2026-05-14T18:14:59-05:00 2025-06-30 410746749 CLIFTONLARSONALLEN LLP 121 WEST BRIDGE STREET OWATONNA MN 55060 990 2024-07-01 816016920 DANIELS MEMORIAL HOSPITAL DANI 4064872296 PO BOX 400 SCOBEY MT 59263 KODY BRINTON CEO 4064872296 2026-05-13 1 0 JUSTIN HARTERT P02236744 5074467100 2026-05-13 2024 2025-03-06 01:10:19Z DANIELS MEMORIAL HEALTHCARE CENTER KODY BRINTON PO BOX 400 SCOBEY MT 59263 12492341 0 X WWW.DANIELSMEMORIALHEALTHCARE.ORG X 1956 MT SEE SCHEDULE O WE ARE DEDICATED TO ENRICHING THE HEALTH OF THOSE WE SERVE AND TO STRENGTHENING OUR COMMUNITY FOR THE FUTURE. 11 11 98 12 0 0 210945 984286 10892615 10665253 32199 262166 874652 580636 12010411 12492341 5042 5755 0 0 5911156 6392264 42000 42000 42000 5227984 4841679 11186182 11281698 824229 1210643 9386252 10308104 1524620 1235826 7861632 9072278 WE ARE DEDICATED TO ENRICHING THE HEALTH OF THOSE WE SERVE AND TO STRENGTHENING OUR COMMUNITY FOR THE FUTURE. 0 0 7594464 5755 10665253 DANIELS MEMORIAL HOSPITAL PROVIDES HEALTH PROFESSIONAL SERVICES SUCH AS ACUTE CARE, SKILLED SWING BED, EMERGENCY, INPATIENT, AND OUTPATIENTS CARE. 7594464 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 3 0 1 98 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X KODY BRINTON 4064872296 PO BOX 400 SCOBEY MT 59263 X TANNER TROWER CHAIR 1.00 0.00 X X 0 0 0 JANITZIA NELSON VICE CHAIR 1.00 0.00 X X 0 0 0 KYMBER CARNEY TREASURER 1.00 0.00 X X 0 0 0 ARLENE KEGLEY SECRETARY 1.00 0.00 X X 0 0 0 JEDDA BARRON SECRETARY (THRU 11/2024) 1.00 0.00 X X 0 0 0 JACK PITTENGER TRUSTEE 1.00 0.00 X 0 0 0 MIKE BJARKO TRUSTEE 1.00 0.00 X 0 0 0 CLIFF HAMES TRUSTEE 1.00 0.00 X 0 0 0 WYATT WILDER TRUSTEE 1.00 0.00 X 0 0 0 CHASE THOMPSON TRUSTEE 1.00 0.00 X 0 0 0 MARIA LAMB TRUSTEE 1.00 0.00 X 0 0 0 KODY BRINTON CHIEF EXECUTIVE OFFICER 40.00 1.00 X 0 0 0 MIKE ROSSI PHYSICIAN ASSISTANT 40.00 0.00 X 241600 0 44396 REBECCA STACEY PHYSICIAN ASSISTANT 40.00 0.00 X 241267 0 21322 SIERA HENTGES PHYSICIAN ASSISTANT 40.00 0.00 X 155578 0 20576 DEANNA FERESTAD NURSE PRACTIONER 40.00 0.00 X 207332 0 47019 JESSICA WINGE-PETERSON DIRECTOR OF NURSING SERVIC 40.00 0.00 X 144923 0 20926 990700 0 154239 14 0 1 1 BILLINGS CLINIC PO BOX 30357 BILLINGS MT 59107 MANAGEMENT 778380 PRN STAFFING 173 AUSTRIAN ROAD VIDA MT 59274 CONTRACT STAFFING 573748 FUSION MEDICAL STAFFING PO BOX 30131 OMAHA NE 68103 CONTRACT STAFFING 363877 TRUSTED HEALTH CARE STAFFING 1402 HALERSON DRIVE MURFREESBORO TN 37128 CONTRACT STAFFING 111568 ERDMAN 918 DEMING WAY MADISON WI 53717 CONTRACT STAFFING 100615 5 65711 918575 984286 PATIENT SERVICE REVENUE 623000 10262851 10262851 340B REVENUE 456110 402402 402402 10665253 262166 262166 MISCELLANEOUS REVENUE 900099 278189 278189 HOSPITAL TAX REVENUE 623000 251125 251125 INVESTMENT FROM INSURANCE CAPTIVE 900001 51322 51322 580636 12492341 10665253 0 842802 X 5755 5755 5062442 3336999 