2019-05-15T16:25:22-05:00 2018-06-30 390758449 WIPFLI LLP 101 EAST FRONT STREET 301 MISSOULA MT 59802 990 2017-07-01 475437700 PIONEER MEDICAL CENTER PION 4069324603 PO BOX 1228 BIG TIMBER MT 59011 BRAD HOWELL CEO 4069324603 2019-05-15 1 PHILIP L YASENAK CPA P01248379 4067281800 2019-05-10 65.158.74.97 2019-05-15 10:53:30 MD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 BE7A92E7B0152C1C6812F3C99C620D56F411D8FD 2017 2019-02-21 02:37:17Z BRAD HOWELL 301 WEST 7TH AVE BIG TIMBER MT 59011 8233366 0 X WWW.PMCMT.ORG X 2016 MT PIONEER MEDICAL CENTER IS A 25-BED CRITICAL ACCESS HOSPITAL, RURAL HEALTH CLINIC, AND 16-UNIT ASSISTED LIVING FACILITY BASED IN BIG TIMBER, MONTANA. PIONEER MEDICAL CENTER HAS A SERVICE AREA OF JUST UNDER 1,900 SQUARE MILES AND PROVIDES MEDICAL SERVICES TO THE SWEET GRASS COUNTY POPULATION OF APPROXIMATELY 3,699 PEOPLE. 7 7 168 28 0 0 284735 35734 7463530 7981155 3461 5437 249171 211040 8000897 8233366 0 0 0 0 3349404 3633912 0 0 0 4275598 4444501 7625002 8078413 375895 154953 3527559 3823684 594006 735178 2933553 3088506 PIONEER MEDICAL CENTER'S MISSION IS SUSTAINABLE EXCELLENCE IN PATIENT AND RESIDENT FOCUSED CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. 0 0 6410716 8192195 PIONEER MEDICAL CENTER SERVES THE RESIDENTS OF SWEET GRASS COUNTY THROUGH ITS 25-BED CRITICAL ACCESS HOSPITAL, RURAL HEALTH CLINIC, AND 16-UNIT ASSISTED LIVING FACILITY. 6410716 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 18 0 1 168 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X GARY HAMILTON CEO 4069324603 PO BOX 1228 BIG TIMBER MT 59011 X PAULA CURTIN BOARD CHAIR NON-VOTING 1.00 X 0 0 0 PERRY ANDERSON BOARD VICE CHAIR 1.00 X X 0 0 0 MARK KETCHAM DIRECTOR 1.00 X 0 0 0 CLINT RECH DIRECTOR 1.00 X 0 0 0 JOY OTT DIRECTOR 1.00 X 0 0 0 BILL WALLACE DIRECTOR 1.00 X 0 0 0 WALLACE WALKER DIRECTOR 1.00 X 0 0 0 CHAD MILLER DIRECTOR 1.00 X 0 0 0 GARY HAMILTON CEO 40.00 X 0 0 0 0 0 0 0 0 0 0 BILLINGS CLINIC PO BOX 31598 BILLINGS MT 59107 MANAGEMENT/ACCOUNTING/IS/LAB 972612 WALLACE WALKER PO BOX 1267 BIG TIMBER MT 59011 PHYSICIAN SERVICES 274370 LIVINGSTON HEALTHCARE 320 ALPENGLOW LN LIVINGSTON MT 59048 FNP/PA SERVICES 144628 WILDERNESS MEDICAL 100 N AVENUE W MISSOULA MT 59801 FNP SERVICES 141085 4 35734 35734 NET PATIENT REVENUE 621110 7334287 7334287 OTHER OPERATING REVENU 621110 619128 619128 340B REVENUE 900099 27740 27740 7981155 5437 5437 4475 0 4475 4475 4475 TAX REVENUE 900099 206565 206565 206565 8233366 8192195 0 5437 X 2734044 2187235 546809 104539 83631 20908 562486 449989 112497 232843 186274 46569 391601 313281 78320 1745 1745 33092 33092 2037515 1680597 356918 26222 13111 13111 163465 130772 32693 5992 2996 2996 66734 33367 33367 36 36 39770 31816 7954 112953 56477 56476 SUPPLIES 494522 395618 98904 BAD DEBT EXPENSE 351810 351810 REPAIRS AND MAINTENANCE 198751 99376 99375 FOOD 131219 104975 26244 389074 289391 99683 8078413 6410716 1667697 0 1128690 1273939 493744 503241 1515747 1665500 115454 110359 26476 39502 269957 57235 189182 212722 