2021-05-03T12:09:57-05:00 2020-06-30 BKD LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2019-07-01 810231784 BILLINGS CLINIC % PRISCILLA NEEDHAM BILL 4062382500 2800 TENTH AVENUE NORTH BILLINGS MT 59101 PRISCILLA NEEDHAM CFO 4062382500 2021-05-05 true Adam R Smith CPA P00958966 7194714290 2019 2022-09-23 18:48:47Z SCOTT ELLNER 2800 TENTH AVENUE NORTH BILLINGS MT 59101 2220892995 false X WWW.BILLINGSCLINIC.COM X 1917 MT BILLINGS CLINIC IS MONTANA'S LARGEST HEALTHCARE ORGANIZATION CONSISTING OF A 304 BED HOSPITAL, PRIMARY CARE AND OVER 50 MULTI SPECIALTY CLINICS. 11 7 5071 200 19568342 9630394 3823440 19789953 756822281 770932547 17946646 23568521 18733224 20883012 797325591 835174033 410918 282583 0 0 394056994 410159852 0 0 0 328929259 368442561 723397171 778884996 73928420 56289037 1051858268 1116696008 336321091 350999223 715537177 765696785 BILLINGS CLINIC MISSION IS HEALTH CARE, EDUCATION AND RESEARCH. BILLINGS CLINIC WILL PROVIDE BEST IN NATION CLINICAL QUALITY, PATIENT SAFETY, SERVICE AND VALUE. false false 266723690 121511 370592771 BILLINGS CLINIC IS A 304 BED HOSPITAL PROVIDING SURGICAL, LABOR AND DELIVERY, PSYCHIATRIC, CANCER CARE, NEONATAL SERVICES AND ACUTE CARE. BILLINGS CLINIC HAD OVER 13,700 ADMISSIONS IN FY20. 285332320 129988 285665261 BILLINGS CLINIC HAS OVER 450 PHYSICIANS AND ADVANCED PRACTITIONERS OFFERING MORE THAN 50 SPECIALTIES. PRIMARY CARE IS AVAILABLE AT MULTIPLE LOCATIONS INCLUDING BILLINGS CLINIC DOWNTOWN, HEIGHTS, WEST END, CODY WY, MILES CITY AND BOZEMAN. IN ADDITION, BILLINGS CLINIC CONDUCTS SPECIALTY CARE CLINICS FOR MORE THAN 20 REGIONAL LOCATIONS IN MONTANA, WYOMING AND NORTH DAKOTA. BILLINGS CLINIC HAD OVER 774,000 PATIENT VISITS IN FY20. 68231642 31084 115810241 BILLINGS CLINIC SPECIALTY PHARMACY FOCUSES ON THE PHARMACY CARE OF CHRONIC, RARE OR COMPLEX CONDITIONS THAT REQUIRE SPECIALTY MEDICATIONS. SPECIALTY MEDICATIONS TYPICALLY REQUIRE SPECIAL HANDLING, ADMINISTRATION OR MONITORING BEYOND THAT WHICH A TRADITIONAL RETAIL PHARMACY CAN PROVIDE. WE WORK TO ENSURE APPROPRIATE MEDICATION USE AND PROMOTE ADHERENCE. BILLINGS CLINIC SPECIALTY PHARMACY IS PART OF THE LARGEST HEALTH CARE SYSTEM IN THE REGION. OUR STAFF WORKS WITH YOU, YOUR PROVIDER AND YOUR INSURANCE COMPANY TO MAKE SURE YOUR NEEDS ARE MET. OUR GOAL IS TO MAKE BILLINGS CLINIC A ONE-STOP SOLUTION. 620287652 true true false true false false false false false true true false false true true false false true false false false false false false false false true true true true true true false false false false false false false true false true true false false false true true true true false true 201 0 5071 true true true false false false false false false false false false false false X 11 7 true false false false false false false true true false false true true true true true true true true true true CA X PRISCILLA NEEDHAM 4062382134 2800 TENTH AVENUE NORTH BILLINGS MT 59101 X Per Sommer MD Physician 60.0 0.0 X 1007583 0 50545 Michael A Morone MD Physician 60.0 0.0 X 1005196 0 50804 Marlin D Richardson MD Physician 60.0 0.0 X 987678 0 53524 Brian R Rah MD Physician 60.0 0.0 X 981195 0 49183 Zachary M Bland MD Physician 60.0 0.0 X 991533 0 33341 John Schallenkamp MD Interim CEO 60.0 0.0 X X 779709 0 60119 Connie F Prewitt Chief Financial Officer 60.0 0.0 X 674961 0 55595 Robert Pueringer MD Physician Board MEmber 60.0 0.0 X 400682 0 57551 Randall Gibb MD Former CEO 60.0 1.0 X X 408835 0 34133 David Brown Former Board Member 5.0 0.0 X 21730 0 4163 Joy Ott Board Chairperson 5.0 0.0 X X 0 0 14303 Penni Nance Board Vice Chair 5.0 0.0 X X 7500 0 6000 Lillian Anderson Board Secretary 5.0 0.0 X X 7500 0 6000 Keith Cook Board Member 5.0 1.0 X 7500 0 6000 Wayne Hirsch Board Member 5.0 0.0 X 6041 0 6041 Elizabeth Fulton Board Treasurer 5.0 0.0 X X 0 0 7487 Craig Bartholomew Board Member 5.0 0.0 X 0 0 6599 Chelsea Bodnar MD Board Member 5.0 0.0 X 0 0 3009 Scott Ellner CEO - Beginning January 2020 60.0 1.0 X 0 0 0 7287643 0 504397 580 true true false HAyes Locums 6700 N Andrews Ave STE 600 FORT LAUDERDALE FL 33309 Physicians Services 12128298 Medefis Consolidated PO Box 5068 NEW YORK NY 100875068 Contract Labor 10273576 Sodexo PO BOX 360170 PITTSBURG PA 15251 Food Service 4630455 Cushing Terrell 303 E 17th Ave 105 DENVER CO 80203 Construction Design 1773565 AE Architects 124 N 28th St STE 100 BILLINGS MT 59101 Const. Planning 1593998 56 4534037 15255745 171 71345 19789953 Patient Service Revenue 621110 690702151 690702151 RETAIL PHARMACY 621110 58443553 58443553 REFERENCE LAB 621500 9636904 9636904 Income on Equity Investees 900099 11737576 6837658 4899918 Clinical trial Revenue 541900 412363 412363 770932547 6634912 116362 6518550 0 0 