2024-05-02T10:40:27-04:00 2023-06-30 200079326 DINGUS ZARECOR & ASSOCIATES PLLC 12015 E MAIN AVE SPOKANE VALLEY WA 99206 990 2022-07-01 810264548 DAHL MEMORIAL HEALTHCARE ASSOCIATION INC DAHL 4067758730 PO BOX 46 EKALAKA MT 59324 JANA FIX CFO 4067758739 2024-04-23 true JANA FIX 999009999 true THOMAS DINGUS P00951009 5092420874 2024-05-02 2022 2023-04-26 12:10:37Z RYAN TOOKE PO BOX 46 EKALAKA MT 59324 8190284 false X WWW.DAHLMEMORIAL.COM X 1957 MT TO IMPROVE LIVES AND PROVIDE QUALITY, SAFE, AND COMPASSIONATE HEALTHCARE TO ALL. 7 6 90 7 0 2142152 284774 6149989 7840014 -101103 783 52284 64713 8243322 8190284 0 0 3525836 4281196 0 0 3037836 4632355 6563672 8913551 1679650 -723267 6189244 5191884 1692962 1418869 4496282 3773015 TO IMPROVE LIVES AND PROVIDE QUALITY, SAFE, AND COMPASSIONATE HEALTHCARE TO ALL. false false 6883559 7840014 DAHL MEMORIAL HEALTHCARE ASSOCIATION (DMHA) IS COMPRISED OF A 25-BED CRITICAL ACCESS HOSPITAL AND A RURAL HEALTH CLINIC WHICH PROVIDES HEALTH CARE SERVICES TO CARTER COUNTY AND THE SURROUNDING AREA. DMHA PROVIDED 98 DAYS OF INPATIENT SERVICES, 402 SWING BED DAYS, 6,669 PATIENT DAYS OF LONG TERM CARE, AND 2,795 CLINIC VISITS DURING 2023. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. 6883559 true false false true false false false false false false true false false true false true true false false false false false false false false false true true false false true false false false false false false true false false false false false false false false false false true 5 0 true 90 true false false false false false false false false false false false false X 7 6 false false false false true true false true true false false true true true true false true true true false X JANA FIX 4067758730 PO BOX 46 EKALAKA MT 59324 MICHELLE MEHLING PHARMACIST 40.00 X 253466 0 14438 CARLA DOWDY PHYSICIAN AS 40.00 X 174633 0 21723 RYAN TOOKE CEO 40.00 X 137021 0 14199 JANA FIX CFO 40.00 X 48550 0 0 JITT SCHNEIDER CHAIR 2.00 X X 0 0 0 GEORGIA BRUSKI VICE CHAIR 2.00 X X 0 0 0 DANE CASTLEBERRY SECRETARY/TR 2.00 X X 0 0 0 RUSTY SPENCER MEMBER 1.00 X 0 0 0 MARILYN SCHULTZ MEMBER 1.00 X 0 0 0 CHARLES PARKS MEMBER 1.00 X 0 0 0 TROY FRUIT MEMBER 1.00 X 0 0 0 613670 50360 3 false true false 275833 8941 284774 NET PATIENT SERVICE REVENUE 624100 7840014 7840014 7840014 783 783 OTHER 900099 56294 56294 MEALS ON WHEELS 900099 8419 8419 64713 8190284 7840014 65496 X 222095 222095 3514674 3128502 386172 73326 61171 12155 190952 164494 26458 280149 219386 60763 107026 107026 77552 77552 2176670 1343167 833503 6876 961 5915 300266 185889 114377 301809 269485 32324 110291 106539 3752 40612 28220 12392 2073 41 2032 380058 357251 22807 79499 300 79199 MEDICAL SUPPLIES & DRUGS 969522 969522 REPAIRS & MAINTENANCE 34531 30813 3718 45570 17818 27752 8913551 6883559 2029992 0 419131 275961 2301712 1154566 881312 1149856 359430 343588 1038 11163 3194213 1584463 1982358 1609750 72855 171408 647000 6189244 5191884 710921 862834 7833 652208 556035 322000 1692962 1418869 X 4496282 3773015 4496282 3773015 6189244 5191884 X -723267 X false true X true false X false false false false false false false false true 6 6 false SCHEDULE C, PART II-B, LINE 1 DMHA DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO STATE AND NATIONAL HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. 