2018-05-14T07:14:55-05:00 2017-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2016-07-01 237169043 Central Montana Medical Facilities Inc CENT 4065387711 408 Wendell Avenue Lewistown MT 59457 Alan R Aldrich CFO 4065386243 2018-05-09 1 Kim Hunwardsen CPA P00484560 6122536500 2018-05-09 2016 2022-09-23 18:48:47Z Central Montana Medical Center Robert M Dowdy 408 Wendell Avenue Lewistown MT 59457 33325052 0 X www.cmmccares.com X 1971 MT The mission of CMMC is to be the leader in assuring community based quality healthcare. 15 12 342 195 0 0 675946 245876 27220554 31660483 218521 310999 590549 592402 28705570 32809760 0 0 0 0 16510942 17236822 0 0 81734 12552995 13642424 29063937 30879246 -358367 1930514 26234871 28178401 8834368 8697132 17400503 19481269 X The mission of Central Montana Medical Center is to be the leader in assuring community based quality healthcare. 0 0 24004865 31660483 Central Montana Medical Facilities, Inc. operates a 25-bed critical access hospital located in Lewistown, Montana.Hospital Inpatient Services for FY 2017:Number of beds: 25Provided 1,982 acute days of care and 790 swing bed days of care for 30.38% occupancy rate. Emergency Services for FY 2017:Provided for 5,448 Emergency visits.24 hour Physician coverage available.Community care and services are also provided through the many reduced price services and free clinics, fairs, and programs offered throughout the year. These include but are not limited to the following (all costs are estimates):1. Twenty-eight foot clinics were held in 2016-2017 in Denton, Stanford, and the Hobson communities. A total of 316 people were served, all received discounted health care. Total community benefits expense of $8,700.2. CMMC educated locals with a babysitting class (24 people served, 1 class offered, total community benefit $538)3. Instead of a Health Fair, CMMC offered lab draws during your birth month at discounted prices. A total of 366 persons participated, with expenses such as staff time and supplies were $6,602.4. CMMC gave several cash donations to different organizations in 2016-2017 totaling $5,422. These included donations to the Community Easter Egg Hunt, Central MT Youth Challenge, and Relay for Life Dinner.6. CMMC staff were representatives of CMMC on several board throughout 2016-2017. These included TORCH Board, Kiwanis Board and Central Montana Foundation Advisory Board Meetings.7. CMMC served our community in a multitude of ways throughout 2016-2017 fiscal year. Staff was involved in the Cardiac Rehab Race (Bill Barry Run), food drives, in-kind donations to local programs including Cowboy Poetry, REACH Camps, and TORCH (Young People in Recovery). They also educated the nursing students with Intro into Micro and Phlebotomy sessions. The facilities maintain records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy. The amount of charges foregone for services provided under the Facilities charity care policy were approximately $800,000 for the fiscal year. Total direct and indirect costs related to these foregone charges were $416,000 based on an average ratio of cost to gross charges.Awards received for FY 2017 were:* June 2016 - NRHA 2016 Top CAH Winner* October 2016 - CMMC Receives International "Baby Friendly" Designations* December 2016 - Recognition Award from Evident (top user among mid-size hospitals)* March 2017 - Top 100 Critical Access Hospital iVantange Health Analytics' Hospital Strength Index* July 2017 - Bennett Physician of the Year Award 24004865 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 45 0 1 342 1 0 0 0 0 0 1 1 0 0 0 0 X 15 12 1 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X Alan R Aldrich 4065357711 408 Wendell Ave Lewistown MT 59457 Dave Phillips President 2.00 X X 0 0 0 Doug Flament Vice Chair (thru Oct) 2.00 X X 0 0 0 Carl Seilstad Vice Chair 2.00 X X 0 0 0 Nancy WilsonSecretary Treasurer (thru Oct) 2.00 X X 0 0 0 Jennifer Saunders Secretary/Treasurer 2.00 X X 0 0 0 Corry Arntzen Member 1.00 X 0 0 0 Brandon Bantz Member 1.00 X 0 0 0 Keith Cook Member 1.00 X 0 0 0 Nick Econom Member 1.00 X 0 0 0 Marvin Mauws Member 1.00 X 0 0 0 Pete Smith Member 1.00 X 0 0 0 Michael Sura MD Member 40.00 X 249402 0 20573 Josh Webber Member 1.00 X 0 0 0 Tamara Welsh MD Member 40.00 X 189306 0 7666 Erik Wood