264275 121584 142691 0 142691 142691 1402177513 16500 1385074834 185570 17102679 -169070 16933609 16933609 0 0 0 0 0 0 670466 336974 333492 312019 21473 Service to Other Hospitals 541519 2928925 2928925 IT CMC 541519 1207802 1207802 COSMETICS 446199 469876 469876 15800226 15360529 287082 152615 20406829 835174033 772068273 19568342 23747465 255303 255303 27280 27280 0 0 2466719 1850779 615940 4184 4184 337228831 273291997 63936834 14883902 12580204 2303698 34162620 20234204 13928416 21413596 16661919 4751677 0 2597076 8830 2588246 324100 324100 158719 158719 0 1467804 1467804 64572871 36509501 28063370 2485436 21872 2463564 6844129 3044953 3799176 22739516 17486688 5252828 0 7127212 6213503 913709 3687273 2636769 1050504 0 59145 59145 8848104 6638732 2209372 0 23566043 19656436 3909607 4787908 2057364 2730544 Medical Supplies 176921777 176567933 353844 Repairs and Maintenace 10619179 10619179 Bed Tax 10696587 8298412 2398175 Dues 3852220 1526250 2325970 17087462 4099544 12987918 778884996 620287652 158597344 0 31863933 46394067 91428424 105567623 0 0 93831239 97526684 0 0 0 0 38956 93263 10123424 10776951 8469833 8491795 593086429 346003301 232794523 247083128 452467617 467298945 0 0 27997283 30060299 0 0 102843036 103403253 1051858268 1116696008 69780360 76019615 0 0 274269 4794456 180322247 177650178 0 0 0 0 42210000 41160000 0 0 43734215 51374974 336321091 350999223 X 665970480 714828874 49566697 50867911 715537177 765696785 1051858268 1116696008 X 56289037 3581610 -9711039 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 158719 158719 778726277 778884996 1000000 250000 false 1000000 1000000 1000000 1000000 4000000 6000000 161509 161410 710510 158719 1192148 250000 250000 250000 250000 1000000 1500000 0 0 0 0 59225624 2802581 2753070 801626 63979649 54349816 1912723 3092661 129576 59225624 49884176 1721868 3130495 386723 54349816 46940725 1430705 1962519 449773 49884176 45241517 808522 1194556 303870 46940725 0.36825 0.51582 0.11593 false true true 9897742 24470095 34367837 204209044 99106248 105102796 1620848 886807 734041 315713169 234552213 81160956 37175531 11458033 25717498 247083128 Notes Receivable from new west 46131808 Due from related party 9923852 DUE FROM JV'S 851792 INTEREST IN FOUNDATION 91117391 INTEREST IN NEW WEST -45725570 INTEREST IN STILLWATER 5288009 INTEREST IN EXPRESSCARE -5199748 INTEREST IN BROADWATER 1015719 103403253 0 Due to MDOR 621770 Deposits 7890 Interest rate Swap Agreement 23839997 Estimated Claims Liability 11478106 Accrued Interest 1927621 Unearned Premiums 13499590 51374974 SCHEDULE D, PART V, LINE 4 THE ORGANIZATION'S ENDOWMENT CONSISTS OF APPROXIMATELY 82 INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE ENDOWMENT INCLUDES BOTH DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE GOVERNING BODY TO FUNCTION AS ENDOWMENTS. ENDOWMENT FUNDS ARE INVESTED AND HELD TO PROVIDE GROWTH OVER THE LONG-TERM. Schedule D, Part X, Line 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true X true X true X true true true false true true 18469457 18469457 0.02360 119780652 114326228 5454424 0.00700 138250109 114326228 23923881 0.03060 3595942 468206 3127736 0.00400 8036061 4985008 3051053 0.00390 34212290 22754966 11457324 0.01470 1257693 426664 831029 0.00110 2027866 1361563 666303 0.00090 49129852 29996407 19133445 0.02460 187379961 144322635 43057326 0.05520 false 12039339 237161452 302399829 -65238377 X true true 1 1 BILLINGS CLINIC 2800 TENTH AVENUE NORTH BILLINGS MT 59101 WWW.BILLINGSCLINIC.COM 13345 X X X X X 1 BILLINGS CLINIC false false true X X X X X X X X X 19 true true true true X SEE PART V, SECTION C FOR URL X WWW.HEALTHYBYDESIGNYELLOWSTONE.ORG X true 19 true SEE PART V, SECTION C FOR URL false true X 200. 400. X X X X X true true X X X X true X WWW.BILLINGSCLINIC.COM/FINASSIST X WWW.BILLINGSCLINIC.COM/FINASSIST X See Part V,Section C for URL X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 THE 2019-20 COMMUNITY HEALTH NEEDS ASSESSMENT FOR YELLOWSTONE COUNTY IS A SYSTEMATIC, DATA-DRIVEN APPROACH TO DETERMINING THE HEALTH STATUS, BEHAVIORS AND NEEDS OF OUR POPULATION. SUBSEQUENTLY, THIS INFORMATION MAY BE USED TO INFORM DECISIONS AND GUIDE EFFORTS TO IMPROVE COMMUNITY HEALTH AND WELLNESS. THERE ARE THREE COMPONENTS THAT ARE ESSENTIAL IN RENDERING A COMPLETE PICTURE OF THE HEALTH OF YELLOWSTONE COUNTY: (1) THE COMMUNITY HEALTH SURVEY [PRIMARY QUANTITATIVE DATA]; (2) EXISTING DATA [SECONDARY QUANTITATIVE DATA]; AND (3) ONLINE KEY INFORMANT DATA [PRIMARY QUALITATIVE DATA]. THE COMMUNITY HEALTH SURVEY DEVELOPED FOR THIS STUDY GIVES US A COMPLETE AND TIMELY VIEW OF THE HEALTH STATUS AND BEHAVIORS OF AREA RESIDENTS THROUGH A RANDOMIZED TELEPHONE SURVEY OF 400 YELLOWSTONE