BILLINGS CLINIC: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization: BILLINGS CLINIC (EIN 81-0231784)
Tax period: 2024-01-01 to 2024-12-31
Filed: 2025-11-14
IRS object ID: 202503189349302335
Schema version: 2024v5.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2025-11-14T08:22:53-06:00	ReturnTs
Tax Period End	2024-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	390859910	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BAKER TILLY ADVISORY GROUP LP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	20 STANWIX STREET	AddressLine1Txt
City	PITTSBURGH	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	15222	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2024-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	810231784	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BILLINGS CLINIC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	BILL	BusinessNameControlTxt
Phone	4062382500	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 TENTH AVENUE NORTH	AddressLine1Txt
City	BILLINGS	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59101	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	PATTI PILGRIM	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	4062382500	PhoneNum
Signature	2025-11-11	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	Yes (1)	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KELLY A BROCIOUS	PreparerPersonNm
PTIN	P01254262	PTIN
Phone	4126976400	PhoneNum
Preparation	2025-11-11	PreparationDt

Field	Value	IRS element (for citing)
Tax	2024	TaxYr
Build TS	2025-03-06 01:10:19Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	CLINT SEGER MD	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 TENTH AVENUE NORTH	AddressLine1Txt
City	BILLINGS	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59101	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,225,852,264	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.BILLINGSCLINIC.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1917	FormationYr
Legal Domicile State	MT	LegalDomicileStateCd
Activity Or Mission	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.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	5486	TotalEmployeeCnt
Total Volunteers	96	TotalVolunteersCnt
Total Gross UBI	$27,755,490	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$8,291,730	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,642,869	PYContributionsGrantsAmt
CY Contributions Grants	$2,142,076	CYContributionsGrantsAmt
PY Program Service Revenue	$508,769,420	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,152,227,526	CYProgramServiceRevenueAmt
PY Investment Income	$17,671,483	PYInvestmentIncomeAmt
CY Investment Income	$58,494,453	CYInvestmentIncomeAmt
PY Other Revenue	$12,322,725	PYOtherRevenueAmt
CY Other Revenue	$12,753,545	CYOtherRevenueAmt
PY Total Revenue	$540,406,497	PYTotalRevenueAmt
CY Total Revenue	$1,225,617,600	CYTotalRevenueAmt
PY Grants And Similar Paid	$128,328	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,125,223	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$250,032,826	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$569,976,890	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$303,035,118	PYOtherExpensesAmt
CY Other Expenses	$673,065,292	CYOtherExpensesAmt
PY Total Expenses	$553,196,272	PYTotalExpensesAmt
CY Total Expenses	$1,244,167,405	CYTotalExpensesAmt
PY Revenues Less Expenses	-$12,789,775	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$18,549,805	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,396,449,787	TotalAssetsBOYAmt
Total Assets EOY	$1,395,798,536	TotalAssetsEOYAmt
Total Liabilities BOY	$496,385,928	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$490,387,916	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$900,063,859	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$905,410,620	NetAssetsOrFundBalancesEOYAmt
Mission	BILLINGS CLINIC'S MISSION IS QUALITY, COMPASSIONATE CRE FOR ALL, WITH A VISION OF REIMAGINING HEALTH CARE THROUGH CONNECTION, SERVICE AND INNOVATION.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$497,111,027	ExpenseAmt
Grant	$1,125,223	GrantAmt
Revenue	$630,630,806	RevenueAmt
