2019-11-12T14:54:55-06:00 2018-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2018-01-01 810232406 Pondera Medical Center POND 4062713211 PO Box 668 Conrad MT 59425 Bill O'Leary CEO 4062713211 2019-11-12 1 Kim Hunwardsen CPA P00484560 6122536500 216.147.181.49 2019-11-12 13:01:40 CS P D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC F9BEE9501A3B4F00F190E63700B8BF2BC70C7B96 2018 2020-04-17 16:48:07Z Bill O'Leary PO Box 668 Conrad MT 59425 15870009 0 X www.ponderamedical.org X 1975 MT Exceed the healthcare expectations of those we serve through all of life's stages. 8 8 257 130 0 0 796969 383621 14918488 15449667 37313 36721 0 0 15752770 15870009 0 0 0 0 8785907 8731036 0 0 0 6298457 6690769 15084364 15421805 668406 448204 7346558 7545092 2097781 1879916 5248777 5665176 X As an essential member of our regional community, PMC strives to be a progressive healthcare business devoted to providing access to quality healthcare and exceeding the expectations of those we serve through all life's stages. 0 0 10407754 0 10691175 Pondera Medical Center is a 25-bed critical access hospital. The Medical Center provided 167 inpatient days and 834 swing bed patient days along with a 24-hour emergency room that accounted for 1651 visits for the year. Outpatient services such as lab, x-ray, physical and occupational therapy, wellness center, surgery, ambulance, cardiac rehab, DME, home health, speech therapy, sleep lab and respiratory therapy were provided to members of our rural community so they could receive the services they needed close to home. The services are essential for the survival of our community.The Medical Center maintains 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 and equivalent service statistics. The amounts of charges foregone for services provided under the Medical Center's charity care policy was $9,730. Total direct and indirect costs related to these foregone charges were approximately $8,000 at December 31, 2018, based on average ratios of cost to gross charges.The Medical Center provides care to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Medical Center does not pursue collection of amounts determined to qualify as charity care, they are not reported as patient and resident service revenue. 2071644 0 3545309 Pondera Medical Center's Extended Care Facility is a 59-bed nursing home offering 24-hour care and nursing services provided by licensed, certified and compassionate staff members. The facility had 18,356total patient days. Specialized services are also available including those offered by a physical therapist, occupational therapist, speech therapist, and medical social worker. We have a remarkable life enrichment program that offers activities 7 days a week to include exercise, socials, games, theme parties, pets, gardening, cooking, live music, crafts and outings.We have a 14-bed Special Care Unit designated for residents with pervasive memory loss and confusion, providing an extra touch of attention and supervision. 709379 0 1213183 Pondera Medical Center Clinic is a Family Practice Rural Health Clinic dedicated to providing and coordinating comprehensive services to the entire family. Our physicians are Board Certified Family Practitioners. Boarded Family Practice Physicians must complete an additional three years of specialized training above and beyond that of medical school. Family Practitioners are trained in all avenues of medicine, so they can provide a full range of care. PMCC Physician Assistants are licensed by the State of Montana and specialize in Family Medicine and Urgent Care. Our Providers promote healthy lifestyles and continually strengthen the relationship between the clinic and community, with excellent, timely, and compassionate patient care. The Clinic has 2 physicians, 2 physician assistant, and 1 nurse practitioner who provided 6,980 total clinic visits including 345 extended care visits and 152 swing bed visits. 13188777 1 1 0 0 0 0 0 0 1 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 21 0 1 257 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X Brenda Ries 4062713211 805 Sunset Blvd Conrad MT 59425 X Bernard Ries Chair 1.00 X X 0 0 0 Darby Donoven Vice Chair 1.00 X X 0 0 0 Janice Hoppoes Treasurer 1.00 X X 0 0 0 Gena Morris-Ries Secretary 1.00 X X 0 0 0 Brent Gaylord Trustee 1.00 X 0 0 0 Gene Hauer Trustee 1.00 X 0 0 0 Debbie Sturm Trustee 1.00 X 0 0 0 Craig Ostman Trustee 1.00 X 0 0 0 Bill O'Leary CEO 32.00 X 0 0 0 Brigid Burke CFO (until Jan 2018) 1.00 X 0 0 0 Jay Taylor Physician Family Medicine 25.00 X 519786 0 37296 Norman Walker PA ER 72.00 X 216284 0 14854 Scott Seager PA ER 36.00 