COUNTY ADULTS. ALL ADMINISTRATION OF THE SURVEYS, DATA COLLECTION AND DATA ANALYSIS WAS CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS, INC. (PRC). THE SAMPLE DRAWN FOR THIS SURVEY IS REPRESENTATIVE OF THE ADULT YELLOWSTONE COUNTY POPULATION IN TERMS OF DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS, AS WELL AS GEOGRAPHICAL LOCATION. THE MAXIMUM ERROR RATE ASSOCIATED WITH THE TOTAL SAMPLE OF 400 IS 4.9% AT THE 95 PERCENT LEVEL OF CONFIDENCE. EXISTING VITAL STATISTICS AND OTHER DATA ARE INCORPORATED INTO THIS ASSESSMENT FOR YELLOWSTONE COUNTY. COMPARISONS ARE ALSO MADE, WHERE AVAILABLE, TO STATE AND NATIONAL BENCHMARKS. FURTHERMORE, WHEREVER POSSIBLE, HEALTH PROMOTION GOALS OUTLINED IN HEALTHY PEOPLE 2020 ARE INCLUDED. TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS ALSO IMPLEMENTED AS PART OF THIS PROCESS. 154 PARTICIPANTS INCLUDED HEALTHCARE PROVIDERS, PUBLIC HEALTH REPRESENTATIVES, GOVERNMENT REPRESENTATIVES, EDUCATORS, BUSINESS LEADERS, AND A VARIETY OF OTHER COMMUNITY LEADERS AND COMMUNITY MEMBERS. INPUT FROM THE GENERAL PUBLIC WAS OBTAINED BY USING A WEB-BASED PLATFORM THAT WAS OPEN TO THE GENERAL PUBLIC. 120 USER ACCESSED THE PLATFORM SUBMITTING 428 COMMENTS. SCHEDULE H, PART V, SECTION B, LINE 6A & 6b BILLINGS CLINIC'S COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN A PRE-EXISTING COMMUNITY HEALTH PARTNERSHIP, THE ALLIANCE, WITH ST. VINCENT HEALTHCARE (HOSPITAL ORGANIZATION) AND RIVERSTONE HEALTH (PUBLIC HEALTH DEPARTMENT FOR CITY AND COUNTY). THE ALLIANCE ALSO CONDUCTED A CHNA IN 2006, 2011, 2014, 2017 AND 2020 SCHEDULE H, PART V, SECTION B, LINE 7A Direct URL for the CHNA: https://www.billingsclinic.com/app/files/public/befdd423-98fd-482e-a94b-54 c2f65e2c19/2019-2020-Community-Needs-Health-Assessment-Report.pdf SCHEDULE H, PART V, SECTION B, LINE 10a Direct URL for Implementation Strategy: https://www.billingsclinic.com/app/files/public/5d8a9fb2-7968-4e91-9405-d6 caa64f123c/CHIP-Community-Benefit-2020-2023.pdf SCHEDULE H, PART V, SECTION B, LINE 11 BILLINGS CLINIC HAS BEEN ADDRESSING THE NEEDS THAT WE HAVE THE RESOURCES TO ADDRESS, BASED ON STRATEGIES TO ALIGN, ENHANCE AND DEVELOP PROGRAMS BASED ON A SET OF CRITERIA ESTABLISHED BY OUR COMMUNITY HEALTH IMPROVEMENT TASK FORCE. WE ARE FOLLOWING OUR 2017-2020 COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). A NEW CHNA PROCESS BEGAN IN THE SPRING OF 2019 AND WILL BE COMPLETED AND RELEASED IN EARLY 2020. THE COUNTY-WIDE 2017 COMMUNITY HEALTH NEEDS ASSESSMENT THAT WE PARTICIPATED IN IDENTIFIED THE FOLLOWING COMMUNITY HEALTH AREAS OF OPPORTUNITY: - ACCESS TO HEALTH CARE SERVICES: COST OF PRESCRIPTIONS, APPOINTMENT AVAILABILITY, FIND A PHYSICIAN - CANCER: CANCER DEATHS (PROSTATE AND COLORECTAL); CANCER INCIDENCE; FEMALE BREAST CANCER SCREENING; CERVICAL CANCER SCREENING. - DEMENTIA, INCLUDING ALZHEIMER'S DISEASE: DEATHS - DIABETES: PREVALENCE OR BORDERLINE/PRE-DIABETES - HEART DISEASE AND STROKE: DEATHS AND PREVALENCE OF HIGH BLOOD PRESSURE - INFANT HEALTH AND FAMILY PLANNING: LOW-WEIGHT BIRTHS AND INFANT MORTALITY - INJURY AND VIOLENCE: MOTOR VEHICLE CRASH DEATHS, SEATBELT USAGE, FIREARM-RELATED DEATHS, FIREARM STORAGE AND SAFETY - MENTAL HEALTH: FAIR/POOR MENTAL HEALTH, DIAGNOSED DEPRESSION, SUICIDE DEATHS, SUICIDE IDEATION - NUTRITION, PHYSICAL ACTIVITY AND WEIGHT: ADULT OBESITY - POTENTIALLY-DISABLING CONDITIONS: ACTIVITY LIMITATIONS; BACK PAIN PREVALENCE; BLINDNESS/VISION - RESPIRATORY DISEASES: CHRONIC LOWER RESPIRATORY DISEASE; PNEUMONIA/INFLUENZA DEATHS - SUBSTANCE ABUSE: CIRRHOSIS/LIVER DISEASE DEATHS; DRUG-INDUCED DEATHS; PERSONAL IMPACT OF SUBSTANCE ABUSE - TOBACCO USE: CIGARETTE SMOKING PREVALENCE BILLINGS CLINIC ADDRESSES THESE NEEDS AT THE ORGANIZATIONAL LEVEL WITH EFFORTS TO IMPROVE AWARENESS AND EDUCATION, AS WELL AS TO REMOVE BARRIERS TO CARE. WORK IS DONE WITH CLINICAL DEPARTMENTS, SERVICE LINES, NURSING AND MEDICAL EDUCATION, COMMUNITY RELATIONS, POPULATION HEALTH, CARE MANAGEMENT, CITY/COUNTY HEALTH DEPARTMENT, AND THE STATE AND FEDERAL GOVERNMENT. AT THIS TIME, BILLINGS CLINIC DOES NOT HAVE THE RESOURCES NECESSARY TO ADDRESS ALL NEEDS, ALTHOUGH WE ARE PART OF SEVERAL COMMUNITY-WIDE COALITION TO ADDRESS THESE IN A COLLABORATIVE WAY. THE NEEDS WE ARE UNABLE TO DIRECTLY ADDRESS INCLUDE LACK OF TRANSPORTATION AS A BARRIER TO ACCESS (MEMBER OF BILLINGS TRANSPORTATION COALITION) AND ACCESS TO DENTAL CARE (WE DO NOT OFFER DENTAL SERVICES). IN SOME AREAS WE DON'T OFFER ANY SERVICES, BUT WE DO ADVOCATE ON POLICY SUCH AS SEAT BELT USAGE, FIREARM SAFETY, AND EXPANDING HEALTH INSURANCE COVERAGE. OUR CHNA WAS FOCUSED ON THE YELLOWSTONE COUNTY, OUR PRIMARY SERVICE AREA WHERE THE MAJORITY OF OUR PATIENTS COME FROM. CHNA