2012-05-10T11:19:23-07:00 2011-06-30 990 2010-07-01 810231784 BILLINGS CLINIC BILL 4062382500 2800 Tenth Avenue North Billings MT 59101 Connie F Prewitt 4062382134 2012-05-15 2010 2016-02-24 21:20:13Z Nicholas Wolter MD 2800 Tenth Avenue N Billings MT 59101 1091195196 0 X billingsclinic.com X 1907 MT Billings Clinic will be a national leader in providing the best clinical quality, patient safety, service and value. 12 9 3893 248 5393358 118877 5252157 3799079 486738291 501834997 4176066 11022251 13867154 16685027 510033668 533341354 0 0 0 0 262345592 269671198 0 0 0 224834233 235125312 487179825 504796510 22853843 28544844 497625440 534176825 231421885 227968706 266203555 306208119 Billings Clinic is a not for profit healthcare organization serving the nearly 600,000 residents of eastern and south-central Montana, northern Wyoming and the western Dakotas. Billings Clinic operates a multi-specilty group practice in Billings and in six regional locations, an acute care hospital and long term care facility. Their mission is healthcare, education and research. 0 0 180207783 0 282694101 Hospital patient care 180804402 0 192785005 Clinic patient care 11157663 0 7677754 Nursing home patient care 7454296 0 17529502 See Schedule O, statement 1 7454296 0 17529502 379624144 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 230 0 1 3893 1 1 1 0 0 0 0 0 0 0 0 0 X 12 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Connie F Prewitt 4062382134 2800 Tenth Avenue North Billings MT 59101 W Ballard 2 X 7500 0 0 D Brown 2 X 0 0 6725 E Fulton 2 X 0 0 3016 T Hathaway 2 X 0 0 7961 L Knight 2 X 12000 0 0 P Nance 2 X 7500 0 0 J Ott 2 X 0 0 6451 L Overstreet 2 X 0 0 7961 M Schaer 2 X 12000 0 0 J Shepard Lovell 2 X 0 0 4613 Dr J Millikan 95 X 552827 0 37557 Dr C McCracken 75.00 X 290421 0 32836 Dr N Wolter 60 X 660565 0 181021 C Prewitt 68 X 307503 0 52964 D Ebel 1 X 20555 0 0 Dr Wentzell 50 X 1124787 0 34369 Dr Morone 75.00 X 985119 0 32047 Dr Purcell 70.00 X 927888 0 32949 Dr Sample 100.00 X 826025 0 32214 Dr Lindenbaum 50.00 X 796772 0 32003 Dr Knostman 0 X 11714 0 835 6543176 0 505522 319 1 1 0 Sodexo C/O Billings Clinic Billings MT 59101 Patient food service 5025851 MD Network Box 731 Cody WY 82414 Transcription services 2095433 Healthcare Resource Group 12610 E Mirabeau Parkway Suite 800 Spokane Valley WA 99216 Temporary staffing 1921533 Weatherby Locums Inc PO Box 972633 Dallas TX 75397 Professional staffing 1716543 Bauer Construction 148 Hallowell Lane Billings MT 59101 Building contractor 1363753 38 0 0 0 3799079 0 0 0 3799079 Patient service revenue 622000 496441639 496441639 0 0 Reference lab 621500 3614459 0 3614459 0 IT services to other hospitals 541519 1148047 0 1148047 0 Optical shop 446130 630264 0 630264 0 Partnership income related to program service 541900 588 0 588 0 0 0 0 0 501834997 5777894 0 0 5777894 0 0 0 0 0 0 0 0 68849 0 101211 0 -32362 0 -32362 0 0 -32362 562139723 537166 556830883 601649 5308840 -64483 5244357 0 0 5244357 0 458024 320099 137925 0 0 137925 Insurance premiums 524298 6819037 6819037 0 0 Share of JV 621300 945708 945708 0 0 8814719 8814719 0 0 16579464 533341354 513021103 5393358 11127814 0 0 0 0 0 0 0 0 2242033 0 2242033 0 0 0 0 0 222925838 181367104 41558734 0 10619638 8633793 1985845 0 19995413 14286553 5708860 0 13888276 10837236 3051040 