2018-11-12T15:31:33-06:00 2017-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2017-01-01 810232406 Pondera Medical Center POND 4062713211 PO Box 668 Conrad MT 59425 Bill O'Leary CEO 4062713211 2018-11-02 1 Kim Hunwardsen CPA P00484560 6122536500 8.39.233.107 2018-11-02 12:33:40 CD P D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC EFC25E59FA7409AE560978A003AFB9E955B778C6 2017 2019-02-21 02:37:17Z Bill O'Leary PO Box 668 Conrad MT 59425 15851637 0 X www.ponderamedical.org X 1975 MT Exceed the healthcare expectations of those we serve through all of life's stages. 8 8 275 130 0 0 343048 796969 14052154 14918488 -7737 37313 0 0 14387465 15752770 0 0 0 0 8407174 8785907 0 0 0 5992628 6298457 14399802 15084364 -12337 668406 6841554 7346558 2270507 2097781 4571047 5248777 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. 1 0 10084931 10117691 Pondera Medical Center is a 25-bed critical access hospital. The Medical Center provided 128 inpatient days and 814 swing bed patient days along with a 24-hour emergency room that accounted for 1704 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 $38,240. Total direct and indirect costs related to these foregone charges were approximately $32,000 at December 31, 2017, 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. 1970688 3682220 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 20,324 total 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. 841629 1118577 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 and 1 physician assistant and provided 7,273 total clinic visits including 359 extended care visits and 142 swing bed visits. In addition, we also utilized locum physicians on an as needed basis that equated to an additional 1,106 visits. 12897248 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 0 0 0 0 0 0 0 0 0 1 23 0 1 275 1 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 Donovan 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 40.00 X 0 0 0 Brigid Burke CFO 1.00 X 0 0 0 Jay Taylor Physician Family Medicine 30.00 X 484263 0 32296 Norman Walker PA ER 60.00 X 211381 0 13727 David Arends PA 40.00 X 115339 0 21185 Scott Seager PA ER 36.00 X 115554 0 1911 Laura Erickson CNO 40.00 X 105127 0 14080 1031664 0 83199 5 0 1 0 Kalispell Regional Medical Center 310 Sunny View Lane Kalispell MT 59901 Professional Fees 806282 Evident 6600 Wall Street Mobile AL 36685 Professional Fees/Software Support 530620 Delta Flex Travelers PO Box 202940 Dallas TX 75320 Contract Staffing 183518 Comphealth Medical Staffing PO Box 972670 Dallas TX 753972670 Contract Staffing 168863 DIS Technologies PO Box 20457 Billings MT 591040457 VOIP Telephone System 138322 5 159758 637211 5800 796969 Patient Service Revenue 622110 9883327 9883327 Nursing Home 623000 3682220 3682220 Bed Tax Revenue 900099 777660 777660 Supporting Revenue 900099 575281 575281 14918488 41180 41180 95000 98867 -3867 -3867 -3867 15752770 14918488 0 37313 X 7174186 6470763 703423 115476 104154 11322 969999 874891 95108 526246 474648 51598 178047 4000 174047 31444 31444 43345 43345 2235832 1743427 492405 24091 2614 21477 851353 643246 208107 231583 38609 192974 859511 851877 7634 24745 24745 36504 33122 3382 22759 22759 510006 510006 145050 145050 Medical Supplies 427090 427090 Food 278994 278994 MT Bed Tax 205731 205731 Bad Debt Expense 184375 184375 7997 2197 5800 15084364 12897248 2187116 0 2217719 2152996 1329140 1724626 146179 157903 64299 69825 13837028 11368257 2270945 2468771 813272 772437 6841554 7346558 1361737 1632079 812942 465702 95828 0 2270507 2097781 X 2544290 2684723 2026757 2564054 4571047 5248777 6841554 7346558 X 668406 9324 X 0 1 X 1 1 1 X 1 5115 4014 2527 6602 0 27854 27854 5282021 4424998 857023 8268064 6766499 1501565 259089 176760 82329 2468771 Other Assets 86901 Workers Compensation Deposit 124578 Beneficial Interest in Perpetual Trust 452255 Estimated Third-Party Payor Settlements 108703 772437 X 15577719 -175051 -175051 15752770 0 15752770 14899989 0 14899989 184375 184375 15084364 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 Medical Center 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 Medical Center 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 -184,375. Change in Beneficial Interest of Perpetual Trust 9,324. Part XII, Line 4b - Other Adjustments: Bad debt expense reported in revenue on financial statements 184,375. 