Desc	BILLINGS 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.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$375,873,603	ExpenseAmt
Revenue	$375,427,215	RevenueAmt
Desc	BILLINGS CLINIC HAS NEARLY 600 PHYSICIANS AND ADVANCED PRACTITIONERS OFFERING MORE THAN 80 SPECIALTIES. PRIMARY CARE IS AVAILABLE AT MULTIPLE LOCATIONS INCLUDING BILLINGS (DOWNTOWN, HEIGHTS AND WEST), BOZEMAN, MILES CITY, AND WEST YELLOWSTONE, MONTANA; AND CODY, WYOMING. IN ADDITION, BILLINGS CLINIC CONDUCTS 145 MONTHLY SPECIALTY CLINIC SERVICES FOR MORE THAN 20 REGIONAL LOCATIONS IN MONTANA, WYOMING AND NORTH DAKOTA.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$94,644,396	ExpenseAmt
Revenue	$130,850,840	RevenueAmt
Desc	BILLINGS CLINIC SPECIALTY PHARMACY FOCUSES ON THE PHARMACY CARE OF CHRONIC, RARE OR COMPLEX CONDITIONS THAT REQUIRE SPECIALTY MEDICATIONS. SPECIALTY MEDICATIONS TYPICALLY REQUIRE SPECIAL HANDLING, ADMINISTRATION OR MONITORING BEYOND THAT WHICH A TRADITIONAL RETAIL PHARMACY CAN PROVIDE. WE WORK TO ENSURE APPROPRIATE MEDICATION USE AND PROMOTE ADHERENCE. BILLINGS CLINIC SPECIALTY PHARMACY IS PART OF THE LARGEST HEALTH CARE SYSTEM IN THE REGION. OUR STAFF WORKS WITHYOU, YOUR PROVIDER AND YOUR INSURANCE COMPANY TO MAKE SURE YOUR NEEDS ARE MET. OUR GOAL IS TO MAKE BILLINGS CLINIC A ONE-STOP SOLUTION.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$967,629,026	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	Yes (1)	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (1)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	217	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	5486	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	Yes (1)	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ERIKA WRIGHT	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	4064356445	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 TENTH AVENUE NORTH	AddressLine1Txt
City	BILLINGS	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59101	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
CRAIG BARTHOLOMEW
CHAIR	5.00	6.00	Yes (X)	Yes (X)	$0	$0	$14,829
KEITH COOK
IMMEDIATE PAST CHAIR	2.00	4.00	Yes (X)		$6,000	$0	$0
KENDRICK TROSTEL MD
PHYSICIAN/VICE CHAIR	49.00	1.00	Yes (X)	Yes (X)	$756,619	$0	$52,436
AMY CEBULL
TREASURER	5.00	3.00	Yes (X)	Yes (X)	$0	$0	$6,239
EILEEN MCDONALD
SECRETARY	5.00	4.00	Yes (X)	Yes (X)	$0	$0	$6,809
HEIDI DUNCAN MD
PHYSICIAN/BOARD MEMBER	48.00	2.00	Yes (X)		$269,240	$0	$37,002
ALICE GORDON
BOARD MEMBER	2.00	3.00	Yes (X)		$6,000	$0	$0
WAYNE HIRSCH
BOARD MEMBER	5.00	1.00	Yes (X)		$6,000	$0	$0
JOHN EDWARDS
BOARD MEMBER	5.00	2.00	Yes (X)		$0	$0	$6,239
BLAKE UNDERRINER
BOARD MEMBER	5.00	1.00	Yes (X)		$0	$0	$3,052
GORDON RIHA MD
BOARD MEMBER	47.00	3.00	Yes (X)		$1,129,562	$0	$51,614
CLINTON SEGER MD
CEO	22.00	38.00		Yes (X)	$1,163,598	$0	$43,294
KATHLEEN QUINONES
CFO	55.00	5.00		Yes (X)	$579,324	$0	$38,096
KEVIN ABEL
SYSTEM CO-CEO	10.00	50.00		Yes (X)	$0	$986,351	$38,583
CRAIG LAMBRECHT MD
SYSTEM CEO (UNTIL 3/11/2024)	10.00	50.00		Yes (X)	$0	$1,715,469	$24,583
WILLIAM GIBSON
CLO	10.00	50.00		Yes (X)	$0	$801,222	$38,623
JUSTIN OTT
CIO	10.00	40.00		Yes (X)	$441,312	$0	$47,594
ELLEN LAYTON
CAO	25.00	35.00		Yes (X)	$770,823	$0	$51,195
DEAN SUKIN MD
PHYSICIAN	50.00				$1,882,634	$0	$44,827	Yes (X)
VANCE FREDRICKSON MD
PHYSICIAN	50.00				$2,196,195	$0	$37,931	Yes (X)
ANTHONY ROCCISANO DO
PHYSICIAN	50.00				$1,808,826	$0	$44,766	Yes (X)
SHERVIN DASHTI MD
PHYSICIAN	50.00				$1,798,191	$0	$23,496	Yes (X)
ANTHONY RUSSO MD
PHYSICIAN	50.00				$2,208,231	$0	$18,601	Yes (X)
SCOTT ELLNER DO
FORMER CEO	0.00				$597,240	$0	$0		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$15,619,795	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,503,042	TotReportableCompRltdOrgAmt
Total Other Compensation	$629,809	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	1085	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
GRANITE PEAK ANESTHESIOLOGY
350 RYMAN STREET	MISSOULA	MT	59802	ANESTHESIOLOGIST SERVICES	$16,026,570
BILLINGS ANESTHESIOLOGY PC
PO BOX 1155	BILLINGS	MT	59103	ANESTHESIOLOGIST SERVICES	$7,643,348
JOBOT LLC
PO BOX 31001-2434	PASADENA	CA	91110	LOCUM PROVIDERS	$4,644,617
MAYO COLLABORATIVE SERV INC
