2019-11-15T06:54:49-06:00 2018-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2018-01-01 810392231 Wheatland Memorial Healthcare WHEA 4066324351 PO Box 287 Harlowton MT 59036 Rick Poss CEO 4066324351 2019-11-14 1 Kim Hunwardsen CPA P00484560 6122536500 2019-11-14 216.147.181.47 2019-11-14 16:26:15 CS P 330E77A2EC15986A2DC713C7FDB26B906589BB96 9EB6867304309B5BA7CF1F8994B8B429DCF961D0 2018 2020-03-31 21:24:44Z Rick Poss PO Box 287 Harlowton MT 59036 8147386 0 X www.wheatlandmemorial.org X 1951 MT To provide healthcare services to the surrounding community 6 6 117 15 0 0 314249 409633 7002553 7499667 174690 62455 17663 9572 7509155 7981327 2000 2436 0 0 4024087 4154902 0 0 0 3349754 3558304 7375841 7715642 133314 265685 6431322 6385560 2231064 2026946 4200258 4358614 X Responsive to the communities we serve, Wheatland Memorial Healthcare is dedicated to providing sustainable quality care with respect, compassion and teamwork. 0 0 6802061 2436 7499667 As a Critical Access Hospital, Wheatland Memorial Healthcare provides a broad range of primary care services to the local community regardless of ability to pay. The objective for operating the Hospital and its various departments is to meet the mission of being responsive to the communities we serve and providing sustainable quality health care with respect, compassion and teamwork.The Hospital provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. Continued on Schedule O.The amounts of charges foregone were $34,533, for the year ended December 31, 2018. The estimated cost of providing these services was approximately $30,000 for the years ended December 31, 2018, calculated by multiplying the ratio of cost to gross charges for the Hospital by the gross uncompensated charges associated with providing charity care to its patients. 6802061 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 1 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 1 1 0 0 0 1 10 0 1 117 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X Patrick McConnell 4066573821 PO Box 37000 Billings MT 59107 X June Voldseth Chairperson 1.00 X X 0 0 0 Aubrey Miller Vice Chairperson 0.50 X X 0 0 0 Jenny Peters Secretary/Treasurer 0.20 X X 0 0 0 Don Amundson Trustee 0.20 X 0 0 0 Tom Bennett Trustee 0.20 X 0 0 0 Katie Rein Trustee 0.20 X 0 0 0 Rick Poss CEO 30.00 X 0 0 0 Patrick McConnell CFO (April-Dec) 10.00 X 0 0 0 Hannah Sexton PA Physician Assistant 40.00 X 140361 0 7159 Kary Engle PA-C Certified Physician Assist 40.00 X 160801 0 11748 Rebecca Sturdevant FNP Family Nurse Practitioner 40.00 X 159663 0 6387 Karen Tomlinson Lab Tech 40.00 X 105069 0 4203 Allison Fenley DON 40.00 X 103206 0 10419 669100 0 39916 5 0 1 0 Billings Clinic PO Box 30357 Billings MT 59107 Mgmt & Consulting Services 423552 AYA Healthcare Inc 5930 Cornerstone Crt W Suite 300 San Diego CA 92121 Traveling Nurse/Provider Service 170312 Wilderness Medical Staffing 1124 West Riverside Suite 215 Spokane WA 99201 Traveler Provider Staffing 128096 3 43828 63400 302405 409633 Patient service revenu 622110 7419313 7419313 80354 80354 7499667 37748 37748 10420 848 9572 9572 9572 189918 165211 24707 24707 24707 7981327 7499667 0 72027 X 1400 1400 1036 1036 3478450 3298492 179958 91026 82525 8501 332377 321026 11351 253049 237683 15366 423552 423552 27319 27319 27600 27600 8768 8768 1339976 1295449 44527 5897 2974 2923 226666 183967 42699 34715 34628 87 182856 140539 42317 14147 8036 6111 23567 16425 7142 56214 56214 441666 441666 50620 129 50491 Medical supplies 237889 237889 Bad debt expense 197044 197044 Repairs, maintenance & 160525 156893 3632 Food expense 84675 84660 15 14608 3386 11222 7715642 6802061 913581 0 162719 192016 1532852 1439757 183625 174860 48024 32357 7797540 5771133 2311395 2026407 1898727 1991280 293980 303883 0 225000 6431322 6385560 881470 949618 3238 2437 1282792 1074891 63564 0 2231064 2026946 X 3820651 3889330 379607 469284 4200258 4358614 6431322 6385560 265685 -107329 0 X 0 1 X 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 60308 60308 2902765 2410794 491971 4834467 3360339 1474128 2026407 X Part IV, Line 2b: The Hospital acts as custodian for funds of certain swing bed patients. These funds are included in assets limited as to use and accounts payable in the financial statements. Swing bed patient trust funds totaled $2,437 and $3,238 at December 31, 2018 and 2017, respectively. Part X, Line 2: The Hospital 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 Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Organization is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose, if applicable. The Hospital has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization business Income Tax Return (Form 990-T) with the IRS. 