2025-03-06T12:20:12-05:00 2024-04-30 GREEN HEALTH GROUP PC 405 FOURTH AVENUE NORTH GLASGOW MT 59230 990 2023-05-01 810373589 CULBERTSON FROID BAINVILLE HEALTHCARE CORPORATION CULB 4067876401 PO BOX 419 CULBERTSON MT 59218 JAMASON SCHMIDT CEO 4067876401 2025-03-05 true true DANIEL GREEN P01311679 4062632615 2025-03-06 2023 2025-03-06 01:10:19Z ROOSEVELT MEDICAL CENTER JAMASON SCHMIDT PO BOX 419 CULBERTSON MT 59218 9697452 false X ROOSEVELTMEDICAL.ORG X 1976 MT ROOSEVELT MEDICAL CENTER IS DEDICATED TO PROVIDING PATIENTS WITH APPROPRIATE, PERSONALIZED, AND QUALITY HEALTH CARE. 10 10 91 296 0 633350 906463 7755836 8251714 -11814 68385 300162 470890 8677534 9697452 0 0 4016987 4394622 0 49608 4222366 4709055 8239353 9103677 438181 593775 10132530 11482274 1705768 2414997 8426762 9067277 ROOSEVELT MEDICAL CENTER IS DEDICATED TO PROVIDING PATIENTS WITH APPROPRIATE, PERSONALIZED, AND QUALITY HEALTH CARE. false false 7559545 8251714 ROOSEVELT MEDICAL CENTER IS DEDICATED TO PROVIDING PATIENTS WITH APPROPRIATE, PERSONALIZED, AND QUALITY HEALTH CARE. 7559545 true true false true false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 17 0 91 true false false false false false false false false false false false false X 10 10 false false false false false false false true true false false true true true true true true true true false X JENNIFER KESSNER 4067876401 PO BOX 419 CULBERTSON MT 59218 DANIELLE CHRISTENSEN RN 64.00 X 192942 0 12008 ZOE FUGERE FNP 40.00 X 187719 0 12126 MICHAEL MADDEN NP 39.00 X 131798 0 10712 AUDREY STROMBERG CEO 40.00 X 128450 0 8230 JOANN SMITH LAB MANAGER 46.00 X 124044 0 11527 JENNIFER KESSNER CFO 44.00 X 122502 0 11395 BLAINE WHITE PA 27.00 X 127142 0 2497 CASSANDRA BERGUM DIRECTOR 1.00 X 0 0 0 RUSSELL BOWKER DIRECTOR 1.00 X 0 0 0 ROBBIE DENT-SAVELKOUL CHAIRMAN 1.00 X 0 0 0 AMBER FOX DIRECTOR 1.00 X 0 0 0 STEVE LARSEN DIRECTOR 1.00 X 0 0 0 JESSE LYON DIRECTOR 1.00 X 0 0 0 SCOTT ROTH DIRECTOR 1.00 X 0 0 0 SHARON SCHMITZ DIRECTOR 1.00 X 0 0 0 WES STEPPLER DIRECTOR 1.00 X 0 0 0 KATHY MCCABE THOMPSON VICE-CHAIRMA 1.00 X 0 0 0 JAMASON SCHMIDT CEO 0.00 X 0 0 0 1014597 68495 7 false true false MONTANA HEALTH NETWORK INC 519 PLEASANT STREET MILES CITY MT 59301 NURSING STAFF 796325 FOREFRONT HEALTHCARE PO BOX 30516 LANSING MI 489098016 DIETARY SVCS 458028 FOCUS STAFF SERVICES LP 10440 E NW HIGHWAY DALLAS TX 75238 LOCUM STAFF 208149 BADLANDS MEDICAL STAFFING 1502 SCHOONER PLACE BISMARCK ND 58504 LOCUM STAFF 138552 PRN STAFFING SOLUTIONS LLC 173 AUSTRIAN ROAD VIDA MT 59274 LOCUM STAFF 120506 5 42495 784383 79585 906463 PATIENT REVENUE 621500 7858004 7858004 MISC REVENUE 900099 393710 393710 8251714 68385 68385 HOSPITAL DISTRICT SUBSIDY 900099 470890 470890 470890 9697452 8790989 X 269912 269912 3441668 3019655 383327 38686 91324 74301 16073 950 281397 224470 54074 2853 310321 252262 54630 3429 2653032 2378964 273984 84 36085 36085 337564 222720 114029 815 156 156 37272 28569 8684 19 42719 34337 8263 119 460734 370154 89290 1290 121219 97388 23492 339 MEDICAL SUPPLIES 474524 474524 REPAIRS & MAINTENANCE 415912 311128 103947 837 MISC 83572 68617 14768 187 BED TAX 39102 39102 7164 2300 4864 9103677 7559545 1494524 49608 2275474 2923339 127655 996456 1879282 1889614 207219 213721 185898 177111 9856377 6326659 3799758 3529718 1657244 1752315 10132530 11482274 459296 743919 1099795 1045536 146677 142961 482581 1705768 2414997 X 6975069 7568844 1451693 1498433 8426762 9067277 10132530 11482274 X 593775 46740 