Civic Intelligence

Billings Clinic

EIN 81-0231784 • 501(c)3 • Billings, MT

Profile

Billings clinic mission is health care, education and research. Billings clinic will provide the best in nation clinical quality, patient safety, service and value.

2800 Tenth Avenue NorthBillings, MT 59101

www.billingsclinic.com

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

56th percentile

0.35x

Higher debt load relative to assets than 56% of similar nonprofits.

501(c)3 • $1B+ nonprofits • Source year 2024

Liabilities / Revenue

35th percentile

0.40x

Higher debt load relative to revenue than 35% of similar nonprofits.

501(c)3 • $1B+ nonprofits • Source year 2024

Net Margin

17th percentile

-1.5%

Higher net margin than 17% of similar nonprofits.

501(c)3 • $1B+ nonprofits • Source year 2024

Top Officer Pay

55th percentile

$2,234,126

Higher top officer pay than 55% of similar nonprofits.

Top officer pay equals 0.2% of source-year revenue.

501(c)3 • $1B+ nonprofits • Source year 2024

Asset Growth

13th percentile

-0.0%

Faster asset growth than 13% of similar nonprofits.

501(c)3 • $1B+ nonprofits • Annualized from 2023 to 2024

Revenue Growth

96th percentile

127%

Faster revenue growth than 96% of similar nonprofits.

501(c)3 • $1B+ nonprofits • Annualized from 2023 to 2024

Assets

Down

$1,395,798,536

Down $651,251 (-0.0%) from 2023

Liabilities

Down

$490,387,916

Down $5,998,012 (-1.2%) from 2023

Net Assets

Up

$905,410,620

Up $5,346,761 (+0.6%) from 2023

Revenue

Up

$1,225,617,600

Up $685,211,103 (+127%) from 2023

Expenses

Up

$1,244,167,405

Up $690,971,133 (+125%) from 2023

Net Income

Down

-$18,549,805

Down $5,760,030 (-45%) from 2023

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$1.5B$1.0B$500M$0Assets 2010: $497,625,440Liabilities 2010: $231,421,885Net Assets 2010: $266,203,5552010Assets 2011: $534,176,825Liabilities 2011: $227,968,706Net Assets 2011: $306,208,1192011Assets 2012: $589,973,650Liabilities 2012: $264,809,291Net Assets 2012: $325,164,3592012Assets 2013: $614,621,362Liabilities 2013: $260,318,573Net Assets 2013: $354,302,7892013Assets 2014: $664,984,296Liabilities 2014: $262,301,525Net Assets 2014: $402,682,7712014Assets 2015: $706,036,383Liabilities 2015: $273,015,058Net Assets 2015: $433,021,3252015Assets 2016: $711,015,080Liabilities 2016: $276,052,936Net Assets 2016: $434,962,1442016Assets 2017: $776,435,285Liabilities 2017: $259,698,478Net Assets 2017: $516,736,8072017Assets 2018: $882,833,730Liabilities 2018: $262,095,510Net Assets 2018: $620,738,2202018Assets 2019: $1,051,858,268Liabilities 2019: $336,321,091Net Assets 2019: $715,537,1772019Assets 2020: $1,116,696,008Liabilities 2020: $350,999,223Net Assets 2020: $765,696,7852020Assets 2021: $1,329,607,252Liabilities 2021: $370,498,997Net Assets 2021: $959,108,2552021Assets 2022: $1,491,215,198Liabilities 2022: $568,758,735Net Assets 2022: $922,456,4632022Assets 2023: $1,396,449,787Liabilities 2023: $496,385,928Net Assets 2023: $900,063,8592023Assets 2024: $1,395,798,536Liabilities 2024: $490,387,916Net Assets 2024: $905,410,6202024