0 0 0 0 0 1350911 2375 1348536 0 182158 0 182158 0 37524 0 37524 0 846809 0 846809 0 31835921 10505061 21330860 0 994706 139339 855367 0 92227877 88164821 4063056 0 5494653 463233 5031420 0 0 0 0 0 6400757 3451592 2949165 0 2474418 1589867 884551 0 0 0 0 0 321995 118837 203158 0 11325346 99811 11225535 0 0 0 0 0 17097750 13249267 3848483 0 15165636 4572896 10592740 0 Recruitment 1661887 5805 1656082 0 Bad debt 36589311 36259311 330000 0 Bed tax 3453397 280947 3172450 0 Dues and fees 980483 163626 816857 0 Repairs 6102137 4946511 1155626 0 581636 486159 95477 0 504796510 379624144 125172366 0 17087854 10559381 21883719 21303735 0 0 68297133 67931288 0 0 0 0 8546299 8704883 6794151 6505363 5524333 5380977 408241254 212978957 186707728 195262297 139090983 171354595 0 0 12191155 11657517 3722305 3222544 27779780 32294245 497625440 534176825 47708467 48962844 0 0 0 0 144839706 137531015 0 0 0 0 2531045 6327042 0 0 36342667 35147805 231421885 227968706 X 240597129 279868321 7725992 7316156 17880434 19023642 266203555 306208119 497625440 534176825 X 28544844 11459720 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 37524 37524 504758986 504796510 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 136064 105276 21245 37524 300109 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 19640069 605720 781122 0 0 0 21026911 18575246 665198 399625 0 0 0 19640069 1781249 1048699 -197238 0 0 0 2632710 0.1 0.9 0 0 1 1 0 17998001 17998001 0 150196046 59104941 91091105 0 1374959 1131838 243121 0 205217322 145114848 60102474 0 33454926 7627330 25827596 195262297 Beneficial interest in Billings Clinic Foundation 32294245 32294245 0 Swap valuation 19210571 Provision for unpaid claims 9294689 Estimated claims 6642545 35147805 533341354 504796510 28544844 11458970 0 0 0 750 11459720 40004564 535472699 11458970 750 0 91 11459811 524012888 846809 8481657 9328466 533341354 495470747 0 0 0 98 98 495470649 846809 8479052 9325861 504796510 SchD_P05_S00_L04 Schedule D, Part V, Line 4 Schedule D, Part V, Line 4 - Endowment funds are to be invested and held in perpetuity to provide a source of income for Billings Clinic programs and needs. SchD_P10_S00_L02 Schedule D, Part X, Line 2 There is no footnote. SchD_P11_S00_L08 Schedule D, Part XI, Line 8 Transfer of donated equipment from Billings Clinic Foundation SchD_P12_S00_L02d Schedule D, Part XII, Line 2d Rounding SchD_P12_S00_L04b Schedule D, Part XII, Line 4b Reclass 1,110,614 MHI income 7,245,376 Auxiliary income 125,667 SchD_P13_S00_L02d Schedule D, Part XIII, Line 2d Rounding SchD_P13_S00_L04b Schedule D, Part XIII, Line 4b Reclass 1,110,614 MHI expenses 7,242,771 Auxiliary expense 125,667 1 1 1 X 1 X 1 1 0 1 1 36860 13980388 0 13980388 0.0299 101446 41029483 44491568 -3462085 0 0 0 0 0 0 0 138306 55009871 44491568 10518303 0.0299 36 103561 3555877 347552 3208325 0.0069 7 553 2577748 518588 2059160 0.0044 12 185239 45466560 38058116 7408444 0.0158 1 12561 3640581 2965 3637616 0.0078 6 3296 196323 0 196323 0.0004 62 305210 55437089 38927221 16509868 0.0353 62 443516 110446960 83418789 27028171 0.0652 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 173808 0 173808 0 3 388 76977 36294 40683 0 0 0 0 0 0 0 7 388 250785 36294 214491 0 0 16410297 5161647 158775249 167364107 -8588858 X 1 1 1 1 Billings Clinic (Deaconess Hospital)

