2020-06-10T15:26:31-05:00 2019-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2018-07-01 237169043 Central Montana Medical Facilities Inc CENT 4065387711 408 Wendell Avenue Lewistown MT 59457 Alan R Aldrich Interim CEO/CFO 4065386243 2020-06-08 1 Kim Hunwardsen CPA P00484560 6122536500 2020-05-20 216.147.181.49 2020-06-08 09:22:58 CD P D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC 5755687E6BF8D8D10BDE3B83E6631EF3D64C584D 2018 2020-09-22 18:59:49Z Central Montana Medical Center Alan R Aldrich 408 Wendell Avenue Lewistown MT 59457 38944338 0 X www.cmmc.health X 1971 MT The mission of CMMC is to be the leader in assuring community based quality healthcare. 16 12 375 160 0 0 583713 1084512 34323979 36891543 233637 253820 593160 600587 35734489 38830462 0 0 0 0 19433515 20886396 0 0 101196 15461570 15744678 34895085 36631074 839404 2199388 28669061 32154222 8080990 9101647 20588071 23052575 X The mission of Central Montana Medical Center is to be the leader in assuring community based quality healthcare. 0 0 28667697 36891543 Central Montana Medical Facilities, Inc. operates a 25-bed critical access hospital located in Lewistown, Montana.Hospital Inpatient Services for FY 2019:Number of beds: 25Provided 1,652 acute days of care and 1,786 swing bed days of care for 37.7% occupancy rate. CMMC upgraded two remodeled patient rooms this year that provide privacy with a view. These rooms are equipped with individual showers and bathrooms, sleeping couches for family, soothing artwork, dimmer switches for the overhead lights and privately-controlled thermostats. Our Swing Bed Activity Room also received a small makeover, providing comfortable seating, a kitchenette, table and chairs, a desk and some local artwork.Emergency Services for FY 2019:Provided for 5,216 Emergency visits.24-hour Physician coverage available.CMMC updated our Code Blue Policies to educate our staff. Three of the AED's were upgraded. OB Services for FY 2019:Provided for 69 births in Central MontanaOur OB Department began to offer different options for the mother during her labor and deliver. They can now choose to receive an epidural or nitrous oxide. With the added availability of pain medication offered, mothers are able to rest much more comfortably during the often long process of labor while anxiously awaiting their new baby. Radiology Services for FY 2019:Our Radiology Department got a state of the art radiology room installed into our Radiology Department. The room is currently being utilized for general radiology and x-ray and once we have recruited a Radiologist, the room will be used primarily for Interventional Radiologic procedures. The radiology department also received a new portable & fixed x-ray. This upgrade offers workflow improvements and significantly more clear images.Community care and services are also provided through the many reduced price services and free clinics, fairs, and programs offered throughout the year. These include but are not limited to the following (all costs are estimates):1. Twenty-three foot clinics were held in 2018-2019 in Denton, Stanford, and the Hobson communities. A total of 273 people were served, all received discounted health care. Total community benefits expense of $2,195.2. CMMC educated locals with our 25 years of Safe Sitter (babysitting class) (24 people served, 1 class offered, total community benefit $1,720)3. Instead of a Health Fair, CMMC offered lab draws during your birth month at discounted prices. A total of 295 persons participated, with expenses such as staff time and supplies were $5,282.4. CMMC gave several cash donations to different organizations in 2018-2019 totaling $1,784. These included a donation to the AHEC MT Billings Med Start Camp.5. CMMC staff were representatives of CMMC on several boards throughout 2018-2019, severing several hours of our employee's time to serve our community. These included (but not limited to) Council on Aging Board, LEPC, Lewistown Downtown Board of Directors, Port Authority Board, Central Mt. Youth Challenge Board, DUI Task Force Board, and Central Montana Foundation Advisory Board Meetings.6. CMMC served our community in a multitude of ways throughout 2018-2019 fiscal year. Staff were involved in serving our elderly