2023-05-12T12:04:01-05:00 2022-06-30 FORVIS LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2021-07-01 810231784 BILLINGS CLINIC % KATHLEEN QUINONES BILL 4062382500 2800 TENTH AVENUE NORTH BILLINGS MT 59101 KATHLEEN QUINONES INTERIM CFO 4062382500 2023-05-15 true Priscilla Needham 999009999 Adam R Smith CPA P00958966 7194714290 2 2021 2023-04-26 12:10:37Z X CLINT SEGER MD 2800 TENTH AVENUE NORTH BILLINGS MT 59101 2750228219 false X WWW.BILLINGSCLINIC.COM X 1917 MT BILLINGS CLINIC IS MONTANA'S LARGEST HEALTHCARE ORGANIZATION CONSISTING OF A 304 BED HOSPITAL, PRIMARY CARE AND OVER 50 MULTI SPECIALTY CLINICS 10 8 5690 80 29294324 11017220 15458311 26342685 868997644 946368358 60599459 36695349 -22449040 27222269 922606374 1036628661 1595980 5325965 0 0 451108736 488650357 0 0 0 429138637 504815161 881843353 998791483 40763021 37837178 1329607252 1491215198 370498997 568758735 959108255 922456463 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 382689827 1871451 522513483 BILLINGS CLINIC IS A 304 BED HOSPITAL PROVIDING SURGICAL, LABOR AND DELIVERY, PSYCHIATRIC, CANCER CARE, NEONATAL SERVICES AND ACUTE CARE. BILLINGS CLINIC HAD APPROXIMATELY 15,000 ADMISSIONS IN FY22. 368132214 3454514 333228794 BILLINGS CLINIC HAS OVER 550 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 BOZEMAN. IN ADDITION, BILLINGS CLINIC CONDUCTS SPECIALTY CARE CLINICS FOR MORE THAN 20 REGIONAL LOCATIONS IN MONTANA, WYOMING AND NORTH DAKOTA. BILLINGS CLINIC HAD OVER 870,000 PATIENT VISITS IN FY22. 78157551 87879446 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. 828979592 true true false true false 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 true false false false false true true true true false false true 208 0 5690 true true true false false false false false false false false false true false X 10 8 false false false false false false false true true false false true true true true true true true true true true X KATHLEEN QUINONES 4064356445 2800 TENTH AVENUE NORTH BILLINGS MT 59101 Scott Ellner Chief Executive Officer 60.0 2.0 X 1034010 0 185703 William Dresen MD Physician 60.0 0.0 X 1093481 0 53755 Michael Morone MD Physician 60.0 0.0 X 1089017 0 54475 Marlin Richardson MD Physician 60.0 0.0 X 1031542 0 57104 Mark Piedra MD Physician 60.0 0.0 X 1035160 0 33902 Daniel Gramins MD Physician 60.0 0.0 X 997806 0 30415 John Schallenkamp MD Physician Board Member 60.0 0.0 X X 595469 0 60122 Randall Gibb MD Former CEO 60.0 0.0 X 650000 0 0 Priscilla Needham Chief Financial Officer 60.0 0.0 X 561018 0 84409 Robert Merchant Former CO-CEO 60.0 0.0 X 471794 0 43904 Heidi Duncan MD Physician Board Member 60.0 0.0 X 237965 0 39204 Connie Prewitt FORMER Chief Financial Officer 60.0 0.0 X 272650 0 0 Joy Ott Secretary 5.0 0.0 X X 27753 0 11437 Keith Cook Board Chair 5.0 1.0 X X 9000 0 9000 Wayne Hirsch Treasurer 5.0 0.0 X X 6000 0 6000 Elizabeth Fulton Board Member 5.0 0.0 X 0 0 7584 Craig Bartholomew Board Member 5.0 0.0 X 0 0 6792 Chelsea Bodnar Board Member 5.0 0.0 X 0 0 4738 Eileen McDonald Board Member 5.0 1.0 X 0 0 3007 Nancy Snyderman MD Board Member 5.0 0.0 X 0 0 0 9112665 0 691551 851 true true false CERNER CORPORATION PO BOX 4100 ROCHESTER MN 55903 IT SERVICES 16634606 HAYES LOCUMS LLC PO BOX 5068 NEW YORK NY 10087 CONTRACT PHYSICIANS 11689758 VIZIENT INC PO BOX 88122 CHICAGO IL 60680 CONTRACT LABOR MGMT 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to MDOR 419239 Deposits 7890 Interest rate Swap Agreement 8728634 Estimated Claims Liability 11650097 Accrued Interest 2482891 Unearned Premiums 12972331 Right of use Lease Liabilities 6919103 43180185 SCHEDULE D, PART V, LINE 4 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. 