2026-03-30T08:18:53-04:00 2025-06-30 200079326 DZA PLLC 12015 E MAIN AVE SPOKANE VALLEY WA 99206 990 2024-07-01 810421823 MISSOULA COMMUNITY HEALTH SERVICES INC MISS 4068224841 1208 6TH AVE SUPERIOR MT 59872 LAUREL CHAMBERS HASKINS CEO 4068224841 2026-02-23 true true RIKKI PATCH P01472231 5092420874 2026-03-30 2024 2025-03-06 01:10:19Z MINERAL COMMUNITY HOSPITAL LAUREL CHAMBERS HASKINS 1208 6TH AVE SUPERIOR MT 59872 12766007 false X WWW.MINERALCOMMUNITYHOSPITAL.COM X 1984 MT TO PROVIDE QUALITY HEALTHCARE SERVICES. 9 8 115 9 0 504301 352027 10667788 12191452 115480 153270 62710 69258 11350279 12766007 0 0 6595179 7256710 0 0 5584611 5675384 12179790 12932094 -829511 -166087 14931786 15140192 4061418 4635911 10870368 10504281 X MINERAL COMMUNITY HOSPITAL PROVIDES QUALITY HEALTHCARE SERVICES REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND FURTHER THAT THEIR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND EDUCATION. false false 11220592 12191452 MINERAL COMMUNITY HOSPITAL IS COMPRISED OF A 25-BED CRITICAL ACCESS HOSPITAL (CAH) WHICH PROVIDES HEALTHCARE SERVICES TO PATIENTS. THE HOSPITAL PROVIDED 5,115 DAYS OF INPATIENT SERVICES, 1,841 EMERGENCY ROOM VISITS, AND 5,680 OUTPATIENT VISITS DURING THE YEAR. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 84,751 FOR CHARITY CARE. 11220592 true true false true false false false false false false true false false true true true true false false false false false false false false false true true false false true false false false false false false true false false false false false false true false false false true 12 0 true 115 true false false false false false false false false false false false false X 9 8 true false false false false true false true true false false true true true true false true true true true false X STACY CONROW-VERVERIS 4068224841 1208 6TH AVE SUPERIOR MT 59872 BRIAN LOPEZ PHYSICIAN 48.00 X 439370 0 20473 JACOB WHETZEL PHYSICIAN 40.00 X 296261 0 16054 KARYN RIDGEWAY PHYSICIAN 36.00 X 297565 0 89 JOHN MILLER PHYSICIAN 36.00 X 234550 0 0 LAUREL CHAMBERS HASKINS CEO 45.00 X 218543 0 13848 JANE WHETZEL NURSE PRACTI 48.00 X 207153 0 13500 STACY CONROW-VERVERIS CFO 45.00 X 152560 0 11838 BESSIE SPANGLER CHAIR 1.00 X X 0 0 0 PEGGY TEMPLE VICE CHAIR 1.00 X X 0 0 0 JESSICA SCHAAK SECRETARY/TR 1.00 X X 0 0 0 KEN VANDEHEY DIRECTOR 1.00 X 0 0 0 MARY JO LOMMEN DIRECTOR 1.00 X 0 0 0 SUSAN HAZLETT DIRECTOR 1.00 X 0 0 0 DIANE MAGONE DIRECTOR 1.00 X 0 0 0 LEONA CRICHTON DIRECTOR 1.00 X 0 0 0 GLORIS CASTLES DIRECTOR 1.00 X 0 0 0 1846002 75802 15 false true false MOUNTAIN MEDICAL STAFFING 18 S HAUSER ST ANACONDA MT 59711 NURSE STAFFING 519777 ABUNDANT LIFE NURSING 1925 GRAND AVE STE 127 BILLINGS