166622 24562 142060 35997 35997 2991594 1523904 1467690 1609750 ESTIMATED THIRD-PARTY SETTLEMENT 643000 OTHER RECEIVABLE 4000 647000 X 9012222 821938 821938 8190284 8190284 9735489 821938 821938 8913551 8913551 SCHEDULE D, PAGE 3, PART X THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE ORGANIZATION EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WERE CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF JUNE 30, 2023 AND 2022, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. SCHEDULE D, PAGE 4, PART XI, LINE 2D DONATED SERVICES & USE OF FACILITIES 821,938 SCHEDULE D, PAGE 4, PART XII, LINE 2D DONATED SERVICES & USE OF FACILITIES 821,938 true true true X true X false true false false 385846 385846 385846 385846 71131 24144 46987 0.00530 16558 16558 0.00190 87689 24144 63545 0.00710 473535 409990 63545 0.00710 65 65 65 65 true 467365 4254040 4422679 -168639 X true true 1 1 DAHL MEMORIAL HEALTHCARE ASSOC PO BOX 46 EKALAKA MT 59324 DAHLMEMORIAL.ORG 12555 X X X X DAHL MEMORIAL HEALTHCARE ASSOC 1 false false true X X X X X X X X X X 21 true false true true X DAHLMEMORIAL.ORG X true 21 true DAHLMEMORIAL.ORG false true X 100.000000000000 200.000000000000 X true true X X X true X DAHLMEMORIAL.ORG X DAHLMEMORIAL.ORG X DAHLMEMORIAL.ORG X X X false X false X X true X false false FACILITY 1, DAHL MEMORIAL HEALTHCARE ASSOC - PART V, LINE 3E IDENTIFICATION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS BEGIN ON PAGE 51 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE. FACILITY 1, DAHL MEMORIAL HEALTHCARE ASSOC - PART V, LINE 5 IN CONDUCTING ITS MOST RECENT CHNA, DMHA TOOK INTO ACCOUNT PERSONS INPUT WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL BY INCLUDING ZIP CODES WITH THE GREATEST NUMBER OF ADMISSIONS IN THE SURVEY SAMPLE. THE PROCESS INCLUDED A RANDOM LIST OF 576 RESIDENTS FROM THESE ZIP CODES. DMHA ALSO FORMED A STEERING COMMITTEE TO ASSIST IN DESIGNING THE SURVEY AND TO REVIEW RESULTS OF THE SURVEY AND FOCUS GROUPS IN THE PRIORITIZATION OF HEALTH NEEDS. THE STEERING COMMITEE WAS MADE UP OF A DIVERSE GROUP OF COMMUNITY MEMBERS REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY INCLUDING PUBLIC HEALTH, ELDERLY, AND UNINSURED. FACILITY 1, DAHL MEMORIAL HEALTHCARE ASSOC - PART V, LINE 6B DMHA COLLABORATED WITH THE MONTANA OFFICE OF RURAL HEALTH TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT TO IMPROVE THE UNDERSTANDING OF THE HEALTH STATUS OF CARTER COUNTY AND SURROUNDING AREA. FACILITY 1, DAHL MEMORIAL HEALTHCARE ASSOC - PART V, LINE 11 DMHA WAS NOT ABLE TO ADDRESS ALL HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA DUE TO NOT CURRENTLY HAVING THE STAFF OR FINANCIAL RESOURCES TO DEVOTE TO