STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

BIG HORN HOSPITAL ASSOCIATION: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
BIG HORN HOSPITAL ASSOCIATION (EIN 81-0384618)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-16
IRS object ID
201141369349301849
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-16T10:13:29-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN810384618EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BIG HORN HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBIGHNameControl
Phone4066652310Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line117 NORTH MILES AVENUEAddressLine1
CityHARDINCity
StateMTState
ZIP Code59034ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRoxie CainName
TitlecONTROLLERTitle
Phone4066652310Phone
Date Signed2011-05-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone6123764500Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTerry BullisNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line117 NORTH MILES AVENUEAddressLine1
CityHARDINCity
StateMTState
ZIP Code59034ZIPCode
FieldValueIRS element (for citing)
Gross Receipts11347790GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteBIGHORNHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1980YearFormation
State Legal DomicileMTStateLegalDomicile
Activity Or Mission DescriptionBig Horn Hospital Association, along with its affiliated staff, will work together to provide caring, economical, quality medical and health services in Big Horn County and surrounding areas.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees217TotalNbrEmployees
Total Nbr Volunteers12TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year198580ContributionsGrantsPriorYear
Contributions Grants Current Year299394ContributionsGrantsCurrentYear
Program Service Revenue Prior Year9656841ProgramServiceRevenuePriorYear
Program Service Revenue CY10850331ProgramServiceRevenueCY
Investment Income Prior Year8429InvestmentIncomePriorYear
Investment Income Current Year11229InvestmentIncomeCurrentYear
Other Revenue Prior Year-5561OtherRevenuePriorYear
Other Revenue Current Year17439OtherRevenueCurrentYear
Total Revenue Prior Year9858289TotalRevenuePriorYear
Total Revenue Current Year11178393TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year5631550SalariesEtcPriorYear
Salaries Etc Current Year6335983SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4155638OtherExpensePriorYear
Other Expenses Current Year4488399OtherExpensesCurrentYear
Total Expenses Prior Year9788188TotalExpensesPriorYear
Total Expenses Current Year10824382TotalExpensesCurrentYear
Revenues Less Expenses Prior Year70101RevenuesLessExpensesPriorYear
Revenues Less Expenses CY354011RevenuesLessExpensesCY
Total Assets BOY8798202TotalAssetsBOY
Total Assets EOY9305775TotalAssetsEOY
Total Liabilities BOY2167856TotalLiabilitiesBOY
Total Liabilities EOY2288607TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY6630346NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7017168NetAssetsOrFundBalancesEOY
Mission DescriptionBig Horn Hospital Association, along with its affiliated staff, will work together to provide caring, economical, quality medical and health services in Big Horn County and surrounding areas.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense9661621Expense
Revenue10850331Revenue
DescriptionBIG HORN HOSPITAL ASSOCIATION IS COMPRISED OF BIG HORN HOSPITAL AND HERITAGE ACRES. BIG HORN HOSPITAL IS A 25-BED ACUTE CARE HOSPITAL. HERITAGE ACRES IS A 36-BED NURSING CARE FACILITY AND A 10-UNIT ASSISTED LIVING AND 10-UNIT INDEPENDENT LIVING. DURING THE YEAR ENDED JUNE 30, 2010, BIG HORN HOSPITAL PROVIDED 724 DAYS OF PATIENT SERVICES AND 4,012 DAYS OF RESIDENT SERVICES; HERITAGE ACRES PROVIDED 12,158 DAYS OF RESIDENT SERVICES. BIG HORN HOSPITAL ASSOCIATION PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDED CARE TO THESE PATIENTS WAS $84,489 FOR THE YEAR ENDED JUNE 30, 2010.Description
Total Program Service Expense9661621TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109627NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees217NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMTStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ROXIE CAIN CONTROLLERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4066652310TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line117 N MILES AVENUEAddressLine1
CityHARDINCity
StateMTState
ZIP Code59034ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
TERRY BULLIS
chairman0.40XX000
C william fisher
vice chairman0.40XX000
james seykora
secretary0.40XX000
sue murphy
treasurer0.40XX000
gary ostahowski md
member0.40X000
chad fenner
member0.40X000
rocky eggart
member0.40X000
gary robertson
CEO40.00X125983011761
Roxie Cain
Controller40.00X70014013706
CARLA TRAFT
DON40.008317202906X
WILLIAM HODGES
FOUNDATION/OUTREACH DIRECTOR40.0072024012731X
PAULA SMALL-PLENTY
HA ADMINISTRATOR40.0074098014031X
Kristi Gatrell
Radiology Director40.008902107133X
Mike Cary
Lab Director40.0082258014031X
FieldValueIRS element (for citing)
Total Reportable Comp From Org195997TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation25467TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name Persondiane fischer - crna pcNamePerson

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14395 highway 87 nAddressLine1
CitybillingsCity
StateMTState
ZIP Code59105ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesCRNADescriptionOfServices
Compensation147320Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Related Organizations157034RelatedOrganizations
Government Grants94548GovernmentGrants
All Other Contributions47812AllOtherContributions
Total Contributions299394TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
Patient Revenue6211101078472310784723
Cafeteria90009932893$32,893
Other Misc Rev90009932715$32,715
FieldValueIRS element (for citing)
Total Program Service Revenue10850331TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column12679TotalRevenueColumn
Exclusion$12,679ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real170259Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real152820Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real17439Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column17439TotalRevenueColumn
Exclusion$17,439ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other15127Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other16577Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-1450Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-1450TotalRevenueColumn