PRIORITIZATION MEETINGS, WITH MORE THAN 100 COMMUNITY MEMBERS ATTENDING, RESULTED IN A PRIORITY OF HEALTHY WEIGHT BASED ON 1. THE SCOPE AND SEVERITY AND 2. THE ABILITY TO IMPACT. HEALTHY WEIGHT INCLUDES THE COMPONENTS OF PHYSICAL ACTIVITY, NUTRITION AND SOCIAL CONNECTION. THESE THREE TOPICS CAN BENEFIT MANY OF THE COMMUNITY HEALTH OPPORTUNITIES, INCLUDING CHRONIC DISEASES SUCH AS DIABETES AND HEART DISEASE, MENTAL HEALTH, AND ADULT OBESITY, AS WELL AS PRIMARY PREVENTION EFFORTS TARGETED AT KIDS AND TEENS. THE YELLOWSTONE COUNTY CHNA PROCESS INCLUDED PRIORITIZING HEALTHY WEIGHT AT THE COUNTY LEVEL FOR WORK BASED ON THE MODEL OF COLLECTIVE IMPACT, WORKING TOGETHER TOWARDS A COMMON GOAL WITH SHARED RESOURCES. WE BASED OUR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) ON THAT PRIORITY, WITH THREE STRATEGIES THAT BILLINGS CLINIC SUPPORTS WITHIN OUR ORGANIZATION AND ACROSS ALL OF YELLOWSTONE COUNTY. OVERVIEW: STRATEGY 1 - HEALTHY FOOD RETAIL AND HEALTHY FOOD PROCUREMENT CURRENT SITUATION: WHILE AN INDIVIDUAL CAN AVOID PHYSICAL ACTIVITY BY SIMPLY NOT DOING IT, DAILY CONSUMPTION OF FOOD IS A NECESSARY PART OF SURVIVAL. HOWEVER, YELLOWSTONE COUNTY RESIDENTS EXPERIENCE SEVERAL BARRIERS TO CONSUMING HEALTHY FOODS, INCLUDING AFFORDABILITY AND AVAILABILITY. WHAT IF YOUR MORNING LATTE CAME WITH A SIDE OF FRESH FRUIT OR A SIMPLE SALAD? ONE KEY STRATEGY FOR INCREASING ACCESS TO HEALTHY FOODS, SUCH AS FRUITS AND VEGETABLES, IS TO ENCOURAGE OUR LOCAL FOOD RETAILERS AND INSTITUTIONS TO STOCK AND PROMOTE THESE ITEMS. ACTIVITIES SELECTED BELOW AIM TO INCREASE THE PREVALENCE OF HEALTHY FOODS THROUGHOUT OUR DAILY LIVES, SO THAT THE HEALTHY CHOICE IS THE EASY CHOICE. STRATEGY DESCRIPTION: THERE IS STRONG EVIDENCE THAT A STRATEGY FOCUSED ON HEALTHY FOOD RETAIL AND HEALTHY FOOD PROCUREMENT METHODS IS AN EFFECTIVE APPROACH TO IMPROVE HEALTHY WEIGHT AND INCREASED CONSUMPTION OF NUTRITIONAL FOODS. RETAIL ENVIRONMENTS AND INSTITUTIONAL MEAL OFFERINGS, INCLUDING SCHOOLS, WORKPLACES, NEIGHBORHOOD CONVENIENCE STORES, AND COFFEE SHOPS, CAN EACH PLAY A SIGNIFICANT ROLE IN CONSUMER FOOD CHOICES, FOR BETTER OR WORSE. THIS IS ESPECIALLY TRUE FOR RESIDENTS OF NEIGHBORHOODS THAT LACK ACCESS TO FULL-SERVICE GROCERY STORES, WHO OTHERWISE MAY FIND IT EASIER TO FIND JUNK FOOD THAN FRUITS AND VEGETABLES. EXAMPLES OF PROVEN ACTIVITIES RELATED TO THIS STRATEGY INCLUDE INCREASING RETAIL OFFERINGS TO INCLUDE NUTRITIOUS OPTIONS, INTENTIONAL PRODUCT PLACEMENT AND MARKETING OF THESE FOODS, WHILE DE-EMPHASIZING UNHEALTHY PRODUCTS SUCH AS TOBACCO, ALCOHOL, SUGARY DRINKS AND OTHER JUNK FOODS. SOURCES: CHANGELAB SOLUTIONS, US SURGEON GENERAL, CDC WINNABLE BATTLES, PROCUREMENT - CITY HEALTH OVERVIEW: STRATEGY 2 - CREATING AND IMPROVING ACCESS TO PLACES, PARKS, AND PLAYGROUNDS FOR PHYSICAL ACTIVITY AND CREATING AND MAINTAINING SAFE NEIGHBORHOODS CURRENT SITUATION: YELLOWSTONE COUNTY AND BILLINGS HAVE SEVERAL BEAUTIFUL PARKS AND PLACES FOR RECREATION. HOWEVER, THE ABILITY TO ACCESS THESE DESTINATIONS WITHOUT A CAR, AND SAFETY CONCERNS RELATED TO SOME OF THESE DESTINATIONS ARE BARRIERS TO THEIR ENJOYMENT. ONE KEY STRATEGY FOR PROMOTING USE OF EXISTING FACILITIES, INCLUDING PARKS AND BIKEWAYS, IS TO NORMALIZE THEIR USE. ACTIVITIES SELECTED BELOW PROMOTE THE NORMALIZATION OF ACTIVE TRANSPORTATION AND PARKS TO INCREASE PHYSICAL ACTIVITY. THE MORE THIS INFRASTRUCTURE IS UTILIZED, THE SAFER AND POPULAR IT BECOMES. STRATEGY DESCRIPTION: THERE IS STRONG EVIDENCE THAT A STRATEGY FOCUSED ON CREATING AND IMPROVING ACCESS TO PLACES FOR PHYSICAL ACTIVITY, MAINTAINING SAFE NEIGHBORHOODS, AND IMPROVING ACCESS TO PARKS AND PLAYGROUNDS IS AN EFFECTIVE APPROACH TO IMPROVE HEALTHY WEIGHT AND PHYSICAL ACTIVITY. EXAMPLES OF PROVEN ACTIVITIES RELATED TO THIS STRATEGY INCLUDE INCREASED ACCESS TO FACILITIES SUCH AS WALKING TRAILS AND EXERCISE SPACES, JOINT AND SHARED USE AGREEMENTS, COMPLETE STREETS POLICIES, COMPLETE PARKS, SAFE ROUTES TO SCHOOL AND PARKS, AND ZONING THAT PROMOTES ACCESSIBILITY AND ACTIVITY. OVERVIEW: STRATEGY 3 - PROVIDE SPACE FOR ORGANIZED ACTIVITIES THAT Encourage Social Participation and Inclusion Current Situation: Overweight and obese adults are more likely to report a number of adverse health conditions, including fair/poor overall health and fair/poor mental health. Yellowstone County residents are increasingly active; however, disparities persist among lower-income residents and seniors. Key informants noted a lack of supportive built environment that does not always support healthy living as a significant concern. Local senior service and mental health representatives believe identification and development of community gathering places would be beneficial to their respective