2024-11-13T15:55:53-06:00 2023-12-31 910189318 MOSS ADAMS LLP 805 SW BROADWAY SUITE 1400 PORTLAND OR 97205 990 2023-01-01 810480587 BENEFIS HEALTH SYSTEM FOUNDATION INC BENE 4064552563 PO BOX 7008 GREAT FALLS MT 59406 JAMI WALD CHIEF OPERATING OFFICER 4064552563 2024-11-09 1 0 WENDY CAMPOS P00448102 5032421447 2024-11-09 2023 2024-10-15 13:58:12Z FORREST EHLINGER PO BOX 7008 GREAT FALLS MT 59406 16933864 0 X WWW.BENEFISFOUNDATION.ORG X 1998 MT IMPROVING AND ENHANCING HEALTHCARE SERVICES FOR PEOPLE THROUGHOUT NORTH CENTRAL MONTANA. 18 17 8 91 0 0 4975555 2948829 0 0 2304824 1484924 87100 140893 7367479 4574646 2198379 2562558 0 0 403422 436767 0 0 296393 347101 341981 2948902 3341306 4418577 1233340 43455290 49947840 1078527 1893144 42376763 48054696 IMPROVING AND ENHANCING HEALTHCARE SERVICES FOR PEOPLE THROUGHOUT NORTH CENTRAL MONTANA. 0 0 2576098 2562558 BENEFIS HEALTH SYSTEM FOUNDATION'S MISSION IS TO IMPROVE AND ENHANCE HEALTHCARE SERVICES FOR PEOPLE THROUGHOUT NORTHCENTRAL MONTANA. THE FOUNDATION RAISES FUNDS PRIMARILY TO SUPPORT THE PROGRAMS AND SERVICES OF BENEFIS HEALTH SYSTEM. SOME OF THE PROGRAMS AND SERVICES OF BENEFIS HEALTH SYSTEM SUPPORTED BY CONTRIBUTIONS RAISED BY THE FOUNDATION INCLUDE PEACE HOSPICE OF MONTANA, CHILDREN'S BEREAVEMENT SERVICES INCLUDING CAMP FRANCIS, SLETTEN CANCER INSTITUTE, GIFT OF LIFE FAMILY HOUSING CENTERS, AND EMERGENCY SERVICES INCLUDING MERCY FLIGHT. BENEFIS HEALTH SYSTEM FOUNDATION ALSO ENCOURAGES CONTRIBUTIONS TO ITS ANGEL FUND AND 221 CHILDREN'S FUND, WHICH HELP FAMILIES WITH CHILDREN WITH MEDICAL CONDITIONS OR A MEDICAL CRISIS. IN ADDITION, THE FOUNDATION RAISES FUNDS FOR AND MANAGES SEVERAL HEALTHCARE SCHOLARSHIPS. 2576098 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 1 5 0 1 8 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 18 17 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X BRUCE HOULIHAN 4064555479 1101 26TH STREET SOUTH SUITE 1 GREAT FALLS MT 59405 FORREST EHLINGER DIRECTOR 2.00 58.00 X 0 766465 153132 JAMI WALD CHIEF OPERATING OFFICER 50.00 X 114828 0 32230 HANNAH DEAN FINANCE DIRECTOR (THRU 7/23) 50.00 X 37115 0 6629 JERRY L LEHMAN CHAIR 3.00 X X 0 0 0 DEBRA J AMMONDSON VICE CHAIR 3.00 2.00 X X 0 0 0 RANDY BOYSUN TREASURER 3.00 X X 0 0 0 SANDI R WILSON SECRETARY 3.00 X X 0 0 0 JARED BROWN DIRECTOR 2.00 X 0 0 0 JAMES SIMMONS DIRECTOR 2.00 X 0 0 0 STEPHEN L'HEUREUX DIRECTOR 2.00 X 0 0 0 DEAN NELSON DIRECTOR 2.00 X 0 0 0 JOAN TIERNEY DIRECTOR 2.00 X 0 0 0 KASSIE LONGFELLOW DIRECTOR 2.00 X 0 0 0 JON MCCARTY DIRECTOR 2.00 X 0 0 0 ERIN TOWNSEND DIRECTOR 2.00 X 0 0 0 RICHARD BLEVINS MD DIRECTOR 2.00 X 0 0 0 CATHIE TRONSON DIRECTOR (FROM 1/23) 2.00 X 0 0 0 ERIC HINEBAUCH DIRECTOR (FROM 1/23) 2.00 X 0 0 0 RON YOUNG DIRECTOR (FROM 