TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) DAVID C HENRY...................................................................... PRESIDENT/CEO	53.00 ................. 2.00	X	X		0	0
(2) RICK STEVENS...................................................................... CHAIR	1.00 ................. 1.00	X	X		0	0
(3) DAVID LEEDS...................................................................... VICE CHAIR	1.00 ................. 1.00	X	X		0	0
(4) MILES HAMILTON...................................................................... TREASURER	1.00 ................. 1.00	X	X		0	0
(5) KARRIE LIEN MD...................................................................... SECRETARY	40.00 ................. 1.00	X	X		532,465	40,090
(6) ANDREW CARLSON...................................................................... TRUSTEE	1.00 ................. 1.00	X			0	0
(7) DEBBIE HEALY...................................................................... TRUSTEE	1.00 ................. 1.00	X			0	0
(8) JENNIFER PATRICK...................................................................... TRUSTEE	1.00 ................. 1.00	X			0	0
(9) PAUL TUSS...................................................................... TRUSTEE	1.00 ................. 1.00	X			0	0
(10) KRISTEN KAMMERZELL...................................................................... TRUSTEE	1.00 ................. 1.00	X			0	0
(11) KEVIN HARADA MD...................................................................... TRUSTEE-IPD MEMBER	40.00 ................. 1.00	X			549,315	38,682
(12) GARY GROW PHD...................................................................... TRUSTEE-IPD MEDICAL DIRECTOR	40.00 ................. 1.00	X			196,708	14,634
(13) CAMERON ACOR DPM...................................................................... TRUSTEE-CHIEF OF MEDICAL STAFF	40.00 ................. 1.00	X			320,976	39,245
(14) KIM LUCKE...................................................................... VP OF FINANCE	53.00 ................. 2.00		X		139,909	18,477
(15) CHRISTEN OBRESLEY...................................................................... VICE PRESIDENT	51.00 ................. 4.00		X		171,728	18,847
(16) MICHAEL FARR DO...................................................................... DO	40.00 ................. 0.00			X	998,580	31,320
(17) WALTER SMITH DO...................................................................... DO	40.00 ................. 0.00			X	750,946	35,510

(A) Name and business address	(B) Description of services	(C) Compensation
SLATE HEALTHCARE LLC 2100 WEST LOOP SOUTH SUITE 900 HOUSTON,TX77027	STAFFING	3,589,296
HAYES LOCUMS LLC 67001 N ANDREWS AVE SUITE 600 FT LAUDERDALE,FL33309	STAFFING	1,470,930
CORONIS HEALTH 5963 EXCHANGE RD SUITE 114 SYKEVILLE,MD21784	PURCHASE SERVICES	1,394,638
ALL STAR HEALTHCARE SOLUTIONS PO BOX 936725 ATLANTA,GA31193	STAFFING	724,007
PARK PLACE INTERNATIONAL 8401 CHAGRIN RD SUITE 15D CHAGRIN FALLS,OH44023	PURCHASE SERVICES	591,916
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 29

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

NORTHERN MONTANA HOSPITAL

Employer identification number

81-0231787

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

NORTHERN MONTANA HOSPITAL

Employer identification number

81-0231787

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization NORTHERN MONTANA HOSPITAL

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization NORTHERN MONTANA HOSPITAL		Employer identification number 81-0231787

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization NORTHERN MONTANA HOSPITAL			Employer identification number 81-0231787
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

right arrow

Complete if the organization is described below. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

NORTHERN MONTANA HOSPITAL

Employer identification number

81-0231787

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... right arrow

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2022

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2022

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

7,660

Total. Add lines 1c through 1i ....................................................................................................

7,660

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	LOBBYING PORTION OF ASSOCIATION DUES.

Schedule C (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

NORTHERN MONTANA HOSPITAL

Employer identification number

81-0231787

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c	16,502
d	Additions during the year ............................	1d	90,122
e	Distributions during the year ..........................	1e	106,624
f	Ending balance ................................	1f	0

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	158,912	152,095	145,017	138,215	132,797
b	Contributions ...	7,040	6,817	7,078	6,802	5,418
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	165,952	158,912	152,095	145,017	138,215

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

0 %

Permanent endowment right arrow

100.000 %

Term endowment right arrow

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	75,272		75,272
b	Buildings ....	30,888,208	23,355,652	7,532,556
c	Leasehold improvements
d	Equipment ....	42,224,008	36,254,048	5,969,960
e	Other .....	2,504,243	1,322,227	1,182,016
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				14,759,804

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)ROU ASSET				4,390,048
(2)ASSET FOR PENSION BENEFITS				4,285,064
(3)ACCRUED INTEREST RECEIVABLE				191,246
(4)DUE FROM AFFILIATES				2,426,396
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				11,292,754

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
ROU LIABILITY	4,833,642
DUE TO AFFILIATES	716,784







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	5,550,426
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2022

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	92,777,660
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	652,534
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d	9,734
e	Add lines 2a through 2d .....................			2e	662,268
3	Subtract line 2e from line 1..................			3	92,115,392
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	92,115,392

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	88,875,842
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ...........	2d	9,734
e	Add lines 2a through 2d....................			2e	9,734
3	Subtract line 2e from line 1...................			3	88,866,108
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.....................			4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	88,866,108

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART IV, LINE 1B:	THE CUSTODIAL FUNDS ARE NOT REPORTED ON THE BALANCE SHEET OF NMH AS THEY ARE PERSONAL RESOURCE FUNDS OF THE RESIDENTS TO BE USED ONLY FOR THEIR PERSONAL NEEDS. IF THE RESIDENT PASSES, THE FUNDS EITHER GO TO THE FAMILY OR BACK TO THE STATE. THEY ARE IN NO WAY AN ASSET OF THE ORGANIZATION.
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 9,734.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSES 9,734.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	RETURNED SCHOLARSHIPS

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

NORTHERN MONTANA HOSPITAL

Employer identification number

81-0231787

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 12500.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other 22500.0000000000 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .		1,875,101		1,875,101	2.110 %
b	Medicaid (from Worksheet 3, column a) . . . . .		16,624,021	16,093,220	530,801	0.600 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .		202,997	347,224	0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		18,702,119	16,440,444	2,405,902	2.710 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .	16,969	10,982,460	6,000,182	4,982,278	5.610 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .		34,128		34,128	0.040 %
j	Total. Other Benefits . .	16,969	11,016,588	6,000,182	5,016,406	5.650 %
k	Total. Add lines 7d and 7j .	16,969	29,718,707	22,440,626	7,422,308	8.360 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

2,071,843

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

350,970

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

17,309,492

Enter Medicare allowable costs of care relating to payments on line 5.....

