2016-11-08T10:41:08-06:00 2015-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2015-01-01 810232406 Pondera Medical Center POND 4062713211 PO Box 668 Conrad MT 59425 Bill O'Leary CEO 4062713211 2016-11-07 1 Kim Hunwardsen CPA P00484560 6122536500 2016-11-07 2015 2017-02-10 21:41:12Z X Bill O'Leary PO Box 668 Conrad MT 59425 14297528 0 X www.ponderamedical.org X 1975 MT Providing access to quality healthcare through all life's stages 9 9 260 162 0 0 465914 587373 12374168 13684178 27680 8415 15289 0 12883051 14279966 0 0 0 0 7697289 7843731 0 0 0 4984442 5602680 12681731 13446411 201320 833555 6015723 6670423 2246285 2088889 3769438 4581534 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 8998439 9118051 Pondera Medical Center is a 25-bed critical access hospital. The Medical Center provided 257 inpatient days and 704 swing bed patient days along with a 24-hour emergency room that accounted for 1,581 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 $82,664. Total direct and indirect costs related to these foregone charges were approximately $66,000 at December 31, 2015, 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. 1689875 3363466 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 19,251 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. 893634 1202661 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 1 physician, 1 nurse practioner and 1 physician assistant and provided 8,487 total clinic visits including 351 extended care visits and 223 swing bed visits. In addition, ee also utilized staffing agencies that provided physicians on an as needed basis that equated to an additional 1305 visits. 11581948 1 1 0 0 0 0 0 0 1 0 1 1 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 1 0 0 0 0 0 0 0 0 1 23 0 1 260 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 1.00 X X 0 0 0 Jaynie Gollehon Trustee 1.00 X 0 0 0 Darby Donovan Trustee (Dec) 1.00 X 0 0 0 Debbie Sturm Trustee (Jun-Dec) 1.00 X 0 0 0 Gena Morris-Ries Trustee 1.00 X 0 0 0 Gene Hauer Trustee 1.00 X 0 0 0 Ted Kronebusch Trustee (Jan-May) 1.00 X 0 0 0 Bill O'Leary CEO 40.00 X 0 0 0 Randy Nightengale CFO 40.00 X 0 0 0 Jay Taylor Physician Family Medicine 20.00 X 336695 0 24954 Shawn Nesbo Physician Family Medicine 20.00 X 162452 0 0 Michael Hewett PA-ER 36.00 X 148338 0 1540 David Arends PA-C 40.00 X 102021 0 15912 749506 0 42406 4 0 1 0 Kalispell Regional Medical Center 310 Sunny View Lane Kalispell MT 59901 Professional Fees 916058 Evident 6600 Wall Street Mobile AL 36685 Professional Fees 534335 2 245423 341950 153040 587373 Patient Service Revenue 622110 9480191 9480191 Nursing Home 623000 3363466 3363466 Supporting Revenue 900099 540540 540540 Bed Tax Revenue 900099 234039 234039 EHR Incentive 900099 65942 65942 13684178 21782 21782 4195 17562 -13367 -13367 -13367 14279966 13684178 0 8415 X 6543962 5904278 639684 53289 48080 5209 774824 699084 75740 471656 425551 46105 167072 4000 163072 4003 4003 33200 33200 1943281 1495927 447354 22124 4941 17183 898230 774289 123941 177694 38050 139644 272825 263306 9519 29720 29720 41467 31802 9665 15371 15371 571189 571189 149956 149956 Medical Supplies 475523 475523 Bad Debt Expense 380036 380036 Food 248168 248168 MT Bed Tax 172633 172633 188 188 13446411 11581948 1864463 0 1352771 1694149 1100778 1391321 137881 154717 45339 88770 13122959 10702261 2371643 2420698 462540 441081 544771 479687 6015723 6670423 1473835 1271731 647035 707827 125415 109331 2246285 2088889 X 1468710 2301423 2300728 2280111 3769438 4581534 6015723 6670423 X 833555 -21459 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 6536 4241 8203 2574 0 48854 48854 9581448 7422644 2158804 3226451 3121017 105434 266206 158600 107606 2420698 Investment in Perpetual Trust 441081 F 441081 Other Assets 71208 Workers Compensation Deposit 124578 Other Accounts Receivable 214253 Estimated Third-Party Payor Settlements 69648 479687 Compensated Absences 109331 109331 X 13863100 -416866 -416866 14279966 0 14279966 13051004 0 13051004 395407 395407 13446411 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 -15,371. Bad debt expense recorded in expense on 990 -380,036. Loss on perpetual trust recorded in non-operating revenue for financial stmt -21,459. Part XII, Line 4b - Other Adjustments: Interest expense recorded in revenue on financial statements 15,371. Bad debt expense recorded in revenue on financial statements 380,036. 