2023-11-15T10:48:16-06:00 2022-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2022-01-01 474717998 Bozeman Health Deaconess Hospital BOZE 4064145000 915 Highland Blvd Bozeman MT 59715 Brad Ludford CFO 4064145000 2023-11-14 1 Brad Ludford 999009999 1 Kim Hunwardsen CPA P00484560 6122536500 2023-11-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Bozeman Health Deaconess Regional Medical Center Brad Ludford 915 Highland Blvd Bozeman MT 59715 732195486 0 X www.bozemanhealth.org X 2015 MT To improve community health and quality of life for residents and visitors of Southwest Montana. 3 2 2352 225 3705230 0 4409397 3488899 416594505 409810088 38302032 -12016024 809489 872084 460115423 402155047 285000 0 0 0 107996468 121579825 0 0 0 309378933 315721199 417660401 437301024 42455022 -35145977 645516596 553038616 252930007 219952977 392586589 333085639 X To improve community health and quality of life. 0 0 132238039 116396986 The Bozeman Health Deaconess Hospital clinics consists of our departments that provide physician services to outpatients. We served 215,842 appointments in 2022 throughout our ambulatory clinic setting, just over 591/day. About 54% of our service revenue in these clinics is from the Medicare and Medicaid population. Total net operating revenues were $116,396,986 with associated operating expenses of $132,238,039. The loss of $15,841,053 is reflective of our commitment to provide access to all patients regardless of their ability to pay. 36542153 134549179 Bozeman Health Deaconess Hospital's Surgical Services strives to offer a wide array of surgical options using state of the art technology. In 2022, we performed 6,684 inpatient and outpatient surgeries. Making up 52% ($69,410,572) of total revenue from these services ($134,549,179), were Medicare and Medicaid patients. Nearly 46% of total revenues was written off ($61,843,733). Our surgical services also recorded $36,542,153 in operating expenses plus another $1,383,411 of indirect overhead. 16405701 57085402 The Emergency Room at Bozeman Health Deaconess Hospital is one of the busiest departments in our organization, with just under 37,000 visits in 2022. Making up 46% ($26,377,637) of total revenue from these services ($57,085,402), were Medicare and Medicaid patients. 45% of total revenues was written off ($25,637,151). Direct and indirect expenses incurred in supporting the operation of this emergency room accumulated to $16,405,701. 193403024 99913860 Bozeman Health Deaconess Hospital operates a 125 bed hospital facility (Hospital), along with a 45 unit assisted living home and a 113 unit independent living home (Hillcrest Senior Living or HSL). All patient and resident service revenue from these operations are used to provide health care services, health care promotion, and health care education to Bozeman and the surrounding communities. 193403024 99913860 378588917 1 1 0 0 0 0 0 0 1 1 1 1 0 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 37 0 1 2352 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 3 2 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X Carrie Morasko 4064141036 915 Highland Blvd Bozeman MT 59715 Katie Daughenbaugh Chair (Jan-Jun) 1.00 1.00 X X 0 0 0 John How Chair starting July 1.00 1.00 X X 0 0 0 Kerri Brown - Treasurer (Jan-Jun)/Vice Chair starting July 1.00 1.00 X X 0 0 0 Kathryn Bertany - Pres of Hosps(Jan-Oct)/Interim CEO(Nov start) 30.00 20.00 X X 0 611024 90626 John Hill Director & CEO (Jan-Oct) 30.00 20.00 X X 0 877924 103626 Dane Sobek Director (Jan-Jun)/Cardiologist 1.00 50.00 X 0 734469 49928 Jerry Cashman Director (Jan-Jun) 1.00 1.00 X 0 0 0 Kerry Petitt Director (Jan-Jun) 1.00 1.00 X 0 0 0 Walt Sales Director (Jan-Jun) 1.00 1.00 X 0 0 0 Brad Ludford CFO 30.00 20.00 X 0 463552 77854 Darci Bentson CAO 30.00 20.00 X 0 428215 73708 Mark Williams Chief Physician Officer 30.00 20.00 X 0 583751 81438 Diane Patterson Chief Nursing Officer 30.00 20.00 X 0 343095 75903 Tamara Havenhill-Jacobs Chief Information Officer 30.00 20.00 X 0 381950 69899 Edie Willey Chief People Officer 30.00 20.00 X 0 317422 64016 Kallie Kujawa Chief Clinical Transformation Officer 30.00 20.00 X 0 282222 69280 Denise Juneau Chief Government & Community Affairs Officer 30.00 20.00 X 0 302889 35670 Mike Bertagnolli Pharmacy System Manager 50.00 0.00 X 225533 0 21827 Brenda Greenfield Nurse 50.00 0.00 X 215787 0 36209 Alan Brayton Pharmacy Supervisor 50.00 0.00 X 192699 0 43220 Chris Pruitt Nurse 50.00 0.00 X 189393 0 21134 Tim Lolatte System Director of Supply Chain 50.00 0.00 X 176664 0 12888 1000076 5326513 927226 147 0 1 0 Trimedx Holdings LLC 5451 Lakeview Pkwy S Drive