17,645,411

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-335,919

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)						Other (describe)
1	NORTHERN MONTANA HOSPITAL 30 13TH STREET HAVRE,MT59501 WWW.NMHCARE.ORG 12835	X	X	X	X	2 PROVIDER BASED RURAL HEALTH CLINICS

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	NORTHERN MONTANA HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 23

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): NMHCARE.ORG/DEPARTMENTS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/

Other website (list url): BULLHOOK.COM AND WWW.HILLCOUNTYHEALTH.COM

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 24

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): NMHCARE.ORG/DEPARTMENTS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	NORTHERN MONTANA HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 125.000000000000%
and FPG family income limit for eligibility for discounted care of 225.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

NMHCARE.ORG/WP-CONTENT/UPLOADS/2020/09/FINANCIAL-ASSISTANCE-POLICY-1.DOCX

The FAP application form was widely available on a website (list url):

NMHCARE.ORG/WP-CONTENT/UPLOADS/2020/09/NMHC-FINANCIAL-ASSISTANCE-APPLICATON

A plain language summary of the FAP was widely available on a website (list url):
NMHCARE.ORG/WP-CONTENT/UPLOADS/2020/09/FINANCIAL-ASSISTANCE-POLICY-1.DOCX

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	NORTHERN MONTANA HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	NORTHERN MONTANA HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