lunch at the Council on Aging, food drives, in-kind donations to local programs including Family Cancer Benefit, Computer Assistance, outdated supplies to third world countries and our local Lewistown School District. They also had Impact Concussion Testing Sessions for our local community and outlying communities at a discounted price. The facilities maintain 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. The amount of charges foregone for services provided under the Facilities charity care policy were approximately $861,214 for the fiscal year. Total direct and indirect costs related to these foregone charges were $347,000 based on an average ratio of cost to gross charges.Awards received for FY 2019 were:* NRHA Top 20 CAH Winner (4 years in a row) Overall Winner from NRHA* Top 100 Critical Access Hospital iVantange Health Analytics' (5 years in a row)* Top 67 Critical Access Hospital Becker's Review (4 years in a row)* NOSORH Performance Leadership Award* Dr. Laura Bennett was honored with the Outstanding Provider Leadership Award from Caravan health for helping patients live better lives and exceeding standards in quality and care.* EMS Service of the Year Award from the State of Montana. This award honors an EMS Agency that consistently exhibits dedication to improving patient care through education, injury prevention, community awareness, medical director involvement and cooperation with other emergency service organizations in their community. 28667697 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 55 0 1 375 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 16 12 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Alan R Aldrich 4065357711 408 Wendell Ave Lewistown MT 59457 Dave Phillips President 2.00 X X 0 0 0 Carl Seilstad Vice Chair 2.00 X X 0 0 0 Jennifer Saunders Secretary/Treasurer 2.00 X X 0 0 0 Josh Webber Member 1.00 X 0 0 0 Pete Smith Member 1.00 X 0 0 0 Marvin Mauws Member 1.00 X 0 0 0 Corry Arntzen Member 1.00 X 0 0 0 Brandon Bantz Member 1.00 X 0 0 0 Keith Cook Member 1.00 X 0 0 0 Erik Wood Member 1.00 X 0 0 0 Nick Econom Member 1.00 X 0 0 0 Bret Carpenter Member 1.00 X 0 0 0 Kim Vincent Member (started October 2018) 1.00 X 0 0 0 Dr Michael Sura Member 40.00 X 356644 0 29871 Dr Tamara Welsh Member 40.00 X 259485 0 10394 Karin Durbin Member 1.00 X 0 0 0 Robert Mike Dowdy - CEO (Administrative Leave Aug 2018) 40.00 X 0 0 0 Alan R Aldrich CFO/Interim Co-CEO (Aug 2018) 40.00 X 159155 0 21718 Dr Laura Bennett Interim Co-CEO (Aug 2018) 40.00 X 184264 0 26356 Karin White CNO 40.00 X 118042 0 10305 Dr Gardner Smith Surgeon 40.00 X 472835 0 20924 Dr Amy A LePage ER Physician 40.00 X 375062 0 31904 Dr Joan M McMahon CMO/Physician 40.00 X 277615 0 18309 Dr Christina Marchion Physician 40.00 X 252853 0 31470 Dr James Fox CRNA 40.00 X 245406 0 9833 2701361 0 211084 24 0 1 0 Billings Clinic PO Box 30357 Billings MT 59107 Management Services 917448 Birdwell Builders PO Box 592 Lewistown MT 59457 Construction 423018 Hall Render Killian Health & Lyman P PO Box 714570 Cincinnati OH 452714570 Legal Services 268224 Atlas MedStaff LLC 11159 Mill Valley Rd Omaha NE 68154 Medical Staffing 175952 Dr William Gallea 3060 Cabernet Suite 2 Helena MT 59601 ER Physician 145672 7 1009353 75159 1084512 Net Patient Revenue 622110 33752871 33752871 Special Programs 900099 2740196 2740196 Cafeteria 722210 398476 398476 36891543 246967 246967 695999 95412 600587 600587 600587 22817 2500 16864 1600 5953 900 6853 6853 38830462 36891543 0 854407 X 1350170 834224 515946 232550 137231 95319 15889749 12820321 3004965 64463 391663 252183 138191 1289 1890169 1545929 333909 10331 1132095 905677 223061 3357 428567 428567 302825 302825 40100 40100 4021495 2930488 1086785 4222 109155 81866 14654 12635 2057136 1317510 736868 2758 1128824 903059 223965 1800 68982 35119 33863 311197 237184 73970 43 190264 145587 44677 1425094 1100934 323912 248 464910 464910 Medical Supplies 3409447 3409447 Bad Debt Allowance 909168 909168 Equipment Rental and Ma 384209 384209 Taxes and Licenses 114989 6742 108247 378316 245909 132357 50 36631074 28667697 7862181 101196 1850527 2137505 5688698 7367797 4329 754337 780241 452065 264546 42485663 30015702 11721806 12469961 3906489 4158582 4290810 4975590 28669061 32154222 3285577 