Indianapolis IN 46268 Equipment servicing 2053586 1 2044448 1444451 3488899 Net Patient Revenue 621110 395441386 395441386 Pharmacy Revenue 456110 6225646 3361849 2863797 Cafeteria Revenue 900099 1224271 1224271 6918785 6077352 841433 409810088 2435317 2435317 1341398 469314 872084 872084 872084 314922126 197658 329403265 167860 -14481139 29798 -14451341 -14451341 402155047 406104858 3705230 -11143940 X 96471499 88468933 8002566 3538580 3234329 304251 14039206 12832100 1207106 7530540 6883056 647484 331942 331942 47799140 35822889 11976251 270187 240459 29728 3789572 1538813 2250759 3529982 626845 2903137 258534 254559 3975 172356 169706 2650 5826127 5826127 15806391 15806391 909413 620179 289234 Medical Supplies 88943185 88879289 63896 Health System Shared Se 77313681 56750255 20563426 Health System Physician 59193545 56655749 2537796 Equipment Rental and Ma 5836136 3529422 2306714 5741008 449816 5291192 437301024 378588917 58712107 0 2009139 8164400 83287632 81240175 125000 102819 12242322 11286279 3382011 3089226 407791387 208401384 194097860 199390003 241868011 101204504 3025977 70532025 1481525 1332819 716035 613744 103281084 76082622 645516596 553038616 36152152 25782536 1129830 1035336 182019419 143983833 6923360 7786771 35266592 26705246 6097909 252930007 219952977 X 373305911 315894958 19280678 17190681 392586589 333085639 645516596 553038616 X -35145977 -19724015 -4630958 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 24534132 68899 -3372760 558203 20672068 20745993 973493 3399161 584515 24534132 18430208 41677 2623596 349488 20745993 16272305 227769 3135666 1205532 18430208 16828400 335927 -723008 169014 16272305 0.63540 0.19020 0.17440 0 1 1 5499464 2972690 8472154 273087423 128289411 144798012 107094275 75493266 31601009 19137535 4618707 14518828 199390003 Private Equity Funds 3114412 F LLCs 37544372 F Investment Trusts 19653895 F Hedge Funds 10219346 F 70532025 Investment in Foundation 20338318 Due from Affiliates 49996394 Operating Lease ROU Assets 5747910 76082622 Estimated Payments to Third Party Payors 350000 Operating Lease 5747909 6097909 X Part IV, Line 2b: The organization holds resident funds on behalf of its residents, as well as security deposits. Part V, Line 4: Each endowment fund is privy to a separate agreement. Donations made for each purpose shall be received, held, and invested by Bozeman Deaconess Foundation according to established policies governing gift acceptance, investment, and distribution. The principal of the fund shall be retained in perpetuity. The interest income is utilized for the greatest needs of the designated department. Policy says the organization can use a portion of interest for operations. The endowment fund reported in Line 1 is currently being held by a related organization, Bozeman Deaconess Foundation, and benefits Bozeman Health and related system entities listed on Schedule R. Due to this relationship the endowment fund is being reported all the Form 990, Schedule D, Part V for all three related entities. Part X, Line 2: The Organization believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Central America and the Caribbean 0 0 Investment 995567 0 0 0 0 0 0 995567 0 995567 1 0 1 1 0 0 Part III Accounting Method: Schedule F, Part IV: The Bozeman Health Deaconess Hospital reviews its direct and indirect investments during the tax period for determining required foreign filings. The Bozeman Health Deaconess Hospital makes direct and indirect transfers to a foreign corporation. The Bozeman Health Deaconess Hospital would file Form 926 if the transfers met the requirements for filing. The Bozeman Health Deaconess Hospital's transfers to foreign corporations did require filing Form 926. The Bozeman Health Deaconess Hospital has ownership interests in a foreign corporation. The Bozeman Health Deaconess Hospital would file Form 5471 if the ownership met the requirements for filing. The Bozeman Health Deaconess Hospital's ownership in foreign corporations did not require filing Form 5471. The Bozeman Health Deaconess Hospital invests in a corporation that holds direct or indirect interests in passive foreign investment companies (PFICs). The Bozeman Health Deaconess Hospital would file Form 8621s for underlying investments that generate unrelated business income. The Bozeman Health Deaconess Hospital would not file Form 8621s where the investment partnerships have properly filed Form 8621s, or where the underlying investments did not generate any unrelated business income. The Bozeman Health Deaconess Hospital did not require filing Form 8621. 