9/23) 2.00 X 0 0 0 SHANNON HOILAND SYSTEM BOARD LIAISON (THRU 12/23) 2.00 4.00 X 0 0 0 151943 766465 191991 1 0 1 0 EDWARD JONES 501 1ST AVE S GREAT FALLS MT 59401 INVESTMENT MANAGEMENT 133453 1 860175 547165 1541489 295323 2948829 1548598 1548598 10681689 1397300 10745363 1397300 -63674 0 -63674 -63674 328228 860175 210440 117788 117788 29220 6115 23105 23105 4574646 0 0 1625817 2285033 2285033 277525 277525 190802 5915 70215 114672 207599 6436 76396 124767 3847 119 1416 2312 8758 271 3223 5264 25761 799 9480 15482 47004 47004 230108 230108 6990 6990 11988 4784 7204 948 378 570 EDUCATION 20069 8008 12061 DUES AND SUBSCRIPTIONS 2423 967 1456 BANK CHARGES 1478 1478 EQUIPMENT 1299 518 781 19674 7850 11824 3341306 2576098 468815 296393 188 9503 1650505 2078489 339930 317914 160042 1402068 1397300 39280707 45509219 202402 206696 424216 423951 43455290 49947840 445670 1260287 632857 632857 1078527 1893144 X 6019696 7162338 36357067 40892358 42376763 48054696 43455290 49947840 X 1233340 4464006 -19413 X 0 1 X 1 0 X 2567370 2995552 3170409 4975555 2948829 16657715 2567370 2995552 3170409 4975555 2948829 16657715 5166405 11491310 1216556 1007582 1498735 1334571 1548598 6606042 11 69 80 23263837 1447065 0.49400 0.49180 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 34105203 732195 5082909 475347 39444960 39626567 1545875 -6090814 976425 34105203 35162047 748384 4331941 615805 39626567 31860774 788828 3254312 741867 35162047 27083798 660548 4862692 746264 31860774 0.10000 0.56500 0.33500 0 0 0 GIFT ANNUITY PAYABLE 632857 632857 X 8882148 4464006 91716 4555722 4326426 230108 18112 248220 4574646 3204215 91716 1301 93017 3111198 230108 230108 3341306 PART V, LINE 4: THE ENDOWMENT FUNDS OF THE FOUNDATION CONSIST OF THE FOLLOWING: THE FUNDS IN THE GENERAL ENDOWMENT ARE RESTRICTED BY DONORS AS PERMANENT ENDOWMENT FUNDS BUT HAVE NO SPECIFIC RESTRICTION ON THE DISTRIBUTION OF EARNINGS. THIS DECISION IS THE RESPONSIBILITY OF THE BOARD OF DIRECTORS OF BENEFIS HEALTH SYSTEM FOUNDATION. THE PEACE HOSPICE RESIDENTIAL ENDOWMENT PROVIDES FOR THE OPERATION AND MAINTENANCE OF THE BENEFIS PEACE HOSPICE RESIDENTIAL FACILITY. BENEFIS PEACE HOSPICE IS A SERVICE OF BENEFIS HEALTH SYSTEM. THE DONOR RESTRICTED ENDOWMENT POOL HOLDS GIFTS FROM DONORS FOR PERMANENT ENDOWMENT FUNDS THAT HAVE SPECIFIC DESIGNATIONS FOR THE USE OF THE EARNINGS OF EACH FUND. THESE MAY INCLUDE FUNDS FOR PROGRAMS OR SERVICES OR SCHOLARSHIPS. BENEFIS HEALTH SYSTEM FOUNDATION ISSUES CHARITABLE GIFT ANNUITIES, DEFERRED PAYMENT CHARITABLE GIFT ANNUITIES AND HAS ESTABLISHED A GIFT ANNUITY POOL TO HOLD THESE FUNDS AS REQUIRED UNDER THE MONTANA CHARITABLE GIFT ANNUITY ACT. THE PURPOSES OF THE FUNDS IN THE POOL ARE DEFINED BY THE INDIVIDUAL ANNUITY CONTRACTS. PART X, LINE 2: THE FOUNDATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. THE FOUNDATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND ESTIMABLE. THE FOUNDATION HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2023 OR 2022. