2017-11-09T15:30:15-06:00 2016-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2016-01-01 810232406 Pondera Medical Center POND 4062713211 PO Box 668 Conrad MT 59425 Bill O'Leary CEO 4062713211 2017-11-09 1 Kim Hunwardsen CPA P00484560 6122536500 198.135.124.203 2017-11-09 10:23:03 CS P 6C9B1A35775087DBDB8A6D25ECA509C7F6C27838 29C631FCBD7EE613918B5A80576D837C30D7D376 2016 2017-02-10 21:41:12Z Bill O'Leary PO Box 668 Conrad MT 59425 14508065 0 X www.ponderamedical.org X 1975 MT Providing access to quality healthcare through all life's stages 9 9 271 130 0 0 587373 343048 13684178 14052154 8415 -7737 0 0 14279966 14387465 0 0 0 0 7843731 8407174 0 0 0 5602680 5992628 13446411 14399802 833555 -12337 6670423 6841554 2088889 2270507 4581534 4571047 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 9420729 9520904 Pondera Medical Center is a 25-bed critical access hospital. The Medical Center provided 214 inpatient days and 681 swing bed patient days along with a 24-hour emergency room that accounted for 1,567 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, 2016, 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. 1825913 3339752 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 20,121 total patient days. Specialized services are also available including those offered by a physical therapist, occupational therapist, speech therapist, registered dietitian, 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. 754860 1191498 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 1106 visits. 12001502 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 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 24 0 1 271 1 0 0 0 0 0 0 0 0 0 0 X 9 9 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 Brent Gaylord Chair 1.00 X X 0 0 0 Bernard Ries Vice Chair 1.00 X X 0 0 0 Janice Hoppoes Treasurer 1.00 X X 0 0 0 Kelly Greer Secretary (Jan-Jun) 1.00 X X 0 0 0 Gena Morris-Ries Trustee (Jan-Jun)/Secretary (Jul-Dec) 1.00 X X 0 0 0 Jaynie Gollehon Trustee 1.00 X 0 0 0 Darby Donovan Trustee 1.00 X 0 0 0 Debbie Sturm Trustee 1.00 X 0 0 0 Bergan Morehouse Trustee (Oct-Dec) 1.00 X 0 0 0 Gene Hauer Trustee 1.00 X 0 0 0 Bill O'Leary CEO 40.00 X 0 0 0 Randy Nightengale CFO 5.00 X 0 0 0 Jay Taylor Physician Family Medicine 20.00 X 444298 0 31320 Norman Walker PA-C ER 64.00 X 185714 0 8575 Michael Hewett PA-ER 54.00 X 151010 0 1243 David Arends PA 40.00 X 113118 0 21894 Laura Erickson CNO 40.00 X 109568 0 13848 1003708 0 76880 5 0 1 0 Kalispell Regional Medical Center 310 Sunny View Lane Kalispell MT 59901 Professional Fees 682598 Evident 6600 Wall Street Mobile AL 36685 Professional Fees 500544 Delta Flex Travelers PO Box 202940 Dallas TX 75320 Professional Fees 207257 Sletten Construction Co 05263 1000 25th St N Great Falls MT 59403 Professional Fees 196000 GE Healthcare Financial Services PO Box 641419 Pittsburgh PA 152641419 Equipment lease 163111 13 220748 122300 4495 343048 Patient Service Revenue 622110 9438858 9438858 Nursing Home 623000 3339752 3339752 Bed Tax Revenue 900099 626134 626134 Supporting Revenue 900099 574453 574453 EHR Incentive 900099 72957 72957 14052154 32863 32863 80000 120600 -40600 -40600 -40600 14387465 14052154 0 -7737 X 6875694 6226442 649252 100421 90939 9482 933037 844933 88104 498022 450995 47027 184296 2000 182296 12014 12014 45100 45100 2010956 1582155 428801 23213 3644 19569 860507 727270 133237 203629 41466 162163 730067 261182 468885 20427 20417 10 45378 39326 6052 13832 13832 576876 576876 141761 141761 Medical Supplies 468657 468657 Food 261477 261477 Bad Debt Expense 212087 212087 MT Bed Tax 177804 177804 4547 4547 14399802 12001502 2398300 0 1694149 2217719 1391321 1329140 154717 146179 88770 64299 13176770 10905825 2420698 2270945 920768 813272 6670423 6841554 1271731 1361737 707827 812942 109331 95828 2088889 2270507 X 2301423 2544290 2280111 2026757 4581534 4571047 6670423 6841554 X -12337 1850 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 2574 80016 77475 5115 0 27854 27854 5262674 4321689 940985 7580578 6418054 1162524 305664 166082 139582 2270945 Other Assets 75568 Workers Compensation Deposit 124578 Beneficial Interest in Perpetual Trust 442931 Estimated Third-Party Payor Settlements 170195 813272 Compensated Absences 95828 95828 X 14163396 -224069 -224069 14387465 0 14387465 14173883 0 14173883 225919 225919 14399802 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: Interest expense reported in non-operating expense on 990 -13,832. Bad debt expense recorded in expense on 990 -212,087. Gain on perpetual trust recorded in non-operating revenue for financial stmt 1,850. Part XII, Line 4b - Other Adjustments: Interest expense recorded in revenue on financial statements 13,832. Bad debt expense recorded in revenue on financial statements 212,087. 1 1 X 1 X 1 X 1 1 0 0 32000 32000 0.00230 32000 32000 0.00230 9204 9204 0.00060 7034215 4771843 2262372 0.15950 7043419 4771843 2271576 0.16010 7075419 4771843 2303576 0.16240 1 212087 0 2899430 2917394 -17964 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 department on their community health needs assessment and participated in the Pondera Healthcare foundation stakeholder meeting to discuss community needs for health and wellness. 