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 443 443 false SCHEDULE C, PART IV 0.62 PERCENT OF DUES PAID TO MHA AND 32.00 PERCENT OF DUES PAID TO AHA, WHICH TOTALED 443, WERE USED FOR LOBBYING EXPENSES BY MHA. 18500 18500 6881436 3854938 3026498 2953124 2471721 481403 3317 3317 3529718 BENEFICIAL INTEREST IN TRUST 1498433 EQUITY IN AIR AMBULANCE CO-OP 188882 EQUITY IN WORKERS' COMP TRUST 65000 1752315 MEDICARE/MEDICAID ESTIMATED PAYABLE 304118 RESIDENT DEPOSITS PAYABLE 178463 482581 X 9697452 9697452 9697452 9103677 9103677 9103677 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 86319 86319 0.00950 86319 86319 0.00950 182755 12450 170305 0.01870 2682623 2014244 668379 0.07340 2865378 2026694 838684 0.09210 2951697 2026694 925003 0.10160 true 3288306 3317664 -29358 X true true 1 1 ROOSEVELT MEDICAL CENTER PO BOX 419 CULBERTSON MT 59218 ROOSEVELTMEDICAL.ORG X X X X ROOSEVELT MEDICAL CENTER 1 false false true X X X X X X X X X X 23 true false true true X ROOSEVELTMEDICAL.ORG X true 23 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 THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS PERFORMED IN THE SPRING OF 2023 IN COLLABORATION WITH THE ROOSEVELT COUNTY HEALTH DEPARTMENT, FORT PECK TRIBES, AND LOVELAND CONSULTING. A DIVERSE GROUP OF STAKEHOLDERS WAS CONVENED TO GUIDE THE PROCESS AND THEY 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 THE SPRING OF 2023, A KEY INFORMANT SURVEY WAS DISTRIBUTED ELECTRONICALLY AND 53 TOTAL RESPONSES WERE RECEIVED. FACILITY 1, ROOSEVELT MEDICAL CENTER - PART V, LINE 6B ROOSEVELT COUNTY HEALTH DEPARTMENT AND FORT PECK TRIBAL HEALTH DEPARTMENT 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, 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. 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. 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 BEHAVIORAL HEALTH PARTNERSHIPS AND AVAILABILITY OF 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 PHYSICIANS/PRACTITIONERS TO ENHANCE MENTAL AND BEHAVIORAL HEALTH SKILLS, KNOWLEDGE, AND TRAINING AND EXPLORING OPPORTUNITIES TO PARTNER WITH LOCAL SCHOOLS, EMS, POLICE, ETC. TO DELIVER HEALTHY LIFESTYLE/RESILIENCE EDUCATION AND PROGRAMMING/EVENTS SUCH AS ENGAGING WITH LOCAL YOUTH ON PEER-SUPPORT. OTHER ACTIVITIES FOR THE THIRD STRATEGY MAY INCLUDE PARTNERING AND PARTICIPATING IN THE FORT PECK CRISES COALITION COMMITTEE WITH AREA AGENCIES AND CONNECTING WITH THE LOCAL TOBACCO PREVENTION SPECIALIST TO DEVELOP AND ENHANCE PARTNERSHIP AND EDUCATIONAL OPPORTUNITIES/RESOURCES OFFERED TO THE EAST SIDE OF THE COUNTY. FIVE HEALTH NEEDS ARE IDENTIFIED THAT ARE UNABLE TO BE ADDRESSED BY RMC. FIRST, RESPONDENTS INDICATED THAT HAVING ACCESS TO MORE PLACES TO EXERCISE WOULD MAKE THE COMMUNITY A BETTER PLACE TO GROW OLD. THE SCHOOL HAS TWO GYMS FOR WALKING AS WELL AS A FITNESS ROOM WITH EQUIPMENT FOR EXERCISING. THERE IS ACCESS TO IKE'S FISHING POND WHICH HAS A WALKING PATH, AND THERE IS A NEWLY CONSTRUCTED WALKING PATH ALONG US HIGHWAY 2. SECOND, RESPONDENTS REPORTED THAT TRANSPORTATION ASSISTANCE WOULD IMPROVE COMMUNITY ACCESS TO HEALTHCARE, MAKING THE COMMUNITY A BETTER PLACE TO GROW OLD IN. RMC DOES NOT HAVE THE CAPACITY TO TAKE ON TRANSPORTATION AT THIS TIME, BUT WILL CONTINUE TO REASSESS/RESEARCH OPPORTUNITIES TO PARTNER WITH OTHER COMMUNITY ORGANIZATIONS TO ADDRESS THIS NEED. THIRD, RESPONDENTS WERE WORRIED ABOUT HAVING ENOUGH FOOD TO EAT DURING THE LAST YEAR. THE LOCAL FOOD BANKS, SCHOOL PROGRAMS, MEALS