1 1 X 1 X 1 X 1 1 0 0 25000 25000 0.00170 3821790 3778095 43695 0.00290 3846790 3778095 68695 0.00460 11608 11608 0.00080 6400728 4248753 2151975 0.14440 6412336 4248753 2163583 0.14520 10259126 8026848 2232278 0.14980 1 184375 0 3065943 3084664 -18721 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 See 16a 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/community-health-needs-assessment Pondera Medical Center Part V, Section B, Line 11: PMC hired a full-time Marketing specialist that promoted services available at PMC via radio ads, social media and newspaper. Education on various health topics was promoted using all of those marketing venues. PMC continued to work with specialty providers such as Cardiology, Oncology and Pulmonary to provide services at our RHC to help meet the needs of the community.Wellness was a focus for 2017 with Biggest Loser competitions offered for the community. PMC purchased an Inbody machine for the Wellness center to help Wellness Center members track body fat/muscle. Education for Wellness Center members was provided by the Fitness Specialist and Registered Dietician. We also collaborated with Pondera Healthcare Foundation and provided a school health fair in September. PMC began an internal Wellness program to further support the health and wellness of its employees and to also support retention.PMC was able to recruit a FNP in April and a PA-C in September to join the RHC staff. However, the addition of staff was offset by a clinic mid-level transitioning to ER. One of our objectives was to increase Women Health Services at RHC which continues to be a goal with ongoing recruitment. We increased our recruitment efforts with the use of different media platforms and successfully hired Physical Therapists and Occupational Therapists.PMC had partnered on a regional grant for care transitions which ended in 2017 and a Clinical Navigator was hired to help patients with care transitions from PMC back home and the necessary follow up. A Community Resource directory was developed that assists patients and their families in knowing what community services are available to them. Mental Health became a focus in 2017 with plans for a Mental Health consortium and the opportunity to participate in a regional Mental Health grant to help bring those services to the community.We partnered with LEPC for a community wide disaster drill and we continue to provide education to community on First Aid/CPR. We worked with Pondera County and Pondera County Commissioners on implementation of EMD (Emergency Medical Dispatch) to further enhance the communication from dispatch for 911 calls. We were unable to implement a Paramedicine program due to EMS staff shortages. 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. Unreimbursed Medicaid was converted to cost using the cost-to-charge ratio derived from the relevant cost center on the Medicare Cost Report. 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 $1,346,021 from a rural health clinic. Part I, Ln 7 Col(f): Bad debt expense of $184,375 removed from the denominator calculation. 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, as well as 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. Part VI, Line 3: Patients are informed about their eligibility for financial assistance during conversations at registration and during follow-up on outstanding account balances. Financial assistance is offered if a 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 2017 was 6,626 and is considered rural. The median household income for 2012-2016 was $42,196 in which 18.4% of the population was below the poverty level. The racial makeup consists of 83% white, 14% American Indian or Alaska Native with the remainder being other races. The largest income producing segment of Pondera County is agriculture and while there are a couple large employers in the county including Pondera Medical Center, small business, and oil and natural gas producers make up the 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.We have partnered with MSU for both RN and LPN nursing students to do their practical's at PMC. 0 0 0 0 0 0 0 0 0 Jay Taylor Physician Family Medicine 484263 0 0 0 0 0 5400 0 26896 0 516559 0 0 0 Norman Walker PA ER 211381 0 0 0 0 0 4271 0 9457 0 225109 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 and CFO compensation. Form 990, Part III, line 2 MRI services offered beginning in April 2017. 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 $134,472 and $3,575 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 and CFO. 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 1,123,257. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,123,257. Recruitment: Program service expenses 68,894. Management and general expenses 2,869. Fundraising expenses 0. Total expenses 71,763. Repairs and maintenance: Program service expenses 175,602. Management and general expenses 0. Fundraising expenses 0. Total expenses 175,602. Purchased services: Program service expenses 368,596. Management and general expenses 489,536. Fundraising expenses 0. Total expenses 858,132. Collection expense: Program service expenses 7,078. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,078. Form 990, Part XI, line 9: Change in Beneficial Interest of Perpetual Trust 9,324.