3847192 3714588 3602829 1080825 1651626 8080990 9101647 X 18143716 20348829 772391 2703746 1671964 0 20588071 23052575 28669061 32154222 X 2199388 5725 259391 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 123009 123009 24130384 15998127 8132257 15845917 12961996 2883921 2386353 1055579 1330774 12469961 Long-Term Prepaid Expenses 668345 Due from Foundation 2703746 Other Receivables 1421323 Estimated Third-Party Payor Settlements 182176 4975590 X 37941547 -909168 -909168 38850715 -20253 -20253 38830462 35817318 95412 95412 35721906 909168 909168 36631074 Part X, Line 2: The Facilities is organized as a Montana nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Facilities is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Facilities is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Facilities' will file an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS to report its unrelated business taxable income, if any. The Facilities 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 Facilities 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: Provision for Bad Debts Reported in Expenses for Tax Purposes -909,168. Part XI, Line 4b - Other Adjustments: Contributions for Specific Purposes Recorded in Fund Balance for F/S 75,159. Rental Expenses Reported in Revenue for Tax Purposes -95,412. Part XII, Line 2d - Other Adjustments: Rental Expenses Reported in Revenue for Tax Purposes 95,412. Part XII, Line 4b - Other Adjustments: Provision for Bad Debts Reported in Expenses for Tax Purposes 909,168. 1 1 X 1 X 1 X 1 1 1 0 0 347000 347000 0.00970 2099269 1581814 517455 0.01450 2446269 1581814 864455 0.02420 14 5505 47038 5965 41073 0.00110 2 42 5792 5792 0.00020 12460250 8695862 3764388 0.10540 4 1480 2796 2796 0.00010 20 7027 12515876 8701827 3814049 0.10680 20 7027 14962145 10283641 4678504 0.13100 4 4872 16436 16436 0.00050 1 523 948 948 0.00000 5 5395 17384 17384 0.00050 1 909168 0 8486727 8525035 -38308 X 1 1 1 1 Central Montana Medical Center 408 Wendall Avenue Lewistown MT 59457 www.cmmc.health 12894 X X X X Home Health / Hospice Central Montana Medical Facilities Inc 1 0 0 1 X X X X X X X X X X 18 1 0 1 1 X https://www.cmmc.health/resources/reports/ X X 1 18 1 https://www.cmmc.health/resources/reports/ 0 1 X 150.000000000000 300.000000000000 X 1 1 X X X 1 X See Part V X See Part V X See Part V X X X X X X 1 X 0 X X X X 1 X 0 0 Central Montana Medical Facilities, Inc. Part V, Section B, Line 3j: Secondary Data: County Profile, Demographic Trends and Economic Impacts Central Montana Medical Facilities, Inc. Part V, Section B, Line 5: A Steering Committee was convened to assist Central Montana Medical Center in conducting CHSD. A diverse group of community members representing various organizations and populations within the community (ex. public health, elderly, uninsured) came together. The Steering Committee met twice during the CHSD process; first to discuss health concerns in the community and offer their perspective in designing the survey instrument and again to review results of the survey and focus groups and to assist in the prioritization of health needs to address. Central Montana Medical Facilities, Inc. Part V, Section B, Line 6b: The Needs Assessment was formed by a committee. Central Montana Community Health Center in Lewiston was included as part of this. Central Montana Medical Facilities, Inc. Part V, Section B, Line 7d: The Needs Assessment is available at the Foundation Office, Administration Assistant Office and at Central Montana Medical Center hospital website. Central Montana Medical Facilities, Inc. Part V, Section B, Line 11: The Organization completed a new CHNA during the 6/30/19 FYE. Survey respondents identified the community's top health concerns as: Alcohol abuse/substance abuse; Cancer; Overweight/obesity.The following summary briefly represents the goals and corresponding strategies which the facility will execute to address the prioritized health needs:Goal 1: Expand access to behavioral health services at Central Montana Medical CenterStrategy 1.1: Develop a workforce and processes to support CMMC's behavioral health activitiesStrategy 1.2: Support local community efforts that address behavioral health needs in the CMMC service areaStrategy 1.3: Ensure sustainability of collaborative care efforts at CMMC which help screen and provide resources for behavioral health needsGoal 2: Increase access to healthcare services at Central Montana Medical Center.Strategy 2.1: Increase access to primary care services at CMMCStrategy 2.2: Increase access to specialty care services at CMMCGoal 3: Enhance patient understanding of healthcare billing, insurance, and navigation of patient financial programs.Strategy 3.1: Improve CMMC education and outreach efforts related to billing, insurance and financial health Goal 4: Enhance population health education and outreach in the CMMC service area.Strategy 4.1: Continue population health related outreach through CMMCStrategy 4.2: Develop community resource to increase knowledge of available health and wellness opportunitiesThe following needs were identified in our most recent CHNA and will not be addressed:1. Secondary data shows Fergus County has a higher unintentional injury death rate (per 100,000 population) compared to state and nation. Additionally, significantly more 2019 survey respondents felt that "Work/farm/ranch related accidents/injuries" were a serious health concern.2. 12.5% of survey respondents indicated cost had prohibited them from getting or taking their prescription medication regularly.3. Top reason identified for survey respondents who delayed or not receive needed care was cost (33.3%).Rationale of needs that were unable to address were as follows:* We live in an ag community where farm accidents are prevalent.* CMMC offers programs/charity care to assist with paying for healthcare costs/medicine at healthcare priced services that are based on current market conditions. CMMC provides Navigator services to the community. CMMC has affiliated with Billings Clinic (as of June 2017) to provide additional healthcare services and physicians.The following actions were taken during the fiscal year to address the needs identified in the prior CHNA:Goal 1: Expand access to behavioral health services. Activities: A community workforce has been developed with processes in place to support behavioral health in our service area. Goal 2: Increase access to health services. Activities: late-night clinic hours have been implemented to serve those wanting to be seen by a provider past 5:00p. Marketing increased in awareness of my patient portal and its effective use. Goal 3: Increase patient understanding of billing, insurance and navigate patient financial issues. Activities: Installed/implemented Cerner software. This electronic medical record will change our billing processes for the better. Goal 4: Enhance population health education and outreach. Activities: Staff have increased public and employee wellness outreach via marketing by educating through support groups, wellness programs and events and Social media. Central Montana Medical Facilities, Inc. Part V, Section B, Line 13h: Eligibility is based on patient's family size, family gross income, personal assets, and other medical debts. Central Montana Medical Facilities, Inc. Part V, Section B, Line 16j: A summary of the financial assistance policy is also posted in the hospital facility's emergency room, waiting rooms, and admissions offices. Part V, Line 16a, FAP Website: https://www.cmmc.health/for-patients/billing-and-financial-assistance/ Part V, Line 16b, FAP Application Website: https://www.cmmc.health/for-patients/billing-and-financial-assistance/ Part V, Line 16c, FAP Plain Language Summary Website: https://www.cmmc.health/for-patients/billing-and-financial-assistance/ 2 1 - Central Montana Medical Center - DME 202 4th Avenue South Lewistown MT 59457 HME/DME Services 2 - Central Montana Medical Center - Clinic 410 Wendell Ave Lewistown MT 59457 Physician Clinic Part I, Line 3c: Eligibility is based on patient's family size, family gross income, personal assets, and other medical debts. Part I, Line 7: The Organization used an average overall ratio of costs to gross charges which addresses all patient segments in order to calculate charity care. Community health improvement services, health professions education and cash and in-kind contributions were based on expenses recorded in the general ledger. Medicaid and subsidized health services