2018-05-15T18:15:07-05:00 2017-06-30 390758449 Wipfli LLP PO Box 1699 Helena MT 59624 990 2016-07-01 810378200 Livingston Healthcare LIVI 4062225011 504 S 13th Street Livingston MT 59047 Deb Anczak CEO 4062225011 2018-05-15 1 Nathan D McCarthy CPA P00368408 4064425520 2018-05-15 2016 2022-09-23 18:48:47Z Bren Lowe 504 S 13th Street Livingston MT 59047 52184141 0 X www.livingstonhealthcare.org X 1955 MT Livingston HealthCare is a unique group of healthcare professionals providing services to the residents of Park County, Montana, and surrounding communities. Included in those services are a 25-bed critical access hospital, a multispecialty physician practice, rehabilitation services, and home-based services such as home care and hospice care. 12 10 428 10 0 0 3198867 2993419 41451411 47919055 69161 57539 303823 1214128 45023262 52184141 0 0 0 0 21324877 22837557 0 0 151580 19670367 21531501 40995244 44369058 4028018 7815083 61459701 66258800 40282359 38334935 21177342 27923865 X The official mission of Livingston HealthCare is excellence in patient-centered care. We have been, and continue to be, successful in that endeavor because of our employees. Each of our employees is committed to maintaining and upholding our standards of excellence in the performance of their job duties and responsibilities. LHC's standards of excellence guide each and every employee, including leadership, medical staff, and managers, in achieving and sustaining the goals defined by our mission, vision, and values. 0 0 38121422 49133183 Medical treatment of sick and injured patients regardless of ability to pay. Includes private payors, insured payors, medicare, medicaid and charity care. 38121422 1 1 0 0 0 0 0 0 0 1 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 1 0 0 0 0 0 0 0 1 0 0 0 1 61 0 1 428 1 0 0 0 0 0 0 0 0 0 0 X 12 10 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X The Organization 4062225006 Livingston Healthcare 504 S 13th Livingston MT 59047 Michelle Becker President 15.00 X X 0 0 0 Denis Prager Vice President 2.00 X X 0 0 0 Ruth Striegel Weissman Secretary 2.00 X X 0 0 0 Joseph Swindlehurst Treasurer 4.00 X X 0 0 0 D Scott Coleman MD Director 40.00 1.00 X 278204 0 0 David Stanley director 2.00 X 0 0 0 Douglas P Wadle MD director 40.00 X 228681 0 0 Dan Kaul director 2.00 X 0 0 0 Michael Schaer director 2.00 X 0 0 0 Jeffry Lindenbaum MD director 2.00 X 0 0 0 Kristen Galbraith director 2.00 X 0 0 0 Shiell Anderson director 2.00 X 0 0 0 Bren Lowe Chief Executive Officer 40.00 1.00 X 0 0 0 Ted R Scofield MD Physician 40.00 X 267073 0 0 Michael Briggs Physician 40.00 X 262741 0 0 Allan Supak Physician 40.00 X 253127 0 0 Rae Stevenson Physician 40.00 X 197012 0 0 Kelly Walker Physician 40.00 X 193565 0 0 1680403 0 0 22 0 1 0 Billings Clinic PO Box 30977 Billings MT 591070977 Management & Other Medical Services 2460592 Medical Solutions 1010 N 102nd Street Suite 300 Omaha NE 68114 Locums 487066 Park County Anesthesia 320 Alpenglow Lane Livingston MT 59047 Anesthesia Services 270627 Grant Palm 1750 Carrie NYE Trail Bozeman MT 59715 Anesthesia Services 226359 Aureus Nursing 2425 S 171st Street Omaha NE 68130 Locums 170455 5 2723769 53876 215774 2993419 Net Patient Revenue 621110 47547226 47547226 Non-Patient Revenue 446110 239611 239611 Sweetgrass Physicians 621110 132218 132218 47919055 15533 15533 76914 0 76914 76914 76914 42006 0 42006 42006 42006 340B Revenue 621110 497009 497009 Meaningful Use Incentive Income 621110 382276 382276 Cafeteria Sales 446110 257929 257929 1137214 52184141 49133183 0 57539 X 18307982 14693155 3521117 93710 414777 413720 1057 2813461 2813461 1301337 1301337 35576 35576 101944 98444 3500 9343 9343 6637233 5393276 1222151 21806 143397 6612 121263 15522 65912 32301 32078 1533 447308 16487 430196 625 496477 452173 44304 74947 50523 23425 999 94814 70179 20024 4611 822766 822766 3007812 3007812 600176 600176 Medical Supplies 3812752 3808247 4505 PROVISION FOR BAD DEBT 2638455 2638455 Other Supplies 1045796 939612 102212 3972 Other Operating Expense 470615 168887 300898 830 1026178 882900 138806 4472 44369058 38121422 6096056 151580 3383326 1929111 10042 6559541 90320 9120574 11942141 307806 0 1385314 1386335 337882 187857 49907259 7037845 45409793 42869414 481442 7507 695871 660754 327651 625820 61459701 66258800 2699774 2695914 37580088 35639021 2497 0 40282359 38334935 X 18176253 26061320 2620849 1482305 380240 380240 21177342 27923865 61459701 66258800 7815083 4061 -1072621 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 436740 907288 88778 1432806 350332 86408 436740 