2024-10-25T15:21:53-05:00 2023-12-31 450250958 Eide Bailly LLP 4585 Coleman St Ste 200 Bismarck ND 58503 990 2023-01-01 474717998 Bozeman Health Deaconess Hospital BOZE 4064145000 915 Highland Blvd Bozeman MT 59715 Brad Ludford CFO 4064145000 2024-10-25 1 1 Lisa Chaffee CPA P00193453 7012551091 2024-10-25 2023 2024-10-15 13:58:12Z Bozeman Health Deaconess Regional Medical Center Brad Ludford 915 Highland Blvd Bozeman MT 59715 466303870 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 132 3730618 0 3488899 3574272 409810088 439285480 -12016024 2687735 872084 855609 402155047 446403096 0 0 0 0 121579825 128417765 0 0 0 315721199 322269226 437301024 450686991 -35145977 -4283895 553038616 571127909 219952977 224094392 333085639 347033517 X To improve community health and quality of life. 0 0 134091744 116528303 The Bozeman Health Deaconess Hospital clinics consists of our departments that provide physician services to outpatients. We served 200,741 appointments in 2023 throughout our ambulatory clinic setting, just over 550/day. About 54% of our service revenue in these clinics is from the Medicare and Medicaid population. Total net operating revenues were $116,528,303 with associated operating expenses of $134,091,744 plus another $31,076,390 of indirect overhead. The loss of $17,563,441 is reflective of our commitment to provide access to all patients regardless of their ability to pay. 36093268 165803950 Bozeman Health Deaconess Hospital's Surgical Services strives to offer a wide array of surgical options using state of the art technology. In 2023, we performed 6,406 inpatient and outpatient surgeries. Making up 55% ($91,181,348) of total revenue from these services ($165,803,950), were Medicare and Medicaid patients. Nearly 51.2% of total revenues was written off ($84,865,520). Our surgical services also recorded $34,637,598 in operating expenses plus another $1,455,670 of indirect overhead. 18609583 62133826 The Emergency Room at Bozeman Health Deaconess Hospital is one of the busiest departments in our organization, with just over 33,500 visits in 2023. Making up 46% ($28,484,571) of total revenue from these services ($62,133,826), were Medicare and Medicaid patients. 48.8% of total revenues was written off ($30,309,778). Direct and indirect expenses incurred in supporting the operation of this emergency room accumulated to $18,609,583. 198850794 91088783 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. 198850794 91088783 387645389 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 43 0 1 2352 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 3 2 0 0 1 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 John How Chair 1.00 1.00 X X 0 0 0 Kerri Brown Vice Chair (Jan-Jun) 1.00 1.00 X X 0 0 0 Jim Berend Vice Chair (as of Jul) 1.00 1.00 X X 0 0 0 Kathryn Bertany Director & CEO 30.00 20.00 X X 0 0 0 Brad Ludford CFO 30.00 20.00 X 0 399699 118580 Steve Klein Chief Legal Officer 30.00 20.00 X 0 314835 78598 Denise Juneau Chief Government & Community Affairs Officer 30.00 20.00 X 0 284214 58797 Kallie Kujawa Chief Operating Officer 30.00 20.00 X 0 282796 77020 Tamara Havenhill-Jacobs Chief Information Officer (Jan-May) 30.00 20.00 X 0 315429 13577 Kiera Pattison Chief Nursing Officer 30.00 20.00 X 0 336053 55333 Haily Cramer Nurse 50.00 0.00 X 207622 0 21715 Chris Pruitt Nurse 50.00 0.00 X 196160 0 23141 Alan Brayton System Manager of Pharmacy 50.00 0.00 X 180955 0 46051 Amanda Wolosyzn System Manager of Pharmacy 50.00 0.00 X 176429 0 20839 Jennifer Schultz System Director of Pharm. Services 50.00 0.00 X 188015 0 48205 John Hill Former CEO 0.00 0.00 X 0 822059 0 Darci Bentson Former CAO 0.00 0.00 X 0 388832 0 Edie Willey Former Chief People Officer 0.00 0.00 X 0 300358 0 Mark Williams Former Chief Physician Officer 0.00 1.00 X 0 128219 0 949181 3572494 561856 147 1 1 0 Trimedx Holdings LLC 5451 Lakeview Pkwy S Drive Indianapolis IN 46268 Equipment servicing 3764506 Mid-America Service Solutions LLC PO Box 15777 Lenexa KS 66285 Purchasing Contract Services 100448 2 3574272 3574272 Net Patient Revenue 621110 423229714 423229714 Pharmacy Revenue 456110 7749250 4018632 3730618 Cafeteria Revenue 900099 1236212 1236212 7070304 7070304 439285480 2724811 2724811 1272161 416552 855609 855609 855609 19445449 1697 19484222 0 -38773 1697 -37076 -37076 446403096 435554862 3730618 3543344 102739098 94654299 8084799 4402180 4044822 357358 13329067 12247047 1082020 7947420 7302269 645151 371925 371925 41844610 27616417 14228193 343687 328762 14925 4308563 1954030 2354533 3880921 634571 3246350 230891 229560 1331 153927 153040 887 5954386 5954386 15657111 15657111 658474 327985 330489 Medical Supplies 90460850 90346632 114218 Health System Shared Se 83855653 61552233 22303420 Health System Physician 63501631 61814488 1687143 Equipment Rental and Ma 4790517 2429272 2361245 6256080 398465 5857615 450686991 387645389 63041602 0 8164400 3048719 81240175 87922531 102819 66098 11286279 12004393 3089226 1077211 434913564 223686049 199390003 211227515 