1725443 104797 64553 40244 854678 531066 323612 370347 251021 119326 31141 31141 35792 35792 42000 42000 2614323 1700391 913932 26207 26207 215516 164873 50643 217557 154197 63360 43198 7943 35255 11440 2178 9262 6920 5390 1530 368845 338206 30639 65140 820 64320 MEDICAL SUPPLIES 568805 539003 29802 REPAIRS AND MAINTENANCE 231665 217809 13856 BAD DEBT EXPENSE 154491 154491 FOOD SUPPLY 103046 103046 147593 16723 130870 11281698 7594464 3645234 42000 2793870 4563165 502589 351869 1314476 1276888 110283 113756 236212 277786 94545 85790 8809603 5731568 2796907 3078035 269234 0 0 9000 1268136 551815 9386252 10308104 829489 884433 138239 101953 556892 249440 1524620 1235826 X 7861632 9072278 7861632 9072278 9386252 10308104 1210643 3 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1766 1766 0 PART II-B, LINE 1: DANIELS MEMORIAL HOSPITAL PAYS MEMBERSHIP DUES TO THE MONTANA HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION, A PORTION OF WHICH IS USED BY THOSE ASSOCIATIONS TO LOBBY ON BEHALF OF THEIR MEMBERS. 271597 271597 5128223 3854773 1273450 2904076 1876795 1027281 505707 505707 3078035 COST REPORT SETTLEMENT RECEIVABLE 185200 RIGHT-OF-USE LEASE ASSETS 233667 SUBSCRIBERS EQUITY IN INSURANCE CAPTIVE 127238 RESIDENT CASH 5710 551815 COST REPORT SETTLEMENT PAYABLE 9000 RIGHT-OF-USE LEASE LIABILITIES 126684 GUARANTEE OF PATIENT LOANS 113756 249440 X 12337853 3 3 12337850 154491 154491 12492341 11127207 0 11127207 154491 154491 11281698 PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FORM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. FEDERAL AND STATE INCOME TAXES ARE PAID ON NONEXEMPT UNRELATED BUSINESS INCOME IN ACCORDANCE WITH THE CODE. CURRENT ACCOUNTING GUIDELINES REQURIE AN ORGANIZATION TO DETERMINE WHETHER IT IS MORE-LIKELY-THAN-NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE HOSPITAL RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. FEDERAL RETURNS FOR TAX YEARS 2020 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 154,491. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 154,491. X X X X X 1 BANNACK GROUP LLC PO BOX 1823 BOZEMAN MT 59715 CAPITAL CAMPAIGN 0 166208 42000 0 166208 42000 MT SCHEDULE G, PART I, LINE 2B, COLUMN (V) THE HOSPITAL AND ITS SUPPORTING ORGANIZATION, DANIELS MEMORIAL HOSPITAL FOUNDATION, ARE CONDUCTING A CAPITAL CAMPAIGN IN WHICH THE FOUNDATION WILL COLLECT ALL CONTRIBUTIONS. THE HOSPITAL AND THE FOUNDATION ARE SPLITTING THE PROFESSIONAL FEES. THE HOSPITAL'S PORTION THE SHARE FEE WAS $42,000 FOR FY2025. 