MT 59102 NURSE STAFFING 299425 LRS HEALTHCARE PO BOX 850349 MINNEAPOLIS MN 554850349 NURSE STAFFING 187461 PRAIRIE TRAVELERS INC 41 1ST ST NORTH GLASGOW MT 59230 NURSE STAFFING 151014 CAH SOLUTIONS GROUP 3667 SOUTHSIDE ROAD SUPERIOR MT 59872 MGMT CONSULTING 150660 9 14390 311551 26086 352027 NET PATIENT SERVICE REVENUE 624100 12191452 12191452 12191452 153270 153270 46675 46675 46675 46675 CAFETERIA REVENUE 722514 18781 18781 OTHER REVENUE 900099 3802 3802 22583 12766007 12191452 222528 X 403863 403863 5832648 5321712 510936 91731 88256 3475 467667 413467 54200 460801 394862 65939 129975 129975 44751 44751 70375 70375 2182805 2099348 83457 10878 275 10603 367349 301864 65485 176985 159598 17387 131691 127093 4598 138883 125168 13715 887408 776592 110816 179027 117834 61193 MEDICAL SUPPLIES & DRUGS 934977 934977 REPAIRS & MAINTENANCE 237488 234882 2606 182792 124664 58128 12932094 11220592 1711502 0 631627 1131025 2953011 3400506 1828052 1883452 137717 180296 108183 109930 14078434 7304282 7545891 6774152 304161 320411 1423144 1340420 14931786 15140192 1079227 1432009 390358 356684 2591833 2847218 4061418 4635911 X 10870368 10504281 10870368 10504281 14931786 15140192 -166087 -200000 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 122 122 false SCHEDULE C, PART IV THE HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO A STATE HOSPITAL ASSOCIATION. THE ASSOCIATION USES A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. 157836 157836 6224138 2986262 3237876 274768 135084 139684 7386952 4182936 3204016 34740 34740 6774152 ESTIMATED THIRD-PARTY SETTLEMENTS 1104050 MONTANA BED TAX RECEIVABLE 125717 TAXES RECEIVABLE 110653 1340420 SOFTWARE SUBSCRIPTION LIABILITIES 2128419 ESTIMATED THIRD-PARTY SETTLEMENT 592356 LEASE LIABILITIES 126443 2847218 X 12766007 12766007 12766007 12932094 12932094 12932094 SCHEDULE D, PAGE 3, PART X THE HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS CLASSIFIED BY THE INTERNAL REVENUE SERVICE AS OTHER THAN A PRIVATE FOUNDATION. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS NECESSARY. THE HOSPITAL EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. THE DISTRICT IS EXEMPT FROM FEDERAL INCOME TAX PURSUANT TO INTERNAL REVENUE CODE SECTION 115. AS OF JUNE 30, 2025 AND 2024, THE HOSPITAL AND DISTRICT HAD NO UNCERTAIN TAX POSITIONS. true true true X 1.300000000000 true X 2.200000000000 true true true false false 62716 62716 0.00480 2033952 2033952 2096668 2033952 62716 0.00480 135046 135046 0.01040 17259 17259 0.00130 3548583 2759701 788882 0.06100 3268 3268 0.00030 3704156 2759701 944455 0.07300 5800824 4793653 1007171 0.07790 15427 15427 0.00120 15427 15427 0.00120 true 571429 3776014 3805947 -29933 X true true