2025-11-11T11:28:25-06:00 2024-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2024-01-01 810232121 Bozeman Deaconess Health Services BOZE 4064145000 915 Highland Boulevard Bozeman MT 59715 Brad Ludford CFO 4064145000 2025-11-10 1 1 Kim Hunwardsen CPA P00484560 6122536500 2025-11-10 2024 2025-03-06 01:10:19Z Bozeman Health Kathryn Bertany 915 Highland Boulevard Bozeman MT 59715 193371526 0 X www.bozemanhealth.org X 1911 MT To improve community health and quality of life for residents and visitors of the Southwest Montana area. 15 13 1014 160 1432682 0 232868 802432 177637504 188734528 1090659 2952017 199246 699866 179160277 193188843 619881 518715 0 0 117614490 133532364 0 0 0 61128489 55998084 179362860 190049163 -202583 3139680 167581983 209808822 118866125 158114917 48715858 51693905 X To improve community health and quality of life. 0 0 75173235 69979298 Bozeman Health Medical Group employs physicians under the Bozeman Health system umbrella. This group of providers compassionately serves the patients of Bozeman Health Deaconess Hospital, Big Sky Medical Center, Bozeman Health Urgent Care, and Bozeman Health Convenience Care, LLC. 17290334 28710909 In efforts to reach our community and surrounding area in multiple facets of healthcare, the Bozeman Health system operates additional healthcare facilities which allows more access and levels of care.Big Sky Medical Center had 92 admissions and saw 4,217 patients in the Emergency Room and 7,075 patients in the clinic in 2024. The net revenue yield on these operations was only 55.9%, or $1,540 per adjusted patient day. With challenging core staffing and related costs, the operating expense (excluding interest, taxes and depreciation) was $2,270 per adjusted patient day. This resulted in a $1.2 million operating loss for the year. (Continued on Schedule O)Bozeman Health is committed to providing access and patient care to the Big Sky community in spite of the financial operational challenges the facility continues to face.Bozeman Health also continues to operate our Main Street Urgent Care as an outpatient healthcare access point. With a 60.1% yield on $7.3M of patient charges and operating costs of $8.7M, the Urgent Care netted a loss of $1.4M in 2024. 12781465 518715 88611639 Bozeman Health serves as the parent company of the Bozeman Health system. As the corporate parent, management, general and administrative services are centralized here and provided to the operating units caring for our patients. These administrative and support services aim to optimize executive, organizational and financial responsibilities to allow the health system to continue to grow and serve the population. In this past year, Bozeman Health had 27,800 inpatient days, 247,714 outpatient hospital visits, 295,807 outpatient clinic visits, 38,003 emergency room visits and performed 7,157 surgeries. 105245034 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 220 0 1 1014 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 13 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 X Carrie Morasko 4064145039 915 Highland Blvd Bozeman MT 59715 John How Chair 1.00 1.00 X X 0 0 0 Jim Berend - Vice ChairJan -Jun)/2nd Vice Chair (as of July) 1.00 1.00 X X 0 0 0 Becky Franks - 2nd Vice Chair (Jan-Jun)/Vice Chair (as of July) 1.00 1.00 X X 0 0 0 Jon Knockey Treasurer 1.00 0.00 X X 0 0 0 Elizabeth Carver Secretary 1.00 0.00 X X 0 0 0 David Crites Director (as of July) 50.00 0.00 X 359027 0 56737 Amy Croover Director (as of July) 1.00 0.00 X 0 0 0 Francisco Ferreyra-Munoz Director (as of July) 1.00 0.00 X 0 0 0 Vicki Groeneweg Director 1.00 0.00 X 0 0 0 Bruce Harmony Director (until June) 1.00 0.00 X 0 0 0 Meghan Johnston Internist/Director 50.00 0.00 X 258392 0 59327 Sara Lattimore Director (as of July) 1.00 0.00 X 0 0 0 Cory Pulfrey Director 1.00 0.00 X 0 0 0 Melinda Roberts Director (until June) 1.00 0.00 X 0 0 0 Walt Sales Director (until June) 1.00 0.00 X 0 0 0 Alyce Schultz Director 1.00 0.00 X 0 0 0 Kim Scurry Director (as of July) 1.00 0.00 X 0 0 0 Dane Sobek Cardiologist/Director (until June) 50.00 0.00 X 731356 0 54414 Dan Taft Director (as of July) 1.00 0.00 X 0 0 0 Kathryn Bertany CEO 20.00 30.00 X 628654 0 169460 Brad Ludford CFO 20.00 30.00 X 422456 0 123596 Christopher Spoja Chief Medical Officer 20.00 30.00 X 491504 0 86916 Kiera Pattison Chief Nursing Officer 20.00 30.00 X 306939 0 