1 1 X 1 X 1 X 1 1 1 0 0 123505 123505 0.01110 1955341 1589863 365478 0.03280 2078846 1589863 488983 0.04390 62088 35035 27053 0.00240 117238 107252 9986 0.00090 179326 142287 37039 0.00330 2258172 1732150 526022 0.04720 1 154491 0 4402220 5085378 -683158 X 1 1 1 1 DANIELS MEMORIAL HOSPITAL PO BOX 400 SCOBEY MT 59263 WWW.DANIELSMEMORIALHEALTHCARE.COM 12791 X X X X RURAL HEALTH CLINIC DANIELS MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 24 1 0 1 1 X SEE PART V, LINE 7D X X 1 24 1 SEE PART V, LINE 7D 0 1 X 200.000000000000 400.000000000000 0 1 X X 1 X SEE PART V, LINE 16J X SEE PART V, LINE 16J X SEE PART V, LINE 16J X X X X X X X 1 X 0 X X X X 1 X 0 1 DANIELS MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: ONE FOCUS GROUP MEETING WAS CONDUCTED BY THE MONTANA OFFICE FOR RURAL HEALTH STAFF TO DISCUSS VARIOUS HEALTH ISSUES FACING DANIELS COUNTY. THE DISCUSSIONS CENTERED AROUND THE GENERAL HEALTH OF THE COMMUNITY INCLUDING WHAT THEY FELT THE MOST IMPORTANT HEALTHCARE ISSUES THE COMMUNITY IS FACING. ALS TALKED ABOUT THE RESOURCES THAT ARE CURRENTLY AVAILABLE AND WHAT MAY NEED TO BE ADDED. IN ADDITION TO THE FOCUS GROUP WAS THE STEERING COMMITTEE AS WELL AS THE SURVEY. THE SURVEY WAS PROVIDED TO 507 RESIDENTS IN THE SERVICE AREA WITH 108 COMPLETED SURVEYS BEING COMPLETED AND RETURNED. DANIELS MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN COOPERATION WITH THE MONTANA OFFICE OF RURAL HEALTH. DANIELS MEMORIAL HOSPITAL PART V, SECTION B, LINE 7D: DANIELS MEMORIAL HOSPITAL CHNA AND IMPLEMENTATION CAN BE FOUND AT THE FOLLOWING WEBSITES: WWW.DANIELSMEMORIALHEALTHCARE.ORG DANIELS MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: DANIELS MEMORIAL HEALTHCARE CENTER (DMHC) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND ADOPTED A 20252028 IMPLEMENTATION STRATEGY TO ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS WITHIN DANIELS COUNTY. BASED ON ASSESSMENT FINDINGS, DMHC PRIORITIZED EFFORTS FOCUSED ON IMPROVING EDUCATION AND AWARENESS OF AVAILABLE HEALTHCARE SERVICES, INCREASING ACCESS TO HEALTHCARE SERVICES, AND ENHANCING MENTAL AND BEHAVIORAL HEALTH RESOURCES.TO IMPROVE EDUCATION AND AWARENESS OF HEALTHCARE SERVICES, DMHC IMPLEMENTED A COORDINATED OUTREACH AND MARKETING APPROACH DESIGNED TO INCREASE COMMUNITY UNDERSTANDING OF LOCALLY AVAILABLE CARE. THESE EFFORTS INCLUDE HIGHLIGHTING THE CAPABILITIES OF DMHC PROVIDERS, PARTICULARLY ADVANCED PRACTICE PROVIDERS, THROUGH RADIO OUTREACH, NEWSPAPER, AND SOCIAL MEDIA COMMUNICATIONS. PROVIDERS ALSO ENGAGE DIRECTLY WITH COMMUNITY ORGANIZATIONS, SCHOOLS, SENIOR CENTERS, AND CIVIC GROUPS TO PROMOTE AWARENESS OF SERVICES AND SUPPORT HEALTH EDUCATION. DMHC FURTHER EXPANDED EDUCATIONAL PROGRAMMING RELATED TO HEALTH AND WELLNESS, WOMEN'S HEALTH, AND MEN'S HEALTH AND PLANS TO INCORPORATE A COMMUNITY FORUM TO SOLICIT FEEDBACK AND ENSURE COMMUNITY INPUT CONTINUES TO INFORM SERVICE DEVELOPMENT.TO INCREASE ACCESS TO HEALTHCARE SERVICES IN DANIELS COUNTY, DMHC CONTINUES TO SUPPORT LOCAL TRANSPORTATION EFFORTS THAT ASSIST RESIDENTS IN ACCESSING MEDICAL APPOINTMENTS BOTH LOCALLY AND REGIONALLY. ACTIVITIES INCLUDE EVALUATING TRANSPORTATION STAFFING STRUCTURES AND SCHEDULES TO