1 1 X 1 X 1 X 0 1 0 0 66000 66000 0.00510 66000 66000 0.00510 6478525 4725317 1753208 0.13420 6478525 4725317 1753208 0.13420 6544525 4725317 1819208 0.13930 1 380036 0 2662330 2677589 -15259 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 14 1 0 0 1 X www.ponderamedical.org/c-health-n-assess X 1 14 1 ponderamedical.org/c-health-n-assess 0 0 1 X 150.000000000000 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 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. Pondera Medical Center Part V, Section B, Line 11: The implementation planning committee identified the most important health needs to be addressed by reviewing the CHNA, secondary data, community demographics, and input from representatives representing the broad interest of the community, including those with public health expertise (see page 8 of the Implementation Strategy for additional information regarding input received from community representatives). 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. Participants then created a goal to achieve using 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). 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 CarePondera Medical Center continues to work on the Needs Assessment Survey Implementation Plan, created from our Community Health Needs Assessment from 2014. The 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 2015, we began developing a marketing strategy by hiring a Marketing Manager 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 started, and a new Clinic Manager was hired. Recruitment/retention throughout our facility was also enhanced by the hiring of a 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 continue to identify and address the culture of our facility, and explore different programs that can assist in building a good leadership base through trainings. Pondera Medical Center Part V, Section B, Line 16i: 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 at our business office. The financial assistance application is also available on our website. We also have partnered with the 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 22d: Pondera Medical Center used the Lookback Method. 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 3 - Pondera Med Ctr Durable Medical Equip 809 Sunset Blvd Conrad MT 59425 Durable Medical Equipment 4 - 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. Part I, Ln 7 Col(f): Bad debt expense of $380,036 removed from the denominator calculation. Part III, Line 2: Bad debt expense is reported 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 a sponsor at sporting events, help with National Night Out and the Harvest Festival. Radio and newspaper articles are also used to help inform the community of special health related events and projects. We also continue to use the survey process to gather updated health data from patients and families about the care we deliver in our facility. 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 2015 was 6,184 and is considered rural. The median household income for 2010-2014 was $40,969 in which 19.2% 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 your 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. 0 0 0 0 0 0 0 0 0 Jay Taylor Physician Family Medicine 336575 0 0 0 120 0 3578 0 21376 0 361649 0 0 0 Shawn Nesbo Physician Family Medicine 162452 0 0 0 0 0 0 0 0 0 162452 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. X 1 139716 FMV X Pollinator Garden 1 13324 FMV 0 0 0 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 $114,467 and $15,605 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 11 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 974,546. Management and general expenses 8,693. Fundraising expenses 0. Total expenses 983,239. Recruitment: Program service expenses 22,814. Management and general expenses 855. Fundraising expenses 0. Total expenses 23,669. Repairs and maintenance: Program service expenses 187,086. Management and general expenses 3,632. Fundraising expenses 0. Total expenses 190,718. Purchased services: Program service expenses 301,684. Management and general expenses 434,174. Fundraising expenses 0. Total expenses 735,858. Collection expense: Program service expenses 9,797. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,797. Form 990, Part XI, line 9: Loss on perpetual trust -21,459.