2018-05-08T16:09:44-05:00 2017-06-30 BKD LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2016-07-01 810286525 Stillwater Hospital Association % KELLEY HARMON STIL 4063225316 710 N 11th St Columbus MT 59019 MIKE FOLLETT Interim CEO 4063225316 2018-05-15 true Adam R Smith CPA P00958966 7194714290 2016 2022-09-23 18:48:47Z Mike Follett 710 N 11th St Columbus MT 59019 11266852 false X www.stillwaterbillingsclinic.com X 1914 MT Stillwater Hospital Association is a rural integrated health care organization bringing together a physician clinic & hospital svcs to deliver quality coordinated care. 9 5 79 5 0 138527 487491 9777223 10189255 31744 55968 -2223 2902 9945271 10735616 4929 6088 0 0 3257627 4892661 0 0 0 6299721 5829754 9562277 10728503 382994 7113 17610146 17273240 14072199 13710728 3537947 3562512 STILLWATER HOSPITAL ASSOCIATION IS A RURAL INTEGRATED HEALTH CARE ORGANIZATION BRINGING TOGETHER A PHYSICIAN CLINIC & HOSPITAL SERVICES TO DELIVER QUALITY COORDINATED CARE. false false 7985459 6088 10183041 ACUTE CARE HOSPITAL AND RURAL HEALTH CLINIC 7985459 true true false false false false false false false true true false false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false true 4 0 79 true false false false false false false false false false false X 9 5 false false false false true true true true true false false true true true true true true false false false X KELLEY HARMON 9706574612 2800 TENTH AVENUE N Billings MT 59107 X Michael Matovich President 3.0 0.0 X X 0 0 0 Luke Kobold Vice President 3.0 40.0 X X 0 151316 33794 Ron Martinez Secretary/Treasurer 3.0 0.0 X X 0 0 0 Dr Camilla Reese Director 3.0 40.0 X 0 305748 29781 Dr Richard Klee Director/physician 40.0 1.0 X 0 311123 34411 Mike Follett Interim CEO 40.0 3.0 X X 0 184960 19381 Bharat Acharya Director 3.0 0.0 X 0 0 0 Dr Dan Vesbach Director 3.0 0.0 X 0 0 0 Tom Chamberlain Director 3.0 0.0 X 0 0 0 Dr Deborah Agnew CEO 14.0 12.0 X 90864 77884 26329 Kelley Evans CAO 20.0 0.0 X 75208 0 19468 Dr David Kane Physician 40.0 0.0 X 0 281430 43748 Susan Ivankovich Physician Assistant 40.0 0.0 X 0 145330 32495 Quinten Lundby Laboratory Supervisor 40.0 0.0 X 114745 0 20703 280817 1457791 260110 1 false true false BILLINGS CLINIC 2800 Tenth Avenue North BILLINGS MT 59101 mgmt/staff services 2733225 WILDERNESS MEDICAL STAFFING PO BOX 616 HOMER AK 99603 MEDICAL STAFFING 133336 2 487491 487491 PATIENT SERVICE REVENUE 621300 10173157 10173157 MEALS 900099 9116 9116 MEANINGFUL USE REVENUE 621110 6982 6982 10189255 7645 7645 0 0 0 0 0 579559 531236 48323 48323 48323 0 0 0 0 0 0 0 0 0 MISCELLANEOUS INCOME 900099 2902 2902 2902 10735616 10183041 65084 6088 6088 0 0 0 357943 306114 51829 0 3774464 2737757 1036707 114640 86618 28022 363792 242332 121460 281822 195357 86465 1184969 983896 201073 755 755 7540 7540 0 0 0 859808 591269 268539 40332 18348 21984 311930 94481 217449 12749 11739 1010 0 202475 159955 42520 81415 50777 30638 0 0 780894 616906 163988 0 959620 692107 267513 160772 20585 140187 PROVISION FOR BAD DEBT 613933 613933 MEDICAL SUPPLIES 540554 514442 26112 DIETARY 33254 31824 1430 REPAIRS & MAINTENANCE 26129 6778 19351 12625 4153 8472 10728503 7985459 2743044 0 2444965 2365749 1048700 1501606 0 0 1256484 1668242 0 0 0 0 0 0 184089 218038 176688 182046 16412797 5127247 12007904 11285550 458976 0 0 0 0 0 0 0 32340 52009 17610146 17273240 507320 467802 0 0 0 0 0 0 0 0 0 0 13301067 12961992 0 0 263812 280934 14072199 13710728 X 3406178 3521112 111769 21400 20000 20000 3537947 3562512 17610146 17273240 7113 17452 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 29176 50 9226 20000 29088 88 29176 29001 87 29088 28914 87 29001 28813 101 28914 1.00000 false false 558194 558194 12088220 2663638 9424582 2853649 2024288 829361 912734 439321 473413 11285550 0 DUE TO RELATED ORGANIZATION 280934 280934 10145409 17452 6274 23726 10121683 613933 613933 10735616 10134239 19669 19669 10114570 613933 613933 10728503 Schedule D, Part V, line 4 DESCRIBE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS: The endowment includes donor-restricted endowment funds. As required by accounting principles generally accepted in the United States of America GAAP), net assets associated with endowment funds are classified and reported based on the existence or absence of donor-imposed restrictions. 