2024-03-08T12:16:26-05:00 2023-04-30 GREEN HEALTH GROUP PC 405 FOURTH AVENUE NORTH GLASGOW MT 59230 990 2022-05-01 810373589 CULBERTSON FROID BAINVILLE HEALTHCARE CORPORATION CULB 4067876401 PO BOX 419 CULBERTSON MT 59218 AUDREY STROMBERG ADMINISTRATOR 4067876401 2024-03-06 true AUDREY STROMBERG XXX-XX-XXXX true DANIEL GREEN P01311679 4062632615 2024-03-08 2022 2023-04-26 12:10:37Z ROOSEVELT MEDICAL CENTER AUDREY STROMBERG PO BOX 419 CULBERTSON MT 59218 8677534 false X ROOSEVELTMEDICAL.ORG X 1976 MT ROOSEVELT MEDICAL CENTER IS DEDICATED TO PROVIDING PATIENTS WITH APPROPRIATE, PERSONALIZED, AND QUALITY HEALTH CARE. 7 7 98 48 0 1138195 633350 7748633 7755836 -18823 -11814 253409 300162 9121414 8677534 0 0 4279793 4016987 0 46259 4119382 4222366 8399175 8239353 722239 438181 8917616 10132530 2394358 1705768 6523258 8426762 ROOSEVELT MEDICAL CENTER IS DEDICATED TO PROVIDING PATIENTS WITH APPROPRIATE, PERSONALIZED, AND QUALITY HEALTH CARE. false false 6914076 7755836 ROOSEVELT MEDICAL 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2886220 2317021 569199 5332 5332 3799758 BENEFICIAL INTEREST IN TRUST 1451693 EQUITY IN AIR AMBULANCE CO-OP 140551 EQUITY IN WORKERS' COMP TRUST 65000 1657244 X 8677534 8677534 8677534 8239353 8239353 8239353 SCHEDULE D, PAGE 3, PART X THE COMPANY BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING THEIR ANNUAL FILING REQUIREMENTS, AND AS SUCH, DO NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. true true true X true X true true true false false 87892 87892 0.01070 87892 87892 0.01070 156822 15105 141717 0.01720 2404651 1649185 755466 0.09170 2561473 1664290 897183 0.10890 2649365 1664290 985075 0.11960 true 2840569 2862201 -21632 X true true 1 1 ROOSEVELT MEDICAL CENTER PO BOX 419 CULBERTSON MT 59218 X X X X ROOSEVELT MEDICAL CENTER 1 false false true X X X X X X X X X X 20 true false false true X ROOSEVELTMEDICAL.ORG X true 20 true ROOSEVELTMEDICAL.ORG false false true X 100.000000000000 200.000000000000 X X X true true X X X X true X WWW.ROOSEVELTMEDICAL.ORG X WWW.ROOSEVELTMEDICAL.ORG X WWW.ROOSEVELTMEDICAL.ORG X X X X true X false X X X X true X X false false FACILITY 1, ROOSEVELT MEDICAL CENTER - PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND ARE IDENTIFIED THROUGH THE CHNA. FACILITY 1, ROOSEVELT MEDICAL CENTER - PART V, LINE 5 A STEERING COMMITTEE WAS CONVENED IN SEPTEMBER 2020 TO ASSIST ROOSEVELT MEDICAL CENTER IN CONDUCTING THE CHNA. IN OCTOBER AND NOVEMBER 2020, TEN KEY INFORMANT INTERVIEWS WERE FACILITATED BY A REPRESENTATIVE WITH THE MONTANA OFFICE OF RURAL HEALTH. THE STEERING COMMITTEE AND KEY INFORMANTS INCLUDED A DIVERSE GROUP OF