IMPROVE CONSISTENCY AND AVAILABILITY AND COLLABORATING WITH THE MONTANA DEPARTMENT OF TRANSPORTATION AND COUNTY PARTNERS TO ADDRESS SERVICE CAPACITY BARRIERS. IN ADDITION, DMHC EVALUATES SPECIALTY REFERRAL PATTERNS TO IDENTIFY COMMUNITY NEEDS AND PURSUES RELATIONSHIPS WITH SPECIALTY PROVIDERS TO EXPAND ACCESS THROUGH VISITING SERVICES AND TELEMEDICINE. THESE EFFORTS FOCUS ON REDUCING TRAVEL BURDENS AND ADDRESSING HIGHDEMAND SPECIALTY SERVICES IDENTIFIED IN THE CHNA.TO ADDRESS MENTAL AND BEHAVIORAL HEALTH NEEDS, DMHC FOCUSES ON INCREASING AWARENESS AND UTILIZATION OF EXISTING SERVICES WHILE STRENGTHENING COMMUNITY PARTNERSHIPS. DMHC PROMOTES ITS MENTAL AND BEHAVIORAL HEALTH RESOURCES, INCLUDING TELEHEALTH SERVICES, TO IMPROVE ACCESS AND REDUCE BARRIERS TO CARE. THE ORGANIZATION ALSO EXPLORES THE FEASIBILITY OF RESTARTING OR RESTRUCTURING A LOCAL ADVISORY COMMITTEE TO SUPPORT COORDINATED, COMMUNITYBASED MENTAL HEALTH EFFORTS AND ENHANCE COLLABORATION AMONG LOCAL AND REGIONAL PARTNERS.CERTAIN NEEDS IDENTIFIED THROUGH THE CHNA, INCLUDING BROADER PRESCRIPTION AFFORDABILITY CHALLENGES AND FOOD INSECURITY, ARE NOT FULLY WITHIN DMHC'S DIRECT CAPACITY TO RESOLVE. HOWEVER, DMHC COLLABORATES WITH COMMUNITY PARTNERS TO SUPPORT MITIGATION EFFORTS, INCLUDING PARTICIPATION IN THE 340B PROGRAM TO IMPROVE MEDICATION AFFORDABILITY FOR ELIGIBLE PATIENTS AND PROVIDING MONETARY AND FOOD DONATIONS AND REFERRALS TO LOCAL FOOD SECURITY RESOURCES.THROUGH THESE STRATEGIES, DMHC REMAINS COMMITTED TO ADDRESSING PRIORITY COMMUNITY HEALTH NEEDS IN A MANNER CONSISTENT WITH AVAILABLE RESOURCES, COMMUNITY PARTNERSHIPS, AND ORGANIZATIONAL MISSION. DANIELS MEMORIAL HOSPITAL PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND FINANCIAL ASSISTANCE APPLICATION ARE AVAILABLE ONLINE AT WWW.DANIELSMEMORIALHEALTHCARE.ORG/FINANCIAL-ASSISTANCE/. DANIELS MEMORIAL HOSPITAL PART V, SECTION B, LINE 24: PATIENT CARE WHICH IS NOT MEDICALLY NECESSARY INCLUDING ELECTIVE, COSMETIC, EXPERIMENTAL OR DEEMED TO BE GENERALLY NOT REIMBURSABLE BY TRADITIONAL INSURANCE CARRIERS AND GOVERNMENTAL PAYERS SHALL NOT BE CONSIDERED ELIGIBLE FOR CHARITY CARE. PART I, LINE 3C: TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, AN INDIVIDUAL MUST RECEIVE MEDICALLY NECESSARY HEALTH CARE SERVICES AT DANIELS MEMORIAL HOSPITAL, COMPLETE A FINANCIAL ASSISTANCE APPLICATION INCLUDING ALL REQUIRED SUPPORTING DOCUMENTATION, AND HAVE INCOME BELOW 400% OF THE FEDERAL POVERTY LEVEL BASED ON THEIR FAMILY SIZE.THERE ARE INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR CHARITY CARE DISCOUNTS, BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE DUE TO LACK OF SUPPORTING DOCUMENTATION. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED BASED ON INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE STATE-FUNDED PRESCRIPTION PROGRAMS, HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC, PARTICIPATION IN THE WOMEN INFANTS AND CHILDREN (WIC) PROGRAM, FOOD STAMP ELIGIBILITY, SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY, LOW-INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS, PATIENT IS DECEASED WITH NO KNOWN ESTATE, AND ENERGY ASSISTANCE PROGRAM ELIGIBILITY.THE ADMINISTRATOR CAN REVIEW ACCOUNTS ON A CASE-BY-CASE BASIS AND LOOK FOR INDICATION THAT THE FULL PAYMENT MAY CAUSE SOCIAL AND FINANCIAL HARDSHIP SO AS TO SIGNIFICANTLY HARM THE PATIENT OR THE FAMILY UNIT. PART I, LINE 7: A COST-TO-CHARGE RATIO WAS CALCULATED USING WORKSHEET 2. ALL AMOUNTS ON LINE 7 WERE CALCULATED USING THE WORKSHEETS PROVIDED IN THE SCHEDULE H INSTRUCTIONS. PART I, LINE 7G: IMMUNIZATIONS ARE THE ONLY SUBSIDIZED HEALTH SERVICE BEING REPORTED IN PART 1, LINE 7G. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 154,491. PART III, LINE 2: THE AMOUNT OF BAD DEBT EXPENSE IS THE BAD DEBT EXPENSE LESS BAD DEBT RECOVERY FROM THE INCOME STATEMENT. PART III, LINE 3: THE ORGANIZATION DOES NOT HAVE A METHODOLOGY TO CALCULATE WITH REASONABLE ACCURACY THE PORTION OF OUR BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT FAILED TO COMPLETE AN APPLICATION. PART III, LINE 4: SEE THE "PATIENT ACCOUNTS RECEIVABLES AND EXPECTED CREDIT LOSSES" PARAGRAPHS ON PAGE 7 OF THE HOSPITAL'S ATTACHED AUDITED FINANCIAL STATEMENTS FOR AN EXPLANATION OF THE ORGANIZATION'S BAD DEBT EXPENSE. PART III, LINE 8: THE COST TO CHARGE RATION IS USED TO DETERMINE COMMUNITY BENEFIT. THIS IS DONE BY APPLYING THE RATIO TO THE TOTAL MEDICARE REVENUE. A SHORTFALL OR OVERAGE IN ANY GIVEN YEAR IS A RESULT OF THE TIMING OF PAYMENTS FROM MEDICARE ON AN INTERIM BASIS AND WHEN FINAL SETTLEMENT IS MADE. MANAGEMENT USES ESTIMATES TO CALCULATE SUCH SETTLEMENTS BUT ACTUAL RESULTS VARY FROM THOSE ESTIMATES. ADDITIONALLY, SHORTFALLS CAN RESULT FROM VARIOUS EXPENSES THAT ARE INCURRED BY THE FACILITY WHICH ARE CONSIDERED NON-REIMBURSABLE BY MEDICARE.SINCE PART OF THE COSTS ARE NOT REIMBURSED IT IS ONLY PRUDENT TO CONSIDER THIS SHORTFALL TO BE A BENEFIT TO THE COMMUNITY. ALSO MEDICARE RECIPIENTS ARE PART OF THE CHARITABLE CLASS AND SO THE PROVISION OF THE MEDICAL CARE FURTHERS THIS CHARITABLE CLASS. PART III, LINE 9B: NOTIFICATION ABOUT THE DMHC CHARITY AVAILABILITY FORM, WHICH SHALL INCLUDE A CONTACT NUMBER, SHALL BE DISSEMINATED BY DMHC BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, THE PUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS. INFORMATION SHALL ALSO BE INCLUDED ON THE FACILITY WEBSITES AND IN THE CONDITIONS OF ADMISSION FORM. SUCH INFORMATION SHALL BE PROVIDED IN THE PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED DMHC. REFERRAL OF PATIENTS FOR CHARITY MAY BE MADE BY ANY MEMBER OF THE DMHC STAFF OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL WORKERS, SOCIAL WORKERS, ETC. A REQUEST