2024-11-15T13:02:52+00:00 2023-12-31 440160260 Forvis Mazars LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2023-07-01 810231784 Billings Clinic BILL 4062382500 2800 Tenth Avenue North Billings MT 59101 KATHLEEN QUINONES CFO 2024-11-15 true true Adam R Smith P00958966 7194714290 2024-11-15 2023 2024-10-15 13:58:12Z CLINT SEGER MD 2800 Tenth Avenue North Billings MT 59101 983590332 false X WWW.BILLINGSCLINIC.COM X 1917 MT BILLINGS CLINIC IS MONTANA'S LARGEST HEALTHCARE ORGANIZATION CONSISTING OF A 336 BED HOSPITAL AND LEVEL 1 TRAUMA CENTER, PRIMARY CARE AND OVER 80 SPECIALTIES. 9 7 6074 86 13916593 5494840 11112553 1642869 971557398 508769420 81683280 17671483 27642818 12322725 1091996049 540406497 277725 128328 0 0 504893175 250032826 0 0 0 596454984 303035118 1101625884 553196272 -9629835 -12789775 1374741411 1396449787 488326129 496385928 886415282 900063859 BILLINGS CLINIC MISSION IS HEALTH CARE, EDUCATION AND RESEARCH. BILLINGS CLINIC WILL PROVIDE THE BEST IN NATION CLINICAL QUALITY, PATIENT SAFETY, SERVICE AND VALUE. false false 216481428 60151 283640168 BILLINGS CLINIC IS A 336 BED HOSPITAL PROVIDING SURGICAL, LABOR AND DELIVERY, PSYCHIATRIC, CANCER CARE, NEONATAL SERVICES AND ACUTE CARE. BILLINGS CLINIC HAD APPROXIMATELY 15,000 ADMISSIONS IN 2023. 198835157 55247 172385061 BILLINGS CLINIC HAS NEARLY 600 PHYSICIANS AND ADVANCED PRACTITIONERS OFFERING MORE THAN 80 SPECIALTIES. PRIMARY CARE IS AVAILABLE AT MULTIPLE LOCATIONS INCLUDING BILLINGS CLINIC DOWNTOWN, HEIGHTS, WEST END, CODY WY, MILES CITY AND A BOZEMAN LOCATION WITH ADDITIONAL SPECIALTIES. IN ADDITION, BILLINGS CLINIC CONDUCTS SPECIALTY CARE CLINICS FOR MORE THAN 20 REGIONAL LOCATIONS IN MONTANA, WYOMING AND NORTH DAKOTA. BILLINGS CLINIC HAD OVER 880,000 PATIENT VISITS IN 2023. 46536247 12930 51199364 BILLINGS CLINIC SPECIALTY PHARMACY FOCUSES ON THE PHARMACY CARE OF CHRONIC, RARE OR COMPLEX CONDITIONS THAT REQUIRE SPECIALTY MEDICATIONS. SPECIALTY MEDICATIONS TYPICALLY REQUIRE SPECIAL HANDLING, ADMINISTRATION OR MONITORING BEYOND THAT WHICH A TRADITIONAL RETAIL PHARMACY CAN PROVIDE. WE WORK TO ENSURE APPROPRIATE MEDICATION USE AND PROMOTE ADHERENCE. BILLINGS CLINIC SPECIALTY PHARMACY IS PART OF THE LARGEST HEALTH CARE SYSTEM IN THE REGION. OUR STAFF WORKS WITH YOU, YOUR PROVIDER AND YOUR INSURANCE COMPANY TO MAKE SURE YOUR NEEDS ARE MET. OUR GOAL IS TO MAKE BILLINGS CLINIC A ONE-STOP SOLUTION. 461852832 true true false true false false false false true true false false true true false false 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 false false false false true true true true false false true 234 0 true 6074 true true true false false false false false false false false false false false X 9 7 false false true false true false true true true false false true true true true true true true true true true X X KATHLEEN QUINONES 4064356445 2800 TENTH AVENUE NORTH BILLINGS MT 59101 KEITH COOK BOARD CHAIR 5.0 2.0 X X 7500 0 9000 WAYNE HIRSCH BOARD TREASURER 5.0 0 X X 0 0 6000 ALICE GORDON BOARD MEMBER 5.0 1.0 X 4500 0 6000 AMY CEBULL BOARD MEMBER 5.0 2.0 X 0 0 3015 CRAIG BARTHOLOMEW BOARD MEMBER 5.0 1.0 X 0 0 10995 EILEEN MCDONALD BOARD MEMBER 5.0 3.0 X 0 0 6447 HEIDI DUNCAN MD PHYSICIAN BOARD MEMBER 60.0 1.0 X 233914 0 61250 JOHN EDWARDS BOARD MEMBER 5.0 1.0 X 0 0 3015 KENDRICK TROSTEL MD PHYSICIAN BOARD MEMBER 5.0 0 X 666254 0 55471 CLINTON SEGER MD CEO 60.0 4.0 X 830292 0 132500 KATHLEEN QUINONES CFO 60.0 3.0 X 448591 0 102141 ANTHONY ROCCISANO DO PHYSICIAN 60.0 0 X 1612546 0 61354 CHRISTOPHER STEWART DO PHYSICIAN 60.0 0 X 1295248 0 48388 MARLIN RICHARDSON MD PHYSICIAN 60.0 0 X 1474845 0 59472 MICHAEL MORONE MD PHYSICIAN 60.0 0 X 1504067 0 56622 VANCE FREDRICKSON MD PHYSICIAN 60.0 0 X 2068644 0 36971 SCOTT ELLNER DO FORMER CEO 60.0 2.0 X 982800 0 1002 11129201 0 659643 1008 true true false HAYES LOCUMS LLC PO BOX 5068 NEW YORK NY 10087 CONTRACT PHYSICIANS 38669086 VAYA WORKFORCE SOUTIONS LLC PO BOX 9416 MINNEAPOLIS MN 55480 CONTRACT LABOR 33262059 BILLINGS ANESTHESIOLOGY PC 2800 10th Ave N BILLINGS MT 59101 ANESTHESIOLOGIST SERVICES 21468730 ORACLE AMERICA INC 2300 ORACLE WAY AUSTIN TX 78741 IT SERVICES 10554844 AVANT HEALTHCARE PROFESSION PO BOX 744554 ATLANTA GA 303744554 CONTRACT NURSING 5516945 52 1642869 1642869 PATIENT SERVICE REVENUE 621110 462376727 462376727 RETAIL PHARMACY 621110 38014858 38014858 REFERENCE LAB 621500 3523889 3523889 INCOME ON EQUITY INVESTEES 900099 4634114 4634114 CLINICAL TRIAL REVENUE 541900 219832 219832 0 0 0 0 508769420 8544290 8544290 108491 213952 -105461 0 -105461 -105461 452017007 442889814 9127193 0 9127193 9127193 258531 80069 178462 166237 12225 REGIONAL PAHRMACY SALES 621110 7987220 7987220 SERVICE TO OTHER HOSPITALS 541519 1870041 1870041 IT CMC 541519 523218 523218 1869245 1812825 0 56420 12249724 540406497 507224593 13916593 17622442 X 120507 120507 7821 7821 0 0 1548992 1162209 386783 2617603 2617603 208393942 170870653 37523289 6627458 5686927 940531 18972993 11276440 7696553 11871838 9237477 2634361 27500 27500 1080683 3674 1077009 337263 337263 74218 74218 710621 710621 81128784 70080236 11048548 0 1784591 15704 1768887 6621978 2946118 3675860 15153410 11652972 3500438 3831622 3340408 491214 2554110 1826444 727666 48873 48873 6034096 4527382 1506714 16590622 13838238 2752384 3416058 1467880 1948178 MEDICAL SUPPLIES 140637741 140356466 281275 REPAIRS AND MAINTENANCE 6256803 6256803 BED TAX 4941473 3833595 1107878 DUES 1871015 741296 1129719 9933657 2603582 7330075 0 553196272 461852832 91343440 0 16079651 31289949 240857717 136439358 147576315 207581779 0 0 1077350 1194984 23262216 24152113 12022494 13846413 773472922 413148507 360824889 360324415 393528818 436077688 0 38197490 30922198 2595143 2424034 138719328 