MEMBERS WHICH REPRESENTED VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY SUCH AS PUBLIC HEALTH, MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY CITIZENS, SENIORS, YOUTH, AND TRIBAL/AMERICAN INDIANS. ALSO, IN OCTOBER 2020, A SURVEY WAS MAILED TO 800 RANDOMLY SELECTED RESIDENTS IN THE HOSPITAL'S SERVICE AREA TO SOLICIT THEIR INPUT. THERE WAS A 20.6 PERCENT RESPONSE. FACILITY 1, ROOSEVELT MEDICAL CENTER - PART V, LINE 11 THE PRIORITIZED HEALTH NEEDS AS DETERMINED THROUGH THE ASSESSMENT PROCESS AND WHICH THE FACILITY WILL BE ADDRESSING RELATES TO THE FOLLOWING HEALTHCARE ISSUES: 1. SENIOR SERVICES 2. HEALTH AND WELLNESS 3. MENTAL AND BEHAVIORAL HEALTH THE FIRST HEALTHCARE ISSUE IS TO ENHANCE SENIOR SERVICES AVAILABLE IN EASTERN ROOSEVELT COUNTY. ONE STRATEGY FOR ADDRESSING THIS ISSUE IS TO EXPAND SERVICES THAT HELP THE LOCAL SENIOR POPULATION TO AGE IN PLACE SUCH AS EXPLORING OFFERING A FOOT CARE CLINIC AND CHECKING IMMUNIZATION STATUS FOR AREA SENIORS, DETERMINING FEASIBILITY OF IMPLEMENTING A COMMUNITY HEALTH WORKER SERVICE OR COMMUNITY PARAMEDICINE MODEL TO ASSIST SENIORS AND COMMUNITY MEMBERS IN THEIR HOMES, CONTINUING PARTNERSHIP WITH MONTANA HEALTH NETWORK TO DISCUSS THEIR NEW GRANT WORKING TO OFFER IN-HOME SERVICES TO SENIORS AT A SIGNIFICANTLY REDUCED COST, AND RMC WILL PROVIDE/SPONSOR LUNCH AND LEARNS IN COLLABORATION WITH AREA SENIOR CENTERS REGARDING VARIOUS HEALTH TOPICS. THE SECOND STRATEGY IS TO IMPROVE AWARENESS AND REACH OF THE CHRONIC CARE MANAGEMENT PROGRAM BY EXPANDING CURRENT EFFORTS BY CONNECTING WITH THE NEW MONTANA HEALTH NETWORK REGIONAL COORDINATOR AND REACHING OUT TO THE LOCAL SENIOR CENTER TO CONDUCT OUTREACH AND EDUCATION RELATED TO THE CHRONIC CARE MANAGEMENT PROGRAM. DUE TO CLINIC STAFFING ISSUES, FOOT CARE CLINICS/IMMUNIZATIONS WERE NOT FEASIBLE AT THE SENIOR CENTERS. EFFORTS WERE MADE TO PARTNER WITH THE COUNTY'S AGING SERVICES. HOWEVER, THEY TOO HAVE A STAFFING/VOLUNTEER ISSUE. HOWEVER, EDUCATIONAL MATERIALS MORE SPECIFIC TO SENIORS SUCH AS THE BENEFITS OF VACCINES, HEALTHY AGING AND SENIOR AGE-RELATED HEALTH CONCERNS AND TOPICS WERE MADE AVAILABLE AT THE SENIOR CENTERS IN THE COMMUNITIES OF CULBERTSON, BAINVILLE, AND FROID THROUGHOUT THE YEAR. CONDUCTING ON-SITE LUNCH AND LEARNS AT THE SENIOR CENTERS DURING THEIR SHORT HOURS OF OPERATION DURING THE LUNCH MEAL HAVE NOT BEEN POSSIBLE DUE TO STAFFING ISSUES/SCHEDULES. INSTEAD, AWARENESS BROCHURES, POSTERS, AND INFORMATION HAVE BEEN MADE AVAILABLE AT THE SENIOR CENTERS TO COINCIDE WITH MONTHLY HEALTH AWARENESS SPOTLIGHTS. THE CHRONIC CARE MANAGEMENT PROGRAM CONTINUES TO GAIN MOMENTUM WITH OVER A DOZEN AREA