1 1 X 1 X 1 X 1 1 1 0 0 9313534 3528159 5785375 0.01320 46840609 40322352 6518257 0.01490 56154143 43850511 12303632 0.02810 9525 9525 0.00000 968 968 0.00000 78037332 55402249 22635083 0.05180 135426 135426 0.00030 78183251 55402249 22781002 0.05210 134337394 99252760 35084634 0.08020 1 9761157 0 66234732 80223766 -13989034 X 1 1 1 1 Bozeman Health Deaconess Hospital 915 Highland Blvd Bozeman MT 59715 www.bozemanhealth.org 12933 X X X Bozeman Health Deaconess Hospital 1 0 0 1 X X X X X X X X X 20 1 1 1 1 X https://www.bozemanhealth.org/chna/ X 1 20 1 https://www.bozemanhealth.org/chna/ 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X X 1 X 0 X X X X 1 X 0 1 Bozeman Health Deaconess Hospital Part V, Section B, Line 5: To solicit input from key informants, those individuals who have a broad interest in the health of the community, an Online Key Informant Survey (OKIS) was implemented as part of the CHNA process. The list for this survey included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. In total, 166 individuals responded to the OKIS in the spring of 2020 from the following organizations, many of which work directly with low-income, minority, or other medically underserved populations:Absaroka Emergency Physicians, Adult Protective Services, Montana, Alcohol and Drug Services of Gallatin County, ASPEN, Belgrade Community Library, Belgrade School District 44, Belgrade Senior Center, Big Sky Community Organization, Big Sky Fire Department, Big Sky Resort, Big Sky School District 72, Big Sky Youth Empowerment, Bozeman Area Chamber of Commerce, Bozeman Health, Bozeman Job Service, Montana, Bozeman Open & Local Coalition, Bozeman School District 7, Bozeman Symphony, Bridger Ski Foundation and Apollo, Bridgercare, Cancer Support Community, Cashman Nursery, Child Care Connections, City of Belgrade, Community Coalition On Drug Awareness (C-CODA), Community Health Partners, Congregation Beth Shalom, Conoco, Big Sky, Cottonwood Elementary School District, County Superintendent of Schools, EBP Concepts, Family Outreach, Bozeman, First Choice Home Health, First Interstate Bank, Forward Montana, Frontier Home Health and Hospice, Gallatin College, Gallatin County Commissioner, Gallatin County Sheriff's Department, Gallatin County Victim Services, Gallatin Gateway Elementary School District, Gallatin Mental Health Center, Gallatin Valley Farm to School, Gallatin Valley Land Trust, Gallatin Valley YMCA, Gallatin-County Health Department, Gender Equality Montana, Greater Gallatin Homeless Action Coalition (GGHAC), Greater Gallatin United Way, Harrison Public School District, HAVEN, Help Center 211, The Human Resource Development Council (HRDC), Intermountain Healthcare, Kasting, Kauffman & Mersen, PC, KLJ Solutions, L'esprit Mental Health, Lamotte Elementary School District, LINKS for Learning, Living Hope Church, Livingston Fire and Rescue, Livingston Food Resource Center, Livingston Healthcare, Livingston Police Department, Livingston Public Schools, Madison County Commissioner, Madison County Public Health Department , Mammoth Clinic at Yellowstone, Manhattan School District, Montana Health Care Foundation, Montana Immigrant Justice Alliance (MIJA), Montana Office of Public Assistance, Montana State University (MSU), Office of the State Public Defender, Montana , Pacific Ventures Management, Park County Government, Park County Health Department, Park County Office of Emergency Management, Park County Senior Citizens Corporation, Printing for Less, Montana , Reach Inc., RM Properties, Route Finder Consulting, Schmieding Dental Group, Sheridan School District, Shields Valley School District, Southwest Chemical Dependency Program (SWCDP), Spring Creek Inn, Three Forks School District, Thrive, Town of West Yellowstone, West Paw, West Yellowstone Schools, Western Montana Mental Health, Women in Action, Yellowstone Club, Youth Court Services/Probation, Youth Dynamics. Bozeman Health Deaconess Hospital Part V, Section B, Line 6a: Big Sky Medical Center and Livingston Healthcare Bozeman Health Deaconess Hospital Part V, Section B, Line 6b: Community Health Partners (CHP)Gallatin City-County Health DepartmentPark County Health Department Bozeman Health Deaconess Hospital Part V, Section B, Line 11: We conducted a CHNA in 2020, which will guide our implementation strategy for 2021-2023. The needs identified and adopted by BHDH are:-Behavioral Health (includes mental health and substance abuse)-Access to Healthcare Services-Nutrition & Physical Activity -Injury & ViolenceWe are addressing all needs identified by the CHNA, but we did shift our strategies for Access to Healthcare. We were providing free preventative health services