2025-04-10T09:47:40-05:00 2024-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2023-07-01 237169043 Central Montana Medical Facilities Inc CENT 4065387711 408 Wendell Avenue Lewistown MT 59457 Perry Howell CFO 4065387711 2025-04-09 1 1 Kim Hunwardsen CPA P00484560 6122536500 2025-03-25 2023 2025-03-06 01:10:19Z Central Montana Medical Center Cody Langbehn 408 Wendell Avenue Lewistown MT 59457 60502735 0 X www.cmmc.health X 1971 MT The mission of CMMC is to be the leader in assuring community based quality healthcare. 12 9 371 130 0 0 9488145 3644659 45640856 53651305 214470 833190 259351 266628 55602822 58395782 0 0 0 0 25155946 25260930 0 0 162219 22853504 25532995 48009450 50793925 7593372 7601857 53403655 61038627 11981717 10952114 41421938 50086513 X The mission of Central Montana Medical Center is to be the leader in assuring community based quality healthcare. 0 0 41964656 53651305 Central Montana Medical Center Facilities, Inc. operates a 25 bed critical access hospital located in Lewistown, MT. Hospice Inpatient Services for FY2024:Number of beds: 25Provided 1,439 acute days of care and 744 swing bed days of care for 23.92% occupancy rateEmergency Services for FY2024:Provided for 5,290 emergency visits24-hour physician coverage availableOB Services for FY2024:Provided for 85 births in Central MontanaThe facilities maintain records to identify and monitor the level of charity care it provides. These records include the amount to charges forgone for services and supplies furnished under the charity care policy.The amount of charges foregone for services provided under the facilities charity care policy were approximately $1,935,420 for the fiscal year.Awards received for FY 2024 were:-2024 Top 100 Critical Access Hospital-PIN Quality Improvement Award for the 2023-2024 grant year (8 consecutive years) for improvement in stroke care-Healthcarefirst's Home Health Honors Award 41964656 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 56 0 1 371 1 0 0 0 0 0 0 1 1 0 0 0 0 0 X 12 9 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X Perry Howell 4065357711 408 Wendell Ave Lewistown MT 59457 Corry Arntzen Chair 1.00 X X 0 0 0 Carl Seilstad Vice Chair 1.00 X X 0 0 0 Ashley Morris Treasurer 1.00 X X 0 0 0 Ryan d'Autremont Secretary 1.00 X X 0 0 0 Keith Cook Member 1.00 X 0 0 0 Marvin Mauws Member 1.00 X 0 0 0 Megan Bartel Member 1.00 X 0 0 0 Melody Montgomery Member 1.00 X 0 0 0 Karen Durbin Member 1.00 X 0 0 0 Christopher Goulet Member 1.00 X 0 0 0 Dr Tamara Welsh Physician/Member 40.00 X 315069 0 8182 Dr Michael Sura Physician/Member 40.00 X 408887 0 34968 Cody Langbehn CEO 40.00 X 0 0 0 Perry Howell CFO 40.00 X 154053 0 8398 Dr Raymond Lee Radiologist 40.00 X 523388 0 28650 Dr Gardner Smith Surgeon 40.00 X 520833 0 32955 Dr Felipe Vile Martignoni Family Practice Doctor 40.00 X 452842 0 39373 Dr Melanie Hardy ER Physician 40.00 X 381539 0 33599 Dr Amy A LePage ER Physician 40.00 X 360580 0 29718 3117191 0 215843 27 0 1 0 Billings Clinic PO Box 30357 Billings MT 59107 Mgmt Fees, Reading, Other Fees 3141650 Synergy Surgicalist PC 12396 World Trade Dr 303 San Diego CA 92128 Physician Staffing 1067760 Cushing Terrell PO Box 30071 Billings MT 59107 Architecture-Building Services 755745 AMN Healthcare PO Box 281939 Atlanta GA 30384 Medical Staffing 409574 Birdwell Builders Inc PO Box 592 Lewistown MT 59457 Construction Staff 312989 12 15000 11352 3618307 1477325 3644659 Net Patient Revenue 621110 51122772 51122772 Special Programs 900099 1783237 1783237 Pharmacy Revenue 456110 739461 739461 Cafeteria 722514 5835 5835 53651305 872025 872025 401162 183334 217828 217828 217828 1855192 1882912 11115 -27720 -11115 -38835 -38835 78392 29592 48800 48800 58395782 53651305 0 1099818 X 997975 784187 213788 234549 234549 20544708 16382249 4057907 104552 484633 334319 146308 4006 1610454 1295229 294971 20254 1388611 1110889 270631 7091 445068 445068 53222 539 52683 103536 103536 7617285 7617285 138879 104159 24009 10711 2546977 1632129 910781 4067 1399647 1108295 289552 1800 51730 51062 668 84043 82208 1835 15082 15082 1941305 1494282 447023 727918 727918 Medical Supplies 7253456 7253383 73 Taxes and Licenses 729613 17675 711938 Equip Rental and Maint 458419 453946 4473 1966815 1280353 683773 2689 50793925 