PO BOX 9146	MINNEAPOLIS	MN	55905	LAB SERVICE PROVIDERS	$4,540,557
HOSPITAL LAUNDRY SERVICES
45 SOUTH 7TH ST WEST	BILLINGS	MT	59102	LINENS/LAUNDRY PROVIDERS	$1,675,604

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	40	CntrctRcvdGreaterThan100KCnt
Government Grants	$2,140,744	GovernmentGrantsAmt
All Other Contributions	$1,332	AllOtherContributionsAmt
Total Contributions	$2,142,076	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE	621110	$987,968,172	$987,968,172
RETAIL PHARMACY	621110	$136,484,123	$136,484,123
INCOME ON EQUITY INVESTEES	900099	$9,979,773	$797,493	$9,182,280
PREMIUM REVENUE	900099	$9,863,623	$9,863,623
REFERENCE LAB	621500	$7,522,258		$7,522,258

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$409,577	TotalRevenueColumnAmt
Related Or Exempt Func Income	$409,577	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,152,227,526	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$17,998,260	TotalRevenueColumnAmt
Exclusion	$17,998,260	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$394,226	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$77,506	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$316,720	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$316,720	TotalRevenueColumnAmt
Exclusion	$316,720	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$40,348,003	SecuritiesAmt
Other	$148,190	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$40,348,003	SecuritiesAmt
Other	$148,190	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$40,496,193	TotalRevenueColumnAmt
Exclusion	$40,496,193	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$609,317	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$157,158	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$452,159	TotalRevenueColumnAmt
Related Or Exempt Func Income	$410,846	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$41,313	UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
IT CMC	541519	$5,626,837	$5,626,837
SERVICE TO OTHER HOSPITALS	541519	$3,455,221	$3,455,221
REGIONAL PHARMACY SALES	621110	$1,927,581	$1,927,581

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$975,027	TotalRevenueColumnAmt
Related Or Exempt Func Income	$975,027	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$11,984,666	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,225,617,600	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,136,908,861	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$27,755,490	UnrelatedBusinessRevenueAmt
Exclusion	$58,811,173	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$939,166	TotalAmt
Program Services	$939,166	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$186,057	TotalAmt
Program Services	$186,057	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$3,536,850	TotalAmt
Program Services	$2,915,798	ProgramServicesAmt
Management And General	$621,052	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$472,053,316	TotalAmt
Program Services	$389,163,266	ProgramServicesAmt
Management And General	$82,890,050	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$20,192,958	TotalAmt
Program Services	$14,226,682	ProgramServicesAmt
Management And General	$5,966,276	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$46,215,651	TotalAmt
Program Services	$32,583,708	ProgramServicesAmt
Management And General	$13,631,943	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$27,978,115	TotalAmt
Program Services	$19,729,916	ProgramServicesAmt
Management And General	$8,248,199	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$1,210,835	TotalAmt
Program Services	$619,032	ProgramServicesAmt
Management And General	$591,803	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$775,461	TotalAmt
Management And General	$775,461	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$156,277	TotalAmt
Management And General	$156,277	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$1,919,501	TotalAmt
Management And General	$1,919,501	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$156,101,007	TotalAmt
Program Services	$123,562,483	ProgramServicesAmt
Management And General	$32,538,524	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$2,127,877	TotalAmt
