SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
Glendive Medical Center
 
Employer identification number

81-6016016
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria 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.
4
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"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
c
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? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (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) .. 		  154 387,418   387,418 1.190 %
b Medicaid (from Worksheet 3,
column a) .... 		  327 2,693,914 3,229,830 -535,916 0 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		  319 341,703 345,088 -3,385 0 %
d Total Financial Assistance
and Means-Tested
Government Programs . 		  800 3,423,035 3,574,918 -151,883 1.190 %
Other Benefits
 6 14,532 150,517   150,517 0.460 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		1 25 107,233   107,233 0.330 %
g Subsidized health services
(from Worksheet 6) .. 		7 3,243 9,466,309 7,547,370 1,918,939 5.880 %
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		3 3,224 42,906   42,906 0.130 %
j Total. Other Benefits .. 17 21,024 9,766,965 7,547,370 2,219,595 6.800 %
k Total. Add lines 7d and 7j . 17 21,824 13,190,000 11,122,288 2,067,712 7.990 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
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 1 10 6,339   6,339 0.020 %
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 1 10 6,339   6,339 0.020 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
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
3,487,471
3
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. ......
3
227,818
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
6,335,722
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
6,288,172
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
47,550
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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.......................

9b

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) 2012
Schedule H (Form 990) 2012
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?1
Name, address, and primary website address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 Glendive Medical Center
202 Prospect Drive
Glendive,MT59330 		X X     X   X      
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
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)
Glendive Medical Center
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A) 1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 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 9.................... 1 Yes  
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4   No
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7 Yes  
8a 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)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, 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) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 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 includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 100.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 200.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 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 actions the hospital facility may take upon non-payment?....... 15 Yes  
16 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 patient’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires 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?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 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.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section C. 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?5
Name and address Type of Facility (describe)
1 Glendive Medical Center Nursing Home
202 Prospect Drive
Glendive,MT59330 		71 bed skilled nursing home
2 Glendive Medical Center Home Health
202 Prospect Drive
Glendive,MT59330 		Home health for Dawson, Wibaux, McCone and Prairie Counties
3 Eastern Montana Veterans Home
2000 Montana Avenue
Glendive,MT59330 		80 bed Veterans skilled nursing home
4 The Heritage on Merrill Avenue
1313 North Merrill Avenue
Glendive,MT59330 		13 suite assisted living center
5 Glendive Medical Center Hospice
202 Prospect Drive
Glendive,MT59330 		Hospice for Dawson and Wibaux Counties
6
7
8
9
10
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments 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.
8 Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
Identifier ReturnReference Explanation
    Part I, Line 6a: Currently, GMC is filing a community benefit report with the State of Montana, in conjunction with other requested information for the State of Montana's report on issues and facts related to the charitable purposes of hospitals and the protection of Montana's consumers.GMC mails to all service area households either a community benefit report or a post card detailing where to go on the gmc.org website to access the community report. GMC's community benefit reports are available at all times on the gmc.org website.
    Part I, Line 7: The cost to charge ratio from Worksheet 2 was utilized for charity care. Unreimbursed Medicaid and other means-tested government programs were calculated using actual amounts captured from internal logs for charges and receipts. Subsidized health services was calculated using actual direct costs and receipts of each department. A step down allocation of the 2013 annual cost report was applied to correctly allocate overhead to each department. These allocations are necessary, as they directly affect the Medicare and Medicaid reimbursement. All others were based off of actual expenses.
    Part I, L7 Col(f): Bad debt expense of $3,487,471 included on Form 990, Part IX, line 25, column (a) has been subtracted for purposes of calculating the percentage in this column.
    Part II: The amount reported in Part II for Community Building Activities represents assistance provided by GMC leaders to develop and maintain an active Economic Development Committee (EDC) formed to assist in projects to enhance the health, safety and well being of the community of Glendive.The initial activity of the EDC during the past several years was obtaining funds and building low income housing for seniors in the community which has been completed. This was a community benefit providing safe housing for those seniors in an area of housing shortages.EDC is made up of community leaders and has the support of the community. It is currently working to bring new businesses to the area, which will create additional employment opportunities for the area's population. Also, these new businesses will provide additional services helping enhance the ability to recruit healthcare providers and professionals. Due to Glendive's remote rural location, this is always a challenge as shown by the Dawson County's designation as a HSPA area which was discussed in Item 4.