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS 18,112. PART XII, LINE 2D - OTHER ADJUSTMENTS: UNCOLLECTIBLE PLEDGES 1,301. PART XI, LINE 4B - OTHER ADJUSTMENTS: THE FOUNDATION'S LIABILITY ASSOCIATED WITH CHARITABLE GIFT ANNUITIES, THE FOUNDATION'S MOST COMMON FORM OF SPLIT INTEREST AGREEMENTS, IS RECALCULATED TO REFLECT THE PRESENT VALUE OF THE LIABILITY EACH YEAR. MAYFAIRE 1188403 860175 328228 8500 75222 21810 49453 28124 27331 1188403 860175 328228 8500 75222 21810 49453 28124 27331 210440 117788 29220 6115 1 1.00000 29220 6115 6115 23105 MT 1 0 1 0 0.50000 0.50000 HANNAH DEAN PO BOX 7008 GREAT FALLS MT 59406 0 HANNAH DEAN 56 CREATE AND OVERSEE THE CALCULATION FOR THE TOURNAMENT RECORD KEEPING AND PAYOUT TO PLAYERS. X 0 0 1 BENEFIS HEALTH SYSTEM 1101 26 ST S GREAT FALLS MT 59405 263538104 501(C)(3) 1662242 0 SEE PART IV BENEFIS HOSPITALS 1101 26 ST S GREAT FALLS MT 59405 810232122 501(C)(3) 136454 0 SEE PART IV BENEFIS TETON MEDICAL CENTER FOUNDATION 915 4TH ST NW CHOTEAU MT 59405 810388136 501(C)(3) 5752 0 GENERAL SUPPORT 3 0 CARING FOR OUR OWN - PROVIDES FINANCIAL ASSISTANCE TO BENEFIS HEALTH SYSTEM EMPLOYEES OR VOLUNTEERS WHO EXPERIENCE AN EMERGENCY. 124 107641 ANGEL FUND - PROVIDES FINANCIAL ASSISTANCE TO FAMILIES WITH CHILDREN WHO HAVE CATASTROPHIC ILLNESSES. 57 39381 NURSING SCHOLARSHIPS - SCHOLARSHIPS TO ELIGIBLE STUDENTS ADVANCING THEIR HEALTHCARE EDUCATION. SOME OF WHOM ARE WILLING TO SIGN A WORK COMMITMENT AGREEMENT WITH BENEFIS HEALTH SYSTEM. 63 107879 221 CHILDREN'S FUND - PROVIDES FINANCIAL ASSISTANCE TO HELP CHILDREN WHO ARE SUFFERING WITH A TERRIBLE ILLNESS OR DISEASE. 4 1456 HEADSPACE - WELLNESS INFORMATION AND RESOURCES PROVIDED TO BENEFIS EMPLOYEES 3966 18522 COST FREE ACCESS TO WELLNESS SOFTWARE PROVIDE BOOKS TO PEDIATRIC PATIENTS AND THEIR FAMILIES TO PROMOTE BETTER HEALTH THROUGH LITERACY 300 2646 COST BOOKS PART I, LINE 2: BENEFIS HEALTH SYSTEM FOUNDATION HAS AN APPLICATION PROCESS FOR POTENTIAL GRANT RECIPIENTS. THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE SUBMITTED APPLICATIONS AND ADHERES TO A FUNDS ALLOCATION POLICY, AS WELL AS NEED, WHEN CHOOSING RECIPIENTS. AFTER RECIPIENTS ARE CHOSEN, THE FOUNDATION COMMUNICATES FREQUENTLY WITH GRANTEES. THE FOUNDATION REQUIRES PROOF THAT THE FUNDS ARE SPENT ACCORDING TO THE APPLICATIONS SUBMITTED. THE TYPE OF PROOF THAT IS REQUIRED IS DETERMINED ON A CASE-BY-CASE BASIS; FOR INSTANCE, THE FOUNDATION REQUIRES RECEIPTS AS WELL AS REPORTS CONTAINING DETAILS ON HOW