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. true true X true X true X true true true false true true 20250937 20250937 0.02020 147409110 133315962 14093148 0.01410 167660047 133315962 34344085 0.03430 3913286 857905 3055381 0.00310 12018076 4979332 7038744 0.00700 72814081 51635914 21178167 0.02110 1530930 426664 1104266 0.00110 612280 612280 0.00060 90888653 57899815 32988838 0.03290 258548700 191215777 67332923 0.06720 false 15981119 259555101 376125185 -116570084 X true true 1 1 BILLINGS CLINIC 2800 TENTH AVE N BILLINGS MT 59101 WWW.BILLINGSCLINIC.COM 13345 X X X X X 1 BILLINGS CLINIC false false true X X X X X X X X X 19 true true true true X SEE PART V, SECTION C FOR URL X WWW.HEALTHYBYDESIGNYELLOWSTONE.ORG true 19 true SEE PART V, SECTION C FOR URL false true X 200. 400. X X X X X true true X X X X true X WWW.BILLINGSCLINIC.COM/FINASSIST X WWW.BILLINGSCLINIC.COM/FINASSIST X See Part V,Section C for URL 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 THE 2019-20 YELLOWSTONE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS A COMPREHENSIVE, DATA-DRIVEN ASSESSMENT OF THE OVERALL HEALTH STATUS, HEALTH BEHAVIORS, AND HEALTH ISSUES WITHIN OUR COMMUNITY. THE CHNA EVALUATES AND INFORMS DECISIONS RELATED TO RESOURCES AND EFFORTS THAT IMPROVE HEALTH AT THE COMMUNITY LEVEL. PRIMARY DATA ONLINE KEY INFORMANT SURVEY - COMMUNITY STAKEHOLDER INPUT - 154 REPRESENTATIVES FROM HEALTHCARE, PUBLIC HEALTH, SOCIAL EDUCATION, GOVERNMENT, AND MORE - BASED ON THEIR EXPERIENCES, THE POPULATIONS THEY SERVE CUSTOMIZED LOCAL HEALTH SURVEY - STATISTICALLY SIGNIFICANT, RANDOMIZED SURVEY OF 400 HOUSEHOLDS - TARGETS HEALTH STATUS, EXPERIENCE, BEHAVIORS - CONDUCTED VIA LANDLINE AND CELL PHONES STREETWYZE USER FEEDBACK - COMMUNITY STAKEHOLDER INPUT - 120 USERS AND 428 COMMENTS - BASED ON USER EXPERIENCES - WEB-BASED PLATFORM OPEN TO THE GENERAL PUBLIC - ADMINISTERED BY HEALTHY BY DESIGN AND ISEEED (STREETWYZE FOUNDER) SECONDARY DATA - COUNTY-LEVEL DATA - CENSUS DATA, VITAL STATISTICS, OTHER HEALTH RELATED DATA SCHEDULE H, PART V, SECTION B, LINE 6A & 6b 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 7A https://www.billingsclinic.com/about-us/community-health-needs-assessments -and-community-health-improvem/ SCHEDULE H, PART V, SECTION B, LINE 11 TThe 2020 CHNA identified 13 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, infant health, injury and violence, mental health, nutrition and physical activity, potentially disabling conditions, respiratory diseases, sexual health, substance abuse and tobacco use. Prioritization ranked three priorities as the top needs: 1) mental health; 2) substance abuse; and 3) 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, 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 more than 4,800 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 $100,000. For the last 17 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. Last year, Billings Clinic spent $862,000 on HealthLine-related costs to ensure that this service is available to the community. Billings Clinic Medication Assistance Program served 5,549 uninsured and underinsured patients with more than 25,474 prescriptions processed in 2022, including financial assistance for necessary medications. The total value of the donated medications was over $1,479,000. 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 more than 150 children, teens and adults annually who were victims of sexual assault at a cost of more than $260,000. Billings Clinic also subsidized the hours for a family medicine 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. Last year, the shortfall totaled $7.3M. Our latest project to increase access to mental health care is Billings Clinic's new 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 - an average of 211 people attended the market every week in 2022. 