MONIDA SHARED IMAGIN MRI SERVICES 0.07000 1 1 MINERAL COMMUNITY HOSPITAL 1208 6TH AVE SUPERIOR MT 59872 WWW.MINERALCOMMUNITYHOSPITAL.COM X X X X MINERAL COMMUNITY HOSPITAL 1 false false true X X X X X X X X 23 true false true true X WWW.MINERALCOMMUNITYHOSPITAL.COM X true 23 true WWW.MINERALCOMMUNITYHOSPITAL.COM false true X 130.000000000000 220.000000000000 X true true X true X WWW.MINERALCOMMUNITYHOSPITAL.COM X WWW.MINERALCOMMUNITYHOSPITAL.COM X WWW.MINERALCOMMUNITYHOSPITAL.COM X X X X X true X false X X X true X false true FACILITY 1, MINERAL COMMUNITY HOSPITAL - PART V, LINE 3E IDENTIFICATION AND PRIORITIZATION OF HEALTH NEEDS BEGIN ON PAGE 6 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE. FACILITY 1, MINERAL COMMUNITY HOSPITAL - PART V, LINE 5 MINERAL COMMUNITY HOSPITAL TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF THE COMMUNITY BY FORMING A STEERING COMMITTEE MADE UP OF A DIVERSE GROUP OF COMMUNITY MEMBERS, REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY (PUBLIC HEALTH, ELDERLY, SCHOOLS, ETC.). FACILITY 1, MINERAL COMMUNITY HOSPITAL - PART V, LINE 6B THE HOSPITAL COLLABORATED WITH THE MINERAL COUNTY HEALTH DEPARTMENT, HEALTHY COMMUNITIES COALITION, AND THE PUBLIC HEALTH SYSTEMS IMPROVEMENT TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT TO IMPROVE THE UNDERSTANDING OF THE HEALTH STATUS OF MINERAL COUNTY. FACILITY 1, MINERAL COMMUNITY HOSPITAL - PART V, LINE 11 THE HOSPITAL WAS NOT ABLE TO ADDRESS ALL HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA DUE TO NOT CURRENTLY HAVING THE STAFF OR FINANCIAL RESOURCES TO DEVOTE TO THE NEED. THE TOP FIVE PRIORITY AREAS ARE ALCOHOL AND SUBSTANCE ABUSE, CHRONIC HEALTH ISSUES, CHILD ABUSE AND NEGLECT, MENTAL AND BEHAVIORAL HEALTH, AND BULLYING. TASK FORCES WERE ASSEMBLED BASED ON AREAS OF EXPERTISE AND INTEREST, THEN GOALS AND OBJECTIVES WERE CREATED. THE HOSPITAL IS ADDRESSING THESE NEEDS USING THE FOLLOWING STRATEGIES: LAUNCH POSITIVE MESSAGE CAMPAIGN TO ADDRESS SHIFTING CULTURAL NORMS AROUND SUBSTANCE ABUSE. FOSTER SUPPORT NETWORKS THROUGH DEVELOPMENT OF PEER TO PEER PROGRAMS WITH TEENS AND ADOLESCENTS IN SCHOOLS. STRENGTHEN PARTNERSHIPS AMONG COUNTY OFFICIALS AND ORGANIZATIONS TO UNIFY EFFORTS IN REDUCING SUBSTANCE ABUSE BY LINKING SYSTEMS TOGETHER. WORK WITH HOSPITAL AND BOTH CLINICS IN MINERAL COUNTY TO REVIEW AND REVISE ANY PATIENT INTAKE SCREENERS THAT CAN HELP IDENTIFY ALCOHOL AND SUBSTANCE ABUSE AND UTILIZE A UNIFIED REFERRAL SYSTEM. CONDUCT A SURVEY FOR COMMUNITY MEMBERS TO ELABORATE ON AREAS WHERE CHRONIC HEALTH ISSUES CAN BE IMPROVED UPON: HEALTH BEHAVIORS, CLINICAL CARE, SOCIAL AND ECONOMIC FACTORS, AND PHYSICAL ENVIRONMENT. WORK WITH EACH SCHOOL TO PROVIDE TRAINING TO