Program Services	$572,382	ProgramServicesAmt
Management And General	$1,555,495	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,995,672	TotalAmt
Program Services	$850,488	ProgramServicesAmt
Management And General	$2,145,184	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$964,973	TotalAmt
Program Services	$273,961	ProgramServicesAmt
Management And General	$691,012	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$7,280,346	TotalAmt
Program Services	$1,958,355	ProgramServicesAmt
Management And General	$5,321,991	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$3,334,759	TotalAmt
Program Services	$897,024	ProgramServicesAmt
Management And General	$2,437,735	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$180,352	TotalAmt
Program Services	$48,513	ProgramServicesAmt
Management And General	$131,839	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$12,106,696	TotalAmt
Program Services	$391,293	ProgramServicesAmt
Management And General	$11,715,403	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$32,809,367	TotalAmt
Program Services	$20,881,592	ProgramServicesAmt
Management And General	$11,927,775	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$9,283,332	TotalAmt
Program Services	$2,497,142	ProgramServicesAmt
Management And General	$6,786,190	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$322,998,527	$322,998,527
REPAIRS AND MAINTENANCE	$48,302,599	$12,993,015	$35,309,584
BAD DEBT EXPENSE	$23,485,281	$6,667,601	$16,817,680
MISCELLANEOUS EXPENSE	$10,390,917	$2,795,073	$7,595,844

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$36,641,513	TotalAmt
Program Services	$9,877,952	ProgramServicesAmt
Management And General	$26,763,561	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,244,167,405	TotalAmt
Program Services	$967,629,026	ProgramServicesAmt
Management And General	$276,538,379	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$31,289,949	BOYAmt
EOY	$55,760,425	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$136,439,358	BOYAmt
EOY	$154,284,538	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$207,581,779	BOYAmt
EOY	$150,479,671	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$1,194,984	BOYAmt
EOY	$853,830	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$24,152,113	BOYAmt
EOY	$28,372,230	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$13,846,413	BOYAmt
EOY	$15,662,826	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$797,801,554	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$441,491,697	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$360,324,415	BOYAmt
EOY	$356,309,857	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$436,077,688	BOYAmt
EOY	$371,607,915	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$2,424,034	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$30,922,198	BOYAmt
EOY	$39,256,682	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
EOY	$2,081,818	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$152,196,856	BOYAmt
EOY	$221,128,744	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,396,449,787	BOYAmt
EOY	$1,395,798,536	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$98,154,128	BOYAmt
EOY	$103,303,602	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$444,976	BOYAmt
EOY	$10,742,606	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$168,864,918	BOYAmt
EOY	$328,067,172	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$187,181,126	BOYAmt
EOY	$7,066,493	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$41,740,780	BOYAmt
EOY	$41,208,043	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$496,385,928	BOYAmt
EOY	$490,387,916	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$818,532,058	BOYAmt
EOY	$815,473,742	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$81,531,801	BOYAmt
EOY	$89,936,878	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$900,063,859	BOYAmt
EOY	$905,410,620	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,396,449,787	BOYAmt