THE MONEY WAS USED, WHO BENEFITTED, AND STORIES FROM THOSE WHO BENEFITTED. SCH I, PART II, LINE 1(H): THE BENEFIS HEALTH SYSTEM FOUNDATION GRANTS FUNDS TO COMMUNITY PROGRAMS AND BENEFIS HEALTH SYSTEM IN SUPPORT OF MANY OF THEIR HOSPITAL PROGRAMS, DEPARTMENTS AND PROJECTS: -GREATEST NEED, UNRESTRICTED FUNDS & ENDOWMENTS -REGIONAL EMERGENCY SERVICES/MERCY FLIGHT/TRAUMA -PEACE HOSPICE OF MONTANA, PEACE HOSPICE RESIDENTIAL FACILITY AND ENDOWMENTS -GIFT OF LIFE HOUSING CENTERS -CHILDREN'S BEREAVEMENT PROGRAM, INCLUDING CAMP FRANCIS -BENEFIS SLETTEN CANCER INSTITUTE FUNDS AND ENDOWMENTS -LABOR AND DELIVERY AND NEONATAL INTENSIVE CARE UNIT -BEHAVIORAL HEALTH -PEDIATRICS -BENEFIS SENIOR SERVICES -HEART AND VASCULAR -WOMEN'S AND CHILDREN'S CENTER 0 1 0 0 0 0 0 1 0 FORREST EHLINGER DIRECTOR 0 515898 0 122252 0 128315 0 133553 0 19579 0 919597 0 97915 PART I, LINE 3 THE COMPENSATION OF THE SENIOR EXECUTIVE TEAM OF BENEFIS HEALTH SYSTEM FOUNDATION, INC. WAS SET BY THE INDEPENDENT COMPENSATION COMMITTEE OF BENEFIS HEALTH SYSTEM, INC., WHICH IS CHARGED WITH ADMINISTERING THE SYSTEM'S EXECUTIVE COMPENSATION PHILOSOPHY, POLICIES AND PROGRAMS IN THE MANNER SET FORTH IN THE COMMITTEE'S WRITTEN CHARTER. THE COMMITTEE'S RESPONSIBILITIES INCLUDE (I) DETERMINING APPROPRIATE COMPENSATION FOR ALL EXECUTIVES, (II) EVALUATING AND ADOPTING EXECUTIVE COMPENSATION PLANS, POLICIES AND PROGRAMS, (III) REVIEWING AND APPROVING EXECUTIVE BENEFIT PLANS, AND (IV) VERIFYING THAT COMPENSATION IS APPROPRIATELY AND FULLY DISCLOSED AND REPORTED. THE COMMITTEE HAS ENGAGED AN INDEPENDENT COMPENSATION CONSULTING FIRM TO ASSIST IN ENSURING THAT AMOUNTS PAID TO THE SYSTEM'S EXECUTIVES ARE CONSISTENT WITH REASONABLE, FAIR MARKET LEVELS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. THIS PROCESS IS COMPLETED ON AN ANNUAL BASIS. PART I, LINE 4B BENEFIS HEALTH SYSTEM, INC. PROVIDES A SECTION 457F NONQUALIFIED DEFERRED COMPENSATION PLAN FOR MR. EHLINGER WHO MEETS THE REQUIREMENTS. MR. EHLINGER RECEIVED A PAYOUT FROM THE PLAN IN 2023. PART I, LINE 7 BENEFIS HEALTH SYSTEM, INC. AND ITS AFFILIATES (INCLUDING THE ORGANIZATION) MAINTAIN AN INCENTIVE COMPENSATION PLAN THAT INCORPORATES BOTH SHARED AND INDIVIDUAL GOALS FOR MEMBERS OF THE EXECUTIVE AND MANAGEMENT LEADERSHIP TEAMS. PAYMENTS PURSUANT TO THE INCENTIVE PLAN ARE SUBJECT TO A PRECONDITION THAT THE SYSTEM MUST ACHIEVE BUDGETED OPERATING PERFORMANCE. THE SYSTEM HAS ADOPTED SHARED PERFORMANCE OBJECTIVES INCLUDING SYSTEM GROWTH AS WELL AS MEASURES TIED TO WORKFORCE, PATIENT EXPERIENCE, PATIENT SAFETY, CLINICAL QUALITY, AND FINANCE/OPERATIONS. THE INDIVIDUAL PERFORMANCE OBJECTIVES ADOPTED ARE BASED ON AN ARRAY OF QUALITY, FINANCIAL, OPERATIONAL AND STRATEGIC INITIATIVES. INCENTIVE