Highlighted filing

2024

Assets$1,395,798,536
Liabilities$490,387,916
Net Assets$905,410,620

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$1.5B$1.0B$500M$0-$500MExpenses 2010: $487,179,8252010Expenses 2011: $504,796,5102011Expenses 2012: $520,265,2072012Expenses 2013: $545,717,1122013Revenue 2014: $593,603,488Expenses 2014: $554,658,646Net Income 2014: $38,944,8422014Revenue 2015: $648,365,278Expenses 2015: $605,741,284Net Income 2015: $42,623,9942015Revenue 2016: $665,026,036Expenses 2016: $640,175,574Net Income 2016: $24,850,4622016Revenue 2017: $752,914,300Expenses 2017: $679,194,521Net Income 2017: $73,719,7792017Revenue 2018: $791,070,161Expenses 2018: $710,874,444Net Income 2018: $80,195,7172018Revenue 2019: $797,325,591Expenses 2019: $723,397,171Net Income 2019: $73,928,4202019Revenue 2020: $835,174,033Expenses 2020: $778,884,996Net Income 2020: $56,289,0372020Revenue 2021: $922,606,374Expenses 2021: $881,843,353Net Income 2021: $40,763,0212021Revenue 2022: $1,036,628,661Expenses 2022: $998,791,483Net Income 2022: $37,837,1782022Revenue 2023: $540,406,497Expenses 2023: $553,196,272Net Income 2023: -$12,789,7752023Revenue 2024: $1,225,617,600Expenses 2024: $1,244,167,405Net Income 2024: -$18,549,8052024

Highlighted filing

2024

Revenue$1,225,617,600
Expenses$1,244,167,405
Net Income-$18,549,805

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Facts available. Structured filing facts are available, but richer extracted sections are limited.$1,396$490$905$1,226$1,244$18.5
2023Detailed filing. Detailed filing data is available for this year.$1,396$496$900$540$553$12.8
2022Detailed filing. Detailed filing data is available for this year.$1,491$569$922$1,037$999$37.8
2021Detailed filing. Detailed filing data is available for this year.$1,330$370$959$923$882$40.8
2020Detailed filing. Detailed filing data is available for this year.$1,117$351$766$835$779$56.3
2019Detailed filing. Detailed filing data is available for this year.$1,052$336$716$797$723$73.9
2018Detailed filing. Detailed filing data is available for this year.$883$262$621$791$711$80.2
2017Detailed filing. Detailed filing data is available for this year.$776$260$517$753$679$73.7
2016Detailed filing. Detailed filing data is available for this year.$711$276$435$665$640$24.9
2015Detailed filing. Detailed filing data is available for this year.$706$273$433$648$606$42.6
2014Detailed filing. Detailed filing data is available for this year.$665$262$403$594$555$38.9
2013Facts available. Structured filing facts are available, but richer extracted sections are limited.$615$260$354$546
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$590$265$325$520
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$534$228$306$505
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$498$231$266$487
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2024 to Dec 31, 2024
Signed
Nov 11, 2025
Return Version
2024v5.2
Gross Receipts
$1,225,852,264
Mission and Program Overview

Mission

Billings clinic mission is health care, education and research. Billings clinic will provide the best in nation clinical quality, patient safety, service and value.

Billings clinic is montana's largest healthcare organization consisting of a 336 bed hospital and level 1 trauma center, primary care and over 80 specialties.

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments in Publicly Traded Securities$436,077,688$371,607,915▼ $64,469,773
Land, Buildings, and Equipment, Net$360,324,415$356,309,857▼ $4,014,558
Savings and Temporary Cash Investments$136,439,358$154,284,538▲ $17,845,180
Accounts Receivable$207,581,779$150,479,671▼ $57,102,108
Cash and Non-Interest-Bearing Accounts$31,289,949$55,760,425▲ $24,470,476
Investments Program Related$30,922,198$39,256,682▲ $8,334,484
Inventories for Sale or Use$24,152,113$28,372,230▲ $4,220,117
Prepaid Expenses and Deferred Charges$13,846,413$15,662,826▲ $1,816,413
Investments Other Securities$2,424,034--
Intangible Assets-$2,081,818-
Other Notes and Loans Receivable, Net$1,194,984$853,830▼ $341,154
Total Assets$1,396,449,787$1,395,798,536▼ $651,251
Other Assets Total$152,196,856$221,128,744▲ $68,931,888
Liabilities
Tax Exempt Bond Liabilities$168,864,918$328,067,172▲ $159,202,254
Accounts Payable and Accrued Expenses$98,154,128$103,303,602▲ $5,149,474
Other Liabilities$41,740,780$41,208,043▼ $532,737
Deferred Revenue$444,976$10,742,606▲ $10,297,630
Mortgage Notes Payable Secured by Investment Property$187,181,126$7,066,493▼ $180,114,633
Total Liabilities$496,385,928$490,387,916▼ $5,998,012
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$818,532,058$815,473,742▼ $3,058,316
Net Assets With Donor Restrictions$81,531,801$89,936,878▲ $8,405,077
Total Net Assets Fund Balance$900,063,859$905,410,620▲ $5,346,761
Total Liabilities and Net Assets / Fund Balance$1,396,449,787$1,395,798,536▼ $651,251