Yes

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
NORTHERN MONTANA HOSPITAL	PART V, SECTION B, LINE 5: THIS ASSESSMENT INCORPORATES DATA FROM PRIMARY AND SECONDARY SOURCES. DATA WAS COLLECTED FROM HILL COUNTY RESIDENTS THROUGH A SURVEY INSTRUMENT IN JUNE 2023, AND EMPLOYEES OF THE MONTANA DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES ANALYZED THE RESULTS. ALONGSIDE KEY FINDINGS OF THESE COMMUNITY SURVEY RESULTS, A REVIEW OF SECONDARY COUNTY DATA AND INPUT FROM COMMUNITY STAKEHOLDERS, HEALTH PROFESSIONALS, AND HUMAN SERVICE ORGANIZATIONS LED TO THE PRIORITIZATION OF THE FOLLOWING AREAS TO BE ADDRESSED IN A SUBSEQUENT COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP): BEHAVIORAL HEALTH, ACCESS TO DENTAL CARE, AND OBESITY. BOTH THIS CHNA AND THE FORTHCOMING CHIP ARE INTENDED TO BE LIVING DOCUMENTS, USED AND UPDATED AS IS MOST STRATEGIC FOR THE ONGOING WORK IN HILL COUNTY OF ENSURING HEALTHY PEOPLE IN HEALTHY COMMUNITIES.
NORTHERN MONTANA HOSPITAL	PART V, SECTION B, LINE 6B: THIS ASSESSMENT WAS LED BY THE HILL COUNTY HEALTH CONSORTIUM (HCHC), WHOSE PRINCIPAL PARTNERS ARE THE HILL COUNTY HEALTH DEPARTMENT, NORTHERN MONTANA HEALTH CARE, BULLHOOK COMMUNITY HEALTH CENTER, DISTRICT 4 HUMAN RESOURCES DEVELOPMENT COUNCIL, AND THE HELP COMMITTEE AND BOYS & GIRLS CLUB OF THE HI-LINE.
NORTHERN MONTANA HOSPITAL	PART V, SECTION B, LINE 7D: THE CHNA IS ELECTRONICALLY DELIVERED TO EVERY MEMBER OF THE CONSORTIUM AND NMH. BULL HOOK COMMUNITY HEALTH CENTER AND THE HILL COUNTY HEALTH DEPARTMENT ALL RECEIVED HARD COPIES AVAILABLE FOR DISTRIBUTION.
NORTHERN MONTANA HOSPITAL	PART V, SECTION B, LINE 11: PRIORITY ISSUE ONE: FACILITY AND COMMUNITY SAFETYNORTHERN MONTANA HOSPITAL (NMH) HEALTH LEADERS CONTINUE TO IDENTIFY FACILITY AND COMMUNITY SAFETY AS THEIR TOP PRIORITY. AT THE FOREFRONT OF SAFETY IS A SAFE WORKING ENVIRONMENT FOR ALL NMH EMPLOYEES. NMH IS WELL STOCKED WITH PERSONAL PROTECTIVE EQUIPMENT (PPE) ON-SITE AND HAS COMPREHENSIVE POLICIES AND PROCEDURES ON ITS USE AND DISPOSAL. BACKUP GENERATORS FOR NORTHERN MONTANA CARE CENTER (NMCC) ARE MAINTAINED, AND ADEQUATE FUEL SUPPLY IS AVAILABLE FOR THE GENERATORS. TOUCH FREE, FOAM HAND SANITIZERS WERE IMPLEMENTED IN THE CARE CENTER FOR IMPROVED SAFETY AND INFECTION PREVENTION. SAFETY IS ALL ABOUT EDUCATION AND NMH EDUCATES ALL EMPLOYEES ON SAFETY AND DISASTER RELATED PROTOCOLS. IN FY 2024, EDUCATION ABOUT VACCINATIONS CONTINUE ACCORDING TO FEDERAL GUIDELINES. NMH CONTINUES THE DRIVE-THROUGH COMMUNITY FLU SHOT CLINIC AND EMPLOYEE FLU CLINIC. VOLUNTARY STAFF COVID-19 VACCINATIONS CONTINUE. MOCK CODE DRILLS WERE INTRODUCED IN THE HOSPITAL AND CONTINUE IN THE CARE CENTER TO FACILITATE TRAINING OF STAFF IN CODE RESPONSE. NORTHERN MONTANA HEALTH CARE (NMHC) WAS TESTED IN REAL TIME WHEN THE ENTIRE COMMUNITY WAS UNDER A BOIL WATER ADVISORY FOR AN EXTENDED TIME DURING THE YEAR. ADDITIONALLY, NMH PARTICIPATED IN FOUR OTHER SAFETY DRILLS. A MEDITECH OUTAGE TESTED THE FACILITY. A TABLETOP DRILL OF A FOODBORNE ILLNESS AND MARBERG VIRUS DRILL INVOLVED NMH AND THE COMMUNITY OF HAVRE. FINALLY, NMH WAS INVOLVED IN A STATEWIDE DISASTER DRILL. HAND HYGIENE AND INFECTION PREVENTION CONTINUE TO BE MANDATORY AND IMPORTANT EDUCATION FOR ALL STAFF MEMBERS. NMH CONTINUES TO BE ACTIVE WITH THE LOCAL EMERGENCY PLANNING COMMITTEE (LEPC) WHICH INCLUDES OTHER COMMUNITY MEMBERS WHO FOCUS ON SAFETY AND DISASTER PLANS. COORDINATION AMONG THESE KEY ENTITIES IS ESSENTIAL TO THE SAFETY OF THE COMMUNITY.NMH LEADERS BELIEVE PART OF A SAFE AND CONSIDERATE WORKING ENVIRONMENT IS DEVELOPING CAMARADERIE THROUGH ACTIVITIES. NMH HOSTS THE EMPLOYEE FAMILY PICNIC, OCTOBERFEST, AND ACTIVITIES DURING HOSPITAL WEEK TO BUILD RELATIONSHIPS. IN FY 2024, EDUCATION ON CONSIDERATE COMMUNICATION WAS ADDED TO THE ANNUAL EDUCATIONAL BOOKS. PRIORITY ISSUE 2: EMPLOYEE RETENTION AND RECRUITMENTALTHOUGH DECLINING, THE VACANCY RATES IN MONTANA HOSPITALS REMAIN HIGH IN THIS POST PANDEMIC ERA ILLUMINATING THE REASON NMH HEALTH LEADERS CONTINUE TO IDENTIFY EMPLOYEE RETENTION AND RECRUITMENT AS THEIR SECOND PRIORITY. IN FY 2024, NMH WAS ABLE TO RECRUIT A SURGEON AMONG OTHER STAFF MEMBERS. SUCCESSFUL RECRUITMENT AND RETENTION PRACTICES MINIMIZE THE NUMBER AND DURATION OF VACANCIES, WHICH IMPROVES THE QUALITY OF CARE PROVIDED TO OUR PATIENTS AND ENSURES SERVICES ARE PROVIDED LOCALLY TO THE COMMUNITY.TO ADDRESS RECRUITMENT OF QUALIFIED, LICENSED MEDICAL STAFF, NMH HAS PARTNERED WITH SEVERAL COLLEGES INCLUDING BUT NOT LIMITED TO MONTANA STATE UNIVERSITY (MSU), MSU-NORTHERN, UNIVERSITY OF MONTANA, UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE (WWAMI), FLATHEAD VALLEY COLLEGE, AANIIH NAKODA COLLEGE, WEBER UNIVERSITY, GREAT FALLS COLLEGE, AND ROCKY MOUNTAIN COLLEGE. NMH HAS PARTNERED WITH THE STATE OF MONTANA TO OFFER AN APPRENTICESHIP FOR MEDICAL ASSISTANTS WISHING TO BECOME CERTIFIED MEDICAL ASSISTANTS. THIS PROGRAM PROVIDES CURRENT STAFF MEMBERS THE OPPORTUNITY TO GROW THEIR KNOWLEDGE, SKILLS, AND CAPABILITIES, WHILE STILL PERMITTING THEM TO WORK FULL TIME. SUBSEQUENTLY, THIS WILL INCREASE THE LEVEL OF CARE PROVIDED TO OUR PATIENTS AND OUR COMMUNITY. NMCC CONTINUES TO OFFER CERTIFIED NURSING ASSISTANT (CNA) CLASSES.NMH BELIEVES THE BEST AMBASSADORS FOR RECRUITMENT ARE CURRENT EMPLOYEES, AND SINCE GREAT PEOPLE SURROUND THEMSELVES WITH OTHER HIGHLY CAPABLE PROFESSIONALS, NMH CONTINUES