THE NEED. ALSO, THERE ARE OTHER RESOURCES AVAILABLE IN THE COMMUNITY THAT ARE A BETTER FIT TO ADDRESS THOSE HEALTHCARE CONCERNS. SPECIFIC HEALTH NEEDS DMHA IS UNABLE TO ADDRESS AT THIS TIME INCLUDE THE FOLLOWING: VISION AND DENTAL HEALTHCARE SERVICES AFFORDABLE HOUSING ASSISTED LIVING FACILITY 1 DAHL MEMORIAL CLINIC PO BOX 46 EKALAKA MT 59324 OUTPATIENT CLINIC SCHEDULE H, PART I, LINE 7 DMHA APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES FOR FIGURES REPORTED IN THE TABLE RELATED TO CHARITY CARE AND UNREIMBURSED MEDICAID (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, MEDICAID PROVIDER TAXES, TOTAL COMMUNITY BENEFIT, AND TOTAL COMMUNITY BUILDING EXPENSES). ACTUAL COSTS WERE USED FOR THE REMAINDER OF THE COMMUNITY BENEFITS REPORTED. SCHEDULE H, PART II CARTER COUNTY IS DESIGNATED AS MEDICALLY UNDERSERVED AND HAS A SHORTAGE IN THE AREA OF HEALTH PROFESSIONALS. DMHA IS CONTINUALLY RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO ITS RURAL SERVICE AREA TO HELP IMPROVE ACCESS TO HEALTHCARE SERVICES AS IDENTIFIED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT. SCHEDULE H, PART III, LINE 2 DMHA REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. SCHEDULE H, PART III, LINE 3 DMHA DID NOT TRACK THE AMOUNT OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER DMHA'S CHARITY CARE POLICY BUT FOR WHOM SUFFICIENT INFORMATION WAS NOT OBTAINED TO MAKE DETERMINATION OF THEIR ELIGIBILITY DURING THE YEAR. SCHEDULE H, PART III, LINE 4 THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 4 ON PAGE 10 OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 8 BEGINNING ON PAGE 12 OF THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 8 THE MEDICARE COST REPORT FOR THE YEAR IS USED TO DETERMINE THE AMOUNTS OF MEDICARE ALLOWABLE COSTS. ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE CONSIDERED A COMMUNITY BENEFIT SINCE SERVICES ARE BEING PROVIDED FOR LESS THAN COSTS TO MEDICARE PATIENTS IN THE COMMUNITY. SCHEDULE H, PART III, LINE 9B IF A PATIENT CANNOT PAY THE ENTIRE BILL WITHIN THE TIMELINE SPECIFIED IN THE BILLING/COLLECTION POLICY, OR THEY ARE SELF PAY WITHOUT INSURANCE AND DO NOT QUALIFY FOR ANY GOVERNMENT PROGRAMS SUCH AS MEDICAID, MEDICARE, ETC, WE DETERMINE IF THEY ARE ELIGIBLE FOR OUR FINANCIAL ASSISTANCE PROGRAM. DMHA HAS PAYMENT CONTRACTS SET UP FOR EACH FISCAL YEAR WITH REGARDS TO PATIENTS THAT QUALIFY FOR PAYMENT ASSISTANCE PROGRAMS. A LETTER EXPLAINING THE PAYMENT OPTIONS IS ENCLOSED WITH THE FIRST STATEMENT IF THE ACCOUNT TOTAL IS OVER 500. SCHEDULE H, PART VI, LINE 2 THE ASSESSMENT WAS COMPLETED WITH ASSISTANCE FROM THE MONTANA OFFICE OF RURAL HEALTH, WITH DATA COLLECTED BY STEERING COMMITTEE MEETINGS, KEY INFORMANT INTERVIEWS, FOCUS GROUPS AND A SURVEY MAILED TO RANDOM HOUSEHOLDS IN OUR SERVICE AREA. WITH THE GLOBAL COVID 19 PANDEMIC RESTRICTIONS BEING LIFTED IN 2022, EFFORTS TRANSITIONED FROM THE GLOBAL HEALTH CRISIS BACK TO THE HEALTH NEEDS OF THE COMMUNITY. DMHA CONDUCTS THE FOLLOWING ANNUAL EVENTS: DISCOUNTED