Exclusion-$1,450ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column11178393TotalRevenueColumn
Related Or Exempt Function Income10784723RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$94,276ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total235324Total
Program Services32394ProgramServices
Management And General202930ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5050481Total
Program Services4695730ProgramServices
Management And General354751ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total82228Total
Program Services72646ProgramServices
Management And General9582ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total604678Total
Program Services536005ProgramServices
Management And General68673ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total363272Total
Program Services343474ProgramServices
Management And General19798ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1163Total
Management And General1163ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total50509Total
Management And General50509ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1063535Total
Program Services1045338ProgramServices
Management And General18197ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total14641Total
Program Services130ProgramServices
Management And General14511ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total725303Total
Program Services666211ProgramServices
Management And General59092ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total24106Total
Program Services7215ProgramServices
Management And General16891ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total189527Total
Program Services189527ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total65712Total
Program Services46036ProgramServices
Management And General19676ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total11412Total
Management And General11412ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total477430Total
Program Services452469ProgramServices
Management And General24961ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total150977Total
Management And General150977ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debt671408671408
Equipment Rental and Ma30514425667948465
Food231653231653
Bed Taxes144801144801
Minor Equipment13764611971717929

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total223432Total
Program Services150188ProgramServices
Management And General73244ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total10824382Total
Program Services9661621ProgramServices
Management And General1162761ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1277270BOY
EOY1270594EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY604341BOY
EOY961333EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1373516BOY
EOY1402498EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY57236BOY
EOY78559EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY137322BOY
EOY173522EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY113855BOY
EOY99957EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis14502816LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec9289033LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5212090BOY
EOY5213783EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY22572BOY
EOY105529EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8798202BOY
EOY9305775EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1118567BOY
EOY1253226EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY152000BOY
EOY136000EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY805000BOY
EOY730000EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
EOY28894EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY92289BOY
EOY140487EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2167856BOY
EOY2288607EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY6451268BOY
EOY6840034EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY179078BOY
EOY177134EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6630346BOY
EOY7017168EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8798202BOY
EOY9305775EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$322OtherActivitiesAmount
Total Lobbying Expenditures IIB322TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1i:Identifier
Return ReferenceExplanation of Other Lobbying Activities:ReturnReference
ExplanationPortion of dues paid to Montana Hospital Association and the American hospital association that is used for lobbying purposes.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis242904OtherCostOrOtherBasis
Book Value242904BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11454491OtherCostOrOtherBasis
Depreciation7240803Depreciation
Book Value4213688BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis185747OtherCostOrOtherBasis
Depreciation78506Depreciation
Book Value107241BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2498153OtherCostOrOtherBasis
Depreciation1969724Depreciation
Book Value528429BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis121521OtherCostOrOtherBasis
Book Value121521BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5213783TotalOfBookValueLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart IV, Line 2b:Identifier
ExplanationThe hospital acts as a custodian for the funds of the nursing home residents. Those funds appear as restricted cash and account payable in the balance sheet.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense117154TotalCommunityBenefitExpense
Net Community Benefit Expense117154NetCommunityBenefitExpense
Percent Of Total Expense0.01150PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense1971592TotalCommunityBenefitExpense
Direct Offsetting Revenue1575517DirectOffsettingRevenue
Net Community Benefit Expense396075NetCommunityBenefitExpense
Percent Of Total Expense0.03900PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense2088746TotalCommunityBenefitExpense
Direct Offsetting Revenue1575517DirectOffsettingRevenue
Net Community Benefit Expense513229NetCommunityBenefitExpense
Percent Of Total Expense0.05050PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2088746TotalCommunityBenefitExpense
Direct Offsetting Revenue1575517DirectOffsettingRevenue
Net Community Benefit Expense513229NetCommunityBenefitExpense
Percent Of Total Expense0.05050PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$512,550BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare2345171AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare2819665CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-474494MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalCritical Access HospitalCriticalAccessHospitalEr24 HoursEr24HoursOtherOther
