2024-05-13T16:22:00-05:00 2023-06-30 390758449 WIPFLI LLP 105 E PINE ST UPPER FLOOR MISSOULA MT 59802 990 2022-07-01 810428854 NORTHERN MONTANA HEALTH CARE INC NORT 4062652211 PO BOX 1231 HAVRE MT 59501 DAVID HENRY PRESIDENT/CEO 4062652211 2024-04-30 1 DAVID HENRY XXX-XX-XXXX 1 SAM BRUNSON CPA P01696998 4067281800 2024-04-30 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z DAVID HENRY PO BOX 1231 HAVRE MT 59501 10323819 0 X WWW.NMHCARE.ORG X 1985 MT PROVISION OF HEALTHCARE SERVICES 13 8 0 8 0 0 11412 0 3398711 9223464 350941 287706 20336 20831 3781400 9532001 0 0 0 0 0 0 0 0 0 1757364 1462384 1757364 1462384 2024036 8069617 104647756 111749945 2232064 1251652 102415692 110498293 X TO DELIVER HIGH QUALITY COMPREHENSIVE HEALTH CARE SERVICES TO THE HI-LINE COMMUNITIES 0 0 1188655 0 9223464 NORTHERN MONTANA HEALTH CARE, INC. (NMHC) SUPPORTS AND ENCOURAGES HEALTH CARE SERVICES BY PROVIDING FINANCIAL AND MANAGERIAL CONSULTING ASSISTANCE TO THE FOLLOWING CONTROLLED HEALTH CARE ORGANIZATIONS: 1) NORTHERN MONTANA HOSPITAL ID# 81-02317872) NORTHERN MONTANA HEALTH CARE FOUNDATION ID# 36-3464641NMHC PROVIDES OVERALL DIRECTION AND COORDINATES THE POLICY MAKING AND LONG-RANGE PLANNING FOR ITS SUBSIDIARIES. IT IS ORGANIZED SOLELY TO CARRY OUT THE PURPOSES OF ITS TAX-EXEMPT SUBSIDIARIES. CONTINUED ON SCHEDULE O...SOME OF THE SERVICES NMHC FURNISHES TO ITS SUBSIDIARIES ARE: ACCOUNTING SERVICES, NEGOTIATION ASSISTANCE WITH RENTAL AGREEMENTS, MANAGEMENT AND HEALTH CARE CONSULTING, AND OTHER MISCELLANEOUS SERVICES. 1188655 1 0 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 8 1 1 0 0 1 0 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X KIM LUCKE 4062652211 PO BOX 1231 HAVRE MT 59501 DAVID C HENRY PRESIDENT/CEO 1.00 53.00 X X 0 0 0 RICK STEVENS CHAIR 1.00 1.00 X X 0 0 0 DAVID LEEDS VICE CHAIR 1.00 1.00 X X 0 0 0 MILES HAMILTON TREASURER 1.00 1.00 X X 0 0 0 KARRIE LIEN MD SECRETARY 1.00 40.00 X X 0 462331 40270 ANDREW CARLSON TRUSTEE 1.00 1.00 X 0 0 0 DEBBIE HEALY TRUSTEE 1.00 1.00 X 0 0 0 JENNIFER PATRICK TRUSTEE 1.00 1.00 X 0 0 0 PAUL TUSS TRUSTEE 1.00 1.00 X 0 0 0 KRISTEN KAMMERZELL TRUSTEE 1.00 1.00 X 0 0 0 KEVIN HARADA MD TRUSTEE 1.00 40.00 X 0 509375 38863 GARY GROW PHD TRUSTEE 1.00 40.00 X 0 213749 19991 CAMERON ACOR DPM TRUSTEE 1.00 40.00 X 0 292332 39425 KIM LUCKE VP OF FINANCE 1.00 53.00 X 0 140288 18752 CHRISTEN OBRESLEY VICE PRESIDENT 2.00 53.00 X 0 170741 19120 0 1788816 176421 0 0 1 0 0 EQUITY IN EARNINGS OF 900099 7992714 7992714 RENT REVENUE 900099 1230375 1230375 SUPPORTING REVENUE 900099 375 375 9223464 181432 181432 33623 12792 20831 20831 20831 705812 179488 647630 131396 58182 48092 106274 106274 9532001 9223464 0 308537 355700 266775 88925 15610 15610 8803 8064 739 5553 5553 41322 1638 39684 83058 31938 51120 73416 73416 774151 753249 20902 65711 16995 48716 REPAIRS & MAINTENANCE 39060 36580 2480 1462384 1188655 273729 0 1501195 1123068 2122 2122 49583 54252 26010563 18947740 7829730 7062823 6581870 7254217 88649756 96196656 33500 56807 104647756 111749945 14800 9719 1468574 1231888 748690 10045 2232064 1251652 X 102415692 110498293 102415692 110498293 104647756 111749945 8069617 12984 0 X X 0 1 X 1 0 X X 1 NORTHERN MONTANA HOSPITAL 810231787 3 1 1350984 0 1 1350984 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 PART IV, SECTION A, LINE 6: THE ORGANIZATION PROVIDES SUPPORT TO NORTHERN MONTANA HEALTH CARE FOUNDATION, WHICH IS A RELATED CONTROLLED ORGANIZATION; THE ORGANIZATION IS THE SOLE MEMBER OF THE FOUNDATION. THE FOUNDATION SUPPORTS AND BENEFITS THE ORGANIZATION'S SUPPORTED ORGANIZATION, SO PROVIDING SUPPORT TO THE FOUNDATION INDIRECTLY SUPPORTS THE IDENTIFIED SUPPORTED ORGANIZATIONS. 