80702 Kallie Kujawa Chief Operating Officer 20.00 30.00 X 287869 0 87706 Steve Klein Chief Legal Officer 20.00 30.00 X 297201 0 88089 Andrew Herman MD Gastroenterologist 50.00 0.00 X 788497 0 29861 Mark Hancock MD Hematology and Oncology 50.00 0.00 X 745578 0 62468 Jason Skenazy MD Urologist 50.00 0.00 X 738927 0 67332 Nathaniel Madsen MD Cardiology 50.00 0.00 X 737253 0 61449 Andrew Gentry MD Gastroenterologist 50.00 0.00 X 724698 0 63302 John Hill Former Officer 0.00 0.00 X 463785 0 0 Tamara Havenhill-Jacobs Former Key Employee 0.00 0.00 X 177401 0 0 8159537 0 1091359 330 1 1 0 Absaroka Emergency Physicians 1184 N 15th Street Suite 1 Bozeman MT 59715 ER Physicians Fee 8568414 System4 of Idaho 82 S Baltic Place Ste 116 Meridian ID 83642 Facility Cleaning 1423761 Kiwi Enterprises LLC 121 N 3rd Ave Bozeman MT 59715 Snow Removal 1183176 Locum Tenenscom LLC 2575 Northwinds Parkway Alpharetta GA 30009 Contract Physicians 656893 Country Plantscapes 62 Dirt RD Belgrade MT 59714 Yard Maintenance 628610 36 802432 802432 Health System Corp Services 900099 78798356 78798356 Health System Provider Services 621110 69979298 69979298 Patient Service Revenue 621110 26086455 26086455 Pharmacy Revenue 456110 2478071 1045389 1432682 11392348 11392348 188734528 3134700 3134700 699866 0 699866 699866 699866 182683 -182683 -182683 -182683 193188843 187301846 1432682 3651883 501715 501715 17000 17000 4607969 1725359 2882610 641186 641186 105707994 73433962 32274032 4022993 2970256 1052737 11853394 5320199 6533195 6698828 4197387 2501441 278186 278186 245821 245821 37931 37931 12694726 1824418 10870308 2720921 26535 2694386 745605 96722 648883 2090732 223105 1867627 479566 35834 443732 319710 23889 295821 867991 867991 10218182 10218182 3087583 55143 3032440 Equipment Rent & Mainte 14676909 39828 14637081 Medical Supplies 3733940 3580474 153466 Goodwill Impairment 869549 869549 Taxes and Licenses 754861 37974 716887 2175871 49061 2126810 190049163 105245034 84804129 0 41521511 83792408 8484626 14521825 443257 455909 9123623 9111953 132972741 60664719 80276836 72308022 8672100 9291270 11979450 11856583 4347747 3478198 2732833 4992654 167581983 209808822 33745739 44186336 100259 8314 19888580 19535078 150047 98740 64981500 94286449 118866125 158114917 X 47534525 50674026 1181333 1019879 48715858 51693905 167581983 209808822 X 3139680 -179 -161454 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 28870 0 1 9061 37931 0 Part II-B, Line 1: Hired consultant to provide lobbying services in connection with governmental affairs representation to ensure hospital, community, and employee interests and needs are represented. Bozeman Deaconess Health Services reimburses certain professional membership dues of employees, a portion of such membership dues are used by the professional associations for lobbying activities. The dues for MHA, AHA, and Leading Age were $9,061. 24878147 1123688 3137317 18184368 10954784 20672068 943397 3632532 369850 24878147 24534132 68899 -3372760 558203 20672068 20745993 973493 3399161 584515 24534132 18430208 41677 2623596 349488 20745993 0.00000 0.46330 0.53670 0 1 1 7095841 9401304 16497145 37839116 9050073 28789043 78312868 51614646 26698222 323612 323612 72308022 Investment in Affiliated Organizations 11856583 F 11856583 Deposits 6288 Capitalized Lease Obligation 3731471 Due To Affliates 85550694 Estimated third-party payor settlements 4997996 94286449 X 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 the 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. Due to this relationship the endowment fund is being reported all the Form 990, Schedule D, Part V for all three related entities. The other expenditure for facilities and programs reported on line 1e includes $17,933,754 which pertains to the removal of board designation. 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. 