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$135,223,535$293,662,045$428,885,580
Buildings$161,110,987$131,292,152$292,403,139
Other Land Buildings$19,620,507$15,206,538$34,827,045
Land$39,668,013-$30,461,628
Leasehold Improvements$686,815$1,330,962$2,017,777
Other Assets Org$6,092,052--

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2024$75,442,533$3,865,589▲ $3,242,317-$82,339,286
2023$73,095,797$429,886▲ $1,995,033-$75,442,533
2022$73,071,314$1,346,174▲ $414,941-$73,095,797
2021$70,534,237$1,143,430▲ $3,769,220-$73,071,314
2020$63,959,649$427,564▲ $6,900,818-$70,534,237
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Vance Fredrickson MdPhysicianFT$2,174,455$59,671$2,234,126
Anthony Russo MdPhysicianFT$1,207,062$1,019,770$2,226,832
Dean Sukin MdPhysicianFT$882,634$1,044,827$1,927,461
Anthony Roccisano DoPhysicianFT$1,806,693$46,899$1,853,592
Shervin Dashti MdPhysicianFT$1,795,841$25,846$1,821,687
Clinton Seger MdCEOPT$1,095,076$111,816$1,206,892
Gordon Riha MdBoard MemberFT$1,128,038$53,138$1,181,176
Ellen LaytonCAOPT$689,644$132,374$822,018
Kendrick Trostel MdPhysician/vice ChairFT$747,666$61,389$809,055
Kathleen QuinonesCFOFT$573,714$43,706$617,420
Scott Ellner DoFormer CEO-$597,240$597,240$597,240
Justin OttCIOPT$434,799$54,107$488,906
Heidi Duncan MdPhysician/board MemberFT$264,322$41,920$306,242
Craig BartholomewChairPT-$14,829$14,829
Eileen McdonaldSecretaryPT-$6,809$6,809
Amy CebullTreasurerPT-$6,239$6,239
John EdwardsBoard MemberPT-$6,239$6,239
Wayne HirschBoard MemberPT$6,000-$6,000
Alice GordonBoard Member-$6,000-$6,000
Keith CookImmediate Past Chair-$6,000-$6,000
Blake UnderrinerBoard MemberPT-$3,052$3,052

Board Members and Trustees

NameTitle
William GibsonCLO
Craig Lambrecht MdSystem CEO (until 3/11/2024)
Kevin AbelSystem Co-CEO

Highest Paid Contractors

ContractorServicesLocationCompensation
Granite Peak AnesthesiologyAnesthesiologist Services350 RYMAN STREET, Missoula, MT 59802$16,026,570
Billings Anesthesiology PCAnesthesiologist ServicesPO BOX 1155, Billings, MT 59103$7,643,348
Jobot LLCLocum ProvidersPO BOX 31001-2434, Pasadena, CA 91110$4,644,617
Mayo Collaborative Serv INCLab Service ProvidersPO BOX 9146, Minneapolis, MN 55905$4,540,557
Hospital Laundry ServicesLinens/laundry Providers45 SOUTH 7TH ST WEST, Billings, MT 59102$1,675,604
Revenue and Support