FOR CHARITY MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE FOR THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. PART VI, LINE 2: PRIMARILY DMHC WORKS CLOSELY WITH THE PUBLIC HEALTH DEPARTMENT AND LOCAL EMS, FIRE AND LAW ENFORCEMENT TO WORK TOGETHER TO ADDRESS ISSUES WITHIN THE COMMUNITY. PART VI, LINE 3: WE INFORM THE PUBLIC ABOUT PROGRAMS, I.E. MEDICARE/MEDICAID THROUGH ADVERTISEMENT IN PRINT AND RADIO, PAMPHLETS IN THE WAITING ROOM, AND SOCIAL SERVICE VISITS WITH PATIENTS. PART VI, LINE 4: DANIELS MEMORIAL HEALTHCARE CENTER IS A FRONTIER CRITICAL ACCESS HOSPITAL SERVING DANIELS COUNTY (POPULATION APPROXIMATELY 1,690) AND SURROUNDING RURAL FRONTIER COMMUNITIES IN NORTHEASTERN MONTANA. THE SERVICE AREA IS HIGHLY RURAL WITH LOW POPULATION DENSITY AND LIMITED ACCESS TO ALTERNATIVE HEALTHCARE RESOURCES. THE HOSPITAL IS LOCATED APPROXIMATELY FIVE HOURS FROM THE NEAREST TERTIARY HOSPITAL AND THREE HOURS FROM THE NEAREST SECONDARY HOSPITAL, MAKING IT THE PRIMARY SOURCE OF CARE FOR THE REGION.THE COMMUNITY SERVED INCLUDES OLDER ADULTS, AGRICULTURAL FAMILIES, AND RESIDENTS WITH ECONOMIC AND GEOGRAPHIC BARRIERS TO CARE. DANIELS MEMORIAL SERVES PATIENTS WHO ARE MEDICARE AND MEDICAID BENEFICIARIES, UNINSURED, OR UNDERINSURED, AND OPERATES IN A MEDICALLY UNDERSERVED FRONTIER AREA WHERE ACCESS TO HEALTHCARE WOULD BE SIGNIFICANTLY LIMITED WITHOUT THE HOSPITAL'S PRESENCE. PART VI, LINE 5: WE ARE GOVERNED BY A COMMUNITY BOARD REPRESENTING THE FULL SERVICES AREA. WE ALSO PARTICIPATE IN EASTERN MONTANA TELEMEDICINE AND ARE ABLE TO OFFER VISITS WITH MULTIPLE SPECIALTY PROVIDERS. 1 PART I, LINE 2: WE MAINTAIN RECORDS TO SUBSTANTIATE ALL GRANTS OR ASSISTANCE RECEIVED. FOR EACH GRANT OR ASSISTANCE AWARD, WE RETAIN THE OFFICIAL AWARD LETTER AND FOLLOW THE REQUIREMENTS OUTLINED IN THAT LETTER. DOCUMENTATION IS MAINTAINED TO SUPPORT HOW THE FUNDS WERE USED, INCLUDING INVOICES, PRODUCT RECORDS, AND ANY OTHER MATERIALS SPECIFIED IN THE AWARD LETTER. ALL RECORDS ARE RETAINED IN ACCORDANCE WITH THE TERMS AND CONDITIONS OF THE GRANT OR ASSISTANCE. 0 0 0 0 0 0 0 0 0 MIKE ROSSI PHYSICIAN ASSISTANT 239100 0 2500 0 0 0 7248 0 37148 0 285996 0 0 0 REBECCA STACEY PHYSICIAN ASSISTANT 238192 0 3075 0 0 0 3619 0 17703 0 262589 0 0 0 DEANNA FERESTAD NURSE PRACTIONER 203757 0 3575 0 0 0 6220 0 40799 0 254351 0 0 0 SIERA HENTGES PHYSICIAN ASSISTANT 152003 0 3575 0 0 0 2334 0 18242 0 176154 0 0 0 JESSICA WINGE-PETERSON DIRECTOR OF NURSING SERVIC 144848 0 75 0 0 0 4348 0 16578 0 165849 0 0 0 FORM 990, PART VII, SECTION A, LINE 5 DANIELS MEMORIAL HOSPITAL CONTRACTS WITH BILLING CLINIC TO PROVIDE SERVICES DIRECTLY TO THE HOSPITAL AND MANAGEMENT. INCLUDED IN THE FEES PAID TO BILLINGS CLINIC IS THE COMPENSATION FOR KODY BRINTON, SEE BELOW FOR DETAILS. BASE SALARY - $163,870 EMPLOYER CONTRIBUTION TO MEDICAL AND DENTAL -$29,313 EMPLOYER