2024-05-14T10:40:20-05:00 2023-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2022-07-01 237169043 Central Montana Medical Facilities Inc CENT 4065387711 408 Wendell Avenue Lewistown MT 59457 Perry Howell CFO 4065387711 2024-05-08 1 Perry Howell 999009999 1 Kim Hunwardsen CPA P00484560 6122536500 2024-04-29 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Central Montana Medical Center Cody Langbehn 408 Wendell Avenue Lewistown MT 59457 56663513 0 X www.cmmc.health X 1971 MT The mission of CMMC is to be the leader in assuring community based quality healthcare. 12 9 366 84 0 0 154656 9488145 45596702 45640856 1560723 214470 352074 259351 47664155 55602822 0 0 0 0 24899576 25155946 0 0 173539 21050886 22853504 45950462 48009450 1713693 7593372 46445765 53403655 12390919 11981717 34054846 41421938 X The mission of Central Montana Medical Center is to be the leader in assuring community based quality healthcare. 0 0 40205507 45640856 Central Montana Medical Facilities, Inc. operates a 25-bed critical access hospital located in Lewistown, Montana.Hospital Inpatient Services for FY 2023:Number of beds: 25Provided 1,441 acute days of care and 850 swing bed days of care for 25.11% occupancy rate. Emergency Services for FY 2023:Provided for 5,382 Emergency visits.24-hour Physician coverage available.OB Services for FY 2023:Provided for 91 births in Central MontanaThe facilities maintain records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy. The amount of charges foregone for services provided under the Facilities charity care policy were approximately $1,527,240 for the fiscal year. Awards received for FY 2023 were:*PIN Quality Improvement Award for the 2022-2023 grant year (7 consecutive years)*Healthcarefirst's Home Health Honors Award*National Leader in Prevention & Wellness from Signify Health*2023 Top 100 Critical Access Hospital*CMS 5-star Overall Hospital Quality Star Rating 40205507 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 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 61 0 1 366 1 0 0 0 0 0 0 0 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 Jennifer Saunders Secretary/Treasurer thru Dec 2022 1.00 X X 0 0 0 Ashley Morris - Member thru Dec 2022/Treasurer as of Jan 2023 1.00 X X 0 0 0 Ryan d'Autremont - Member thru Dec 2022/Secretary as of Jan 2023 1.00 X X 0 0 0 Megan Bartel Member 1.00 X 0 0 0 Keith Cook Member 1.00 X 0 0 0 Christopher Goulet Member as of Oct 2022 1.00 X 0 0 0 Karen Durbin Member 1.00 X 0 0 0 Marvin Mauws Member 1.00 X 0 0 0 Melody Montgomery Member 1.00 X 0 0 0 Dr Tamara Welsh Physician/Member 40.00 X 293863 0 7455 Dr Michael Sura Physician/Member 40.00 X 308857 0 33571 Mary Albers Member thru Sept 2022 1.00 X 0 0 0 Brandon Bantz Member thru Oct 2022 1.00 X 0 0 0 Cody Langbehn CEO 40.00 X 0 0 0 Perry Howell CFO 40.00 X 87615 0 8982 Dr Raymond Lee Radiologist 40.00 X 508634 0 25745 Dr Gardner Smith Surgeon 40.00 X 467702 0 34807 Dr Felipe Vile Martignoni Family Practice Doctor 40.00 X 402637 0 30154 Dr Amy A LePage ER Physician 40.00 X 353020 0 28810 Dr Augusto Amaral Neto Family Practice Doctor 40.00 X 346736 0 27420 2769064 0 196944 34 0 1 0 Billings Clinic PO Box 30357 Billings MT 59107 Mgmt, reading & other fees 2098450 Synergy Surgicalist PC 12396 World Trade Dr 303 San Diego CA 92128 Physician Staffing 1086013 Sletten Construction Company 1000 25th St N Great Falls MT 59403 Construction Staff 505400 Cushing Terrell PO Box 30071 Billings MT 59107 Architecture-Building Services 171161 Triage Medical Staff PO Box 773328 Chicago IL 60677 Medical Staffing 143081 8 3156408 6331737 9488145 Net Patient Revenue 621110 43029009 43029009 Special Programs 900099 1739288 1739288 Pharmacy Revenue 456110 790991 790991 Cafeteria 722514 81568 81568 45640856 279143 279143 424226 164875 259351 259351 259351 830543 600 891018 4798 -60475 -4198 -64673 -64673 55602822 45640856 0 473821 X 888750 780372 108378 200782 200782 21572905 17153899 4291302 127704 472410 352710 116652 3048 1054079 839909 204935 9235 967020 773617 184448 8955 346862 346862 70697 70697 71925 71925 6653605 6653605 105008 78755 14736 11517 1886340 1204091 680272 1977 1126327 890788 233739 1800 55535 55235 300 111355 111227 128 164906 126258 38648 1908671 1469246 439425 719540 719540 Medical Supplies 6673011 6672999 12 Equipment Rental and Ma 644908 636045 8863 Taxes and Licenses 52234 15751 36483 2262580 1470678 791902 48009450 40205507 7630404 173539 8217869 13278114 4065167 5047999 11055451 8193325 996694 995026 210140 367805 50135971 36646278 11912212 13489693 4686638 5117907 5301594 6913786 46445765 53403655 5274876 4807096 1921316 3236672 3105547 1547300 2094758 410755 1974316 12390919 11981717 X 24460383 27356640 9594463 14065298 34054846 41421938 46445765 53403655 X 7593372 310615 -536895 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 123009 123009 26979484 18899510 8079974 20220454 16467966 3752488 2813024 1278802 1534222 13489693 Long-Term Prepaid Expenses 585898 Due from Foundation 3152401 Other Receivables 1263887 Finance Lease ROU Asset 57546 Operating Lease ROU Asset 20181 ERC Receivable 1833873 6913786 Estimated Third-Party Payor Settlements 1893966 Operating Lease Liability 20181 Finance Lease Obligation 60169 1974316 X 56078312 310615 310615 55767697 -164875 -164875 55602822 48174325 164875 164875 48009450 0 48009450 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 -164,875. Part XII, Line 2d - Other Adjustments: Rental Expenses Reported in Revenue for Tax Purposes 164,875. 