2800 Tenth Avenue North Billings MT 59101

X X X X X Billings Clinic (Deaconess Hospital) 1 6 Billings Clinic (Billings Clinic)

2800 Tenth Avenue North Billings MT 59101

Multispecialty physician outpatient clinics Billings MRI Center

1041 N 29th St Billings MT 59101

Medical imaging Billings Clinic (Aspen Meadows)

3155 Avenue C Billings MT 59102

Long term care facility Bozeman Dialysis Center

931 Highland Blvd Bozeman MT 59715

Dialysis unit Livingston Imaging

504 S 13th St Livingston MT 59047

Medical imaging Billings Clinic Sheridan Dialysis

1401 West 5th St Sheridan WY 82801

Dialysis unit SchH_P01_S00_L03c Schedule H, Part I, Line 3c The Federal Poverty Guidelines (FPG) are utilized to determine eligibility. In addition, Billings Clinic utilizes a calculator that has built into the formulas the FPG and the cost of living within our area to help determine the patient's ability to pay. Our application requires submitting bank statement and investment account information to consider assets as part of the process. The application includes: o Completed and signed application and financial assistance checklist completed. o Letter of need completed. o Complete copies of previous years federal and state tax returns, all pages, all schedules, all W-2's. o Debt to income ratio o Type of employment (part/time, seasonal, etc.) o Copies of earnings for last three months for each person in the household, i.e., paystubs, social security, pensions, unemployment benefits, etc. Profit and Loss statement for self employed applicants. o Copies of last three months bank statements, savings statements, investment account statements. o Letters of support from assisting party if household is receiving assistance from family and/or friends. o Award letters from SNAP, LIEAP, TANF, college loans, general assistance, etc. o If currently unemployed, when was last day of work? o How they spend their income (Information from bank statements). SchH_P01_S00_L07 Schedule H, Part I, Line 7 For the calculation of the unreimbursed cost of charity care and Medicaid, a ratio of patient care cost to charges using worksheet 2 was utilized. For the calculation of the cost of subsidized services, individual department cost to charge ratios were used, rather than facility wide. SchH_P01_S00_L072f Schedule H, Part I, Line 7, Column f Bad debt expense included on Form 990, Part IX, line 25, Column A, but subtracted for purposes of calculating the percentage column is $36,589,311. SchH_P01_S00_L07g Schedule H, Part I, Line 7g Included as subsidized health services are the unreimbursed costs attributable to our rural primary care physician clinics and regional physician outreach clinics (minus bad debt, charity care, Medicaid and Medicare) at a total net benefit of $2,637,190. The specialty outreach clinics offer biweekly or monthly specialty care in rural areas without that care available. Outreach clinics provided 15,053 specialty appointments. Primary care branch clinics had 114,806 encounters in FY11. Both outreach and primary care branch clinics offer financial asistance to eligible patients, and they see patients with Medicare, Medicaid and Health Montana Kids (SCHIP). SchH_P02_S00_L00 Schedule H, Part II Billings Clinic's community building activities include support for the Alliance, a partnership between city-county public health department, St. Vincent Healthcare and Billings Clinic for community health improvement efforts, community influenza vaccinations and disaster response planning. This includes advocacy for community health at the local and regional level. Under Workforce Development, Billings Clinic coordinates and sponsors a regional Science Expo to encourage young scientists to become future nurses, physicians or health care professionals. SchH_P03_S0A_L04 Schedule H, Part III, Section A, Line 4 The Organization reports patient accounts receivable for services rendered at net realizable amounts from third-party payors, patients and others. The Organization provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient, the Organization bills third-party payers directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. For the calculation of the unreimbursed cost of bad debt, a ratio of patient care cost to charges using worksheet 2 was utilized and applied to charges written off to bad debt. The facility does not routinely discount patient charges and any payments received would reduce the bad debt expense. At this time, the provider does not have a methodology in place to determine amounts applicable to patients who would qualify for charity care, but did not provide sufficient information. Many of these accounts are written off to charity care under the organization's current