SCHOOL AND DEPARTMENT OF TRANSPORTATION PHYSICALS HEALTHCARE TOPIC EDUCATION HEALTHCARE PROVIDER WORKS WITH LOCAL COACHES AND RESPONDERS TO INCREASE AWARENESS OF IMPACT ASSESSMENTS AND TRAINING CONCERNING HEAD INJURIES SUPPORTS COUNTY COUNCIL ON AGING FOR MEALS ON WHEELS PROGRAM AS WELL AS PROVIDING RESPITE CARE ASSIST/COORDINATES TRANSPORTATION FOR PATIENT VISITS OUTSIDE OF THE SERVICE AREA THROUGH CARTER CHARTER AND COMMUNITY VOLUNTEERS ADDITIONALLY, DMHA ANNUALLY CONDUCTS A 2-DAY HEALTH FAIR FOR THE COMMUNITY AND PERIODICALLY PUBLISHES A PUBLIC SERVICE ANNOUNCEMENT REGARDING COMMUNITY HEALTH IN THE LOCAL NEWPAPERS, ON THE LOCAL TV STATION, AND ON THE FACILITY'S WEBSITE. WE ARE CONTINUALLY TAKING IN INFORMATION AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. COPIES ARE AVAILABLE AT THE HOSPITAL UPON REQUEST OF THE MOST RECENTLY ADOPTED COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY OR A COPY CAN BE FOUND AT THE HOSPITAL'S WEBSITE AT THE FOLLOWING URL: HTTPS://DAHLMEMORIAL.ORG/MONTANA/UPLOADS/2020/06/EKALAKA-2020_FINAL- REPORT.PDF SCHEDULE H, PART VI, LINE 3 THE INFORMATION IS DISTRIBUTED TO THE COMMUNITY IN A VARIETY OF WAYS. DMHA POSTED FLYERS THROUGHOUT THE FACILITY INFORMING ALL WHO ENTER THE BUILDING ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. THE INFORMATION IS ALSO AVAILABLE ON THE WEBSITE. A COPY OF THE LATEST FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT THE HOSPITAL'S WEBSITE AT THE FOLLOWING URL: HTTPS://DAHLMEMORIAL.ORG/MONTANA/UPLOADS/2019/07/FINANCIAL-ASSISTANCE.PDF SCHEDULE H, PART VI, LINE 4 DMHA'S PRIMARY SERVICE AREA INCLUDES THE COMMUNITIES OF EKALAKA, HAMMOND, BELTOWER, MILL IRON, ALBION, BAKER, PLEVENA, AND WIBAUX. LOCATED IN SOUTHEAST MONTANA, CARTER COUNTY CONSISTS OF NEARLY 3,350 SQUARE MILES OF LAND AREA AND IS HOME TO APPROXIMATELY 1,160 PEOPLE. CARTER COUNTY HAS A LOW POPULATION DENSITY AND IS CONSIDERED A FRONTIER (SIX OR LESS PEOPLE PER SQUARE MILE) BY THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE COUNTY HAS A 8.9% VETERAN AND 18.1% DISABILITY STATUS. 24.4% OF THE RESIDENTS ARE 65 YEARS OLD OR OLDER, WITH A MEDIAN INCOME OF 45,347, OF WHICH 11.8% ARE BELOW POVERTY LEVEL, AND 15% UNINSURED ADULTS. SCHEDULE H, PART VI, LINE 5 DMHA'S BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY MEMBERS FROM THE PRIMARY SERVICE AREA AND DEDICATE TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. MEDICAL STAFF PRIVILEGES AT DMHA ARE OPEN TO ALL QUALIFED MEDICAL PROVIDERS WITH ACTIVE LICENSURE. APPLICANTS MUST MEET CREDENTIALING STANDARDS AND BE APPROVED BY THE GOVERNING BOARD. AS A NON-PROFIT ORGANIZATION, ANY SURPLUS FUNDS ARE REINVESTED INTO OUR FACILITY, EQUIPMENT AND EMPLOYEE EDUCATION. DMHA FOCUSES ON MEETING THE HEALTH NEEDS OF OUR COMMUNITY. SCHEDULE H, PART VI, LINE 6 N/A X false false false false false false false false false MICHELLE MEHLING PHARMACIST 243194 10272 7704 6734 267904 CARLA DOWDY PHYSICIAN ASSISTANT 162181 12452 5239 16484 196356 RYAN TOOKE CEO 131422 5599 4199 