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- Billings 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. 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 $1,800. Tobacco use - Billings Clinic provi SCHEDULE H, PART V, SECTION B, LINE 16c DIRECT URL FOR PLAIN LANGUAGE SUMMARY: https://www.billingsclinic.com/app/files/public/6543cb1d-af22-4520-975f-6a 72cd1c6612/BCLFinancialAssistanceBrochureJan22.pdf Schedule H, Part V, Section B, Line 16I TRANSLATION OF FAP FOR LEP POPULATIONS: BILLINGS CLINIC HAS CONSIDERED THE NEED FOR A PLAIN LANGUAGE SUMMARY FOR THOSE WITH LIMITED ENGLISH PROFICIENCY. WE HAVE TRANSLATION OF MOST LANGUAGES AVAILABLE TO PATIENTS THROUGH OUR MARTTI TRANSLATION SERVICES, ONLINE OR BY PHONE TRANSLATION FOR DISCUSSING AND TRANSLATING FINANCIAL ASSISTANCE MATERIALS. 14 BILLILNGS 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 CLIN 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 PYSCHIATRIC 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 MEDICIN BILLINGS CLINIC BOZEMAN 3905 WELLNESS WAY BOZEMAN MT 59718 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 I, LINE 7 COSTING METHODOLOGY: 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 I, LINE 7G SUBSIDIZED HEALTH SERVICE COSTS: 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 $72,814,081 AND NET COMMUNITY BENEFIT OF THOSE SERVICES WAS DETERMINED TO BE $21,178,167. SCHEDULE H, PART III, SECTION A, LINE 2 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, SECTION A, LINE 3 BAD DEBT AS COMMUNITY BENEFIT: 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, SECTION B, LINE 8 ALLOWABLE MEDICARE COSTING METHODOLOGY: BILLINGS CLINIC ESTIMATES THAT 45 PERCENT OF BILLINGS CLINIC'S MEDICARE SHORTFALLS SHOULD BE COUNTED AS COMMUNITY BENEFIT. OUR RATIONALE IS THAT 45 PERCENT 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, SECTION C, LINE 9B COLLECTION PRACTICES: 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 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 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 4,300 EMPLOYEES INCLUDING MORE THAN 450 PHYSICIANS AND ADVANCED PRACTITIONERS OFFERING MORE THAN 50 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 122 OUTREACH CLINICS PER MONTH AT 20 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. SCHEDULE H, PART VI, LINE 6 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 TO STRENGTHEN THEIR COMMITMENT TO QUALITY, PATIENT SAFETY AND SERVICE VALUES. true COMMUNITY CRISIS CENTER 704 NORTH 30TH STREET BILLINGS MT 59101 203231164 501(C)(3) 81191 SUPPORT OPERATIONS ST JOHNS UNITED 2429 MISSION WAY BILLINGS MT 59102 810485182 501(C)(3) 25000 SUPPORT NURSING PROGRAM BILLINGS CLINIC FOUNDATION 2917 TENTH AVENUE NORTH BILLINGS MT 59101 810407289 501(C)(3) 13771 SUPPORT PROGRAM POWELL VALLEY HEALTH CARE INC 777 AVENUE H POWELL WY 82435 830300467 501(C)(3) 171590 FMV EMR SUPPORT PATIENT CARE BILLINGS AREA CHAMBER OF COMMERCE 815 SOUTH 27TH STREET BILLINGS MT 59101 810111570 501(C)(6) 27500 SUPPORT PROGRAMS - DIVERSITY AND INCLUSION COMMUNITY HEALTH PARTNERS 214 E MENDENHALL BOZEMAN MT 59715 841420492 501(C)(3) 25000 CAPITAL CAMPAIGN MONTANA RESCUE MISSION PO BOX 3232 BILLINGS MT 59103 816013963 501(C)(3) 15000 CAPITAL CAMPAIGN TOWNSEND HEALTH SYSTEMS INC 110 NORTH OAK ST TOWNSEND MT 59644 810398400 501(C)(3) 4795362 Book Value Property & Equipment AMERICAN CANCER SOCIETY PO BOX 20893 BILLINGS MT 59103 131788491 501(c)(3) 16500 SUPPORT PROGRAMS RONALD