58266 18421 3527559 3823684 590882 733773 3124 1405 594006 735178 X 2902483 3009110 31070 79396 2933553 3088506 3527559 3823684 154953 0 X X 0 1 X 1 0 X 112777 14454 98323 5311 2124 3187 151869 40657 111212 212722 CASH HELD IN TRUST FOR RESIDENTS 1405 1405 X 8847242 975110 975110 7872132 361234 361234 8233366 8692289 975110 975110 7717179 361234 361234 8078413 PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. FEDERAL AND STATE INCOME TAXES ARE PAID ON NONEXEMPT UNRELATED BUSINESS INCOME IN ACCORDANCE WITH THE CODE. CURRENT ACCOUNTING GUIDELINES REQUIRE AN ORGANIZATION TO DETERMINE WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED ON THE FINANCIAL STATEMENTS. THE HOSPITAL RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 351,810. CHARITY CARE EXPENSES 9,424. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 351,810. CHARITY CARE EXPENSES 9,424. 1 1 1 X 1 X 1 1 1 0 1 1 20941 20941 0.00260 1023613 1000657 22956 0.00280 1044554 1000657 43897 0.00540 6814 6814 0.00080 380212 332757 47455 0.00590 387026 332757 54269 0.00670 1431580 1333414 98166 0.01210 1 351811 70362 3804654 4363274 -558620 X 1 1 1 1 PIONEER MEDICAL CENTER 301 WEST 7TH AVENUE BIG TIMBER MT 59011 WWW.PMCMT.ORG X X X PIONEER MEDICAL CENTER 1 0 0 1 X X X X X X X X 17 1 0 0 1 X PMCMT.ORG/ABOUT/OVERVIEW X 0 17 0 1 X 100.000000000000 200.000000000000 X X 1 1 X X X 1 X WWW.PMCMT.ORG X WWW.PMCMT.ORG X WWW.PMCMT.ORG X X X 1 X 0 X 1 0 0 PIONEER MEDICAL CENTER PART V, SECTION B, LINE 5: THE HOSPITAL INVITED A STEERING GROUP CONSISTING OF HEALTHCARE PROVIDERS, COMMUNITY HEALTH OFFICIALS, SCHOOL OFFICIALS, FAITH-BASED REPRESENTATIVES, AND CONCERNED CITIZENS WHO ASSISTED IN DEVELOPMENT AND REVIEW OF THE ASSESSMENT. PIONEER MEDICAL CENTER PART V, SECTION B, LINE 11: 1ST PRIORITY IMPROVE ACCESS TO HEALTHCARE SERVICES IN SWEET GRASS COUNTY.I. PMC HAS HIRED ADDITIONAL PROVIDERS FOR ER SERVICES AND HAS FREED UP TIME IN RURAL HEALTH CLINIC FOR ADDITIONAL APPOINTMENTS.II. PMC HAS SET ASIDE A TELEMEDICINE ROOM IN THE RURAL HEALTH CLINIC. PMC CONTINUES TO WORK TO DEVELOP TELEMEDICINE ARRANGEMENTS WITH BILLINGS CLINIC SPECIALISTS.III. PMC OPERATES A HOSPICE SERVICE AT A FINANCIAL LOSS. PMC DOES THIS IN CONSIDERATION OF ITS COMMITMENT TO PROVIDE CARE TO ALL SEGMENTS OF THE COMMUNITY.IV. PMC CONTINUES TO WORK TO ENHANCE ITS TRANSITIONAL CARE PROGRAM IN ORDER TO ENSURE CONTINUITY OF CARE.2ND PRIORITY - ENHANCE PIONEER MEDICAL CENTER OUTREACH AND EDUCATION EFFORTS IN THE PMC SERVICE AREA.I. PMC PROVIDES HEALTH DISTRICT SERVICES AND HAS HIRED A REGISTERED NURSE WHO WORKS IN THE COMMUNITY AND OFFERS A VARIETY OF COMMUNITY HEALTH PREVENTATIVE SERVICES AND EDUCATION.II. PMC HAS HIRED A COMMUNITY SOCIAL WORKER WHO IS STATIONED AT THE LOCAL HIGH SCHOOL. SHE HAS BEEN A RESOURCE AND CONTACT TO HIGH SCHOOL AGE PATIENTS SUFFERING MENTAL HEALTH CONDITIONS AND HAS BEEN ABLE TO ALIGN PATIENTS WITH LIMITED RESOURCES.3RD PRIORITY - STRENGTHEN PMC'S COMMUNITY ENGAGEMENT AND COLLABORATION EFFORTS TO ENHANCE COMMUNITY