2016-05-03T14:08:09-05:00 2015-06-30 BKD LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2014-07-01 810286525 Stillwater Hospital Association % TERESA GRAYSON STIL 4063225316 710 N 11th St Columbus MT 59019 KELLEY EVANS CHIEF ADMINISTRATIVE OFFICER 4063225316 2016-04-27 true Rita F Worster CPA P00290681 7194714290 2014 2016-08-17 19:52:53Z KELLY EVANS CAO 710 N 11th St Columbus MT 59019 9560773 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. 8 4 64 4 0 174590 420175 7940608 9049799 23751 43527 29910 47272 8168859 9560773 6625 5385 0 0 2620149 2691464 0 0 0 6084073 6096947 8710847 8793796 -541988 766977 17294868 17570478 14836193 14374429 2458675 3196049 STILLWATER HOSPITAL ASSOCIATION IS A RURAL INTEGRATED HEALTH CARE ORGANIZATION BRINGING TOGETHER A PHYSICIAN CLINIC & HOSPITAL SERVICES TO DELIVER QUALITY COORDINATED CARE. false false 7063636 5385 9089413 ACUTE CARE HOSPITAL AND RURAL HEALTH CLINIC 7063636 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 6 0 true 64 true false false false false false false false false false false X 8 4 false false false false true true true true true false false true true true true true true false false false X TERESA GRAYSON 4066574629 2800 TENTH AVENUE N Billings MT 59107 John Hungerford President 3.0 0.0 X X 0 0 0 Ron Martinez Secretary/Treasurer 3.0 0.0 X X 0 0 0 Dr Kent Brown Director 3.0 0.0 X 0 0 0 Dr Richard Klee Physician/Director 40.0 3.0 X 0 253666 36377 Luke Kobold Director 3.0 40.0 X 0 150267 31737 Michael Matovich Vice President 3.0 0.0 X X 0 0 0 Mike Follett Director 3.0 40.0 X 0 178438 8089 Dr Deborah Agnew Physician/Director 3.0 40.0 X 0 255263 39294 Tim Russell CEO 40.0 0.0 X 0 122885 27603 Kyle Gee CFO 40.0 10.0 X 0 291232 66628 Dr David Kane Physician 40.0 0.0 X 0 230038 44790 Lorraine Ackerman Nurse Practitioner 40.0 0.0 X 0 119679 22948 0 1601468 277466 0 false true false BILLINGS CLINIC 2800 Tenth Avenue North BILLINGS MT 59101 management services 2497200 WILDERNESS MEDICAL STAFFING PO BOX 616 HOMER AK 99603 MEDICAL STAFFING 126227 2 181148 239027 420175 PATIENT SERVICE REVENUE 621300 9042141 9042141 MEALS 900099 7658 7658 9049799 43527 43527 0 0 0 0 0 0 0 0 0 MISCELLANEOUS INCOME 900099 47272 47272 47272 9560773 9089413 51185 5385 5385 0 0 0 464503 416874 47629 0 0 1877616 1518381 359235 22779 18238 4541 179418 144076 35342 147148 109902 37246 1779368 1442845 336523 0 0 0 0 0 679603 520578 159025 25290 1492 23798 214790 144858 69932 0 0 228568 146751 81817 64332 16325 48007 0 0 836098 644297 191801 0 962080 749852 212228 103264 83507 19757 PROVISION FOR BAD DEBT 676659 676659 MEDICAL SUPPLIES 357358 357358 DIETARY 39232 39232 REPAIRS & MAINTENANCE 32286 3175 29111 98019 23851 74168 8793796 7063636 1730160 0 X 227391 1768459 566037 821380 0 0 1945027 1259998 0 0 0 0 0 0 152657 166162 153331 158943 16098630 3207658 13726851 12890972 502932 466691 0 0 0 0 0 0 20642 37873 17294868 17570478 309576 312024 0 0 0 0 0 0 0 0 0 0 14031865 13654273 0 0 494752 408132 14836193 14374429 X 2433686 2977018 4989 199031 20000 20000 2458675 3196049 17294868 17570478 766977 -29603 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 33990 194042 87 228119 33903 87 33990 33802 101 33903 0 34397 595 33802 0.03980 0.08770 0.87250 false false 558194 558194 12088220 1617771 10470449 2449482 1332746 1116736 1002734 257141 745593 12890972 0 DUE TO RELATED ORGANIZATION 208132 DUE TO MEDICARE 200000 408132 8885960 -29603 31449 1846 8884114 676659 676659 9560773 8134368 17231 17231 8117137 676659 676659 8793796 Schedule D, Part V, line 4 DESCRIBE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS: The endowment includes both donor-restricted endowment funds and funds designated by the governing body to function as endowments (board-designated endowment funds). As required by accounting principles generally accepted in the United States of America GAAP), net assets associated with endowment funds, including board-designated 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 4B REVENUE ON RETURN, NOT ON BOOKS PROVISION FOR BAD DEBT NET WITH REVENUE ON FINANCIALS, TREATED AS EXPENSE ON RETURN 676,659 SCHEDULE D, PART XII, LINE 4B EXPENSE ON RETURN, NOT ON BOOKS PROVISION FOR BAD DEBT NET WITH REVENUE ON FINANCIALS, TREATED AS EXPENSE ON RETURN 676,659 SCHEDULE D, PART XI, LINE 2D REVENUE ON BOOKS, NOT ON RETURN: ACTIVITY OF STILLWATER FOUNDATION CONSOLIDATED IN FINANCIALS, EXCLUDED FOR TAX RETURN 31,449 SCHEDULE D, PART XI, LINE 2D EXPENSE ON BOOKS, NOT ON RETURN: ACTIVITY OF STILLWATER FOUNDATION CONSOLIDATED IN FINANCIALS, EXCLUDED FOR TAX RETURN 17,231 true true X true X true X true true true false true true 88578 0 88578 0.01090 335260 315804 19456 0.00240 423838 315804 108034 0.01330 78594 31298 47296 0.00580 3974 3881 93 14985 0 14985 0.00180 97553 35179 62374 0.00760 521391 350983 170408 0.02090 true 676659 2668139 2597167 70972 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 12 true false false true X www.stillwaterbillingsclinic.com X true 12 true