SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2016
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 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.
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) . . . 		    622,000   622,000 1.520 %
b Medicaid (from Worksheet 3, column a) . . . . .     8,320,610 7,487,212 833,398 2.040 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     8,942,610 7,487,212 1,455,398 3.560 %
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) . . . .     13,099,974 4,894,685 8,205,289 20.080 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .            
j Total. Other Benefits . .     13,099,974 4,894,685 8,205,289 20.080 %
k Total. Add lines 7d and 7j .     22,042,584 12,381,897 9,660,687 23.640 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2016
Schedule H (Form 990) 2016
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
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
2,067,155
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
0
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
9,310,107
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
9,285,834
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
24,273
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) 2016
Schedule H (Form 990) 2016
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) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Glendive Medical Center
202 Prospect Drive
Glendive,MT59330
13226 		X X     X   X      
Schedule H (Form 990) 2016
Page 4
Schedule H (Form 990) 2016
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)
Glendive Medical Center
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): 		1
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 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 ................. 5 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.................................. 6a   No
b 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. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): See Part V, Line 7d
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2016
Page 5
Schedule H (Form 990) 2016
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Glendive Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
www.gmc.org/docs/Financial_Assistance.doc
b
http://www.gmc.org/docs/Financial_Assistance_Application.pdf
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2016
Page 6
Schedule H (Form 990) 2016
Page 6
Part VFacility Information (continued)

Billing and Collections
Glendive Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2016
Page 7
Schedule H (Form 990) 2016
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Glendive Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
22 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
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2016
Page 8
Schedule H (Form 990) 2016
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, 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
Glendive Medical Center Part V, Section B, Line 5: A. Needs Assessment Steering Committee Members - 1. Dawson County Health Department Director - Public Health Focus 2. Dawson County Superintendent of Schools 3. Glendive Medical Center - CEO, CFO, Community Relations coordinator, Marketing Coordinator, GMC Foundation Director, Executive AssistantB. Focus Groups - 1. Population: Low Income 2. Population: Youth 3. Population: SeniorsC. Survey - Mailing to Service Area
Glendive Medical Center Part V, Section B, Line 7d: http://www.gmc.org/docs/GMC_Implementation_Plan_Report_2016.pdfIt is also available at Glendive's Public Library.
Glendive Medical Center Part V, Section B, Line 11: Improving resident's access to health through better recruiting and retention of providers, improving health outcomes for chronic diseases and behavioral health, and expanding health education opportunities.These will be addressed through the following strategies:1. An Urgent Care Clinic was built with an opening scheduled for April 2018.2. Began offering telemedicine, an ENT began providing services December 2016, and is continuing to expand Pediatric services.3. Improve access to specialty services by exploring Sleep Study services at GMC.4. Improve access to transportation services in Dawson Co. through strategic partnership with community organizations.5. Decrease barriers to accessing health care services due to cost by conducting community outreach to educate community on billing and registrations process, developing new marketing materials on Navigator and Patient Advocate resources, convening community partner workgroups, partnerning with local bank to provide Patient Loan program and develop marketing for the Patient Loan Program.6. Continued towards re-opening GMC Behavioral Health Unit by completing remodeling.7. Improve access to mental health services through telehealth.8. Enhance behavioral health services for victims of sexual assault by developing a referral process protocol for victims of sexual assault and integrating behavioral health referral protocol into SANE process (Sexual Assault Nursing Exam).9. Explore development of a Safe Room at GMC.10. Expand prevention and educational offerings in schools regarding behavioral and mental health. This would include meeting with local schools to determine opportunities to work with youth.11. Increase community awareness of available educational programs and classes.12. Continue partnership with Dawson County Healthy Community Coalition.Needs Unable to Address1. "Cancer" (55%) was chosen as the second-most serious health concern by survey respondents. GMC currently provides Oncology/Chemotherapy Infusionservices. Offering additional cancer services would not be feasible from a staffing and financial standpoint.2. "Dermatology" (27.7%) was chosen as the most desired local healthcare service not currently available. At this time, GMC currently offers dermatology services through visiting physicians, approximately once a month. GMC is working with the provider to expand offerings/and or determine if telemedicine is a feasible option.3. "Women's health" (27.7%) was the third-most desired educational class/program. GMC currently offers OB/GYN services and will look to the future to expand Women's Health services for women in Dawson County and the surrounding region.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2016
Page 9
Schedule H (Form 990) 2016
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?5
Name and address Type of Facility (describe)
1 1 - Glendive Medical Center Nursing Home
202 Prospect Drive
Glendive,MT59330 		56 bed skilled nursing home
2 2 - Glendive Medical Center Home Health
202 Prospect Drive
Glendive,MT59330 		Home health for Dawson, Wibaux, McCone and Prairie Counties
3 3 - Eastern Montana Veterans Home
2000 Montana Avenue
Glendive,MT59330 		80 bed Veterans skilled nursing home
4 4 - The Heritage on Merrill Avenue
1313 North Merrill Avenue
Glendive,MT59330 		13 suite assisted living center
5 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) 2016
Page 10
Schedule H (Form 990) 2016
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 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's community benefit reports are available at all times on the gmc.org website.
Part I, Line 7: The cost to charge ratio for charity care was calculated by multiplying the ratio of cost to gross charges by the uncompensated care policy without charge or at amounts less than established rates. Subsidized health services and Medicaid were determined using the Medicare cost report and applying the Medicare ratio of cost to charge for the respective cost centers.
Part I, Line 7g: Subidized health services includes $6,383,438 of costs from physician clinics and a rural health clinic.
Part I, Ln 7 Col(f): Bad debt expense of $2,067,155 included on Form 990, Part IX, line 25, column (a) has been subtracted for purposes of calculating the percentage in this column.
Part III, Line 2: Bad debt is reported at charges.
Part III, Line 4: 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 the Centers for Medicare and Medicaid Services. 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.
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.The organization does not send balances to collections until 120 days after the date of the first invoice. If at any time in the next 120 days an individual begins the application process for financial assistance the Hospital removes them from the collection process.
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 2016.A review and the implementation plan based on the results of the survey were completed in June 2016.
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 information is 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 are 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 2014 Dawson County population has grown to 9,518, an increase of 6.2% since 2010. At the same time the State of Montana as a whole showed an increase of 3.5%. Approximately 23,000 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. 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 eleven 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, which 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 seven (7) physicians and twelve (12) 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, outreach clinic in Wibaux, Montana. Six (6) of the seven (7) physicians are board certified. A full time orthopedic surgeon began providing services at the medical center beginning in August 2014. A Specialty Clinic at GMC is utilized by physicians from Billings, Montana and Bismarck, North Dakota 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 (refinanced in 2017) 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: GMC in September, 2013 began an affiliation with Billings Clinic. This affiliation provides 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.
Schedule H (Form 990) 2016
Additional Data


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