4A (Expenses $ 28860184 including grants of $ 0) (Revenue $ 36296589)
PROVIDE QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES TO THE PATIENTS THAT WE SERVE.

FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 3E
THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND ARE IDENTIFIED THROUGH THE CHNA.

FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 5
IN APRIL 2022, A SURVEY WAS MAILED TO A RANDOMLY CHOSEN SAMPLE OF 300 RESIDENTS IN THE PRIMARY SERVICE AREA TO SOLICIT THEIR INPUT. THE SURVEY WAS ALSO MADE AVAILABLE ONLINE THROUGH SURVEY MONKEY AND MARKETED VIA THE FACILITY'S WEBSITE AND FACEBOOK PAGE. MAIL RETURNS AND ON-LINE SURVEYS WERE COMBINED WHICH RESULTED IN 133 SURVEYS BEING RETURNED. CONSULTATIONS WITH INDIVIDUALS WHO REPRESENTED VARIOUS CONSUMER GROUPS OF HEALTH CARE INCLUDING SENIOR CITIZENS, PUBLIC HEALTH, MEDICALLY UNDERSERVED, LOW INCOME, UNDERINSURED, MINORITY CITIZENS, LOCAL COMMUNITY MEMBERS, AND STUDENTS WERE CONDUCTED TO SOLICIT THEIR INPUT.

FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 6A
NORTHEAST MONTANA HEALTH SERVICES - POPLAR COMMUNITY HOSPITAL.

FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 7D
THE CHNA IS ALSO AVAILABLE AT THE PUBLIC LIBRARY.