MCDONALD HOUSE CHARITIES 1144 N 30TH ST BILLINGS MT 59101 810400667 501(C)(3) 6000 SUPPORT PROGRAMS BIG SKY STATE GAMES PO BOX 7136 BILLINGS MT 59103 810431595 501(C)(3) 7000 SUPPORT PROGRAMS 11 SCHOLARSHIPS 68 15355 SCHEDULE I, PART I, LINE 2 DESCRIPTION OF MONITORING PROCESS FOR SCHOLARSHIPS AND GRANTS: 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 Randall Gibb MD Former CEO 0 0 0 0 650000 0 0 0 0 0 650000 0 Connie Prewitt FORMER Chief Financial Officer 0 0 0 0 272650 0 0 0 0 0 272650 0 Scott Ellner Chief Executive Officer 890005 0 129464 0 14541 0 158731 0 26972 0 1219713 0 Priscilla Needham Chief Financial Officer 491852 0 61651 0 7515 0 60001 0 24408 0 645427 0 Robert Merchant Former CO-CEO 446424 0 1151 0 24219 0 24358 0 19546 0 515698 0 John Schallenkamp MD Physician Board Member 591300 0 500 0 3669 0 25150 0 34972 0 655591 0 Heidi Duncan MD Physician Board Member 234739 0 730 0 2496 0 20577 0 18627 0 277169 0 William Dresen MD Physician 1090353 0 500 0 2628 0 25150 0 28605 0 1147236 0 Michael Morone MD Physician 1086195 0 500 0 2322 0 25025 0 29450 0 1143492 0 Marlin Richardson MD Physician 1028053 0 575 0 2914 0 25025 0 32079 0 1088646 0 Mark Piedra MD Physician 1026313 0 5639 0 3208 0 25025 0 8877 0 1069062 0 Daniel Gramins MD Physician 939619 0 53899 0 4288 0 25025 0 5390 0 1028221 0 SCHEDULE J, PART I, LINE 4A SEVERANCE OR CHANGE OF CONTROL PAYMENTS: CONNIE PREWITT, FORMER BILLINGS CLINIC CFO, RECEIVED A QUALIFYING PAYMENT OF $272,650 IN 2021. RANDALL GIBB, FORMER BILLINGS CLINIC CEO, RECEIVED A QUALFYING PAYMNET OF $650,000 IN 2021. 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 DESCRIPTION OF NON-QUALIFIED RETIREMENT PLAN: TTHE 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 2021 CALENDAR YEAR WHICH IS INCLUDED IN DEFERRED COMPENSATION ON SCHEDULE J, PART II, COLUMN C: SCOTT ELLNER - 134,999 PRISCILLA NEEDHAM - 60,001 SCHEDULE J, PART I, LINE 7 DESCRIPTION OF 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. A MONTANA FACILITY FINANCE AUTHORITY 364615155 61204KLQ2 2018-10-01 125786085 See Part VI false 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 7865000 59420000 128688498 0 51823 0 0 0 0 43387426 85247023 2226 true false false true B 0 0 56585075 0 91 0 0 0 0 75863 56509118 4 true false false true C 0 0 59736796 0 0 59054339 194301 0 0 0 488156 0 true false false true A false false true true false 0.00100 0.00000 0.00100 false false false true B false false true true false 0.00200 0.00000 0.00200 false false false true C false false true true false 0.00100 0.00000 0.00100 false false false true A false true true false true false 0 false 0 true true B false true true false true false 0 false 0 true true C false true true false true false 0 false 0 true true A true B true C true SCHEDULE K, PART I(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 EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. SCHEDULE K, PART IV, LINE 2(B), COLUMN A THE REFUNDING PORTION OF THE BONDS HAS MET AN EXCEPTION TO THE REBATE REQUIREMENT. SCHEDULE K, PART I(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 2(B), COLUMN B THE REFUNDING PORTION OF THE BONDS HAS MET AN EXCEPTION TO THE REBATE REQUIREMENT. SCHEDULE K, PART I(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 EARNING ON INVESTED PROCEEDS. SCHEDULE K, PART II, LINE 13, COLUMN C SINCE THE PROCEEDS OF THE BONDS WERE USED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE. 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 2(B), COLUMN C BONDS PROCEEDS HAVE MET AN EXCEPTION TO THE REBATE REQUIREMENT. E JAMES DUNCAN SEE PART V 440840 EMPLOYEE COMPENSATION false Schedule L, Part IV Relationship Between Interested Person & the Organization: Line 2, Column B - E. James Duncan has a family relationship with board member Heidi Duncan. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW 990: 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, SECTION B, LINE 12C PROCESS TO MONITOR 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, SECTION B, LINE 15A & 15B PROCESS TO DETERMINE CEO COMPENSATION: BILLINGS CLINIC HAS AN EXECUTIVE COMPENSATION PROGRAM ADMINISTERED ANNUALY 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 DECEMBER 2021 AND ON AN AD HOC BASIS AS NEEDED. FORM 990, PART VI, SECTION C, LINE 19 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 XI, LINE 9 OTHER CHANGE IN NET ASSETS: 7,756,590 - CHANGE IN FAIR VALUE OF INTEREST RATE SWAP (6,296,819) - CHANGE IN INTEREST OF FOUNDATION 4,171,843 - CHANGE IN INTEREST IN AFFILIATES 5,631,614 - TOTAL FORM 990 PART IX LINE 11G DESCRIPTION:AMBULANCE SERVICES TOTAL FEES:251525 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT LABOR TOTAL FEES:3018868 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTIONS TOTAL FEES:1333379 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING TOTAL FEES:3102043 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:32275749 FORM 990 PART IX LINE 11G DESCRIPTION:HEALTH CARE PRO. SERVICES TOTAL FEES:61784 FORM 990 PART IX LINE 11G DESCRIPTION:HEALTH CARE TECH SERVICES TOTAL FEES:7724289 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL TEST SERVICES TOTAL FEES:6692791 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:18953372 FORM 990 PART IX LINE 11G DESCRIPTION:PATIENT CARE SERVICES TOTAL FEES:4939864 FORM 990 PART IX LINE 11G DESCRIPTION:NURSING TOTAL FEES:26556733 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:8821483 MONTANA HEALTHCARE INDEMNITY LLC 2800 TENTH AVENUE NORTH BILLINGS MT 59101 INSUR CAPTIVE MT 7042166 21839030 Billings Cli SPECIALTY SUPPLIES AND SERVICES LLC 2800 TENTH AVENUE NORTH BILLINGS MT 59101 364871868 SPEC SUPPLY MT 84189971 18971305 Billings Cli BILLINGS CLINIC ONCALL LLC 2800 TENTH AVENUE NORTH BILLINGS MT 59101 873543333 TELEHEALTH MT 955 638 Billings Cli BILLINGS CLINIC FOUNDATION 2917 TENTH AVENUE NORTH BILLINGS MT 59101 810407289 FUNDRAISING MT 501(C)(3) 7 BILLINGS CLI true STILLWATER HOSPITAL ASSOCIATION 710 N 11TH STREET COLUMBUS MT 59019 810286525 HOSPITAL MT 501(C)(3) 3 BILLINGS CLI true TOWNSEND HEALTH SYSTEMS INC 110 NORTH OAK STREET TOWNSEND MT 59644 810398400 HEALTHCARE MT 501(C)(3) 3 BILLINGS CLI true BILLINGS CLINIC EXPRESS CARE 2800 TENTH AVENUE NORTH BILLINGS MT 59101 463355499 URGENT CARE MT BILLINGS CLINIC C CORP 12482 220329 1.00000 true NEW WEST HEALTH SERVICES 130 NEILL AVENUE HELENA MT 59601 841418136 INSURANCE SALES MT BILLINGS CLINIC C CORP 0 0 0.65000 true true true true true false false false false false false false false true true true false true true true BILLINGS CLINIC EXPRESS CARE A 81700 INTERCO AMOUNT TOWNSEND HEALTH SYSTEMS INC B 4795362 INTERCO AMOUNT BILLINGS CLINIC FOUNDATION C 8813543 INTERCO AMOUNT BILLINGS CLINIC FOUNDATION D 240172 INTERCO AMOUNT BILLINGS CLINIC EXPRESS CARE D 5900633 INTERCO AMOUNT STILLWATER HOSPITAL ASSOCIATION D 3822359 INTERCO AMOUNT TOWNSEND HEALTH SYSTEMS INC D 2606863 INTERCO AMOUNT STILLWATER HOSPITAL ASSOCIATION L 1353443 INTERCO AMOUNT TOWNSEND HEALTH SYSTEMS INC L 622328 INTERCO AMOUNT BILLINGS CLINIC EXPRESS CARE O 104849 INTERCO AMOUNT STILLWATER HOSPITAL ASSOCIATION O 14866172 INTERCO AMOUNT TOWNSEND HEALTH SYSTEMS INC O 5115202 INTERCO AMOUNT STILLWATER HOSPITAL ASSOCIATION Q 7844213 INTERCO AMOUNT TOWNSEND HEALTH SYSTEMS INC Q 6155035 INTERCO AMOUNT BILLINGS CLINIC EXPRESS CARE R 69500 INTERCO AMOUNT