clients as social isolation and inactivity are often interwoven. A key strategy to promote activity and social engagement is to enhance or create spaces that are welcoming and accessible to all, with organized activities and opportunities for social engagement. Strategy Description: The evidence states this is an effective strategy for improved weight and increased physical activity by creating safe, attractive opportunities for all residents to be active and engaged. Research shows that perceptions of poor safety, unwelcoming spaces, and inaccessibility are all barriers to activity and that social engagement is associated with better health outcomes. Schedule H, Part V, Section B, Line 16c DIRECT URL FOR PLAIN LANGUAGE SUMMARY: https://www.billingsclinic.com/app/files/public/61391694-7adb-4551-9b3c-39 cf4c9c9150/Financial-Assistance-Policy-Summary.pdf SUMMARY.PDF Schedule H, Part V, Section B, Line 16i TRANSLATION OF FAP FOR LEP POPULATIONS: BILLINGS CLINIC HAS CONSIDERED THE NEED FOR A PLAIN LANGUAGE SUMMARY FOR THOSE WITH LIMITED ENGLISH PROFICIENCY. WE HAVE TRANSLATION OF MOST LANGUAGES AVAILABLE TO PATIENTS THROUGH OUR MARTTI TRANSLATION SERVICES, ONLINE OR BY PHONE TRANSLATION FOR DISCUSSING AND TRANSLATING FINANCIAL ASSISTANCE MATERIALS. 13 BILLINGS CLINIC 1045 N 30TH STREET BILLINGS MT 59101 OUTPATIENT CLINIC BILLINGS CLINIC MILES CITY 620 SOUTH HAYNES AVENUE MILES CITY MT 59301 OUTPATIENT CLINIC BILLINGS CLINIC HEIGHTS 760 WICKS LANE BILLINGS MT 59105 OUTPATIENT CLINIC BOZEMAN OBGYN 925 HIGHLAND BLVD BOZEMAN MT 59715 OBSTETRICS AND GYNECOLOGY CLIN BILLINGS CLINIC SURGERY CENTER 2929 TENTH AVENUE NORTH BILLINGS MT 59101 OUTPATIENT SURGERY CENTER BILLINGS CLINIC WEST 2675 CENTRAL AVENUE BILLINGS MT 59102 OUTPATIENT CLINIC BEHAVIORAL HEALTH CENTER 1020 NORTH 27TH STREET 4TH FL BILLINGS MT 59101 OUTPATIENT MENTAL HEALTH Center BILLINGS CLINIC CODY 201 YELLOWSTONE AVENUE CODY WY 92414 OUTPATIENT CLINIC BILLINGS CLINIC CANCER CENTER 801 NORTH 29TH STREET BILLINGS MT 59101 CANCER CARE, INFUSION, PSYCHIATRIC CENTER 1020 NORTH 27TH STREET BILLINGS MT 59101 INPATIENT PSYCHIATRIC CENTER HOME OXYGEN 801 N 27TH STREET BILLINGS MT 59101 DURABLE MEDICAL EQUIPMENT BOZEMAN PEDIATRICS 1819 S 22ND STREET BOZEMAN MT 59715 PEDIATRIC OUTPATIENT CENTER Medicine BILLINGS CLINIC ORTHOPEDICS 2702 8TH AVENUE NORTH BILLINGS MT 59101 ORTHOPEDICS AND SPORTS SCHEDULE H, PART I, LINE 3C DESCRIPTION OF ADDITIONAL CRITERIA TO DETERMINE FINANCIAL ASSISTANCE: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES BILLINGS CLINIC ALSO USES ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART I, LINE 6A RELATED ORGANIZATION ANNUAL COMMUNITY BENEFIT REPORT: STILLWATER COMMUNITY HOSPITAL, A RELATED CRITICAL ACCESS HOSPITAL, PREPARES THEIR OWN INDEPENDENT COMMUNITY BENEFIT REPORT. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A AND 7B. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. BILLINGS CLINIC USED THE SAME COST-TO-CHARGE RATIO THROUGHOUT THE ENTIRE SCHEDULE TO DETERMINE THE COST OF THOSE ACTIVITIES. SCHEDULE H, PART I, LINE 7G SUBSIDIZED HEALTH SERVICE COSTS: SUBSIDIZED HEALTH SERVICES INCLUDES VARIOUS PHYSICIAN CLINICS IN ORDER TO BETTER SERVE THE MONTANA AREAS. MANY CRITICAL SERVICES WERE NOT FULLY REIMBURSED SUCH AS BEHAVIORAL HEALTH, PEDIATRIC SPECIALTIES, SEXUAL ASSAULT NURSE EXAMINATION AND RURAL OUTREACH CLINICS. PRIMARY CARE CLINICS WERE ONLY INCLUDED IF THEY WERE IN RURAL, UNDERSERVED AREAS OUTSIDE OUR PRIMARY SERVICE AREA. TOTAL COSTS FOR THE SUBSIDIZED SERVICES WERE $34,212,290 AND NET COMMUNITY BENEFIT OF THOSE SERVICES WAS DETERMINED TO BE $11,457,324. SCHEDULE H, PART III, SECTION A, LINE 2 THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT AS COMMUNITY BENEFIT: THE ORGANIZATION DOES NOT CONSIDER ANY OF ITS BAD DEBT EXPENSE TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART III, SECTION B, LINE 8 ALLOWABLE MEDICARE COSTING METHODOLOGY: BILLINGS CLINIC ESTIMATES THAT 45 PERCENT OF BILLINGS CLINIC'S MEDICARE SHORTFALLS SHOULD BE COUNTED AS COMMUNITY BENEFIT. OUR RATIONALE IS THAT 45 PERCENT IS THE BEST ESTIMATE OF THE PERCENTAGE OF MONTANA'S MEDICARE POPULATION (65 AND OLDER) WHO ARE AT OR BELOW 200% OF FEDERAL POVERTY LEVEL, BASED ON MEDICARE AND U.S. CENSUS DATA, AND THOSE PATIENTS WOULD QUALIFY FOR FULL FINANCIAL ASSISTANCE. A HIGHER PERCENTAGE WOULD QUALIFY FOR PARTIAL FINANCIAL ASSISTANCE WITH INCOMES FROM 200- 400 PERCENT OF FEDERAL POVERTY LEVEL. FOR THE CALCULATION OF THE UNREIMBURSED COST OF MEDICARE A RATIO OF PATIENT COST-TO CHARGES USING WORKSHEET 2 WAS UTILIZED AND APPLIED TO GROSS MEDICARE CHARGES. WE DO NOT USE THE MEDICARE COST REPORT FOR THIS NUMBER. THE COST REPORT ONLY CAPTURES REVENUE