policies, based upon known factors, such as homelessness. Others are written off to bad debt, but cannot be identified. We do have a number that would cover possible patients who would have qualified for charity care in the hospital only, but did not provide enough information to qualify. That amount is a cost of $5,161,647. SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 For the calculation of the unreimbursed cost of Medicare a ratio of patient care cost to charges using worksheet 2 was utilized and applied to gross Medicare charges. Billings Clinic provided care for 382,186 Medicare patient encounters, at an unreimbursed cost of $8,588,858. We do not use the Cost Report for this number. The Cost Report only captures revenue related to the facility and does not capture revenue/losses related to clinical professional services, which are a substantial portion of Billings Clinic Medicare shortfalls. SchH_P03_S0C_L09b Schedule H, Part III, Section C, Line 9b There was not a formal, written policy in tax year 2010. We do now have one which is effective as of 10/5/11 (OHA-205 "Patient Financial Services"). However, during tax year 2010 we did have a collection process, which was used to screen patients for financial assistance prior to making payment arrangements for care. The policy applies equally to all patients - insured, under-insured or uninsured. Once a determination has been made and adjustments applied to the account balance, any remaining balance would fall into the regular guidelines of collection, giving patients financing options that will work within their monthly budget. Patients who cannot meet the requirements of a payment arrangement should be offered a loan program and/or financial assistance as options. If the patient agrees to financial assistance, the application should be requested. Agency will print and mail financial assistance applications. This will be completed by the end of each business day. After a patient completes the application, the patient will send it back to Billings Clinic for financial assistance determination. SchH_P06_S00_L02 Schedule H, Part VI, Line 2 The 2010 Community Health Needs Assessment (CHNA) was a systematic, data driven approach to determining the health status, behaviors and needs of residents in Yellowstone County. Billings Clinic partnered with another local hospital, St. Vincent Healthcare, and city/county health department, RiverStone Health, to coordinate and pay for the CHNA. It serves as a tool to improve the health status and improve the quality of life overall of Yellowstone County residents. The 2010 Community Health Survey consisted of 400 randomized telephone contacts representing the diverse socioeconomic and geographic characteristics of Yellowstone County. Existing vital statistics and other health-related data are incorporated into the assessment as secondary sources. In addition, focus groups were conducted among physicians, legislators, social services, educators and employers. Results of the 2010 Community Health Assessment were reviewed by the Alliance, a Healthy By Design sponsored community forum, and the Billings Clinic Community Health Improvement Committee. Findings were compared between 2010 and the 2006 assessment results. And Implementation Plan has been completed, both for the Alliance (community-wide) and for Billings Clinic (organization-wide). SchH_P06_S00_L03 Schedule H, Part VI, Line 3 * All patients may apply for financial assistance - informational brochures and applications are available at registration desks in the clinic and hospital, the Emergency Department discharge desk, care management staff and on our website at billingsclinic.com. * Information about financial assistance is printed on the back of patient bills. * Patients hospitalized without identifying a third party payer source are screened for coverage/assistance - SSI (Social Security Supplemental income, if approved will qualify for Medicaid), SSDI (Social Security Disability Income), Veterans' Administration, Indian Health Services, Workers Compensation, Medicaid, Crime Victims, and health insurance coverage. * A Financial Assistance brochure is mailed to new patients (Clinic and Hospital) in their pre-admission packets. These packets are mailed to all patients, even if they cannot be reached by phone in advance. * An application is mailed to patients whose payment pattern indicates that they may need assistance. * Staff is available to help any patient needing assistance to complete an application. * According to our existing Financial Application policy, a patient is not eligible for charity assistance if the account is sent to bad debt. We do bring accounts back in house for charity assistance on a