2015-05-15T16:10:37-05:00 2014-06-30 BKD LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2013-07-01 810231784 Billings Clinic % CONNIE F PREWITT BILL 4062382500 2800 Tenth Avenue North Suite Billings MT 59101 Connie Prewitt CFO 4062382500 2015-05-15 true Rita F Worster CPA P00290681 4062382500 2013 2016-03-07 17:11:31Z Nicholas Wolter MD 2800 Tenth Avenue North Billings MT 59101 1299990646 false X www.billingsclinic.com X 1907 MT Billings Clinic will be a national leader in providing the best clinical quality, patient safety, service and value. 12 7 4225 325 8577231 691062 6635189 2223188 543532933 564854800 6855638 15284806 3171645 11240694 560195405 593603488 0 759754 0 0 299067297 302242677 0 0 338073 246649815 251656215 545717112 554658646 14478293 38944842 623814849 664984296 266575283 262301525 357239566 402682771 X Billings Clinic is a not-for-profit, physician-led, multispecialty medical group practice integrated with a hospital and long term care facility, serving the communities of Montana, northern Wyoming and the western Dakotas. Our mission is health care, education and research. false false 195837676 320481062 Hospital patient care inpatient days 70,594 208663644 224630592 Clinic patient care encounters 906,062 8451724 7911010 Nursing home patient care skilled and assisted days 39,511 9527894 759754 22585905 Research, Regional & Other 9527894 759754 22585905 422480938 true true false true false false false false false true true false false true true false true true false false false false false false false false true true true true true true false false false false false false false true false false true false false false true true true true false true 167 0 true 4225 true true true false false false false false false false false false X 12 7 true false false false false false false true true false false true true true true true true true true true true MT X CONNIE F PREWITT 4062382134 2800 TENTH AVENUE NORTH Billings MT 59101 Lil Anderson Board Member 3.0 X 6000 Darrell Ehrlick Board Member 3.0 X 6000 Elizabeth Fulton Secretary 5.0 X X 6000 David Brown Vice Chair 5.0 X X 6000 Robert N Hurd MD Board Member, Physician 73.0 3.0 X 402041 36653 Clayton H McCracken MD Board Member, Physician 73.0 X 365937 46577 J Scott Millikan MD Chair, Physician 78.0 X X 624362 51064 Penni Nance Board Member 30.0 X 6000 Joy Ott Treasurer 5.0 1.0 X X 6000 Aaron Sparboe Board Member 3.0 1.0 X 6000 Maria Valandra Board Member 3.0 X 6000 Nicholas Wolter MD CEO 73.0 3.0 X X 1121335 0 36243 Connie F Prewitt CFO 70.0 1.0 X 527218 106901 Randall K Gibb MD Physician 70.0 X 1057594 44730 Scott A Sample MD Physician 70.0 X 1023533 46724 Roger G Santala MD Physician 70.0 X 824839 41613 Micheal A Morone MD Physician 70.0 X 792603 48399 Jared J Lund MD Physician 70.0 X 791347 52257 Lyle Knight former board member 0.0 X 13441 0 7544250 0 559161 332 true true false SODEXO INC BOX 37000 BILLINGS MT 59107 FOOD SERVICE 5748661 HEALTHCARE OUTSOURCING NETWORK 621 17TH STREET STE 1800 DENVER CO 80293 EARLY OUT VENDOR 2496864 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BILLINGS CLINC 2736443 EXPRESSCARE -455720 ACCRUED INTEREST 561194 49677468 0 DUE TO MDOR 375279 DEPOSITS 15800 INTEREST RATE SWAP AGREEMENT 23417939 ESTIMATED CLAIMS LIABILITY 7441641 ACCRUED BOND INTEREST & INTEREST SWAPS 991694 PROVISION FOR UNPAID CLAIMS 12251064 44493417 564456238 15525334 865368 16390702 548065536 1005611 44532341 45537952 593603488 519013033 519013033 1005611 34640002 35645613 554658646 DESCRIBE THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 The Clinics endowment is held by the BILLINGS CLINIC Foundation. The endowment consists of approximately 70 individual funds established for a variety of purposes. The endowment includes both donor restricted endowment funds and funds designated by the governing body to function as endowments (board-designated endowment funds). Endowment funds are invested and held in perpetuity to provide a source of income for Billings Clinic programs and needs. UNCERTAIN TAX POSITIONS SCHEDULE D, PART X, LNE 2 The Clinic has been recognized as exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code and a similar provision of state law. Accordingly, no provision for income taxes for these entities has been made in the accompanying financial statements. However, the Clinic is subject to federal and state income tax on any unrelated business taxable income. The Clinic files tax returns in the U.S. federal jurisdiction. With a few exceptions, the Clinic