FACILITY 1, NEMHS - TRINITY HOSPITAL - PART V, LINE 11
THE PRIORITIZED HEALTH NEEDS AS DETERMINED THROUGH THE ASSESSMENT PROCESS AND WHICH THE FACILITY WILL BE ADDRESSING RELATES TO THE FOLLOWING HEALTHCARE ISSUES: 1. ACCESS TO HEALTHCARE SERVICES 2. EDUCATION AND AWARENESS OF SERVICES THE FIRST HEALTHCARE ISSUE IS TO INCREASE ACCESS TO HEALTHCARE SERVICES IN THE NEMHS SERVICE AREA. ONE STRATEGY FOR ADDRESSING THIS ISSUE IS TO INCREASE ACCESS TO PRIMARY CARE SERVICES AT NEMHS BY PROVIDING LOCAL NURSE TRAINING OPPORTUNITIES AND PARTNERING WITH THE COMMUNITY COLLEGE IN FORT BELKNAP TO HOST NURSING CLINIC SITE ROTATIONS FOR STUDENTS, CONTINUING TO OFFER AND EXPLORING EXPANDING INTERNAL PAIN MANAGEMENT SERVICES WITH ON STAFF CRNA, ATTEMPTING TO RECRUIT PRIMARY CARE PHYSICIANS AND A PHYSICAL THERAPIST, ASSESSING THE FEASIBILITY OF EXPANDING OCCUPATIONAL THERAPY SERVICES(HOURS AND/OR ADDITIONAL STAFF), AND AIMING TO RECRUIT A NURSE PRACTITIONER TO ADDRESS THE INCREASED NUMBER OF PAIN MANAGEMENT PATIENTS. THE SECOND STRATEGY IS TO INCREASE ACCESS TO SPECIALTY CARE SERVICES AT NEMHS BY BRINGING IN PODIATRY ONCE A MONTH FOR TWO OR THREE DAYS, EXPLORING INCREASING THE HOURS OF MENTAL HEALTH TELEMEDICINE, EXPANDING PHYSICAL THERAPY SERVICES TO INCLUDE PELVIC FLOOR TRAINING, EXPLORING OFFERING AQUATIC THERAPY SESSIONS, EXPLORING THE FEASIBILITY OF IMPLEMENTING A CARDIAC REHAB PROGRAM, AND CONDUCTING A FEASIBILITY STUDY REGARDING HIPAA COMPLIANCE IN THE E.R. THE SECOND HEALTHCARE ISSUE IS TO ENHANCE THE KNOWLEDGE OF SERVICES AND RESOURCES PROVIDED BY NEMHS. THE STRATEGY FOR ADDRESSING THIS ISSUE IS TO EXPAND EDUCATION AND OUTREACH EFFORTS TO IMPROVE AWARENESS OF AVAILABLE SERVICES AT NEMHS BY CONTINUING OUTREACH VIA RADIO AND SOCIAL MEDIA OUTLETS(FACEBOOK, INSTAGRAM, WEBSITE), CONTINUING TO PLACE HEALTH EDUCATION MATERIALS IN WAITING ROOMS AND HEALTH EDUCATION KIOSKS IN EXAM ROOMS, IMPROVING AWARENESS OF SLEEP STUDIES CONDUCTED BY THE FACILITY, CONTINUING TO HOST THE EMS BASH TO PROMOTE HOSPITAL AND EMS SERVICES, INCREASING COMMUNITY AWARENESS OF EMS SERVICES VIA BILLBOARD, CONTINUING TO HOST THE ANNUAL HEALTH FAIR AND GOLF TOURNAMENT, AND PARTNERING WITH REGIONAL ORGANIZATIONS TO SUPPORT STUDENT INTERESTS IN HEALTHCARE CAREERS. THE HEALTH NEEDS IDENTIFIED BY NEMHS THAT THEY ARE UNABLE TO ADDRESS: FIRST, THERAPY SERVICES WERE IDENTIFIED AS HIGH AREAS OF CONCERN IN BOTH SURVEY AND KEY INFORMANT DATA. THESE SERVICES ARE AVAILABLE TO TRIBAL MEMBERS THROUGH INDIAN HEALTH SERVICES AND HEALTH PROMOTION DISEASE PREVENTION. SECOND, 14% OF RESPONDENTS SAID THAT MEDICATION COSTS HAD PROHIBITED THEM FROM GETTING OR TAKING THEIR PRESCRIPTIONS REGULARLY. TRIBAL MEMBERS CAN GET THEIR MEDICATIONS THROUGH INDIAN HEALTH SERVICES FREE OF CHARGE. THE COPAY FOR THE MEDICATIONS IS DECIDED BY THE INSURANCE COMPANY OF THE PATIENT AND THERE ARE A COUPLE FACTORS FOR EACH PRESCRIPTION SUCH AS DEDUCTIBLE, PRICE OF MEDICATION, ETC. THIRD, DENTAL SERVICES WERE IDENTIFIED AS NEEDED SERVICES NOT CURRENTLY AVAILABLE FOR BOTH ADULTS AND CHILDREN. THESE SERVICES ARE AVAILABLE TO TRIBAL MEMBERS THROUGH INDIAN HEALTH SERVICES AND HEALTH PROMOTION DISEASE PREVENTION. THERE IS ALSO A PRIVATE, LOCAL DENTIST. PROVIDING DENTAL SERVICES IS BEYOND THE SCOPE OF NEMHS AT THIS TIME. FOURTH, 28.3% OF ADULTS IN ROOSEVELT COUNTY ARE BELOW THE POVERTY LEVEL; 26% OF ADULTS ARE UNINSURED. TSHIP(TRIBAL SPONSORED HEALTH INSURANCE PROGRAM) IS AVAILABLE TO ALL MEMBERS WHO ARE UNDERINSURED OR NOT INSURED. NEMHS HAS A SLIDING-FEE SCALE THROUGH WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC. FIFTH, THE PERCENTAGE OF SMOKING DURING PREGNANCY IN ROOSEVELT COUNTY IS 30.7% COMPARED TO 16.5% FOR THE STATE. THIS ISSUE IS BEING ADDRESSED BY NEMHS AND INDIAN HEALTH SERVICES. IT IS AN ONGOING ISSUE AND EDUCATION IS PROVIDED FOR EVERY PATIENT. SIXTH, ROOSEVELT COUNTY HAS A RATE OF 2159.2 PER 100,000 PEOPLE WITH SEXUALLY TRANSMITTED DISEASES COMPARED TO 551.6 FOR THE STATE. SEXUALLY TRANSMITTED DISEASES ARE TRADITIONALLY HIGH WITHIN ROOSEVELT COUNTY AND THE RESERVATION. SOME STEPS HAVE BEEN TAKEN TO ADDRESS THIS ISSUE; INDIAN HEALTH SERVICES HAS IMPLEMENTED A NEEDLE EXCHANGE TO HELP FIGHT THE STD CRISIS.

FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 3E
THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND ARE IDENTIFIED THROUGH THE CHNA.

FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 5
IN APRIL 2022, A SURVEY WAS MAILED TO A RANDOMLY CHOSEN SAMPLE OF 300 RESIDENTS IN THE PRIMARY SERVICE AREA TO SOLICIT THEIR INPUT. THE SURVEY WAS ALSO MADE AVAILABLE ONLINE THROUGH SURVEY MONKEY AND MARKETED VIA THE FACILITY'S WEBSITE AND FACEBOOK PAGE. MAIL RETURNS AND ON-LINE SURVEYS WERE COMBINED WHICH RESULTED IN 133 SURVEYS BEING RETURNED. CONSULTATIONS WITH INDIVIDUALS WHO REPRESENTED VARIOUS CONSUMER GROUPS OF HEALTH CARE INCLUDING SENIOR CITIZENS, PUBLIC HEALTH, MEDICALLY UNDERSERVED, LOW-INCOME, UNDERINSURED, MINORITY CITIZENS, LOCAL COMMUNITY MEMBERS, AND STUDENTS WERE CONDUCTED TO SOLICIT THEIR INPUT.

FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 6A
NORTHEAST MONTANA HEALTH SERVICES - TRINITY HOSPITAL.

FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 7D
THE CHNA IS ALSO AVAILABLE AT THE PUBLIC LIBRARY.

