2022-03-08T12:37:42-06:00 2020-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2020-01-01 810232406 Pondera Medical Center POND 4062713211 PO Box 668 Conrad MT 59425 Brenda Ries Director of Finance 4062713211 2022-03-03 1 Brenda Ries 999009999 Kim Hunwardsen CPA P00484560 6122536500 2022-03-02 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z X Laura Erickson PO Box 668 Conrad MT 59425 19195893 0 X www.ponderamedical.org X 1975 MT Exceed the healthcare expectations of those we serve through all of life's stages. 7 7 229 7 0 0 243610 2935181 14621762 16209846 47167 50866 0 0 14912539 19195893 0 0 0 0 8658350 9088372 0 0 0 6882318 6479711 15540668 15568083 -628129 3627810 6944091 15504100 1878962 6785677 5065129 8718423 X As an essential member of our regional community, PMC strives to be a progressive healthcare business devoted to providing access to quality healthcare and exceeding the expectations of those we serve through all life's stages. 0 0 8211392 11232382 Pondera Medical Center is a 25-bed critical access hospital. The Medical Center provided 146 inpatient days and 516 swing bed patient days along with a 24-hour emergency room that accounted for 1269 visits for the year. Outpatient services such as lab, x-ray, physical and occupational therapy, wellness center, surgery, ambulance, cardiac rehab, DME, home health, speech therapy, sleep lab and respiratory therapy were provided to members of our rural community so they could receive the services they needed close to home. The services are essential for the survival of our community.See Schedule O for Continued...The Medical Center maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy and equivalent service statistics. The amounts of charges foregone for services provided under the Medical Center's charity care policy was $5,956. Total direct and indirect costs related to these foregone charges were approximately $9,000 at December 31, 2020, based on average ratios of cost to gross charges.The Medical Center provides care to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Medical Center does not pursue collection of amounts determined to qualify as charity care, they are not reported as patient and resident service revenue. 3181673 3856913 Pondera Medical Center's Extended Care Facility is a 59-bed nursing home offering 24-hour care and nursing services provided by licensed, certified and compassionate staff members. The facility had 16,154 total patient days. Specialized services are also available including those offered by a physical therapist, occupational therapist, speech therapist, and medical social worker. We have a remarkable life enrichment program that offers activities 7 days a week to include exercise, socials, games, theme parties, pets, gardening, cooking, live music, crafts and outings. See Schedule O for Continued...We have a 14-bed Special Care Unit designated for residents with pervasive memory loss and confusion, providing an extra touch of attention and supervision. 1567324 1120551 Pondera Medical Center Clinic is a Family Practice Rural Health Clinic dedicated to providing and coordinating comprehensive services to the entire family. Our physicians are Board Certified Family Practitioners. Boarded Family Practice Physicians must complete an additional three years of specialized training above and beyond that of medical school. Family Practitioners are trained in all avenues of medicine, so they can provide a full range of care. PMCC Physician Assistants are licensed by the State of Montana and specialize in Family Medicine and Urgent Care. Our Providers promote healthy lifestyles and continually strengthen the relationship betweenSee Schedule O for Continued...the clinic and community, with excellent, timely, and compassionate patient care. The Clinic has 1 physicians, 2 physician assistant, and 2 nurse practitioners who provided 5,411 total clinic visits including 360 extended care visits and 159 swing bed visits. 12960389 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 27 0 1 229 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X Brenda Ries 4062713211 805 Sunset Blvd Conrad MT 59425 Bernard Ries Chair 1.00 X X 0 0 0 Craig Ostman Vice Chair 1.00 X X 0 0 0 Janice Hoppoes Treasurer 1.00 X X 0 0 0 Debbie Sturm Secretary 1.00 X X 0 0 0 Brent Gaylord Trustee 1.00 X 0 0 0 Jim Morren Trustee 1.00 X 0 0 0 Jane Weber Trustee (Feb-Dec) 1.00 X 0 0 0 William O'Leary CEO (Jan-Dec) & CFO (Jan-Feb) 40.00 X 213038 0 5275 Julianne Kipple CFO (Mar-Dec) 40.00 X 0 0 0 Jay Taylor Physician Family Medicine 30.00 X 519608 0 36942 Norman Walker Physician Assistant 90.00 X 324947 0 15482 David Arends Physician Assistant 40.00 X 126588 0 10876 Laura Erickson CNO 40.00 X 146966 0 12172 Patrick Alduenda Physician Assistant 36.00 X 131197 0 2624 1462344 0 83371 10 0 1 0 Evident 6600 Wall Street Mobile AL 366850309 Purchased Services 525363 Skillgigs Inc PO Box 7064 San Francisco CA 94120 Staffing - Contract Labor 389454 ServiceMaster 2400 River Drive North Great Falls MT 59401 Purchased Services 310764 Aureus Nursing LLC PO Box 310854 Des Moines IA 503310854 Staffing - Contract Labor 207592 Prairie Travelers Inc 130 3rd St S Glasgow MT 592302303 Staffing - Contract Labor 157748 7 2761090 174091 2935181 Patient Service Revenue 622110 11126907 11126907 Nursing Home 623000 3856913 3856913 Pharmacy