Member 1.00 X 0 0 0 Dan Thomas Member 1.00 X 0 0 0 Greg Smith Member 1.00 X 0 0 0 Francis Weinheimer Member (thru Oct) 1.00 X 0 0 0 Robert Mike Dowdy CEO 40.00 X 219016 0 16280 Alan R Aldrich CFO 40.00 X 126126 0 20870 Delilah Duffy CNO (retired 6/17) 40.00 X 95051 0 15068 Karin White CNO 40.00 X 0 0 0 Joan M McMahon Emergency Medicine 40.00 X 262120 0 19369 James Fox CRNA 40.00 X 255559 0 9500 Amy A LePage Emergency Medicine 40.00 X 294640 0 22128 Gardner Smith Surgeon 40.00 X 326563 0 18099 Christina Marchion Family Practice Physician 40.00 X 230537 0 19577 2248320 0 169130 9 0 1 0 0 47933 147086 50857 245876 Net Patient Revenue 622110 29549669 29549669 Special Programs 900099 1748191 1748191 Cafeteria 722210 382555 382555 Int in Central MT Fdtn 900099 -19932 -19932 31660483 158048 158048 696526 104124 592402 592402 592402 554183 393839 7393 160344 -7393 152951 152951 9936 47933 9936 0 32809760 31660483 0 903401 X 1098648 582848 515800 80239 80239 13102197 10466607 2590606 44984 337987 273841 61897 2249 1680632 1379737 288030 12865 937119 749695 184557 2867 120000 120000 171118 171118 29950 29950 3116943 1954270 1159341 3332 75697 37849 29336 8512 1792993 1148757 642385 1851 1000542 793662 205080 1800 39040 39040 140523 91314 48167 1042 202758 155147 47611 1516184 1171073 344504 607 544577 520776 23801 Medical Supplies 3553961 3553961 Bad Debt Allowance 725848 725848 Equipment Rental and Ma 205643 121645 83998 Taxes and Licenses 153445 6635 146810 0 253202 151921 99656 1625 30879246 24004865 6792647 81734 1123463 2222507 5433175 5259674 2532 2565 644687 756446 204797 389362 39348896 27492506 12317443 11856390 3210317 3615759 14070 7035 3284387 4068663 26234871 28178401 2583829 2854208 58493 0 3923091 3820626 1256175 1157508 1012780 864790 8834368 8697132 X 15137231 17237929 698138 629018 1565134 1614322 17400503 19481269 26234871 28178401 1930514 150252 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 123009 123009 23238395 14562917 8675478 14529884 12029003 2500881 1457608 900586 557022 11856390 Long-Term Prepaid Expenses 658243 Due from Foundation 2243340 Other Receivables 1167080 4068663 Estimated Third-Party Payor Settlements 864790 864790 X 32157111 -725848 -725848 32882959 -73199 -73199 32809760 30257522 104124 104124 30153398 725848 725848 30879246 Part X, Line 2: The Facilities 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 Facilities is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Facilities are subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Organization files an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS to report its unrelated business taxable income, if any. The Facilities believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Facilities would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Provision for Bad Debts Reported in Expenses for Tax Purposes -725,848. Part XI, Line 4b - Other Adjustments: Contributions for Specific Purposes Recorded in Fund Balance for F/S 50,857. Rental Expenses Reported in Revenue for Tax Purposes -104,124. Change in interest of net assets of Foundation -19,932. Part XII, Line 2d - Other Adjustments: Rental Expenses Reported in Revenue for Tax Purposes 104,124. Part XII, Line 4b - Other Adjustments: Provision for Bad Debts Reported in Expenses for Tax Purposes 725,848. Golf Tournament 28325 24779 3546 600 297 2474 175 Quilt/Gun Auction 22004 15881 6123 100 3400 2321 302 1 7540 7273 267 267 57869 47933 9936 700 3697 4795 744 9936 0 1 1 X 1 X 1 X 1 1 0 1 1 416000 416000 0.01380 416000 416000 0.01380 9 3088 18059 6235 11824 0.00040 1 27 73 73 0.00000 8430309 4554299 3876010 0.12850 2 880 5597 5597 0.00020 12 3995 8454038 4560534 3893504 0.12910 12 3995 8870038 4560534 4309504 0.14290 4 716 4322 4322 0.00010 4 716 4322 4322 0.00010 1 725848 0 7278568 7304950 -26382 X 1 1 1 1 Central Montana Medical Center 408 Wendall Avenue Lewistown MT 59457 www.cmmccares.com 12894 X X X X Home Health / Hospice Central Montana Medical Facilities Inc 1 0 0 1 X X X X X X X X 15 1 0 1 1 X www.cmmccares.org X X 1 15 1 www.cmmccares.org 0 1 X 150.000000000000 300.000000000000 X 1 1 X X X 1 X See Part V X See Part V X See Part V X X X X X X X 1 X 0 X X X X 1 X 0 0 Central Montana Medical Facilities, Inc. Part V, Section B, Line 3j: Secondary Data: County