EOY	$1,395,798,536	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$18,549,805	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$7,398,721	NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments	$219,790	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	$31,075,497	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Total Direct Lobbying TotalDirectLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$176,425	FilingOrganizationsTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$176,425	FilingOrganizationsTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,243,990,980	FilingOrganizationsTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,244,167,405	FilingOrganizationsTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,000,000	FilingOrganizationsTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$250,000	FilingOrganizationsTotalAmt

Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$0	FilingOrganizationsTotalAmt

Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$0	FilingOrganizationsTotalAmt

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$1,000,000	CurrentYearMinus3Amt
Current Year Minus2	$1,000,000	CurrentYearMinus2Amt
Current Year Minus1	$1,000,000	CurrentYearMinus1Amt
Current Year	$1,000,000	CurrentYearAmt
Total	$4,000,000	TotalAmt

Field	Value	IRS element (for citing)
Lobbying Ceiling	$6,000,000	LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$264,515	CurrentYearMinus3Amt
Current Year Minus2	$278,299	CurrentYearMinus2Amt
Current Year Minus1	$124,457	CurrentYearMinus1Amt
Current Year	$176,425	CurrentYearAmt
Total	$843,696	TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$250,000	CurrentYearMinus3Amt
Current Year Minus2	$250,000	CurrentYearMinus2Amt
Current Year Minus1	$250,000	CurrentYearMinus1Amt
Current Year	$250,000	CurrentYearAmt
Total	$1,000,000	TotalAmt

Field	Value	IRS element (for citing)
Grassroots Ceiling	$1,500,000	GrassrootsCeilingAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$75,442,533	BeginningYearBalanceAmt
Contributions	$3,865,589	ContributionsAmt
Investment Earnings Or Losses	$3,242,317	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$211,153	GrantsOrScholarshipsAmt
End Year Balance	$82,339,286	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$73,095,797	BeginningYearBalanceAmt
Contributions	$429,886	ContributionsAmt
Investment Earnings Or Losses	$1,995,033	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$78,183	GrantsOrScholarshipsAmt
End Year Balance	$75,442,533	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$73,071,314	BeginningYearBalanceAmt
Contributions	$1,346,174	ContributionsAmt
Investment Earnings Or Losses	$414,941	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$1,736,632	GrantsOrScholarshipsAmt
End Year Balance	$73,095,797	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$70,534,237	BeginningYearBalanceAmt
Contributions	$1,143,430	ContributionsAmt
Investment Earnings Or Losses	$3,769,220	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$2,375,573	GrantsOrScholarshipsAmt
End Year Balance	$73,071,314	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$63,959,649	BeginningYearBalanceAmt
Contributions	$427,564	ContributionsAmt
Investment Earnings Or Losses	$6,900,818	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$753,794	GrantsOrScholarshipsAmt
End Year Balance	$70,534,237	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.36320	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.50730	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.12951	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$9,206,385	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$30,461,628	OtherCostOrOtherBasisAmt
Book Value	$39,668,013	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$292,403,139	OtherCostOrOtherBasisAmt
Depreciation	$131,292,152	DepreciationAmt
Book Value	$161,110,987	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,017,777	OtherCostOrOtherBasisAmt
Depreciation	$1,330,962	DepreciationAmt
Book Value	$686,815	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$428,885,580	OtherCostOrOtherBasisAmt
Depreciation	$293,662,045	DepreciationAmt
Book Value	$135,223,535	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$34,827,045	OtherCostOrOtherBasisAmt
Depreciation	$15,206,538	DepreciationAmt
Book Value	$19,620,507	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$356,309,857	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