OPPORTUNITY LEVELS ARE CALCULATED BASED ON PREDETERMINED PERCENTAGES OF THE EXECUTIVE'S AND DIRECTOR'S BASE SALARY, AND VARY BASED ON THE ACHIEVEMENT OF THRESHOLD, TARGET OR STRETCH LEVELS AS TO EACH PERFORMANCE OBJECTIVE. THE SYSTEM ALSO MAINTAINS A LONG-TERM INCENTIVE PLAN DIRECTED AT RECRUITING AND RETAINING EXECUTIVE LEADERSHIP. PAYMENTS UNDER THE LONG-TERM INCENTIVE PLAN ARE CONDITIONED ON THE EXECUTIVE REMAINING EMPLOYED BY THE SYSTEM AND MAINTAINING SATISFACTORY OVERALL PERFORMANCE. INCENTIVE OPPORTUNITIES UNDER THE LONG-TERM PLAN ARE APPROVED IN ADVANCE BY THE BENEFIS HEALTH SYSTEM, INC. COMPENSATION COMMITTEE, WITH LATER PAYOUTS APPROVED BY THE COMMITTEE BASED ON ACTUAL PERFORMANCE RESULTS. X 11 201634 FAIR MARKET VALUE X 1 28092 FAIR MARKET VALUE X AUCTION ITEMS 127 53657 FAIR MARKET VALUE X GIFT CARDS 1 11940 FAIR MARKET VALUE 0 0 1 1 PART I, COLUMN (B): THE CONTRIBUTIONS DISCLOSED IN COLUMN (B) ARE BASED ON NUMBER OF CONTRIBUTIONS. PART I, LINE 32B: THE ORGANIZATION HIRES AN AUCTIONEER TO AUCTION OFF DONATED ITEMS LISTED ON PART I, LINE 25 AT THE ORGANIZATION'S ANNUAL FUNDRAISER. FORM 990, PART VI, SECTION A, LINE 1A THE ORGANIZATION IS AN AFFILIATE OF BENEFIS HEALTH SYSTEM, INC. (BHS), A TAX EXEMPT MONTANA NON-PROFIT CORPORATION SERVING AS THE PARENT ENTITY OF AN INTEGRATED SYSTEM OF PROVIDER ORGANIZATIONS ADDRESSING THE HEALTH NEEDS OF PERSONS THROUGHOUT NORTH CENTRAL MONTANA. AS THE CORPORATE MEMBER OF THE ORGANIZATION, BHS HOLDS VARIOUS RESERVED POWERS IN RELATION TO THE ORGANIZATION, INCLUDING THE AUTHORITY TO ELECT ITS BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF THE ORGANIZATION INCLUDES CERTAIN INDIVIDUALS WHO ARE EMPLOYED BY THE ORGANIZATION OR ITS AFFILIATES, AND WHO MAY NOT BE CONSIDERED "INDEPENDENT" FOR PURPOSES OF FORM 990. HOWEVER, AS ACKNOWLEDGED BY THE IRS IN ITS "CPE TEXT FOR FISCAL YEAR 1997," IN A MULTI-ENTITY HOSPITAL SYSTEM, THE BOARD OF A SUBSIDIARY NON-PROFIT HEALTH CARE ORGANIZATION IS CONSIDERED TO BE COMPRISED OF INDEPENDENT COMMUNITY MEMBERS IF IT IS CONTROLLED BY AN EXEMPT ORGANIZATION WHOSE OWN BOARD IS COMPRISED OF A MAJORITY OF VOTING MEMBERS WHO ARE INDEPENDENT COMMUNITY MEMBERS. THE ORGANIZATION MEETS THIS STANDARD BECAUSE IT IS A CONTROLLED SUBSIDIARY OF BHS, AND BHS'S OWN GOVERNING BOARD INCLUDES INDEPENDENT COMMUNITY MEMBERS AS A MAJORITY THEREOF. FORM 990, PART VI, SECTION A, LINE 2 CERTAIN OFFICERS AND DIRECTORS LISTED IN PART VII ALSO HOLD OFFICER AND/OR DIRECTOR POSITIONS IN RELATION TO THE ORGANIZATION'S AFFILIATES (AS IDENTIFIED IN SCHEDULE R) AND, IN THAT REGARD, MAY BE CONSIDERED TO HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER. SUCH BUSINESS RELATIONSHIPS ARE UNDERTAKEN IN THE ORDINARY COURSE OF BUSINESS. FORM 990, PART