STUDENTS, STAFF, AND PARENTS ABOUT POSITIVE PARENTING AND RESILIENCY. PLAN AND IMPLEMENT A PUBLIC HEALTH CAMPAIGN REGARDING CHILD ABUSE AND REPORTING FOR ALL COMMUNITY MEMBERS. GIVE STEPS TO REPORTING, AND WHEN/WHERE TO REPORT. SHOULD BE THREE TYPES OF MEDIA- BILLBOARD, PAMPHLET, COMMERCIAL, HANDOUT, ETC.). INCREASE PUBLIC AWARENESS AND REDUCE STIGMA ASSOCIATED WITH MENTAL HEALTH ISSUES AND/OR SUICIDAL IDEATION. IMPLEMENT A PUBLIC EDUCATION CAMPAIGN/ MEDIA CAMPAIGN THAT INCLUDES HARM REDUCTION, REDUCING MENTAL HEALTH STIGMA, AND INCREASING AWARENESS OF RISKS AND PROTECTIVE FACTORS FOR MENTAL HEALTH. INCREASE ACCESS TO MENTAL HEALTH PROFESSIONALS IN SCHOOLS FOR YOUTH WITH MENTAL HEALTH NEEDS. TELEMED IN EMERGENCY ROOM FOR PATIENTS EXPERIENCING MENTAL DISTRESS AND/OR CRISIS. MINERAL COMMUNITY HOSPITAL CLINIC HAS AN INTEGRATED BEHAVIOR HEALTH SPECIALIST WHO SCREENS ALL CLINIC PATIENTS FOR MENTAL HEALTH NEEDS WITH PHQ TESTING. WE ARE CONTINUALLY ASSESSING THE HEALTH NEEDS OF OUR COMMUNITY AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. WE ARE IN THE PROCESS OF CONDUCTING THE 2025-2026 CHNA IN CONJUNCTION WITH THE MONTANA OFFICE OF RURAL HEALTH AND LOCAL COMMUNITY STAKEHOLDERS. FACILITY 1, MINERAL COMMUNITY HOSPITAL - PART V, LINE 16J THE FINANCIAL ASSISTANCE POLICY IS ALSO VERBALLY DISCUSSED TO A PATIENT WHEN THEY CALL THE HOSPITAL OR THE HOSPITAL CALLS THEM FOR FOLLOW UP ON PAYMENT STATUS. THE LATEST FINANCIAL ASSISTANCE POLICY (FAP) IS AVAILABLE ON THE HOSPITAL WEBSITE. FACILITY 1, MINERAL COMMUNITY HOSPITAL - PART V, LINE 24 PATIENTS ARE BILLED THE GROSS CHARGE FOR ALL SERVICES RECEIVED. IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THE BILL IS ADJUSTED AS DETERMINED BY OUR CHARITY CARE POLICY GUIDELINES. SCHEDULE H, PART I, LINE 7G THE HOSPITAL HAS INCLUDED COSTS ASSOCIATED WITH PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES IN PART I, LINE 7G IN THE AMOUNT OF 726,074 IN COLUMN C AND 717,124 IN COLUMN D. SCHEDULE H, PART I, LINE 7 THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES FOR AMOUNTS REPORTED IN THE TABLE (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, PROVIDER TAXES, TOTAL COMMUNITY BENEFIT AND TOTAL COMMUNITY BUILDING EXPENSES). SCHEDULE H, PART II MINERAL COUNTY IS DESIGNATED AS MEDICALLY UNDERSERVED AND HAS A SHORTAGE IN THE AREA OF HEALTH PROFESSIONALS. THE HOSPITAL IS CONTINUALLY RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO ITS RURAL SERVICE AREA TO HELP IMPROVE ACCESS TO HEALTHCARE SERVICES AS IDENTIFIED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT. HOSPITAL STAFF ARE ALSO ACTIVE DIRECTORS OF THE LOCAL HEALTH DEPARTMENT AND VOLUNTEER AMBULANCE. SCHEDULE H, PART III, LINE 2 THE HOSPITAL