Revenue 622110 585730 585730 Bed Tax Revenue 900099 320187 320187 Supporting Revenue 900099 320109 320109 16209846 50866 50866 19195893 16209846 0 50866 X 218313 218313 7241051 6396174 844877 161966 143506 18460 947991 813448 134543 519051 445385 73666 87766 5000 82766 48088 48088 46800 46800 2950865 2483653 467212 22584 1942 20642 961753 791541 170212 257128 45225 211903 489028 489028 26095 24969 1126 34698 28647 6051 7772 7772 423203 423203 171428 171428 MT Bed Tax 349263 257656 91607 Medical Supplies 339361 339361 Food 198892 198892 Pandemic Expenses 64987 64987 15568083 12960389 2607694 0 2067446 9882012 1956023 2622452 146923 196962 58139 49502 14568183 12546422 1930810 2021761 784750 731411 6944091 15504100 1701049 1578569 1819187 177913 87649 1496000 0 1804272 1878962 6785677 X 4460435 8008274 604694 710149 5065129 8718423 6944091 15504100 X 3627810 25484 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1589 5600 1517 5672 0 27854 27854 5304046 4693133 610913 8994504 7656700 1337804 241779 196589 45190 2021761 Estimated Third-Party Payors 112595 CMS Advance Payment 1691677 1804272 X 19221377 25484 25484 19195893 0 19195893 15568083 0 15568083 0 15568083 Part IV, Line 1b: The funds are the personal funds of the nursing home residents and are to be used only for specific personal expenditures as requested by the residents. Part X, Line 2: The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Medical Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Change in Beneficial Interest of Perpetual Trust 25,484. 1 1 X 1 X 1 X 1 1 0 0 9000 9000 0.00060 9000 9000 0.00060 6792028 3899839 2892189 0.18580 6792028 3899839 2892189 0.18580 6801028 3899839 2901189 0.18640 1 234015 41655 3402493 3382616 19877 X 1 1 1 1 Pondera Medical Center 805 Sunset Blvd Conrad MT 59425 www.ponderamedical.com 13510 X X X X Provider Based Rural Health Clinic Pondera Medical Center 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X See line 7d Narrative X X 1 19 1 See Line 7d Narrative 0 1 X 100.000000000000 250.000000000000 1 1 X X X 1 X www.ponderamedical.org/billing-and-payments X See 16a X See 16a X X X X X X X 1 X 0 X X X X 1 X 0 1 Pondera Medical Center Part V, Section B, Line 5: We conducted two meetings with a 14-person steering committee which included public health, health care providers, commissioners, business owners, parents, farmers, and many other persons from the community. We sent out a random survey to all areas of our patient population and had a high response rate. We conducted 4 focus groups with persons of all age groups and demographics throughout the community. Other input was accepted via email.In addition to the survey process, PMC continues to collaborate with community partners on the implementation of the CHNA. PMC works closely with Pondera Healthcare Foundation and Pondera County Health department. Staff from PMC also serve on DUI Taskforce, Mental Health Advisory Board and Pondera County Health board which further integrates PMC with the community and helps with understanding the needs of the community. PMC also collaborates regionally with other CAH in projects related to cardiac disease/stroke and patient care transitions to promote access to healthcare and promote wellness. PMC utilizes feedback received from surveys conducted at RHC, Home Health, DME, Rehab services and HCAHPS to explore opportunities to improve healthcare delivery. Pondera Medical Center Part V, Section B, Line 7d: The CHNA report and Implementation strategy are available at https://www.ponderamedical.org/chna Pondera Medical Center Part V, Section B, Line 11: In the most recent CHNA, the following needs were identified that will be addressed:1) Improve access to health and wellness2) Promote and explore opportunities to expand senior services 3) Improve access to health care servicesDue to financial restraints and space limitation, we will not be expanding worksite wellness.In March 2020 a Public Health Emergency (PHE) was declared which created new challenges for the delivery of healthcare in all venues due to restrictions. PMC experienced decrease in ability to provide services due to state-wide lockdowns. In an effort to continue to reach our goal to improve access to health and wellness PMC increased their presence on social media and local radio station to provide health and wellness updates related to the PHE. Additionally, the Rural Health Clinic (RHC) expanded the use of Telehealth to address the healthcare needs of the community and access to specialists. Our community outreach programs were cancelled due to the PHE. Our RHC started a Chronic Disease Program in January 2020 to promote wellness for patients that meet the criteria, and the RHC also participated in a mental health grant that addressed members of the community that benefited from mental health support.PMC Marketing specialist has promoted services provided at PMC via various social media platforms and has partnered with our community partners on promoting health and wellness. PMC RHC continues to work with specialty providers including Pulmonologist, Cardiologist and Oncology and expanded access to telehealth. The addition of MRI services weekly at PMC helped enhance services for the community and the Respiratory Therapy Department achieved Sleep Lab Accreditation and the Cardiac Rehab program received