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. SCHEDULE D, PART XI, LINE 2D REVENUE ON BOOKS, NOT ON RETURN: ACTIVITY OF STILLWATER FOUNDATION CONSOLIDATED IN FINANCIALS, EXCLUDED FOR TAX RETURN 6,274 SCHEDULE D, PART XI, LINE 4B REVENUE ON RETURN, NOT ON BOOKS: BAD DEBT NET WITH REVENUE ON FINANCIALS, TREATED AS EXPENSE ON TAX RETURN 613,933 SCHEDULE D, PART XII, LINE 2D EXPENSE ON BOOKS, NOT ON RETURN: ACTIVITY OF STILLWATER FOUNDATION CONSOLIDATED IN FINANCIALS, EXCLUDED FOR TAX RETURN 19,669 SCHEDULE D, PART XII, LINE 4B EXPENSE ON RETURN, NOT ON BOOKS: BAD DEBT NET WITH REVENUE ON FINANCIALS, TREATED AS EXPENSE ON TAX RETURN 613,933 true true X true X true X true true false true true 29496 29496 0.00290 790356 795845 819852 795845 29496 0.00290 6750 6750 0.00070 226023 147722 78301 0.00770 6088 6088 0.00060 238861 147722 91139 0.00900 1058713 943567 120635 0.01190 true 613933 2281494 2752298 -470804 X true true 1 1 Stillwater Hospital Association 710 N 11th St Columbus MT 59019 stillwaterbillingsclinic.com 13418 X X X X X PHYSICIAN CLINIC 1 Stillwater Hospital Association false false true X X X X X X X X X 17 true false false true X See part V, Section C for URL true 17 true See part V, Section C for URL true true 50000 true X 100 300. X X X X true true X X X true X See PArt V Section C for URL X see part v section c for URL X See part V Section C for URL X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Describe how the Hospital took into account persons who represent the community: A STEERING COMMITTEE WAS FORMED WHICH INCLUDED A DIVERSE GROUP OF COMMUNITY MEMBERS (public health, elderly, uninsured, business owners and hospital staff) INCLUDING: 1. STILLWATER COUNTY PUBLIC HEALTH NURSE 2. STILLWATER BILLINGS CLINIC DIRECTOR OF QUALITY 3. STILLWATER COUNTY BUSINESS OWNER 4. STILLWATER COUNTY ECONOMIC DEVELOPMENT 5. PARAMEDIC STILLWATER EMS 6. RETIRED CITIZEN COLUMBUS 7. COUNTY CITIZEN 8. REED POINT COUNTY CITIZEN 9. STILLWATER COUNTY SHERIFFS OFFICE 10. ABSAROKEE ST. VINCENTS CLINIC 11. STILLWATER BILLINGS CLINIC CEO The Steering Committee determined the most important health needs to be addressed by reviewing the Community Health Needs Assessment (CHNA), secondary data, community demographics, and input from representatives representing the broad interest of the community, including those with public health expertise. The Steering Committee met twice between March 2017 and November 2017 during the Community Health Services Development (CHSD) process, first to discuss health concerns in the community and again to review the results of the survey and focus groups and to assist in the prioritization of health needs to address. Schedule H, part V, Section B, Line 7a Direct URL where CHNA report is made widely available on the Organization's website: HTTP://STILLWATERBILLINGSCLINIC.COM/WP-CONTENT/UPLOADS/COMMUNITY-HEALTH-NE EDS_2017.PDF Schedule H, part V, section B, Line 10a Direct URL where implementation plan is made widely available: The implemenation plan is included with the 2017 CHNA the URL is HTTP://STILLWATERBILLINGSCLINIC.COM/WP-CONTENT/UPLOADS/COMMUNITY-HEALTH-NE EDS_2017.PDF Schedule H, Part V, Section B, Line 11 STILLWATER COMMUNITY HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA BY IDENTIFYING THE TOP 5 GOALS ALONG WITH CORRESPONDING STRATEGIES AND ACTIVITIES, PERSONS RESPONSIBLE AND TIMELINE FOR ADAPTATION. The top five goals and corresponding strategies are as follows: 1)Goal - Improve awareness of services through enhanced community outreach and education Strategies - Explore opportunities to enhance SBC community engagement and partnership in community events by partnering with the local athletic department to co-sponsor events, developing community outreach materials to market services, sponsor community dinners before football games, booster club participation, and patient experience stories in newspaper and on social media; Enhance website features and develop social media marketing presence by developing a social media campaign, designating staff to be responsible for marketing and outreach, determining feasibility of adding online clinic scheduling to website, and adding current events scrolling banner to website; and Improve community knowledge of available health services in Stillwater County by researching community events, programs and resources, developing list of community resources and marketing campaign, meet and partner with schools to develop health and wellness resource page, and hosting an open house. 2)Goal - Improve communitys access to transportation in and around Stillwater County Strategy Collaborate with community partners on transportation needs in Stillwater County by determining a community stakeholder group, identifying transportation needs and opportunities, researching community models and best practices, exploring grant opportunities and developing patient transportation protocol for staff if/when assisting patients. 