Profile, Demographic Trends and Economic Impacts Central Montana Medical Facilities, Inc. Part V, Section B, Line 5: A Steering Committee was convened to assist Central Montana Medical Center in conducting CHSD. A diverse group of community members representing various organizations and populations within the community (ex. public health, elderly, uninsured) came together in November 2015. The Steering Committee met twice during the CHSD process; first to discuss health concerns in the community and offer their perspective in designing the survey instrument and again to review results of the survey and focus groups and to assist in the prioritization of health needs to address. Central Montana Medical Facilities, Inc. Part V, Section B, Line 6b: The Needs Assessment was conjoined with the Central Montana Community Health Center in Lewistown. Central Montana Medical Facilities, Inc. Part V, Section B, Line 7d: The Needs Assessment is available at the Community Relations Office at Central Montana Medical Center as well as on the hospital website. Central Montana Medical Facilities, Inc. Part V, Section B, Line 11: Respondents indicated significant needs to:* increase access to healthcare services in the community* provide increased access to behavioral health services* improve population health of the communityIn order to respond to these needs CMMC will look at increasing access to specialists at CMMC, increasing hours available for outpatient services, and increasing the number of primary care providers. To provide increased access to behavioral health CMMC will continue providing mental health services and will evaluate the possibilities of expanding behavioral health services. In order to improve population health of the community CMMC will continue to provide and evaluate expanding education and outreach components of the population health program. Three areas were identified health needs that CMMC is unable to address. They include:* Cancer* Those that reported that they were unable to receive or had to delay receiving healthcare services (33%), the reason most cited was "It costs too much" (42.7%). * Focus groups indicated a need for more services specific to seniors.Rationale of needs that were unable to address were as follows:* CMMC provides Infusion Services (chemotherapy) and visiting oncologist, which helps eliminate unnecessary travel for CMMC patients. Offering additional cancer services would not be feasible from a staffing and financial standpoint.* CMMC offers programs/charity care to assist with paying for healthcare costs at healthcare priced services that are based on current market conditions. CMMC provides Navigator services to the community. * CMMC is aware of a need for more services specific to seniors; however, the facility feels that there are not enough resources available to address the issue at this time.CMMC has affiliated with Billings Clinic (as of June 2017) to provide additional healthcare services and physicians. CMMC offers a Behavioral Health Counselor through our Care Coordination Program that started October 2017. Central Montana Medical Facilities, Inc. Part V, Section B, Line 13h: Eligibility is based on patient's family size, family gross income, personal assets, and other medical debts. Central Montana Medical Facilities, Inc. Part V, Section B, Line 16j: A summary of the financial assistance policy is also posted in the hospital facility's emergency room, waiting rooms, and admissions offices. Part V, Line 16a, FAP Website: http://www.cmmccares.org/index.php/services/business-office/financial-assistance-available.html Part V, Line 16b, FAP Application Website: http://www.cmmccares.org/index.php/services/business-office/financial-assistance-available.html Part V, Line 16c, FAP Plain Language Summary Website: http://www.cmmccares.org/services/business-office/financial-assistance-available.html 1 1 - Central Montana Medical Center - DME 202 4th Avenue South Lewistown MT 59457 HME/DME Services Part I, Line 3c: Eligibility is based on patient's family size, family gross income, personal assets, and other medical debts. Part I, Line 6a: The Organization's community benefit report can be found on its website at: www.cmmccares.org. Part I, Line 7: The Organization used an average overall