X 117829 0 2825 Laura Erickson CNO 40.00 X 108432 0 16033 962331 0 71008 4 0 1 0 Kalispell Regional Medical Center 310 Sunny View Lane Kalispell MT 59901 Professional Services 698480 Evident 6600 Wall Street Mobile AL 36685 Professional Services/Software Support 588408 Prairie Travelers Inc 130 3rd St S Glasgow MT 59230 Staffing 158720 Comphealth Medical Staffing PO Box 972670 Dallas TX 75397 Staffing 133978 Priority Inc PO Box 1051 Spearfish SD 57783 Staffing 120575 6 50074 333547 181910 383621 Patient Service Revenue 622110 10452757 10452757 Nursing Home 623000 3545309 3545309 Bed Tax Revenue 900099 826399 826399 Supporting Revenue 900099 625202 625202 15449667 34686 34686 2035 0 2035 2035 2035 15870009 15449667 0 36721 X 7158078 6324523 833555 119163 105287 13876 939811 830370 109441 513984 454131 59853 150000 4000 146000 947 947 45100 45100 2488167 1961053 527114 18910 2535 16375 819680 664229 155451 189461 39501 149960 904822 904822 37779 37779 76882 44242 32640 19493 19493 490378 490378 142716 142716 Medical supplies 523089 523089 Bad Debt Expense 279529 279529 MT Bed Tax 253145 253145 Food 250671 250671 15421805 13188777 2233028 0 2152996 2302774 1724626 1976791 157903 152591 69825 70461 13988025 11706725 2468771 2281300 772437 761175 7346558 7545092 1632079 1575932 465702 303984 2097781 1879916 X 2684723 5108130 2564054 557046 5248777 5665176 7346558 7545092 X 448204 -31805 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 6602 10088 14252 2438 0 27854 27854 5293466 4517306 776160 8421781 7004466 1417315 244924 184953 59971 2281300 Other Assets 101108 Workers compensation Deposit 124577 Beneficial Interest in Perpetual Trust 420450 Estimated Third-Party Payor Settlements 115040 761175 X 15558675 -311334 -311334 15870009 0 15870009 15142276 0 15142276 279529 279529 15421805 Part IV, Line 1b: The funds are the personal funds of the nursing home residents and are to be used only for specific personal expenditures as requested by the residents. Part X, Line 2: The Hospital is organized as a Montana nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Medical Center is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. The Hospital 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 Medical Center 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 2d - Other Adjustments: Bad debt expense reported in expenses on 990 -279,529. Change in Beneficial Interest of Perpetual Trust -31,805. Part XII, Line 4b - Other Adjustments: Bad debt expense reported in revenue on financial statements 279,529. 1 1 X 1 X 1 X 1 1 0 0 8219 8219 0.00050 8219 8219 0.00050 8307 8307 0.00050 6540626 3926077 2614549 0.17270 6548933 3926077 2622856 0.17320 6557152 3926077 2631075 0.17370 1 279529 0 3220643 3239374 -18731 X 1 1 1 1 Pondera Medical Center 805 Sunset Blvd Conrad MT 59425 www.ponderamedical.com 13510 X X X X Provider Based Rural Health Clinic Pondera Medical Center 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X See line 7d Narrative X X 1 16 1 See Line 7d Narrative 0 1 X 100.000000000000 250.000000000000 1 1 X X X 1 X www.ponderamedical.org/billing-and-payments X See 16a X n/a X X X X X X 1 X 0 X X X X 1 X 0 1 Pondera Medical Center Part V, Section B, Line 5: Pondera Medical Center set up a community steering committee to help gather information and prioritize specific healthcare needs for our Needs Assessment survey. During the data collection period, we also set up focus groups with various individuals and groups throughout the community, to assist in gathering additional healthcare interests and needs information. These groups also had opportunity to see and understand our data results.PMC also worked in collaboration with the Pondera County Health departmenton their community health needs assessment and participated in the PonderaHealthcare foundation stakeholder meeting to discuss community needs forhealth and wellness.PMC continues to collaborate with community partners on the implementation of the CHNA. PMC works closely with Pondera Healthcare Foundation and Pondera County Health department. Staff from PMC also serve on DUI Taskforce, Mental Health Advisory Board and Pondera County Health board which further integrates PMC with the community and helps with understanding the needs of the community. Pondera Medical Center Part V, Section B, Line 7d: The CHNA report and Implementation strategy are available at https://www.ponderamedical.org/chna Pondera Medical Center Part V, Section B, Line 11: PMC has continued to work with our community partners in an active role for Community Wellness. We continue to host the quarterly Mental Health Consortium and have