are reported according to costs allocated to the relevant cost centers on the Medicare cost report. Part I, Ln 7 Col(f): The amount of bad debt expense removed from the denominator of the calculation was $909,168. Part II, Community Building Activities: Community Building activities promoted the health of the communities served by providing service and donations for a healthy, active, and educated public. Central Montana Medical Center staff donated time to community boards, such as LEPC (Lewistown Emergency Preparedness Community), Central Montana Youth Challenge, EPI Committing Meeting, and the DUI Task Force. By being a part of these community meetings CMMC staff provides a range of knowledge to the community members with a foundation on health and medical needs. All of these programs benefit central Montana area and promote health and wellness. Part III, Line 2: Bad debt expense is reported at charges as recorded by the organization.Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year. Part III, Line 4: Footnote from organization's financial statements: The footnote that describes bad debt expense is found on page 8 and 9 of the attached audit report. Part III, Line 8: Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.All of the Medicare shortfall should be treated as a community benefit. The Organization treats individuals regardless of the ability to pay. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. Part III, Line 9b: Patients deemed by CMMC to be unable to pay at any time during the revenue cycle may be eligible to receive available financial assistance. On every patient statement it states that the Hospital assistance application is available upon request. Patients must complete an application. Our collection practice is to refrain from collection efforts until financial assistance is determined. Applications received prior to 120 days are not referred to a collection agency. Any collection actions started on an application received from day 120-240 are immediately suspended in order to allow for the financial assistance application to be processed. Normal collection efforts would resume if the application is not returned timely or after the write-off is complete and the patient owes a balance. Applications are available upon request and on the website for clients to access. Part VI, Line 2: Currently, CMMC assesses the health care needs of the community by the number of responses to ads and articles released through the local media. Also tracked were the kinds of support requested of CMMC such as children's safety, wellness initiatives and healthcare assessments. In FYE 2019 CMMC completed a Community Health Needs Assessment with the help of Montana State University. Mail and phone surveys were completed and "town hall" type meetings were held in Lewistown, as well as some smaller surrounding communities. Part VI, Line 3: CMMC has financial assistance signage posted in the admissions areas and the ER waiting area. A pamphlet explaining our financial assistance program, the application process and contact information is available at all hospital registration areas. The Charity Care policy and application along with a checklist and contact information is posted on our website on the internet. Prior to discharge someone from discharge planning discusses with the patient the availability of various government benefits, such as Medicaid, and assists the patient with qualifications for such programs, where applicable. Assistance with filling out the Charity Care application is also provided at this time. Private Pay in-patients are informed of Charity Care either prior to scheduled admission by physician referral or prior to discharge from the facility. We also send out information with first time statements. All other patients are informed upon inquiry. Part VI, Line 4: Lewistown is an agricultural community and the county seat for Fergus County Montana. Lewistown is located in the center of Montana and is surrounded by five mountain ranges: the Snowies, the Judiths, the Moccasins, the Belts and the Highwoods. Lewistown's elevation is 3,963 feet with 3,102 people per square mile (average).The city of Lewistown and the surrounding rural towns are supported by one hospital, Central