    Part III, Line 4: Bad debt expense is reported at charges as recorded by the organization.The amount of bad debt shown to be attributable to patients eligible for charity care was based on applications submitted without the necessary information or paperwork to enable the completion of the application. The information was not obtained even though the the collection department aggressively worked with the parties through letters, telephone calls, and meetings. Therefore, as shown in Schedule H, Part III, Line 3, with the education and assistance provided, the amount reported is appropriate and should be considered a community benefit.Footnote from organization's financial statements: The footnote that describes bad debt expense is found on page 9 and 10 of the attached audit report.
    Part III, Line 8: Medicare allowable cost is based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by CMS. In addition to hospital services, Home Health, Hospice, and Skilled Nursing Facility are also included in the Organization's cost report. All of these activities are subsidized health services shown on line 7 or Part I. Therefore, the Medicare piece related to these activities is shown on Part I, Line 7. As noted in the Schedule H instructions, the cost report does not reflect certain programs which GMC provides - Durable Medical Equipment, Medicare Part C, Medicare Part D, and Provider Based Services - Emergency Room Providers, Certified Nurse Anesthetists, and Radiologists. Since GMC is in a very rural area, to have 24 hour coverage by these providers for our service area is definitely a quality and safety issue, and therefore, a community benefit.Due to utilizing the allowable Medicare cost from the cost report, Part III does not reflect the fact that there is Medicare shortfall to this facility, due to a number of factors such as the following:1. Any non patient revenue received for reimbursable departments must be offset against expenses. But at the same time, it is not allowed to offset revenue against expenses of non-reimbursable departments. This results in substantial shifting of a substantial amount of administrative expenses to the non-reimbursable areas due to allocation of the administrative costs being based on total expense without the offset of revenue on the non-reimbursable departments.2. Allocating administrative expense based on the percent of total expense also shifts an excess of costs to areas such as GMC's retail pharmacy due to high cost of drugs again resulting in overstating administrative expenses in a non-reimbursable department which in turn lowers reimbursement to Medicare reimbursable departments.3. Medicare Advantage (Part C) plans are creating additional cost and shortfall and are not currently reported in Part III.4. Medicare Part D - With two nursing homes, being in a very rural area with no other area pharmacies providing Unit Dose dispensing which is required for the safety of our residents, GMC again is seeing a shortfall which is not being reported while providing the necessary services to our local residents and is definitely a benefit to the resident and their families.
    Part III, Line 9b: For those that are known to qualify for financial assistance, the portion that is identified as charity care is written off to charity care. The Hospital policy states if there is a portion of the patient account that does not qualify for free care the remaining unpaid portion falls under the same collection policy as the accounts that do not qualify for financial assistance.
Glendive Medical Center   Part V, Section B, Line 3: A. Needs Assessment Steering Committee Members - 1. Dawson County Health Department Director - Public Health Focus 2. Dawson County Superintendent of Schools 3. Glendive Economic Development Executive Director 4. Dawson County Commissioner - Population Consultation Focus 5. Glendive Police Department Officers (2) - Population Consultation Focus6. Glendive Medical Center - CEO, DFO, Community Relations coordinator, Marketing Coordinator, GMC Foundation Director, Executive AssistantB. Focus Groups - Population: Seniors 1. Richey MT Senior Center 2. Glendive MT Senior Center 3. Wibaux MT Senior CenterC. Survey - Mailing to Service Area
Glendive Medical Center   Part V, Section B, Line 5c: The hospital Community Health Needs Assessment can be found at: http://www.gmc.org/getpage.php?name=home_tab_communityIt is also available at Glendive's Public Library.