152196856 1374741411 1396449787 86164548 98154128 688976 444976 172378620 168864918 0 0 190130457 187181126 38963528 41740780 488326129 496385928 X 814969320 818532058 71445962 81531801 886415282 900063859 1374741411 1396449787 X -12789775 10763358 15674994 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 124457 124457 553071937 553196394 1000000 0 250000 0 0 false 1000000 1000000 1000000 1000000 4000000 6000000 165280 264515 278299 124457 832551 250000 250000 250000 250000 1000000 1500000 0 0 73095797 429886 1995033 78183 75442533 73071314 1346174 414941 1736632 73095797 70534237 1143430 3769220 2375573 73071314 63959649 427564 6900818 753794 70534237 59205624 2802581 2753070 801626 63959649 0.3705 0.4783 0.1512 false true true 9206385 30671395 39877780 287894811 123491535 164403276 2017777 1150073 867704 404172894 274377367 129795527 39509660 14129532 25380128 360324415 DUE FROM RELATED PARTY 4863654 DUE FROM JV INTEREST IN FOUNDATION 139180004 RIGHT-OF-USE-ASSETS OPERATING LEASE 8153198 152196856 DUE TO MDOR 359954 DEPOSITS INTEREST RATE SWAP AGREEMENT 3751740 ESTIMATED CLAIMS LIABILITY 11043547 ACCRUED INTEREST 4126484 UNEARNED PREMIUMS 14238359 RIGHT-OF-USE LEASE LIABILITIES 8220696 41740780 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 V, Line 4 Intended uses of endowment funds THE ENDOWMENT INCLUDES BOTH DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE GOVERNING BODY TO FUNCTION AS ENDOWMENTS. ENDOWMENT FUNDS ARE INVESTED AND HELD TO PROVIDE GROWTH OVER THE LONG-TERM. true true X true X true X true true true false true true 8814970 8814970 0.0158 67206805 42281942 24924863 0.0446 0 0.0 0 0 76021775 42281942 33739833 0.0604 2734982 943058 1791924 0.0032 8808847 4301325 4507522 0.0081 26643380 17325973 9317407 0.0167 2063588 2063588 0.0037 7271828 7271828 0.0130 0 0 47522625 22570356 24952269 0.0447 0 0 123544400 64852298 58692102 0.1051 0 0.0 0 0.0 4410 4410 0.0000 0 0.0 0 0.0 0 0.0 147685 147685 0.0003 0 0.0 0 0.0 0 0 152095 0 152095 0.0003 false 15207016 146740250 225915950 -79175700 X true true 1 1 BILLINGS CLINIC 2800 TENTH AVE N BILLINGS MT 59101 WWW.BILLINGSCLINIC.COM 13345 X X X X X 1 1 1 false false true X X X X X X X X X 22 true true true true X https://www.billingsclinic.com/app/files/public/fbf7c4e7-f7ee-456f-8c82-70f785998d10/Report_2023CHNA X WWW.HEALTHYBYDESIGNYELLOWSTONE.ORG true 19 true https://www.billingsclinic.com/app/files/public/5d8a9fb2-7968-4e91-9405-d6caa64f123c/CHIP-Community- false true X 200.0 400.0 X X X X X true true X X X X true X WWW.BILLINGSCLINIC.COM/FINASSIST X WWW.BILLINGSCLINIC.COM/FINASSIST X WWW.BILLINGSCLINIC.COM/FINASSIST X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility 1, 1 Facility 1, 1 - BILLINGS CLINIC. Billings Clinic conducted the 2020-23 CHNA in collaboration with the city-county health department, Riverstone Health and St. Vincent Healthcare, a hospital located in Billings MT. In 2020, Billings Clinic, RiverStone Health and St. Vincent Healthcare released Yellowstone County's most recent Community Health Needs Assessment with primary, secondary and qualitative research into the health needs in the community. The 2020 CHNA was a follow-up to similar surveys conducted in 2011, 2014, and 2017 which allowed for historical data in addition to solicited input from key informants and community stakeholders. Community stakeholders and key informants are members of organizations from government, education, health care and public health. Underserved and underrepresented populations were represented by key informants including individuals from various populations comprised of various racial and socio-economic backgrounds. Schedule H, Part V, Section B, Line 6a Facility 1, 1 Facility 1, 1 - BILLINGS CLINIC. BILLINGS CLINIC'S COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN A PRE-EXISTING COMMUNITY HEALTH PARTNERSHIP, THE HEALTHY BY DESIGN ALLIANCE, WITH ST. VINCENT HEALTHCARE (HOSPITAL ORGANIZATION) AND RIVERSTONE HEALTH (PUBLIC HEALTH DEPARTMENT FOR CITY AND COUNTY). THE ALLIANCE ALSO CONDUCTED A CHNA IN 2006, 2011, 2014, 2017 AND 2020. Schedule H, Part V, Section B, Line 11 Facility 1, 1 Facility 1, 1 - BILLINGS CLINIC. The CHNA identified 11 areas of opportunity after consideration of various criteria, including a comparison with benchmark data and historical trends, analysis of the number of persons affected and significance of findings. These areas of opportunity identified included access to health care, cancer, diabetes, heart disease and stroke, injury and violence, mental health, nutrition and physical activity, potentially disabling conditions, respiratory diseases, sexual health and substance abuse. Prioritization ranked four priorities as the top needs: 1) mental health; 2) substance abuse; 3) access to health care and 4) nutrition, physical activity and weight. Billings Clinic addresses these CHNA-identified needs at the organizational level with efforts to improve awareness and education, as well as to remove barriers to care. Work is done with clinical departments, service lines, nursing and medical education, community relations, population health, care management, city/county health department, and the state and federal government. Billings Clinic is part of several community-wide coalitions to address community health needs in a collaborative way. Access to health care - Billings Clinic participated in improving access to health care through appointment availability, transportation from appointments, cost of prescriptions and increased telemedicine offerings in rural communities. This year, more than 100 Billings Clinic physicians in 28 specialties traveled in excess of 260,000 miles to provide specialty care for residents of rural Montana, Wyoming, and