is no longer subject to U.S. federal examinations by tax authorities for years before 2011. REVENUE ON BOOKS, NOT ON RETURN SCHEDULE D, PART XI, LINE 2D CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 865,368 REVENUE ON RETURN, NOT ON BOOKS SCHEDULE D, PART XI, LINE 4B CHANGE IN INTEREST OF AFFILIATES 9,586,487 BAD DEBT EXPENSE RECLASSED TO EXPENSE 34,640,002 INTEREST IMPUTED ON INTERCOMPANY RECEIVABLES 305,852 TOTAL 44,532,341 EXPENSE ON RETURN, NOT ON BOOKS SCHEDULE D, PART XII, LINE 4B BAD DEBT EXPENSE RECLASSED TO EXPENSE 34,640,002 true true X true X 120. true X true true true false true true 14490315 14490315 0.02780 47319732 43939406 3380326 0.00650 61810047 43939406 17870641 0.03430 3160042 561217 2598825 0.00500 5421072 1523758 3897314 0.00750 49537533 38301313 11236220 0.02160 1137013 315814 821199 0.00160 560932 325 560607 0.00110 59816592 40702427 19114165 0.03680 121626639 84641833 36984806 0.07110 140 21211 21211 60 27657 27657 0.00010 500 48407 25979 22428 700 97275 25979 71296 0.00010 false 34640002 0 166499307 183433038 -16933731 X true true 1 1 Billings Clinic 2800 Tenth Avenue North Billings MT 59101 www.billingsclinic.com 13345 X X X X X Billings Clinic true X X X X X X X X X 13 true true true X www.billingsclinic.com X www.healthybydesignyellowstone.org X X X X X X X X false false true true 120. true 300. true X X X X X X X X true true X X X X X X true false X X X X true X false false SCHEDULE H, PART V, LINE 3 Describe how the hospital took into account input from persons who represent the community: Key Informant Focus Groups were held in the community, including five different groups with 8-12 participants in each. The groups represented local social services providers, legislators, physicians and other health professionals, employers, educators and low-income groups. Employers, Educators & public service were represented by the following organizations: Laurel Public schools, chamber of commerce, rocky mountain college, billings gazette, CTA architects engineers, MET transit & City County planning department & the Billings Police Department. Social Service providers were represented by: Center for children and families, family services, United Way of Yellowstone county, parents let's unite for kids, HRDC, Rimrock foundation, Easter seals Montana, and La Vie. Physicians and other Health professionals were represented by: Yellowstone naturopathic clinic, St. Vincent Healthcare, Billings Clinic, Rocky Mountain Health Network, Montana-Wyoming Tribal Leaders Council, Advanced Care Hospital, Riverstone Health, Mental Health Center, and Community Crisis Center. Legislators and Elected Officials were represented by: City Council Member, State Legislative Representative, Mayor, and City Administrator. The Billings Southside Community group was represented by 24 individual members of the community. The survey itself included a random sample of 400 individuals 18 and older living in Yellowstone County. SCHEDULE H, PART V, LINE 4 Other hospitals included with the CHNA: The entire CHNA was conducted by Professional Research Consultants (PRC). Billings Clinic's Community Health Needs Assessment was conducted in a pre-existing community health partnership called "The Alliance" with St. Vincent Healthcare (hospital organization) and RiverStone Health (public health department for city and county). The Alliance had conducted a CHNA in 2006 & 2011 as well. SCHEDULE H, PART V, LINE 7 Needs not addressed in the most recently conducted CHNA: Billings Clinic has started to address the needs that we have the assets and resources to address. The objective of Billings Clinic's community benefit plan for the next several years is to align, enhance and/or develop programs based on a set of criteria established by our Community Health Improvement Committee, including: * Billings Clinic's mission, vision and values, * Billings Clinic's strategic operating plan, * Data obtained through the 2005, 2011 and 2014 Community Health Needs Assessments, * The Alliance Plan to Improve the Community's Health, * IRS 990 Schedule H requirements, and * The Institute for Healthcare Improvement's Triple Aim (Improve the health of the population; enhance the patient experience of care (including quality, access and reliability); and reduce, or at least control, the per capita cost of care.) We will, as appropriate and possible, design methods to measure program effectiveness in the short and longer terms and at the organizational and population levels. If any community health