Glendive Medical Center   Part V, Section B, Line 6i: The hospital Community Health Needs Assessment can be found at: http://www.gmc.org/getpage.php?name=home_tab_community
Glendive Medical Center   Part V, Section B, Line 14g: GMC's Credit Department sends the policy and application to patients/guarantors who have made no effort to complete an application or make arrangements for payments at the time the account becomes past due. In addition to providing the full policy upon request, a summary of the policy is posted in the emergency rooms, waiting rooms, admissions office and provided upon admission.
Glendive Medical Center   Part V, Section B, Line 18e: At the time the patient/guarantor receives their final notice of nonpayment, the financial assistance application is again sent to them and contact persons are provided who can assist them in completing their application.
Glendive Medical Center   Part V, Section B, Line 20d: GMC calculates the amount based on the average of all negotiated commercial insurance rates.
    Part VI, Line 2: 1. Over the past years, GMC has identified and prioritized community needs through a variety of community surveys in collaboration with various organizations including the City of Glendive and Dawson County.2. Public meetings were held by GMC at various times to receive community input.3. Strategic Planning sessions are held by GMC to plan and prioritize the needs of the community on an annual basis. These sessions include the Board of Directors, the Foundation's Board of Directors, Physicians and other Medical Providers and the Administration of GMC. Areas identified and services implemented from the prior community surveys included the need for Hospice, Assisted Living and Behavior Health Services.4. Planning for a Community Assessment survey was completed with the Dawson County Public Health Department in April 2013.A review and the implementation plan based on the results of the survey were completed in June 2013. Monthly meetings to review the progress and update the plan are in place and will continue during the upcoming months.
    Part VI, Line 3: GMC provides information and education concerning assistance through various programs and the organization's charity care policy in a variety of ways including:1. Through the social services department, patient financial services and other areas, assistance is offered and given to all patients and their families about available programs. Beginning in fiscal year 2012, a Patient Advocate Liaison (PAL) was added to assist patients throughout the organization. The PAL's role is to assist all patients and provide them with information on available programs, etc. Beginning in January 2014 Emergency Department Specialists will be available seven days a week after the patient has been treated to assist patients and their families to provide the financial assistance information including the charity care program and assist them with applying for these programs if appropriate.2. GMC's website, www.gmc.org, provides charity care and other financial assistance policies and procedures, including applications.3. Signage is posted throughout the facilities in admissions areas, the emergency room and waiting rooms. The signage provides information concerning charity care and other financial assistance available throughout GMC.4. A Guest Information Book for the patient and their family's use is in each patient's room and other areas providing various information including financial assistance information that is available and the appropriate personnel to contact if they have not been contacted. Contact information for the social services department is included in the information book if the patient needs assistance or has questions about various government and other programs available in the area. 5. GMC's monthly statement provides information for the person(s) to contact if financial assistance is needed. The credit and collection department includes financial assistance information including an application and the contact person at GMC who can assist them with all collection letters.6. GMC employees are aware of the financial assistance programs and are able to provide direction to patients or their families in their departments concerning charity care. Quarterly, at the CEO forums, the employees are provided with the amount of charity care provided by the facility while expressing the importance of providing the free care for people that are in need.