41964656 8667050 162219 13278114 18784456 5047999 1428501 8193325 8339813 995026 1073795 367805 395330 50314920 32384424 13489693 17930496 5117907 7214265 6913786 5871971 53403655 61038627 4807096 5068740 3105547 2981309 2094758 1644227 1974316 1257838 11981717 10952114 X 27356640 38725047 14065298 11361466 41421938 50086513 53403655 61038627 X 7601857 251051 811667 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 123009 123009 26954728 19670854 7283874 14454727 11406107 3048620 8782456 1307463 7474993 17930496 Long-Term Prepaid Expenses 660015 Due from Foundation 3964068 Other Receivables 1147175 Finance Lease ROU Asset 22515 Operating Lease ROU Asset 5851 Estimated Third-Party Payor Settlements 72347 5871971 Estimated Third-Party Payor Settlements 300000 Operating Lease Liability 5851 Finance Lease Obligation 24302 Construction Payable 927685 1257838 X 58834224 251051 251051 58583173 -187391 -187391 58395782 50981316 187391 187391 50793925 0 50793925 Part X, Line 2: The Facilities 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 financial statements. The Facilities 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 4b - Other Adjustments: Rental Expenses Reported in Revenue for Tax Purposes -183,334. Gaming Expenses Reported in Revenue for Tax Purposes -4,057. Part XII, Line 2d - Other Adjustments: Rental Expenses Reported in Revenue for Tax Purposes 183,334. Gaming Expenses Reported in Revenue for Tax Purposes 4,057. 78392 25535 4057 1 0.97000 78392 25535 4057 29592 48800 MT 0 CMMC is not licensed and according to the raffle guidelines of the State of Montana, non-profits are not required to have a license. 0 1 0 0.04700 0.95300 Abby Franks 408 Wendell Ave Lewistown MT 59457 0 Cody Langbehn 0 Oversight of department responsible for tracking/recording X 0 Form 990, Schedule G, part III, line 16: The Organization held a one-time raffle. Cody Langbehn had high-level oversight over the raffle. None of his compensation should be allocated to gaming activities. 1 1 X 1 X 1 X 1 1 1 0 1 0 945000 945000 0.01860 945000 945000 0.01860 14 33211 49954 3920 46034 0.00090 1 7 153 153 0.00000 16382912 9829051 6553861 0.12900 3 12573 9418 9418 0.00020 18 45791 16442437 9832971 6609466 0.13010 18 45791 17387437 9832971 7554466 0.14870 2 225116 25153 25153 0.00050 2 225116 25153 25153 0.00050 1 332208 0 9484765 9499507 -14742 X 1 1 1 1 Central Montana Medical Center 408 Wendall Avenue Lewistown MT 59457 www.cmmc.health 12894 X X X X Home Health / Hospice Central Montana Medical Facilities Inc 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X https://www.cmmc.health/resources/reports/ X 1 21 1 https://www.cmmc.health/resources/reports/ 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X See Part V X See Part V X See Part V X X X X X X 1 X 0 X X X X 1 X 0 0 Central Montana Medical Facilities, Inc. Part V, Section B, Line 5: In January 2022, surveys were mailed out to the residents in Fergus County, Montana. Survey respondents had the ability to complete the survey mailed to them, or could complete via an online survey hosted at Montana State University's HELPS Lab web portal. The survey was based on a design that has been used extensively in the states of Washington, Wyoming, Alaska, Montana, and Idaho. The survey was designed to provide each facility with information from local residents regarding: -Demographics of respondents -Hospitals, primary care providers and specialists used, plus reasons for selection -Local healthcare provider usage -Services preferred locally -Perception and satisfaction of local healthcare Key informant interviews and focus groups were conducted to identify important local healthcare issues, how to improve the health of the community, and gaps in health services. It was intended that this research would help determine the awareness of local programs and services, as well as the level of satisfaction with local services, providers, and facilities. Central Montana Medical Facilities, Inc. Part V, Section B, Line 11: In the most recent CHNA conducted the following needs were identified:1. Health concerns including expanding access to mental and behavioral health services through CMMC2. Increasing access to healthcare services at CMMC3. Improving the health and wellness of