through the HealthCare Connections mobile screening program through July 13, 2022; however, staffing required us to shift to meet this need via coordinating with the Gallatin County Health Department Cancer Screening Program and providing free vouchers via the Mammogram Project and discounted lab vouchers for personalized bloodwork. Additionally, we shifted our strategy from hosting and sharing a podcast called All Things Health (through October 20, 2022) with limited engagement, to Engaging in Service Coordination with the Housing First Village and developing a Medical Respite program, as a means of improving Access to Healthcare for houseless populations. We also shifted our focus from the 5210+ Gallatin County to an emerging steering called Health in All Policies, as one strategy to address nutrition and physical activity in our design of parks and trails for physical activity.In the current year the facility has taken the following actions:Behavioral Health: 1) Implemented Youth Aware of Mental Health (YAM) programming in high schools and middle schools and 2) Championed and disseminated community-wide awareness and stigma reduction efforts via the Are You In? campaign and 988 posters promoting mental health crisis support. We also provided grants to local nonprofits focused on mindfulness programing in schools.Access to Healthcare: 1a) Provided free preventative health services through the HealthCare Connections mobile screening program through July 13, 2022. 1b) Coordinated with the Gallatin County Health Department Cancer Screening Program and provided free vouchers via the Mammogram Project and discounted lab vouchers for personalized bloodwork. 2a) Hosted and shared the Bozeman Health podcast, All Things Health through October 20, 2022. 2b) Engaged in and provided grants for Service Coordination with the Housing First Village and capital campaign investments and program development for a Medical Respite program, as a means of improving Access to Healthcare for houseless populations. We also provided grants to nonprofits working on service coordination for Spanish speaking students in schools and Spanish speaking adults via health fairs. We provided a grant to host events where our doctors visit with Headstart parents to discuss access to healthcare and how to proactively address respiratory issues in children during cold and flu season. We also invested in a capital campaign for a nearby rural fire department with a rescue squad that transports patients to our emergency department.Nutrition & Physical Activity: 1) Convened and supported the 5210+ Gallatin County Coalition or support the Health in All Policies steering committee. 2) Supported GoNoodle access for schools in Park, Madison, and Gallatin Counties. We also provided grants to nonprofits focused on physical activities on land trust trails, a cross country ski event, a learning garden for preschool students, afterschool programs with healthy snacks, and a capital campaign for a teaching kitchen at a local public library.Injury & Violence Prevention: 1) Provided "Stepping On" fall prevention trainings. 2) Promoted the "Stop the Bleed" campaign. Another grant focused on Stop the Bleed kits via a high school Future Health Professionals student club.3) Hosted community events to raise awareness, reduce stigma, provide resources, and promote domestic violence prevention, which was completed in 2022 via a capital campaign to build intake rooms in our new domestic violence shelter and raising awareness in community organizations via a training on Violence Against Women Act and U Visa policies for women experiencing intimate partner violence and immigrants who have been victims of crime. We also provided a grant to a nonprofit focused on prevention programing for teen mothers with infants, as well as a bicycle rodeo focused on child safety and safe touch. Additionally, we invested in a housing coalition to conduct strategic planning for affordable housing in our region which can prevent exposure related deaths tied to houselessness. Bozeman Health Deaconess Hospital Part V, Section B, Line 13h: Any individual and their dependents who are at 200% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. In addition, Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but the parient must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Bozeman Health Deaconess Hospital Part V, Section B, Line 16j: Medical Advocacy Services in Healthcare (MASH) will give out our financial application after determining a patient is ineligible for federal and state programs.A summary of the financial assistance policy is attached to