1 1 X 1 X 1 X 1 1 1 0 0 1056905 63647 993258 0.00520 3237745 1676295 1561450 0.00820 4294650 1739942 2554708 0.01340 431615 17298 414317 0.00220 17000 17000 0.00010 7266324 6053028 1213296 0.00640 521759 20000 501759 0.00260 8236698 6090326 2146372 0.01130 12531348 7830268 4701080 0.02470 1 2993510 0 4618724 7373704 -2754980 X 1 1 1 Rocky Mountain Surgical Center LLC Outpatient Surgical Center 0.51010 0.00000 0.48990 2 Deaconess Intercity Imaging LLC Radiology 0.77500 0.00000 0.22500 4 West Bozeman Surgery Center LLC Outpatient Surgical Center 0.35070 0.00000 0.30000 1 1 Big Sky Medical Center 334 Town Center Ave Big Sky MT 59716 www.bigskymedicalcenter.com 13563 X X X X Big Sky Medical Center LLC 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 Big Sky Medical Center, LLC 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. Big Sky Medical Center, LLC Part V, Section B, Line 6a: Bozeman Health Deaconess Hospital, dba Bozeman Deaconess Regional Medical Center Big Sky Medical Center, LLC Part V, Section B, Line 11: In the most recent CHNA conducted, the following needs were identified:-Behavioral Health (includes mental health and substance abuse)-Access to Healthcare Services-Socioeconomic and Health Measures-Chronic Disease PreventionSeveral of the CHNA identified needs were not selected as priority areas for Bozeman Health. In order to best impact health outcomes, we focused on prioritizing health issues for which there are existing internal and external resources we can leverage to affect change. Additionally, some of the needs below will be indirectly impacted through our priority areas: -Alzheimer's & Dementia: Bozeman Health's Geriatric Service is available for consultation with any Bozeman Health or community provider and regularly reviews cases for patients referred to them to assist primary care or other providers with treatment decisions. In addition, memory consults with board-certified geriatricians are available to develop a comprehensive understanding of the patient's disease and current state, often before significant disease progression. Within the community, Bozeman Health advertises and helps socialize dementia awareness through support groups and other organizations for those struggling with dementia or prediagnosis of dementia. Through these efforts, Bozeman Health and its partners will continue to tackle this difficult condition and look for additional supports to best serve the community. -Diabetes & Heart Disease: The strategies listed under the Chronic Disease Prevention theme focus on trying to stave off new onset common chronic diseases, such as type 2 diabetes and hypertension, which can be prevented by lifestyle modifications such as healthier diets and prioritizing more regular physical activity. Through these efforts, Bozeman Health and its partners look forward to positive impacts. -Maintaining a Healthy Weight: The strategies listed under the Chronic Disease Prevention theme focus on lifestyle modification such as healthier diets and prioritizing regular physical activity, which in turn can help individuals maintain a healthy weight. Through these efforts, Bozeman Health and its partners look forward to positive impacts.Bozeman Health completed the latest CHNA at the end of 2023 and began addressing the newly identified health needs in the first half of 2024 after the implementation strategy was completed. Progress towards the identified health priorities as part of the CHNA Implementation plan include: 1. Behavioral HealthGoal: Increase access to behavioral health services across the care continuum. Expanded Integrated Behavioral Health (IBH) services in primary care, including launching a program at the Women's Clinic with a care manager and psychiatric nurse practitioner. Opened a walk-in psychiatric care clinic in September 2024, serving 57 patients by year-end. Broke ground on an inpatient behavioral health unit, expected to open in Fall 2025. Explored outpatient substance use disorder services and strengthened referral networks. Invested over 1,500 hours in community-based behavioral health initiatives. Funded grants to support behavioral health access, including: Bridgercare's Collaborative Care Program Wellness in Action's Affordable Counseling Program in Big Sky CHP/One Health's Pathways to Wellness School-based and community mental health programs in Bozeman and Big Sky2. Access to HealthcareGoal: Increase access to care for patients affected by health equity challenges. Redesigned the HealthCare Connections (HCC) mobile program to deliver no-cost vaccines and prepare for expanded screenings in 2025. Supported Wellness in Action to connect Big Sky residents to care and resources. Participated in planning for Homeward Point, a new shelter with medical respite services. Led transportation initiatives, including participation in the Health Transportation Coalition. Planned expansion of RV parking for