Central MontanaThe organization will not address the need identified for affordable housing. This is a challenging issue to tackle alone. As time allows in the future, CMMC would be open to engaging with community partners for discussions related to housing affordability and accessibility.In the current year the facility has taken the following actions:To address increasing access to healthcare: -fixed option for online bill pay, improved timeliness of patient statements and standardized the billing process-moved patient records and billing office to an easy entrance-added a part time ER provider-added a visiting pulmonologist To address improving the health and wellness of Central Montana-a stoke support group was started-participated in several community wide health fairs-CMMC is currently building a cancer center which will allow people to stay in their community to receive treatmentTo address health concerns including expanding access to mental and behavioral health services:-CMMC hired a nurse practitioner 2 years ago to increase behavioral health services. The patient base is growing.-CMMC is also currently seeking a LCPC to supplement mental health services offered for the community. Central Montana Medical Facilities, Inc. Part V, Section B, Line 13h: Eligibility is based on patient's family size, family gross income, personal assets, and other medical debts. Central Montana Medical Facilities, Inc. Part V, Section B, Line 16j: A summary of the financial assistance policy is also posted in the hospital facility's emergency room, waiting rooms, and admissions offices. Part V, Line 16a, FAP Website: https://www.cmmc.health/for-patients/billing-and-financial-assistance/ Part V, Line 16b, FAP Application Website: https://www.cmmc.health/for-patients/billing-and-financial-assistance/ Part V, Line 16c, FAP Plain Language Summary Website: https://www.cmmc.health/for-patients/billing-and-financial-assistance/ 2 1 - Central Montana Medical Center - DME 410 Wendell Ave Ste 3 Lewistown MT 59457 HME/DME Services 2 - Central Montana Medical Center-Clinic 410 Wendell Ave Lewistown MT 59457 Physician Clinic Part I, Line 3c: Eligibility is based on patient's family size, family gross income, personal assets, and other medical debts. Part I, Line 7: The Organization used an average overall ratio of costs to gross charges which addresses all patient segments in order to calculate charity care. Community health improvement services, health professions education and cash and in kind contributions were based on expenses recorded in the general ledger. Medicaid and subsidized health services are reported according to costs allocated to the relevant cost centers on the Medicare cost report. Part II, Community Building Activities: Community Building activities promote the health of the communities served by providing services and donations for a healthy, active, and educated public. Central Montana Medical Center staff donated time to several Community Boards, including the Chamber of Commerce, Kiwanis, the Lewistown Downtown Association, and other meetings with volunteers servicing our community. CMMC participated in community events including the Central Montana Fair. By contributing in these different ways, CMMC staff provide a range of knowledge to the community members with a foundation on health and medical needs. All these programs benefit central Montana and promote health and wellness. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. Part III, Line 4: The footnote to the Organization's financial statements can be found on pages 12-13 of the attached audited financial statements. Part III, Line 8: Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.All of the Medicare shortfall should be treated as a community benefit. The Organization treats individuals regardless of the ability to pay. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. Part III, Line 9b: Whenever the patient is determined eligible the account will be adjusted based on the determined eligibility. In the first 120 days the patient will receive a minimum of 3 letters and possibly more dependent on the status of the account; and a minimum of 3 phone calls depending on the status of the account. After 120 days, if the account has already been sent to collections and the patient is determined eligible, the account is immediately returned from the collection agency while the application is in process. The account will be adjusted immediately based on determined eligibility. Financial assistance can have a presumptive eligibility without receiving an application from the patient. Presumptive eligibility is listed in charity care policy outlining the 7 criteria for presumptive eligibility qualifications. If a patient does provide an application and is determine ineligible for financial assistance, denials are written and include instructions for appeals or reconsideration. Collection actions may be pursued after patients are found ineligible. These collection practices follow the Fair Debt Collection Practice Act. Also, in the written denial notification there will be a deadline no earlier than 30 days after the written response of the outlined Extraordinary Collection Action (ECA) that will be initiated. Part VI, Line 2: Currently, CMMC assesses the health care needs of the community by the number of responses to ads and articles released through the local media. Also tracked were the kinds of support requested of CMMC such as children's safety, wellness initiatives and healthcare assessments. In FYE 2022 CMMC completed a Community Health Needs Assessment with the help of Montana State University. Mail and phone surveys were completed and "town hall" type meetings were held in Lewistown. Part VI, Line 3: CMMC has financial assistance signage posted in the admissions areas and the ER waiting area. A pamphlet explaining our financial assistance program, the application process and contact information is available at all hospital registration areas. The Charity Care policy and application along with a checklist and contact information is posted on our website on the internet. Prior to discharge someone from discharge planning discusses with the patient the availability of various government benefits, such as Medicaid, and assists the patient with qualifications for such programs, where applicable. Assistance with filling out the Charity Care application is also provided at this time. Private Pay in-patients are informed of Charity Care either prior to scheduled admission by physician referral or prior to discharge from the facility. We also send out information with first time statements. All other patients are informed upon inquiry. Part VI, Line 4: Lewistown is an agricultural community and the county seat for Fergus County Montana. Lewistown is located in the center of Montana and is surrounded by five mountain ranges: the Snowies, the Judiths, the Moccasins, the Belts and the Highwoods. Lewistown's elevation is 3,963 feet with 3,194 people per square mile (average).The city of Lewistown and the surrounding rural towns are supported by one hospital, Central Montana Medical Center. Fergus County is located in a federally designated medically underserved area.As of the census of 2022, the population of Lewistown MT is 6,076 (2,879 female and 3,197 male). The county's population was 11,872 and there are 2.73 persons per square mile.March 2022 cost of living index in our zip code (59457) is 87.4%, U.S. average is 100.Real estate property taxes paid for housing units with mortgages in 2022 was $1,765. Renter-occupied apartments were 35% compared to the state average of 31%.The median resident age for this zip code is 48.1 years old with an average household size of 2.2 people.The population 25 years and over in 59457 shows High school or higher: 93.3%, Bachelor's degree or higher: 23.0%, Graduate or professional degree: 4.2%, Unemployed:6.0%Information obtained from www.city-data.com/city/Lewistown-Montana.html Part VI, Line 5: The CMMC Governing Board consisted of 12 volunteer community members including members from surrounding communities and 1 member from our affiliate, Billings Clinic.CMMC extends medical staff privileges to qualified physicians based upon community needs.Surplus funds, when available, are applied to patient care needs, equipment and building maintenance and medical education requirements. The expenditure of these funds is approved by the Governing Board which meets on a monthly basis.CMMC operates a 24 ER that is