VI, SECTION A, LINE 3 PURSUANT TO A CONTRACTUAL ARRANGEMENT, THE ORGANIZATION OBTAINS CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES FROM ITS PARENT ENTITY, BENEFIS HEALTH SYSTEM, INC. (BHS). BHS, AS THE PARENT AND SYSTEM ENTITY, PROVIDES THE SERVICES TO ITS SUBSIDIARY TAX-EXEMPT NON-PROFIT CORPORATE ENTITIES ON A CENTRALIZED BASIS. THE SERVICES INCLUDE THE FOLLOWING: - MANAGEMENT OF HUMAN RESOURCES INCLUDING POLICIES AND PRACTICES AND BENEFITS - MANAGEMENT, PLANNING, BUDGETING AND REPORTING OF FINANCIAL OPERATIONS - MANAGEMENT OF BILLING AND COLLECTIONS POLICIES AND FUNCTIONS - MANAGEMENT OF INFORMATION TECHNOLOGY SERVICES - OVERSIGHT OF QUALITY STANDARDS, COMPLIANCE AND RISK MANAGEMENT - MANAGEMENT OF REGIONAL, COMMUNITY AND GOVERNMENT RELATIONS AND MARKETING - MANAGEMENT OF GRANTS DEVELOPMENT THE FOLLOWING PERSONS LISTED IN PART VII WERE COMPENSATED BY BHS: FORREST EHLINGER - $919,597 (COMPENSATION FOR SERVICES AS OFFICER OF BHS) JAMI WALD - $147,058 HANNAH DEAN - $43,733 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS BENEFIS HEALTH SYSTEM, INC., A MONTANA NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATION THAT HAS BEEN RECOGNIZED BY THE IRS AS DESCRIBED IN IRC SECTION 501(C)(3). FORM 990, PART VI, SECTION A, LINE 7A BENEFIS HEALTH SYSTEM IS THE SOLE VOTING MEMBER AND HAS THE FOLLOWING RESERVED POWERS OVER BENEFIS HEALTH SYSTEM FOUNDATION: - TO ELECT AND REMOVE THE DIRECTORS AND OFFICERS OF THE FOUNDATION - TO INITIATE AND APPROVE ANY PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION - TO APPROVE ALL AMENDMENTS TO THE FOUNDATION'S ARTICLES OF INCORPORATION AND BYLAWS - TO CONTINUOUSLY REVIEW AND MONITOR THE FINANCIAL CONDITION OF THE FOUNDATION, INCLUDING THROUGH AN ANNUAL AUDIT - TO APPROVE THE ANNUAL BUDGET OF THE FOUNDATION AND ALL MATERIAL DEVIATIONS FROM THE APPROVED BUDGET - TO DELINEATE BY POLICY THE REQUIREMENTS FOR APPROVAL OF ALL ARRANGEMENTS AND TRANSACTIONS INVOLVING THE ASSETS AND FINANCES OF THE FOUNDATION - TO SET THE COMPENSATION FOR ALL OF THE OFFICERS OF THE FOUNDATION, INCLUDING THE PRESIDENT - TO APPROVE ALL MISSION AND/OR VISION STATEMENTS AND ALL STRATEGIC OR LONG-TERM PLANS OF THE FOUNDATION - TO APPROVE THE CREATION, ACQUISITION, DISPOSITION OR TERMINATION OF SUBSIDIARIES OR CONTROLLED AFFILIATES, AND ANY MERGERS, CONSOLIDATIONS, AND PERMANENT OR LONG-TERM AFFILIATIONS OF THE FOUNDATION OR ANY OF ITS SUBSIDIARIES OR CONTROLLED ENTITIES - TO APPOINT A CERTIFIED PUBLIC ACCOUNTANT TO PERFORM THE ANNUAL AUDIT OF THE FOUNDATION'S FINANCIAL STATEMENTS IN CONJUNCTION WITH THE ANNUAL AUDIT OF THE MEMBER'S FINANCIAL STATEMENTS - TO APPROVE ANY AGREEMENT THAT OBLIGATES THE FOUNDATION TO PAY OR INCUR LIABILITY OF MORE THAN TEN THOUSAND