needs do not meet the above criteria, we will not be able to address that particular need in the next few years. At this time, Billings Clinic does not have the resources necessary to address all needs, including: * lack of transportation (only available during weekdays on a limited basis); * Access to dental care (we don't have dental services) * Availability of substance abuse treatment (limited). In some areas we don't offer any services but do advocate on policy, such as: * Seat belt usage * Firearm safety, * Lack of healthcare coverage (Medicaid expansion efforts) 16 Billings Clinic (Billings Clinic) 2800 Tenth Avenue North Billings MT 59101 Multispeciality Physician Outpatient Clinics Billings Clinic (Aspen Meadows) 3155 Avenue C Billings MT 59102 Long Term Care Facility Livingston Imaging 504 S 13th St Livingston MT 59047 Medical Imaging Billings Clinic Sheridan Dialysis 1401 West 5th St Sheridan WY 82801 Dialysis Unit Beartooth Billings Clinic 2525 North Broadway Red Lodge MT 59068 Primary Care Behavioral Health Center 1020 North 27th Street 4th Floor Billings MT 59101 Mental Health Billings Clinic Anticoagulation Clinic 1020 North 27th Street 1st Floor Billings MT 59101 Anticoagulation Clinic Billings Clinic Cancer Center 801 North 29th Street Billings MT 59101 Cancer Care, Gynecologic Care Billings Clinic Cody 201 Yellowstone Avenue Cody WY 82414 Anticoagulation, Cancer, Pediatrics Billings Clinic Heights 760 Wicks Lane Billings MT 59105 primary care Billings Clinic Miles City 620 South Haynes Avenue Miles City MT 59301 primary care, pediatrics Billings Clinic North 30th Building 1045 N 30th St Billings MT 59101 Diabetes, Endocrinology Billings Clinic Surgery Center 2929 Tenth Ave North Billings MT 59101 general surgery, urology Billings Clinic West 2675 Central Avenue Billings MT 59102 Obstetrics & Gynecology Billings Sports Plex 5000 Southgate Dr Billings MT 59101 Sports medicine Bozeman OBGYN 925 Highland Blvd Bozeman MT 59715 Obstetrics & Gynecology 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 $34,640,002. 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. Line 7g, subsidized health services includes various physican clinics in order to better serve the Montana areas. Total costs for the physician clinics were $24,162,214. SCHEDULE H, PART III, LINE 2 Explain the organization's methodology to estimate the amount reported for bad debt expense: The Organization analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. SCHEDULE H, PART III, LINE 4 See page 11 of the attached audited financial statements for the footnote that describes bad debt expense. SCHEDULE H, PART III, LINE 8 We believe that 46 percent of Billings Clinic's Medicare shortfalls should be counted as a community benefit. Our rationale is that 46 percent is the best estimate of the percentage of Montana's Medicare population (65 and older) who are at or below 300% of Federal Poverty Level, based on U.S. Census data. The upper limit of our financial assistance policy is 300%. For the calculation of the unreimbursed cost of Medicare a ratio of patient care cost to charges using worksheet 2 was utilized and applied to gross Medicare charges. We do not use the Cost Report for this number. The Cost Report only captures revenue related to the facility and does not capture revenue/losses related to clinical professional services, which are a substantial portion of Billings Clinic Medicare shortfalls. SCHEDULE H, PART III, LINE 9b Billings Clinic had a formal, written policy in tax year 2013, effective as of 10/5/11 (OHA-205 "Patient Financial Services"). We did have a collection process, which was used to screen patients for financial assistance prior to making payment arrangements for care. The policy applies equally to all patients - insured, under-insured or uninsured. Once a determination has been made and adjustments applied to the account balance, any remaining balance would fall into the regular guidelines of collection, giving patients financing options that will work within their monthly budget. Patients who cannot meet the requirements of a payment arrangement should be offered the loan program and/or financial assistance as options. If the patient agrees to financial assistance, the application should be requested. Agency will print and mail financial assistance applications and this will be completed by the end of each business day. After a patient completes the application, the patient will send it back to Billings Clinic for financial assistance determination. NEEDS