FACILITY 2, NEMHS - POPLAR COMMUNITY HOSPITAL - PART V, LINE 11
THE PRIORITZED HEALTH NEEDS AS DETERMINED THROUGH THE ASSESSMENT PROCESS AND WHICH THE FACILITY WILL BE ADDRESSING RELATES TO THE FOLLOWING HEALTHCARE ISSUES: 1. ACCESS TO HEALTHCARE SERVICES 2. EDUCATION AND AWARENESS OF SERVICES THE FIRST HEALTHCARE ISSUE IS TO INCREASE ACCESS TO HEALTHCARE SERVICES IN THE NEMHS SERVICE AREA. ONE STRATEGY FOR ADDRESSING THIS ISSUE IS TO INCREASE ACCESS TO PRIMARY CARE SERVICES AT NEMHS BY PROVIDING LOCAL NURSE TRAINING OPPORTUNITIES AND PARTNERING WITH THE COMMUNITY COLLEGE IN FORT BELKNAP TO HOST NURSING CLINIC SITE ROTATIONS FOR STUDENTS, CONTINUING TO OFFER AND EXPLORING EXPANDING INTERNAL PAIN MANAGEMENT SERVICES WITH ON STAFF CRNA, ATTEMPTING TO RECRUIT PRIMARY CARE PHYSICIANS AND A PHYSICAL THERAPIST, ASSESSING THE FEASIBILITY OF EXPANDING OCCUPATIONAL THERAPY SERVICES(HOURS AND/OR ADDITIONAL STAFF), AND AIMING TO RECRUIT A NURSE PRACTITIONER TO ADDRESS THE INCREASED NUMBER OF PAIN MANAGEMENT PATIENTS. THE SECOND STRATEGY IS TO INCREASE ACCESS TO SPECIALTY CARE SERVICES AT NEMHS BY BRINGING IN PODIATRY ONCE A MONTH FOR TWO OR THREE DAYS, EXPLORING INCREASING THE HOURS OF MENTAL HEALTH TELEMEDICINE, EXPANDING PHYSICAL THERAPY SERVICES TO INCLUDE PELVIC FLOOR TRAINING, EXPLORING OFFERING AQUATIC THERAPY SESSIONS, EXPLORING THE FEASIBILITY OF IMPLEMENTING A CARDIAC REHAB PROGRAM, AND CONDUCTING A FEASIBILITY STUDY REGARDING HIPAA COMPLIANCE IN THE E.R. THE SECOND HEALTHCARE ISSUE IS TO ENHANCE THE KNOWLEDGE OF SERVICES AND RESOURCES PROVIDED BY NEMHS. THE STRATEGY FOR ADDRESSING THIS ISSUE IS TO EXPAND EDUCATION AND OUTREACH EFFORTS TO IMPROVE AWARENESS OF AVAILABLE SERVICES AT NEMHS BY CONTINUING OUTREACH VIA RADIO AND SOCIAL MEDIA OUTLETS(FACEBOOK, INSTAGRAM, WEBSITE), CONTINUING TO PLACE HEALTH EDUCATION MATERIALS IN WAITING ROOMS AND HEALTH EDUCATION KIOSKS IN EXAM ROOMS, IMPROVING AWARENESS OF SLEEP STUDIES CONDUCTED BY THE FACILITY, CONTINUING TO HOST THE EMS BASH TO PROMOTE HOSPITAL AND EMS SERVICES, INCREASING COMMUNITY AWARENESS OF EMS SERVICES VIA BILLBOARD, CONTINUING TO HOST THE ANNUAL HEALTH FAIR AND GOLF TOURNAMENT, AND PARTNERING WITH REGIONAL ORGANIZATIONS TO SUPPORT STUDENT INTERESTS IN HEALTHCARE CAREERS. THE HEALTHCARE NEEDS IDENTIFIED BY NEMHS THAT THEY ARE UNABLE TO ADDRESS: FIRST, THERAPY SERVICES WERE IDENTIFIED AS HIGH AREAS OF CONCERN IN BOTH SURVEY AND KEY INFORMANT DATA. THESE SERVICES ARE AVAILABLE TO TRIBAL MEMBERS THROUGH INDIAN HEALTH SERVICES AND HEALTH PROMOTION DISEASE PREVENTION. SECOND, 14% OF RESPONDENTS SAID THAT MEDICATION COSTS HAD PROHIBITED THEM FROM GETTING OR TAKING THEIR PRESCRIPTIONS REGULARLY. TRIBAL MEMBERS CAN GET THEIR MEDICATIONS THROUGH INDIAN HEALTH SERVICES FREE OF CHARGE. THE COPAY FOR THE MEDICATIONS IS DECIDED BY THE INSURANCE COMPANY OF THE PATIENT AND THERE ARE A COUPLE FACTORS FOR EACH PRESCRIPTION SUCH AS DEDUCTIBLE, PRICE OF MEDICATION, ETC. THIRD, DENTAL SERVICES WERE IDENTIFIED AS NEEDED SERVICES NOT CURRENTLY AVAILABLE FOR BOTH ADULTS AND CHILDREN. THESE SERVICES ARE AVAILABLE TO TRIBAL MEMBERS THROUGH INDIAN HEALTH SERVICES AND HEALTH PROMOTION DISEASE PREVENTION. THERE IS ALSO A PRIVATE, LOCAL DENTIST. PROVIDING DENTAL SERVICES IS BEYOND THE SCOPE OF NEMHS AT THIS TIME. FOURTH, 28.3% OF ADULTS IN ROOSEVELT COUNTY ARE BELOW THE POVERTY LEVEL; 26% OF ADULTS ARE UNINSURED. TSHIP(TRIBAL SPONSORED HEALTH INSURANCE PROGRAM) IS AVAILABLE TO ALL MEMBERS WHO ARE UNDERINSURED OR NOT INSURED. NEMHS HAS A SLIDING-FEE SCALE THROUGH WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC. FIFTH, THE PERCENTAGE OF SMOKING DURING PREGNANCY IN ROOSEVELT COUNTY IS 30.7% COMPARED TO 16.5% FOR THE STATE. THIS ISSUE IS BEING ADDRESSED BY NEMHS AND INDIAN HEALTH SERVICES. IT IS AN ONGOING ISSUE AND EDUCATION IS PROVIDED FOR EVERY PATIENT. SIXTH, ROOSEVELT COUNTY HAS A RATE OF 2159.2 PER 100,000 PEOPLE WITH SEXUALLY TRANSMITTED DISEASES COMPARED TO 551.6 FOR THE STATE. SEXUALLY TRANSMITTED DISEASES ARE TRADITIONALLY HIGH WITHIN ROOSEVELT COUNTY AND THE RESERVATION. SOME STEPS HAVE BEEN TAKEN TO ADDRESS THIS ISSUE; INDIAN HEALTH SERVICES HAS IMPLEMENTED A NEEDLE EXCHANGE TO HELP FIGHT THE STD CRISIS.