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: The implementation planning committee determined which needs or opportunities could be addressed considering Pondera Medical Center's parameters of resources and limitations. The committee then prioritized the needs/opportunities using the additional parameters of the organization's vision, mission, and/or values, as well as existing and potential community partners. The prioritized health needs as determined through the assessment process and which the facility will be addressing relates to the following:1. Access to Healthcare2. Healthy Behaviors and Lifestyles3. Quality of CareThe goals, strategies, and activities are compiled in a progress tracker that is updated every quarter. Details of our plan are also updated to show our progress and the impact on the community. Updated details are available on our website.During 2016, our Marketing Manager continued to assist in building awareness in the community of our existing services and targeting what outreach was needed. We also began developing a strategy to recruit providers to our facility by working with the WWAMI Program and recruiting through Educational avenues. This was a need that was not being met at an acceptable level prior to our Needs Assessment. *Walk In Clinic hours were continued. Recruitment/retention throughout our facility was continued with our new Human Resources Director. We are teaching Certified Nursing Assistant classes to help with recruitment. Job Fairs have not been used, as most are now on-line. *We continue to partner with Public Health and Human Services to address health and wellness services in the community with several different outreach programs for all ages.*We also partnered with Kalispell Regional Healthcare to work on facility culture change and leadership education. KRH has provided leadership training onsite and is assisting in training PMC staff on culture change so we are able to provide the education in house on a consistent basis. In 2016 the 4 priorities identified by community stakeholders were:1. Senior services2. Health and wellness3. Marketing4. Recruitment and retentionDue to the timing of the approval of the 2016 Implementation Strategy we were not able to fully address all of these needs before year end. 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, Ln 7 Col(f): Bad debt expense of $212,087 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 sponsor a community health fair with a focus on wellness and prevention to include annual lab testing and flu shots. Several health related vendors from other areas also attend the fair. We participate in National Night Out and the Harvest Festival as well as attend monthly Chamber of Commerce meetings and Pondera Healthcare Foundation meetings. Our marketing team continues to do outreach with targeted wellness and prevention campaigns. 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 2016 was 6,084 and is considered rural. The median household income for 2011-2015 was $42,264 in which 20.1% 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. Pondera Medical Center extends medical staff privileges to all qualified physicians in the community. Surpluses of cash, when available, are invested back into the Hospital for equipment purchases and wage considerations.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, 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 Montana State University to do distance learning for Practical Nursing students with the first students to begin in January 2017.Our Registered Dietician became certified in diabetic education as an outreach to the community, and we also hired a wellness coach to work with employees and the community on fitness while utilizing the wellness center. 0 0 0 0 0 0 0 0 0 Jay Taylor Physician Family Medicine 444298 0 0 0 0 0 5300 0 26020 0 475618 0 0 0 Norman Walker PA-C ER 185714 0 0 0 0 0 909 0 7666 0 194289 0 0 0 Michael Hewett PA-ER 151010 0 0 0 0 0 640 0 603 0 152253 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 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 $141,887 and $4,409 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 1,051,115. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,051,115. Recruitment: Program service expenses 38,096. Management and general expenses 3,255. Fundraising expenses 0. Total expenses 41,351. Repairs and maintenance: Program service expenses 182,129. Management and general expenses 750. Fundraising expenses 0. Total expenses 182,879. Purchased services: Program service expenses 303,813. Management and general expenses 424,796. Fundraising expenses 0. Total expenses 728,609. Collection expense: Program service expenses 7,002. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,002. Form 990, Part XI, line 9: Gain on perpetual trust 1,850.