INTEREST IN FOUNDATION	$159,942,665
RIGHT-OF-USE-ASSETS OPERATING LEASE	$6,391,844
DUE FROM THIRD PARTIES	$48,702,183
DUE FROM AFFILIATES	$6,092,052

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$221,128,744	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)

DescDesc	AmtAmt
DUE TO MDOR	$440,969
INTEREST RATE SWAP AGREEMENT	$3,105,889
ESTIMATED CLAIMS LIABILITY	$9,650,209
ACCRUED INTEREST	$4,057,289
UNEARNED PREMIUMS	$13,695,997
RIGHT-OF-USE LEASE LIABILITIES	$6,312,795
DUE TO THIRD PARTIES	$3,847,911
LEASE LIABILITIES	$96,984

Field	Value	IRS element (for citing)
Total Liability	$41,208,043	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$29,654,615	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$29,654,615	NetCommunityBenefitExpnsAmt
Total Expense	0.02430	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$157,259,937	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$139,585,771	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,674,166	NetCommunityBenefitExpnsAmt
Total Expense	0.01450	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$186,914,552	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$139,585,771	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$47,328,781	NetCommunityBenefitExpnsAmt
Total Expense	0.03880	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,786,985	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,238,442	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,548,543	NetCommunityBenefitExpnsAmt
Total Expense	0.00290	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,240,713	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,504,122	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,736,591	NetCommunityBenefitExpnsAmt
Total Expense	0.00880	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$59,024,454	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$40,335,658	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$18,688,796	NetCommunityBenefitExpnsAmt
Total Expense	0.01530	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,099,271	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$627,050	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,472,221	NetCommunityBenefitExpnsAmt
Total Expense	0.00280	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,778,199	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$14,778,199	NetCommunityBenefitExpnsAmt
Total Expense	0.01210	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$96,929,622	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$45,705,272	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$51,224,350	NetCommunityBenefitExpnsAmt
Total Expense	0.04190	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$283,844,174	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$185,291,043	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$98,553,131	NetCommunityBenefitExpnsAmt
Total Expense	0.08070	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,631	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,631	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$195,466	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$195,466	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$201,097	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$201,097	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Bad Debt Expense	$23,485,281	BadDebtExpenseAmt
Reimbursed By Medicare	$287,240,873	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$497,786,501	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$210,545,628	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BILLINGS CLINIC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 TENTH AVE N	AddressLine1Txt
City	BILLINGS	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59101	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.BILLINGSCLINIC.COM	WebsiteAddressTxt
State License	13345	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Research Facility	Yes (X)	ResearchFacilityInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	BILLINGS CLINIC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	23	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART VI FOR URL	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	WWW.HEALTHYBYDESIGNYELLOWSTONE.ORG	OtherWebsiteURLTxt