ratio of costs to gross charges which addresses all patient segments in order to calculate charity care. Community health improvement services, Health Professions Education, and cash and in-kind contributions were based on expenses recorded in the general ledger. Subsidized health services are reported according to costs allocated to the relevant cost centers on the Medicare cost report. Part I, Ln 7 Col(f): The amount of bad debt expense removed from the denominator of the calculation was $725,848. Part II, Community Building Activities: Community Building activities promoted the health of the communities served by providing service and donations for a healthy, active, and educated public. Central Montana Medical Center staff donated time to community boards, such as LEPC (Lewistown Emergency Preparedness Community), Central Montana Youth Challenge, EPI Committing Meeting, and the DUI Task Force. By being a part of these community meetings CMMC staff provides a range of knowledge to the community members with a foundation on health and medical needs. All of these programs benefit central Montana area and promote health and wellness. Part III, Line 2: Bad debt expense is reported at charges as recorded by the organization.Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year. Part III, Line 4: Footnote from organization's financial statements: The footnote that describes bad debt expense is found on page 7 of the attached audit report. Part III, Line 8: Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.All of the Medicare shortfall should be treated as a community benefit. The Organization treats individuals regardless of the ability to pay. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. Part III, Line 9b: Patients deemed by CMMC to be unable to pay at any time during the revenue cycle may be eligible to receive available financial assistance. Patients must complete an application. Our collection practice is to refrain from collection efforts until financial assistance is determined. Normal collection efforts would resume if the application is not returned timely or after the write-off is complete and the patient owes a balance. Part VI, Line 2: Currently, CMMC assesses the health care needs of the community by the number of responses to ads and articles released through the local media. Also tracked were the kinds of support requested of CMMC such as children's safety, wellness initiatives and healthcare assessments. In FYE 2016 CMMC completed a 2nd Community Health Needs Assessment with the help of Montana State University. Mail and phone surveys were completed and "town hall" type meetings were held in Lewiston as well as most of the surrounding smaller communities. Part VI, Line 3: CMMC has financial assistance signage posted in the admissions areas and the ER waiting area. A pamphlet explaining our financial assistance program, the application process and contact information is available at all hospital registration areas. The Charity Care policy and application along with a checklist and contact information is posted on our website on the internet. Prior to discharge someone from discharge planning discusses with the patient the availability of various government benefits, such as Medicaid, and assists the patient with qualifications for such programs, where applicable. Assistance with filling out the Charity Care application is also provided at this time. Private Pay in-patients are informed of Charity Care either prior to scheduled admission by physician referral or prior to discharge from the facility. We also send out information with first time statements. All other patients are informed upon inquiry. Part VI, Line 4: Lewistown is an agricultural community and the county seat for Fergus County Montana. Lewistown is located in the center of Montana and is surrounded by five mountain ranges: the Snowies, the Judiths, the Moccasins, the Belts and the Highwoods. Lewistown's elevation is 3,963 feet with 3,102 people per square mile (average).The city of Lewistown and the surrounding rural towns are supported by one hospital, Central Montana Medical Center. Fergus County is located in a federally designated medically underserved area. As of the census of 2015, the population of Lewistown MT is 9,200 with