101204504 88447619 70532025 79004814 1332819 1678128 613744 511453 76082622 86139428 553038616 571127909 25782536 33437747 1035336 959773 143983833 141129451 7786771 7777863 35266592 35266592 6097909 5522966 219952977 224094392 X 315894958 330294550 17190681 16738967 333085639 347033517 553038616 571127909 X -4283895 20160483 -1928710 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 20672068 943397 3632532 369850 24878147 24534132 68899 -3372760 558203 20672068 20745993 973493 3399161 584515 24534132 18430208 41677 2623596 349488 20745993 16272305 227769 3135666 1205532 18430208 0.64350 0.15890 0.19760 0 1 1 5499464 2972690 8472154 293526242 136196955 157329287 118715697 82540238 36175459 14199471 4948856 9250615 211227515 Private Equity Funds 5342208 F LLCs 43965678 F Investment Trusts 17569220 F Hedge Funds 12127708 F 79004814 Investment in Foundation 19400852 Due from Affiliates 61571531 Operating Lease ROU Assets 5167045 86139428 Estimated Payments to Third Party Payors 350000 Operating Lease 5172966 5522966 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 4961736 0 0 0 0 0 0 4961736 0 4961736 1 0 1 1 0 0 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 6789624 3484737 3304887 0.00730 45825119 30920698 14904421 0.03310 52614743 34405435 18209308 0.04040 70753110 48191782 22561328 0.05010 222595 222595 0.00050 70975705 48191782 22783923 0.05060 123590448 82597217 40993231 0.09100 1 9580021 0 70117325 84336636 -14219311 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 23 1 1 0 1 X https://www.bozemanhealth.org/chna/ X 1 23 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: The 2023 CHNA focused on mailed surveys and focus groups. The Montana Office of Rural Health conducted the surveying for the 2023 CHNA and helped inform the questions and validate the data. A steering committee comprised of the Gallatin County Health Department, the local Federally Qualified Health Center (FGHC), and the local social service provider, Human Resource Development Council (HRDC), were all collaborated with when creating the survey questions and identifying potential focus group participants. 2,402 surveys were mailed out in a randomized approach to residents in the Bozeman Health service area in May 2023. Bozeman Health conducted 9 focus groups that targeted medically underserved, low-income, and minority populations from May to November, 2023. Planning for the CHNA began in April, and their surveys were mailed out in May, with final results from the Office of Rural Health given in November of 2023. Bozeman Health Deaconess Hospital Part V, Section B, Line 6a: Big Sky Medical Center Bozeman Health Deaconess Hospital Part V, Section B, Line 11: We conducted a CHNA in 2023, which guides our implementation strategy for 2024-2027. The needs identified and adopted by BHDH are:-Behavioral Health (includes mental health and substance abuse)-Access to Healthcare Services-Socioeconomic and Health Measures-Chronic Disease PreventionBozeman Health is addressing priority area needs identified by the CHNA either through direct services or via partnering with local organizations on programming to address the needs. There were needs that were identified but not selected as priority areas due to being indirectly impacted through other priority areas or due to focusing on needs that Bozeman Health is best able to leverage existing resources. Alzheimer's and Dementia was an identified need that is being indirectly addressed through our Geriatric Services and memory consults. Diabetes and heart disease is a need that falls indirectly under Chronic Disease Prevention. Maintaining a healthy weight was a final need that is not a priority area, however, also is indirectly affected through our chronic disease prevention strategies and through our Lifestyle Medicine services. Behavioral Health: 1) Championed and disseminated community-wide awareness and stigma reduction efforts via the Are You In? Campaign and 988 posters promoting mental health crisis support. 2) We were leaders on the Gallatin County Behavioral Health Coalition and finalized plans for our behavioral health inpatient unit. 3) We provided grants to local service providers working to address mental health in our communities, including funding a behavioral health coordinator role at the local FQHC.Access to Healthcare: 1) Coordinated with the Gallatin County Health Department Cancer Screening Program and provide free vouchers via the Mammogram Project. 2) We launched the second year of the Medical Respite program that provides brief housing and case management to houseless individuals who cannot safely be discharged from the hospital back to their current living situation (car, shelter, street, etc). We engaged in and provided program development for the Medical Respite program, and funded service coordination for residents, as a means of improving Access to Healthcare for houseless populations. 3) We also provided grants to nonprofits working on increasing access to services to Spanish speaking individuals via health fairs. 