TO ENLIST THEIR STAFF FOR ASSISTANCE IN RECRUITMENT. WE OFFER REFERRAL BONUSES TO OUR EMPLOYEES AND SIGN-ON BONUSES TO OUR CANDIDATES. NMH CONTINUES TO EXPAND THEIR OUTREACH EFFORTS BY UTILIZING SOCIAL MEDIA, ADVERTISING ON MULTIPLE JOB BOARDS, AND PARTICIPATING IN SEVERAL CAREER FAIRS ANNUALLY. IN FY 2024, JOB FAIRS WERE EXTENDED INTO HIGH SCHOOLS IN SEARCH OF SUMMER AND AFTER SCHOOL WORKERS. OUR DIRECTORS PROMOTE AND EMBRACE FLEXIBILITY IN SCHEDULING AND SUPPORT AND ENCOURAGE A DIVERSE AND INCLUSIVE WORKPLACE CULTURE.NMH UNDERSTANDS THE IMPORTANCE OF HAVING A COMPETITIVE ADVANTAGE; THUS, NMH WILL CONTINUE TO EVALUATE WAGES AND INCREASE SCALES WHERE APPROPRIATE TO REMAIN COMPETITIVE IN THE COMMUNITY AND THE HEALTHCARE INDUSTRY. EMPLOYEES ARE THE NUMBER ONE ASSET AT NMH. WE BELIEVE THAT EMPLOYEE RETENTION INVOLVES STRATEGIC ACTION FOR EMPLOYEES TO REMAIN MOTIVATED AND ENGAGED SO THEY ELECT TO REMAIN WITH THE ORGANIZATION, REDUCING EMPLOYEE TURNOVER. NMH HAS ESTABLISHED AN EMPLOYEE ENGAGEMENT PROGRAM TO ADVANCE CO-WORKER RELATIONSHIPS, ELEVATE HEALTH AND WELLNESS AND ENCOURAGE COMMUNITY INVOLVEMENT. NMH BELIEVES STRONG LEADERSHIP IS ESSENTIAL FOR RECRUITMENT AND RETENTION SUCCESS. TO IMPROVE THE DIRECTOR'S KNOWLEDGE, NMH IMPLEMENTED A NEW DIRECTOR ONBOARDING PROGRAM TO EXPEDITE THE EDUCATION AND GROWTH OF NEW LEADERSHIP. WE BELIEVE THE SOONER WE EQUIP OUR LEADERS WITH THE INFORMATION AND TOOLS THEY NEED, THE MORE SUCCESSFUL WE WILL BE AS AN ORGANIZATION.WE CONTINUE TO RECOGNIZE OUR EMPLOYEES' EFFORTS INDIVIDUALLY THROUGH THE C.A.R.E (COMPASSIONATELY ACHIEVING REMARKABLE EXCELLENCE) AWARD AND THE "PICKLE BARREL". BOTH ARE RECOGNITION PROGRAMS THAT ALLOW EMPLOYEES AND PATIENTS TO RECOGNIZE OUR STAFF MEMBERS. NMH UNDERSTANDS THE VALUE IN EMPLOYMENT LONGEVITY AND CELEBRATES EVERY FIVE-YEAR INTERVAL OF AN EMPLOYEE'S CAREER AT NMH THROUGH OUR ANNUAL EMPLOYEE AWARDS BANQUET AND MILESTONE GIFTS. ADDITIONALLY, WE RECOGNIZE EMPLOYEES AND THEIR FAMILY MEMBERS DURING GRADUATION SEASON. THE BRIDGE WEEKLY NEWSLETTER PROMOTES THE WINNERS OF THE C.A.R.E. AND PICKLE BARREL AWARDS AND CELEBRATES AND HIGHLIGHTS ACTIVITIES AND NEW HIRES WITHIN THE ORGANIZATION. MANDATORY OVERTIME IS NOT UTILIZED TO COVER SHIFTS TO SUPPORT STAFF'S WORK FAMILY BALANCE. STAFF MEMBERS SUPPORT EACH OTHER WHEN THEY HAVE TIME TO RECHARGE. DE-ESCALATION TRAINING WAS ADDED INTO THE NEW HIRE ORIENTATION. DE-ESCALATION TRAINING FACILITATES STAFF'S ABILITY TO DEAL WITH FRUSTRATED OR ANGRY INDIVIDUALS AND DECREASES STRESS WHICH IMPROVES RETENTION. NMH CHAMPIONS A BEHAVIORAL HEALTH NEWSLETTER FOR ITS EMPLOYEES. PRIORITY ISSUE 3: BEHAVIORAL HEALTHNMH HEALTH LEADERS IDENTIFIED BEHAVIORAL HEALTH AS THEIR THIRD PRIORITY. THE COVID-19 PANDEMIC INCREASED ANXIETY AND DEPRESSION WORLDWIDE. NOW IN THE POST PANDEMIC ERA, BEHAVIORAL HEALTH IS A SIGNIFICANT PRIORITY AS MENTAL HEALTH ISSUES AFFECT INDIVIDUALS OF ALL AGES, RACES, AND SOCIOECONOMIC STATUS. NMH HAS SERVICES AVAILABLE TO SUPPORT THOSE STRUGGLING WITH MENTAL HEALTH AND CONTINUES TO FINETUNE THE SERVICES THAT WILL IMPROVE THE WELL-BEING OF THE COMMUNITY MEMBERS.IN FY 2024 THE NEED FOR ASSISTANCE FOR SUBSTANCE USE DISORDERS FOR ADULTS AND BEHAVIORAL HEALTH SERVICES FOR ADULTS, ADOLESCENTS AND CHILDREN IS GREAT AS EVER. CHEMICAL DEPENDENCY TREATMENT SERVICES (CDTS) AND BEHAVIORAL HEALTH SERVICES (BHS) CONTINUE TO BE OFFERED VIA TELEHEALTH. THE PROVIDERS AT THE FAMILY MEDICAL CENTER AND SPECIALTY MEDICAL CENTER CONTINUE TO USE NUMEROUS TOOLS TO ASSESS PATIENTS' MENTAL HEALTH ANNUALLY AND AS INDICATED, INCLUDING: THE PHQ-9 (DEPRESSION), GAD-7 (ANXIETY), CRAFTT (SUBSTANCE ABUSE IN ADOLESCENTS), AND THE C-SSRS (SUICIDE SEVERITY). INTEGRATED BEHAVIORAL HEALTH BENEFITS THE PATIENTS BY PROVIDING WARM HANDOFFS TO A LICENSED CLINICAL PROFESSIONAL COUNSELOR (LCPC) TO OFFER MENTAL HEALTH INTERVENTION IN THE PATIENTS' TIME OF NEED. WARM HANDOFFS AND TIMELY CARE ENSURE BETTER OUTCOMES AND PRIORITIZE MENTAL HEALTH FOR EACH PATIENT. DURING THE SPORTS PHYSICAL JAMBOREE, STAFF PROVIDED INFORMATION ON ALCOHOL USE, STDS, AND HOW TO SEEK BEHAVIORAL HEALTH SERVICES FOR THE YOUTH.THE MEADOWLARK INITIATIVE, SPONSORED BY NMH AND THE MONTANA HEALTHCARE FOUNDATION, INTEGRATES PRENATAL AND POSTNATAL CARE, AND BEHAVIORAL HEALTH TO IMPROVE MATERNAL AND NEONATAL OUTCOMES USING THE EPSD POSTNATAL DEPRESSION SCREENING TOOL. IN FY 2024, IT WAS EXPANDED TO PROVIDE SERVICES DURING THE BABY'S FIRST YEAR OF LIFE. CONSIDERING THE INCREASING AWARENESS OF AND NEED FOR BEHAVIORAL HEALTH, IT IS ONLY RIGHT TO FOCUS EFFORTS ON WOMEN AND THEIR INFANTS DURING THIS TIME OF TRANSITION TO HELP THEM OBTAIN HELP FOR MENTAL HEALTH PROBLEMS AND SUBSTANCE ABUSE.TO INCREASE COLLABORATION WITH NMH'S PARTNERS IN THE PROVISION OF MENTAL HEALTH SERVICES AND IMPROVE THE CONTINUITY OF CARE FOR PATIENTS, NMH MEETS WITH PROVIDERS FROM ROCKY BOY HEALTH CENTER, BEAR PAW RECOVERY, AND BULLHOOK COMMUNITY HEALTH CENTER.
NORTHERN MONTANA HOSPITAL	PART V, SECTION B, LINE 16J: IN ADDITION, A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE FACILITY'S EMERGENCY ROOM AND WAITING ROOMS AS WELL AS ADMISSIONS OFFICES. THE HOSPITAL'S "CONDITIONS OF TREATMENT" ALSO INCLUDES INFORMATION REGARDING THE FINANCIAL ASSISTANCE POLICY.
NORTHERN MONTANA 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 CHARGED GROSS CHARGES ON ELECTIVE PROCEDURES.