patients/families at the medical center. Expanded DEIB efforts, including interpreter device audits and Spanish signage updates. Funded grants for programs like Thrive's Spanish-speaking Parent Liaison and Spanish for Healthcare training.3. Chronic Disease PreventionGoal: Reduce the impact of chronic disease and cancer through prevention and healthy lifestyles. Distributed mammogram vouchers and promoted cancer screening awareness. Expanded partnership with Cancer Support Community, including planning a men's retreat in Big Sky and hiring a mental health provider. Hosted cooking and lifestyle education classes through Lifestyle Medicine. Reinvigorated the TrailsRX program and began planning new trail access. Developed health promotion signage for trail systems. Funded the YMCA's ReCharge program for cancer survivors.4. Socioeconomic & Health MeasuresGoal: Promote "Housing is Healthcare and support affordable housing initiatives. Participated in and funded the Regional Housing Coalition. Began evaluating health outcomes for residents in Housing First Village. Funded KidsLink afterschool program to reduce financial barriers for families. Big Sky Medical Center, LLC 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 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. Big Sky Medical Center, LLC 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. Big Sky Medical Center, LLC 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://bozemanhealth.org/wp-content/uploads/2025/05/Financial-Assistance-Charity-Care.pdfhttps://bozemanhealth.org/wp-content/uploads/2025/05/Financial-Assistance-Application-March-2025.pdfhttps://bozemanhealth.org/wp-content/uploads/2024/11/fa-policy-plain-language-summary-2023.pdf 6 1 - Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Imaging Center 2 - Rocky Mountain Surgery Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 Outpatient Surgical Center 3 - Hospice of Southwest Montana LLC 3810 Valley Commons Dr Ste 1 Bozeman MT 59715 Hospice Services 4 - Bozeman Health Urgent Care LLC 1006 W Main Bozeman MT 59715 Outpatient Health Care 5 - Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 Contracted Provider Services 6 - Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 Outpatient Health Care 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 and Medicaid. 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 $7,266,324. The Urgent Care disregarded entity was reported as a subsidized services, pulling out the financial assistance and Medicaid to report separately as appropriate. 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 a cost 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.For the Joint Ventures, Net Medicare Revenue was used as the revenue received, and that percentage of total revenues was applied against operating expenses to determine related costs. The Joint Venture portion of the shortfall is $2,715,344. 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 Big Sky Medical Center (BSMC) 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 is deeply committed to providing financial assistance to patients needing, but unable to afford, medically necessary health care services. As a hospital operating in the Bozeman Health system, Big Sky Medical Center (BSMC) posts notice of its Financial Assistance Policy in all admitting areas, as well as on the website. At the earliest feasible time, BSMC 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 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: BH Big Sky Medical Center (BSMC) primarily serves a three-zip code region in Gallatin County Montana: 59716 Big Sky, 59730 Gallatin Gateway, and 59758 West Yellowstone (note in certain zip code boundary definitions, 59716 Big Sky is in both Gallatin and Madison County-although the most populous area is in Gallatin County). These 3 communities account for more than 75% of clinic visits at BSMC Big Sky Clinic in 2024. In addition, these same communities account for 17.9% of BSMC's inpatient admissions while 21.1% were of patients originating outside Montana. The population of the tri-zip code area was an estimated 10,929 (59716: 3,396, 59730: 5,598, and 59758: 1935) in 2020 (US Census Data, 2020). The average median household income in the combined communities was an estimated $87,437 and 5.9% of the population was estimated to be in poverty in 2023 (ACS 5yr estimates, 2023). 