PARTNERSHIPS AND KNOWLEDGE OF AVAILABLE SERVICES.I. PMC HAS OBTAINED A MENTAL HEALTH SERVICES GRANT AND HAS ESTABLISHED A MENTAL HEALTH COALITION TO ADDRESS MENTAL HEALTH FOR ALL SEGMENTS OF THE POPULATION.II. PMC IS SEEKING TO GAIN THE PATIENT CENTERED PRIMARY CARE CREDENTIAL. AS PART OF THIS ACTIVITY, THE PMC RURAL HEALTH CENTER IS DEVELOPING A PATIENT ADVISORY GROUP.NEEDS NOT ABLE TO ADDRESSI. SHORTAGE OF VOLUNTEERS COMMUNITY WIDE - SMALL COMMUNITY AND DECREASED DESIRE OF COMMUNITY MEMBERS TO BE INVOLVED IN VOLUNTEER WORK. STAFFING SHORTAGES AT HOSPITAL IMPACT WILLINGNESS OF STAFF TO PERFORM VOLUNTEER WORK.II. AFFORDABLE HOUSING AND CHILDCARE SHORTAGES - BEYOND THE SCOPE OF SERVICES THE HOSPITAL PROVIDES. PART III, LINE 2: THE ORGANIZATION'S BAD DEBT EXPENSE IS EQUAL TO THE ACTUAL WRITE-OFFS DURING THE YEAR PLUS OR MINUS ANY ADJUSTMENTS MADE TO THE PROVISION ACCOUNT THROUGHOUT THE YEAR. PART III, LINE 3: THE ORGANIZATION ESTIMATES THAT ABOUT 20 PERCENT OF ITS BAD DEBT EXPENSE SHOULD BE INCLUDED AS COMMUNITY BENEFIT. PART III, LINE 4: PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS CONTAINS THE FOOTNOTE DESCRIBING BAD DEBT EXPENSE. PART III, LINE 8: THE COST TO CHARGE RATIO IS USED TO DETERMINE COMMUNITY BENEFIT. THIS IS DONE BY APPLYING THE RATIO TO THE TOTAL MEDICARE REVENUE. A SHORTFALL OR OVERAGE IN ANY GIVEN YEAR IS A RESULT OF THE TIMING OF PAYMENTS FROM MEDICARE ON AN INTERIM BASIS AND WHEN FINAL SETTLEMENT IS MADE. MANAGEMENT USES ESTIMATES TO CALCULATE SUCH SETTLEMENTS BUT ACTUAL RESULTS VARY FROM THOSE ESTIMATES. ADDITIONALLY, SHORTFALLS CAN RESULT FROM VARIOUS EXPENSES THAT ARE INCURRED BY THE FACILITY WHICH ARE CONSIDERED NON-REIMBURSABLE BY MEDICARE. SINCE PART OF THE COSTS ARE NOT REIMBURSED IT IS ONLY PRUDENT TO CONSIDER THIS SHORTFALL TO BE A BENEFIT TO THE COMMUNITY. ALSO MEDICARE RECIPIENTS ARE PART OF A CHARITABLE CLASS AND SO THE PROVISION OF MEDICAL CARE FURTHERS THIS CHARITABLE CLASS.MEDICARE ALLOWABLE COST IS BASED ON THE MEDICARE COST REPORT WHICH IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CMS. PART III, LINE 9B: THE ORGANIZATION FOLLOWS THE COLLECTION AND FINANCIAL ASSISTANCE PRACTICES MANDATED IN 501R OF THE AFFORDABLE CARE ACT. ONCE A FINANCIAL ASSISTANCE APPLICATION IS RECEIVED IT IS REVIEWED TO ENSURE ALL AREAS ARE COMPLETED AND ALL REQUESTED DOCUMENTS ARE PROVIDED. AT THIS TIME ALL COLLECTION ACTION IS SUSPENDED UNTIL A DECISION CAN BE MADE ON THE APPLICANT'S FINANCIAL ASSISTANCE REQUEST. IF THE PATIENT QUALIFIES FOR ASSISTANCE IN ACCORDANCE TO THE SLIDING FEE SCHEDULE AND THE FEDERAL POVERTY GUIDELINES, A PATIENT FINANCIAL REPRESENTATIVE THEN LOOKS BACK 240 DAYS FROM THE DATE THE APPLICATION WAS RECEIVED AND APPLIES THAT PERCENTAGE OF DISCOUNT TO ALL ACCOUNTS. SOME ACCOUNTS AT THIS POINT MAY HAVE ALREADY BEEN TURNED OVER TO A COLLECTION AGENCY. THOSE ACCOUNTS ARE PULLED BACK FROM THE COLLECTION AGENCY AND THE SAME DISCOUNT IS APPLIED. ONCE ALL DISCOUNTS ARE APPLIED, COLLECTION ACTION IS PROCEEDED AS NORMAL. PART