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?1
Name and address		Type of Facility (describe)
1	1 - NORTHERN MONTANA CARE CENTER 24 13TH STREET HAVRE,MT59501	NURSING HOME
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 7:	CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID, LINE 7B, WAS CALCULATED USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. COMMUNITY HEALTH IMPROVEMENT SERVICES, LINE 7E, HEALTH PROFESSIONAL EDUCATION, LINE 7F, AND CASH AND IN-KIND DONATIONS, LINE 7I, ARE ACTUAL COSTS REPORTED IN THE GENERAL LEDGER. THE COST FOR SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G WAS DETERMINED USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2.
PART III, LINE 2:	THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS AND RESIDENTS.
PART III, LINE 3:	THE ESTIMATED AMOUNT OF IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BY USING THE PERCENT OF POPULATION IN THE ORGANIZATION'S SERVICE AREA BELOW FPG. THE ORGANIZATION FEELS IT IS REASONABLE TO ASSUME AT LEAST THE SAME PERCENTAGE OF IMPLICIT PRICE CONCESSIONS IS ATTRIBUTABLE TO THOSE THAT WOULD HAVE QUALIFIED FOR CHARITY CARE, HAD THE ORGANIZATION HAD THE INFORMATION AVAILABLE TO DETERMINE ELIGIBILITY.
PART III, LINE 4:	PAGE 15 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS CONTAINS THE FOOTNOTE DESCRIBING BAD DEBT EXPENSE.
PART III, LINE 8:	SERVICES ARE PROVIDED TO PATIENTS UNDER THE MEDICARE PROGRAM KNOWING THAT NOT ALL COSTS ASSOCIATED WITH PROVIDING THESE SERVICES WILL BE RECOVERED. PROVIDING THESE SERVICES IS ESSENTIAL TO THESE PATIENTS AND THE COMMUNITY AND INCREASES THEIR ACCESS TO HEALTHCARE SERVICES. THEREFORE, THE ENTIRE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT.MEDICARE ALLOWABLE COST IS BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES & REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES.
PART III, LINE 9B:	THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES INFORMATION ON COLLECTION PRACTICES FOR THOSE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. THE POLICY STATES "DURING THE PATIENT REGISTRATION OR COLLECTION PROCESS, THE HOSPITAL WILL MAKE AN INITIAL DETERMINATION OF ELIGIBILITY BASED ON VERBAL OR WRITTEN APPLICATION FOR CHARITY CARE. PENDING FINAL ELIGIBILITY DETERMINATION, THE HOSPITAL WILL NOT INITIATE COLLECTION EFFORTS OR REQUEST FOR DEPOSITS, PROVIDED THAT THE RESPONSIBLE PARTY IS COOPERATIVE WITH THE HOSPITAL'S EFFORTS TO REACH A DETERMINATION OF STATUS." THE COLLECTION POLICY CURRENTLY SENDS ALL PATIENT ACCOUNTS WITH A PRIVATE PAY BALANCE TO A BILLING SERVICE AFTER 120 DAYS. THE BILLING SERVICE WORKS DIRECTLY WITH THE PATIENT TO MAKE A PAYMENT ARRANGEMENT. IF THEY DEFAULT ON THE PAYMENT PLAN THE BILLING SERVICE RECOMMENDS TO THE HOSPITAL TO SEND THE ACCOUNT TO COLLECTIONS; HOWEVER, IF THE PATIENT APPLIES FOR FINANCIAL ASSISTANCE WITHIN 240 DAYS OF THE DATE OF THE FIRST INVOICE THE HOSPITAL PULLS THE ACCOUNT BACK FROM COLLECTIONS AND THE BILLING SERVICE TO REVIEW AND COMPLETE THE APPLICATION PROCESS.
PART VI, LINE 2:	IN ADDITION TO CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENTS, NORTHERN MONTANA HOSPITAL ASSESSES THE NEEDS OF THE COMMUNITY IT SERVES IN SEVERAL WAYS. NMH REVIEWS THE TOP TEN DIAGNOSIS IN IT'S TWO RURAL HEALTH CLINICS AT LEAST QUARTERLY. WE ALSO MONITOR "LEFT WITHOUT BEING SEEN" PATIENTS IN THE EMERGENCY DEPARTMENT. WE MONITOR BLOOD PRESSURE AND TOBACCO AND ALCOHOL STATUS WITH EVERY PATIENT VISIT. WE ALSO HAVE A DIABETES PREVENTION PROGRAM THAT MEETS AT LEAST MONTHLY WITH ENROLLED PATIENTS. IN ADDITION, WE HAVE A CHRONIC CARE MANAGEMENT PROGRAM IN WHICH OUR TWO CARE COORDINATORS MONITOR HIGH RISK PATIENTS VIA PHONE CALLS AND A SOFTWARE PROGRAM CALLED CHRONIC CARE IQ THAT PATIENTS IN THE PROGRAM INTERACT WITH AND RECORD THEIR VITAL SIGNS BACK TO NMH REGULARLY.
PART VI, LINE 3:	NORTHERN MONTANA HOSPITAL INFORMS AND EDUCATES PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE THROUGH SIGNS POSTED AT OUR ADMISSIONS DESK, NOTES IN THE BROCHURE WE GIVE PATIENTS AT OUR CLINICS, AND SIGNS POSTED AT OUR CLINIC REGISTRATION DESK. IN ADDITION, OUR COLLECTION STAFF OFFERS CHARITY CARE AS AN OPTION WHEN THEY ARE DISCUSSING THE PATIENT'S BALANCE AS WELL AS THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS SUCH AS MEDICAID OR STATE PROGRAMS. NMH HAS CONTRACTED WITH A COMPANY TO ASSIST THE PATIENT WITH QUALIFICATION FOR PROGRAMS SUCH AS MEDICAID AND DISABILITY DETERMINATION. WE ALSO PUBLISH A COMMUNITY BENEFIT REPORT ANNUALLY WHICH STATES HOW MUCH FINANCIAL ASSISTANCE WE HAVE GIVEN AWAY, AND WE POST OUR COMMUNITY BENEFIT REPORT ON OUR WEBSITE NOTING THAT WE PROVIDE FINANCIAL ASSISTANCE.
PART VI, LINE 4:	THE HOSPITAL'S SERVICE AREA CONSISTS OF HILL, BLAINE, LIBERTY, PHILIPS AND THE BIG SANDY CENSUS DISTRICT OF CHOTEAU COUNTIES. THE POPULATION OF THIS SERVICES AREA IS APPROXIMATELY 35,300. THE MEDIAN HOUSEHOLD INCOME IS ABOUT $55,600. APPROXIMATELY 17% OF THE POPULATION ARE IN POVERTY BASED ON THE FEDERAL POVERTY GUIDELINES. APPROXIMATELY 21% OF THE POPULATION IS COVERED BY MEDICAID AND 43% BY MEDICARE. ADDITIONALLY, ANOTHER 2% OF THE POPULATION IS COVERED BY INDIAN HEALTH SERVICES. THE ENTIRE SERVICE AREA IS CONSIDERED RURAL AND HAS BEEN DESIGNATED A HEALTH PROFESSIONAL SHORTAGE AREA FOR ALL PRIMARY MEDICAL CARE, MENTAL HEALTH AND DENTAL. IN ADDITION, THE ENTIRE SERVICE AREAS IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA. NORTHERN MONTANA HOSPITAL IS THE ONLY LOCAL HOSPITAL IN ITS SERVICE AREA; HOWEVER, THERE ARE 4 CRITICAL ACCESS HOSPITALS, 4 RURAL HEALTH CLINICS, 3 COMMUNITY HEALTH CLINICS AND 3 IHS-TRIBAL CLINICS WITHIN ITS SERVICE AREA.
PART VI, LINE 5:	MORE THAN 50% OF NORTHERN MONTANA HOSPITAL'S GOVERNING BOARD CONSISTS OF VARIOUS LOCAL BUSINESS PEOPLE WHO RESIDE WITHIN OUR SERVICES AREA AND ARE NOT EMPLOYED OR CONTRACTED BY THE ORGANIZATION. NORTHERN MONTANA HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. THE ORGANIZATION APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE BY KEEPING ITS MEDICAL EQUIPMENT UP TO DATE, SENDING ITS EMPLOYED PHYSICIANS FOR FURTHER CONTINUING EDUCATION, SUPPORTING NURSING EDUCATION THROUGH LOAN REPAYMENT ASSISTANCE AND SCHOLARSHIP PROGRAMS AND SUPPORTING HEALTH CARE EDUCATION THROUGH AN EDUCATION ASSISTANCE PROGRAM. IN ADDITION, THE HOSPITAL SUBSIDIZES ITS EMERGENCY DEPARTMENT BY OFFERING 24/7 EMERGENCY CARE COVERAGE TO ALL, REGARDLESS OF THEIR ABILITY TO PAY. NORTHERN MONTANA HOSPITAL OFFERS DIALYSIS SERVICES TO PATIENTS IN OUR SERVICE AREA, DESPITE THE FACT THAT THIS SERVICE IS PROVIDED AT A LOSS TO NMH. WITHOUT THIS SERVICE, PATIENTS WOULD HAVE TO TRAVEL WELL OVER 100 MILES EACH WAY, 3 TIMES PER WEEK TO RECEIVE THIS SERVICE. NORTHERN MONTANA HOSPITAL HAS SOLE COMMUNITY DESIGNATION. THE NEAREST PPS HOSPITAL IS LOCATED 110 MILES FROM HAVRE. NORTHERN MONTANA HOSPITAL ALSO PARTICIPATES IN ALL GOVERNMENT SPONSORED HEALTH PROGRAMS, SUCH AS CHIP, HEALTHY MONTANA KIDS AND THE MONTANA CERVICAL AND BREAST CANCER PROGRAM, WHERE IT ACCEPTS PAYMENTS FOR SERVICES AT GREATLY DISCOUNTED RATES. SEVERAL MEMBERS OF NORTHERN MONTANA HOSPITAL'S LEADERSHIP TEAM SERVE ON OTHER COMMUNITY BOARDS, SUCH AS: HAVRE CHAMBER OF COMMERCE, HILL COUNTY HEALTH CONSORTIUM, LOCAL EMERGENCY PLANNING, FETAL/INFANT/CHILD MORTALITY REVIEW BOARD, HAVRE/HILL COUNTY PLANNING BOARD, HILL AND BLAINE COUNTY ADULT PROTECTIVE SERVICES COMMITTEE, HILL COUNTY UNITED WAY, HRDC MEDICAL ADVISORY BOARD, MSU-N NURSING ADVISORY BOARD, AND THE SAFE KIDS SAFE COMMUNITIES COMMITTEE.
PART VI, LINE 7, REPORTS FILED WITH STATES	MT