SENIORS BENEFITTING FROM THE PROGRAM. PROVIDING INFORMATION ABOUT THE PROGRAM TO THE COMMUNITY IS ONGOING. THE SECOND HEALTHCARE ISSUE IS TO ENHANCE HEALTH, WELLNESS, AND PREVENTION OUTREACH IN EASTERN ROOSEVELT COUNTY. ONE STRATEGY FOR ADDRESSING THIS ISSUE IS TO CONTINUE RMC'S PROMOTION OF HEALTH AND WELLNESS EFFORTS IN CULBERTSON AND THE SURROUNDING AREA BY OFFERING A COMMUNITY HEALTH FAIR, CONTINUING ANNUAL HEALTH SCREENING LABS, AND CONTINUING TO PROMOTE AND SPONSOR COMMUNITY HEALTH AND WELLNESS ACTIVITIES. THE SECOND STRATEGY IS TO GROW RMC'S PRESENCE IN THE COMMUNITY AS A SOURCE FOR HEALTH EDUCATION, OUTREACH, AND RESOURCES BY ENHANCING EDUCATIONAL RESOURCES AND OUTREACH TO THE COMMUNITY REGARDING HEALTH, WELLNESS, AND PREVENTION SUCH AS PROMOTING MONTHLY WELLNESS TOPICS, PROVIDING EDUCATION MATERIALS AT SCHOOL FUNCTIONS AND COMMUNITY EVENTS, AND SPONSORSHIP OF THE K-12 HEALTH BAGS. ANOTHER ACTIVITY FOR THE SECOND STRATEGY MAY INCLUDE PUBLISHING AN ANNUAL HEALTH AND WELLNESS NEWSLETTER. RMC DISTRIBUTED INFORMATIONAL AND FUN BAGS FILLED WITH GOODIES AND HEALTH TIPS TO THE ENTIRE STUDENT POPULATION BEFORE THE END OF THE SCHOOL YEAR. A TEDDY BEAR CLINIC WAS HELD WHICH IS DESIGNED TO ADDRESS A CHILD'S CONCERNS OR FEARS OVER CLINIC VISITS AND ROUTINE MEDICAL PROCEDURES. A PINK NORSKIES AND TACOS NIGHT, MATERIALS LEFT AT AREA POST OFFICES, SOCIAL MEDIA POSTS, AND A PINK PUMPKIN CONTEST WERE ACTIVITIES TO PROMOTE BREAST CANCER AWARENESS. A WINTER SHOWCASE BOOTH WAS SET UP TO PROMOTE HEALTHLY HOLIDAY EATING. ALSO, EACH MONTH RMC HELD A CAMPAIGN VIA SOCIAL MEDIA AND GIVEAWAYS AT DESIGNATED COMMUNITY LOCATIONS TO RAISE AWARENESS FOR VARIOUS HEALTH TOPICS. THROUGHOUT THE YEAR, MONTHLY NATIONAL AWARENESS CAMPAIGNS WERE HIGHLIGHTED VIA SOCIAL MEDIA AND AWARENESS INFORMATION WAS DISSEMINATED THROUGH THE COMMUNITIES VIA THE LOCAL POST OFFICE/SENIOR CENTERS/AREA BUSINESSES. AS THE COMMUNITY DOES NOT HAVE TRADITIONAL DAILY MEDIA OUTLETS, COMMON PLACES WHERE PEOPLE GATHER ARE UTILIZED TO GET INFORMATION OUT. RMC PARTICIPATED IN A SCHOOL CAREER DAY TO PROMOTE THE OPPORTUNITIES OF PURSUING A HEALTH CAREER WHILE PROVIDING AREA YOUTH WITH HANDS-ON OPPORTUNITIES FOR TRYING TO PERFORM CPR AND IDENTIFY ANATOMY. PROVIDERS AND STAFF, IN COLLABORATION WITH THE COUNTY'S TABACCO PREVENTIONIST ATTENDED LOCAL PARENT/TEACHER CONFERENCES AND SET UP BOOTHS WITH AWARENESS INFORMATION. A COMMUNITY HEALTH FAIR WAS HELD IN CONJUNCTION WITH THE ROOSEVELT COUNTY FAIR WITH A DOZEN STAFF IN ATTENDANCE. A SEPARATE EDUCATIONAL BOOTH WAS SET UP TO PROMOTE THE IMPORTANCE OF STAYING HEALTHY BY DEVELOPING A TRUSTING RELATIONSHIP WITH YOUR