USED THE RATIO OF PATIENT CARE COSTS TO CHARGES TO DETERMINE THE COST OF BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 3 THE HOSPITAL DID NOT TRACK THE AMOUNT OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY BUT FOR WHOM SUFFICIENT INFORMATION WAS NOT OBTAINED TO MAKE DETERMINATION OF THEIR ELIGIBILITY DURING THE YEAR. THE HOSPITAL ACCOUNTS FOR DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS IN DETERMINING BAD DEBTS AS FOLLOWS: PATIENTS CAN REQUEST A PROMPT PAYMENT DISCOUNT OF 10% IF THEY PAY THEIR SELF PAY PORTION IN FULL WITHIN 10 DAYS OF IT BECOMING SELF PAY. ONCE A PATIENT IS DETERMINED TO BE PRIVATE PAY, COLLECTIONS ARE INITIATED AND STATEMENTS ARE SENT EVERY 30 DAYS. IF THE BALANCE HAS NOT BEEN PAID IN FULL WITHIN 120 DAYS THE BALANCE GOES TO CENTRON PATIENT BUSINESS SERVICES WHERE THEY ACT AS AN EXTENSION OF OUR BUSINESS OFFICE AND MAKE PAYMENT ARRANGEMENTS. IF NO PAYMENT ARRANGEMENTS ARE MADE FOR 120 DAYS OF BEING WITH PATIENT BUSINESS SERVICES THE BALANCE TRANSFERS TO CENTRON COLLECTIONS AND IS WRITTEN OFF TO BAD DEBT AT THAT TIME. SCHEDULE H, PART III, LINE 4 THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 4, ON PAGE 12, OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 7 BEGINNING ON PAGE 17 OF THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 8 ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. SCHEDULE H, PART III, LINE 9B THE HOSPITAL ADMITTING AREA WILL COLLECT CHARITY CARE APPLICATIONS AND ASSIST THEM IN THE MEDICAID APPLICATION PROCESS IF THE PATIENT IS UNABLE TO PAY. THE BUSINESS OFFICE STAFF WILL ALSO HELP SET UP A PAYMENT PLAN OR HELP WITH OTHER SOURCES OF FINANCIAL ASSISTANCE. THE BUSINESS OFFICE STAFF GOES OVER THE IN-HOUSE CHARITY CARE GUIDELINES AND APPLICATION WITH THE PATIENT. PATIENTS ARE REQUIRED TO PROVIDE FINANCIAL DATA SUCH AS TAX INFORMATION, BANK STATEMENTS, PAY STUBS, ETC. THE APPLICATIONS ARE REVIEWED AND EVALUATED FOR CHARITY CARE STATUS AND WRITTEN OFF WHEN APPROPRIATE. ALL CHARITY APPLICATIONS ARE REVIEWED AND APPROVED BY THE CFO. CENTRON PATIENT BUSINESS SERVICES ALSO ASSISTS IN CHARITY CARE APPLICATIONS. SCHEDULE H, PART VI, LINE 2 THE HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES BY UTILIZING MULTIPLE SOURCES INCLUDING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, COUNTY HEALTH DEPARTMENT, COUNTY HEALTH PROFILE, MONTANA VITAL STATISTICS AS WELL AS COMMUNITY SURVEYS. WE USE MANY SOURCES OF INFORMATION TO COMPILE OUR COUNTY'S HEALTH NEEDS AND HOW TO ADDRESS THEM. WE ARE CONTINUALLY TAKING IN INFORMATION AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. A COPY OF THE MOST RECENTLY ADOPTED COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE AVAILABLE