been active in Community Health Fair, Public School events, Stop The Bleed training, National Night Out, Pondera Health Care Foundation and DUI Taskforce. Due to financial restraints we have been unable to expand worksite wellness to local businesses but we have maintained an active role in Chamber of Commerce and have increased our social media presence with wellness topics. PMC has been unable to expand women health services in 2018 but anticipate in 2019 adding an FNP to the RHC. The Paramedecine program for the state of Montana is under review and PMC is not fully staffed to implement a program at this time. Pondera Medical Center Part V, Section B, Line 16j: Patients are informed about their eligibility for financial assistance during conversations at registration and during follow-up on outstanding account balances. Information regarding financial assistance and applications are available in the Patient Financial Services department. The financial assistance application is also available on our website. We also have partnered with the Medical Advocacy Services for Healthcare, Inc. (MASH) program. They contact our private pay patients to see if they might qualify for state funded programs and help them complete FAP if they don't qualify for state programs. Pondera Medical Center Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. 3 1 - Pondera Med Ctr Extended Care Facility 805 Sunset Blvd Conrad MT 59425 Long Term Care 2 - Pondera Med Ctr Durable Medical Equip 809 Sunset Blvd Conrad MT 59425 Durable Medical Equipment 3 - Pondera Medical Center Home Health 809 Sunset Blvd Conrad MT 59425 Home Health Care Part I, Line 7: Charity care expense was converted to cost based on an overall cost-to-charge ratio addressing all patient segments. The cost for subsidized health services was determined using the Medicare Cost Report. The community health improvement was determined based on actual general ledger expenses. Part I, Line 7g: Line 7g subsidized health services includes costs of $1,327,133 from a rural health clinic. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 279,529. Part III, Line 2: Bad debt expense is reported at charges net of discounts and contractual allowances. We are using the bad debt expense as reported on the financial statements. Payments on accounts previously written off to bad debt expense reduce bad debt expense in the current year. Part III, Line 4: The footnote to the organization's financial statements can be found on page nine of the attached audited financial statements. Part III, Line 8: Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services.The Medicare shortfall represents a cost absorbed by the hospital as a result of providing care to Medicare patients. The cost of providing this benefit to the community should be reported as such. Part III, Line 9b: Patients must complete a financial assistance application to be considered for charity care. Those patients known to qualify for financial assistance or that have contacted the business office and are in the process of completing an application or setting up a payment schedule will not receive additional collection notices. Patient accounts are not sent to collections until 120 days from the date of the first invoice for the service. If a patient applies for financial assistance within the next 120 days all collection actions will cease. Part VI, Line 2: We conduct a Health Fair each fall for the community and schools that is focused on Health and Wellness, annual Lab work, and Flu Shots. Several health related vendors also attend this Fair. We are also a sponsor at sporting events, help with National Night Out and the Harvest Festival. Radio and newspaper articles are also used to help inform the community of special health related events and projects. We also continue to use the survey process to gather updated health data from patients and families about the care we deliver in our facility. PMC has staff that are members on the Pondera County Health Board, DUI Taskforce and Pondera Health Department Coalition. Part VI, Line 3: Information about financial assistance is available in admission areas, patients are informed of financial assistance as part of the intake process, financial assistance contact information is printed on patient bills, and patients are informed of financial assistance as part of the follow-up process if patient is unable to make a payment. Part VI, Line 4: Pondera Medical Center serves the population of Pondera County, Montana. The population of Pondera County in 2018 was 5,972 and is considered rural. The median household income for 2013-2017 was $44,597 