RELATED TO THE FACILITY AND DOES NOT CAPTURE REVENUE/LOSSES RELATED TO CLINICAL PROFESSIONAL SERVICES, WHICH ARE A SUBSTANTIAL PORTION OF MEDICARE SHORTFALLS. SCHEDULE H, PART III, SECTION C, LINE 9B Collection Practices: ACCOUNTS ARE BILLED WITH INSURANCE INFORMATION SUPPLIED BY THE PATIENT AND WHEN AVAILABLE, VERIFIED BY BILLINGS CLINIC. BILLINGS CLINIC SENDS PATIENT BILLING STATEMENTS THAT INCLUDE THE SUMMARY OF SERVICES PROVIDED, AMOUNTS PENDING INSURANCE AND AMOUNTS OWED BY THE PATIENT. FINANCIAL ASSISTANCE IS OFFERED TO PATIENTS WHO ARE UNINSURED OR UNDERINSURED. BILLINGS CLINIC ASSISTS PATIENTS APPLYING FOR FINANCIAL ASSISTANCE, AND PUBLIC PROGRAMS SUCH AS MEDICAID. BILLINGS CLINIC ALSO ASSISTS PATIENTS WITH PAYMENT PLANS INTEREST FREE FOR 12 MONTHS OR THROUGH AN EXTENDED LOAN OPTION UP TO 60 MONTHS. BILLINGS CLINIC WILL NOT REFER A PATIENT TO COLLECTIONS UNTIL AFTER 120 DAYS OF THE INDIVIDUAL BEING AWARE OF THEIR OPTIONS. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: SINCE 1994, BILLINGS CLINIC, RIVERSTONE HEALTH AND ST. VINCENT HEALTHCARE HAVE BEEN WORKING TOGETHER AS THE ALLIANCE, CREATING AND SUSTAINING INNOVATIVE PROGRAMS THAT ADDRESS COMPLEX COMMUNITY-WIDE HEALTH ISSUES. RIVERSTONE HEALTH IS THE PUBLIC HEALTH DEPARTMENT FOR THE YELLOWSTONE COUNTY AND ST. VINCENT HEALTHCARE IS A 501(C)(3) HEALTHCARE ENTITY ALSO SERVING THE BILLINGS AREA. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY ASSISTANCE: ALL PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE. INFORMATIONAL BROCHURES WITH ONE-PAGE PLAIN LANGUAGE SUMMARY AND APPLICATION FORMS ARE AVAILABLE AT REGISTRATION DESKS IN THE CLINIC AND THE HOSPITAL, THE EMERGENCY DEPARTMENT DISCHARGE DESK, AND ON OUR WEBSITE AT WWW.BILLINGSCLINIC.COM/FINASSIST. OUR WEBPAGE INCLUDES THE FULL FINANCIAL ASSISTANCE POLICY. PATIENTS CAN ALSO CALL A DIRECT LINE TO TALK TO A PATIENT FINANCIAL REPRESENTATIVE. INFORMATION ABOUT FINANCIAL ASSISTANCE IS PRINTED ON THE BACK OF PATIENT BILLS. PATIENTS HOSPITALIZED WITHOUT IDENTIFIYING A THIRD PARTY PAYER SOURCE ARE SCREENED FOR COVERAGE/ASSISTANCE (DISABILITY, MEDICAID, VETERANS ADMINSTRATION, INDIAN HEALTH SERVICES AND WORKERS COMPENSATIONS). APPLICATIONS ARE MAILED TO PATIENTS WHOSE PAYMENT PATTERN INDICATES THAT THEY MAY NEED ASSISTANCE. PATIENT FINANCIAL SERVICES STAFF IS AVAILABLE TO HELP ANY PATIENT NEEDING ASSISTANCE COMPLETING AN APPLICATION. LANGUAGE TRANSLATION SERVICES ARE ALSO AVAILABLE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: BILLINGS CLINIC IS BASED IN BILLINGS, MONTANA AND IS MONTANA'S LARGEST HEALTH CARE ORGANIZATION SERVING A VAST REGION COVERING MUCH OF MONTANA, WYOMING AND NORTH DAKOTA. BILLINGS CLINIC IS ONE OF MONTANA'S LARGEST EMPLOYERS WITH APPROXIATELY 4,300 EMPLOYEES INCLUDING MORE THAN 450 PHYSICIANS AND ADVANCED PRACTITIONERS OFFERING MORE THAN 50 SPECIALTIES. COMMUNITY BENEFIT INCLUDES HEALTH CARE SERVICES PROVIDED AT BILLINGS CLINIC LOCATIONS, INCLUDING THE HOSPITAL, MAIN CLINIC, BRANCH CLINICS AND OUTREACH CLINICS. BILLINGS CLINIC SPECIALISTS PROVIDE 122 OUTREACH CLINICS PER MONTH AT 20 DIFFERENT REGIONAL LOCATIONS FOR THE RESIDENTS OF MONTANA, WYOMING AND NORTH DAKOTA. Schedule H, Part Vi, Line 5 PROMOTION OF COMMUNITY HEALTH: AS A NOT-FOR PROFIT COMMUNITY-GOVERNED ORGANIZATION, WORKING WITH OTHER ORGANIZATIONS IN THE COMMUNITY TO ADDRESS THE HEALTH CARE NEEDS IS AN IMPORTANT PART OF OUR MISSION. BILLINGS CLINIC HAS BEEN INVOLVED IN MEETING THE NEEDS OF INDIVIDUALS AND COMMUNITIES THROUGH COOPERATIVE EFFORTS WITH OTHER ORGANIZATIONS IN YELLOWSTONE COUNTY AND IN OUR REGION. COMMUNITY HEALTH COLLABORATION SINCE 1994, BILLINGS CLINIC, RIVERSTONE HEALTH AND ST. VINCENT HEALTHCARE HAVE BEEN WORKING TOGETHER, CREATING AND SUSTAINING INNOVATIVE PROGRAMS THAT ADDRESS COMPLEX COMMUNITY-WIDE HEALTH ISSUES. THEIR PURPOSE IS TO CREATE SUSTAINED CHANGE IN HOW OUR COMMUNITY RESPONDS TO THE CHALLENGE OF THE HIGH COST OF PRESCRIPTION DRUGS FOR THE UNINSURED AND THE POPULATION LIFESTYLE ISSUES OF OBESITY, POOR NUTRITION AND PHYSICAL ACTIVITY HABITS. THESE ARE EXAMPLES OF THE PAST AND FUTURE SUCCESSES OF THE ALLIANCE'S EFFORTS. COMMUNITY CRISIS CENTER - THE COMMUNITY CRISIS CENTER (CCC), ENHANCES\ACCESS TO BEHAVIORAL HEALTH CARE IN BILLINGS. THE CCC HAS SUCCESSFULLY REDUCED INAPPROPRIATE UTILIZATION OF LOCAL EMERGENCY DEPARTMENTS, DECREASED THE NUMBER OF SHORT-TERM INPATIENT HOSPITAL ADMISSIONS, AND HAS BEEN A DRIVING FORCE IN REDUCING THE INMATE POPULATION AT THE YELLOWSTONE COUNTY DETENTION FACILITY. MEDICATION ASSISTANCE PROGRAM (MAP) - MAP HELPS PATIENTS AFFORD THE PRESCRIPTION DRUGS THEY NEED BY CONNECTING INDIVIDUALS WITH AVAILABLE PATIENT ASSISTANCE PROGRAMS OFFERING DISCOUNTED OR FREE