2018-05-15T11:14:47-05:00 2017-06-30 390758449 Wipfli LLP PO Box 1699 Helena MT 59624 990 2016-07-01 475437700 Pioneer Medical Center PION 4069324603 PO Box 1228 Big Timber MT 59011 Gary Hamilton CEO 4069324603 2018-05-14 1 Nathan D McCarthy CPA P00368408 4064425520 2018-05-14 65.158.74.97 2018-05-14 16:46:53 MD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 A8CCFEE0E2A316B14E893D1040E4D147629627FA 2016 2021-01-29 14:40:06Z Gary Hamilton 301 West 7th Ave Big Timber MT 59011 8000897 0 X www.pmcmt.org X 2016 MT Pioneer Medical Center is a 25-bed Critical Access Hospital, rural health clinic, 25-bed nursing home, 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 7 136 37 0 0 0 284735 0 7463530 0 3461 0 249171 0 8000897 0 0 0 0 0 3349404 0 0 0 0 4275598 0 7625002 0 375895 0 3527559 0 594006 0 2933553 Pioneer Medical Center's mission is sustainable excellence in patient and resident focused care regardless of the patient's ability to pay. 0 0 5911360 7712701 Pioneer Medical Center serves the residents of Sweet Grass County through its 25-bed Critical Access Hospital, rural health clinic, 25-bed nursing home, and 16-unit assisted living facility. 5911360 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 1 0 0 0 0 0 0 0 0 0 0 0 1 16 0 1 136 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 Curtain Board Chair 1.00 X X 0 0 0 Perry Anderson Board Vice Chair 1.00 X X 0 0 0 Mark Ketchum Director 1.00 X 0 0 0 Clint Roch Director 1.00 X 0 0 0 Joy Ott Director 1.00 X 0 0 0 Susie Mosness Director 1.00 X 0 0 0 Chad Miller Director 1.00 X 0 0 0 Gary Hamilton CEO 1.00 X 0 0 0 0 0 0 0 0 0 0 Billings Clinic PO Box 30977 Billings MT 591070977 Management/Accounting/IS/Lab 844435 Wallace Walker PO Box 1267 Big Timber MT 59011 Physician Services 234360 Wilderness Medical 100 N Avenue W Missoula MT 59801 FNP Services 170612 Livingston Healthcare 320 Alpenglow Ln Livingston MT 59048 FNP/PA Services 134877 Bauer Construction 148 Hallowell Ln Billings MT 59101 Contractor Services 111614 5 284735 284735 Net Patient Revenue 621110 6739743 6739743 Other Operating Revenu 621110 645662 645662 340B Revenue 900099 78125 78125 7463530 961 961 5205 0 5205 5205 5205 2500 0 2500 2500 2500 Tax Revenue 900099 243966 243966 243966 8000897 7712701 0 3461 X 2447211 1957769 489442 100104 80083 20021 590485 472388 118097 211604 169283 42321 410433 328346 82087 18588 18588 49018 49018 1755902 1427783 328119 14960 7480 7480 156808 125446 31362 766 383 383 70584 35292 35292 314 157 157 17464 13971 3493 111166 55583 55583 Supplies 498006 348604 149402 Repairs and Maintenance 302160 151080 151080 Bad Debt Expense 300513 300513 Food 130252 104202 26050 438664 332997 105667 7625002 5911360 1713642 0 1128690 493744 1515747 115454 26476 206646 17464 0 189182 58266 0 3527559 590882 0 3124 0 594006 X 2902483 31070 0 2933553 0 3527559 X 375895 2557658 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 85930 4943 80987 5311 1062 4249 115405 11459 103946 189182 Cash Held in Trust for Residents 3124 3124 X 8675494 975110 975110 7700384 300513 300513 8000897 8299599 975110 975110 7324489 300513 300513 7625002 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 Part XII, Line 4b - Other Adjustments: Provision for Bad Debts 1 1 1 X 1 X 1 1 1 0 0 61938 61938 0.00810 1287769 1287769 0.16890 1349707 1349707 0.17700 16622 5800 10822 0.00140 340994 254806 86188 0.01130 357616 260606 97010 0.01270 1707323 260606 1446717 0.18970 1 300512 60102 2514817 2691757 -176940 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 1 1 0 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 X 0 0 Pioneer Medical Center Part V, Section B, Line 2: Prior to 2016, Pioneer Medical Center was a facility of Sweet Grass County, MT and was accounted for on the County's books. In 2016, PMC was officially transitioned from an enterprise fund of the County to a separate reporting 501(c)(3) entity. 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. 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 servces 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. 0 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 1,069,757. Management and general expenses 267,439. Fundraising expenses 0. Total expenses 1,337,196. Contract Labor: Program service expenses 267,006. Management and general expenses 0. Fundraising expenses 0. Total expenses 267,006. Computer Consulting Fees: Program service expenses 91,020. Management and general expenses 60,680. Fundraising expenses 0. Total expenses 151,700. Form 990, Part XI, line 9: Net Assets Transferred from County 2,557,658. Part XII, Line 2c The finance committee reviews the audit before it is presented to the full Board of Directors.