billing invoices, posted in the patient admissions area, and provided to patients upon admission to the hospital facility. Bozeman Health Deaconess Hospital Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be billed gross charges on elective procedures. Schedule H, Part V, Section B, Line 16a-16c: https://www.bozemanhealth.org/patients-and-visitors/patient-financial-services/financial-assistance/ 3 1 - Hillcrest Senior Living 1201 Highland Blvd Bozeman MT 59715 Independent and assisted living facility 2 - Bozeman Health Belgrade Clinic 206 Alaska Frontage Rd Belgrade MT 59714 Ambulatory healthcare services 3 - Bozeman Health Clinical Research 950 Stoneridge Dr 1 Bozeman MT 59715 Outpatient healthcare research Part I, Line 3c: Any individual and their dependents who are at 200% of the Federal Poverty income level or below will be eligible to receive a 100% write-off of the self-pay portion of incurred charges, upon completion of an application. Completion of the Financial Assistance application will be required. In addition, Catastrophic Financial Assistance is available to individuals who have a large balance remaining after all third party payments have been taken into account. The balance under consideration is that amount which is deemed to be the patient's financial responsibility. If such responsibility is greater than 50% of the family's annual household income, the excess amount will be treated as Catastrophic Financial Assistance and written off of the patient's account. This assistance is available without respect to the FPG, but the patient must follow the same process as all other patients seeking financial assistance based upon FPG. Asset tests are not used for determining any level of financial assistance. Prior to providing services, BH will make an effort to notify the patient regarding their eligibility for financial assistance. Part I, Line 7: The cost to charge ratio from Worksheet 2 was used to obtain the costs related to Charity Care, Medicaid, and Other Means-Tested Programs. All net benefit expenses were calculated using direct costs and revenue with reasonable indirect overhead allocation methods. Benefits are allocated at 23% of payroll dollars. For Subsidized Services, other indirect overhead costs are allocated based on historical reasonableness of 15% of total expenses. Our internal system does record patient revenues based on type (inpatient vs. outpatient vs. emergency) and payor (Medicaid, Medicare, Commercial, Self-Pay, etc.). Related costs are then determined based on the pro-rated share as a percentage of the total. For example, if Medicaid comprises 7% of a department's revenue, Medicaid expenses are calculated at 7% of the total as well.Lines 7e, 7f, 7i are based on actual expenses. Part I, Line 7g: Amount of cost attributable to a physician clinic is $78,037,332. All costs associated with a provider-based clinic operational department were considered part of this total. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. Part III, Line 4: The footnote to the organization's financial statements that describes implicit price concessions is located in Footnote 1 on pages 16-17 of the attached financial statements. Part III, Line 8: The entire amount of shortfall should be considered a community benefit.The Medicare shortfall represents costs absorbed by the Hospital as a result of providing care to Medicare patients. The contract driving this loss is a nondiscretionary contract, as is providing the services to this population of individuals. The cost of providing this benefit to the community should be reportable as such.Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: Providing the patient, either directly or through its contracted collection agency with at least one written notice informing the patient about the Extraordinary Collection Actions that we intend to 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 include a copy of the plain language summary and will not be mailed or delivered to a patient earlier than 30 days prior to the end of the Notification Period.No Extraordinary Collection Actions will be undertaken during the 120 day Notification Period, during which time we will take reasonable efforts to determine whether the patient is eligible for Financial Assistance. Patients that may qualify for financial assistance, and that have accounts with the contracted collection agencies, will be vetted throughout the financial assistance process. Meanwhile, accounts will be placed on hold until the financial assistance eligibility is determined. If the patient is eligible, accounts will be appropriately adjusted