SCHEDULE H, PART I, LINE 7G
THERE WAS NO BAD DEBT EXPENSE TO REMOVE FROM THE COMMUNITY BENEFIT IN COLUMN C. PHYSICIAN CLINIC COSTS ARE NOT INCLUDED IN SUBSIDIZED HEALTHCARE SERVICES.

SCHEDULE H, PART I, LINE 7
USED ADJUSTED COST TO CHARGE RATIOS FOR PATIENT CARE FROM THE MEDICARE COST REPORT, ADJUSTED FOR BED TAX AND WORKFORCE DEVELOPMENT EXPENSE. BAD DEBT EXPENSE AND FINANCIAL ASSISTANCE ARE ALREADY EXCLUDED FROM THE MEDICARE COST REPORT.

SCHEDULE H, PART II
THE STAFF AT NEMHS DESIGNATES TIME FOR THE DEVELOPMENT OF COMMUNITY HEALTH PROGRAMS AND PARTNERSHIPS. THESE ACTIVITIES/INITIATIVES OFTEN TARGET ENVIRONMENTAL STRATEGIES, ECONOMIC DEVELOPMENT AND LEADERSHIP, ADVOCACY AND SUPPORT THAT INDIRECTLY AFFECT THE HEALTH OF THE COMMUNITY. PART II, LINE 8: NEMHS IS LOCATED IN A HEALTH PROFESSIONAL SHORTAGE AREA AND SPENT 99,442 TO RECRUIT PHYSICIANS AND OTHER HEALTH PROFESSIONALS NEEDED IN THE COMMUNITY. THE COST IS COMPRISED OF PAYMENTS TO RECRUITING FIRMS, NEWSPAPER AND PERIODICALS ADVERTISING, LEGAL FEES FOR FOREIGN PROFESSIONALS, AND TRAVEL AND LODGING FOR SITE VISITS.

SCHEDULE H, PART III, LINE 2
THE ORGANIZATION'S PATIENT CARE COST TO CHARGE RATIO, AFTER ELIMINATING BAD DEBT EXPENSE, FINANCIAL ASSISTANCE, BED TAX, AND COMMUNITY BENEFIT EXPENSE, IS APPLIED TO GROSS BAD DEBT CHARGES, NOT INCLUDING IMPLICIT PRICE CONCESSIONS, TO ARRIVE AT THE COST OF BAD DEBT. DISCOUNTS AND IMPLICIT PRICE CONCESSIONS REDUCE REVENUE AND ARE NOT RECORDED AS BAD DEBT. PAYMENTS RECEIVED ON PREVIOUSLY WRITTEN OFF ACCOUNTS ARE RECORDED AS RECOVERIES OF IMPLICIT PRICE CONCESSIONS OR BAD DEBT, WHICH REDUCE IMPLICIT PRICE CONCESSIONS OR BAD DEBT EXPENSE. PATIENT OBLIGATIONS WHICH QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT RECORDED AS IMPLICIT PRICE CONCESSIONS OR BAD DEBT EXPENSE.