PRIMARY CARE PROVIDER. DURING THE SUMMER BASEBALL/SOFTBALL SEASON, RMC PARTNERED TO AID DURING THE GAMES WITH THE SNACK SHACK TO PROMOTE HEALTHY, ACTIVE, OUTDOOR ACTIVITIES. STAFF PARTNERED WITH CULBERTSON SCHOOL FOR THE ANNUAL PACK THE GYM IN PINK BREAST CANCER AWARENESS NIGHT IN OCTOBER. FLU VACCINE COLORING BOOKS WERE DISSEMINATED TO AREA ELEMENTARY SCHOOLS (GRADES K-5) SHOWCASING THE CDC READY WRIGLEY COLORING BOOKS. END-OF-YEAR "HEALTHY SUMMER" BAGS WERE PROVIDED TO AREA STUDENTS. SENIOR GRADUATION HEALTH BAGS WERE PROVIDED TO ALL 12TH GRADE GRADUATES WITH INFORMATION ON HEALTHY, LIFESTYLE CHOICES AS THEY MOVE INTO ADULTHOOD AND INDEPENDENT DECISION MAKING. A HAUNTED HALLOWEEN HOSPITAL WAS HOSTED BY STAFF TO PROVIDE AREA YOUTH A SAFE PLACE TO CELEBRATE HALLOWEEN. THERE, EDUCATIONAL STEM ACTIVITIES TOOK PLACE AND SAFETY/WELLNESS AWARENESS WAS PROMOTED. STAFF PARTICIPATED IN THE ANNUAL WINTER SHOWCASE WHERE HEALTHY WINTER LIVING TIPS WERE PROMOTED THROUGH EDUCATION AND GIVEAWAYS. STAFF ALSO SHOWCASED PARADE FLOATS THROUGH SUMMER/WINTER CELEBRATIONS TO PROMOTE HEALTH AND WELLNESS. IN COLLABORATION WITH CULBERTSON SCHOOL, WE HAVE IMPLEMENTED OUR FIRST EMS CLASS AS AN OPPORTUNITY FOR YOUTH INTERESTED IN HEALTH CARE. SEPARATELY, EMS HAS HOSTED CPR TRAINING FOR SCHOOL COACHES AND BUS DRIVERS. EMS ALSO PROVIDES STAND-BY AMBULANCES AT ALL HOME VARSITY FOOTBALL GAMES AND SUMMER EVENTS SUCH AS RODEOS AND STREET DANCES. EMS ALSO VISITS LOCAL DAYCARE FACILITIES FOR AWARENESS ABOUT WHEN TO CALL 9-1-1 AND PROVIDES AMBULANCE TOURS. RMC PARTNERS WITH THE SCHOOL DURING THEIR ANNUAL COLOR RUN. TWICE ANNUALLY, THE LABORATORY PROVIDES WELLNESS LABS SCREENINGS TO THE COMMUNITY. STAFF SERVE AS ACTIVE MEMBERS OF THE CHAMBER OF COMMERCE, LOCAL EMERGENCY PLANNING COMMITTEE, COUNTY EPIDEMIOLOGY COMMITTEE, AND THE CITY'S AIRPORT BOARD. "WELCOME TO TOWN" KITS ARE PROVIDED BY RMC TO AREA TOWN HALLS TO PROMOTE HEALTH AND WELLNESS IN THE AREA TO NEW RESIDENTS. THE THIRD HEALTHCARE ISSUE IS TO IMPROVE ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES IN EASTERN ROOSEVELT COUNTY. THE FIRST STRATEGY FOR ADDRESSING THIS ISSUE IS TO INCREASE COMMUNITY AWARENESS OF NEW AND ENHANCED MENTAL AND BEHAVIORAL HEALTH SERVICES IN THE AREA BY PROVIDING OUTREACH TO THE COMMUNITY ON THE NEW FRONTIER PSYCHIATRY PARTNERSHIP AND AVAILABILITY OF THE NEW TELE-MENTAL HEALTH CAPABILITIES AT RMC AND PROMOTING MENTAL HEALTH SERVICES OFFERED THROUGH THE LICENSED SOCIAL WORKER CANDIDATE AT RMC. THE SECOND STRATEGY IS TO EXPLORE NEW TRAINING OPPORTUNITIES AND PARTNERSHIPS TO ENHANCE THE COMMUNITY'S ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES BY PROMOTING MORH/AHEC'S BEHAVIORAL HEALTH TRAININGS TO RMC STAFF AND AREA PROVIDERS TO ENHANCE MENTAL AND BEHAVIORAL HEALTH SKILLS, KNOWLEDGE, AND TRAINING AND EXPLORING OPPORTUNITIES TO PARTNER WITH LOCAL SCHOOLS, EMS, POLICE, ETC. TO DELIVER SUBSTANCE ABUSE PREVENTION EDUCATION AND PROGRAMMING/EVENTS. OTHER ACTIVITIES FOR THE THIRD STRATEGY MAY INCLUDE MEETING WITH AREA MENTAL HEALTH STAKEHOLDERS TO EXPLORE THE DEVELOPMENT OF A LOCAL MENTAL HEALTH ADVISORY COMMITTEE AND CONNECTING WITH THE NEW LOCAL TOBACCO PREVENTION SPECIALIST TO DEVELOP AND ENHANCE PARTNERSHIP AND EDUCATIONAL OPPORTUNITIES/RESOURCES. A PROVIDER EMPLOYED BY RMC HELD A STRESS LESS FEST WHICH PRESENTED ATTENDEES WITH INFORMATION ON HOW TO REDUCE STRESS AND BALANCE BODY AND MIND. THIS YEAR, RMC HIRED A LICENSED SOCIAL WORKER CANDIDATE TO SEE PATIENTS ON-SITE AND VIRTUALLY THROUGH THE EASTERN MONTANA BEHAVIORAL HEALTH NETWORK. NUMEROUS SERVICE CAMPAIGNS HAVE OCCURRED THROUGHOUT THE YEAR. CURRENTLY, STAFF MEMBERS ARE PART OF THE ROOSEVELT COUNTY/FORT FECK TRIBES CRISES COALITION WHICH MEETS MONTHLY WITH STAKEHOLDERS TO PROMOTE/TACKLE THE ISSUES FACING THE REGION PERTAINING TO THE MENTAL HEALTH AND ADDICTION CRISES. TOGETHER, WE ARE DEVISING PLANS OF ACTION THAT CAN BENEFIT MORE PEOPLE AND GET THEM THE HELP THEY NEED TO LIVE A HEALTHY LIFE. PLANS ARE FOCUSED ON KEEPING PEOPLE OUT OF THE JAIL SYSTEM AND PERPETUAL CYCLES OF ADDICTION AND RELAPSE WHILE ALSO FOCUSING ON SUICIDE PREVENTION. FIVE HEALTH NEEDS ARE IDENTIFIED THA 1 ROOSEVELT MEDICAL CLINIC 818 2ND AVE E CULBERTSON MT 59218 RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 7G THERE IS NO COST OF BAD DEBT TO REMOVE FROM THE COMMUNITY BENEFIT EXPENSE IN COLUMN C. PROVIDER PROFESSIONAL SERVICES MAKE UP 197,154 OF COLUMN C, 137,078 OF COLUMN D, AND 60,076 OF COLUMN E. ROOSEVELT MEDICAL CENTER'S EFFORTS TO RECRUIT AND RETAIN PROVIDERS ARE DEPENDENT ON OUR ABILITY TO COMPETE WITH ALL OTHER COMMUNITIES THAT ARE RECRUITING SIMILAR PROVIDERS. BECAUSE OF OUR SMALL COMMUNITY SIZE AND REMOTE LOCATION FAR REMOVED FROM MEDICAL COMMUNITIES OF GREATER SCOPE, WE EMPLOY PROVIDERS AND SUBSIDIZE THEIR PRACTICES TO OFFER APPROPRIATELY COMPETITIVE SALARIES AND PRACTICE ENVIRONMENTS, INCLUDING REASONABLE CALL SCHEDULES. WE BELIEVE OUR ABILITY TO OFFER CORE NECESSARY PRIMARY CARE AND EMERGENCY SERVICES IS DEPENDENT ON SUBSIDIZATION OF PROVIDER PRACTICES DUE TO LOW VOLUMES IN THE ER RESULTING IN LOW REVENUES, BUT HIGH EXPENSES FROM HAVING TO STAFF A PROVIDER 24 HOURS PER DAY. SCHEDULE H, PART I, LINE 7 USED ADJUSTED COST TO CHARGE RATIOS FOR PATIENT CARE FROM THE MEDICARE COST REPORT, ADJUSTED