WWW.STILLWATERBILLINGSCLINIC.COM false false true X 100 300. X X X X X true true X X X X true X see part v section c for full url X X X X true X false X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 DESCRIBE HOW THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY: SURVEYS AND COMMUNITY MEETINGS WERE HELD, INCLUDING CORRESPONDENCE WITH PUBLIC HEALTH NURSE, SCHOOL NURSES, AND AMBULANCE CREW MEMBERS. Individuals from the following groups represented the community: Columbus EMS, Faith Community, Columbus Fire Department, Stillwater Chamber of Commerce, Stillwater County Mental Health Center, Stillwater/Sweet Grass Co-op, Stillwater Billings Clinic Community Health; Stillwater Co. Public Health Nurse, & Stillwater Billings Clinic Administration. THE MONTANA STATE UNIVERSITY OFFICE OF RURAL HEALTH EDUCATION CENTER ACCESSED AND ANALYZED THE DATA. SCHEDULE H, PART V, SECTION B, LINE 11 Stillwater Hospital Association continues to follow the Implementation Plan established in the 2013 Community Health Needs Assessment, in the following areas: 1. Ensuring access to Primary Care, but continued recruiting efforts for another Primary Care Physician and/or a Mid-level. The Hospital was successful in recently recruiting a full-time Physician Assistant with interests in Diabetes management and Preventive Care. 2. Working with Billings Clinic regarding increased scope and services for Specialty clinics, notably in General Surgery and Endoscopy. 3. Continued Healthier lifestyle awareness and education in the community, including event sponsorships and educational opportunities. 4. Working with Providers and the community on various topics including Diabetes management, education and training. Also, the hospital has a permanent Registered Dietitian who provides nutritional classes and education regularly. Needs not addressed in most recently conducted CHNA: The following needs were identified in the CHNA and were not able to be addressed due to lack of resources or budgetary limitations: Recruit a primary care provider to ensure access to primary care in the Stillwater County and the surrounding areas. Interviews are ongoing and previously interviewed candidates have declined this position. Create a communication/marketing strategy for targeted populations in the hospital's service area. This need has not been addressed as the marketing and social work position is still vacant. Explore sponsoring a "lunch and learn" program for community members on various health costs and insurance topics. The lunch and learn programs are still in the development phase. SCHEDULE H, PART V, SECTION B, LINE 16b website URL for FAP application form: http://stillwaterbillingsclinic.com/wp-content/uploads/Charity-care.pdf 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 $676,659. SCHEDULE H, PART I, LINE 7 THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A, 7B AND 7G. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. THE INFORMATION FOR LINES 7E AND 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 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 4 See page 11 of the attached audited financial statements for the footnote that describes bad debt expense. 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 true false false false false false Dr Richard Klee Physician/Director 0 214930 0 1972 0 36764 0 21944 0 14433 0 290043 0 0 Luke Kobold Director 0 140367 0 9900 0 0 0 13040 0 18697 0 182004 0 Mike Follett Director 0 154082 0 24356 0 0 0 5254 0 2835 0 186527 0 0 Tim Russell CEO 0 115685 0 7200 0 0 0 8819 0 18784 0 150488 0 0 Kyle Gee CFO 0 223417 0 42985 0 24830 0 48713 0 17915 0 357860 0 0 Dr David Kane Physician 0 187414 0 0 0 42624 0 20355 0 24435 0 274828 0 0 Dr Deborah Agnew Physician/Director 0 255263 0 0 0 0 0 20231 0 19063 0 294557 0 0 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. SCHEDULE J, PART I, LINE 4B 457(F) PLAN: The Billings Clinic supplemental retirement agreement for senior executives (SERP) is a non-elective 457(f) agreement and provides for annual deferrals, which become vested and payable after 4 years. Vesting will occur on January 1, 2017. Kyle Gee participated in the plan and a payment of $30,000 was made and is included in deferred compensation on Schedule J, Part II, column C. 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 or 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 CAH 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 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 BILLINGS false STILLWATER COMMUNITY HEALTHCARE FDN 710 N 11TH ST COLUMBUS MT 59019 200748325 fundraising MT 501(c)(3) line 7 billings false New West Health Services 130 Neill Avenue Helena MT 59601 841418136 Insurance Sales MT Billings Clinic C-Corporation Billings Clinic Express Care LLC 2800 10th Avenue north Bilings MT 59101 463355499 Outpatient Clinic MT Billings Clinic C-Corporation false true false true true false false false false false false false true true true true false false false