accreditation. One of our objectives was to increase women's health services at the RHC which was met with the recruitment of a FNP in 2019. The Opioid and Mental Health Grant which is being well utilized at the RHC with positive patient outcomes continued to be utilized in 2020. The RHC implemented a Chronic Disease Management program in 2020 which will further promote health and wellness. During the PHE even with restrictions for community events the facility was able to continue promoting health and wellness through increased marketing using different platforms. Pondera Medical Center Part V, Section B, Line 16j: Patients are informed about their eligibility for financial assistance during conversations at registration and during follow-up on outstanding account balances. Information regarding financial assistance and applications are available in the Patient Financial Services department. The financial assistance application is also available on our website. We also have partnered with the Medical Advocacy Services for Healthcare, Inc. (MASH) program. They contact our private pay patients to see if they might qualify for state funded programs and help them complete FAP if they don't qualify for state programs. Pondera Medical Center Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. 3 1 - Pondera Med Ctr Extended Care Facility 805 Sunset Blvd Conrad MT 59425 Long Term Care 2 - Pondera Med Ctr Durable Medical Equip 809 Sunset Blvd Conrad MT 59425 Durable Medical Equipment 3 - Pondera Medical Center Home Health 809 Sunset Blvd Conrad MT 59425 Home Health Care Part I, Line 7: Charity care expense was converted to cost based on an overall cost-to-charge ratio addressing all patient segments. The cost for subsidized health services was determined using the Medicare Cost Report. Part I, Line 7g: Line 7g subsidized health services includes costs of $1,477,983 from a rural health clinic. Part III, Line 2: The amount reported on line 2 represents implicit price concessions. PMC determines its estimate of implicit price concessions based on its historical collection experience with this class of patients and residents. Part III, Line 3: PMC estimates that the percentage of implicit price concessions attributable to patients eligible under the financial assistance policy is based on the percentage of the population that is below the federal poverty guidelines. In 2020 the percentage of the population that is below the federal poverty guidelines is 17.8%. Part III, Line 4: The footnote to the organization's financial statements addressing implicit price concessions may be found on pages 10-12 of the attached audited financial statements. Part III, Line 8: Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services.The Medicare shortfall, if any, represents a cost absorbed by the hospital as a result of providing care to Medicare patients. The cost of providing this benefit to the community should be reported as such. Part III, Line 9b: Patients must complete a financial assistance application to be considered for charity care. Those patients known to qualify for financial assistance or that have contacted the business office and are in the process of completing an application or setting up a payment schedule will not receive additional collection notices. Patient accounts are not sent to collections until 120 days from the date of the first invoice for the service. If a patient applies for financial assistance within the next 120 days all collection actions will cease. Part VI, Line 2: PMC was unable to complete all outreach events but utilized social media platforms and programs such as Zoom and Microsoft Teams to continue to participate in the Pondera County Health Board, DUI Taskforce and Pondera County Health Department Coalition. We continued to provide annual lab work outside of the Health Fair to promote wellness. The facility continued to use survey platforms to provide feedback on services provided and opportunities to improve healthcare delivery to the community. Part VI, Line 3: Information about financial assistance is available in admission areas, patients are informed of financial assistance as part of the intake process, financial assistance contact information is printed on patient bills, and patients are informed of financial assistance as part of the follow-up process if patient is unable to make a payment. Part VI, Line 4: Pondera Medical Center serves the population of Pondera County, Montana. The population of Pondera County in 2019 was 5,911 and is considered rural. The median household income for 2014-2018 was $45,458 in which 17.8% of the population was below the poverty level. The racial makeup consists of 82% white, 15% American Indian or Alaska Native with the remainder being other races. The largest income producing segment of Pondera County is agriculture. Healthcare, including Pondera Medical Center is the major employer in the county, with small business wholesale & retail trade, construction and accommodation/food services being the other majority of employers. The nearest hospital is Marias Medical Center, a 20-bed acute care hospital located in Shelby, MT. Marias Medical Center is located approximately 27 miles north of Conrad, MT. Part VI, Line 5: The Board of Directors is comprised of community members throughout Pondera County, and all board meetings