2024 estimates suggest that 14.7% of the population in Gallatin County are covered by Medicaid (Montan Healthcare Foundation, 2023). It is estimated that 13.03% are uninsured (ACS, 2023) and 6,145 individuals in the three zip codes are insured under Medicare (KFF, 2024). Bozeman Health Big Sky Medical Center is the only hospital in the BSMC three zip code service area and is one of two hospitals in Gallatin County (BH BSMC and BH Deaconess Hospital). Part VI, Line 5: The governing body of Bozeman Health 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, we have an open medical staff and require 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 award multiyear scholarships to college students studying health professions, support medical and nursing students at our facility, and provide community health improvement grants to local organizations who are working in alignment with our community benefit priority area. Part VI, Line 6: Bozeman Deaconess Health Services owned a majority interest in Deaconess Intercity Imaging, LLC and Rocky Mountain Surgery Center in the current tax year. Although these joint ventures are not licensed hospitals, these organizations hold similar policies regarding providing care to all members of the community and offering financial assistance as determined by ability to pay. 1 MT State University Foundation PO Box 172750 Bozeman MT 59717 816001649 501(c)3 285715 0 Support improving access to Health Services in our service area Cancer Support Comununity MT 102 S 11th Ave Bozeman MT 59715 810542266 501(c)3 60000 0 Support cancer support services within our service area Thrive PO Box 4325 Bozeman MT 59772 363501185 501(c)3 30000 0 Support human service needs within our service area Community Health Partners 214 E Mendenhall Bozeman MT 59715 841420492 501(c)3 26000 0 Support improving access to Health Services in our service area Wellness in Action 47855 Gallatin Rd Big Sky MT 59716 204166175 501(c)3 20000 0 Support behavioral health services within our service area Bridgercare 1288 N 14th Ave 201 Bozeman MT 59715 810363189 501(c)3 20000 0 Support improving access to Health Services in our service area Human Resource Development Council of District IX (HRDC) 32 S Tracy Ave Bozeman MT 59715 810350886 501(c)3 10000 0 Support resources for low income population in our service area Bridger Ski Foundation 851 Bridger Drive STE 1243 Bozeman MT 59771 810384359 501(c)3 10000 0 Support healthy lifestyles for youth in our service area Gallatin Valley Land Trust PO Box 7021 Bozeman MT 59771 810464513 501(c)3 10000 0 Support healthy lifestyles in our service area 9 0 Scholarships 17 17000 Part I, Line 2: Recipients of grants and assistance prepare informational reports substantiating the use of the funds that were earmarked to support community health programs. Involvement of Bozeman Deaconess Health Services staff and/or administration as volunteers in the activities being supported also ensures proper usage of funds. Scholarships provided are paid directly to the institute on behalf of the recipient. X X X X 1 1 0 0 0 0 0 0 0 Andrew Herman MD Gastroenterologist 542871 0 245302 0 324 0 20700 0 11477 0 820674 0 0 0 Mark Hancock MD Hematology and Oncology 706665 0 36537 0 2376 0 20700 0 44674 0 810952 0 0 0 Jason Skenazy MD Urologist 564683 0 173884 0 360 0 20700 0 49070 0 808697 0 0 0 Nathaniel Madsen MD Cardiology 699220 0 37205 0 828 0 20700 0 43724 0 801677 0 0 0 Kathryn Bertany CEO 621167 0 1537 0 5950 0 137731 0 34854 0 801239 0 0 0 Andrew Gentry MD Gastroenterologist 536083 0 187067 0 1548 0 20700 0 44886 0 790284 0 0 0 Dane Sobek Cardiologist/Director (until June) 693323 0 37205 0 828 0 20700 0 36689 0 788745 0 0 0 Christopher Spoja Chief Medical Officer 437028 0 51537 0 2939 0 47342 0 41545 0 580391 0 0 0 Brad Ludford CFO 415435 0 1537 0 5484 0 80767 0 44849 0 548072 0 0 0 John Hill Former Officer 0 0 0 0 463785 0 0 0 0 0 463785 0 196620 0 David Crites Director (as of July) 344669 0 13822 0 536 0 20700 0 37637 0 417364 0 0 0 Kiera Pattison Chief Nursing Officer 296106 0 1537 0 9296 0 45437 0 36817 0 389193 0 0 0 Steve Klein Chief Legal Officer 293204 0 1537 0 2460 0 46646 0 43004 0 386851 0 0 0 Kallie Kujawa Chief Operating Officer 283926 0 1537 0 2406 0 51669 0 37636 0 377174 0 0 0 Meghan Johnston Internist/Director 241899 0 16234 0 259 0 17621 0 42926 0 318939 0 0 0 Tamara Havenhill-Jacobs