Montana Medical Center. Fergus County is located in a federally designated medically underserved area. As of the census of 2015, the population of Lewistown MT is 9,200 with a 2010 estimate of 9,105 people. There is an estimate of 4,615 males compared to 4,585 females. March 2016 cost of living index in our zip code (59457) is 83.1%, U.S. average is 100. Lewistown Montana has an estimate of 11,096 people per square mile with our land area at an estimated 829.1 square miles.Real estate property taxes paid for housing units with mortgages in 2015 was $1,326. Renter-occupied apartments were 31% compared to the state average of 33%.The median resident age for this zip code is 45.8 years old with an average household size of 2.2 people.The population 25 years and over in 59457 shows High school or higher: 94.0%, Bachelor's degree or higher: 29.1%, Graduate or professional degree: 6.9%, Unemployed: 2.8%, Mean travel time to work (commute): 10.8 minutesInformation obtained from www.city-data.com/city/Lewistown-Montana.html Part VI, Line 5: The CMMC Governing Board consisted of 16 volunteer community members including residents from Grass Range, Winifred, Hobson and 2 members from our affiliate, Billings Clinic. CMMC extends medical staff privileges to qualified physicians based upon community needs.Surplus funds, when available, are applied to patient care needs, equipment and building maintenance and medical education requirements. The expenditure of these funds is approved by the Governing Board which meets on a monthly basis. Part VI, Line 6: CMMC is part of an affiliated health care system with Billings Clinic. Central Montana Medical Center is involved in promoting community health by participating in Population Health programs offered by Medicare and other third party insurers. Billings Clinic and CMMC collaborate on Population Health and Care Coordination initiatives that are provided to the community. CMMC has an independent Care Coordination department focused on promoting the health of the individuals in our community. Part VI, Line 7, Reports Filed With States MT X 1 0 0 0 0 0 0 0 0 Dr Michael Sura Member 356644 0 0 0 0 0 8948 0 22021 0 387613 0 0 0 Dr Tamara Welsh Member 259485 0 0 0 0 0 10394 0 1112 0 270991 0 0 0 Alan R Aldrich CFO/Interim Co-CEO (Aug 2018) 159155 0 0 0 0 0 5679 0 17173 0 182007 0 0 0 Dr Laura Bennett Interim Co-CEO (Aug 2018) 184264 0 0 0 0 0 5432 0 20924 0 210620 0 0 0 Dr Gardner Smith Surgeon 472835 0 0 0 0 0 0 0 20924 0 493759 0 0 0 Dr Amy A LePage ER Physician 375062 0 0 0 0 0 10980 0 20924 0 406966 0 0 0 Dr Joan M McMahon CMO/Physician 277615 0 0 0 0 0 10459 0 8950 0 297024 0 0 0 Dr Christina Marchion Physician 252853 0 0 0 0 0 10545 0 20924 0 284322 0 0 0 Dr James Fox CRNA 245406 0 0 0 0 0 9833 0 1130 0 256369 0 0 0 Part I, Line 3 CMMC relied on Billings Clinic to establish appropriate compensation for CEO Robert Dowdy. The Board of Directors established the compensation for Interim Co-CEO's Alan Aldrich and Dr. Laura Bennett. Part I, Line 4a The CEO Robert Dowdy was paid a severance payment of $21,000 in November 2018, by Billings Clinic as employer. A Fergus County Montana 816001358 000000000 2014-05-01 4500000 Emergency and laboratory expansion and remodel of existing facility 0 0 0 A 897171 4500000 4500000 2015 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 Annie Davis Family Member of Board Member 95318 Payment of Compensation 0 Terrie Dowdy Family Member of CEO 48410 Payment of Contract Compensation 0 Madison Kahner Dowdy Family Member of CEO 33017 Payment of Compensation 0 Amanda Maws Family Member of Board Member 55804 Payment of Compensation 0 Form 990, Part VI, Section A, line 1 The Executive Committee includes the President or Chair, Vice President or Vice Chair, Secretary and Treasurer and 2 members-at-large and their authority is similar to that of the full governing board. Form 990, Part VI, Section A, line 3 Mr. Robert (Mike) Dowdy was an employee of Billings Clinic until November 2, 2018. Central Montana Medical Center was affiliated with Billings Clinic and Mr. Dowdy served as the CEO of CMMC until August 2018. Central Montana Medical Center paid $128,567 to Billings Clinic for Mike's services as CEO during fiscal year 2019. In addition, the