AT THE HOSPITAL UPON REQUEST OR CAN BE FOUND ON THE HOSPITAL'S WEBSITE AT THE FOLLOWING URL: HTTPS://HTTPS://MINERALCOMMUNITYHOSPITAL.COM/WP- CONTENT/UPLOADS/2023/07/MINERAL-COMMUNITY_HEALTH_ASSESSMENT-2022.PDF HTTPS://MINERALCOMMUNITYHOSPITAL.COM/WP-CONTENT/UPLOADS/2023/10/MINERAL- COMMUNITY-CHIP-2023.PDF SCHEDULE H, PART VI, LINE 3 THE HOSPITAL INCLUDES A BROCHURE DEFINING THE FINANCIAL ASSISTANCE PROGRAM IN THE FINANCIAL ASSISTANCE APPLICATION AND ALSO INCLUDES A COPY WHEN THE FINAL NOTICE IS SENT. SCHEDULE H, PART VI, LINE 4 MINERAL COUNTY IS DESIGNATED AS A FRONTIER, MEDICALLY UNDERSERVED, PROVIDER SHORTAGE AREA. AS OF NOVEMBER 2025 MINERAL COUNTY RANKS 39TH IN HEALTH OUTCOMES AND 38TH FOR HEALTH FACTORS IN THE STATE. CURRENT DATA SHOWS MINERAL COUNTY HAS 1 PHYSICIAN TO 2,530 (ESTIMATED) RESIDENTS (THE STATEWIDE AVERAGE IS 1 TO 1,200) WITH ONE HOSPITAL (ACTUAL PHYSICIAN/PATIENT FACE TIME); IT ALSO SHOWS WE HAVE 1 TO MENTAL HEALTH PROVIDER TO 320 (ESTIMATED) RESIDENT (THE STATEWIDE AVERAGE IS 1 TO 230). MEDIAN HOUSEHOLD INCOME IN MINERAL COUNTY IS 58,832 COMPARED TO ROUGHLY 70,939 STATE WIDE. 29.1% OF OUR RESIDENTS ARE 65 AND OLDER. ACCORDING TO "2025 COUNTY HEALTH RANKINGS", UNEMPLOYMENT IN MINERAL COUNTY WAS 4.9% COMPARED TO THE STATEWIDE AVERAGE OF 2.9%. 18% OF CHILDREN IN MINERAL COUNTY LIVE IN POVERTY COMPARED TO 13% FOR THE STATEWIDE AVERAGE. 12% OF ADULTS AND CHILDREN ARE UNINSURED COMPARED TO 10% STATEWIDE ACCORDING TO THIS REPORT. SCHEDULE H, PART VI, LINE 5 ALL OF THE HOSPITAL'S BOARD MEMBERS RESIDE IN THE PRIMARY SERVICE AREA RANGING FROM BUSINESS OWNERS TO HOMEMAKERS TO RETIREES REPRESENTING THE COMMUNITY IT SERVES. THIS VOLUNTEER BOARD DEDICATES TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. MEDICAL STAFF PRIVILEGES AT THE HOSPITAL ARE OPEN TO ALL MEDICAL PROVIDERS WITH ACTIVE LICENSURE. WHILE THE CREDENTIALING PROCESS ENSURES PRACTITIONERS OF THE HIGHEST CALIBER ARE PRIVILEGED, PRACTITIONERS FROM NUMEROUS SPECIALTIES ARE ENCOURAGED TO MEET THE EVER EXPANDING HEALTHCARE NEEDS OF THE COMMUNITY. AS A NON-PROFIT CORPORATION, THE HOSPITAL DOES NOT HAVE ANY SHAREHOLDERS AND SURPLUS FUNDS ARE REINVESTED INTO THE FACILITY, EQUIPMENT, AND EMPLOYEE EDUCATION. THE ABSENCE OF SHAREHOLDERS ELIMINATES THE POTENTIAL FOR CONFLICTS OF INTEREST RELATED TO INFLATED PROFIT MARGINS AND ALLOWS THE HOSPITAL TO FOCUS ON MEETING THE HEALTH AND WELFARE NEEDS OF THE COMMUNITIES WE SERVE. THE HOSPITAL PARTICIPATES IN MULTIPLE ACTIVITIES WITHIN ITS COMMUNITY TO PROMOTE THE HEALTH OF THE COMMUNITY IT SERVES INCLUDING THE FOLLOWING: HEALTH FAIR, HOSPITAL EMPLOYEES RAISE MONEY FOR A SPECIFIC CAUSE WHICH WILL GO TOWARDS AN OUTDOOR EATING AND BREAK AREA FOR EMPLOYEES, TUITION