North Dakota. Billings Clinic is the home office of the Eastern Montana Telemedicine Network, which provided thousands of telemedicine appointments with medical specialists, as well as administrative and operational support to people attending education and meetings through 40 partner sites in Montana, western North Dakota, and northern Wyoming. Billings Clinic supports medical careers classes in local high schools, clinical rotations for nursing students, dietary students and pharmacy students each year to help increase students in the healthcare rural workforce pipeline. Billings Clinic provides free transportation for patients who are financially unable to get home from outpatient and inpatient stays, for a total, unreimbursed cost of $38,000. For the last 19 years, Billings Clinic has offered HealthLine, which is a free service available to all community members to ask health-related questions to medical professionals, twenty-four hours a day, seven days a week. From July to December of 2023, Billings Clinic spent $221,000 on HealthLine-related costs to ensure that this service is available to the community. Billings Clinic Medication Assistance Program served thousands of uninsured and underinsured patients with tens of thousands of prescriptions processed in 2023, including financial assistance for necessary medications. The total value of the donated medications was over $1 million. Cancer - Billings Clinic provides financial and in-kind support for the American Cancer Society, Montana Women's Run, cancer research and screenings. Free or low-cost screenings for cancer are coordinated and reported on through the Cancer Committee's community outreach task group. Cancer Care Navigators help with non-clinical needs to impact patient care. Diabetes - Billings Clinic provides financial and in-kind support for Diabetes Camp for Kids in addition to diabetes prevention and self-management education at no or low charge (subsidized). Heart disease and stroke - Billings Clinic makes annual financial donations and provides in-kind leadership, health policy advocacy, special event and committee support for organizations supporting prevention, research and advocacy for many chronic diseases, including the American Heart Association. Billings Clinic also partners with the Alliance for Healthy Montanans to advocate for health policies that benefit persons with chronic diseases, including support for Medicaid expansion. In addition, Billings Clinic offers free community education during Heart Month and throughout the year including awareness for the signs and symptoms of heart attack and through our cardiac rehabilitation program. Infant health - Billings Clinic provides parental education resources and free lactation education and consultations for new moms. Injury and violence - Trauma and Injury Prevention is subsidized at a 0.5 (half time) position in the Emergency and Trauma Center by a registered nurse who provided education for safe driving, falls prevention, brain and spinal cord injury prevention, helmet safety and more. The Sexual Assault Nursing Exam (SANE) program provides subsidized medical treatment and emotional support to children, teens and adults annually who were victims of sexual assault at a cost of more than $121,000. Billings Clinic also subsidized the hours for a physician to serve as the medical director of the SANE program and to provide free follow-up care for children under 18. The SANE staff and volunteers also provide training in the region. Billings Clinic also provides in-kind time support for local organizations and the city to address public safety. Mental health - Billings Clinic is a founding member of the Community Crisis Center which is a point of access for people in our community seeking crisis stabilization services for mental health, substance abuse and/or social service needs regardless of their ability to pay. We support the Community Crisis Center for people with co-occurring disorders of mental health and substance use through financial support, leadership and staffing of mental health workers and social workers, as well as board membership by our Director of Psychiatric Services. The Community Crisis Center serves thousands of individuals with assessments, case management, group therapy, addiction counseling, referrals and stabilization services to people in need 24/7. Billings Clinic provides psychiatric hospital admissions at the only inpatient psychiatric hospital for children, teens and adults in central/eastern Montana and northern Wyoming. Psychiatric services are subsidized at a multi-million-dollar shortfall each year. Over the last six months of 2023, the shortfall totaled $2.3M. Our latest project to increase access to mental health care is Billings Clinic's Psychiatric Residency Program, which started in July 2019 and is the only one of its kind in the surrounding region. In addition, we provide financial donations to several mental health organizations, including the Out of the Darkness Walk for suicide prevention and Rimrock Foundation. Nutrition and weight - Billings Clinic is a founding member of the Healthy By Design Coalition which aims to address issues of underinsured and underserved community members. Billings Clinic in partnership with Healthy By Design, provided access to low-cost fresh fruits and vegetables at the Healthy By Design Gardeners' Market by accepting WIC and SNAP for payment. Billings Clinic provided financial support for major events to encourage thousands of individuals and families to exercise together, including Big Sky State Games, Big Sky Fit Kids, Saturday Live Fun Run, Run Turkey Run, Montana Marathon, Montana Women's Run, and many other run/walk fundraisers