Schedule H (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
NORTHERN MONTANA HOSPITAL

Employer identification number
81-0231787

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2023

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) EDUCATIONAL ASSISTANCE	17	40,339
(2) NURSE LOAN REPAYMENTS	2	16,906
(3) NURSING SCHOLARSHIPS	5	25,000
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

PART I, LINE 2:

THE ORGANIZATION PROVIDES EDUCATION ASSISTANCE TO QUALIFIED EMPLOYEES. THE ORGANIZATION MONITORS THE USE OF THE ASSISTANCE BY DISBURSING THE FUNDS DIRECTLY TO THE INSTITUTION.

PART III:

THE ORGANIZATION WILL PAY UP TO $5,250 PER PERSON PER YEAR FOR EDUCATIONAL ASSISTANCE IN A HEALTHCARE RELATED FIELD. NOT ALL RECIPIENTS REQUEST THE TOTAL AMOUNT. THE ORGANIZATION ANTICIPATES 3-8 RECIPIENTS PER YEAR. THE ORGANIZATION WILL PAY UP TO $5,000 PER PERSON FOR NURSING SCHOLARSHIPS. THE ORGANIZATION ANTICIPATES 3-6 PER YEAR. THE ORGANIZATION WILL PAY UP TO $7,500 PER PERSON FOR LOAN REPAYMENTS. THE ORGANIZATION ANTICIPATES 2-4 PER YEAR.

Schedule I (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

NORTHERN MONTANA HOSPITAL

Employer identification number

81-0231787

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Yes

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1MICHAEL FARR DO DO	(i) (ii)	998,097 ------------- 0	0 ------------- 0	483 ------------- 0	6,600 ------------- 0	24,720 ------------- 0	1,029,900 ------------- 0	0 ------------- 0
2WALTER SMITH DO DO	(i) (ii)	749,758 ------------- 0	0 ------------- 0	1,188 ------------- 0	6,600 ------------- 0	28,910 ------------- 0	786,456 ------------- 0	0 ------------- 0
3DAMIAN YMZON MD MD	(i) (ii)	745,500 ------------- 0	0 ------------- 0	293 ------------- 0	6,600 ------------- 0	33,495 ------------- 0	785,888 ------------- 0	0 ------------- 0
4KEVIN HARADA MD TRUSTEE-IPD MEMBER	(i) (ii)	549,120 ------------- 0	0 ------------- 0	195 ------------- 0	6,600 ------------- 0	32,082 ------------- 0	587,997 ------------- 0	0 ------------- 0
5CAROLYN AKS MD MD	(i) (ii)	554,258 ------------- 0	0 ------------- 0	2,286 ------------- 0	6,600 ------------- 0	9,826 ------------- 0	572,970 ------------- 0	0 ------------- 0
6KARRIE LIEN MD SECRETARY	(i) (ii)	531,626 ------------- 0	0 ------------- 0	839 ------------- 0	6,600 ------------- 0	33,490 ------------- 0	572,555 ------------- 0	0 ------------- 0
7CAMERON SCRATON MD MD	(i) (ii)	516,105 ------------- 0	0 ------------- 0	162 ------------- 0	6,600 ------------- 0	25,064 ------------- 0	547,931 ------------- 0	0 ------------- 0
8CAMERON ACOR DPM TRUSTEE-CHIEF OF MEDICAL STAFF	(i) (ii)	320,527 ------------- 0	0 ------------- 0	449 ------------- 0	6,600 ------------- 0	32,645 ------------- 0	360,221 ------------- 0	0 ------------- 0
9GARY GROW PHD TRUSTEE-IPD MEDICAL DIRECTOR	(i) (ii)	194,231 ------------- 0	0 ------------- 0	2,477 ------------- 0	3,948 ------------- 0	10,686 ------------- 0	211,342 ------------- 0	0 ------------- 0
10CHRISTEN OBRESLEY VICE PRESIDENT	(i) (ii)	170,924 ------------- 0	0 ------------- 0	804 ------------- 0	3,555 ------------- 0	15,292 ------------- 0	190,575 ------------- 0	0 ------------- 0
11KIM LUCKE VP OF FINANCE	(i) (ii)	139,056 ------------- 0	0 ------------- 0	853 ------------- 0	2,925 ------------- 0	15,552 ------------- 0	158,386 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 3	THE 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 USING THE FORM 990 OF OTHER ORGANIZATIONS, A WRITTEN EMPLOYMENT CONTRACT, A COMPENSATION SURVEY OR STUDY, AND THE APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 5	KARRIE LIEN, KEVIN HARADA, J. GARY GROW, AND CAMERON ACOR ARE COMPENSATED AS A PERCENTAGE OF THE PRIOR THREE MONTHS' AVERAGE GROSS REVENUE EARNED FOR THE HOSPITAL BY THE PHYSICIAN, WITH THE PERCENTAGE BEING BASED ON THEIR SPECIALTY.