organization pays Billings Clinic a Management Fee of $25,000 per month for services provided through our affiliation. After August 28th, 2018, Mr. Alan R. Aldrich and Dr. Laura Bennett became Central Montana Medical Center's interim co-CEO's. All compensation to Mr. Aldrich and Dr. Bennett has been paid by Central Montana Medical Center. Form 990, Part VI, Section A, line 6 The organization has two classes of membership: Class A general membership and Class B membership, with the sole member of the Class B Membership being Billings Clinic. Class A Membership in the Corporation shall consist of residents of Central Montana residing within the counties of Fergus, Judith Basin and Petroleum who are at least eighteen (18) years of age and who have or shall indicate their interest in the maintenance of adequate medical facilities and high standards of medical care in the area, served by CMMC, and who indicate a willingness and desire to be a member of the Corporation by attending and signing the register at the Corporation's annual meeting. Form 990, Part VI, Section A, line 7a The board has two classes of directors. Class A Directors are elected by the Class A Members and Class B Directors are appointed by the Billings Clinic. There shall be at last nine but no more than thirteen Class A Directors. There shall be at least one but no more than two Billings Clinic Directors, as determined by Billings Clinic from time to time. Each Class A Director must reside within the counties of Fergus, Judith Basin or Petroleum. Two Class A Directors must be physicians holding privileges on CMMC's active Medical Staff. Further, so long as the Corporation remains obligated for the repayment of any long-term tax-exempt financing, underwritten through Fergus County, Montana, one Class A Director shall be selected from the Fergus County Commissioners. The Board and Billings Clinic shall communicate concerning the appointment of Billings Clinic Directors with the objective of selecting individuals who will work cooperatively with the Class A Directors for the benefit of CMMC. Form 990, Part VI, Section A, line 7b Any amendment to the bylaws affecting the voting rights and powers of membership, must be approved by both a two-thirds majority of the board present at any regular or special meeting of the board and Billings Clinic. Additionally, Billings Clinic must consent to any amendment of the bylaws relating to CMMC's purpose, the membership, the members of the board, including but not limited to the number of directors, the composition of the board, the term of office of directors or the method or way in which directors are elected or selected. Form 990, Part VI, Section B, line 11b A draft copy of the Form 990 is reviewed by the CFO and Board of Directors prior to its filing. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy by discussing at the Board of Director Meetings and obtaining signed statements from members. All officers, board members, and key employees are covered by the policy. The board determines whether conflicts exist and all potential conflicts are reviewed by the board. Any person with a conflict is not allowed to vote on conflicted issues. Form 990, Part VI, Section B, line 15 CMMC relied on Billings Clinic to establish appropriate compensation for CEO Robert Dowdy. The Board of Directors established the compensation for Interim Co-CEO's Alan Aldrich and Dr. Laura Bennett. These processes take place on an annual basis. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. A copy may be requested by calling, emailing, walk-in or via mail. Form 990, Part IX, line 11g Medical/Professional Fees: Program service expenses 1,078,897. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,078,897. Service Contracts: Program service expenses 680,012. Management and general expenses 323,614. Fundraising expenses 4,222. Total expenses 1,007,848. Purchased Services: Program service expenses 1,171,579. Management and general expenses 763,171. Fundraising expenses 0. Total expenses 1,934,750. Form 990, Part XI, line 9: Change in Interest in Central Montana Foundation 259,391. Form 990, Page 1, Item F, Name and Address of Principal Officer: Dr. Laura Bennett is serving as Interim Co-CEO along with Alan R. Aldrich.