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	23	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART VI FOR URL	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART VI FOR URL	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART VI FOR URL	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART VI FOR URL	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
BILLINGS CLINIC	PART V, SECTION B, LINE 5: BILLINGS CLINIC CONDUCTED THE 2023-2025 CHNA IN COLLABORATION WITH THE CITY-COUNTY HEALTH DEPARTMENT, RIVERSTONE HEALTH AND ST. VINCENT HEALTHCARE, A HOSPITAL LOCATED IN BILLINGS MT. IN 2023, BILLINGS CLINIC, RIVERSTONE HEALTH AND ST. VINCENT HEALTHCARE RELEASED YELLOWSTONE COUNTY'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT WITH PRIMARY, SECONDARY AND QUALITATIVE RESEARCH INTO THE HEALTH NEEDS IN THE COMMUNITY. THE 2023 CHNA WAS A FOLLOW-UP TO SIMILAR SURVEYS CONDUCTED IN 2011, 2014, 2017 AND 2020, WHICH ALLOWED FOR HISTORICAL DATA IN ADDITION TO SOLICITED INPUT FROM KEY INFORMANTS AND COMMUNITY STAKEHOLDERS. COMMUNITY STAKEHOLDERS AND KEY INFORMANTS ARE MEMBERS OF ORGANIZATIONS FROM GOVERNMENT, EDUCATION, HEALTH CARE AND PUBLIC HEALTH. UNDERSERVED AND UNDERREPRESENTED POPULATIONS WERE REPRESENTED BY KEY INFORMANTS INCLUDING INDIVIDUALS FROM VARIOUS POPULATIONS COMPRISED OF VARIOUS RACIAL AND SOCIO-ECONOMIC BACKGROUNDS.
BILLINGS CLINIC	PART V, SECTION B, LINE 6A: BILLINGS CLINIC'S COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN A PRE-EXISTING COMMUNITY HEALTH PARTNERSHIP, THE HEALTHY BY DESIGN ALLIANCE, WITH INTERMOUNTAIN HEALTH ST. VINCENT REGIONAL HOSPITAL (HOSPITAL ORGANIZATION) AND RIVERSTONE HEALTH (PUBLIC HEALTH DEPARTMENT FOR CITY AND COUNTY). THE ALLIANCE ALSO CONDUCTED A CHNA IN 2006, 2011, 2014, 2017, 2020 AND 2023.
BILLINGS CLINIC	PART V, SECTION B, LINE 6B: THE HEALTHY BY DESIGN COALITION AND RIVERSTONE HEALTH
BILLINGS CLINIC	PART V, SECTION B, LINE 7D: TO FURTHER DISTRIBUTE AND PUBLICIZE THE CHNA, PRINTED COPIES OF THE CHNA REPORT WERE DISTRIBUTED TO COMMUNITY MEMBERS, MEDIA AND LOCAL NON-PROFIT ORGANIZATIONS. THE CHNA IS ALSO AVAILABLE ELECTRONICALLY ON THE HEALTHY BY DESIGN COALITION WEBSITE: HTTP://WWW.HEALTHYBYDESIGNYELLOWSTONE.ORG.
BILLINGS CLINIC	PART V, SECTION B, LINE 11: THE CHNA IDENTIFIED 11 AREAS OF OPPORTUNITY AFTER CONSIDERATION OF VARIOUS CRITERIA, INCLUDING A COMPARISON WITH BENCHMARK DATA AND HISTORICAL TRENDS, ANALYSIS OF THE NUMBER OF PERSONS AFFECTED AND SIGNIFICANCE OF FINDINGS. THESE AREAS OF OPPORTUNITY IDENTIFIED INCLUDED ACCESS TO HEALTH CARE, CANCER, DIABETES, HEART DISEASE AND STROKE, INJURY AND VIOLENCE, MENTAL HEALTH, NUTRITION AND PHYSICAL ACTIVITY, POTENTIALLY DISABLING CONDITIONS, RESPIRATORY DISEASES, SEXUAL HEALTH AND SUBSTANCE ABUSE. PRIORITIZATION RANKED FOUR PRIORITIES AS THE TOP NEEDS: 1) MENTAL HEALTH; 2) SUBSTANCE ABUSE; 3) ACCESS TO HEALTH CARE AND 4) NUTRITION, PHYSICAL ACTIVITY AND WEIGHT. BILLINGS CLINIC ADDRESSES THESE CHNA-IDENTIFIED NEEDS AT THE ORGANIZATIONAL LEVEL WITH EFFORTS TO IMPROVE AWARENESS AND EDUCATION, AS WELL AS TO REMOVE BARRIERS TO CARE. WORK IS DONE WITH CLINICAL DEPARTMENTS, SERVICE LINES, NURSING AND MEDICAL EDUCATION, COMMUNITY RELATIONS, POPULATION HEALTH, CARE MANAGEMENT, CITY/COUNTY HEALTH DEPARTMENT, COMMUNITY PARTNERS AND THE STATE AND FEDERAL GOVERNMENT. BILLINGS CLINIC IS PART OF SEVERAL COMMUNITY-WIDE COALITIONS TO ADDRESS COMMUNITY HEALTH NEEDS IN A COLLABORATIVE WAY. ACCESS TO HEALTH CARE - BILLINGS CLINIC PARTICIPATED IN IMPROVING ACCESS TO HEALTH CARE THROUGH APPOINTMENT AVAILABILITY, TRANSPORTATION FROM APPOINTMENTS, COST OF PRESCRIPTIONS AND INCREASED TELEMEDICINE OFFERINGS IN RURAL COMMUNITIES. THIS YEAR, MORE THAN 100 BILLINGS CLINIC PHYSICIANS IN 28 SPECIALTIES TRAVELED IN EXCESS OF 260,000 MILES TO PROVIDE SPECIALTY CARE FOR RESIDENTS OF RURAL MONTANA, WYOMING, AND NORTH DAKOTA. BILLINGS CLINIC IS THE HOME OFFICE OF THE EASTERN MONTANA TELEMEDICINE NETWORK, WHICH PROVIDED THOUSANDS OF TELEMEDICINE APPOINTMENTS WITH MEDICAL SPECIALISTS, AS WELL AS ADMINISTRATIVE AND