for local nonprofit organizations. Billings Clinic also supports local schools in the promotion of physical activity and wellness through the "Superstar Awards" $100 grant awards for 10 teachers per year to encourage physical activity and wellness in their classrooms, for all grades, in partnership with the YMCA. Disabling conditions - Billings Clinic offers support groups for caregivers of persons with disabilities and provides financial support to local nonprofits in advancing health equity for individuals with disabilities. Respiratory diseases - Clinic provides education for adults and teens about the dangers of vaping and tools/information for cessation. In coordination with community health partners, Billings Clinic provides ongoing community education for the prevention and treatment of respiratory illness. Sexual health - Billings Clinic conducts numerous outreach clinics for underserved populations in rural regions in addition to free education focused on sexual health. Schedule H, Part V, Section B, Line 11 Facility 1, 2 Facility 1, 2 - BILLINGS CLINIC. Substance abuse - Billings Clinic is a member of the Substance Abuse Connect Coalition which focuses its work on prevention, education, and diversion to increase access to resources. Billings Clinic's participation in the coalition allows for coordinated efforts and increased impact. In addition, Project ECHO provided training and support to mental health professionals, nurses and physicians across the region throughout the year in educational sessions for the Department of Corrections, Integrated Addictions and Psychiatry and Pediatric Mental Health at an unreimbursed cost of $5,000. Tobacco use - Billings Clinic provides free education for adults and teens about the dangers of vaping, tobacco cessation screening and reduction in insurance premiums for Billings Clinic employees who don't use tobacco, as well as a free tobacco cessation course. Billings Clinic addresses the social determinants of health through advocacy, in-kind leadership and financial support of a variety of organizations doing work on important issues that affect health, including housing/homelessness, substance abuse, transportation and education. Billings Clinic is a member of several coalitions in Yellowstone County working on social determinants of health, including healthy neighborhoods, built environment and social connections (Healthy By Design Coalition and Age Friendly Billings); transportation (led by Met Transit); and housing (Continuum of Care Coalition, led by United Way and Tumbleweed). Billings Clinic provides board leadership, in-kind and financial support for economic development and security for residents of Yellowstone County and our surrounding region through Big Sky Economic Development and the Chamber of Commerce (Billings and Montana state Chambers of Commerce). 17 BILLINGS CLINIC 1045 N 30TH ST BILLINGS MT 59101 OUTPATIENT CLINIC BILLINGS CLINIC MILES CITY 620 S HAYNES AVE MILES CITY MT 59301 OUTPATIENT CLINIC BILLINGS CLINIC HEIGHTS 760 WICKS LN BILLINGS MT 59105 OUTPATIENT CLINIC BILLINGS CLINIC OBGYN 925 HIGHLAND BLVD BOZEMAN MT 59715 OBSTETRICS AND GYNECOLOGY CLINIC BILLINGS CLINIC SURGERY CENTER 2929 TENTH AVE N BILLINGS MT 59101 OUTPATIENT SURGERY CENTER BILLINGS CLINIC WEST 2675 CENTRAL AVE BILLINGS MT 59102 OUTPATIENT CLINIC BEHAVIORAL HEALTH CENTER 2800 10TH AVE N BILLINGS MT 591010703 OUTPATIENT MENTAL HEALTH CENTER BILLINGS CLINIC CODY 201 YELLOWSTONE AVE CODY WY 92414 OUTPATIENT CLINIC BILLINGS CLINIC CANCER CENTER 801 N 29TH ST BILLINGS MT 59101 CANCER CARE, INFUSION PSYCHIATRIC CENTER 1020 N 27TH ST BILLINGS MT 59101 INPATIENT PSYCHIATRIC CENTER HOME OXYGEN 1050 S 25TH ST W BILLINGS MT 59102 DURABLE MEDICAL EQUIPMENT BOZEMAN PEDIATRICS 1819 S 22ND ST BOZEMAN MT 59715 PEDIATRIC OUTPATIENT CENTER BILLINGS CLINIC ORTHOPEDICS 2702 8TH AVE N BILLINGS MT 59101 ORTHOPEDICS AND SPORTS MEDICINE BILLINGS CLINIC BOZEMAN 3905 WELLNESS WAY BOZEMAN MT 59718 OUTPATIENT CLINIC BILLINGS CLINIC CODY ORTHOPEDICS 3030 BIG HORN AVE CODY MT 82414 ORTHOPEDICS BILLINGS CLINIC CODY MRI & CT IMAGING 613 YELLOWSTONE AVE CODY WY 82414 MRI & CT IMAGING BILLINGS CLINIC WEST YELLOWSTONE 236 YELLOWSTONE AVE WEST YELLOWSTONE WY 59758 OUTPATIENT CLINIC Schedule H, Part I, Line 3c DESCRIPTION OF ADDITIONAL CRITERIA TO DETERMINE FINANCIAL ASSISTANCE IN ADDITION TO THE FEDERAL POVERTY GUIDELINES BILLINGS CLINIC ALSO USES ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. Schedule H, Part I, Line 6a RELATED ORGANIZATION ANNUAL COMMUNITY BENEFIT REPORT STILLWATER COMMUNITY HOSPITAL, A RELATED CRITICAL ACCESS HOSPITAL, PREPARES THEIR OWN INDEPENDENT COMMUNITY BENEFIT REPORT. Schedule H, Part V, Section B, Line 16c DIRECT URL FOR FINANICAL POLICY: HTTPS://WWW.BILLINGSCLINIC.COM/APP/FILES/PUBLIC/7C016AF9-3E3F-4FA1-A20DB85669557B4C/BCL_FINANCIALASSISTANCEBROCHUREMAY23.PDF Schedule H, Part I, Line 7g Subsidized Health Services SUBSIDIZED HEALTH SERVICES INCLUDES VARIOUS PHYSICIAN CLINICS IN ORDER TO BETTER SERVE THE MONTANA AREAS. MANY CRITICAL SERVICES WERE NOT FULLY REIMBURSED SUCH AS BEHAVIORAL HEALTH, PEDIATRIC SPECIALTIES, SEXUAL ASSAULT NURSE EXAMINATION AND RURAL OUTREACH CLINICS. PRIMARY CARE CLINICS WERE ONLY INCLUDED IF THEY WERE IN RURAL, UNDERSERVED AREAS OUTSIDE OUR PRIMARY SERVICE AREA. TOTAL COSTS FOR THE SUBSIDIZED SERVICES WERE $26,643,380 AND NET COMMUNITY BENEFIT OF THOSE SERVICES WAS DETERMINED TO BE $9,317,408. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 0 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance 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. BILLINGS CLINIC USED THE SAME COST-TO-CHARGE RATIO THROUGHOUT THE ENTIRE SCHEDULE TO DETERMINE THE COST OF THOSE ACTIVITIES. Schedule H, Part II Community Building Activities COMMUNITY BUILDING ACTIVITIES: BILLINGS CLINIC'S COMMUNITY BUILDING ACTIVITIES INCLUDE COMMUNITY SUPPORT AND ADVOACY FOR PATIENT CARE. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE ORGANIZATION DOES NOT CONSIDER ANY OF ITS BAD DEBT EXPENSE TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs IS THE BEST ESTIMATE OF THE PERCENTAGE OF MONTANA'S MEDICARE POPULATION (65 AND OLDER) WHO ARE AT OR BELOW 200% OF FEDERAL POVERTY LEVEL, BASED ON MEDICARE AND U.S. CENSUS DATA, AND THOSE PATIENTS WOULD QUALIFY FOR FULL FINANCIAL ASSISTANCE. A HIGHER PERCENTAGE WOULD QUALIFY FOR PARTIAL FINANCIAL ASSISTANCE WITH INCOMES FROM 200- 400 PERCENT OF FEDERAL POVERTY LEVEL. FOR THE CALCULATION OF THE UNREIMBURSED COST OF MEDICARE A RATIO OF PATIENT COST-TO CHARGES USING WORKSHEET 2 WAS UTILIZED AND APPLIED TO GROSS MEDICARE CHARGES. WE DO NOT USE THE MEDICARE 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 MEDICARE SHORTFALLS. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance ACCOUNTS ARE BILLED WITH INSURANCE INFORMATION SUPPLIED BY THE PATIENT AND WHEN AVAILABLE, VERIFIED BY BILLINGS CLINIC. BILLINGS CLINIC SENDS PATIENT BILLING STATEMENTS THAT INCLUDE THE SUMMARY OF SERVICES PROVIDED, AMOUNTS PENDING INSURANCE AND AMOUNTS OWED BY THE PATIENT. FINANCIAL ASSISTANCE IS OFFERED TO PATIENTS WHO ARE UNINSURED OR UNDERINSURED. BILLINGS CLINIC ASSISTS PATIENTS APPLYING FOR FINANCIAL ASSISTANCE, AND PUBLIC PROGRAMS SUCH AS MEDICAID. BILLINGS CLINIC ALSO ASSISTS PATIENTS WITH PAYMENT PLANS INTEREST FREE FOR 12 MONTHS OR THROUGH AN EXTENDED LOAN OPTION UP TO 60 MONTHS. BILLINGS CLINIC WILL NOT REFER A PATIENT TO COLLECTIONS UNTIL AFTER 120 DAYS OF THE INDIVIDUAL BEING AWARE OF THEIR OPTIONS. Schedule H, Part V, Section B, Line 16a FAP website 1 - BILLINGS CLINIC: Line 16a URL: WWW.BILLINGSCLINIC.COM/FINASSIST; Schedule H, Part V, Section B, Line 16b FAP Application website 1 - BILLINGS CLINIC: Line 16b URL: WWW.BILLINGSCLINIC.COM/FINASSIST; Schedule H, Part V, Section B, Line 16c FAP plain language summary website 1 - BILLINGS CLINIC: Line 16c URL: WWW.BILLINGSCLINIC.COM/FINASSIST; Schedule H, Part VI, Line 2 Needs assessment SINCE 1994, BILLINGS CLINIC, RIVERSTONE HEALTH AND ST. VINCENT HEALTHCARE HAVE BEEN WORKING TOGETHER AS THE ALLIANCE, CREATING AND SUSTAINING INNOVATIVE PROGRAMS THAT ADDRESS COMPLEX COMMUNITY-WIDE HEALTH ISSUES. RIVERSTONE HEALTH IS THE PUBLIC HEALTH DEPARTMENT FOR THE YELLOWSTONE COUNTY AND ST. VINCENT HEALTHCARE IS A 501(C)(3) HEALTHCARE ENTITY ALSO SERVING THE BILLINGS AREA. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance ALL PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE. INFORMATIONAL BROCHURES WITH ONE-PAGE PLAIN LANGUAGE SUMMARY AND APPLICATION FORMS ARE AVAILABLE AT REGISTRATION DESKS IN THE CLINIC AND THE HOSPITAL, THE EMERGENCY DEPARTMENT DISCHARGE DESK, AND ON OUR WEBSITE AT WWW.BILLINGSCLINIC.COM/FINASSIST. OUR WEBPAGE INCLUDES THE FULL FINANCIAL ASSISTANCE POLICY. PATIENTS CAN ALSO CALL A DIRECT LINE TO TALK TO A PATIENT FINANCIAL REPRESENTATIVE. INFORMATION ABOUT FINANCIAL ASSISTANCE IS PRINTED ON THE BACK OF PATIENT BILLS. PATIENTS HOSPITALIZED WITHOUT IDENTIFIYING A THIRD PARTY PAYER SOURCE ARE SCREENED FOR COVERAGE/ASSISTANCE (DISABILITY, MEDICAID, VETERANS ADMINSTRATION, INDIAN HEALTH SERVICES AND WORKERS COMPENSATIONS). APPLICATIONS ARE MAILED TO PATIENTS WHOSE PAYMENT PATTERN INDICATES THAT THEY MAY NEED ASSISTANCE. PATIENT FINANCIAL SERVICES STAFF IS AVAILABLE TO HELP ANY PATIENT NEEDING ASSISTANCE COMPLETING AN APPLICATION. LANGUAGE TRANSLATION SERVICES ARE ALSO AVAILABLE. Schedule H, Part VI, Line 4 Community information BILLINGS CLINIC IS BASED IN BILLINGS, MONTANA AND IS MONTANA'S LARGEST HEALTH CARE ORGANIZATION SERVING A VAST REGION COVERING MUCH OF MONTANA, WYOMING AND NORTH DAKOTA. BILLINGS CLINIC IS ONE OF MONTANA'S LARGEST EMPLOYERS WITH APPROXIATELY 4,500 EMPLOYEES INCLUDING MORE THAN 600 PHYSICIANS AND ADVANCED PRACTITIONERS OFFERING MORE THAN 80 SPECIALTIES. COMMUNITY BENEFIT INCLUDES HEALTH CARE SERVICES PROVIDED AT BILLINGS CLINIC LOCATIONS, INCLUDING THE HOSPITAL, MAIN CLINIC, BRANCH CLINICS AND OUTREACH CLINICS. BILLINGS CLINIC SPECIALISTS PROVIDE 110 OUTREACH CLINICS PER MONTH AT 21 DIFFERENT REGIONAL LOCATIONS FOR THE RESIDENTS OF MONTANA, WYOMING AND NORTH DAKOTA. Schedule H, Part VI, Line 5 Promotion of community health AS A NOT-FOR PROFIT COMMUNITY-GOVERNED ORGANIZATION, WORKING WITH OTHER ORGANIZATIONS IN THE COMMUNITY TO ADDRESS THE HEALTH CARE NEEDS IS AN IMPORTANT PART OF OUR MISSION. BILLINGS CLINIC HAS BEEN INVOLVED IN MEETING THE NEEDS OF INDIVIDUALS AND COMMUNITIES THROUGH COOPERATIVE EFFORTS WITH OTHER ORGANIZATIONS IN YELLOWSTONE COUNTY AND IN OUR REGION. COMMUNITY HEALTH COLLABORATION SINCE 1994, BILLINGS CLINIC, RIVERSTONE HEALTH AND ST. VINCENT HEALTHCARE HAVE BEEN WORKING TOGETHER, CREATING AND SUSTAINING INNOVATIVE PROGRAMS THAT ADDRESS COMPLEX COMMUNITY-WIDE HEALTH ISSUES. THEIR PURPOSE IS TO CREATE SUSTAINED CHANGE IN HOW OUR COMMUNITY RESPONDS TO THE CHALLENGE OF THE HIGH COST OF PRESCRIPTION DRUGS FOR THE UNINSURED AND THE POPULATION LIFESTYLE ISSUES OF OBESITY, POOR NUTRITION AND PHYSICAL ACTIVITY HABITS. THESE ARE EXAMPLES OF THE PAST AND FUTURE SUCCESSES OF THE ALLIANCE'S EFFORTS. COMMUNITY CRISIS CENTER - THE COMMUNITY CRISIS CENTER (CCC), ENHANCES\ACCESS TO BEHAVIORAL HEALTH CARE IN BILLINGS. THE CCC HAS SUCCESSFULLY REDUCED INAPPROPRIATE UTILIZATION OF LOCAL EMERGENCY DEPARTMENTS, DECREASED THE NUMBER OF SHORT-TERM INPATIENT HOSPITAL ADMISSIONS, AND HAS BEEN A DRIVING FORCE IN REDUCING THE INMATE POPULATION AT THE YELLOWSTONE COUNTY DETENTION FACILITY. MEDICATION ASSISTANCE PROGRAM (MAP) - MAP HELPS PATIENTS AFFORD THE PRESCRIPTION DRUGS THEY NEED BY CONNECTING INDIVIDUALS WITH AVAILABLE PATIENT ASSISTANCE PROGRAMS OFFERING DISCOUNTED OR FREE PRESCRIPTION MEDICATION. MAP ASSISTS LOW INCOME, UNINSURED OR UNDER INSURED PEOPLE IN GETTING THE MEDICATIONS THEY NEED, BUT CAN'T AFFORD. HEALTHY BY DESIGN - TO HELP RECOGNIZE ORGANIZATIONS IN YELLOWSTONE COUNTY COMMITTED TO IMPROVING OUR COMMUNITY'S HEALTH, BILLINGS CLINIC, RIVERSTONE HEALTH, AND ST. VINCENT HEALTHCARE LAUNCHED A COMMUNITY HEALTH COALITION CALLED HEALTHY BY DESIGN. HEALTHY BY DESIGN ENCOURAGES, RECOGNIZES, EDUCATES AND CREATES A STANDARD OF EXCELLENCE FOR PROMOTING HEALTHY LIFESTYLES BY ENCOURAGING ACTIVE LIVING AND HEALTHY CHOICES THAT SHAPE THE FUTURE OF THE COMMUNITY. FOR PROMOTING HEALTHY LIFESTYLES BY ENCOURAGING ACTIVE LIVING AND HEALTHY CHOICES THAT SHAPE THE FUTURE OF THE COMMUNITY. Schedule H, Part VI, Line 6 Affiliated health care system AFFILIATED HEALTH CARE SYSTEM: BILLINGS CLINIC HAS AN AFFILIATED RELATIONSHIP WITH BEARTOOTH BILLINGS CLINIC, STILLWATER HOSPITAL ASSOCIATION AND BROADWATER HEALTHCARE. EACH HOSPITAL IS A MONTANA NON-PROFIT CORPORATION. BEARTOOTH AND STILLWATER HAVE BEEN AFFILIATES OF BILLINGS CLINIC SINCE 2002 WITH A SHARED MANAGEMENT AGREEMENT. BROADWATER HEALTHCARE BEGAN THEIR AFFILIATION IN 2019. WITHIN THE AGREEMENT BILLINGS CLINIC PROVIDES MANAGEMENT, DIGITAL INFORMATION SYSTEMS, AND ANCILLARY SUPPORT SERVICES TO AREA HOSPITALS AND CLINICS. THE AFFILIATION BRINGS A STRONGER ALIGNMENT WITHIN THE GROUP DUE TO A DESIRE TO STABILIZE AND ENHANCE THE LEVEL AND SCOPE OF HEALTH CARE SERVICES AVAILABLE IN EACH COMMUNITY. THE AFFILIATION ALLOWED THEM TOSTRENGTHEN THEIR COMMITMENT TO QUALITY, PATIENT SAFETY AND SERVICE VALUES. true COMMUNITY CRISIS CENTER 704 NORTH 30TH STREET BILLINGS MT 59101 203231164 501(C)(3) 40595 SUPPORT OPERATIONS BILLINGS COMMUNITY FOUNDATION 404 N 30TH ST BILLINGS MT 59101 BILLINGS MT 59101 204286919 501(C)(3) 10000 SUBSTANCE ABUSE PROGRAMS Rocky Mountain College 1511 Poly Dr Billings MT 59102 810235407 501(C)(3) 5500 EDUCATION PROGRAMS 3 0 SCHOLARSHIPS 9 7821 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. BILLINGS CLINIC AWARDS SCHOLARSHIPS TO INDIVIDUALS WHO EXHIBIT A STRONG DESIRE AND POTENTIAL TO EXCEL IN THE HEALTHCARE FIELD. BILLINGS CLINIC ALSO PROVIDES GRANTS TO OTHER HEALTH RELATED ORGANIZATIONS. MONTHLY FINANCIAL REPORTS ARE REVIEWED AND SIGNED BY THE GRANT MANAGER, AND THEN SUBMITTED FOR APPROVAL OF THE DRAWING OF FUNDS FOR GRANTS. X X X X X X true true false false false false false true false HEIDI DUNCAN MD PHYSICIAN BOARD MEMBER 231799 0 0 0 2115 0 23387 0 37863 0 295164 0 0 0 KENDRICK TROSTEL MD PHYSICIAN BOARD MEMBER 660998 0 0 0 5256 0 30017 0 25454 0 721725 0 0 0 SCOTT ELLNER DO FORMER CEO 18900 0 0 0 963900 0 1002 0 0 0 983802 0 0 0 KATHLEEN QUINONES CFO 445263 0 0 0 3328 0 89147 0 12994 0 550732 0 0 0 CLINTON SEGER MD CEO 770581 0 0 0 59711 0 114630 0 17870 0 962792 0 56104 0 MICHAEL MORONE MD PHYSICIAN 1500503 0 0 0 3564 0 28150 0 28472 0 1560689 0 0 0 VANCE FREDRICKSON MD PHYSICIAN 2046757 0 20000 0 1887 0 27482 0 9489 0 2105615 0 0 0 MARLIN RICHARDSON MD PHYSICIAN 1472913 0 0 0 1932 0 28150 0 31322 0 1534317 0 0 0 ANTHONY ROCCISANO DO PHYSICIAN 1610326 0 0 0 2220 0 28150 0 33204 0 1673900 0 0 0 CHRISTOPHER STEWART DO PHYSICIAN 1273724 0 20000 0 1524 0 19900 0 28488 0 1343636 0 0 0 Schedule J, Part I, Line 4a Severance or change-of-control payment SCOTT ELLNER, FORMER BILLINGS CLINIC CEO. THESE PAYMENTS ARE INCLUDED IN THE AMOUNT OF OTHER REPORTABLE COMPENSATION REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II. Schedule J, Part I, Line 4b Supplemental nonqualified retirement 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. THE FOLLOWING INDIVIDUALS ARE PARTICIPANTS IN THE PLAN DURING THE 2023 CALENDAR YEAR WHICH IS INCLUDED IN DEFERRED COMPENSATION ON SCHEDULE J, PART II, COLUMN C: CLINTON SEGER - 90,002 KATHLEEN QUINONES - 67,367 THE FOLLOWING INDIVIDUAL PARTICIPATED IN THE 457(F) PLAN AND RECEIVED A PAYMENT REPORTED IN PART II, COLUMN (F) THAT WAS REPORTED AS DEFERRED COMPENSATION BY BILLINGS CLINIC IN A PRIOR YEAR: CLINTON SEGER - 56,104 Schedule J, Part I, Line 7 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 AWARDED BASED ON FINANCIAL PERFORMANCE AS WELL AS ORGANIZATIONAL PERFORMANCE MEASUREMENTS IN QUALITY, PATIENT SATISFACTION, EMPLOYEE SATISFACTION AND THE INDIVIDUAL GOALS SET EACH YEAR IF THE TARGET IS TRIGGERED. THE INCENTIVE IS PAID ONLY IF TRIGGERED FOLLOWING THE FINANCIAL AUDIT PRESENTATION. NO INCENTIVES WERE PAID IN THE PERIOD. A MONTANA FACILITY FINANCE AUTHORITY 364615155 61204KLQ2 2018-10-01 125786085 SEE PART VI true false false B MONTANA FACILITY FINANCE AUTHORITY 364615155 2018-10-01 56580000 SEE PART VI false false false C MONTANA FACILITY FINANCE AUTHORITY 364615155 61204KNX5 2022-05-17 59605571 SEE PART VI false false false A 73795000 128688498 51823 43367802 85247023 2022 true false true true B 56585037 91 75828 56509118 2022 true false true true C 1440000 59736796 194301 59542495 true false false true A false false true true false 0.002 0.002 false false true B false false true true false 0.003 0.003 false false true C false false true true false 0.002 0.002 false false true A false false true true true false false true true B false false true true true false false true true C false false true false true false false true true A true B true C true Schedule K, Part I, Column (f) Column A THE BONDS WERE ISSUED TO FINANCE CAPITAL PROJECTS, TO REISSUE SERIES 2011A BONDS (ISSUED ON OCTOBER 6, 2014) AND TO CURRENT REFUND SERIES 2008 BONDS (ISSUED ON MAY, 30, 2008). Schedule K, Part II, Line 3 Column A The total proceeds shown in Part II, Line 3 differs