Big Horn Hospital Association
17 N MilesHardinMT59034XXX
Heritage Acres
200 North MitchellHardinMT59034Extended Care Facility (SNF, Assisted Living, and Independent Living)

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaPart I, Line 3c: The "test" for community care is in the form of income, which is verified with the tax returns. If a person meets the 100% of Federal Poverty Guidelines their entire bill is written off except for a $10 co-pay. The organization then provides a sliding fee scale for discounted care up to 200% of the federal poverty guildlines. The Organization provides customers with an application upon request, if the customer is strictly private pay or if we have knowledge of a financial hardship. The Organization keeps a log of community care applications given to customers as well as for community care awarded and denied.IncomeBasedCriteria
Subsidized Health Services ExplnPart I, Line 7g: Physician's fees billed from BHHA are written off if a customer is eligible for community care.SubsidizedHealthServicesExpln
Bad Debt FootnotePart III, Line 4: Part III, Line 4: The following is from the "Patient and Resident Accounts Receivable" paragraph in Note 1 to the Hospital's Financial Statements:"The Hospital reports patient and resident accounts receivable for services rendered at net realizable amounts from third-party payors, patients, residents and others. The Hospital provides and allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient and resident, the Hospital bills third-party payors directly and bills the patients and resident when the patient and resident's liability is determined. Patient and resident accounts receivable are ordinarily due in full when billed. Delinquent receivables are written off based on individual credit evaluation and specific circumstances of the patient and resident or third-party payor."The amount of bad debt expense (at cost) reports in part III, line 2 is calculated as follows: payment arrangement include prospectively determined rates per discharge, reimbursed costs, discounted charges and per diem payments. Net patient service revenue is reported at the estimated net realizable amounts from patients, third-part payors, and others for services rendered, including estimated retroactive adjustments under reimbursement agreements with third-party payors.BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: Shortfall will be $332,961 of deductable and coinsurance and $141,523 settlement. From Part III, line 6 the total allowable cost reports to medicare was based on the 2010 filed medicare cost report.ShortfallAsCommunityBenefit
Number Of Facility Type ExplnPart V: 1 hospital and 1 skilled nursing facility.NumberOfFacilityTypeExpln
Needs AssessmentPart VI, Line 2: The Hospital has done a mail survey to help assess the needs of the community. BHHA also uses communication with the physician practice as to what would be useful and needed by their paitient population.NeedsAssessment
Patient Education AssistancePart VI, Line 3: The facility keeps forms on hand that are available (on in plain site) for different gov't programs such as Health MT Kids. The patient accounts representative will inform any private pay patient of our community care and will also relay this information to customers when discussing payment options for outstanding bills.PatientEducationAssistance
Community InformationPart VI, Line 4: BHHA servers a high poverty level. They are on the edge of the Crow Indian Reservation and have a lot of customers who utilize Indian Health Services as a payor source for health care. Their population has a large population of Medicare and Medicaid customers. As they serve a small town in Montana, the population consists of a lot of children as well as elderly, both of which utilize our healthcare system.CommunityInformation
Community Building ActivitiesPart VI, Line 5: BHHA uses the local papers as an outlet for giving the public information on different type of health concerns, such as diabetes, weight loss etc. Their public health educatior is developing a health council to help educate and share ideas with other health providers in the community as to the type of services needed in the area and how to get those services to the population.CommunityBuildingActivities
Other InformationPart VI, Line 6: BHHA does have a community board to help not on "run" the facility with policies and procedures, but to give input to the management team about the needs they see for the community in which they live. BHHA is developing more educational programs for items such as women's health, diabetes managment and smoking cesastion.OtherInformation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 1THE EXECUTIVE COMMITTEE SHALL HAVE ALL OF THE POWERS OF THE BOARD OF DIRECTORS WHEN THE BOARD IS NOT IN SESSION AND SHALL GENERALLY PERFORM SUCH DUTIES AND EXERCISE SUCH POWERS AS MAY BE PERFORMED AND EXERCISED BY THE BOARD OF DIRECTORS FROM TIME TO TIME.
Form 990, Part VI, Section B, line 11990 is reviewed by the Controller and CEO, a copy is not presented to the Board before filing.
Form 990, Part VI, Section B, line 12cRegular compliance meetings duscuss any actual conflicts or potential conflicts. There is also a hotline number to call for compliance or HIPAA issues that is operated by MHA, not BHHA. Board members sign yearly conflict of interest statements and if a conflict occurs on a specific item, they abstain from the vote on that item.
Form 990, Part VI, Section B, line 15aAll positions - MHA salary survey is completed and reviewed every year to allow fair pay for all positions. THE BOARD ALSO REVIEWS AND APPROVES THE CEO'S COMPENSATION AND WAS LAST DONE IN 2010.
Form 990, Part VI, Section C, line 19Governing documents, Conflict of Interest Policy and Financial Statements are made availabe to the public upon request to the business office.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
Big Horn County Memorial Hospital and Healthcare Foundation
17 N Miles AvenueHardinMT59034810504410Hospital FundraisingMT501(c)(3)11 Type 1N/A
Big Horn County Memorial Hospital Auxiliary
HC 36 Box 2065HardinMT59034810428249Funds to benefit Big Horn County Memorial HospitalMT501(c)(3)11 Type 2N/A
Heritage Acres Auxiliary Limited
PO Box 474HardinMT59034810444017Funds to benefit Heritage Acres Nursing HomeMT501(c)(3)11 Type 2N/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Big Horn Hospital and Health Care FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeCTransactionType
Amount Involved157034AmountInvolved