and adjusted amounts will be reported to the collection agency.No Extraordinary Collection Actions are taken prior to the 240th day after the date of the first invoice. Part VI, Line 2: In addition to the CHNA, Bozeman Health Deaconess Hospital (BHDH) assesses community health care needs in a number of ways. We look at other available health data and reports for our service area provided by the State of Montana and our local City-County Health Department. We also work closely with area non-profits and social service providers to hear about the needs of their clients / customers to help inform our outreach strategies and community health improvement efforts. Part VI, Line 3: Bozeman Health Deaconess Hospital (BHDH) is deeply committed to providing financial assistance to patients needing, but unable to afford, medically necessary health care services. BHDH posts notice of its Financial Assistance Policy in all admitting areas, as well as on the website. At the earliest feasible time, BHDH will attempt to determine whether a patient has third party coverage for any part of the hospital services provided. If a patient does not have third party coverage, a patient advocate from the Medical Advocacy Services in Healthcare (MASH) program will screen all inpatient cases and any outpatient cases exceeding $1,000 in total charges to determine if the patient qualifies for third party funding. If not, the patient advocate will explain the Financial Assistance Policy and give the patient an application if desired. In circumstances where payment in full will cause financial hardship that will significantly harm the patient or patient's family, the applicant may be asked to visit with Consumer Credit Counseling Services to further review their financial situations. Upon request, patients may be asked to complete an application for Medicaid participation or for coverage by other governmental payment programs. Patient bills also contain billing information explaining financial options and provide contact information to the appropriate resources. Part VI, Line 4: Bozeman Health Deaconess Hospital (BHDH) primarily serves Gallatin, Park, and Madison Counties. 84.6% of 2018 inpatient admissions were of patients originating from these three counties (Gallatin: 77.28%, Park 4.68%, and Madison 3.67%). The population of the tri-county region was an estimated 133,274 in 2018 (IBM Watson Health). Bozeman (in Gallatin County) was listed in the 2017 ACS as a Micropolitan area whereas Belgrade (Gallatin County), Four Corners (Gallatin County), and Livingston (Park County) were listed as Urban Clusters in the 2010 Census. As of 2017, 12.9% of the population was below the poverty level in the tri-county region-ranging from 13.4% in Park County, 13.0% in Gallatin County, and 10.6% in Madison (2017 ACS 5yr estimates). Median household income was an estimated $59,397 in Gallatin County followed by Madison ($47,900) and Park ($44,920) (2017 ACS 5 Year Estimates). Estimates suggest that about 13.4% of residents in the tri-county area were insured by Medicaid, roughly 14.1% were insured by Medicare, and about 6.67% were uninsured in 2018 (IBM Watson Health, 2018). About 17.3% of BHDH inpatients were insured under Medicaid in 2018.BHDH's tri-county service area houses five hospitals-of which, three are critical access hospitals (CAH): Bozeman Health Deaconess Hospital (Bozeman, MT), Bozeman Health Big Sky Medical Center (Big Sky, MT), Livingston HealthCare-CAH (Livingston, MT), Madison Valley Medical Center-CAH (Ennis, MT), and Ruby Valley Hospital-CAH (Sheridan, MT).As listed on the MT DPPHS webpage, low income populations in Gallatin and Park Counties and total geographic populations in Madison County are designated Mental Health Care Health Professional Shortage Areas (HPSAs). Additionally, low income populations in Gallatin, Park, and Madison Counties are designated Primary Care HPSAs as of 2019. (https://dphhs.mt.gov/publichealth/primarycare/-shortage-area-designations) Part VI, Line 5: The governing body of BHDH is comprised of individuals who represent our community and live in our service area; a majority of whom are independent of the organization. To ensure immediate access to care, BHDH has an open medical staff and requires each medical staff member to care for anyone presenting in the Emergency Department. As an organization, we devote a significant amount of funds into maintaining and advancing high-level, innovative, and responsive patient care. This includes recent investments in expanding integrated behavioral health, access to telepsychiatry, and embedding crisis response in our