DOLLARS ($10,000), AND TO APPROVE ANY AGREEMENT THAT OBLIGATES THE FOUNDATION TO PAY AN AMOUNT OR INCUR A LIABILITY NOT INCLUDED IN THE THEN CURRENT BUDGET OF THE FOUNDATION, WHICH WAS APPROVED BY THE MEMBER PURSUANT TO THESE POWERS LISTED - TO DETERMINE AND ENSURE COMPLIANCE WITH THE FOUNDATION'S STATED CHARITABLE PURPOSES - TO INITIATE AND APPROVE, IN CONSULTATION WITH THE BOARD, SUCH OPERATING POLICIES REGARDING THE FOUNDATION'S ACTIVITIES, OPERATIONS, FINANCES AND ASSETS AS IT DEEMS NECESSARY OR APPROPRIATE FROM TIME TO TIME - TO ENSURE THAT THE FOUNDATION IS HONORING THE INTENTIONS AND DIRECTIONS OF ALL OF ITS DONORS WITH RESPECT TO THE INVESTMENT AND USE OF THEIR DONATIONS FORM 990, PART VI, SECTION A, LINE 7B AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, BENEFIS HEALTH SYSTEM, INC. RETAINS CERTAIN RESERVED POWERS WITH RESPECT TO THE ORGANIZATION, INCLUDING AUTHORITY OVER MATTERS SUCH AS (WITHOUT LIMITATION) THE ORGANIZATION'S MISSION AND VISION STATEMENTS, STRATEGIC AND LONG-TERM PLANS, ELECTION OF ITS DIRECTORS AND OFFICERS, ANNUAL CAPITAL AND OPERATING BUDGETS, CHARITY CARE AND COMMUNITY BENEFIT POLICIES, AND ANY AMENDMENTS TO ITS ARTICLES OF INCORPORATION AND BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THIS FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT PERSONNEL OF BENEFIS HEALTH SYSTEM, INC. IN COLLABORATION WITH ITS ACCOUNTING FIRM. PRIOR TO FILING, A COPY OF THIS FORM 990 WAS MADE AVAILABLE TO ALL MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS, AND WAS PRESENTED TO THE BENEFIS HEALTH SYSTEM, INC. BOARD BY THE ACCOUNTING FIRM. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ANNUALLY COMPLETE A FORM TO DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. IN ADDITION, AT THE START OF EACH BOARD MEETING, MEMBERS ARE ASKED TO INDICATE WHETHER THEY HAVE A CONFLICT OF INTEREST WITH RESPECT TO ANY ITEMS ON THE AGENDA FOR THE MEETING. CONSISTENT WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY, BOARD MEMBERS ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND VOTING ON ANY MATTERS AS TO WHICH THEY HAVE A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION OF THE SENIOR EXECUTIVE TEAM WAS SET BY THE INDEPENDENT COMPENSATION COMMITTEE OF BENEFIS HEALTH SYSTEM, INC., WHICH IS CHARGED WITH ADMINISTERING THE SYSTEM'S EXECUTIVE COMPENSATION PHILOSOPHY, POLICIES AND PROGRAMS IN THE MANNER SET FORTH IN THE COMMITTEE'S WRITTEN CHARTER. THE COMMITTEE'S RESPONSIBILITIES INCLUDE (I) DETERMINING APPROPRIATE COMPENSATION FOR ALL EXECUTIVES AND OTHER KEY EMPLOYEES, (II) EVALUATING AND ADOPTING EXECUTIVE COMPENSATION PLANS, POLICIES AND PROGRAMS, (III) REVIEWING AND APPROVING EXECUTIVE BENEFIT PLANS, AND (IV) VERIFYING THAT COMPENSATION IS APPROPRIATELY