10000 151220 SAMANTHA CASTLEBERRY FAMILY 37323 EMPLOYMENT false FORM 990, PAGE 6, PART VI, LINE 6 MEMBERSHIP IN THE ASSOCIATION SHALL BE OPEN TO ANY PERSON EIGHTEEN (18) YEARS OF AGE OR OLDER, WHO IS A CURRENT RESIDENT OF CARTER COUNTY. A PERSON IS ENTITLED TO MEMBERSHIP UPON PAYMENT OF NOT LESS THAN THE SUM OF TEN DOLLARS (10). A MEMBER OF THE ASSOCIATION THAT IS IN GOOD STANDING SHALL 1)BE QUALIFIED TO VOTE ON ANY ISSUE THAT MAY PROPERLY COME BEFORE ANY MEETING OF THE MEMBERS OF THE ASSOCIATION AND 2) HOLD ANY OFFICE IN THE ASSOCIATION TO WHICH HE/SHE MAY BE ELECTED OR APPOINTED. FORM 990, PAGE 6, PART VI, LINE 7A THE GOVERNING BOARD SHALL CONSISTS OF SEVEN (7) MEMBERS, DEFINED IN ARTICLE I, SECTION 1, ELECTED BY THE MEMBERS OF DAHL MEMORIAL HEALTHCARE ASSOCIATION. AN INDIVIDUAL WHO IS EMPLOYED BY THE ASSOCIATION SHALL NOT BE ELIGIBLE TO SERVE ON THE ASSOCIATION'S GOVERNING BOARD. ELECTION OF ALL BOARD MEMBERS SHALL OCCUR IN SEPTEMBER OF EACH YEAR. THEIR TERMS OF OFFICE SHALL BE FOR A PERIOD OF THREE (3) YEARS AND SHALL BEGIN IMMEDIATELY AFTER AN ELECTION. THE GOVERNING BOARD SHALL HAVE THE AUTHORITY TO APPOINT AN ASSOCIATION MEMBER TO FILL VACANT BOARD POSITION(S) UNTIL AN ELECTION OF THE ASSOCIATION MEMBERSHIP IS CONDUCTED. UPON ELECTION BY ASSOCIATION MEMBERSHIP, THE ELECTED BOARD MEMBER(S) SHALL FILL THE ENTIRE REMAINING TERM OF THE ORIGINAL BOARD MEMBER(S). FORM 990, PAGE 6, PART VI, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE CEO, CFO AND THE BOARD WHO REVIEW THE FORM, SCHEDULES, AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL APPROVAL IS GIVEN TO THE PREPARER BEFORE FINALIZING. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CFO SIGNS FORM 8879-TE AUTHORIZING THE PREPARER TO E-FILE THE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C THE MEMBERS OF THE BOARD OF DIRECTORS (THE BOARD) OF DAHL MEMORIAL HEALTHCARE ASSOCIATION, INC. (DMHA) MUST ACT AT ALL TIMES IN THE BEST INTERESTS OF DMHA. THE PURPOSE OF THIS POLICY IS TO HELP IN FORM THE BOARD ABOUT WHAT CONSTITUTES A CONFLICT OF INTEREST, ASSIST THE BOARD IN IDENTIFYING AND DISCLOSING ACTUAL AND POTENTIAL CONFLICTS, AND HELP ENSURE THE AVOIDANCE OF CONFLICTS OF INTEREST WHERE NECESSARY. IF ANY POTENTIAL CONFLICTS ARE IDENTIFIED, THE CEO ALONG WITH THE BOARD WILL REVIEW TO DETERMINE IF A CONFLICT EXISTS. FORM 990, PAGE 6, PART VI, LINE 15A THE SOURCES UTILIZED BY DMHA IN REGARD TO FAIR MARKET VALUE ARE SALARY DATA PUBLISHED BY THE MONTANA HOSPITAL ASSOCIATION (MHA) TO DETERMINE COMPENSATION FOR THE CEO. THE MHA SURVEY ITEMIZES ALL HOSPITALS AS A GROUP, CAH HOSPITALS AND HOSPITALS BY REGION. THE BOARD OF DIRECTORS APPROVES THE MANAGEMENT SERVICES CONTRACT FOR THE INTERIM CEO. FORM 990, PAGE 6, PART VI, LINE 15B SEE FORM 990, PART VI, LINE 15A. FORM 990, PAGE 6, PART VI, LINE 19 DMHA MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES 1,343,167 833,503 0 FORM 990, PART XI, LINE 9 DONATED SERVICES & USE OF FACILITIES 821,938 DONATED SERVICES & USE OF FACILITIES -821,938