VI, LINE 2: THE ORGANIZATION IS CURRENTLY IN THE PROCESS OF COMPLETING A COMMUNITY HEALTH NEEDS ASSESSMENT AND IDENTIFYING ADDITIONAL WAYS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. PART VI, LINE 3: THE ORGANIZATION ENSURES ALL PATIENTS ARE NOTIFIED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AT EVERY ADMISSION. AT ADMISSION, THE PATIENT SIGNS A CONDITION OF ADMISSION WHICH STATES THAT ASSISTANCE IS AVAILABLE. IN ADDITION, FINANCIAL ASSISTANCE PACKETS ARE HANDED OUT BY THE ADMISSION'S CLERK TO THOSE WHO ARE UNDERINSURED/UNINSURED OR EXPRESS NEED FOR ASSISTANCE. THIS PACKET INCLUDES ALL PAYMENT OPTIONS, MEDICAID INFORMATION AND FINANCIAL ASSISTANCE APPLICATION. IN ADDITION THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL'S WEBSITE AND POSTERS ARE PLACED AROUND THE FACILITY EXPLAINING PAYMENT OPTIONS AND FINANCIAL ASSISTANCE AVAILABILITY. EACH STATEMENT SENT OUT TO THE PATIENT STATES THAT FINANCIAL ASSISTANCE IS AVAILABLE. PART VI, LINE 4: PIONEER MEDICAL CENTER IS LOCATED IN A SMALL, RURAL COMMUNITY IN MT. PMC'S SERVICE AREA IS JUST UNDER 1,900 SQUARE MILES AND PROVIDES MEDICAL SERVICES TO THE SWEET GRASS COUNTY POPULATION OF APPROXIMATELY 3,699 PEOPLE. PART VI, LINE 5: PIONEER MEDICAL CENTER OFFERS MANY SERVICES THAT PROMOTE THE HEALTH OF THE COMMUNITY IT SERVES INCLUDING, BUT NOT LIMITED TO THE FOLLOWING: 1) PUBLIC HEALTH NURSE2) WORKING WITH SCHOOLS TO EDUCATE CHILDREN ABOUT IMPORTANT HEALTH TOPICS3) BOARD OF DIRECTORS THAT CONSISTS OF VOLUNTEERS FROM THROUGHOUT THE COMMUNITY IN ORDER TO HAVE DIVERSE REPRESENTATION GARY HAMILTON MR. HAMILTON IS PIONEER MEDICAL CENTER'S CEO. MR. HAMILTON IS AN EMPLOYEE OF THE BILLINGS CLINIC, INC., THE INDEPENDENT CONTRACTOR HIRED TO MANAGE THE HOSPITAL, AND RECEIVED ALL COMPENSATION FOR HIS SERVICES AS CEO FROM BILLINGS CLINIC. 0 FORM 990, PART VI, SECTION A, LINE 3 PMC HAS A MANAGEMENT CONTRACT WITH THE BILLINGS CLINIC. PMC'S CEO IS A BILLINGS CLINIC EMPLOYEE. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD WILL REVIEW THE 990 PRIOR TO ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C PMC HAS OVERSIGHT WITH THE BILLINGS CLINIC COMPLIANCE OFFICER WITH ANNUAL AUDITS. FORM 990, PART VI, SECTION B, LINE 15 PMC UTILIZES MHA WAGE DATA COLLECTION SERVICES ON AN ANNUAL BASIS. WAGES FOR THE CEO AND OTHER LEADING TEAM MEMBERS ARE REVIEWED WITH COMPARABLE SITES IN THE SURROUNDING AREA TO BE COMPETITIVE. THE SAME PROCESSES ARE USED FOR ALL EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THESE FORMS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,174,726. MANAGEMENT AND GENERAL EXPENSES 293,682. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,468,408. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 411,017. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 411,017. COMPUTER CONSULTING FEES: PROGRAM SERVICE EXPENSES 94,854. MANAGEMENT AND GENERAL EXPENSES 63,236. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 158,090. PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.