SCHEDULE H, PART III, LINE 4
THERE IS NO BAD DEBT EXPENSE RECORDED AND THEREFORE NO RELATED BAD DEBT FOOTNOTE. AFTER ADOPTING THE NEW REVENUE RECOGNITION GUIDANCE IN FASB ASU 2014-09, MOST TRANSACTIONS THAT PREVIOUSLY WOULD HAVE BEEN RECORDED AS BAD DEBT EXPENSE ARE NOW RECORDED AS IMPLICIT PRICE CONCESSIONS, WHICH ARE REDUCTIONS OF REVENUE VERSUS BAD DEBT EXPENSE. NOTE 10 TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS DISCUSSES IMPLICIT PRICE CONCESSIONS ON PAGES 19 AND 20.

SCHEDULE H, PART III, LINE 8
THERE IS A MEDICARE SURPLUS SINCE CRITICAL ACCESS HOSPITALS ARE REIMBURSED 101 PERCENT OF COST FROM MEDICARE AND THE 2 PERCENT SEQUESTRATION ADJUSTMENT WAS REINSTATED IN APRIL 2022. MEDICARE COSTS ON PART III, LINE 6 ARE DIRECTLY FROM THE MEDICARE COST REPORT, PLUS AMBULANCE MEDICARE COSTS BASED ON THE AMBULANCE COST-TO-CHARGE RATIO ON THE COST REPORT. MEDICARE REVENUE ON PART III, LINE 5 IS DIRECTLY FROM THE MEDICARE COST REPORT, PLUS AMBULANCE MEDICARE REVENUE FROM THE MEDICARE PS&R REPORT.

SCHEDULE H, PART III, LINE 9B
THE ORGANIZATION USES A SLIDING SCALE BASED ON FEDERAL POVERTY GUIDELINES, AND ALSO A MEDICALLY INDIGENT TEST REGARDLESS OF INCOME, TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. THE ORGANIZATION DOES NOT ATTEMPT TO COLLECT CHARGES APPROVED AS FINANCIAL ASSISTANCE UNLESS THE PATIENT QUALIFIES FOR DISCOUNTED CARE AND THEN DEFAULTS ON THE PAYMENT PLAN ON THE BALANCE OF THE ACCOUNT. THIS IS A SPECIFIC POLICY FOR PATIENTS QUALIFYING FOR FREE OR DISCOUNTED CARE.

SCHEDULE H, PART VI, LINE 2
PURSUANT TO THE PROVISIONS OF THE AFFORDABLE CARE ACT, NEMHS ADOPTED A COMMUNITY HEALTH NEEDS ASSESSMENT AND AN IMPLEMENTATION PLAN DURING FISCAL YEARS 2022, 2019 AND 2016 (TAX YEARS 2021, 2018 AND 2015). THESE ARE A CONTINUATION AND EXPANSION OF WHAT WE ARE ALREADY DOING TO BETTER SERVE OUR COMMUNITY. WE ARE DILIGENTLY TRACKING LOCAL TRENDS IN HEALTH CARE NEEDS THROUGH AN CUSTOM SURVEY SOLUTIONS PATIENT SATISFACTION SURVEY GIVEN TO ALL INPATIENTS AS WELL AS THE USE OF OUR INTERNAL BALANCED SCORE CARD. A SELECTED TEAM OF MANAGERS MEET QUARTERLY TO DISCUSS OUTCOMES FROM OUR SURVEY REPORTS AND BALANCED SCORE CARD FINDINGS.