3)Goal Enhance health and wellness opportunities in Stillwater County Strategy Explore creating a Stillwater County Recreation Coalition by determining a community stakeholder group to discuss resources and needs for potential projects, explore developing a walking trail around hospital campus and engage with MT BACI program to explore feasibility of BACI program in Stillwater County. 4)Goal Improve access to mental health services in Stillwater County Strategy Improve access and education of mental health resources for community and SBC staff by exploring available training and education for mental health and substance abuse, determining staff responsible to deliver mental health education for staff and community, developing suicide risk assessment protocol for all staff at Stillwater Billings Clinic, adopting and modifying education for community members as appropriate and meeting with local schools to develop mental health, suicide risk, and substance abuse resource page for teachers and counselors. 5)Goal Improve access to specialty services at Stillwater Billings Clinic Strategy - Explore opportunities to expand specialty services at SBC by exploring feasibility of offering dermatology and optometry visiting specialists and expanding telemedicine at SBC (i.e. tele-phsychiatry) and create marketing campaign for new services and providers. Stillwater Billings Clinic will determine which needs or opportunities could be addressed considering SBCs parameters of resources and limitations. The committee will prioritize the needs/opportunities using the additional parameters of the organizational vision, mission, and/or values, as well as existing and potential community partners. The participants will create goals to achieve through strategies and activities, as well as the general approach to meeting the stated goal (i.e. staff member responsibilities, timeline, potential community partners, anticipated impact(s), and performance/evaluation measures). This plan will be documented and posted along with the CHSD assessment report. THERE WERE THREE NEEDS THAT HAVE BEEN IDENTIFIED AS UNABLE TO ADDRESS: 1) One need Identified during the process was for more physicians MORE PRIMARY PROVIDERS-A PA-C AND A PHYSICIAN WERE added while the survey was still being performed the survey indicates that this is still a need but was meet during the process; 2) DESIRE FOR SPECIALISTS INCLUDING CARDIOLOGIST, OB/GYN AND SLEEP STUDIES - FINANCIALLY UNMANAGEABLE AND LACKS PATIENT VOLUME NEEDED TO SUPPORT THESE SERVICES; 3) ADDITIONAL SENIOR SERVICES-MANY SERVICES ALREADY EXIST IN THE COMMUNITY AND OTHER SERVICES ARE BEYOND THE SCOPE OF WHAT THE HOSPITAL CAN PROVIDE (I.E. SWIMMING POOL). SCHEDULE H, PART V, SECTION B, LINE 16a Direct URL for Financial assistance policy: In 2017 Stillwaters Hospital Association who is related to Billings Clinic adopted Billings Clinic Financial policies. There is a link on Stillwaters hospital website that is a direct link to billings Clinic Financial policy. TO Navigate there start at Stillwaters website: http://stillwaterbillingsclinic.com/ Click on Patient Info, then Financial Assistance. The direct link is: https://www.billingsclinic.com/app/files/public/2227/Financial-Assistance- Policy.pdf SCHEDULE H, PART V, SECTION B, LINE 16b Direct URl for Financial assistance policy: In 2017 Stillwaters Hospital Association who is related to Billings Clinic adopted Billings Clinic Financial policies. There is a link on Stillwaters hospital website that is a direct link to billings Clinic Financial policy. TO Navigate there start at Stillwaters website: http://stillwaterbillingsclinic.com/ Click on Patient Info, then Financial Assistance. The direct link is: https://www.billingsclinic.com/app/files/public/114/Financial-Assistance-A pplication.pdf Schedule H, part V, Section B, Line 16c Direct URl for Financial assistance policy: In 2017 Stillwaters Hospital Association who is related to Billings Clinic adopted Billings Clinic Financial policies. There is a link on Stillwaters hospital website that is a direct link to billings Clinic Financial policy. TO Navigate there start at Stillwaters website: http://stillwaterbillingsclinic.com/ Click on Patient Info, then Financial Assistance. The direct link is: https://www.billingsclinic.com/app/files/public/113/Financial-Assistance.p df Schedule H, Part