350332 350332 350332 350332 362920 39781 52369 350332 0.10390 0.89610 0 1 1 2439317 2439317 36212092 3008051 33204041 11255850 4029794 7226056 42869414 X Part V, Line 4: The Organization has adopted investment and spending policies for endowment assets that attempt to provide a predictable stream of funding to programs supported by its endowment while seeking to maintain the purchasing power of the endowment assets. Endowment assets include those assets of donor-restricted funds that the Organization must hold in perpetuity or for a donor-specified period(s) as well as board-designated funds. Under this policy, as approved by the Board of Directors, the endowment assets are invested in a manner that is intended to preserve endowment capital. Funds shall be invested such that no less than 30% and no more than 70% of such funds shall be invested in equities, with the balance invested in fixed income securities, while assuming a moderate level of investment risk. The Organization expects its endowment funds, over time, to provide a reasonable current rate of return. 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. Federal returns for tax years 2015 and beyond remain subject to examination by the Internal Revenue Service. Part V, Line 1(b) THE $907,288 "CONTRIBUTION" IS AN ADJUSTMENT TO CORRECT THE BALANCE OF THE ENDOWMENT FUND. Part V, Line 3a(ii) A portion of this endowment fund is held by The Ough Charitable Trust, a trust established to make charitable contributions to Livingston HealthCare. 1 1 1 X 1 X 1 1 0 1 1 336534 336534 0.00810 9435728 11230960 0 0.00000 9772262 11230960 336534 0.00810 161544 161544 0.00390 15846 15846 0.00040 177390 177390 0.00430 9949652 11230960 513924 0.01240 1 2638455 2638455 10578210 10578210 X 1 1 1 BILLINGS CLINIC MANAGES THE HOSPITAL AND AFFILIATED WITH HOSPITAL 0.25000 1 1 LIVINGSTON HEALTHCHARE 504 S 13TH STREET LIVINGSTON MT 59047 X LIVINGSTON HEALTHCARE 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X livingstonhealthcare.org/About-Us.aspx X 1 16 1 livingstonhealthcare.org/About-Us.aspx 0 1 X 100.000000000000 200.000000000000 X X X X X 1 1 1 X X 1 X 1 X X X 1 0 0 LIVINGSTON HEALTHCARE Part V, Section B, Line 5: The hospital facility consulted a Steering Committee that was made up of a diverse group of community members representing various organizations and populations within the community. The various organizations follow: Child and Family Services, Clinics, Community Health Partners, Health Department, Special Ed Co-op and School Nurses, Chemical Dependency Program, Mental Health Center, Health and Nutrition Coordinator, Community Foundation, Agency on Aging, Environmental Health, and from the hospital itself. The Steering Committee met to discuss health concerns in the community and offer their perspective in designing the survey and they met again to review the results of the survey and the focus groups interviews.The adopted Implementation Plan can be found on Livingston Healthcare's website on the following web page under Community Health Needs Assessment: https://www.livingstonhealthcare.org/About-Us/Community-Health-Needs-Assessment.aspx LIVINGSTON HEALTHCARE Part V, Section B, Line 11: Needs not addressed are 1) more affordable healthcare, 2) more specialists, 3) aging services. These needs are not addressed due to limited staff time and resources; they will be addressed at a future date. 6 1 - RIVER DRIVE LHC CLINIC 1001 RIVER DRIVE LIVINGSTON MT 59047 CLINIC 2 - WEST CRAWFORD LHC CLINIC 1315 WEST CRAWFORD LIVINGSTON MT 59047 CLINIC 3 - LIVINGSTON HEALTHCARE HOME CAREHOSPICE 1429 WEST MONTANA LIVINGSTON MT 59047 HOME CARE 4 - LIVINGSTON HEALTHCARE HOME OXYGENDME 1429 WEST MONTANA LIVINGSTON MT 59047 HOME OXYGEN 5 - Livingston Urgent Care 104 Centennial Dr 103 LIVINGSTON MT 59047 Clinic 6 - Livingston Clinic Shields Valley 309 Elliot St N Wilsall MT 59086 CliNIC Part I, Line 3c: FINANCIAL ASSISTANCE WILL BE PROVIDED TO LIVINGSTON HEALTHCARE PATIENTS WHO MEET SPECIFIED FINANCIAL CRITERIA AND REQUEST SUCH ASSISTANCE. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 2,638,455. Part III, Line 4: The footnote that describes bad debt expense is on page 10 of the attached audited financial statements. Part III, Line 8: The source used to determine the amount of Medicare allowable costs reported was the cost report. Part III, Line 9b: Once a patient is approved for Financial Assistance, it is expected that the patient continue to meet his/her financial commitments to Livingston Healthcare. If a patient is approved for a percentage allowance due to financial hardship and the patient does not make the required initial payment within 60 days toward their part of the bill, the Financial Assistance allowance will be reversed and the patient will owe the entire amount. The Organization recommends that the patient make a good faith payment at the beginning of the Financial Assistance period. Part VI, Line 2: Since 1955, Livingston HealthCare has provided premier quality healthcare to the residents of Park County and surrounding communities. The Organization keeps its community healthy with a broad scope of services, provided by well-trained and highly-skilled professionals. Included in those services are a 25-bed Critical Access Hospital (CAH), a multi-specialty physician practice, home care, home oxygen, hospice care, and the regionally-renowned Orthopedic and Rehabilitation Institute. Part VI, Line 3: Financial Assistance will be provided to Livingston Healthcare patients who meet specified financial criteria and request such assistance. A Notice of the availability of Financial Assistance Program will be posted at patient registration sites within each facility and presented to patients upon request. Part VI, Line 4: Livingston is a city in and the county seat of Park County, Montana, United States. The population was approximately 7,380 people in 2009. Livingston is located in southwestern Montana, on the Yellowstone River, north of Yellowstone National Park. The median income for a household in Livingston is about $35,907. Part VI, Line 5: Livingston HealthCare is also the largest employer in Park County. As such, we have a significant economic impact on this area. Some of the effects of that impact include:(1) For every 3 full-time jobs at Livingston Healthcare, another full-time job is supported in Park County. (2) For every $1 in wages and benefits paid to Livingston Healthcare employees, another $0.19 is generated in wages and benefits in the community. (3) For each $10 spent on healthcare services provided by Livingston HealthCare an estimated $2.50 of local economic activity is produced in the community. Part VI, Line 7, Reports Filed With States MT 0 0 0 0 0 0 0 0 0 D Scott Coleman MD Director 278204 0 0 0 0 0 0 0 0 0 278204 0 0 0 Douglas P Wadle MD director 228681 0 0 0 0 0 0 0 0 0 228681 0 0 0 Ted R Scofield MD Physician 267073 0 0 0 0 0 0 0 0 0 267073 0 0 0 Michael Briggs Physician 262741 0 0 0 0 0 0 0 0 0 262741 0 0 0 Allan Supak Physician 253127 0 0 0 0 0 0 0 0 0 253127 0 0 0 Rae Stevenson Physician 197012 0 0 0 0 0 0 0 0 0 197012 0 0 0 Kelly Walker Physician 193565 0 0 0 0 0 0 0 0 0 193565 0 0 0 Bren Lowe Mr. Lowe is the CEO of Livingston Healthcare Mr. Lowe is an employee of Billings Clinic, 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 LHC has a management contract with the Billings Clinic. The CEO and Clinic Director are employees of Billings Clinic. Form 990, Part VI, Section A, line 6 The Organization has members. Form 990, Part VI, Section A, line 7a The organization's members have the authority to elect more members per the By-laws. Form 990, Part VI, Section B, line 11b THE FINANCE COMMITTEE REVIEWS THE 990 PRIOR TO ITS ISSUING. Form 990, Part VI, Section B, line 12c Through open communication and review of the policy. Form 990, Part VI, Section B, line 15a LHC's CEO is employed by the Billings Clinic, as part of the management contract. They recommend the salary, and the LHC board makes final approval. Form 990, Part VI, Section C, line 19 Forms are available upon request. The organization also has an annual report available on its website. Form 990, Part IX, line 11g Purchased Services: Program service expenses 4,755,141. Management and general expenses 1,158,335. Fundraising expenses 21,806. Total expenses 5,935,282. CRNA FEES: Program service expenses 614,802. Management and general expenses 0. Fundraising expenses 0. Total expenses 614,802. Other Fees: Program service expenses 23,333. Management and general expenses 63,816. Fundraising expenses 0. Total expenses 87,149. Form 990, Part XII, Line 2c: LHC HAS NOT CHANGED ITS METHOD FOR OVERSIGHT OF THE EXTERNAL AUDIT. LIVINGSTON HEALTHCARE FOUNDATION 504 S 13TH STREET LIVINGSTON MT 59047 810621997 TO SUPPORT LIVINGSTON HEALTHCARE PROGRAMS MT 501(c)(3) Line 12a, I 0 THE OUGH CHARITABLE TRUST 504 S 13TH STREET LIVINGSTON MT 59047 816080844 TO SUPPORT LIVINGSTON HEALTHCARE PROGRAMS MT 501(c)(3) Line 12c, III-FI 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 LIVINGSTON HEALTHCARE FOUNDATION C 2723769 CASH LiVINGSTON HEALTHCARE FOUNDATION O 93710 CASH