FOR BED TAX AND COMMUNITY BENEFIT. BAD DEBT EXPENSE AND FINANCIAL ASSISTANCE ARE ALREADY EXCLUDED FROM THE MEDICARE COST REPORT. SCHEDULE H, PART III, LINE 2 THE ORGANIZATION'S PATIENT CARE COST TO CHARGE RATIO, AFTER ELIMINATING BAD DEBT EXPENSE, FINANCIAL ASSISTANCE, BED TAX, AND COMMUNITY BENEFIT EXPENSE, IS APPLIED TO GROSS BAD DEBT CHARGES, NOT INCLUDING IMPLICIT PRICE CONCESSIONS, TO ARRIVE AT THE COST OF BAD DEBT. DISCOUNTS AND IMPLICIT PRICE CONCESSIONS REDUCE REVENUE AND ARE NOT RECORDED AS BAD DEBT. PAYMENTS RECEIVED ON PREVIOUSLY WRITTEN OFF ACCOUNTS ARE RECORDED AS RECOVERIES OF IMPLICIT PRICE CONCESSIONS OR BAD DEBT, WHICH REDUCE IMPLICIT PRICE CONCESSIONS OR BAD DEBT EXPENSE. PATIENT OBLIGATIONS WHICH QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT RECORDED AS IMPLICIT PRICE CONCESSIONS OR BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 4 THERE WERE NO BAD DEBT EXPENSES RECORDED AND THEREFORE NO RELATED FOOTNOTE AFTER ADOPTING THE NEW REVENUE RECOGNITION GUIDANCE IN FASB ASU 2014-09. MOST TRANSACTIONS WHICH PREVIOUSLY WOULD HAVE BEEN RECORDED AS BAD DEBT EXPENSE ARE CLASSIFIED AS IMPLICIT PRICE CONCESSIONS WHICH ARE RECORDED AS REDUCTIONS IN REVENUE VERSUS BAD DEBT EXPENSE. NOTE 11 TO THE CONSOLIDATED FINANCIAL STATEMENTS DISCUSSES IMPLICIT PRICE CONCESSIONS ON PAGES 21, 22, AND 23. SCHEDULE H, PART III, LINE 8 THERE IS A MEDICARE SHORTFALL SINCE CRITICAL ACCESS HOSPITALS ARE REIMBURSED 101 PERCENT OF COST FROM MEDICARE FOR MOST SERVICES, LESS THE 2% SEQUESTRATION ADJUSTMENT, AND SOME SERVICES ARE PAID BASED ON FEE SCHEDULES WHICH ARE OFTEN LESS THAN COST. MEDICARE COSTS ON PART III, LINE 6 ARE DIRECTLY FROM THE MEDICARE COST REPORT. MEDICARE REVENUE ON PART III, LINE 5 IS DIRECTLY FROM THE MEDICARE COST REPORT AND THE MEDICARE PROVIDER SUMMARY REPORT. SCHEDULE H, PART III, LINE 9B IF APPROVED FOR FINANCIAL ASSISTANCE UNDER THE PROVISIONS OF THE FINANCIAL ASSISTANCE POLICY (FAP), THE PATIENT WILL RECEIVE NOTIFICATIONS THAT INCLUDE: A. THE DISCOUNT OF GROSS CHARGES TO THE AGB. THEN FINANCIAL ASSISTANCE DISCOUNTS WILL BE APPLIED TO THE AGB IN ACCORDANCE WITH THE DISCOUNT OF AGB CHARGES SCHEDULE DESCRIBED IN THE "DISCOUNT" SECTION OF THE FAP. B. PROVIDING THE PATIENT WITH A BILLING STATEMENT THAT INDICATES THE AMOUNT THE PATIENT OWES, IF THEY ARE NOT ELIGIBLE FOR FREE CARE. C. REFUNDING ANY EXCESS PAYMENTS MADE BY THE INDIVIDUAL BEYOND THE AGB ON ELIGIBLE ACCOUNTS IF NECESSARY. D. TAKING ALL REASONABLY AVAILABLE MEASURES TO REVERSE EXTRAORDINARY COLLECTION ACTIONS THAT OCCURRED. SCHEDULE H, PART VI, LINE 2 WE SEND OUT PATIENT SATISFACTION SURVEYS TO OUR PATIENTS. SCHEDULE