REIMBURSEMENT FOR HEALTHCARE RELATED DEGREES, POSTING ARTICLES RELATED TO VARIOUS WELLNESS TOPICS AND TRAUMA PREVENTION ON THEIR WEBSITE, FACEBOOK AND INSTAGRAM PAGES ACCESSIBLE BY THOSE WITHIN THE COMMUNITY, AND ONE OF OUR EMERGENCY ROOM PROVIDERS ACTS AS THE MEDICAL DIRECTOR OF A VOLUNTEER AMBULANCE/QRU. THE CEO ALSO ACTS AS THE HEALTH OFFICER FOR THE MINERAL COUNTY HEALTH DEPARTMENT. THE HOSPITAL DONATES A LARGE SPACE TO THE MINERAL COUNTY HEALTH DEPARTMENT. THE HOSPITAL PREPARES HOME DELIVERED MEALS FOR SENIORS IN THE COMMUNITY IN CONJUNCTION WITH THE SUPERIOR SENIOR CENTER; 1,938 MEALS PREPARED THIS YEAR. THE HOSPITAL ALSO PARTICIPATES IN THE FOLLOWING ACTIVITIES: REACH TRAINING PROGRAM FOR COUNTY HIGH SCHOOL STUDENTS, DISTRIBUTING COMMUNITY HEALTH FLYERS TO RESIDENCES IN THE COMMUNITY, TRAUMA EDUCATION AND TRAUMA TRAINING TABLE IN CONJUNCTION WITH SUPERIOR FIRE AND QRU AT THE MINERAL COUNTY FAIR, COUNTY 5K SCHOOL FUN RUN, AND VARIOUS SCHOOL HEALTH /CAREER FAIR DAYS. WE ALSO WORK WITH THE SCHOOL TO HELP PROVIDE SAFETY EDUCATION AND ONE OF OUR DOCTORS COMPLETES WEIGHT CERTIFICATIONS FOR THE HIGH SCHOOL WRESTLING TEAM. THE HOSPITAL OFFERS A HEALTH FAIR EACH YEAR WHERE MEDICAL TESTS ARE PROVIDED AT REDUCED PRICES TO ENSURE THE COMMUNITY KNOWS THEIR NUMBERS AND RISKS, FOCUSING ON PREVENTION AND INTERVENTION. THE HOSPITAL ALSO OFFERED A 3-DAY YOUTH HEALTH FAIR EVENT WHERE YOUTH COULD RECEIVE THEIR SPORTS PHYSICALS AT A REDUCED CASH PRICE. THE HOSPITAL HOSTS NURSING AND OTHER MEDICAL RELATED COLLEGE STUDENTS AS WELL AS HIGH SCHOOL STUDENTS LOOKING FOR SHADOWING OPPORTUNITIES. THE HOSPITAL IS PART OF A DISASTER PREPAREDNESS PROGRAM FOR ANY LOCAL EMERGENCY OR DISASTER (NOT LIMITED TO MEDICAL CARE). THE HOSPITAL HAS A COMMITTED EMERGENCY PLANNING COMMITTEE AND A DISASTER PREPAREDNESS TRAILER READY TO LAUNCH AT A MOMENTS NOTICE. THE FACILITIES MANAGER ATTENDS AND IS ACTIVE IN DISCUSSIONS AND TRAINING EXERCISES THAT COULD AFFECT OUR COMMUNITY THROUGH THE MINERAL COUNTY LOCAL EMERGENCY PLANNING COMMITTEE. THE EXECUTIVE ADMINISTRATIVE ASSISTANT ALSO SERVES ON THE MINERAL COUNTY ECONOMIC DEVELOPMENT COMMITTEE AND THE DIRECTOR OF CLINICAL SERVICES IS PART OF THE HEALTHY COMMUNITY COALITION. THE HOSPITAL ALSO PARTICIPATES IN A SCHOOL SUPPLY PROGRAM FOR CHILDREN IN THE THREE SCHOOLS IN MINERAL COUNTY. THIS PROGRAM PROVIDES SCHOOL SUPPLIES TO CHILDREN THROUGHOUT THE COUNTY THE HOSPITAL CONDUCTS SEVERAL FOOD DRIVES THROUGHOUT THE YEAR TO SUPPORT THE SUPERIOR SCHOOL PANTRY PROGRAM AND LOCAL FOOD BANKS AND ALSO PARTICIPATED IN A HATS/MITTENS DRIVE IN CONJUNCTION WITH THE LIONS CLUB. IN ADDITION, THE HOSPITAL IS CONTINUALLY WORKING WITH LOCAL OFFICIALS TO PROVIDE NEEDED