SCHEDULE H, PART VI, LINE 3
NORTHEAST MONTANA HEALTH SERVICES EMPLOYS TWO SOCIAL SERVICE EMPLOYEES TO ASSIST PATIENTS WITH THEIR FINANICAL NEEDS AND OPTIONS. COMMUNITY ADVERTISEMENT IS USED TO EDUCATE PATIENTS AND SUPPORT IS GIVEN ON A ONE-ON-ONE BASIS TO ASSIST COMMUNITY MEMBERS. PATIENTS ARE NOTIFIED BY THE BILLING DEPARTMENT OF OUR POLICY FOR FINANCIAL ASSISTANCE AND ARE SENT A SIMPLE APPLICATION. OUR WEBSITE PROVIDES DETAILS OF OUR FINANCIAL ASSISTANCE POLICY AND THE FINANCIAL ASSISTANCE AVAILABLE. THE PATIENT INVOICES INCLUDE A STATEMENT ABOUT THE FINANCIAL ASSISTANCE POLICY AND HOW TO FIND FURTHER INFORMATION.

SCHEDULE H, PART VI, LINE 4
THE ORGANIZATION OPERATES ON THE FORT PECK RESERVATION. GEOGRAPHICALLY THIS IS A REMOTE LOCATION WHERE ACCESS TO OTHER HEALTH FACILITIES IS AT LEAST 50 MILES AWAY. WITH SEVERE WEATHER CONDITIONS OFTEN RESULTING IN BLIZZARDS AND IMPASSABLE ROADS, NORTHEAST MONTANA HEALTH SERVICES IS THE FRONTLINE OF CARE FOR THE COMMUNITY. THE POPULATION OF SIOUX AND ASSINIBOINE TRIBAL MEMBERS MAKE UP OUR HIGHEST CONCENTRATION OF PATIENTS WITH DISPARITIES THAT INCLUDE CULTURAL BARRIERS, LOW HOUSEHOLD INCOME, HIGH UNEMPLOYMENT RATES, HIGHER RATES OF TOBACCO, ALCOHOL AND ILLEGAL DRUG USE, AS WELL AS HIGHER THAN AVERAGE RATES OF HEART DISEASE, DIABETES, FETAL ALCOHOL SYNDROME, AND SUICIDE. AS WE CONTINUE OUR EFFORTS TO SERVE THE PUBLIC THROUGH HEALTHCARE AND EDUCATION, THERE IS PROGRESS BEING MADE TO IMPROVE THE QUALITY OF LIFE FOR COMMUNITY MEMBERS.

SCHEDULE H, PART VI, LINE 5
NORTHEAST MONTANA HEALTH SERVICES IS GOVERNED BY A VOLUNTARY BOARD OF COMMUNITY MEMBERS REPRESENTING THE GEOGRAPHICAL AREAS OF OUR PRIMARY SERVICE AREA. OUR HOSPITALS PROVIDE 24/7 EMERGENCY SERVICE COVERAGE TO TREAT PATIENTS, INCLUDING THOSE THAT ARE UNABLE TO PAY.

SCHEDULE H, PART VI, LINE 6
TWO AFFILIATED RURAL HEALTH CLINICS, WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC, PROVIDE PROFESSIONAL PHYSICIAN AND OTHER PROVIDER SERVICES WHILE NORTHEAST MONTANA HEALTH SERVICES PROVIDES INPATIENT AND OUTPATIENT HOSPITAL SERVICES AND SKILLED NURSING SERVICES. THE TWO RURAL HEALTH CLINICS ARE OPERATED, AND SUBSIDIZED IF NEEDED, BY NORTHEAST MONTANA HEALTH SERVICES.

SCHEDULE H, PART VI
PART V: WOLF POINT CLINIC ASSOCIATION AND RIVERSIDE FAMILY CLINIC ARE RURAL HEALTH CLINICS THAT ARE OPERATED AND SUBSIDIZED IF NEEDED BY NORTHEAST MONTANA HEALTH SERVICES. THEIR REVENUES AND EXPENSES ARE NOT INCLUDED ON NORTHEAST MONTANA HEALTH SERVICES' FORM 990.