152095 6817 158912 145017 7078 152095 138215 6802 145017 132797 5418 138215 126935 5862 132797 0.00000 1.00000 0.00000 0 1 1 100000 100000 25179919 18332481 6847438 157586 144645 12941 573058 470614 102444 7062823 INVESTMENT IN AFFILIATES 96196656 C 96196656 DUE TO AFFLIATE NMHCF 10045 10045 X 9557777 12984 12792 25776 9532001 0 9532001 1475176 12792 12792 1462384 0 1462384 PART V, LINE 4: THE ENDOWMENT FUNDS ARE IN THE POSSESSION OF NORTHERN MONTANA HEALTH CARE FOUNDATION, A RELATED ORGANIZATION. THE FUNDS ARE USED TO PROVIDE FUNDING FOR SPECIFIC ACTIVITIES AND GENERAL OPERATIONS. 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 12,792. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 12,792. 0 0 0 0 0 0 0 0 0 KEVIN HARADA MD TRUSTEE 0 509199 0 0 0 176 0 6100 0 32763 0 548238 0 0 KARRIE LIEN MD SECRETARY 0 461492 0 0 0 839 0 6100 0 34170 0 502601 0 0 CAMERON ACOR DPM TRUSTEE 0 291883 0 0 0 449 0 6100 0 33325 0 331757 0 0 GARY GROW PHD TRUSTEE 0 211272 0 0 0 2477 0 4383 0 15608 0 233740 0 0 CHRISTEN OBRESLEY VICE PRESIDENT 0 169937 0 0 0 804 0 3537 0 15583 0 189861 0 0 KIM LUCKE VP OF FINANCE 0 139470 0 0 0 818 0 2934 0 15818 0 159040 0 0 PART I, LINE 3 PRESIDENT/CEO IS COMPENSATED BY AN UNRELATED MANAGEMENT COMPANY. A RELATED ORGANIZATION AND THE MANAGEMENT COMPANY HAVE A PROCESS IN PLACE TO DETERMINE THE CEO'S COMPENSATION: A COMPENSATION COMMITTEE, USING THE FORM 990 OF OTHER ORGANIZATIONS, AND THE APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. A CITY OF HAVRE MONTANA 816001274 000000000 2007-11-30 3186968 FUND NEW MEDICAL BUILDING 0 0 0 A 1955080 3186968 61968 3125000 2008 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 0 0 0 0 0 A 0 SCHEDULE K, PART IV, LINE 2C: THE ARBITRAGE CALCULATION PERFORMED MARCH 16, 2018 WAS PREPARED THROUGH MAY 17, 2017. THIS IS THE FINAL ARBITRATION CALCULATION REQUIRED TO BE PERFORMED DUE TO ALL THE PROCEEDS BEING SPENT. FORM 990, PART VI, SECTION A, LINE 2 DAVID HENRY, KIM LUCKE, AND CHRISTEN OBRESLEY HAVE A BUSINESS RELATIONSHIP WITH KARRIE LIEN, KEVIN HARADA, GARY GROW, AND CAMERON ACOR. DAVID, KIM, AND CHRISTEN ARE OFFICERS OF A RELATED NONPROFIT ORGANIZATION THAT EMPLOYS THESE BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 3 DAVID C. HENRY, PRESIDENT/CEO IS EMPLOYED BY FUNDAMENTAL FINANCIAL GROUP, AN UNRELATED MANAGEMENT COMPANY. NORTHERN MONTANA HOSPITAL (NMH) PAYS THE UNRELATED MANAGEMENT COMPANY FOR DAVID'S SERVICES PROVIDED TO THE HOSPITAL, NORTHERN MONTANA HEALTH CARE, INC. AND NORTHERN MONTANA HEALTH CARE FOUNDATION. THE PRESIDENT/CEO'S RESPONSIBILITIES INCLUDE IMPLEMENTING DECISIONS AND SUPERVISING THE MANAGEMENT, ADMINISTRATION AND OPERATION OF THE HOSPITAL AND THE RELATED, EXEMPT ORGANIZATIONS. THE AMOUNT OF COMPENSATION PAID DURING THE CALENDAR YEAR 2022 WAS $566,000. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION ALLOWS FOR A TOTAL NUMBER OF 20 TO 50 MEMBERS. ALL MEMBERS MUST BE ELECTED FROM PERSONS WHO RESIDE IN THE AREA SERVED BY NORTHER MONTANA HOSPITAL. MEMBERS SHALL SERVE FOR A TERM OF THREE YEARS AND UNTIL THEIR SUCCESSORS ARE DULY ELECTED AND QUALIFIED. ADDITIONAL MEMBERS MAY BE ELECTED AT ANY MEETING TO FILL VACANCIES CREATED BY THE DEATH OR RESIGNATION OF A MEMBER DURING HIS OR HER TERM OF SERVICE. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS OF THE CORPORATION SHALL HAVE THE FOLLOWING POWERS: (I) TO APPROVE OR DISAPPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION THAT AFFECT THE IDENTITY, POWER, AND/OR DUTIES OF THE MEMBERS OF THE CORPORATION, OR MERGERS OR CONSOLIDATIONS WITH ANOTHER CORPORATION, OR SALES OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS, (II) TO APPROVE OR DISAPPROVE LIQUIDATIONS OF THE CORPORATION'S MERGERS OR CONSOLIDATIONS OF THE CORPORATION WITH ANOTHER CORPORATION, OR SALES OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS, (III) TO ELECT THE MEMBERS OF THE CORPORATION, AND (IV) TO APPROVE OR DISAPPROVE AMENDMENTS TO THE BYLAWS WHICH AFFECT THE IDENTITY, POWER, AND/OR DUTIES OF THE MEMBERS OF THE CORPORATION. THE MEMBERS SHALL HAVE NO OTHER POWERS WITH REGARD TO THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 8B NO COMMITTEE HAD THE AUTHORITY TO ACT ON BEHALF OF THE BOARD DURING THE FISCAL YEAR ENDED JUNE, 30 2023. FORM 990, PART VI, SECTION B, LINE 11B THE VP OF FINANCE REVIEWS THE FORM. THE BOARD OF DIRECTORS RECEIVES A COPY OF THE REVIEWED FORM 990 VIA E-MAIL BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS ALL TRUSTEES, DIRECTORS, OFFICERS, AND KEY EMPLOYEES. THE BOARD IDENTIFIES POTENTIAL CONFLICTS FROM ANNUAL DISCLOSURES. DISCLOSURES ARE REVIEWED BY ADMINISTRATION AFTER ALL ARE GATHERED. THE BOARD DISCUSSES THE POTENTIAL CONFLICTS AND DETERMINES IF VOTING ON RELATED ITEMS WOULD BE A CONFLICT OF INTEREST. IF A CONFLICT IS DETERMINED TO EXIST, THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE CONFLICTED ITEM. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT/CEO IS COMPENSATED BY AN UNRELATED MANAGEMENT COMPANY. THE UNRELATED MANAGEMENT COMPANY RECEIVES A FEE FOR SERVICE FROM A RELATED ORGANIZATION FOR THE CEO'S SERVICE PROVIDED TO THIS ORGANIZATION AND RELATED ORGANIZATIONS, NORTH MONTANA HOSPITAL (NMH) AND NORTH MONTANA HEALTH CARE FOUNDATION, INC (NMHCF). IN DETERMINING THE CEO'S COMPENSATION, THE GOVERNING BOARD, WITH THE EXCEPTION OF THE CEO, MEETS AND REVIEWS NMH AND NMHC FINANCIAL RESULTS, CEO'S CURRENT YEAR PRIORITIES, DISCUSSES EVALUATION TOOLS TO BE USED FOR THE CEO'S EVALUATION, HOW COMPARATIVE SALARIES WILL BE OBTAINED AND DISCUSSES THE HISTORY OF COMPENSATION TO THE CEO. AT A SECOND MEETING, THE BOARD REVIEWS NON-FINANCIAL ACTIVITY OF NMH AND NMHC AND THE RESULTS OF THE CEO EVALUATIONS COMPLETED BY THE BOARD MEMBERS. THEN THEY REVIEW AND DISCUSS A COMPENSATION COMPARATIVE SUMMARY OF MONTANA'S CEO COMPENSATION. THEY AGREE UPON A LIST OF THE COMING YEAR'S PRIORITIES FOR THE CEO AND PROPOSED COMPENSATION WITH THE COMPENSATION SET BY BOARD VOTE. THIS ANNUAL PROCESS WAS COMPLETED DURING FISCAL YEAR 2023. THE CEO REVIEWS AND APPROVES THE COMPENSATION FOR ALL OTHER OFFICERS AND PHYSICIANS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. NORTHERN MONTANA HOSPITAL PO BOX 1231 HAVRE MT 59501 810231787 HEALTH CARE SERVICES MT 501(C)(3) LINE 3 NORTHERN MONTANA HEALTH CARE INC 1 NORTHERN MONTANA HEALTH CARE FOUNDATION INC PO BOX 1231 HAVRE MT 59501 363464641 SUPPORT OF NORTHERN MONTANA HOSPITAL MT 501(C)(3) LINE 7 NORTHERN MONTANA HEALTH CARE INC 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 1 1 NORTHERN MONTANA HOSPITAL J 900000 FMV NORTHERN MONTANA HOSPITAL M 300900 COST NORTHERN MONTANA HOSPITAL P 675294 COST NORTHERN MONTANA HOSPITAL R 500000 COST NORTHERN MONTANA HOSPITAL O 54800 COST NORTHERN MONTANA HEALTH CARE FOUNDATION INC R 54187 COST