ON WHEELS, AND SENIOR SERVICES WORK TO ADDRESS FOOD INSECURITY. RMC WILL ASSIST AND PARTNER WHENEVER POSSIBLE. FOURTH, RESPONDENTS RATED CRIME AS A BIG PROBLEM IN ROOSEVELT COUNTY. RMC DOES NOT FEEL THIS IS AN AREA WE CAN TRULY MAKE INROADS WITH OTHER THAN PARTNERING WITH LOCAL LAW ENFORCEMENT WHEN PATIENTS ARE PRESENT AT THE ER WITH MENTAL HEALTH NEEDS. IN THIS CAPACITY, WE CAN ADVOCATE FOR PROCEDURES THAT GET PATIENTS THE HEALTHCARE THEY NEED. FIFTH, RESPONDENTS FEEL THAT THE HOUSING CONDITIONS IN THE COMMUNITY ARE NOT ADEQUATE OR THERE IS NOT ENOUGH AFFORDABLE HOUSING AVAILABLE. DURING THE OIL BOOM, WE DID LOOK AT A PARTNERSHIP WITH THE SCHOOL TO BUILD HOUSING FOR INCOMING STAFF BUT IT WAS NOT AFFORDABLE. WE DO ALWAYS WORK TO PROVIDE ASSISTANCE TO NEW COMMUNITY MEMBERS THROUGH WORD-OF-MOUTH ABOUT POTENTIAL PLACES THAT ARE AVAILABLE FOR RENT OR PURCHASE. HOWEVER, WE DO NOT FEEL THIS IS AN AREA OF NEED WE CAN TRULY MAKE ANY INROADS WITH THAT WOULD BE SUCCESSFUL. 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. PHYSICIAN/PRACTITIONER PROFESSIONAL SERVICES MAKE UP 235,193 OF COLUMN C, 152,462 OF COLUMN D, AND 82,731 OF COLUMN E. ROOSEVELT MEDICAL CENTER'S EFFORTS TO RECRUIT AND RETAIN PHYSICIANS/PRACTITIONERS ARE DEPENDENT ON OUR ABILITY TO COMPETE WITH ALL OTHER COMMUNITIES THAT ARE RECRUITING SIMILAR PHYSICIANS/PRACTITIONERS. BECAUSE OF OUR SMALL COMMUNITY SIZE AND REMOTE LOCATION FAR REMOVED FROM MEDICAL COMMUNITIES OF GREATER SCOPE, WE EMPLOY PHYSICIANS/PRACTITIONERS 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 PHYSICIAN/PRACTITIONER PRACTICES DUE TO LOW VOLUMES IN THE ER RESULTING IN LOW REVENUES, BUT HIGH EXPENSES FROM HAVING TO STAFF A PHYSICIAN/PRACTITIONER 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 10 TO THE CONSOLIDATED FINANCIAL STATEMENTS DISCUSSES IMPLICIT PRICE CONCESSIONS ON PAGES 18, 19, AND 20. 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 CEO 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 192942 3463 8545 204950 ZOE FUGERE FNP 187719 3581 8545 199845 FORM 990, PAGE 1, PART I, LINE 6 THE VOLUNTEERS ARE BOARD MEMBERS, MINISTERS AND INDIVIDUALS/GROUPS COMING IN TO HOST THE SOCIAL HOURS AND ACTIVITIES. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS REVIEWED BY THE CEO, 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 CEO'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 CEO 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 0 141,870 0 ADMIN PURCHASED SERVICES 0 46,520 0 CLINIC PROF FEES 104,375 0 0 DIETARY PURCHASED SERVICES 383,474 80,499 0 LAB PROF FEES 54,850 0 0 LAB PURCHASED SERVICES 76,308 0 0 MAINT PURCHASED SERVICES 7,870 1,898 27 MEDICAL & SURGICAL PROF FEES 373,815 0 0 MEDICAL & SURGICAL PURCH SVCS 8,164 0 0 MEDICAL RECORDS PURCH SVCS 0 360 0 PT PURCHASED SERVICES 85,314 0 0 AMBULANCE PURCHASED SERVICES 2,022 0 0 RADIOLOLGY PURCHASED SERVICES 86,114 0 0 SWING BED PROF FEES 800,283 0 0 SPEECH THERAPY PURCHASED SVCS 18,303 0 0 RADIOLOGY PROF FEES 279,860 0 0 PHARMACY PURCHASED SVCS 80,821 0 0 CLINIC PURCHASED SERVICES 9,795 0 0 ER PURCHASED SERVICES 129 0 0 ADMIN COLLECTION FEE 0 1,399 0 INFO SYSTEMS-PURCHASED SVCS 4,947 1,438 57 TELEMEDICINE-PURCHASED SVCS 2,520 0 0 TOTAL 2,378,964 273,984 84 FORM 990, PART XI, LINE 9 CHANGE IN VALUE OF INTEREST IN TRUST 46,740 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 42495 SUPPORT ROOSEVELT MEMORIAL HEALTHCARE FOUND O 45918 PAYROLL ROOSEVELT MEMORIAL HEALTHCARE FOUND N 3690 OCCUPANCY