available to anyone determined to be in need of care, regardless of their ability to pay. There is representation on the CMMC Governing Board from both the immediate and surrounding communities. There is also a diverse representation from across the immediate and surrounding communities which serve on the CMMC PFAC (Advocacy Committee).Community care and services are also provided through the many reduced-price services and free clinics, fairs, and programs offered throughout the year. Care and services provided this year includes but is not limited to the following (all costs are estimates):Services provided for fiscal year 23-24:*Concussion Testing: - 604 students tested-Established baseline cognitive functioning for all area schools' athletic programs (Lewistown High School and Junior High, Winifred, Roy, Hobson, and Moore)-Educated on importance of brain health and injury prevention-Estimated Cost: $6,608*Sports Physical Clinics:-Provided 242 sports physical exams to area students that included a musculoskeletal exam by CMMC Rehab department: Donated proceeds back to individual school athletic programs-Estimated cost: $8,552*CPR / First Aid:-70 students taught at Fergus High School: 7 day class / 6 class periods per day-Educated on 9-1-1 emergency calls; basic adult / infant CPR; AED training; seizure care; allergic reactions and training in use of an Epi-pen; Stop the Bleed training; diabetic s/sx and response to abnormal issues; total of 118 staff hours-Estimated cost: $2,804 (in-kind) TOTAL cost: $5304*Rural EMS volunteer services:-NO volunteer EMTs served this FY.-Estimated cost: $0*Volunteer Services: -34 volunteers served-Lab testing, COVID and flu vaccines, TB testing-4 staff and supplies used -Estimated cost: $1,702 (does not include staff time)*Student Services:-88 students served (Nursing Resident, FHS EMT, etc)-Drug testing, Lab testing, COVID and flu vaccines, TB testing, Respirator Fit testing-4 staff used and supplies used-Estimated cost: $1,852*Hospice Annual Volunteer Training: - 15 volunteers served-Educated on immunizations; appropriate PPE, and Covid precautions / symptoms for Covid-Estimated cost: $93 Part VI, Line 6: CMMC is part of an affiliated health care system with Billings Clinic. Central Montana Medical Center is involved in promoting community health by participating in Population Health programs offered by Medicare and other third party insurers. Billings Clinic and CMMC collaborate on Population Health and Care Coordination initiatives that are provided to the community. CMMC has an independent Care Coordination department focused on promoting the health of the individuals in our community. Part VI, Line 7, Reports Filed With States MT X 0 0 0 0 0 0 0 0 0 Dr Gardner Smith Surgeon 520833 0 0 0 0 0 9000 0 25348 0 555181 0 0 0 Dr Raymond Lee Radiologist 523388 0 0 0 0 0 20000 0 8650 0 552038 0 0 0 Dr Felipe Vile Martignoni Family Practice Doctor 452842 0 0 0 0 0 15655 0 23718 0 492215 0 0 0 Dr Michael Sura Physician/Member 408887 0 0 0 0 0 11250 0 25111 0 445248 0 0 0 Dr Melanie Hardy ER Physician 381539 0 0 0 0 0 9881 0 23718 0 415138 0 0 0 Dr Amy A LePage ER Physician 360580 0 0 0 0 0 6000 0 23718 0 390298 0 0 0 Dr Tamara Welsh Physician/Member 315069 0 0 0 0 0 8182 0 1393 0 324644 0 0 0 Perry Howell CFO 154053 0 0 0 0 0 4092 0 6001 0 164146 0 0 0 A Fergus County Montana 816001358 000000000 2014-05-01 4500000 Emergency and laboratory expansion and remodel of existing facility 0 0 0 A 1518691 4500000 4500000 2015 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 Amie D'Autremont Sister of board member, Ryan D'Autremont 83087 Employee compensation 0 Amy D'Autremont Wife of board member, Ryan D'Autremont 103448 Employee compensation 0 Amy Howell Wife of CFO, Perry Howell 48014 Employee compensation 0 X 1 1451790 Avg. Hi/Low Mkt Value X Camper 1 14950 Retail Value X Miscellaneous 16 10585 Cost 0 0 1 0 Form 990, Part VI, Section A, line 1a The Executive Committee includes the President or Chair, Vice President or Vice Chair, Secretary and Treasurer and 2 members-at-large and their authority is similar to that of the full governing board. Form 990, Part VI, Section A, line 3 Cody Langbehn is a contract employee of Billings Clinic. Central Montana Medical Center is affiliated