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 Hospital 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. 1 1 X 1 X 1 X 175.000000000000 1 1 0 1 1 30000 30000 0.00400 2098685 1752633 346052 0.04600 2128685 1752633 376052 0.05000 712868 463171 249697 0.03320 712868 463171 249697 0.03320 2841553 2215804 625749 0.08320 0 197044 39015 2599765 2621919 -22154 X 1 1 1 1 Wheatland Memorial Healthcare PO Box 287 Harlowton MT 59036 www.wheatlandmemorial.org 13546 X X X X Provider based RHC - Bair Memorial Clinic Wheatland Memorial Healthcare 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X See Part V, Section C X 1 16 1 See Part V, Section C 0 1 X 100.000000000000 175.000000000000 X X X 1 1 X X X X 1 X www.wheatlandmemorial.org/resources/compassionate-care/ X www.wheatlandmemorial.org/resources/compassionate-care/ X www.wheatlandmemorial.org/resources/compassionate-care/ X X X X X X 1 X 0 X X X X 1 X 0 1 Wheatland Memorial Healthcare Part V, Section B, Line 5: A Steering Committee was convened to assist Wheatland Memorial Healthcare in conducting its CHNA. A diverse group of community members representing various organizations and populations within the community (ex. Public health, elderly, uninsured) came together in June 2016. Wheatland Memorial Healthcare Part V, Section B, Line 11: 2018 updates regarding the needs identified on the 2016 Community Health Needs Assessment are as follows: Improve access to healthcareWe are providing sleep studies. Wheatland Memorial continues the use of the Zio Patch that is a new form of ambulatory cardiac monitoring described as a wearable patch. The Hospital uses the new Ultrasound Machine, 64-slice CT Scanner, and a vein finder for better patient care. The Hospital continues to work with local agencies for mental health opportunities. Accommodate community needsWheatland publishes articles in the newspaper and on social media on chronical disease, health and wellness. WMH Trauma Coordinator continues to do the "Stop the Bleed" training throughout our service area. The Hospital continues its program to Debrief Critical Stress at the workplace/Trauma Events for staff or community members free of charge. Enhance awarenessThe Hospital issues newsletters highlighting services, education, staffing and philanthropy. An open house chalk night (partnering with our local chamber) was held September 11, 2018 and offered tours of newly remodeled bathroom, CT Scanner room and eEmergency demos. The Hospital's Medical Provider continues to speak at local high school sports meetings to raise awareness on concussions and The Impact Test which provides a baseline test on all students in sport related activities. Community Care Coordination The Hospital advertised for a position for 6 months, however, the position was removed because of lack of grant funding as the pilot program was completed. Leadership will reassess in the upcoming fiscal year. There was communication on partnering with Lewistown Care Coordinator in June 2018. The Hospital hopes to start up this program in 2019. Wheatland Memorial Healthcare Part V, Section B, Line 16j: A summary of the financial assistance policy and information on how to obtain an application or view the entire policy is posted in the emergency room, waiting rooms, and admission areas of the Hospital. A summary is also available on the Hospital's website. The financial assistance policy is also provided with the initial collection effort notices. Wheatland Memorial Healthcare 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. However patient payments are eligible for other discounts from gross charges. Schedule H, Part V, Section B, Line 7a: CHNA Report:http://www.wheatlandmemorial.org/resources/community-health-needs-assessment-report-2016/ Schedule H, Part V, Section B, Line 10a: Implementation Strategy:http://www.wheatlandmemorial.org/resources/chna-implementation-plan/ Part I, Line 3c: At 101%-125% of FPG patients receive a 75% write-offAt 126%-150% of FPG patients receive a 50% write-offAt 151%-175% of FPG patients receive a 25% write-offOver 175% of FPG patients do not receive a write-off Part I, Line 6a: Wheatland Memorial's annual community benefit report can be found on their website. Part I, Line 7: Charity care was recorded at cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. The cost for subsidized health services on line 