case-by-case basis. * An account is sent to bad debt at least 120 days after they are considered just "self-pay", at least three statements, and/or multiple attempts to contact the patient. SchH_P06_S00_L04 Schedule H, Part VI, Line 4 Billings Clinic is based in Billings, Montana, the largest city in Montana, with more than 148,000 people in Yellowstone County. In Billings there are two not-for-profit hospitals of similar size. Billings Clinic is an integrated, not for profit, community-governed health care organization providing services to a forty-three county area in eastern Montana and northern Wyoming. Billings Clinic defines its broad geographic service area as 43 counties in eastern Montana and northern Wyoming, encompassing nearly 128,000 square miles with a population of 595,000 people. Today, Billings Clinic employs more than 3,400 employees, including 238 physicians, and 81 mid-level practitioners, and operates a multi-specialty physician clinic; 272-bed acute care hospital; level II trauma center; a 90-bed long-term care facility; a clinical research center; and a variety of ambulatory, diagnostic and treatment services. Thirty-eight of those 40 counties are either wholly or partly designated as Health Professional Shortage Areas (HPSA) by the US Department of Health and Human Services, Health Resources and Services Administration under the Primary Medical Care discipline. The area includes five American Indian Reservations and an American Indian population of 38,882, or 6.9% of the service area's population. The US Census Bureau 2008 estimates show that 27.3% of Montana families are below 200% of the Federal Poverty level, compared to 26.6% for the nation and Montana is ranked 13th lowest of 50 states in Median Family Income. According to the 2010 US Census, Montana had 17.3% of the population without health insurance coverage in 2010, including all ages of the civilian, non-institutionalized population. SchH_P06_S00_L05 Schedule H, Part VI, Line 5 Billings Clinic is an integrated health care organization, combining a not-for-profit multi-specialty medical group practice with a hospital and long term care facility. Our organization promoted community health in many ways in Fiscal Year 2011, including: * Substantial financial assistance and charity care was provided to patients in need. Billings Clinic provides more charity care than another other hospital or health care organization in Montana. * Care was provided to Medicare and Medicaid patients, as well as SCHIP for children. * Our Board's governance and nominating committee reviewed the entire 990, including Schedule H, which was then discussed with the entire Board of Directors. The Community Benefit Report, used for Schedule H, is also reviewed by the Board committee for Community Health Improvement. * Billings Clinic is a teaching hospital and supports, along with Riverstone Health and St. Vincent Healthcare, the only post-graduate medical education in Montana - the Montana Family Medicine Residency Program. Nearly 90 percent of the graduates establish a practice in rural, medically underserved settings in Montana. In addition we provide ongoing preceptorships for medical, nursing and pharmacy students so that they can obtain real-life experience during college and graduate school. * Billings Clinic is a Medicaid disproportionate share hospital serving a significantly disproportionate number of low-income patients. * Billings Clinic has the only inpatient psychiatric services available in our region of central and eastern Montana and northern Wyoming, despite significant financial loss. We are committed to mental health care and continually work to find ways to reach those in need in the region, such as through telemedicine programs and education for primary care providers. * Our full-time emergency department is maintained where no one is denied care, within our capacity to provide care. * Our board of directors is composed of community members who reside in the primary service area. Only three out of 12 board members are employees - two are employed physicians and one is our CEO. * Medical staff privileges are open to all qualified physicians in our community. Operating surpluses are directed solely toward meeting our charitable purposes, including education, research, capital expenses, debt amortization, patient care improvements and medical education. SchH_P06_S00_L06 Schedule H, Part VI, Line 6 Not applicable. SchH_P06_S00_L07 Schedule H, Part VI, Line 7 Billings Clinic files a community benefit report to the state of Montana's Attorney General's office. X X 1 1 X X X X X 0 1 0 0 0 1 0 0 0 Dr J Millikan 549976 0 0 0 2851 0 29088 0 8271 0 590186 0 0 0 Dr C McCracken 290421 0 0 0 0 0 26259 0 6379 