ASSESSMENT The 2014 Community Health Needs Assessment (CHNA) was a systematic, data driven approach to determining the health status, behaviors and needs of residents in Yellowstone County. Billings Clinic partnered with the local health care Alliance, including another local hospital, St. Vincent Healthcare, and city/county health department, RiverStone Health, to coordinate and pay for the CHNA. It serves as a tool to improve the health status and improve the quality of life overall of Yellowstone County residents. In the winter of 2013-2014, the Yellowstone County Community Health Survey consisted of 400 randomized telephone (landline & mobile) contacts representing the diverse socioeconomic and geographic characteristics of Yellowstone County. Existing vital statistics and other health-related data are incorporated into the assessment as secondary sources. In addition, focus groups were conducted among physicians, legislators, social services, educators, employers and low-income groups. Results of the 2014 Community Health Assessment were reviewed by the Alliance, a community forum sponsored by the Alliance's community health coalition (called Healthy By Design), and the Billings Clinic Community Health Improvement Committee (a Board committee). Findings were compared between 2014, 2011 and 2006 assessment results. An Implementation Plan has been completed, both for the Alliance (community-wide) and for Billings Clinic (organization-wide). Implementation of many of the objectives has begun, with community workgroups, using measures and evaluation. The URL for the CHNA is located at http://www.billingsclinic.com/about-us/giving-back-to-the-community PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE * All patients may apply for financial assistance - informational brochures with a one-page summary, and application forms are available at registration desks in the clinic and hospital, the Emergency Department discharge desk, care management staff and on our website at billingsclinic.com. * Information about financial assistance is printed on the back of patient bills. * Patients hospitalized without identifying a third party payer source are screened for coverage/assistance - SSI (Social Security Supplemental income, if approved will qualify for Medicaid), SSDI (Social Security Disability Income), Veterans' Administration, Indian Health Services, Workers Compensation, Medicaid, Crime Victims, and health insurance coverage. * A Financial Assistance brochure is mailed to new patients (Clinic and Hospital) in their pre-admission packets. These packets are mailed to all patients, even if they cannot be reached by phone in advance. * An application is mailed to patients whose payment pattern indicates that they may need assistance. * Patient Financials Services staff is available to help any patient needing assistance to complete an application. * According to our existing Financial Application policy, a patient is not eligible for financial assistance if the account has been sent to bad debt. We do bring accounts back in-house for charity assistance on a case-by-case basis. * An account is sent to bad debt at least 158 days after they are considered "self-pay," including at least three statements, letter and phone call attempts to contact the patient. COMMUNITY INFORMATION Billings Clinic is based in Billings, Montana, the largest city in Montana, with more than 150,000 people in Yellowstone County. In Billings, there are two not-for-profit hospitals of similar size. Billings Clinic is an integrated, not for profit, community-governed health care organization providing services to a forty-three county area in eastern Montana and northern Wyoming. Billings Clinic defines its broad geographic service area as 43 counties in eastern Montana and northern Wyoming, encompassing nearly 128,000 square miles with a population of 595,000 people. Today, Billings Clinic employs more than 4,225 employees, including 259 physicians, and 90 mid-level practitioners, and operates a multi-specialty physician clinic; 285-bed acute care hospital; level II trauma center; a 90-bed long-term care facility; a clinical research center; and a variety of ambulatory, diagnostic and treatment services. Thirty-eight of those 43 counties are either wholly or partly designated as Health Professional Shortage Areas (HPSA) by the US Department of Health and Human Services, Health Resources and Services Administration under the Primary Medical Care discipline. The area includes five American