7g was determined using the Medicare Cost Report. Part I, Ln 7 Col(f): The amount of bad debt expense removed from total expenses to determine the percentage was $197,044. Part III, Line 2: Patient accounts are not classified as bad debt until every effort is made to collect on the account. Insurance is filed and all payments are applied including contractual allowances and discounts. Any payment on an account that was written off to bad debt reduces bad debt expense in the current year. Bad debt expense on line 2 is reported at charges as presented on the financial statements. Part III, Line 3: The estimated amount of the Organization's bad debt expense attributable to patients eligible under the Organization's charity care policy is calculated by using the percentage of individuals within the community who are below the federal poverty level at 19.8%. Part III, Line 4: The footnote to the Organization's financial statements can be found on page 9 of the attached audited financial statements. Part III, Line 8: Wheatland Memorial Healthcare is a critical access hospital and in prior years has not shown a Medicare shortfall. There was a shortfall for 2018 due to sequestration. Even though Medicare was at a loss, the Hospital provides services to these patients because access to healthcare and individual's health is important to the Hospital. Therefore, the Medicare shortfall is considered a community benefit. 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. Part III, Line 9b: The Hospital is aware of patients who are in the process of applying for financial assistance and these accounts are not sent to collections. If a patient does not cooperate or is not in compliance with their payment arrangement the account is turned over to a collection agency. Collection efforts cease while a patient is under review for charity care or while a patient is in compliance with a payment arrangement. After financial assistance is awarded, any personal portion due follows the same collection procedure as other accounts. Part VI, Line 2: Wheatland Memorial Healthcare assesses the needs of the community through patient surveys, general public surveys, and community meetings. A Steering Committee was convened to assist Wheatland Memorial Healthcare in conducting its CHNA. The Hospital used a diverse group of community members representing various organizations and populations within the community. The 12/31/2016 needs assessment and implementation strategy is posted to the Hospital website. Part VI, Line 3: Wheatland Memorial Healthcare tries to determine if patients qualify or possibly qualify for any financial assistance either at registration or discharge. We notify patients of our programs by making available financial assistance brochures in waiting rooms, emergency room areas, and other patient access areas and local newspaper ads. Financial assistance information is provided in all correspondence regarding patient bills. We also have staff available to assist in applications for state aid. Part VI, Line 4: Wheatland Memorial Healthcare (WMH) is a 25-bed critical access hospital and rural health clinic located in Harlowton, Montana. Harlowton is a ranching community in central Montana with approximately 1.6 people per square mile. The population of Harlowton was 932 and Wheatland County was 2,108. WMH serves residents of Wheatland, Golden Valley, Judith Basin and portions of Sweet Grass and Meagher counties. The most common industries are management, farming, fishing, and construction. The nearest tertiary care facility is 93 miles south east of Harlowton, in Billings, MT. The next closest tertiary care facility is 130 miles north west of Harlowton, in Great Falls, MT. Lewistown which is 60 miles north from WMH, has a secondary care facility. The median household income in Wheatland County was $37,222, and individuals living below the federal poverty level in was 19.8%. Part VI, Line 5: Our Board is comprised of members within our local and outlying service area. These Members are not employees or contractors of the organization. At this time the Organization has lacked excess funds from operations but has pursued grants aggressively in order to replace aging equipment and establish community health programs that will allow us to continue serving the health care needs of our community during these challenging economic times. Our emergency room is available 24/7 and serves all individuals regardless of ability to pay. We extend privileges to medical staff that are licensed and qualified. The