are open to the public. Surpluses of cash, when available, are invested back into the Hospital for equipment purchases and wage considerations. Pondera Medical Center extends medical staff privileges to all qualified physicians in the community. Pondera Medical Center operates an emergency room available to all regardless of ability to pay, 20 acute care beds for hospital stays, surgery center, 59 bed extended care center, special care unit, rural health clinic, wellness center, cardiac rehab, home health agency, physical therapy, occupation therapy, speech therapy, cardio pulmonary rehab, and DME and numerous other services to meet the community's daily and long-term health care needs. Pondera Medical Center seeks and encourages community members to become involved and volunteer in our Extended Care facility. PMC continues to partner with MSU for Senior nursing students to complete their leadership training at PMC. PMC has continued to provide Basic Life Support training to community members including the School District, Law Enforcement and Daycare providers. X 0 0 0 0 0 0 0 0 0 Jay Taylor Physician Family Medicine 519608 0 0 0 0 0 7454 0 29488 0 556550 0 0 0 Norman Walker Physician Assistant 324947 0 0 0 0 0 7454 0 8028 0 340429 0 0 0 William O'Leary CEO (Jan-Dec) & CFO (Jan-Feb) 213038 0 0 0 0 0 5275 0 0 0 218313 0 0 0 Laura Erickson CNO 146966 0 0 0 0 0 4144 0 8028 0 159138 0 0 0 Schedule J, Part I, Line 3: The CEO/CFO compensation for prior years through February 9, 2020 was set by Kalispell Regional Medical Center , an unrelated management company. The board reviews and signs the contract, as well as reviews and approves the monthly management statement billing associated with the CEO/CFO compensation. The CEO became an employee of PMC in February 2020. The CFO compensation was set with a contract through Lutz Financial, an unrelated management company. Form 990, Part IV, Line 20b: The Organization is in the process of an audit of the financial statements for the year ended December 31, 2020. However, at the time of filing this return, the audit is not yet complete. The Organization has attached a copy of its most recent audited financial statements for the years ended December 31, 2019 and answered yes to Part IV, line 20b. Form 990, Part VI, Section A, line 3 Pondera Medical Center contracted with Kalispell Regional Healthcare System for CEO/CFO services for William O'Leary from January through February 9, 2020, at which time he became an employee of Pondera Medical Center. Compensation of $25,021 was paid to Kalispell Regional Healthcare System for the CEO/CFO position, respectively. Pondera Medical Center contracted with Lutz Financial for CFO services for Julianne Kipple from March through December. Compensation of $53,711 was paid to Lutz Financial for the CFO position, respectively. Form 990, Part VI, Section A, line 8b The organization does not have committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the governing board prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Officers and Trustees annually disclose potential conflicts, which are discussed at a Board of Trustees meeting. Segregation of duties is strictly enforced for any potential family or business conflicts of interest. If there is a potential conflict at a board meeting, the board member is not allowed to vote on the conflicting issue. Form 990, Part VI, Section B, line 15 The CEO compensation for William O'Leary was set by Kalispell Regional Medical Center, an unrelated management company, for January through February 9, 2020. The board reviewed and signed the contract, as well as reviewed and approves the monthly management statement billing associated his CEO compensation. In February 2020 the CEO became an employee of Pondera Medical Center. The Board reviewed and signed an employment contract with the CEO for services beginning in February 2020. The CFO compensation for Julianne Kipple was set by Lutz Financial, an unrelated management company. The board reviewed and signed the contract, as well as reviewed and approved monthly billing statements associated with the CFO compensation contract. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part IX, line 11g Professional Fees: Program service expenses 1,404,310. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,404,310. Recruitment: Program service expenses 54,131. Management and general expenses 12,965. Fundraising expenses 0. Total expenses 67,096. Repairs and maintenance: Program service expenses 178,821. Management and general expenses 0. Fundraising expenses 0. Total expenses 178,821. Purchased services: Program service expenses 842,369. Management and general expenses 454,247. Fundraising expenses 0. Total expenses 1,296,616. Collection Expense: Program service expenses 4,022. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,022. Form 990, Part XI, line 9: Change in Beneficial Interest of Perpetual Trust 25,484. AMENDED RETURN The tax return has been amended to tie out to the final audited financial statements. The original return was prepared using draft financial statements. The item that changed was the provider relief funds. $2,530,450 moved from a liability on the balance sheet to revenue in the statement of operations. The parts of the return that changed include Part I, Part VIII, Part X and Schedule D.