Former Key Employee 0 0 0 0 177401 0 0 0 0 0 177401 0 43956 0 Part I, Lines 4a-b Line 4a: In 2024, the following former officers received severance payments: John Hill: $267,165 Tamara Havenhill-Jacobs: $133,445 Line 4b: Schedule J, Part II, column (c) reflects contributions paid by the organization into their individual 457(f) plan. The following employer contributions were made in 2024: Kathryn Bertany: $117,031 Brad Ludford: $60,067 Christopher Spoja: $47,342 Kiera Pattison: $26,377 Kallie Kujawa: $32,357 Steve Klein: $28,022 The following received distribution payments from the 457f plan in 2024: John Hill: $196,620 Tamara Havenhill-Jacobs: $43,956 A Montana Facility Finance Authority 364615155 61240MBM8 2014-11-05 23005852 Refinance 2004 bond issued 3/4/2004; fund add'n of Big Sky Medical Facility 0 0 0 A 3206201 23008884 3032 377976 17500000 5127876 2015 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 Date Rebate Computation Performed Issuer Name: Montana Facility Finance Authority Date the Rebate Computation was Performed: 06/01/2019 Schedule K, Part I, Line A(e): Part I issue price and Part II Line 3 bond proceeds differ due to interest earned on the proceeds. Schedule K, Part IV, Line 2c: No remaining or new bond proceeds exist and there is no arbitrage rebate liability, therefore no further arbitrage calculations are necessary. Form 990, Part VI, Section A, line 7a The Yellowstone Conference of the Methodist Church confirms the Board Members and has authority to appoint the clergy member of the board. Form 990, Part VI, Section A, line 7b Changing 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 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 issue, 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: Change in Temp Restricted Investment of Foundation -161,454. Big Sky Medical Center LLC 334 Town Center Ave Big Sky MT 59716 474718253 Healthcare - Inpatient and Outpatient Servcies MT 20596527 28748287 Bozeman Deaconess Health Services Bozeman Health Convenience Care LLC 915 Highland Blvd Bozeman MT 59715 822848277 Healthcare-Ambulatory Clinic Outpatient Care MT 1090776 471790 Bozeman Deaconess Health Services Bozeman Health Urgent Cares LLC 1006 W Main Bozeman MT 59715 465318746 Healthcare - Physician Outpatient Care MT 7328012 15578693 Bozeman Deaconess Health Services Bozeman Health Medical Group LLC 915 Highland Blvd Bozeman MT 59715 475126599 Physician Employment & Contract to Bozeman Health System MT 77183684 8908684 Bozeman Deaconess Health Services Spanish Peaks Plaza LLC 120 N 19th Ave Suite A Bozeman MT 59718 810539803 Rental Real Estate for VA Med Clinic & Chiro MT -4110 72140 Bozeman Deaconess Health Services 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 1 Bozeman Health Deaconess Hospital 915 Highland Blvd Bozeman MT 59715 474717998 Healthcare - Inpatient and Outpatient Services MT 501(c)(3) Line 3 Bozeman Deaconess Health Services 1 Deaconess Intercity Imaging LLC 915 Highland Blvd Bozeman MT 59715 810666871 Healthcare - Imaging Services MT Bozeman Deaconess Health Services Related 1447980 3176952 0 1 0.77500 Rocky Mountain Surgical Center LLC 1450 Ellis St Suite 101 Bozeman MT 59715 364462300 Healthcare - Surgical Services MT Bozeman Deaconess Health Services Related 3416017 3388172 0 0 0.51010 Bozeman HealthUSP Surgery Centers LLC 14201 Dallas Parkway Dallas TX 75254 823991148 Ambulatory Surgery Center TX Bozeman Deaconess Health Services Related 1661924 2286169 0 0 0.50100 Bozeman Deaconess Real Estate Development Corp PO Box 10490 Bozeman MT 59719 205496567 Sale of real estate property and residences to seniors MT Bozeman Deaconess Health Services C 33420 4259900 1.00000 1 0 0 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 1 Bozeman Health Deaconess Hospital L 148764139 General ledger and corp. records Bozeman Deaconess Foundation C 802432 General ledger and corp. records Bozeman Deaconess Foundation Q 156229 General ledger and corp. records Rocky Mountain Surgical Center LLC S 3341429 General ledger and corp. records Bozeman HealthUSP Surgery Centers LLC S 1605082 General ledger and corp. records Bozeman Deaconess Real Estate Development Corp Q 147999 General ledger and corp. records Bozeman Deaconess Real Estate Development Corp S 87812 General ledger and corp. records Part I Spanish Peaks Plaza, LLC became a 100% owned disregarded entity during 2024.