a 2010 estimate of 9,105 people. There is an estimate of 4,615 males compared to 4,585 females. March 2016 cost of living index in our zip code (59457) is 83.1%, U.S. average is 100. Lewistown Montana has an estimate of 11,096 people per square mile with our land area at an estimated 829.1 square miles.Real estate property taxes paid for housing units with mortgages in 2015 was $1,326. Renter-occupied apartments were 31% compared to the state average of 33%.The median resident age for this zip code is 45.8 years old with an average household size of 2.2 people.The population 25 years and over in 59457 shows High school or higher: 94.0%, Bachelor's degree or higher: 29.1%, Graduate or professional degree: 6.9%, Unemployed: 2.8%, Mean travel time to work (commute): 10.8 minutesInformation obtained from www.city-data.com/city/Lewistown-Montana.html Part VI, Line 5: The CMMC Governing Board consists of 14 volunteer community members including residents from Grass Range, Stanford, Denton and Judith Gap. CMMC extends medical staff privileges to qualified physicians based upon community needs.Surplus funds, when available, are applied to patient care needs, equipment and building maintenance and medical education requirements. The expenditure of these funds is approved by the Governing Board which meets on a monthly basis. Part VI, Line 6: N/A Part VI, Line 7, Reports Filed With States MT X X X 0 0 0 0 0 0 0 0 0 Michael Sura MD Member 249402 0 0 0 0 0 8136 0 13575 0 271113 0 0 0 Tamara Welsh MD Member 189306 0 0 0 0 0 7666 0 1166 0 198138 0 0 0 Robert Mike Dowdy CEO 219016 0 0 0 0 0 0 0 17337 0 236353 0 0 0 Joan M McMahon Emergency Medicine 262120 0 0 0 0 0 10600 0 8769 0 281489 0 0 0 James Fox CRNA 255559 0 0 0 0 0 9500 0 22 0 265081 0 0 0 Amy A LePage Emergency Medicine 294640 0 0 0 0 0 9681 0 12447 0 316768 0 0 0 Gardner Smith Surgeon 326563 0 0 0 0 0 0 0 18099 0 344662 0 0 0 Christina Marchion Family Practice Physician 230537 0 0 0 0 0 6935 0 12642 0 250114 0 0 0 Part I, Line 3 These processes were utilized until June 5th, 2017 when the CEO became employed by Billings Clinic. CMMC relies on Billings Clinic to establish appropriate compensation for the CEO. A Fergus County Montana 816001358 2014-05-01 4500000 Emergency and laboratory expansion and remodel of existing facility 0 0 0 A 679374 4500000 4500000 2015 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 Christina Marchion MD Employee Recruiting X 45000 2565 0 1 1 2565 Annie Davis Family Member of Board Member 68701 Payment of Compensation 0 Terrie Dowdy Family Member of CEO 11538 Payment of Contract Compensation 0 Form 990, Part VI, Section A, line 1 The Executive Committee includes the President or Chair, Vice President or Vice Chair, Secretary and Treasurer and 2 members-at-large and their authority is similar to that of the full governing board. Form 990, Part VI, Section A, line 2 Greg Smith and Alan R. Aldrich have a business relationship. Form 990, Part VI, Section A, line 3 Mr. Robert (Mike) Dowdy is a contract employee of Billings Clinic as of June 1st, 2017. Central Montana Medical Center became affiliated with Billings Clinic and Mr. Dowdy serves as the CEO. Billings Clinic was paid $0 for Mike's services during fiscal year 2017. The organization pays Billings Clinic a Management Fee of $25,000 per month for our affiliation. Form 990, Part VI, Section A, line 4 Articles of incorporation were changed to differentiate between Class A and Class B members. The following changes were made to the bylaws: 1. Article III - Members a. Creates a class "B" membership, with the sole members being appointed by the Billings Clinic; b. Expands Class A membership to persons living in Petroleum county; c. Defines the process for notification of a "special meeting of the members", by mail in lieu of publication in local newspapers. Annual meetings will still be announced in the local newspapers; 2. Article IV - Board of Directors a. Provides language that the facility CEO will be an employee of the Billings Clinic; b. Creates two classes of Directors i. Class A - not less than nine (9) nor more than thirteen (13) Class A Directors, to be elected by the Class A membership ii. Class B - at least one (1), but no more than two (2) Class B Directors to be appointed by the Billings