with Billings Clinic and Cody serves as the CEO. Billings Clinic was paid a total of $362,957 for Cody's services during calendar year 2023. Compensation: $305,427 Benefits: $57,530 The organization pays Billings Clinic a management fee of $37,089 per month for our affiliation. Form 990, Part VI, Section A, line 6 The organization has two classes of membership: Class A general membership and Class B membership, with the sole member of the Class B Membership being Billings Clinic. Class A Membership in the Corporation shall consist of residents of Central Montana residing within the counties of Fergus, Judith Basin and Petroleum who are at least eighteen (18) years of age and who have or shall indicate their interest in the maintenance of adequate medical facilities and high standards of medical care in the area, served by CMMC, and who indicate a willingness and desire to be a member of the Corporation by attending and signing the register at the Corporation's annual meeting. Form 990, Part VI, Section A, line 7a The board has two classes of directors. Class A Directors are elected by the Class A Members and Class B Directors are appointed by the Billings Clinic. There shall be at last nine but no more than thirteen Class A Directors. There shall be at least one but no more than two Billings Clinic Directors, as determined by Billings Clinic from time to time. Each Class A Director must reside within the counties of Fergus, Judith Basin or Petroleum. Two Class A Directors must be physicians holding privileges on CMMC's active Medical Staff. Further, so long as the Corporation remains obligated for the repayment of any long-term tax-exempt financing, underwritten through Fergus County, Montana, one Class A Director shall be selected from the Fergus County Commissioners. The Board and Billings Clinic shall communicate concerning the appointment of Billings Clinic Directors with the objective of selecting individuals who will work cooperatively with the Class A Directors for the benefit of CMMC. Form 990, Part VI, Section A, line 7b Any amendment to the bylaws affecting the voting rights and powers of membership, must be approved by both a two-thirds majority of the board present at any regular or special meeting of the board and Billings Clinic. Additionally, Billings Clinic must consent to any amendment of the bylaws relating to CMMC's purpose, the membership, the members of the board, including but not limited to the number of directors, the composition of the board, the term of office of directors or the method or way in which directors are elected or selected. Form 990, Part VI, Section B, line 11b A draft copy of the Form 990 is reviewed by the CFO and Board of Directors prior to its filing. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy by discussing at the Board of Director Meetings and obtaining signed statements from members. All officers, board members, and key employees are covered by the policy. The board determines whether conflicts exist and all potential conflicts are reviewed by the board. Any person with a conflict is not allowed to vote on conflicted issues. Form 990, Part VI, Section B, line 15a Cody Langbehn, CEO, is employed by Billings Clinic. Billings Clinic provided market data to the Board and the Board takes action annually to set his compensation level. CFO compensation was determined by the CEO after looking at market data from MHA and consulting with a recruitment company about market data for the CFO pay range. The specific pay rate was then set based on the market range and relevant experience. These processes take place on an annual basis. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. A copy may be requested by calling, emailing, walk-in or via mail. Form 990, Part IX, line 11g Medical/Professional Fees: Program service expenses 845,916. Management and general expenses 0. Fundraising expenses 0. Total expenses 845,916. Service Contracts: Program service expenses 888,093. Management and general expenses 0. Fundraising expenses 0. Total expenses 888,093. Purchased Services: Program service expenses 5,883,276. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,883,276. Form 990, Part XI, line 9: Change in Interest in Central Montana Foundation 811,667.