0 323059 0 0 0 Dr N Wolter 583023 0 77438 0 104 0 171775 0 9048 0 841388 0 0 0 C Prewitt 256940 0 50563 0 0 0 46264 0 6502 0 360269 0 0 0 Dr Wentzell 1124687 0 0 0 100 0 21775 0 12396 0 1158958 0 0 0 Dr Morone 790367 0 0 0 194751 0 20461 0 11389 0 1016968 0 194751 0 Dr Purcell 699177 0 31500 0 197211 0 21775 0 10061 0 959724 0 197211 0 Dr Sample 825026 0 0 0 0 0 21775 0 10241 0 857042 0 0 0 Dr Lindenbaum 776772 0 20000 0 0 0 21775 0 10030 0 828577 0 0 0 Dr Knostman 0 0 0 0 11714 0 835 0 0 0 12549 0 11714 0 SchJ_P01_S00_L01a Schedule J, Part I, Line 1a Billings Clinic perioldically arranges and pays for charter travel for management and/or Board members attending governance education conferences, State legislative hearings and association meetings. There were 17 of these flights in FY11. Billings Clinic also pays for the travel expenses of spouses of Board members attending organizationally approved/arranged goverance education. This reimbursement is reported as income consistent with the Board travel reimbursement policy. SchJ_P01_S00_L04 Schedule J, Part I, Line 4 Schedule J, Part I, Line 4 - Supplemental Retirement Agreement (CEO) - nonelective 457(f) agreement provides for fixed annual deferrals in amounts ranging from $115,000 to $165,000, which become vested and payable after continued employement on June 30, 2013 or earlier death, disability, involuntary termination without cause, or involuntary termination for good reason following a change in control of the corporation. Physician 457(f) Plan - Nonelective 457(f) agreement provides for one-time deferral of $200,000 in August 2006 to become vested and payable on July 1, 2010 or in a prorated amount on earlier death, disability or involuntary termination of employment without cause. SchJ_P01_S00_L06 Schedule J, Part I, Line 6 Scheduel J, Part I, Line 6 - The Board of Directors annually determines the incentive plan amount for the CEO and the Senior Executive Team based on an external compensation study. The availability of the incentive is triggered by the organizational operating margin performance target. The incentive is awarded based on financial performance as well as organizational performance measurements in quality, service satisfaction, both patient and employee satisfaction and then individual goals set each year if the target is triggered. The incentive is paid only if triggered following the financial audit presentation. Montana Facility Finance Authority 810302402 2008-05-30 60000000 Property, plant and equipment 0 0 0 Montana Facility Finance Authority 810302402 2009-06-24 12720000 Property, plant and equipment 0 0 0 0 0 60000000 5535735 0 0 1200000 0 0 53264265 0 0 2009 0 0 1 1 0 0 12720000 0 0 0 58000 0 0 12662000 0 0 2009 0 0 1 1 0 0 0 0 1 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The 990 review is completed before the return is filed is as follows: 1)CFO, 2)Executive group, 3)Governance and Nominating Committee of the Board, and 4)Board of Directors. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The Governance and Nominating Committee of the Board of Directors, according to their charter, reviews annually the disclosure statements of the Board of Directors and senior exectives and takes action to resolve conflicts. A Conflict of Interest Review Panel, chaired by the Compliance Officer, as outlined in organizational policy, is responsible for reviewing disclosed conflicts and approving necessary conflict management plans of all other interested persons at Billings Clinic. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 Billings Clinic has an executive compensation program administered by independent trustees following best practices and the highest regulatory standards expected of a not-for-profit organization. They follow a board approved charter and overall executive compensation philosophy which defines the market as a comparable set of not-for-profit health care delivery systems. They look at relevant market data of similar roles in similar organizations. Annual disclosure of the committee's actions and decisions to the full Board is required. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Billings Clinic makes its tax forms available for public inspection through individual request. F990_P11_S00_L05 Form 990, Part XI, Line 5 Part XI, line 5 unrealized gains and transfer of equipment from Billings Clinic Foundation Montana Healthcare Indemnity LLC 2800 Tenth Avenue North Billings MT 59101 810231784 Insurance captive MT 7245376 9666532 Billings Clinic Billings Clinic Foundation 2917 Tenth Avenue North Billings MT 59101 810407289 Fund raising MT 501(c)(3) 7 Billings Clinic 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 1 Billings Clinic Foundation c 3799079