facility. We also use surplus funds, among other ways, to support medical and nursing students at our facility. Part VI, Line 6: Bozeman Health Deaconess Hospital is a nonprofit public benefit corporation with a sole corporate member, Bozeman Deaconess Health Services d/b/a Bozeman Health. X X X 0 1 0 0 0 0 0 0 0 John Hill Director & CEO (Jan-Oct) 0 685269 0 174858 0 17797 0 75959 0 28831 0 982714 0 0 Dane Sobek Director (Jan-Jun)/Cardiologist 0 680641 0 53000 0 828 0 18300 0 32387 0 785156 0 0 Kathryn Bertany - Pres of Hosps(Jan-Oct)/Interim CEO(Nov start 0 524119 0 82663 0 4242 0 64820 0 26700 0 702544 0 0 Mark Williams Chief Physician Officer 0 487081 0 87892 0 8778 0 67530 0 14802 0 666083 0 0 Brad Ludford CFO 0 394386 0 64924 0 4242 0 44976 0 33772 0 542300 0 0 Darci Bentson CAO 0 362701 0 62352 0 3162 0 40380 0 34222 0 502817 0 0 Tamara Havenhill-Jacobs Chief Information Officer 0 315000 0 63788 0 3162 0 43489 0 27305 0 452744 0 0 Diane Patterson Chief Nursing Officer 0 300560 0 38293 0 4242 0 46126 0 30671 0 419892 0 0 Edie Willey Chief People Officer 0 276506 0 38187 0 2729 0 42282 0 22627 0 382331 0 0 Kallie Kujawa Chief Clinical Transformation Office 0 247773 0 10882 0 23567 0 37096 0 32862 0 352180 0 0 Denise Juneau Chief Government & Community Affairs 0 269173 0 30000 0 3716 0 23868 0 12528 0 339285 0 0 Brenda Greenfield Nurse 89204 0 0 0 126583 0 13490 0 23004 0 252281 0 0 0 Mike Bertagnolli Pharmacy System Manager 111775 0 7957 0 105801 0 0 0 22207 0 247740 0 0 0 Alan Brayton Pharmacy Supervisor 170803 0 1636 0 20260 0 13313 0 30456 0 236468 0 0 0 Chris Pruitt Nurse 186052 0 0 0 3341 0 11468 0 9959 0 210820 0 0 0 Tim Lolatte System Director of Supply Chain 95244 0 11958 0 69462 0 0 0 13203 0 189867 0 0 0 Part I, Line 3 The CEO is paid by Bozeman Deaconess Health Services (BDHS), a related organization. The BDHS Board of Directors uses the methods selected in Line 3 to determine the CEO compensation. The Board of Directors of the filing organization also serves on the BDHS Board of Directors. Part I, Line 4b Line 4b: Schedule J, Part II, column (c) reflects contributions paid by the organization into their individual 457(f) plan. The following contributions were made in 2022. John Hill: $63,845 Brad Ludford: $26,676 Darci Bentson: $22,080 Kathryn Bertany: $46,520 Mark Williams: $49,230 Diane Patterson: $27,826 Tamara Havenhill-Jacobs: $25,189 Edie Willey: $23,982 Kallie Kujawa: $18,796 Denise Juneau: $23,868 A Montana Facility Finance Authority 364615155 000000000 2015-09-10 19522471 Refinance 2005 bond 0 0 0 B Montana Facility Finance Authority 364615155 61204MDA2 2018-04-24 74139881 Master Facility Plan, Lawson, DaVinci Surgical Robot 0 0 0 C Montana Facility Finance Authority 364615155 000000000 2021-07-14 64096782 Retire 2011, 2015A, and 2015B debt, various capital projects 0 0 0 A 6909645 19522471 243567 19278904 2015 1 0 1 1 B 5653870 76462824 2322943 808710 73332463 2020 0 0 1 1 C 360089 64169361 6582 258872 3926610 31834484 28711933 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 0 0 0 0 0 1 A 1 B 1 C 1 Date Rebate Computation Performed Issuer Name: Montana Facility Finance Authority Date the Rebate Computation was Performed: 11/28/2022 Schedule K, Part I, Line A(e) Bond A and C: 2015 Series C and 2021 Series C Part I issue price and Part II Line 3 bond proceeds differ due to interest earned on the proceeds. Schedule K, Part VI, Line 2c, Bond B: As of the date of the arbitrage computation, there were no remaining proceeds of the 2018 Bonds. Therefore, future arbitrage calculations are not required. Form 990, Part VI, Section A, line 6 Bozeman Deaconess Health Services, dba Bozeman Health, is the sole member of the organization. Form 990, Part VI, Section A, line 7a Bozeman Deaconess Health Services, dba Bozeman Health, is the sole member of BHDH. Bozeman Health appoints the board members. The Bozeman Health Board Chair, Vice Chair and CEO serve as the board members of BHDH. The Yellowstone Conference of the Methodist Church confirms the Board Members for Bozeman Health and has authority to appoint the clergy member of the board. Form 990, Part VI, Section A, line 7b Bozeman Health has the authority over the following items: 1) approval of mission, vision and values 2) approval of the strategic plans 3) adoption of annual capital and operating budgets 4) oversight of financial operations, including the consolidated audit 5) incurrance of any long-term debt 6) establishment of policies specifying the level of internal authority 7) approval of annual quality plan and aoption of policies and procedures regarding healthcare services and law and