Revenue Composition

Contributions and Grants
$2,142,076
Program Service Revenue
$1,152,227,526
Investment Income
$58,494,453
Other Revenue
$12,753,545
All Other Contributions
$1,332
Change in Net Assets
$-18,549,805
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$673,065,292
Salaries, Compensation, and Employee Benefits$569,976,890
Grants and Similar Amounts Paid$1,125,223
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$389,163,266$82,890,050-$472,053,316
Fees for Services Other$123,562,483$32,538,524-$156,101,007
Other Employee Benefits$32,583,708$13,631,943-$46,215,651
All Other Expenses$9,877,952$26,763,561-$36,641,513
Depreciation Depletion$20,881,592$11,927,775-$32,809,367
Payroll Taxes$19,729,916$8,248,199-$27,978,115
Pension Plan Contributions$14,226,682$5,966,276-$20,192,958
Interest$391,293$11,715,403-$12,106,696
Other Expenses$2,795,073$7,595,844-$10,390,917
Insurance$2,497,142$6,786,190-$9,283,332
Occupancy$1,958,355$5,321,991-$7,280,346
Current Officers, Directors, Trustees, and Key Employees$2,915,798$621,052-$3,536,850
Travel$897,024$2,437,735-$3,334,759
Office Expenses$850,488$2,145,184-$2,995,672
Advertising$572,382$1,555,495-$2,127,877
Fees for Service Investment Mgmnt Fees-$1,919,501-$1,919,501
Fees for Services Legal$619,032$591,803-$1,210,835
Information Technology$273,961$691,012-$964,973
Grants to Domestic Orgs$939,166--$939,166
Fees for Services Accounting-$775,461-$775,461
Grants to Domestic Individuals$186,057--$186,057
Conferences and Meetings$48,513$131,839-$180,352
Fees for Services Lobbying-$156,277-$156,277
Total Functional Expenses$967,629,026$276,538,379$0$1,244,167,405
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Montana State UniversityBozeman, MT501(c)(3)Land for Nursing School Building$316,000
Community Crisis CenterBillings, MT501(c)(3)Operations Support$81,191
American Cancer SocietyBillings, MT501(c)(3)Relay for Life$12,500
Billings Public Schools Education FoundationBillings, MT501(c)(3)Education Programs$9,000
Billings Clinic FoundationBillings, MT501(c)(3)Support Operations$5,500
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Subject to proxy tax
No
Insider Transactions and Loans

Interested-Person Transactions

Interested PartyRelationshipDescriptionShared RevenueAmount
E James DuncanE. James Duncan Has a Family Relationship With Board Member Heidi DuncanEmployee CompensationNo$424,027
Nadine SegerNadine Seger Has a Family Relationship With CEO Clint SegerEmployee CompensationNo$418,004
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Unearned Premiums$13,695,997
Estimated Claims Liability$9,650,209
Right-of-use Lease Liabilities$6,312,795
Accrued Interest$4,057,289
Due to Third Parties$3,847,911
Interest Rate Swap Agreement$3,105,889
Due to Mdor$440,969
Lease Liabilities$96,984

Bond Issues

BondIssuerIssuedIssue PricePurpose
AMontana Facility Finance Authority2018-10-01$125,786,085SEE PART VI
CMontana Facility Finance Authority2022-05-17$59,605,577SEE PART VI
BMontana Facility Finance Authority2018-10-01$56,580,000SEE PART VI

Bond Proceeds

BondTotal ProceedsSpentRetiredIssuance Costs
A$128,666,648$85,247,023$77,945,000$194,301
C$59,736,796$59,542,495--
B$56,585,037$56,509,118$2,635,000-

Bond Financing Compliance

No rebate due
Yes
Rebate not yet due
No
Form 8038-T filed
No
Gross proceeds invested
Yes
Gross proceeds invested in GIC
No
Exception to rebate
Yes
Corrective action procedures
Yes
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
Yes
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 6

Mtwy health inc is sole member of billings clinic. With rights to approve governance decisions.

Form 990, Part VI, Section A, Line 7B

Mtwy health inc as the sole member approves amendments to the bylaws, dissolution, change in name, approval of budgets and strategic plans, action or inaction in material variance to the member and any matters required by to be submitted to member.

Form 990, Part VI, Section B, Line 11B

The organization has a cpa firm prepare its form 990. The return is completed in draft form and reviewed by management of the organization. The return is then finalized and the board is provided a copy of the form 990 to review before it is filed.

Form 990, Part VI, Section B, Line 12C

The organization annually requires its board members, officers and key employees to fill out a conflicts of interest form. The compliance officer reviews them, identifies potential conflicts, and forwards to the administrative team if a potential conflict exists, as outlined in the organizational policy. During board meetings, if an interested party has a conflict, he or she recuses themselves from voting.