V, Line 16G Patient notification of the FAP: For the tax year of the return Stillwater Hospiptal association was not able to mark the box for part V, Line 16G. However, Stillwater has taken corrective actions to be able to comply with this question. they have posted the FAP in visible areas near the reception desk and have started to provide copies of the FAP policy at check in. Stillwater was already providing a conspicous written notive about the FAp on the billing statements. SCHEDULE H, PART I, LINE 7 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. THE INFORMATION FOR LINES 7E THROUGH 7I WAS DERIVED FROM INFORMATION IN THE GENERAL LEDGER AND OTHER FINANCIAL DATA RELATED SPECIFICALLY TO THE VARIOUS TYPES OF COMMUNITY BENEFITS. SCHEDULE H, PART I, LINE 7, Column (f) Bad debt expense included on Form 990, part IX, line 25 but excluded for purposes of calculating percentages in this column equal $613,933. SCHEDULE H, PART III, Section A, LINE 2 Bad debt is estimated by actual write offs plus a reserve calculated using different percentages based on aging category of receivables. SCHEDULE H, PART III, Section A, LINE 3 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 A, LINE 4 See page 12 of the attached audited financial statements for the footnote that describes bad debt expense. SCHEDULE H, PART III, Section B, Line 8 ALLOWABLE MEDICARE COSTING METHODOLOGY: STILLWATER BILLINGS CLINIC ESTIMATES THAT 45 PERCENT OF STILLWATER 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 100% 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 100-300 PERCENT OF FEDERAL POVERTY LEVEL. SCHEDULE H, PART III, Section C, LINE 9b Patients are screened by the organization's financial counselors to see if they qualify for financial assistance. If they qualify, their account balances are adjusted accordingly. If there is a balance after the adjustment, the organization follows the normal debt collection practice. In unusual situations where the patient's circumstances have changed, the CEO has the authority to grant exceptions to the policy. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: The organization assesses the health care needs of the communities it serves through day to day patient care and the work of the community health services department. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: The Organization employs a Business office lead who is responsible for administering the Financial Assistance Program, assuring the determination for financial assistance meets the requirements of the policy, and notifying the patient and/or responsible party of the final determination of amounts approved under the policy. Patient representatives work with the patients in completing applications that determine eligibility for financial assistance under the hospital's financial assistance policy. Information is also in printed form on patient bills. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: Stillwater County stretches 75 miles of two lane roads from north to south connecting mountain ranges to the lake basins, coulees, and rolling plains. Interstate 90 passes through the County at Columbus. County has population of 9,185 with 6 unincorporated communities and 1 incorporated community of Columbus where the hospital resides. County has a vast array of outdoor recreational opportunities. SCHEDULE H, PART VI, LINE 5 Promotion of community health: Stillwater Hospital Association's Community health services department strives to provide broad-based community health information and services to the residents, facilities and guests of Stillwater County. The board has community members serving. SCHEDULE H, PART VI, LINE 6 Affiliated health care system: Stillwater Billings Clinic is managed by Billings Clinic and works closely with Billings Clinic and other hospitals also managed by Billings Clinic to provide high quality patient care. false false false false false false false Luke Kobold Vice President 0 141510 0 9806 0 0 0 14031 0 19763 0 185110 0 0 Dr Camilla Reese Director 0 255748 0 0 0 50000 0 23275 0 6506 0 335529 0 0 Dr Richard Klee Director/physician 0 192872 0 2563 0 115688 0 23027 0 11384 0 345534 0 0 Mike Follett Interim CEO 0 161390 0 23570 0 0 0 16489 0 2892 0 204341 0 0 Dr David Kane Physician 165339 116091 23275 20473 325178 Dr Deborah Agnew CEO 86657 74278 4207 3606 7849 6728 6328 5424 105041 90036 Susan Ivankovich Physician Assistant 145130 200 9800 22695 177825 SCHEDULE J, PART I, LINE 3 DESCRIBE HOW CEO COMPENSATION IS DETERMINED: COMPENSATION FOR THE CEO IS