| DALE ADISHIAN | |||||||||||||
| 621145 | 0 | 0 | 0 | 0 | 0 | 12360 | 0 | 51996 | 0 | 685501 | 0 | 696937 | 0 |
| JOSEPH LEAL | |||||||||||||
| 263406 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 25346 | 0 | 288752 | 0 | 270986 | 0 |
| SONJA SAMSOONDAR MD | |||||||||||||
| 251499 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 31365 | 0 | 282864 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer |
|---|---|---|---|---|---|---|
| MONTANA FINANCE AUTHORITY | ||||||
| 810302402 | 06121PFE5 | 1999-08-29 | 1590000 | CONSTRUCTION - SEE SCHEDULE O | 0 | 0 |
| MONTANA FINANCE AUTHORITY | ||||||
| 364615155 | 612043GD5 | 2008-07-01 | 29716927 | CONSTRUCTION - SEE SCHEDULE O | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount UnspentAmountUnspent | Working Capital ExpendituresWorkingCapitalExpenditures |
|---|---|---|---|---|---|---|---|---|---|---|
| 1614370 | 157258 | 31800 | 1425312 | 1997 | 0 | 0 | 1 | 1 | ||
| 30587166 | 2098389 | 594338 | 20085103 | 2011 | 0 | 0 | 0 | 1 | 3134539 | 1783498 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Loan Table LoanTable (2 entries)
| Purpose Of LoanPurposeOfLoan | Loan From OrganizationLoanFromOrganization | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|
| GABERT MEDICAL SERVICES | |||||
| TO FUND OPERATIONS | X | 2419744 | 0 | 1 | 1 |
| PHYSICIAN LOAN RECEIVABLE | |||||
| HOUSING | X | 177794 | 0 | 1 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 2597538 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section B, line 11 | A COPY OF THE 990 WAS MADE AVAILABLE TO THE CFO AND DISTRIBUTED TO THE BOARD FOR REVIEW. |
| Form 990, Part VI, Section B, line 12c | AT EACH BOARD MEETING CONFLICTS OF INTEREST ARE DISCUSSED IF THERE ARE ANY. |
| Form 990, Part VI, Section B, line 15 | A MARKET SALARY SURVEY IS PERFORMED AND COMPARED TO OFFICERS AND KEY EMPLOYEES SALARY AND APPROVED BY THE BOARD. |
| Form 990, Part VI, Section C, line 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE KEPT AT THE HOSPITAL AND ARE AVAILABLE UPON REQUEST. |
| THE BEGINING BALANCES RELATING TO INVESTMENTS ON LINES 11 & 12 HAVE BEEN ADJUSTED TO REFLECT A SWITCH FROM VALUING SECURITIES AT COST TO VALUING THEM AT MARKET. THE PRIOR YEAR AMOUNT WAS LISTED AT COST. BEGINING NET ASSETS WERE ALSO ADJUSTED TO REFLECT THIS CHANGE. THE TOTAL AMOUNT OF THE ADJUSTMENT IS $224,980 WHICH WAS REFLECTED IN THE ENTITIE'S 2008 TAX FILING ON SCHEDULE D PART XI LINE 9. | |
| PART 1 LINE A REMODEL AND EXPAND CLINIC FACILITIES, CENTRALIZED MEDICAL RECORDS DEPARTMENT, HOME HEALTH CARE OFFICES, AND CENTERALIZED CONFERENCE ROOMS FOR THE MEDICAL CENTER. A PORTION OF THE PROCEEDS WAS USED FOR A NEW INFORMATION SYSTEM WITH CLINICAL AND FINANCIAL APPLICATIONS. | |
| PART 1 LINE B CONSTRUCTING, EQUIPPING AND FURNISHING A THREE SUITE SURGERY CENTER IN THE MEDICAL CENTER, RENOVATION AND EXPANDING THE EMERGENCY DEPARTMENT INCLUDING AN AMBULANCE CANOPY, BUILDING A NEW NURSING HOME WING DUE TO THE NEED TO DEMOLISH EXISTING NURSING HOME WING DUE TO THE SURGERY CENTER CONSTRUCTION, REPLACEMENT OF STEAM BOILERS WITH A NEW BOILER PLANT, AND RENOVATION AND EXPANDING THE PARKING AREA WERE THE PRIMARY USE OF THE PROCEEDS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GLENDIVE MEDICAL CENTER FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 202 PROSPECT | AddressLine1 |
| City | GLENDIVE | City |
| State | MT | State |
| ZIP Code | 59330 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810440518 | EIN |
| Primary Activities | RAISING FUNDS FOR GLENDIVE MEDICAL CENTER AND COMMUNITY MEDICAL NEEDS | PrimaryActivities |
| Legal Domicile State | MT | LegalDomicileState |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GABERT MEDICAL CLINIC INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 107 DILWORTH | AddressLine1 |
| City | GLENDIVE | City |
| State | MT | State |
| ZIP Code | 59330 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810477745 | EIN |
| Primary Activity | PROVIDES COMPREHENSIVE MEDICAL CARE AND RELATED HEALTH SERVICES. | PrimaryActivity |
| Legal Domicile State | MT | LegalDomicileState |
| Type Of Entity | C | TypeOfEntity |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GLENDIVE MEDICAL CENTER FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 112260 | AmountInvolved |
Form990 Schedule R Part VI Form990ScheduleRPartVI
Name Of Business NameOfBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH NET LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 SOUTH 7THSUITE 241 | AddressLine1 |
| City | MILES CITY | City |
| State | MT | State |
| ZIP Code | 59301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810506005 | EIN |
| Primary Activity | DATA PROCESSING | PrimaryActivity |
| Legal Domicile State | MT | LegalDomicileState |
| All Partners C3 S | 1 | AllPartnersC3S |
| Share Of EOY Assets | 198367 | ShareOfEOYAssets |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 1 | GeneralOrManagingPartner |