CONTRIBUTION TO LIFE INSURANCE AND LONG-TERM DISABILITY - $512 FORM 990, PART VI, SECTION A, LINE 3 DANIELS MEMORIAL HOSPITAL HAS A MANAGEMENT AGREEMENT WITH BILLINGS CLINIC. THEY PROVIDE MANAGEMENT, IT, AND ACCOUNTING SERVICES. INCLUDED IN THE FEES PAID TO BILLINGS CLINIC IS THE COMPENSATION FOR HOSPITAL'S CURRENT CEO, KODY BRINTON. DURING 2024, THE CEO RECEIVED THE FOLLOWING AS COMPENSATION FOR SERVICES PROVIDED TO THE HOSPITAL: BASE SALARY - $163,870 EMPLOYER CONTRIBUTION TO MEDICAL AND DENTAL -$29,313 EMPLOYER CONTRIBUTION TO LIFE INSURANCE AND LONG-TERM DISABILITY - $512 FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE CORPORATION SHALL BE 18 YEARS OF AGE WITH A MAILING ADDRESS IN DANIELS COUNTY, SHERIDAN COUNTY, ROOSEVELT COUNTY, OR VALLEY COUNTY, MONTANA WHO IS REGISTERED AS A MEMBER BY COMPLETING AND SUBMITTING A MEMBER REGISTRATION FORM PRIOR TO THE ORGANIZATION'S ANNUAL MEETING. THIS IS THE ONLY CLASS OF MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A THE CHAIR OF THE HOSPITAL DISTRICT AUTHORITY FOR DANIELS COUNTY, MONTANA IS A VOTING MEMBER OF THE BOARD. ALL OTHER BOARD MEMBERS ARE APPOINTED BY MAJORITY VOTE OF THE MEMBERSHIP AT THE MEMBERS' ANNUAL MEETING FORM 990, PART VI, SECTION B, LINE 11B AFTER APPROVAL BY THE CEO, THE FORM 990 WAS PROVIDED TO THE BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS, EMPLOYEES, VOLUNTEERS, CONTRACTED WORKFORCE AND MEDICAL STAFF. CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND SIGNED BY ALL TRUSTEES AND BY THE LEADERSHIP TEAM UPON JOINING THE ORGANIZATION AND ANNUALLY THEREAFTER. ANY CONFLICTS OF INTEREST ARE REVIEWED AND MONITORED BY THE ADMINISTRATIVE COUNCIL AND/OR COMPLIANCE COMMITTEE. IF IT APPEARS AN INDIVIDUAL HAS VIOLATED THE CONFLICT OF INTEREST POLICY, A MEMBER OF THE COMPLIANCE COMMITTEE, HUMAN RESOURCES, OR LEGAL DEPARTMENT WILL INVESTIGATE AND TAKE APPROPRIATE ACTION UP TO AND INCLUDING TERMINATION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF TRUSTEES REVIEWS AND MAKES DECISIONS ON THE COMPENSATION PACKAGE FOR THE CEO. THE CEO COMPENSATION IS PART OF THE MANAGEMENT CONTRACT PAID TO THE OUTSIDE MANAGEMENT COMPANY. ALL MANAGERS REPORT TO THE CEO AND THE CEO REVIEWS AND MAKES DECISIONS ON THE MANAGER'S COMPENSATION. BOARD OFFICERS ARE NOT COMPENSATED. THE CEO REVIEWS MHA WAGE SURVEY INFORMATION AS WELL AS INTERNAL EQUITY TO DETERMINE COMPENSATION OF KEY EMPLOYEES. THESE PROCESSES LAST OCCURRED IN 2025. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 1,700,391. MANAGEMENT AND GENERAL EXPENSES 913,932. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,614,323. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. DANIELS MEMORIAL HOSPITAL FOUNDATION 105 5TH AVENUE SCOBEY MT 59263 363461891 COMMUNITY HEALTHCARE SUPPORT MT 501(C)(3) LINE 12D, III-O N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0