regulation 8) appointment and removal of board members and officers 9) approval of any affiliations, mergers, and dissolutions 10) approval of closures of medical staffs and services 11) approval of any amendment of the Articles or Bylaws Due to Bozeman Health governing documents any changes in the Articles of Incorporation in relationship to the process of selecting board membership must be approved by the Yellowstone Conference of the United Methodist Church. Form 990, Part VI, Section A, line 8b The organization does not have any committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Health Systems Planning and Finance Committee will review the Form 990 with the Finance Team and will make a recommendation to the full Board for acceptance. A copy of the 990 is provided to the Board of Directors prior to filing. Form 990, Part VI, Section B, line 12c An Annual Disclosure Statement is obtained from the Board, Operating Committee, and Executive Team Members. Disclosures are reviewed with the Conflict of Interest (COI) Panel (Compliance Officer, Board Compliance Committee Chair, Chief Executive Officer, & Chief Legal Officer). The COI Panel assesses the disclosure, develops an acknowledgement and management plan. The management plan is reviewed with the affected member, if the COI Panel and the member are unable to resolve the disclosure, the disclosure is reported to the Board Compliance Committee for further review. Conflicts are addressed annually in writing and verbally during meetings. If a COI exists, the member shall not participate in any deliberations or vote regarding the transaction or arrangement at issues, and shall not be present in the meeting room for any part of the deliberations or vote relating to the transaction or arrangement. Form 990, Part VI, Section B, line 15 The Board Executive Committee, which is comprised of independent board members, serves as the organization's compensation committee. The Executive Committee receives a formal presentation by an independent compensation consultant (as selected by the Committee) qualified to perform compensation reviews including usage of comparability data. This person presents recommendations to the Executive Committee. The Executive Committee then makes decisions annually regarding compensation for Officers and Senior Administration. The Executive Committee's compensation review process is outlined in an Executive Compensation Philosophy Policy that was adopted by the full Board. Form 990, Part VI, Section C, line 19 Tax documents required to be available for public inspection are available upon request. The audited financial statements are required to be attached to the Form 990 and provided to the Municipal Securities Rulemaking Board, which is our tax-exempt bonds trustee, via an on-line, central filing location called Electronic Municipal Market Access (EMMA). The financial statements can be obtained by the general public at the EMMA website. Form 990, Part IX, line 11g Other Fees: Program service expenses 35,822,889. Management and general expenses 11,976,251. Fundraising expenses 0. Total expenses 47,799,140. Form 990, Part XI, line 9: Transfer of Net Assets to Related Party -676,300. Change Investment of Foundation -3,954,658. Rocky Mountain Real Estate Holdings LLC 915 Highland Blvd Bozeman MT 59715 851058455 Property Acquisition MT 0 5549570 Bozeman Health Deaconess Hospital Rocky Mountain Real Estate Manager LLC 915 Highland Blvd Bozeman MT 59715 851033814 Property Management MT 0 0 Bozeman Health Deaconess Hospital Bozeman Deaconess Health Services (dba Bozeman Health) 915 Highland Blvd Bozeman MT 59715 810232121 Hospital and Healthcare Services MT 501(c)(3) Line 3 N/A 0 Bozeman Deaconess Foundation dba Bozeman Health Foundation 931 Highland Blvd Suite 3200 Bozeman MT 59715 841407943 Raise Funds to Support Bozeman Deaconess Health Services MT 501(c)(3) Line 7 Bozeman Deaconess Health Services 0 Deaconess Intercity Imagining LLC 915 Highland Blvd Bozeman MT 59715 810666871 Healthcare - Imaging Services MT N/A 0 0 Rocky Mountain Surgical Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 364462300 Healthcare - Surgical Services MT N/A 0 0 Spanish Peaks Plaza LLC 120 N 19th Ave Suite A Bozeman MT 59718 810539803 Rental Real Estate for VA Med Clinic & Chiro MT N/A 0 0 Bozeman HealthUSP Surgery Centers LLC 14201 Dallas Parkway Dallas TX 75254 823991148 Ambulatory Surgery Center TX N/A 0 0 Bozeman Deaconess Real Estate Development PO Box 10490 Bozeman MT 59719 205496567 Sale of Real Estate Property and Residences to Seniors MT N/A C 0 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 0 1 1 0