1 1 X 1 X 1 X 1 1 1 0 0 740000 740000 0.01540 3253427 3179922 73505 0.00150 3993427 3179922 813505 0.01690 14 14727 55989 55989 0.00120 1 20 135 135 0.00000 14313011 8312073 6000938 0.12500 2 1175 3260 3260 0.00010 17 15922 14372395 8312073 6060322 0.12630 17 15922 18365822 11491995 6873827 0.14320 4 300871 17568 17568 0.00040 4 300871 17568 17568 0.00040 1 2662159 0 8868976 8884271 -15295 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 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 the needs in the most recent CHNA:1. Health concerns including expanding access to mental and behavioral health services through CMMC-We added an RN Behavioral Health Care Navigator to our behavioral health department. -We continue to recruit for a full-time LCSW or LCPC, but have not been successful in that effort to date.2. Increasing access to healthcare services at CMMC:-Hired a financial navigator-Completed a comprehensive review of all charges to ensure pricing accuracy and consistency-Added option for online bill pay-Improved timeliness of patient statements and standardized the billing process-Added pediatric after hours hotline-Participated in community wide health fair-Upgraded phone system to allow community members more efficient access to services & added diabetes & stroke support group. 3. Improving the health and wellness of Central Montana:-We participated in the community wide health fair.-Started a diabetes support group & stroke group-Started fundraising for a comprehensive Cancer Care Center.-Got accredited by ADCES to provide Diabetes Self-management education and support-Purchased a new high tech MRI machine 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 202 4th Avenue South 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 Cancer Center town hall meetings, the local Youth Challenge, and the Central Montana Fair. CMMC also participated in a food drive. 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 13-14 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: On every patient statement it states that the Hospital financial assistance application is available upon request. Applications received prior to 120 days are reivewed and accounts are not referred to a collection agency. Any application received from day 120-240 will have the account immediately returned from any collection agency for the application to be processed. Applications are available upon request and on the website for clients to access. 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.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 22-23:*Concussion Testing: - 536 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: $5,690*Sports Physical Clinics:-Provided 251 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: $8,612*CPR / First Aid:-99 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: $2,710*Rural EMS volunteer services:-2 volunteer EMTs served.-Respirator fit testing, TB testing & immunization assessment completed-Estimated cost: $181*Volunteer Services: -110 volunteers served-Lab testing, COVID and flu vaccines, TB testing-4 staff and supplies used -Estimated cost: $2,108 (does not include staff time)*Student Services:-176 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: $2,802*Hospice Annual Volunteer Training: - 13 volunteers served-Educated on immunizations; appropriate PPE, and Covid precautions / symptoms for Covid-Estimated cost: $90 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. X 0 0 0 0 0 0 0 0 0 Dr Raymond Lee Radiologist 508634 0 0 0 0 0 17208 0 8537 0 534379 0 0 0 Dr Gardner Smith Surgeon 467702 0 0 0 0 0 9111 0 27089 0 503902 0 0 0 Dr Felipe Vile Martignoni Family Practice Doctor 402637 0 0 0 0 0 6833 0 23320 0 432790 0 0 0 Dr Amy A LePage ER Physician 353020 0 0 0 0 0 5489 0 23320 0 381829 0 0 0 Dr Augusto Amaral Neto Family Practice Doctor 346736 0 0 0 0 0 4100 0 23320 0 374156 0 0 0 Dr Michael Sura Physician/Member 308857 0 0 0 0 0 10250 0 23320 0 342427 0 0 0 Dr Tamara Welsh Physician/Member 293863 0 0 0 0 0 7455 0 1393 0 302711 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 1394453 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 74452 Employee compensation 0 Amy D'Autremont Wife of board member, Ryan D'Autremont 104942 Employee compensation 0 Amy Howell Wife of CFO, Perry Howell 21388 Employee compensation 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 as of August 31, 2020. Central Montana Medical Center became affiliated with Billings Clinic and Cody serves as the CEO. Billings Clinic was paid a total of $346,862 for Cody's services during calendar year 2022. Compensation: $286,510 Benefits: $60,352 The organization pays Billings Clinic a management fee of $32,023.81 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 83,384. Management and general expenses 0. Fundraising expenses 0. Total expenses 83,384. Service Contracts: Program service expenses 749,051. Management and general expenses 0. Fundraising expenses 0. Total expenses 749,051. Purchased Services: Program service expenses 5,821,170. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,821,170. Form 990, Part XI, line 9: Change in Interest in Central Montana Foundation -536,895.