from the Issue Price shown in Part I, (e) due to interest earnings on invested proceeds. Schedule K, Part III, Line 7 Column A As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private security or payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, Line 6. The organization has not undertaken an analysis of the private security or payment test with respect to the bonds, as the level of private business use and/or unrelated trade or business use reported in Part III, Line 6 is not in excess of amounts permitted under Section 145 of the Code. Schedule K, Part IV, Line 2b Column A THE REFUNDING PORTION OF THE BONDS HAS MET AN EXCEPTION TO THE REBATE REQUIREMENT. Schedule K, Part I, Column (f) Column B THE BONDS WERE ISSUED TO FINANCE CAPITAL PROJECTS AND TO REISSUE SERIES 2011B BONDS (ISSUED ON JUNE 28, 2016). Schedule K, Part II, Line 3 Column B The total proceeds shown in Part II, Line 3 differs from the Issue Price shown in Part I, (e) due to interest earnings on invested proceeds. Schedule K, Part III, Line 7 Column B AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. Schedule K, Part IV, Line 2b Column B The refunding and new money portions of the Bonds have met exceptions to the rebate requirement. Schedule K, Part IV, Line 2c Column B The most recent 5th year rebate report was prepared on October 11, 2023. Schedule K, Part I, Column (f) Column C THE BONDS WERE ISSUED TO CURRENT REFUND THE SERIES 2018C BONDS (ISSUED ON OCTOBER 1, 2018). Schedule K, Part II, Line 3 Column C The total proceeds shown in Part II, Line 3 differs from the Issue Price shown in Part I, (e) due to interest earnings on invested proceeds. Schedule K, Part III, Line 7 Column C As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private security or payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, Line 6. The organization has not undertaken an analysis of the private security or payment test with respect to the bonds, as the level of private business use and/or unrelated trade or business use reported in Part III, Line 6 is not in excess of amounts permitted under Section 145 of the Code. Schedule K, Part IV, Line 2b Column C Bond proceeds have met an exception to the rebate requirement. Schedule K, Part IV, Line 2c Column A The most recent 5th year rebate report was prepared on October 25, 2023. E JAMES DUNCAN E. JAMES DUNCAN HAS A FAMILY RELATIONSHIP WITH BOARD MEMBER HEIDI DUNCAN. 403760 EMPLOYEE COMPENSATION false NADINE SEGER NADINE SEGER HAS A FAMILY RELATIONSHIP WITH CEO CLINT SEGER. 206534 EMPLOYEE COMPENSATION false Form 990, Part VI, Line 4 Significant changes to organizational documents Description of Significant Changes to Bylaws: Billings Clinic added a sole member, MTWY Health Inc. and explains the role of MTWY Health INC as the sole member. Form 990, Part VI, Line 6 Classes of members or stockholders Description of Members: MTWY Health Inc is Sole member of Billings Clinic. With rights to approve governance decisions. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Description of Governance Decision by Member: MTWY Health INC as the Sole Member approves Amendments to the bylaws, Dissolution, Change in Name, Approval of budgets and strategic plans, Action or inaction in material variance to the Member and any matters required by to be submitted to Member. Form 990, Part VI, Line 11b Review of form 990 by governing body THE 990 REVIEW IS COMPLETED BEFORE THE RETURN IS FILED. IT IS REVIEWED BY THE CONTROLLER, CFO AND THEN THE BOARD OF DIRECTORS. Form 990, Part VI, Line 12c Conflict of interest policy THE COMPLIANCE OFFICER ALONG WITH THE GOVERNANCE AND NOMINATING COMMITTEE OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR MONITORING THE EFFECTIVENESS OF THE CONFLICT OF INTEREST REPORTING AND MANAGEMENT FOR BILLINGS CLINIC. IN ADDITION, BILLINGS CLINIC VICE PRESIDENTS ARE RESPONSIBLE FOR ENSURING THAT THEIR DIRECT REPORTS ARE COMPLYING WITH THIS POLICY. Form 990, Part VI, Line 15a Process to establish compensation of top management official BILLINGS CLINIC HAS AN EXECUTIVE COMPENSATION PROGRAM ADMINISTERED ANNUALLY BY INDEPENDENT TRUSTEES FOLLOWING BEST PRACTICES AND THE HIGHEST REGULATORY STANDARDS EXPECTED OF A NOT-FOR PROFIT ORGANIZATION. THEY FOLLOW 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. BILLINGS CLINIC ENGAGES SULLIVAN COTTER TO PERFORM REGULAR COMPENSATION REVIEWS FOR EXECUTIVES, MANAGER AND DIRECTORS. SULLIVAN COTTER PERFORMED EXECUTIVE COMPENSATION REVIEWS IN 2023 AND ON AN AD HOC BASIS AS NEEDED. Form 990, Part VI, Line 15b Process to establish compensation of other employees BILLINGS CLINIC HAS AN EXECUTIVE COMPENSATION PROGRAM ADMINISTERED ANNUALLY BY INDEPENDENT TRUSTEES FOLLOWING BEST PRACTICES AND THE HIGHEST REGULATORY STANDARDS EXPECTED OF A NOT-FOR PROFIT ORGANIZATION. THEY FOLLOW 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. BILLINGS CLINIC ENGAGES SULLIVAN COTTER TO PERFORM REGULAR COMPENSATION REVIEWS FOR EXECUTIVES, MANAGER AND DIRECTORS. SULLIVAN COTTER PERFORMED EXECUTIVE COMPENSATION REVIEWS IN 2023 AND ON AN AD HOC BASIS AS NEEDED. Form 990, Part VI, Line 19 Required documents available to the public BILLINGS CLINIC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ON AN AS NEEDED BASIS. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue - Total Revenue: 1869245, Related or Exempt Function Revenue: 1812825, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 56420; Form 990, Part IX, Line 11g Other Fees AMBULANCE SERVICES - Total Expense: 103766, Program Service Expense: 103766, Management and General Expenses: , Fundraising Expenses: ; CONTRACT LABOR - Total Expense: 1124286, Program Service Expense: 635671, Management and General Expenses: 488615, Fundraising Expenses: ; COLLECTIONS - Total Expense: 647143, Program Service Expense: 365895, Management and General Expenses: 281248, Fundraising Expenses: ; CONSULTING - Total Expense: 743686, Program Service Expense: 420480, Management and General Expenses: 323206, Fundraising Expenses: ; CONTRACT MANAGEMENT - Total Expense: 26717, Program Service Expense: 15106, Management and General Expenses: 11611, Fundraising Expenses: ; CONTRACT SERVICES - Total Expense: 20886186, Program Service Expense: 11809050, Management and General Expenses: 9077136, Fundraising Expenses: ; HEALTH CARE TECH SERVICES - Total Expense: 3834506, Program Service Expense: 3834506, Management and General Expenses: , Fundraising Expenses: ; MEDICAL TEST SERVICES - Total Expense: 3453159, Program Service Expense: 3453159, Management and General Expenses: , Fundraising Expenses: ; PHYSICIAN FEES - Total Expense: 32761255, Program Service Expense: 32761255, Management and General Expenses: , Fundraising Expenses: ; PATIENT CARE SERVICES - Total Expense: 1743475, Program Service Expense: 1743475, Management and General Expenses: , Fundraising Expenses: ; NURSING - Total Expense: 13810283, Program Service Expense: 13810283, Management and General Expenses: , Fundraising Expenses: ; OTHER PURCHASED SERVICES - Total Expense: 1994322, Program Service Expense: 1127590, Management and General Expenses: 866732, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN FAIR VALUE OF INTEREST RATE SWAP - -299253; CHANGE IN INTEREST OF FOUNDATION - 15974247; MONTANA HEALTHCARE INDEMNITY LLC 2800 TENTH AVENUE NORTH BILLINGS MT 59101 INSUR CAPTIVE MT 4537699 30383407 BILLINGS CLINIC SPECIALTY SUPPLIES AND SERVICES LLC 2800 TENTH AVENUE NORTH BILLINGS MT 59101 364871868 SPEC SUPPLY MT 44475326 17261379 BILLINGS CLINIC BILLINGS CLINIC ONCALL LLC 2800 TENTH AVENUE NORTH BILLINGS MT 59101 873543333 TELEHEALTH MT 3705 9258 BILLINGS CLINIC BILLINGS CLINIC FOUNDATION 2917 TENTH AVENUE NORTH BILLINGS MT 59101 810407289 FUNDRAISING MT 501(c)(3) 7 BILLINGS CLINIC true STILLWATER HOSPITAL ASSOCIATION 710 N 11TH STREET COLUMBUS MT 59019 810286525 HOSPITAL MT 501(c)(3) 3 BILLINGS CLINIC true TOWNSEND HEALTH SYSTEMS INC 110 NORTH OAK STREET TOWNSEND MT 59644 810398400 HEALTHCARE MT 501(c)(3) 3 BILLINGS CLINIC true Billincs Clinic Employee Benefit Trust 2800 10th Ave North Billings MT 59107 810391600 Employee Benefits MT 501(c)(9) Billings Clinic true MTWY HEALTH INC 310 Sunnyview Ln KALISPELL MT 59901 932584380 Support MT 501(c)(3) Type II NA false KALISPELL REGIONAL MEDICAL CENTER 310 SUNNYVIEW LANE KALISPELL MT 59901 237293874 ACUTE CARE HOSPITAL MT 501(c)(3) 3 LOGAN HEALTH false KALISPELL REGIONAL HEALTHCARE FOUNDATION 310 SUNNYVIEW LANE KALISPELL MT 59901 311703013 SUPPORTING ORGANIZATION MT 501(c)(3) Type I KALISPELL REGIONAL MEDICAL CENTER false ASSIST-FLATHEAD VALLEY 310 SUNNYVIEW LANE KALISPELL MT 59901 462669324 WELLNESS RESOURCE PROVIDER MT 501(c)(3) 10 KALISPELL REGIONAL MEDICAL CENTER false KALISPELL REGIONAL MEDICAL CENTER VOLUNTEERS 310 SUNNYVIEW LANE KALISPELL MT 59901 273866474 SUPPORTING ORGANIZATION MT 501(c)(3) 10 KALISPELL REGIONAL MEDICAL CENTER false LIBERTY COUNTY HOSPITAL AND NURSING HOME INC 315 W MADISON AVE CHESTER MT 59522 810515463 PROVIDE ACUTE HOSPITAL CARE MT 501(c)(3) 3 LOGAN HEALTH false LOGAN HEALTH - CONRAD 805 SUNSET BLVD CONRAD MT 59425 810232406 PROVIDE ACUTE HOSPITAL CARE MT 501(c)(3) 3 LOGAN HEALTH false LOGAN HEALTH - CUT BANK 226 9TH AVE SE CUT BANK MT 59427 810530457 PROVIDE ACUTE HOSPITAL CARE MT 501(c)(3) 3 LOGAN HEALTH false LOGAN HEALTH - SHELBY 640 PARK AVE SHELBY MT 59474 862327525 PROVIDE ACUTE HOSPITAL CARE MT 501(c)(3) 3 LOGAN HEALTH false LOGAN HEALTH - WHITEFISH 1600 HOSPITAL WAY WHITEFISH MT 59937 810247969 PROVIDE ACUTE HOSPITAL CARE MT 501(c)(3) 3 LOGAN HEALTH false LOGAN HEALTH EMERGENCY MEDICAL SERVICES 310 SUNNYVIEW LANE KALISPELL MT 59901 880538346 EMERGENCY SERVICES MT 501(c)(3) 7 LOGAN HEALTH false MONTANA PEDIATRICS 259 W FRONT ST STE B MISSOULA MT 59802 854133807 AMBULATORY CARE MT 501(c)(3) 7 LOGAN HEALTH false NORTHWEST HORIZONS INC 310 SUNNYVIEW LANE KALISPELL MT 59901 810420653 LONG-TERM AMBULATORY CARE MT 501(c)(3) 10 LOGAN HEALTH false SUMMIT MEDICAL FITNESS CENTER 310 SUNNYVIEW LANE KALISPELL MT 59901 203752312 COMMUNITY HEALTH & WELLNESS CENTER MT 501(c)(3) 10 LOGAN HEALTH false NORTH VALLEY HOSPITAL FOUNDATION 1600 HOSPITAL WAY WHITEFISH MT 59937 810526541 SUPPORTING ORGANIZATION MT 501(c)(3) Type III-FI LOGAN HEALTH - WHITEFISH false LOGAN HEALTH ASSISTED LIVING - SHELBY 111 2ND ST S SHELBY MT 59474 862394240 RETIREMENT & ASSISTED LIVING MT 501(c)(3) 10 NORTHWEST HORIZONS INC false LOGAN HEALTH CARE CENTER - SHELBY 630 PARK DRIVE SHELBY MT 59474 862346458 LONG-TERM CARE & SKILLED NURSING MT 501(c)(3) 10 NORTHWEST HORIZONS INC false LOGAN HEALTH 310 Sunnyview Ln Kalispell MT 59901 810406485 SUPPORT SUBSIARY HEALTH ORGANIZATIONS MT 501(c)(3) 3 MTWY Health false BILLINGS CLINIC INNOVATION FERTILITY 399 KNOLLWOOD ROAD SUITE 303 WHITE PLAINS NY 10603 881032699 FERTILITY CLINIC NY NA N/A false 0.4900 false true true true false false false false false false false false true true true false true false true BILLINGS CLINIC FOUNDATION C 1642869 INTERCOMPANY AMOUNT BILLINGS CLINIC FOUNDATION D 451797 INTERCOMPANY AMOUNT STILLWATER HOSPITAL ASSOCIATION D 855019 INTERCOMPANY AMOUNT TOWNSEND HEALTH SYSTEMS INC D 3641569 INTERCOMPANY AMOUNT STILLWATER HOSPITAL ASSOCIATION Q 7417250 INTERCOMPANY AMOUNT TOWNSEND HEALTH SYSTEMS INC Q 2218939 INTERCOMPANY AMOUNT BILLINGS CLINIC SPECIALTY SUPPLIES AND SERVICES LLC S 3000000 INTERCOMPANY AMOUNT STILLWATER HOSPITAL ASSOCIATION O 3735289 INTERCOMPANY AMOUNT TOWNSEND HEALTH SYSTEMS INC O 2484929 INTERCOMPANY AMOUNT