4) We provided 3 off-site no-cost flu and COVID vaccine clinics to underserved populations in West Yellowstone, the local food bank, and a low-income apartment complex in Bozeman. We served 59 individuals through these clinics. Due to the timing of the 2023 CHNA, the following efforts were made to support the needs identified in the prior CHNA:Nutrition & Physical Activity: 1) Support the Health in All Policies steering committee. 2) Support GoNoodle access for schools in Park, Madison, and Gallatin Counties. 3) We also provided grants to nonprofits focused on physical activities on land trust trails, a cross country ski event, and supplies and programming for a teaching kitchen at a local public library.4) We launched a Prescription Produce Program that allowed pediatricians to "prescribe" produce and through a third part vendor, a weekly produce box would be delivered to their homes weekly for 16 weeks. Injury & Violence Prevention: 1) Provided "Stepping On" fall prevention trainings to more 75 older adult participants and 10 training opportunities in 2023. 2) Promote the "Stop the Bleed" campaign, which included Big Sky Search and Rescue. Another grant focused on Stop the Bleed kits via schools and public buildings along with trainings on how to use the kits.3) Supported a local Indigenous Women violence prevention symposium and provided 50 copies of the book "Incarceration of Native American Women".4) We also helped support a bicycle rodeo focused on child safety in West Yellowstone. 5) 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. 6) We provided over 230 bike and ski helmets to local youth across the Bozeman and Big Sky service areas to reduce the number of traumatic brain injuries caused by not wearing a helmet while recreating. 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 $70,753,110. 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 15-16 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 1 1 0 0 0 0 0 0 0 John Hill Former CEO 0 26647 0 0 0 795412 0 0 0 30 0 822089 0 0 Brad Ludford CFO 0 395457 0 0 0 4242 0 82296 0 37957 0 519952 0 0 Steve Klein Chief Legal Officer 0 293245 0 0 0 21590 0 43538 0 36429 0 394802 0 0 Kiera Pattison Chief Nursing Officer 0 272478 0 0 0 63575 0 31800 0 24671 0 392524 0 0 Darci Bentson Former CAO 0 15186 0 0 0 373646 0 0 0 19 0 388851 0 0 Kallie Kujawa Chief Operating Officer 0 280400 0 0 0 2396 0 44977 0 33457 0 361230 0 0 Denise Juneau Chief Government & Community Affairs 0 278352 0 0 0 5862 0 42753 0 17438 0 344405 0 0 Tamara Havenhill-Jacobs Chief Information Officer (Jan-May) 0 132133 0 0 0 183296 0 0 0 14021 0 329450 0 0 Edie Willey Former Chief People Officer 0 11785 0 0 0 288573 0 0 0 19 0 300377 0 0 Jennifer Schultz System Director of Pharm. Services 187605 0 0 0 410 0 12087 0 36962 0 237064 0 0 0 Haily Cramer Nurse 207622 0 0 0 0 0 12479 0 9236 0 229337 0 0 0 Alan Brayton System Manager of Pharmacy 165777 0 0 0 15178 0 12717 0 34101 0 227773 0 0 0 Chris Pruitt Nurse 190733 0 0 0 5427 0 11868 0 11688 0 219716 0 0 0 Amanda Wolosyzn System Manager of Pharmacy 176304 0 0 0 125 0 10665 0 10879 0 197973 0 0 0 Mark Williams Former Chief Physician Officer 0 4955 0 0 0 123264 0 0 0 19 0 128238 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, Lines 4a-b Line 4a: In 2023, the following former officers received severance payments from a related organization: John Hill: $795,025 Darci Bentson: $373,477 Mark Williams: $123,000 Edie Willey: $288,462 In 2023, the following officer received severance payments from a related organization: Tamara Havenhill-Jacobs: $181,971 Line 4b: Schedule J, Part II, column (c) reflects contributions paid by the related organization into their individual 457(f) plan. The following employer contributions were made in 2023. Kathryn Bertany: $77,622 Brad Ludford: $40,933 Kiera Pattison: $12,000 Kallie Kujawa: $24,840 Steve Klein: $24,000 Denise Juneau: $24,000 Mark Williams was a participant in the 457f plan for 2023. He did not have any contributions in that year, but is still an active participant with a balance to be paid in the future. 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 8059769 19522471 243567 19278904 2015 1 0 1 1 B 7169699 76462824 2322943 808710 73332463 2020 0 0 1 1 C 600149 65500496 67027 258872 30103191 31834484 3236922 2023 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 4 The bylaws were revised in 2023 to simplify the board governance structure. This involved: (a) consolidating a number of overlapping board committees for the purpose of streamlining our governance structure; and (b) cleanup changes to ensure the bylaws are consistent with current practices. 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 XI, line 9: Transfer of Net Assets to Related Party -991,245. Change Investment of Foundation -937,465. Rocky Mountain Real Estate Holdings LLC 915 Highland Blvd Bozeman MT 59715 851058455 Property Acquisition MT 0 5516461 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