Hospital provides space for immunization clinics to ensure children in the community receive recommended immunizations. We also provide space for the regional WIC (Women, Infants and Children) clinic to promote the services offered by that organization. The Hospital has established a strong working relationship with the chaplains of several churches who provide support to patients and families of the facility and participate in care planning and regular meetings. The CEO regularly attends county commissioner meetings to provide the community with an update of the events going on at the Hospital. Board members also frequently attend these commissioner meetings. The Hospital and its attached rural health clinic is the sole provider of health care services within the community. Part VI, Line 6: An "affiliated health care system" is a system that includes affiliates under common governance or control, or that cooperate in providing health care services to their community or communities. 0 0 0 0 0 0 0 0 0 Kary Engle PA-C Certified Physician Assist 160801 0 0 0 0 0 5457 0 6291 0 172549 0 0 0 Rebecca Sturdevant FNP Family Nurse Practitioner 159663 0 0 0 0 0 6387 0 0 0 166050 0 0 0 Schedule J, Part I, Question 3: Wheatland Memorial Healthcare does not pay compensation to the CEO directly. The CEO is a common law employee of and compensated by Billings Clinic. Billings Clinic determines compensation based on the processes described in Part I, Question 3 and other methods they have established. Form 990, Part VI, Section A, line 3 The CEO and CFO positions at Wheatland Memorial Healthcare are considered common law employees of Billings Clinic. Billings Clinic may, in its discretion at any time, remove and replace the CEO and CFO. The CEO has the responsibility of supervising management and administrating the operation of Wheatland Memorial Healthcare. The CFO has the responsibility of managing the Organization's finances. The amounts below were paid to each individual based on an hourly rate. Rick Poss, CEO Salary $120,000 Patrick McConnell, CFO Salary $16,244 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 A copy of the completed Form 990 is provided to the Board Members before it is filed. The CEO and CFO review the Form 990. Form 990, Part VI, Section B, line 12c All officers, trustees, and key employees are required upon hire and at least annually thereafter to disclose any conflicts or potential conflicts and sign a conflict of interest policy. A conflict of interest can be considered to exist in any instance where the actions or activities of an individual on behalf of Wheatland Memorial also involve the obtaining of an improper gain or advantage, or adverse effect on the interests of Wheatland Memorial. The CEO reviews the statements and investigates all disclosures of possible conflicts of interest. The CEO prepares a report for the Executive Committee. The Executive Committee is responsible for final review and investigation of potential conflicts of interest and presentation of its findings to the Wheatland Memorial Board of Directors on an annual basis. Upon disclosure of a possible conflict of interest, Board Members will refrain from deliberating on the matter until all relevant and pertinent facts and circumstances have been disclosed and any potential conflict has been avoided or resolved. The individual with a conflict is not allowed to be present when the matter is discussed or voted upon. All matters of discussion are documented. Form 990, Part VI, Section B, line 15 The CEO and CFO are common law employees of Billings Clinic. Billings Clinic determines compensation based on methods they have established. The Board of Directors approves the management relationship with Billings Clinic. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request. The financial statements are also attached to the Form 990. Form 990, Part IX, line 11g Professional Fees: Program service expenses 982,854. Management and general expenses 18,963. Fundraising expenses 0. Total expenses 1,001,817. Recruitment: Program service expenses 21,008. Management and general expenses 56. Fundraising expenses 0. Total expenses 21,064. Contracted Services: Program service expenses 291,587. Management and general expenses 25,508. Fundraising expenses 0. Total expenses 317,095. Wheatland Memorial Healthcare Foundation PO Box 287 Harlowton MT 59036 454035841 Support Wheatland Memorial Healthcare MT 501(c)(3) Line 12a, I Wheatland Memorial Healthcare 1 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0