PAID BY BILLINGS CLINIC, A RELATED ORGANIZATION. PLEASE SEE SCHEDULE O, PART VI, LINE 15A NARRATIVE FOR HOW CEO COMPENSATION IS DETERMINED. Form 990, Part VI, Section A, Line 6 DESCRIBE CIRCUMSTANCES FOR HAVING MEMBERS: Billings Clinic is the sole member of Stillwater Hospital Association. Form 990, Part VI, Section A, Line 7a Members who can elect members of the governing body: The sole member has authority to recommend, approve and reject nominations of board members. Form 990, Part VI, Section A, Line 7b Decisions of governing body subject to approval by members: The following are Governance decisions of the organization which are subject to approval by the sole member: - Amendments to the organization's articles of incorporation, bylaws, or name; - Dissolution, mergers, or consolidations with or into another entity; - Sale, lease, exchange or dispositions of property of the organization; - Approval of budgets; - Incurrence orf debt and purchases made by the organization in amounts exceeding $100,000; - Selection, hiring, primary supervision, discipline and termination of the organization's Chief Executive Officer; - Addition or discontinuance of any service offered to by the organization. Form 990, Part VI, Section B, line 11b Process to Review the Form 990: The form 990 is prepared by a third party and review is performed by the board of directors. Any changes and comments are provided back to the preparer and the final form 990 is provided to the full board prior to filing. The organization was provided an e-file submission form with the completed return which was signed and submitted for ERO processing. Form 990, Part VI, Section B, line 12c Process for Monitoring Compliance with Conflict of Interest Policy: All directors, officers, employees, and members of a committee with board delegated powers are covered by the conflict of interest policy and must provide an annual statement indicating they have reviewed and are in compliance with the policy. The board is charged with periodically reviewing and monitoring the policy to ensure the organization acts in a manner consistent with its charitable purpose. If a potential conflict is identified, the board will investigate any alternatives and determinations as to whether the transaction or arrangement is in the organizations best interest and will establish procedures for violations of the policy. Form 990, Part VI, Section B, line 15a Describe process for determining CEO/Executive compensation: Compensation is paid through Billings Clinic, the sole member. Compensation is determined by an annual review of external market data for similar size organizations through use of survey data with MHA and Yaffee & Company, and Rural Critical Access Hospital facilities. Compensation is reviewed and approved by the Board of Directors as recommended by the VP of Regional Services. The review is done at the time of the CEO's annual performance review. Form 990, Part VI, Section B, line 15b DESCRIBE PROCESS FOR DETERMINING COMPENSATION OF OTHER OFFICERS: Other officer Compensation is paid through Billings Clinic, the sole member. Salaries for the other key officers/leaders in the organization are reviewed for comparison to other similar size organizations through use of external salary survey sources such as MHA and Associated Employers. This review is conducted by Stillwater's HR Generalist and the CEO. Budget recommendations are formulated for review and approval by the VP of Regional Services and for final approval by the Board of Directors/Finance Committee. Form 990, Part VI, Section C, line 19 DESCRIBE HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC: The organizations governing documents, conflict of interest policy, and financials statementS are available upon request. Billings Clinic (BC) 2800 Tenth Avenue North Billings MT 59101 810231784 HOSPITAL MT 501(c)(3) LINE 3 NA false Billing Clinic Foundation 2917 Tenth Avenue North Billings MT 59101 810407289 FUNDRAISING MT 501(c)(3) LINE 7 BC false STILLWATER COMMUNITY HEALTHCARE FDN 710 N 11TH ST COLUMBUS MT 59019 200748325 fundraising MT 501(c)(3) Line 7 stillwater true New West Health Services 130 Neill Avenue Helena MT 59601 841418136 Insurance Sal MT Billings Clinic C-Corporation Billings Clinic Express Care LLC 2800 10th Avenue north Bilings MT 59101 463355499 Outpatient Cl MT Billings Clinic C-Corporation false false false true true false false false false false false false true true true true false false false stillwater community healthcare FDN d 52009 Interco Amount