H, PART VI, LINE 3 RMC WILL MAKE ALL REASONABLE EFFORTS TO NOTIFY A PATIENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THIS POLICY BY: 1. ATTEMPTING TO DETERMINE WHETHER A PATIENT HAS THIRD-PARTY COVERAGE FOR ANY PART OF THE EMERGENCY OR MEDICALLY NECESSARY HEALTH CARE SERVICE PROVIDED. IF A PATIENT DOES NOT HAVE OR QUALIFY FOR THIRD-PARTY FUNDING, THE BUSINESS OFFICE STAFF WILL EXPLAIN THE FINANCIAL ASSISTANCE POLICY, PROVIDE AN APPLICATION FOR FINANCIAL ASSISTANCE AND PROVIDE ASSISTANCE WITH COMPLETING THE APPLICATION, IF DESIRED. 2. OFFERING THE PATIENT A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE AVAILABLE UNDER THIS POLICY AT THE TIME OF ADMISSION OR BEFORE DISCHARGE FROM RMC. 3. PROVIDING THE INFORMATION DURING THE NOTIFICATION PERIOD ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE ON AT LEAST THREE (3) BILLING STATEMENTS AND IN ALL OTHER WRITTEN COMMUNICATIONS IN REFERENCE TO FINANCIAL RECORDS TO THE PATIENT; 4. INFORMING PATIENTS DURING THE NOTIFICATION PERIOD ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE DURING ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE CARE THAT OCCURRED; 5. PROVIDING THE PATIENT WITH AT LEAST ONE WRITTEN NOTICE INFORMING THE PATIENT ABOUT THE EXTRAORDINARY COLLECTION ACTIONS THAT RMC MAY TAKE IF THE PATIENT DOES NOT SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE OR PAY THE AMOUNT DUE BY AT LEAST THIRTY DAYS FOLLOWING THE DATE OF THE NOTICE. THE NOTICE WILL NOT BE MAILED OR DELIVERED TO A PATIENT EARLIER THAN 30 DAYS PRIOR TO THE END OF THE NOTIFICATION PERIOD; AND 6. RMC WILL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS AGAINST A PATIENT UNTIL SUCH TIME AS IT DETERMINES THE PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER THIS POLICY DURING THE 120 DAY NOTIFICATION PERIOD AND HAS PROVIDED THE PATIENT WITH THE NOTICE AS DESCRIBED ABOVE. SCHEDULE H, PART VI, LINE 4 WE PROVIDE SERVICE TO THE POPULATION IN EASTERN ROOSEVELT COUNTY, SOUTHERN SHERIDAN COUNTY, AND NORTHERN RICHLAND COUNTY. SCHEDULE H, PART VI, LINE 5 THE ADMINISTRATOR AND MARKETING DIRECTOR OF ROOSEVELT MEDICAL CENTER PARTICIPATE IN THE LOCAL CHAMBER OF COMMERCE. THE MARKETING DIRECTOR WRITES ARTICLES FOR THE LOCAL NEWSPAPER TO PROMOTE THE FACILITY AND DOES PUBLIC SERVICE ANNOUNCEMENTS THROUGH PRINTED MEDIA AND SOCIAL MEDIA (FACEBOOK). X X X false false false false false false false false false DANIELLE CHRISTENSEN RN 180761 8460 189221 ZOE FUGERE FNP 163237 300 8461 171998 FORM 990, PAGE 1, PART I, LINE 6 THE VOLUNTEERS ARE BOARD MEMBERS, MINISTERS AND GROUPS COMING IN TO SERVE DURING SOCIAL HOUR. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS REVIEWED BY THE ADMINISTRATOR, CFO, AND BOARD OF DIRECTORS BEFORE IT IS FILED. FORM 990, PAGE 6, PART VI, LINE 12C COMPLIANCE IS REVIEWED ANNUALLY. FORM 990, PAGE 6, PART VI, LINE 15A THE ADMINISTRATOR'S COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS WHICH IS USUALLY BASED ON THE AMOUNT/PERCENTAGE OF RAISE THE REST OF THE EMPLOYEES ARE GOING TO RECEIVE. FORM 990, PAGE 6, PART VI, LINE 15B THE CFO COMPILES INFORMATION FROM THE ANNUAL MHA SALARY SURVEY REGARDING AVERAGE WAGE BEING PAID FOR EACH JOB DESCRIPTION BASED ON PEER GROUP, CRITICAL ACCESS HOSPITALS, OR MHA REGION. THE CFO AND ADMINISTRATOR COMPARE AVERAGES BEING PAID TO THE CURRENT ROOSEVELT MEDICAL CENTER SALARY SCALE TO SEE IF ADJUSTMENTS NEED TO BE MADE TO KEEP EACH JOB COMPETITIVE WITHIN THE INDUSTRY. RECOMMENDATIONS FOR SALARY INCREASES ARE MADE TO THE BOARD OF DIRECTORS FOR APPROVAL OR DISAPPROVAL WHICH IS RECORDED IN THE BOARD MINUTES. FORM 990, PAGE 6, PART VI, LINE 19 DOCUMENTS RELATING TO ROOSEVELT MEDICAL CENTER ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G ADMIN PROF FEES 0 48,825 0 ADMIN PURCHASED SERVICES 0 27,873 0 CLINIC PROF FEES 317,575 0 0 DIETARY PURCHASED SERVICES 376,645 58,029 0 LAB PROF FEES 14,400 0 0 LAB PURCHASED SERVICES 46,035 0 0 MAINT PURCHASED SERVICES 1,925 462 7 MEDICAL /SURG. CONTRACT STAFF 121,707 0 0 MEDICAL & SURGICAL PURCH SVCS 8,398 0 0 MEDICAL RECORDS PURCH SVCS 0 417 0 OT PURCHASED SERVICES 11,221 0 0 PT PURCHASED SERVICES 194,400 0 0 AMBULANCE PURCHASED SERVICES 1,400 0 0 RADIOLOLGY PURCHASED SERVICES 8,231 0 0 SWING BED CONTRACT STAFF 657,781 0 0 SPEECH THERAPY PURCHASED SVCS 21,851 0 0 RADIOLOGY PROF FEES 322,430 0 0 PHARMACY PURCHASED SVCS 46,733 0 0 BUSINESS OFFICE PURCH SVCS 0 216 0 CLINIC PURCHASED SERVICES 920 0 0 ER PURCHASED SERVICES 30 0 0 ADMIN COLLECTION FEE 0 1,378 0 INFO SYSTEMS-PROF FEES 2,625 778 30 TOTAL 2,154,307 137,978 37 FORM 990, PART XI, LINE 9 PRIOR PERIOD ADJUSTMENT FOR INTEREST IN TRUST 1,465,324 ROUNDING -1 TOTAL 1,465,323 PRIOR PERIOD ADJUSTMENT FOR BENEFICIAL INTEREST IN PERPETUAL TRUST. SEE NOTE 2 AND NOTE 10 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS. ROOSEVELT MEMORIAL HEALTHCARE FOUND PO BOX 419 CULBERTSON MT 59218 810529284 SUPPORT OR MT 501C3 7 N/A false NE MT STAT AIR AMB COOP 81 AIRPORT ROAD GLASGOW MT 59230 204748673 AIR AMBUL MT 501C3 12B NA N/A false false false true false false false false false false false false false false true true false false false false ROOSEVELT MEMORIAL HEALTHCARE FOUND C 63315 SUPPORT ROOSEVELT MEMORIAL HEALTHCARE FOUND O 42857 PAYROLL ROOSEVELT MEMORIAL HEALTHCARE FOUND N 3402 OCCUPANCY