in which 19.0% of the population was below the poverty level. The racial makeup consists of 84% white, 15% American Indian or Alaska Native with the remainder being other races. The largest income producing segment of Pondera County is agriculture. Healthcare, including Pondera Medical Center, is the major employer in the county, with small business wholesale & retail trade, construction and accommodation/food services being the other majority of employers. The nearest hospital is Marias Medical Center, a 20-bed acute care hospital located in Shelby, MT. Marias Medical Center is located approximately 27 miles north of Conrad, MT. Part VI, Line 5: The Board of Directors is comprised of community members throughout Pondera County and all board meetings are open to the public. Surpluses of cash, when available, are invested back into the Hospital for equipment purchases and wage considerations. Pondera Medical Center extends medical staff privileges to all qualified physicians in the community. Pondera Medical Center operates an emergency room available to all regardless of ability to pay, 20 acute care beds for hospital stays, surgery center, 59 bed extended care center, special care unit, rural health clinic, wellness center, cardiac rehab, home health agency, physical therapy, occupation therapy, speech therapy, cardio pulmonary rehab, and DME and numerous other services to meet the communities daily and long-term health care needs. Pondera Medical Center seeks and encourages community members to become involved and volunteer in our Extended Care facility. PMC continues to partner with MSU for Senior nursing students to complete their leadership training at PMC. PMC provided classes regionally on Stop the Bleed free of charge to participants and has continued to provide Basic Life Support training to community members including the School District, Law Enforcement and Daycare providers. 0 0 0 0 0 0 0 0 0 Jay Taylor Physician Family Medicine 519786 0 0 0 0 0 5400 0 31896 0 557082 0 0 0 Norman Walker PA ER 216284 0 0 0 0 0 4389 0 10466 0 231139 0 0 0 Schedule J, Part I, Line 3: The CEO and CFO compensation is set by Kalispell Regional Medical Center, an unrelated management company. The board reviews and signs the contract, as well as reviews and approves the monthly management statement billing associated with the CEO compensation. X Ambulance 1 181910 FMV 0 0 0 0 Part I, Column (b): The number in Part I column b represents the number of items contributed. Form 990, Part VI, Section A, line 3 Pondera Medical Center contracts with Kalispell Regional Healthcare System for Chief Executive Officer and Chief Financial Officer services. Compensation of $110,000 and $0 was paid to Kalispell Regional Healthcare System for the Chief Executive Officer and Chief Financial Officer, respectively. Form 990, Part VI, Section A, line 8b The organization does not have committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the CEO. After their review a draft copy of the 990 is provided by e-mail to the board members for review. The final copy of the Form 990 is e-mailed to the board prior to filing. Form 990, Part VI, Section B, line 12c Officers and Trustees annually disclose potential conflicts, which are discussed at a Board of Trustees meeting. Segregation of duties is strictly enforced for any potential family or business conflicts of interest. If there is a potential conflict at a board meeting, the board member is not allowed to vote on the conflicting issue. Form 990, Part VI, Section B, line 15 The CEO and CFO compensation is set by Kalispell Regional Medical Center, an unrelated management company. The board reviews and signs the contract, as well as reviews and approves the monthly management statement billing associated with the CEO and CFO compensation. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part IX, line 11g Professional Fees : Program service expenses 1,218,568. Management and general expenses 71,984. Fundraising expenses 0. Total expenses 1,290,552. Recruitment : Program service expenses 11,099. Management and general expenses 4,170. Fundraising expenses 0. Total expenses 15,269. Repairs and maintenance : Program service expenses 168,464. Management and general expenses 0. Fundraising expenses 0. Total expenses 168,464. Purchased services : Program service expenses 558,738. Management and general expenses 450,960. Fundraising expenses 0. Total expenses 1,009,698. Collection Expense : Program service expenses 4,184. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,184. Form 990, Part XI, line 9: Change in Beneficial Interest of Perpetual Trust -31,805.