Form 990, Part VI, Section B, Line 15

The organization's ceo, officers, and key employees are paid by billings clinic and logan health. Billings clinic and logan health have an executive compensation program administered annually by independent trustees following best practices and the highest regulatory standards expected of a not-for profit organization. Salary and benefits for the chief executive officer are determined by the board of directors. The board reviews base and total compensation data from an array of compensation surveys of hospitals similar in size and complexity to logan health and billings clinic. The board considers these reports and determines the status of the base salary, benefits, and total compensation for the ceo. Additionally, the ceo utilizes the market information provided to determine recommendations for other senior executives and engages in a rigorous analysis through use of independent survey results. The board reviews benefit levels and total compensation to ensure appropriateness in the not-for-profit health care sector.

Form 990, Part VI, Section C, Line 19

The organization makes its governing documents, conflict of interest policy and financial statements available to the public on an as needed basis.

Filing and Contact Details

Filer

Filer Name
Billings Clinic
EIN
81-0231784
Phone
4062382500
Address
2800 TENTH AVENUE NORTH, BILLINGS, MT 59101

Signing Officer

Name
Patti Pilgrim
Title
CFO
Phone
4062382500
Signed
2025-11-11
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Clint Seger Md
Formed
1917
Legal Domicile
Mt
Voting Board Members
11
Independent Board Members
8
Employees
5,486
Volunteers
96

Preparer

Firm
Baker Tilly Advisory Group Lp
Address
20 STANWIX STREET, PITTSBURGH, PA 15222
Preparer
Kelly a Brocious
Phone
4126976400
Supplemental Narrative

Additional Explanations

Form 990, Part IX, Line 11G

Contract labor: program service expenses 25,030,536. Management and general expenses 0. Fundraising expenses 0. Total expenses 25,030,536. Locum providers: program service expenses 64,496,269. Management and general expenses 0. Fundraising expenses 0. Total expenses 64,496,269. Professional fees: program service expenses 2,645,497. Management and general expenses 2,529,127. Fundraising expenses 0. Total expenses 5,174,624. Purchased services: program service expenses 31,390,181. Management and general expenses 30,009,397. Fundraising expenses 0. Total expenses 61,399,578.

FORM 990, PART XI, LINE 9:

Change in fair value of interest rate swap 645,851. Net assets released from restriction 2,512,659. Restricted contributions 15,344,242. Equity interest in foundation 12,572,745.

Financial Statement Notes

PART V, LINE 4:

The endowment includes both donor-restricted endowment funds and funds designated by the governing body to function as endowments. Endowment funds are invested and held to provide growth over the long-term.

PART X, LINE 2:

The corporation files income tax returns with the u.s. Federal government, various states and local jurisdictions. The corporation is no longer subject to examination primarily for tax years before 2021 based upon the various statutes of limitations and is not currently under examination. The corporation has no uncertain tax positions at december 31, 2024.

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IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt0GRANITE PEAK ANESTHESIOLOGY
IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt1BILLINGS ANESTHESIOLOGY PC
IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt2JOBOT LLC
IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt3MAYO COLLABORATIVE SERV INC
IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt4HOSPITAL LAUNDRY SERVICES
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IRS990/ContractorCompensationGrp/ServicesDesc3LAB SERVICE PROVIDERS
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IRS990/Desc0BILLINGS CLINIC IS A 336 BED HOSPITAL PROVIDING SURGICAL, LABOR AND DELIVERY, PSYCHIATRIC, CANCER CARE, NEONATAL SERVICES, ACUTE CARE AND A LEVEL 1 TRAUMA CENTER. BILLINGS CLINIC HAD OVER 16,000 ADMISSIONS IN 2024.
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IRS990/Form990PartVIISectionAGrp/TitleTxt14SYSTEM CEO (UNTIL 3/11/2024)
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IRS990/MissionDesc0BILLINGS CLINIC'S MISSION IS QUALITY, COMPASSIONATE CRE FOR ALL, WITH A VISION OF REIMAGINING HEALTH CARE THROUGH CONNECTION, SERVICE AND INNOVATION.

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