Schedule J (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

NORTHERN MONTANA HOSPITAL

Employer identification number

81-0231787

Return Reference	Explanation
FORM 990, PART III, LINE 3	NORTHERN MONTANA CARE CENTER BECAME ITS OWN ENTITY SEPARATE FROM NORTHERN MONTANA HOSPITAL DURING THE TAX YEAR ENDING JUNE 30, 2024.
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 2023 WAS $579,000.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF THE ORGANIZATION IS NORTHERN MONTANA HEALTH CARE, INC.
FORM 990, PART VI, SECTION A, LINE 7B	THE SOLE MEMBER OF THE ORGANIZATION SHALL HAVE SUCH RIGHTS AND POWERS AS ARE PROVIDED FOR IN THE ARTICLES OF INCORPORATION, THE BYLAWS OF THE ORGANIZATION AND THE LAWS OF THE STATE OF MONTANA, INCLUDING BUT NOT LIMITED TO, THE EXCLUSIVE POWER: (A) TO REMOVE ANY TRUSTEE FROM ANY OFFICE AT ANY TIME, WITH OR WITHOUT CAUSE; (B) TO PROPOSE AND APPROVE (I) A PLAN OF DISSOLUTION OR LIQUIDATION OF THE ORGANIZATION OR (II) A PLAN OF MERGER OR CONSOLIDATION OF THE ORGANIZATION WITH ANOTHER CORPORATION; (C) TO PROPOSE AND APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION AND OR THE BYLAWS; (D) TO ADOPT AN ANNUAL OR LONG-TERM CAPITAL OR OPERATIONAL BUDGET OR ANY CHANGES THEREIN EXCEEDING $75,000; (E) TO AUTHORIZE THE ORGANIZATION TO ENTER INTO ANY CONTRACT OR ENGAGE IN ANY TRANSACTION WHICH IS NOT PROVIDED FOR IN AN ANNUAL OR LONG-TERM CAPITAL OR OPERATIONAL BUDGET APPROVED BY THE SOLE MEMBER OF THE ORGANIZATION WHERE THE AMOUNT INVOLVED EXCEEDS $50,000; (F) TO ADOPT SUBSTANTIVE CHANGES TO EXISTING LONG-TERM OR MASTER INSTITUTIONAL PLANS OF THE ORGANIZATION; (G) TO AUTHORIZE THE ORGANIZATION TO ENGAGE IN, OR ENTER INTO, ANY TRANSACTION PROVIDING FOR THE SALE, MORTGAGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION; (H) TO ORGANIZE OR ACQUIRE, OR AUTHORIZE THE ORGANIZATION OR ACQUISITION OF, ANY SUBSIDIARY OR AFFILIATE OF THE ORGANIZATION; (J) TO APPROVE LONG-TERM BORROWING OF MONEY BY THE ORGANIZATION OR AUTHORIZE THE ORGANIZATION TO INCUR INDEBTEDNESS INVOLVING A MORTGAGE OR LIEN ON ASSETS; OR (K) TO APPROVE THE TRUSTEES OR THE PRESIDENT OF THE ORGANIZATION FROM A SLATE PREPARED BY THE NOMINATING COMMITTEE OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 8B	NO COMMITTEE HAS THE AUTHORITY TO ACT ON BEHALF OF THE BOARD.
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 CONFLICT INDIVIDUAL IS EXCLUDED FROM VOTING ON THE CONFLICTED ITEM.
FORM 990, PART VI, SECTION B, LINE 15A	THE PRESIDENT/CEO IS COMPENSATED BY AN UNRELATED MANAGEMENT COMPANY. THE UNRELATED MANAGEMENT COMPANY RECEIVES A FEE FOR SERVICE FOR THE CEO'S SERVICE PROVIDED TO THIS ORGANIZATION AND RELATED ORGANIZATIONS, NORTHERN MONTANA HEALTH CARE, INC. (NMHC) AND NORTHERN 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 CEO'S 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 THE FISCAL YEAR 2024. 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. THE FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 PER THE IRS INSTRUCTIONS.
FORM 990, PART IX, LINE 11G	PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,102,563. MANAGEMENT AND GENERAL EXPENSES 4,408,052. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,510,615. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 8,799,273. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,799,273.
FORM 990, PART XI, LINE 9:	MINIMUM PENSION LIABILITY ADJUSTMENT -62,094. EQUITY TRANSFER TO AFFILIATE - NMHC, INC. -500,000.
FORM 990, PART XII, LINE 2C:	THE CONTROLLING ORGANIZATION, NORTHERN MONTANA HEALTH CARE, INC'S. BOARD HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT AUDITOR.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

NORTHERN MONTANA HOSPITAL

Employer identification number

81-0231787

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)NORTHERN MONTANA HEALTH CARE INC PO BOX 1231 HAVRE,MT59501 81-0428854	SUPPORTING ORGANIZATION	MT	501(C)(3)	LINE 12B, II	N/A		No
(2)NORTHERN MONTANA HEALTH CARE FOUNDATION INC PO BOX 1231 HAVRE,MT59501 36-3464641	FUNDRAISING	MT	501(C)(3)	LINE 7	NORTHERN MONTANA HEALTH CARE INC		No
(3)NORTHERN MONTANA CARE CENTER PO BOX 1231 HAVRE,MT59501 93-2157998	LONG TERM CARE	MT	501(C)(3)	LINE 10	NORTHERN MONTANA HEALTH CARE INC		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2023