PRESCRIPTION MEDICATION. MAP ASSISTS LOW INCOME, UNINSURED OR UNDER INSURED PEOPLE IN GETTING THE MEDICATIONS THEY NEED, BUT CAN'T AFFORD. HEALTHY BY DESIGN - TO HELP RECOGNIZE ORGANIZATIONS IN YELLOWSTONE COUNTY COMMITTED TO IMPROVING OUR COMMUNITY'S HEALTH, BILLINGS CLINIC, RIVERSTONE HEALTH, AND ST. VINCENT HEALTHCARE LAUNCHED A COMMUNITY HEALTH COALITION CALLED HEALTHY BY DESIGN. HEALTHY BY DESIGN ENCOURAGES, RECOGNIZES, EDUCATES AND CREATES A STANDARD OF EXCELLENCE FOR PROMOTING HEALTHY LIFESTYLES BY ENCOURAGING ACTIVE LIVING AND HEALTHY CHOICES THAT SHAPE THE FUTURE OF THE COMMUNITY. Schedule H, Part VI, Line 6 AFFILIATED HEALTH CARE SYSTEM: BILLINGS CLINIC HAS AN AFFILIATED RELATIONSHIP WITH BEARTOOTH BILLINGS CLINIC, STILLWATER HOSPITAL ASSOCIATION and Broadwater Healthcare. EACH HOSPITAL IS A MONTANA NON-PROFIT CORPORATION. BEARTOOTH AND STILLWATER HAVE BEEN AFFILIATES OF BILLINGS CLINIC SINCE 2002 WITH A SHARED MANAGEMENT AGREEMENT. Broadwater Healthcare began their affiliation in 2019. WITHIN THE AGREEMENT BILLINGS CLINIC PROVIDES MANAGEMENT, DIGITAL INFORMATION SYSTEMS, AND ANCILLARY SUPPORT SERVICES TO AREA HOSPITALS AND CLINICS. THE AFFILIATION BRINGS A STRONGER ALIGNMENT WITHIN THE GROUP DUE TO A DESIRE TO STABILIZE AND ENHANCE THE LEVEL AND SCOPE OF HEALTH CARE SERVICES AVAILABLE IN EACH COMMUNITY. THE AFFILIATION ALLOWED THEM TO STRENGTHEN THEIR COMMITMENT TO QUALITY, PATIENT SAFETY AND SERVICE VALUES. true COMMUNITY CRISIS CENTER 704 NORTH 30TH STREET BILLINGS MT 59101 203231164 501(C)(3) 81191 SUPPORT OPERATIONS TUMBLEWEED 505 N 24TH STREET BILLINGS MT 59101 363343886 501(C)(3) 50000 CNA Nursing Program ST JOHNS UNITED 2429 MISSION WAY BILLINGS MT 59102 810485182 501(C)(3) 25000 Support Nursing Program ALBERTA BAIR THEATRE 2801 3RD AVENUE NORTH BILLINGS MT 59101 810406157 501(C)(3) 8500 Handicap Accessibility BIG HORN HOSPITAL 17 N MILES AVENUE HARDIN MT 59034 810384618 501(C)(3) 7500 Hospital Expansion Billings Clinic Foundation 2917 Tenth Avenue North Billings MT 59101 810407289 501(c)(3) 21100 Support PRogram 6 Scholarships 76 27280 SCHEDULE I, PART I, LINE 2 DESCRIPTION OF MONITORING PROCESS FOR SCHOLARSHIPS AND GRANTS: BILLINGS CLINIC AWARDS SCHOLARSHIPS TO INDIVIDUALS WHO EXHIBIT A STRONG DESIRE AND POTENTIAL TO EXCEL IN THE HEALTHCARE FIELD. BILLINGS CLINIC ALSO PROVIDES GRANTS TO OTHER HEALTH RELATED ORGANIZATIONS. MONTHLY FINANCIAL REPORTS ARE REVIEWED AND SIGNED BY THE GRANT MANAGER, AND THEN SUBMITTED FOR APPROVAL OF THE DRAWING OF FUNDS FOR GRANTS. X X X X X X false true false false false false false true false Connie F Prewitt Chief Financial Officer 551580 0 110212 0 13169 0 24400 0 31195 0 730556 0 40589 Randall Gibb MD Former CEO 403825 0 0 0 5010 0 24400 0 9733 0 442968 0 Robert Pueringer MD Physician Board MEmber 396233 0 275 0 4174 0 30999 0 26552 0 458233 0 John Schallenkamp MD Interim CEO 647951 0 128567 0 3191 0 30527 0 29592 0 839828 0 Per Sommer MD Physician 1004787 0 0 0 2796 0 24400 0 26145 0 1058128 0 Michael A Morone MD Physician 1002874 0 0 0 2322 0 24400 0 26404 0 1056000 0 Marlin D Richardson MD Physician 984864 0 0 0 2814 0 24400 0 29124 0 1041202 0 Zachary M Bland MD Physician 983564 0 5125 0 2844 0 22703 0 10638 0 1024874 0 Brian R Rah MD Physician 977933 0 100 0 3162 0 24400 0 24783 0 1030378 0 David Brown Former Board Member 0 0 0 0 21730 0 4163 0 0 0 25893 0 SCHEDULE J, PART I, LINE 4b DESCRIPTION OF NON-QUALIFIED RETIREMENT PLAN: THE BILLINGS CLINIC SUPPLEMENTAL RETIREMENT AGREEMENT FOR SENIOR EXECUTIVES (SERP) IS A NON-ELECTIVE 457(F) AGREEMENT AND PROVIDES FOR ANNUAL DEFERRALS, WHICH BECOME VESTED AND PAYABLE AFTER 4 YEARS. THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT DURING THE 2019 CALENDAR YEAR WHICH IS INCLUDED IN OTHER REPORTABLE COMPENSATION ON SCHEDULE J, PART II, COLUMN B: CONNIE PREWITT - 40,589 Schedule J, Part I, Line 7 DESCRIPTION OF NON-FIXED PAYMENTS: THE BOARD OF DIRECTORS ANNUALLY DETERMINES THE INCENTIVE PLAN AMOUNT FOR THE CEO AND THE SENIOR EXECUTIVE TEAM BASED ON AN EXTERNAL COMPENSATION STUDY. THE AVAILABILITY OF THE INCENTIVE IS AWARDED BASED ON FINANCIAL PERFORMANCE AS WELL AS ORGANIZATIONAL PERFORMANCE MEASUREMENTS IN QUALITY, PATIENT SATISFACTION, EMPLOYEE SATISFACTION AND THE INDIVIDUAL GOALS SET EACH YEAR IF THE TARGET IS TRIGGERED. THE INCENTIVE IS PAID ONLY IF TRIGGERED FOLLOWING THE FINANCIAL AUDIT PRESENTATION. A MONTANA FACILITY FINANCE AUTHORITY 364615155 2018-10-01 56580000 Refund 2011 Bonds false false false B Montana Facility Finance Authority 364615155 61204KLQ2 2018-10-01 125786085 REFUND 2008/2011 Issue false false false A 0 0 56580000 0 0 0 0 0 0 0 56580000 0 2019 true false false true B 2931022 0 125786085 33707574 