Clinic; 3. Article VII - Functioning of the Board and its Committees a. Provides language for notification of the Class B Director of Executive Committee Meetings 4. Article XI - Review and Amendment of Bylaws a. Provides for "reserve power" in favor of the Billings Clinic which requires the consent of the Billings Clinic to any Bylaw amendment which might affect the voting rights and powers of the Class B Membership (the Billings Clinic) Form 990, Part VI, Section A, line 6 The organization has two classes of membership: Class A general membership and Class B membership, with the sole member of the Class B Membership being Billings Clinic. Class A Membership in the Corporation shall consist of residents of Central Montana residing within the counties of Fergus, Judith Basin and Petroleum who are at least eighteen (18) years of age and who have or shall indicate their interest in the maintenance of adequate medical facilities and high standards of medical care in the area, served by CMMC, and who indicate a willingness and desire to be a member of the Corporation by attending and signing the register at the Corporation's annual meeting. Form 990, Part VI, Section A, line 7a The board has two classes of directors. Class A Directors are elected by the Class A Members and Class B Directors are appointed by the Billings Clinic. There shall be at last nine but no more than thirteen Class A Directors. There shall be at least one but no more than two Billings Clinic Directors, as determined by Billings Clinic from time to time. Each Class A Director must reside within the counties of Fergus, Judith Basin or Petroleum. Two Class A Directors must be physicians holding privileges on CMMC's active Medical Staff. Further, so long as the Corporation remains obligated for the repayment of any long-term tax exempt financing, underwritten through Fergus County, Montana, one Class A Director shall be selected from the Fergus County Commissioners. The Board and Billings Clinic shall communicate concerning the appointment of Billings Clinic Directors with the objective of selecting individuals who will work cooperatively with the Class A Directors for the benefit of CMMC. Form 990, Part VI, Section A, line 7b Any amendment to the bylaws affecting the voting rights and powers of membership, must be approved by both a two-thirds majority of the board present at any regular or special meeting of the board and Billings Clinic. Additionally, Billings Clinic must consent to any amendment of the bylaws relating to CMMC's purpose, the membership, the members of the board, including but not limited to the number of directors, the composition of the board, the term of office of directors or the method or way in which directors are elected or selected. Form 990, Part VI, Section B, line 11b A draft copy of the Form 990 is reviewed by the CFO and Board of Directors prior to its filing. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy by discussing at the Board of Director Meetings and obtaining signed statements from members. All officers, board members, and key employees are covered by the policy. The board determines whether conflicts exist and all potential conflicts are reviewed by the board. Any person with a conflict is not allowed to vote on conflicted issues. Form 990, Part VI, Section B, line 15a Compensation of the CEO was determined by the compensation Committee, and then approved by the Governing Board and comparability data was used until the CEO became a Billings Clinic employee. CMMC relies on Billings Clinic to establish appropriate compensation for the CEO. Compensation of the CFO is determined by the CEO. These processes take place on an annual basis. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. A copy may be requested by calling, emailing, walk-in or via mail. Form 990, Part IX, line 11g Medical/Professional Fees: Program service expenses 363,562. Management and general expenses 0. Fundraising expenses 0. Total expenses 363,562. Service Contracts: Program service expenses 551,432. Management and general expenses 340,491. Fundraising expenses 3,332. Total expenses 895,255. Purchased Services: Program service expenses 1,039,276. Management and general expenses 818,850. Fundraising expenses 0. Total expenses 1,858,126.