Indian Reservations and an American Indian population of 38,882, or 6.9% of the service area's population. The US Census Bureau 2008 estimates show that 27.3% of Montana families are below 200% of the Federal Poverty level, compared to 26.6% for the nation and Montana is ranked 13th lowest of 50 states in Median Family Income. According to the 2010 US Census, Montana had 17.3% of the population without health insurance coverage in 2010, including all ages of the civilian, non-institutionalized population. Promotion of community health Billings Clinic is an integrated health care organization, combining a not-for-profit multi-specialty medical group practice with a hospital and long term care facility. Our organization promoted community health in many ways in Fiscal Year 2014, including: * Substantial financial assistance and charity care was provided to patients in need. Billings Clinic provides more charity care than another other hospital or health care organization in Montana. * Care was provided to Medicare and Medicaid patients, as well as SCHIP for children. * Our Board's governance and nominating committee reviewed the entire 990, including Schedule H, which was then discussed with the entire Board of Directors. The Community Benefit Report, including Schedule H data, is also reviewed by the Board committee for Community Health Improvement. * Billings Clinic is a teaching hospital and supports, along with Riverstone Health and St. Vincent Healthcare, the only post-graduate medical education in Montana - the Montana Family Medicine Residency Program. Nearly 90 percent of the graduates establish a practice in rural, medically underserved settings in Montana. In addition we provide ongoing preceptorships for medical, nursing and pharmacy students so that they can obtain real-life experience during college and graduate school. In 2013, we also created and were approved for a new Internal Medicine Residency program. Residents started the program in July of 2014. * Billings Clinic is a Medicaid disproportionate share hospital serving a significantly disproportionate number of low-income patients. * Our full-time emergency department is maintained where no one is denied care, within our capacity to provide care. * Our board of directors is composed of community members who reside in the primary service area. Only three out of 12 board members are employees - two are employed physicians and one is our CEO. * Medical staff privileges are open to all qualified physicians in our community. Operating surpluses are directed solely toward meeting our charitable purposes, including education, research, capital expenses, debt amortization, patient care improvements and medical education. * Billings Clinic has the only inpatient psychiatric services for youth and adults available in our region of central and eastern Montana and northern Wyoming, despite significant financial loss. We are committed to mental health care and continually work to find ways to reach those in need in the region, such as through telemedicine programs and education for primary care providers. State filing of community benefit report Billings Clinic files a community benefit report to the state of Montana's Attorney General's office, with different values than requested by Schedule H. true BILLINGS CLINIC FOUNDATION 2917 Tenth Avenue North Billings MT 59101 810407289 501(C)(3) 257739 support operations MONTANA HEALTH NETWORK 11 SOUTH 7TH STREET MILES CITY MT 59301 816073209 501(C)(3) 23600 RURAL HEALTH DEVELOPMENT YELLOWSTONE CITY-COUNTY HLTH DBA RIVERSTONE HEALTH 123 SOUTH 27TH STREET BILLINGS MT 59101 810513538 GOVT 20000 SUPPORT OPERATIONS Community Crisis Center 704 N 30TH ST BILLINGS MT 59101 203231164 501(c)(3) 74425 SUPPORT OPERATIONS RIVERSTONE HEALTH FOUNDATION PO BOX 1562 BILLINGS MT 59103 352332179 501(c)(3) 30000 SUPPORT OPERATIONS RONALD MCDONALD HOUSE CHARITIES OF MONTANA 1144 NORTH 30TH STREET BILLINGS MT 59101 810400667 501(C)(3) 12500 SUPPORT OPERATIONS YES Kids 3814 PARKHILL DR BILLINGS MT 59102 10000 SUPPORT OPERATIONS FAMILY MED RESIDENCY OF W MT 401 WEST RAILROAD MISSOULA MT 59802 816001713 501(c)(6) 211988 SUPPORT OPERATIONS MACK PRODUCTIONS 3333 2ND AVENUE N 170 BILLINGS MT 59101 14799 SPONSORSHIP BIG SKY STATE GAMES PO BOX 7139 BILLINGS MT 59103 810431595 501(C)(3) 6000 SPONSORSHIP 7 3 scholarships 51 12422 ORGANIZATION'S PROCEDURES FOR MONITORING USE OF GRANT FUNDS IN THE U.S. SCHEDULE I, PART I, LINE 2 The organization awards scholarships to individuals who exhibit a