SERVICES AND DONATE TIME AND EFFORT TO THE COMMUNITY. WE PROVIDE SUBSTANTIAL AMOUNTS OF UNCOMPENSATED CARE TO INDIVIDUALS THAT ARE IN NEED. THE HOSPITAL ALSO PROVIDES OR MAKES ARRANGEMENTS WHEN NECESSARY FOR RIDES TO THOSE PATIENTS WHO HAVE BEEN STRANDED AT OUR FACILITY OR WHO MAY HAVE AN APPOINTMENT AT ANOTHER FACILITY. SCHEDULE H, PART VI, LINE 6 N/A X X X false false false false false false false false false BRIAN LOPEZ PHYSICIAN 439220 150 13177 7296 459843 JACOB WHETZEL PHYSICIAN 276111 20150 8768 7286 312315 KARYN RIDGEWAY PHYSICIAN 297415 150 89 297654 JOHN MILLER PHYSICIAN 234400 150 234550 LAUREL CHAMBERS HASKINS CEO 218393 150 6552 7296 232391 JANE WHETZEL NURSE PRACTITIONER 207003 150 6210 7290 220653 STACY CONROW-VERVERIS CFO 149160 3400 4542 7296 164398 LAUREL CHAMBERS HASKINS CEO 237065 EMPLOYMENT false FORM 990 - ORGANIZATION'S MISSION MINERAL COMMUNITY HOSPITAL PROVIDES QUALITY HEALTHCARE SERVICES REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND FURTHER THAT THEIR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND EDUCATION. FORM 990, PAGE 6, PART VI, LINE 2 LAUREL CHAMBERS HASKINS MARY JO LOMMEN CEO DIRECTOR FAMILY RELATIONSHIP FORM 990, PAGE 6, PART VI, LINE 7A MINERAL COUNTY HOSPITAL DISTRICT APPOINTS FIVE OF THE NINE VOTING DIRECTORS TO THE BOARD OF MISSOULA COMMUNITY HEALTH SERVICES, INC., DOING BUSINESS AS MINERAL COMMUNITY HOSPITAL. FORM 990, PAGE 6, PART VI, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO THE CEO AND THE BOARD, WHO REVIEW THE FORM, SCHEDULES, AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER. ONCE MANAGEMENT IS SATISFIED WITH THE FORM 990, A FINAL APPROVAL IS GIVEN TO THE PREPARER BEFORE FINALIZING THE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C ON AN ANNUAL BASIS, OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO READ AND SIGN AN UPDATED CONFLICT OF INTEREST STATEMENT DISCLOSING ANY CONFLICTS OF INTEREST. THE CONFLICT OF INTEREST GUIDELINES ARE MONITORED BY THE CEO. FORM 990, PAGE 6, PART VI, LINE 15A THE MAIN SOURCE AVAILABLE TO THE HOSPITAL IN REGARD TO FAIR MARKET VALUE IN SALARIES IS THE MONTANA HOSPITAL ASSOCIATION ANNUAL SURVEY. THIS SURVEY IS UTILIZED BY THE BOARD IN DETERMINING THE CEO'S COMPENSATION. FORM 990, PAGE 6, PART VI, LINE 15B THE CEO UTILIZES THE ANNUAL EVALUATION PROCESS AND UNION RATES TO REVIEW AND APPROVE THE CFO AND SUPERVISORS' COMPENSATION. FORM 990, PAGE 6, PART VI, LINE 19 THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES 2,099,348 83,457 0 MINERAL COUNTY MEDICAL FOUNDATION PO BOX 66 SUPERIOR MT 59872 810414741 SUPPORT MT 501C 7 N/A false false false true false false false false false false false false false false false false false false false false