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2023

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVISION OF HEALTHCARE SERVICES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	676
6	Total number of volunteers (estimate if necessary) .............	6	25
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	456,434
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,904,595	219,295
9	Program service revenue (Part VIII, line 2g) .........	81,302,321	90,423,815
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,902,319	1,472,391
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-952	-109
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	86,108,283	92,115,392
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	62,180	111,634
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	38,474,494	41,665,933
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 32,469
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	40,918,261	47,088,541
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	79,454,935	88,866,108
19	Revenue less expenses. Subtract line 18 from line 12.......	6,653,348	3,249,284
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	106,252,889	113,894,367
21	Total liabilities (Part X, line 26).............	12,527,140	16,828,894
22	Net assets or fund balances. Subtract line 21 from line 20.....	93,725,749	97,065,473

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 72,256,539 including grants of $ 111,634 ) (Revenue $ 89,967,381 )
	NORTHERN MONTANA HOSPITAL (HOSPITAL) INCLUDES 25 ACUTE CARE HOSPITAL BEDS, 135 SKILLED NURSING BEDS, 10 ASSISTED LIVING BEDS AND TWO MEDICAL CLINICS LOCATED IN HAVRE, MONTANA. THE HOSPITAL PROVIDES QUALITY HEALTHCARE 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 THESE ESSENTIAL SERVICES. IT IS THE HOSPITAL'S MISSION TO SERVE THE SURROUNDING AREA BY PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION TO ALL COMMUNITY MEMBERS.CONTINUED ON SCHEDULE O...DURING THE YEAR ENDED JUNE 30, 2024, THE HOSPITAL PROVIDED $290,000 OF MEDICAL SERVICES, BASED ON CHARGES, TO INDIVIDUALS WHO WERE DETERMINED UNABLE TO PURCHASE SUCH SERVICES UNDER THE HOSPITAL'S CHARITY CARE POLICY AND GUIDELINES. IN ADDITION TO FREE CARE AND/OR SUBSIDIZED CARE, CARE IS ALSO PROVIDED AT BELOW COST RATES TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS $74.2 MILLION FOR THE YEAR ENDED JUNE 30, 2024. DURING THE FISCAL YEAR ENDED JUNE 30, 2024, THE HOSPITAL PROVIDED OVER 4,900 DAYS OF HOSPITAL SERVICES. THE NURSING HOME PROVIDED JUST OVER 17,400 FROM JULY 2023-FEBRUARY 2024. THE HOSPITAL ALSO PROVIDES COMMUNITY CARE AND SERVICES THROUGH MANY HEALTHCARE ACTIVITIES AND PROGRAMS PROVIDED TO SUPPORT THE COMMUNITY. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SENIOR SERVICES, HEALTHCARE SCREENING, SPECIAL PROGRAMS FOR SPECIFIC GROUPS, PUBLISHED ARTICLES, RADIO PROGRAMS, AND A VARIETY OF COMMUNITY SUPPORTED ACTIVITIES. THE HOSPITAL ALSO RECEIVED MANY HOURS OF VOLUNTEER HELP FROM THE COMMUNITY RESIDENTS.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses72,256,539

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) DAMIAN YMZON MD........................................................................ MD	40.00 .......................0.00	X	745,793	0	40,095
(19) CAROLYN AKS MD........................................................................ MD	40.00 .......................0.00	X	556,544	0	16,426
(20) CAMERON SCRATON MD........................................................................ MD	40.00 .......................0.00	X	516,267	0	31,664

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	5,479,231	0	324,990

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	28,842
e	Government grants (contributions)		1e	46,703

f	All other contributions, gifts, grants, and similar amounts not included above		1f	143,750

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		219,295

		Business Code
2a	PATIENT SERVICE REVENUE	621110	54,726,268	54,726,268
b	PHARMACY	456110	32,436,679	31,980,245	456,434
c	HEALTHCARE CONSULTING	900099	394,190	394,190
d	CAFETERIA REVENUE	722514	281,314	281,314
e
f	All other program service revenue.		2,585,364	2,585,364
g	Total. Add lines 2a–2f .....		90,423,815

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,065,783			1,065,783
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	9,625
b	Less: rental expenses	6b	9,734
c	Rental income or (loss)	6c	-109
d	Net rental income or (loss).......			-109			-109
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	4,201,541	260,193
b	Less: cost or other basis and sales expenses	7b	3,801,453	253,673
c	Gain or (loss)	7c	400,088	6,520
d	Net gain or (loss).........			406,608			406,608
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			92,115,392	89,967,381	456,434	1,472,282

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	29,389	29,389
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	82,245	82,245
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	2,138,633	1,746,565	390,538	1,530
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	34,621,649	28,274,594	6,322,291	24,764
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	503,558	411,243	91,955	360
9	Other employee benefits .......	2,004,202	1,636,779	365,989	1,434
10	Payroll taxes ...........	2,397,891	1,902,609	493,182	2,100
11	Fees for services (non-employees):
a	Management ......	810,000	648,000	162,000
b	Legal .........	28,152		28,152
c	Accounting ...........	141,843		141,843
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	15,309,888	10,901,836	4,408,052
12	Advertising and promotion ....	213,602		213,602
13	Office expenses .......	606,039	157,878	448,116	45
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	2,168,577	1,313,889	854,688
17	Travel ............	54,568	4,036	50,532
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	2,477,402	1,981,855	493,959	1,588
23	Insurance ...	1,666,563	1,333,250	333,313
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	17,706,286	17,276,626	429,012	648
b	HOSPITAL BED TAX	1,603,882	1,603,882
c	TRAVELER PER DIEM	1,478,823	1,478,823
d	REPAIRS & MAINTENANCE	1,187,527	1,134,858	52,669
e	All other expenses	1,635,389	338,182	1,297,207
25	Total functional expenses. Add lines 1 through 24e	88,866,108	72,256,539	16,577,100	32,469
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			4,702	1	4,702
2	Savings and temporary cash investments .........			34,069,125	2	22,918,658
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			25,230,953	4	42,758,011
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			2,810,897	8	2,966,964
9	Prepaid expenses and deferred charges ......			1,340,541	9	1,291,225
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	75,691,731
b	Less: accumulated depreciation	10b	60,931,927	14,869,503	10c	14,759,804
11	Investments—publicly traded securities .			18,823,125	11	17,902,249
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			9,104,043	15	11,292,754
16	Total assets. Add lines 1 through 15 (must equal line 33)...			106,252,889	16	113,894,367

17	Accounts payable and accrued expenses .....	7,629,430	17	9,108,859
18	Grants payable ...		18
19	Deferred revenue .........		19	2,169,609
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	4,897,710	25	5,550,426
26	Total liabilities. Add lines 17 through 25..	12,527,140	26	16,828,894

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	93,725,749	27	97,065,473
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	93,725,749	32	97,065,473
33	Total liabilities and net assets/fund balances ........	106,252,889	33	113,894,367