AND FULLY DISCLOSED AND REPORTED. THE COMMITTEE HAS ENGAGED AN INDEPENDENT COMPENSATION CONSULTING FIRM TO ASSIST IN ENSURING THAT AMOUNTS PAID TO THE SYSTEM'S EXECUTIVES ARE CONSISTENT WITH REASONABLE, FAIR MARKET LEVELS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. THIS PROCESS IS COMPLETED ON AN ANNUAL BASIS. THE COMPENSATION OF THE ORGANIZATION'S KEY EMPLOYEES AND MANAGERS WAS SET BY THEIR RESPECTIVE SUPERVISORY EXECUTIVES IN CONSULTATION WITH BENEFIS HEALTH SYSTEM'S HUMAN RESOURCES DEPARTMENT AND EXECUTIVE LEADERSHIP, BASED ON A REVIEW OF INDEPENDENT DATA AS TO AMOUNTS PAID BY SIMILAR SITUATED ORGANIZATIONS FOR PERSONS PERFORMING COMPARABLE SERVICES. FORM 990, PART VI, SECTION C, LINE 19 BENEFIS HEALTH SYSTEM FOUNDATION, INC. PROVIDES COPIES OF THE FORM 990 TO THE PUBLIC UPON REQUEST DURING NORMAL BUSINESS HOURS. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS -18,112. UNCOLLECTIBLE PLEDGE -1,301. BENEFIS CASCADE RIDGE LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 274602798 REAL ESTATE MT BENEFIS HEALTH SYSTEM INC BENEFIS HEALTH SYSTEM FOUNDATION PROPERTIES LLC PO BOX 7008 GREAT FALLS MT 59406 272514629 HOLDS REAL PROPERTY DONATED TO FOUNDATION MT 0 0 BENEFIS HEALTH SYSTEM FOUNDATION INC WALK IN EXPRESS LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 320481028 OUTPATIENT CLINIC MT BENEFIS HEALTH SYSTEM INC HELENA AMBULATORY CENTER LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 263538104 INACTIVE MT BENEFIS HEALTH SYSTEM INC BENEFIS HEALTH SYSTEM INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 263538104 MANAGEMENT AND SUPPORT SERVICES MT 501(C)(3) LINE 12C, III-FI N/A 0 BENEFIS MEDICAL GROUP INC 1401 25TH STREET SOUTH GREAT FALLS MT 59405 263538192 PHYSICIAN SERVICES MT 501(C)(3) LINE 3 BENEFIS HEALTH SYSTEM INC 0 BENEFIS COMMUNITY CARE INC 1411 9TH STREET SOUTH GREAT FALLS MT 59405 810431871 HOME HEALTH AND RELATED PRODUCTS MT 501(C)(3) LINE 10 BENEFIS HEALTH SYSTEM INC 0 BENEFIS HOSPITALS INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 810232122 HOSPITAL MT 501(C)(3) LINE 3 BENEFIS HEALTH SYSTEM INC 0 BENEFIS COMMUNITY HOSPITALS INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 473448483 CRITICAL ACCESS HOSPITAL MT 501(C)(3) LINE 3 BENEFIS HEALTH SYSTEM INC 0 GREAT FALLS ATHLETIC CLUB LLC 1800 BENEFIS COURT GREAT FALLS MT 59405 912081505 FITNESS CLUB MT N/A 0 0 TREASURE STATE HEALTHCARE NETWORK LLC 500 15TH AVENUE SOUTH GREAT FALLS MT 59405 810534714 HEALTHCARE SERVICES MT N/A 0 0 OLIVET HOUSING LLC 101 E FRONT ST STE 304 MISSOULA MT 59802 881547771 HOUSING RENTALS MT N/A 0 0 BHS 2017 TRUST 400 HOWARD STREET SAN FRANCISCO CA 94105 306559361 INVESTMENT TRUST CA N/A T 0 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0