0 0 0 0 0 0 8769336 83309175 true false false true A false false false false 0 false false false true B false false false false 0 false false false true A false true false false true false 0 false 0 true B false true false false true false 0 true Beyerische Landesban 2.875 true false true A true B true CRAIG BARTHOLOMEW SEE PART V 1629650 PURCHASE OF OFFICE SUPPLIES false Schedule L, Part IV Relationship Between Interested Person & the Organization: Line 1, Column B - Craig Bartholomew, is a board member of Billings Clinic and owns an office supply company. Billings clinic purchased office supplies from the company. Transactions were conducted at arm's length for fair value with the knowledge and approval of the board. X 2 7600 FMV X 475 FMV X 10000 FMV X 33 15513 FMV X Gift Cards 10 7444 FMV X Furniture 3 3250 FMV X Daycare Supplies 8 1749 FMV X Masks 19 25314 FMV 0 false true false Schedule M, PArt I, Column (B) EXPLANATION FOR NUMBER OF CONTRIBUTIONS REPORTED: THE NUMBER OF CONTRIBUTIONS REPORTED IS THE NUMBER OF CONTRIBUTIONS RECEIVED, NOT THE NUMBER OF INDIVIDUAL ITEMS DONATED. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS OR FAMILY TRANSACTION: CONNIE PREWITT, JOY OTT, AND SCOTT ELLNER HAVE A BUSINESS RELATIONSHIP BECAUSE THEY ARE DIRECTORS OR OFFICERS OF THE SUBSIDIARY NEW WEST DISCLOSED ON SCHEDULE R, PART IV. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW 990: THE 990 REVIEW IS COMPLETED BEFORE THE RETURN IS FILED. IT IS REVIEWED BY THE CFO AND THEN THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR CONFLICT OF INTEREST POLICY: THE COMPLIANCE OFFICER ALONG WITH THE GOVERNANCE AND NOMINATING COMMITTEE OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR MONITORING THE EFFECTIVENESS OF THE CONFLICT OF INTEREST REPORTING AND MANAGEMENT FOR BILLINGS CLINIC. IN ADDITION, BILLINGS CLINIC VICE PRESIDENTS ARE RESPONSIBLE FOR ENSURING THAT THEIR DIRECT REPORTS ARE COMPLYING WITH THIS POLICY. FORM 990, PART VI, SECTION B, LINE 15A & 15b PROCESS TO DETERMINE CEO COMPENSATION: BILLINGS CLINIC HAS AN EXECUTIVE COMPENSATION PROGRAM ADMINISTERED ANNUALY BY INDEPENDENT TRUSTEES FOLLOWING BEST PRACTICES AND THE HIGHEST REGULATORY STANDARDS EXPECTED OF A NOT-FOR PROFIT ORGANIZATION. THEY FOLLOW BOARD APPROVED CHARTER AND OVERALL EXECUTIVE COMPENSATION PHILOSOPHY WHICH DEFINES THE MARKET AS A COMPARABLE SET OF NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. THEY LOOK AT RELEVANT MARKET DATA OF SIMILAR ROLES IN SIMILAR ORGANIZATIONS. ANNUAL DISCLOSURE OF THE COMMITTEE'S ACTIONS AND DECISIONS TO THE FULL BOARD IS REQUIRED. BILLINGS CLINIC ENGAGES SULLIVAN COTTER TO PERFORM REGULAR COMPENSATION REVIEWS FOR EXECUTIVES, MANAGER AND DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 BILLINGS CLINIC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ON AN AS NEEDED BASIS. Form 990, Part XI, Line 9 Other Changes in Net Assets: (5,556,500) - Change in Fair Value of Interest Rate Swap 2,642,857 - Change in Interest of Foundation (6,797,396) - Change in Interest of Affiliates (9,711,039) - Total MONTANA HEALTHCARE INDEMNITY LLC 2800 TENTH AVENUE NORTH BILLINGS MT 59101 INSUR CAPTIVE MT 6148022 18620464 BILLINGS CLI SPECIALTY SUPPLIES AND SERVICES LLC 2800 TENTH AVENUE NORTH BILLINGS MT 59101 364871868 SPEC. SUPPLY MT 51394030 8448989 BILLINGS CLI BILLINGS CLINIC FOUNDATION 2917 TENTH AVENUE NORTH BILLINGS MT 59101 810407289 FUNDRAISING MT 501(C)(3) 7 BILLINGS CLI true STILLWATER HOSPITAL ASSOCIATION 710 N 11TH STREET COLUMBUS MT 59019 810286525 HOSPITAL MT 501(C)(3) 3 BILLINGS CLI true Townsend Health Systems Inc 110 NORTH OAK STREET TOWNSEND MT 59644 810398400 HEALTHCARE MT 501(C)(3) 3 BILLINGS CLI true NEW WEST HEALTH SERVICES 130 NEILL AVENUE HELENA MT 59601 841418136 INSURANCE SAL MT BILLINGS CLINIC C CORP 3613330 0.65000 true BILLINGS CLINIC EXPRESS CARE 2800 TENTH AVENUE NORTH BILLINGS MT 59101 463355499 OUTPATIENT CL MT BILLINGS CLINIC C CORP 902458 366260 1.00000 true true true true true false false false false false false false true true true true true true false false Billings Clinic Express Care A 116362 InterCo Amount Billings Clinic Foundation C 4534037 INTERCO AMOUNT New West Health Services D 46131808 Interco Amount Billings Clinic FOundation D 258834 InterCo Amount Stillwater Hospital Association D 1737759 Interco Amount Billings Clinic Express Care D 5558933 Interco Amount Townsend Health Systems Inc D 2508670 Interco Amount Stillwater Hospital Association L 1928252 InterCo Amount Stillwater Hospital Association Q 6817882 INterCo Amount Townsend Health Systems Inc Q 397847 Interco Amount Billings Clinic Express Care R 250000 INterco Amount Townsend Health Systems INc R 559193 Interco Amount