    Part VI, Line 4: GMC's primary service area is Dawson County on the eastern edge of Montana. GMC's secondary service areas are surrounding counties, McCone, Richland, Fallon, Prairie and Wibaux.Projections by the National Planning Association Data Services, Inc. projected that Dawson County would experience a decrease in population from the 2000 Census until after 2020 when a slow and steady growth pattern was projected. Instead, the population of Dawson County based on the 2010 census increased to 8,966, compared to the projected population of 8,520. By 2013 Dawson County population has grown to 9,445, an increase of 5.3% since 2010. At the same time the State of Montana as a whole showed an increase of 2.6%. Approximately 22,000 persons are now in the area GMC serves. The increase in population and area's health care services is related to the increase in the senior population and the energy-related services which continue to show strong growth. Based on the current trends, Dawson County will continue to see growth due to the outlying energy related services.Glendive is a medical, retail and agricultural trade center for the county and the surrounding communities within a 30-60 mile radius. Glendive's economic base continues to be closely tied to agriculture and the transportation industry, particularly rail services. GMC is the largest employer in Glendive. Other significant employers in the GMC's service area are state, county and city governments, Burlington Northern Santa Fe Railway, Glendive Public Schools, Dawson County Community College and Williston Basin Interstate Pipeline.Dawson County is designated as a Health Professional Shortage Area (HPSA) with shortages of mental health providers. Beginning in July of 2010 GMC has a psychiatrist on staff, the only one east of Billings, MT, 200 miles to the west. The Behavior Care Unit opened in July, 2010 as part of the Critical Access Hospital to provide a needed service throughout Eastern Montana and Western North Dakota.The service area residents see GMC and its providers as a place to come to receive treatment, without regard to whether they have insurance or are uninsured, knowing they will be treated and cared for in a respectful and caring manner.GMC also provides outreach in various ways to the very small critical access frontier facilities as small as one bed facilities in neighboring counties and to four counties in the service area for home care services in sparsely populated areas.There are no other providers in GMC's primary service area. Sidney Health Center, a critical access hospital located 50 miles north of Glendive, and Holy Rosary Medical Center, a critical access hospital located 70 miles south of Glendive, are the closest facilities.
    Part VI, Line 5: GMC Board of Directors:The governing body of GMC is its Board of Directors (the "Board"), which consists of nine members. The Board includes the Chief of Medical Staff and one member of GMC's active medical staff. Other members are selected to promote a representative composition of the Board by gender, rural/urban, professional/non-professional and geography. Board members are selected from GMC's service area by the Board's nominating committee and approved by the existing Board members. The members of the Board serve in a voluntary capacity and receive no compensation for their services. Members of the Board have various relationships with services or products, who may, from time to time, have dealings with the GMC, but these relationships are not considered to be material. The Chief of Staff and member of the medical staff are employed by the GMC as physicians and medical advisors. The Board has an established conflict of interest policy to detect and manage such relationships.GMC Medical Staff:The active medical staff of GMC currently is comprised of nine (9) physicians and thirteen (13) allied health professionals. These providers are all employed by GMC and provide services at all of GMC facilities, including the attached for profit clinic, Gabert Medical Services, and two of the frontier critical access hospitals in McCone and Prairie County. Eight (8) of the nine (9) physicians are board certified. An additional internist, family practitioner and orthopedic surgeon are being recruited and will be in place during next fiscal year.A Specialty Clinic at GMC is utilized by physicians from Billings, MT and Bismarck, ND to provide services that are not available by the GMC Medical Staff. The patients are able to stay at home in Glendive and have the services provided by out of town physicians locally without traveling great distances.Tele Health is also utilized by GMC providers and providers in Billings and other locations. This allows the patients to have follow up visits with providers via video conferencing instead of traveling great distances to see the providers.GMC extends medical staff privileges to all qualified physicians in the area. GMC also extends those privileges to the qualified specialty physicians who provide services through the Specialty Clinic.GMC Surplus Funds:All funds in excess of expenses are utilized in the following ways:1. The facilities' debt service payments on the 2008 $30,000,000 bond issue obtained to provide a much needed expansion and renovation of the Surgery Suite, an additional nursing home wing and expansion and renovation of the emergency department.2. A substantial amount of funds are needed each year and utilized for the ongoing capital needs of the facility to ensure the appropriate equipment is available to meet the needs of the community. All departments have a three to five year plan in place to forecast these needs.3. Continued assistance to providers and professional staff for education to maintain GMC's standards to provide the care needed in the community.4. To increase reserve funds to ensure the ability to continue meeting the above obligations in future years when surplus funds are not available.
    Part VI, Line 6: After careful evaluation, GMC decided to move forward with an affiliation with Billings Clinic. An agreement has been agreed upon and will be signed in September 2013.This affiliation will provide resources to Glendive Medical Center which should assist in retaining providers and staff which will assist us to continue to provide quality care to our community.
Reports Filed With States Part VI, Line 7 MT
Schedule H (Form 990) 2012
Additional Data


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