strong desire and potential to excel in the health care field. Students must complete an application form which includes their most recent official high school transcript or G.E.D. and current college transcript. The application must include three individual references on using the organization's recommendation questionnaire. The organization also provides grants to other health related organizations. X X true true X X X X X X false true false false false false false true false Robert N Hurd MD Board Member, Physician 398770 0 3271 21726 14927 438694 0 Clayton H McCracken MD Board Member, Physician 365638 0 299 26617 19960 412514 0 J Scott Millikan MD Chair, Physician 623852 0 510 31525 19539 675426 0 Nicholas Wolter MD CEO 940678 0 175998 0 4659 0 22525 0 13718 0 1157578 0 0 0 Connie F Prewitt CFO 439214 87574 430 82225 24676 634119 0 Lyle Knight former board member 13441 0 0 0 0 13441 12000 Randall K Gibb MD Physician 1052987 0 4607 22525 22205 1102324 0 Scott A Sample MD Physician 1018954 0 4579 22525 24199 1070257 0 Roger G Santala MD Physician 824166 0 673 25525 19088 869452 0 Micheal A Morone MD Physician 791956 0 647 21013 27386 841002 0 Jared J Lund MD Physician 790701 0 646 22525 29732 843604 0 INFORMATION REGARDING BENEFITS PROVIDED SCHEDULE J, PART I, LINE 1A Billings Clinic periodically arranges and pays for charter travel for management and/or Board members attending governance education, State legislative hearings and association meetings. Billings Clinic also pays for the travel expense of spouses of Board members attending organizationally approved/arranged governance education. This reimbursement is reported as income consistent with the Board travel reimbursement policy. there was no taxable travel utilized in FY14. NON-QUALIFIED BENEFIT PLANS SCHEDULE J, PART I, LINE 4B The Billings Clinic Board Deferred Compensation Plan provides that all amounts earned are deferred until age 65 when payments are made over 5 years. Interest is accrued and credited each quarter and account balances are always 100% vested. During the year, former board member Lyle Knight received payment on previously reported deferrals in the amount of $13,441. 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. The following individuals are participants in the plan and received a deferral during the 2013 calendar year which is included in deferred compensation on Schedule J, Part II, column C. Connie F. Prewitt - $59,700 NON-FIXED PAYMENTS The Board of Directors annually determines the incentive plan amount for the CEO and the Senior Executive Team based on an external compensation study. The availability of the incentive is triggered by the organizational operating margin performance targets. The incentive is awarded based on financial performance as well as organizational performance measurements in quality, service satisfaction, both patient and employee satisfaction and then individual goals set each year if the target is triggered. The incentive is paid only if triggered following the financial audit presentation. A MONTANA FACILITY FINANCE AUTHORITY 364615155 612043FL8 2008-05-30 60000000 capital projects true false false B MONTANA FACILITY FINANCE AUTHORITY 364615155 61204MAA5 2011-08-24 140000000 capital projects, refund 2008 bond false false false A 31315000 0 60000000 5535735 0 0 1200000 0 0 49976092 0 0 2009 false false true true B 6785000 0 140124100 0 0 0 858750 0 0 42097226 84553156 12614968 false true false true A false false false false 0.00000 0.00000 0.00000 false false 0.00000 false true B false false false false 0.00000 0.00000 0.00000 false false 0.00000 false true A false false false true false false 0 false 0 false true B false true false false true false 0 false 0 false true A true B true schedule k, part iv, line 2c the 2008 bond issue rebate calculation was completed on 02/25/13. AARON SPARBOE SEE PART v 811693 RENT false NEW WEST HEALTH SERVICES SEE PART V 13931015 CLAIMS PAID false RELATIONSHIP BETWEEN INTERESTED PERSON & THE ORGANIZATION PART IV, LINE 1 COLUMN B AARON SPARBOE, BOARD MEMBER OF BILLINGS CLINIC, RENTS TWO CLINICS TO THE ORGANIZATION. PART IV, LINE 2 COLUMN B NICHOLAS WOLTER, CONNIE PREWITT, AND JOY OTT ARE OFFICERS OR DIRECTORS OF BOTH BILLINGS CLINIC AND OF NEW WEST HEALTH SERVICES, A WHOLLY-OWNED SUBSIDIARY OF BILLINGS CLINIC. DURING THE YEAR, NEW WEST HEALTH SERVICES PAID CLAIMS FOR BILLINGS CLINIC IN THE AMOUNT OF $13,931,015. THIS TRANSACTION IS ALSO DISCLOSED ON SCHEDULE R, PART V, LINE 2, CODE M. X 1 250000 fair market value X other miscellaneous 3 29307 fair market value false false false NONCASH CONTRIBUTIONS SCHEDULE M, PART I, COLUMN B THE NUMBER IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED Buisiness & Family Relationships FORM 990, Part VI, LINE 2 NICHOLAS WOLTER, CONNIE PREWITT, AND JOY OTT have a business relationship because they are directors or officers of the WHOLLY-owned subsidiary disclosed on Schedule R, Part IV. DESCRIBE THE PROCESS TO REVIEW THE FORM 990 FORM 990, PART VI, LINE 11B The 990 review is completed before the return is filed. It is reviewed by the CFO, the executive group, the governance and nominating committee of the board and finally the board of directors. DESCRIBE HOW CONFLICT OF INTEREST POLICY IS MONITORED & ENFORCED FORM 990, PART VI, LINE 12C The Governance and Nominating Committee of the Board of Directors, according to their charter, review annually the disclosure statements of the Board of Directors and senior executives and take action to resolve conflicts. A Conflict of Interest Review Panel, chaired by the Compliance Officer, as outlined in organizational policy, is responsible for reviewing disclosed conflicts and approving necessary conflict management plans of all other interested persons at Billings Clinic. DESCRIBE PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, LINE 15A & 15B Billings Clinic has as executive compensation program administered by independent trustees following best practices and the highest regulatory standards expected of a not-for-profit organization. They follow a board approved charter and overall executive compensation philosophy which defines the market as a comparable set of not-for-profit health care delivery systems. They look at relevant market data of similar roles in similar organizations. Annual disclosure of the committee's actions and decisions to the full Board is required. DESCRIBE HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC FORM 990, PART VI, LINE 19 Billings Clinic makes it governing documents, conflict of interest policy and financial statements available to the public on an as needed basis. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 865,368 CHANGE IN INTEREST OF AFFILIATES (9,586,487) INTEREST IMPUTED ON INTERCOMPANY RECEIVABLES 305,852 TOTAL (9,026,971) PRIOR YEAR BALANCE SHEET PART X, COLUMN A DURING 06/30/14, THE ORGANIZATION MADE RECLASSIFICATIONS TO THE 06/30/13 CONSOLIDATED FINANCIAL STATEMENTS TO CONFORM TO THE 06/30/14 FINANCIAL STATEMENT PRESENTATION. THESE RECLASSIFICATIONS DID NOT HAVE A NET EFFECT ON THE CONSOLIDATED FINANCIALS, HOWEVER FOR 990 PURPOSES, THE RECLASSIFICATION RESULTED IN A CHANGE TO THE 06/30/13 NET ASSETS. 06/30/13 PRIOR YEAR NET ASSETS - 354,302,789 06/30/13 RESTATED PRIOR YEAR NET ASSETS - 357,239,566 INCREASE IN NET ASSETS - 2,936,777* * THE INCREASE IN NET ASSETS IS ATTRIBUTABLE TO THE PRESENTATION OF HOW BILLINGS CLINIC SHOWS THEIR INVESTMENT IN AN AFFILIATE. THE AFFILIATE IS ELIMINATED ON THE CONSOLIDATED FINANCIALS BUT IS TREATED AS A SEPERATE ENTITY FOR TAX PURPOSES AND IS NOT ELIMINATED ON THE BILLINGS CLINIC 990. Montana Healthcare Indemnity LLC 2800 Tenth Avenue North Billings MT 59101 810231784 Ins. Captive MT 990342 13266236 Billings Billings Clinic Foundation 2917 Tenth Avenue North Billings MT 59101 810407289 fundraising MT 501(c)(3) line 7 billings true Stillwater Hospital Association 710 N 11th St Columbus MT 59019 810286525 hospital MT 501(c)(3) line 3 billings true STILLWATER COMMUNITY HEALTHCARE FDN 710 11TH ST COLUMBUS MT 59019 200748325 fundraising MT 501(c)(3) line 7 billings true New West Health Services 130 Neill Avenue Helena MT 59601 841418136 Insurance sales MT Billings Clinic C-Corporation 157806229 29175582 1.00000 true Billings Clinic Express Care LLC 2800 10th Avenue north Bilings MT 59101 463355499 Outpatient Clinic MT Billings Clinic C-Corporation 168416 510601 1.00000 true true true true true false false false false false false false true true true true false true false false NEW WEST HEALTH SERVICES A 644530 interco amount BILLINGS CLINIC FOUNDATION B 580305 interco amount BILLINGS CLINIC FOUNDATION B 257739 interco amount BILLINGS CLINIC FOUNDATION C 2223188 interco amount NEW WEST HEALTH SERVICES D & Q 33782799 interco amount BILLINGS CLINIC FOUNDATION D 72447 interco amount STILLWATER HOSPITAL ASSOCIATION D 494752 interco amount BILLINGS CLINIC EXPRESS CARE LLC D 956870 interco amount STILLWATER HOSPITAL ASSOCIATION L 559780 interco amount NEW WEST HEALTH SERVICES M 13931015 interco amount