OPERATIONAL SUPPORT TO PEOPLE ATTENDING EDUCATION AND MEETINGS THROUGH 40 PARTNER SITES IN MONTANA, WESTERN NORTH DAKOTA, AND NORTHERN WYOMING. BILLINGS CLINIC SUPPORTS MEDICAL CAREERS CLASSES IN LOCAL HIGH SCHOOLS, CLINICAL ROTATIONS FOR NURSING STUDENTS, DIETARY STUDENTS AND PHARMACY STUDENTS EACH YEAR TO HELP INCREASE STUDENTS IN THE HEALTHCARE RURAL WORKFORCE PIPELINE. AT ITS OWN EXPENSE, BILLINGS CLINIC PROVIDES FREE TRANSPORTATION FOR MANY PATIENTS WHO ARE FINANCIALLY UNABLE TO GET HOME FROM OUTPATIENT AND INPATIENT STAYS. FOR MORE THAN 20 YEARS, BILLINGS CLINIC HAS OFFERED HEALTHLINE, WHICH IS A FREE SERVICE AVAILABLE TO ALL COMMUNITY MEMBERS TO ASK HEALTH-RELATED QUESTIONS TO MEDICAL PROFESSIONALS, 24 HOURS A DAY, SEVEN DAYS A WEEK. IN 2024, BILLINGS CLINIC SPENT $221,000 ON HEALTHLINE-RELATED COSTS TO ENSURE THAT THIS SERVICE IS AVAILABLE TO THE COMMUNITY. THE BILLINGS CLINIC MEDICATION ASSISTANCE PROGRAM SERVED THOUSANDS OF UNINSURED AND UNDERINSURED PATIENTS WITH TENS OF THOUSANDS OF PRESCRIPTIONS PROCESSED IN 2024, INCLUDING FINANCIAL ASSISTANCE FOR NECESSARY MEDICATIONS. THE TOTAL VALUE OF THE DONATED MEDICATIONS WAS OVER $1 MILLION. CANCER - BILLINGS CLINIC PROVIDES FINANCIAL AND IN-KIND SUPPORT FOR THE AMERICAN CANCER SOCIETY, MONTANA WOMEN'S RUN, CANCER RESEARCH AND SCREENINGS. FREE OR LOW-COST SCREENINGS FOR CANCER ARE COORDINATED AND REPORTED ON THROUGH THE CANCER COMMITTEE'S COMMUNITY OUTREACH TASK GROUP. CANCER CARE NAVIGATORS HELP WITH NON-CLINICAL NEEDS TO IMPACT PATIENT CARE. ADDITIONALLY, BILLINGS CLINIC PROVIDES FREE BREAST CANCER SCREENINGS TO PATIENTS THROUGH ITS WOMEN'S WELLNESS FUND.DIABETES - BILLINGS CLINIC PROVIDES FINANCIAL AND IN-KIND SUPPORT FOR DIABETES CAMP FOR KIDS IN ADDITION TO DIABETES PREVENTION AND SELF-MANAGEMENT EDUCATION AT NO OR LOW CHARGE (SUBSIDIZED). HEART DISEASE AND STROKE - BILLINGS CLINIC MAKES ANNUAL FINANCIAL DONATIONS AND PROVIDES IN-KIND LEADERSHIP, HEALTH POLICY ADVOCACY, SPECIAL EVENT AND COMMITTEE SUPPORT FOR ORGANIZATIONS SUPPORTING PREVENTION, RESEARCH AND ADVOCACY FOR MANY CHRONIC DISEASES, INCLUDING THE AMERICAN HEART ASSOCIATION. BILLINGS CLINIC ALSO PARTNERS WITH THE ALLIANCE FOR HEALTHY MONTANANS TO ADVOCATE FOR HEALTH POLICIES THAT BENEFIT PERSONS WITH CHRONIC DISEASES, INCLUDING SUPPORT FOR MEDICAID EXPANSION. IN ADDITION, BILLINGS CLINIC OFFERS FREE COMMUNITY EDUCATION DURING HEART MONTH AND THROUGHOUT THE YEAR INCLUDING AWARENESS FOR THE SIGNS AND SYMPTOMS OF HEART ATTACK AND THROUGH OUR CARDIAC REHABILITATION PROGRAM. INFANT HEALTH- BILLINGS CLINIC PROVIDES PARENTAL EDUCATION RESOURCES AND FREE LACTATION EDUCATION AND CONSULTATIONS FOR NEW MOMS.INJURY AND VIOLENCE - TRAUMA AND INJURY PREVENTION IS SUBSIDIZED AT A 0.5 (HALF TIME) POSITION IN THE EMERGENCY AND TRAUMA CENTER BY A REGISTERED NURSE WHO PROVIDED EDUCATION FOR SAFE DRIVING, FALLS PREVENTION, BRAIN AND SPINAL CORD INJURY PREVENTION, HELMET SAFETY AND MORE. THE SEXUAL ASSAULT NURSING EXAM (SANE) PROGRAM PROVIDES SUBSIDIZED MEDICAL TREATMENT AND EMOTIONAL SUPPORT TO CHILDREN, TEENS AND ADULTS ANNUALLY WHO WERE VICTIMS OF SEXUAL ASSAULT AT A COST OF MORE THAN $330,000. BILLINGS CLINIC ALSO SUBSIDIZED THE HOURS FOR A PHYSICIAN TO SERVE AS THE MEDICAL DIRECTOR OF THE SANE PROGRAM AND TO PROVIDE FREE FOLLOW-UP CARE FOR CHILDREN UNDER 18. THE SANE STAFF AND VOLUNTEERS ALSO PROVIDE TRAINING IN THE REGION. BILLINGS CLINIC ALSO PROVIDES IN-KIND TIME SUPPORT FOR LOCAL ORGANIZATIONS AND THE CITY TO ADDRESS PUBLIC SAFETY. MENTAL HEALTH BILLINGS CLINIC IS A FOUNDING MEMBER OF THE COMMUNITY CRISIS CENTER WHICH IS A POINT OF ACCESS FOR PEOPLE IN OUR COMMUNITY SEEKING CRISIS STABILIZATION SERVICES FOR MENTAL HEALTH, SUBSTANCE ABUSE AND/OR SOCIAL SERVICE NEEDS REGARDLESS OF THEIR ABILITY TO PAY. WE SUPPORT THE COMMUNITY CRISIS CENTER FOR PEOPLE WITH CO-OCCURRING DISORDERS OF MENTAL HEALTH AND SUBSTANCE USE THROUGH FINANCIAL SUPPORT, LEADERSHIP AND STAFFING OF MENTAL HEALTH WORKERS AND SOCIAL WORKERS, AS WELL AS BOARD MEMBERSHIP BY OUR DIRECTOR OF PSYCHIATRIC SERVICES. THE COMMUNITY CRISIS CENTER SERVES THOUSANDS OF INDIVIDUALS WITH ASSESSMENTS, CASE MANAGEMENT, GROUP THERAPY, ADDICTION COUNSELING, REFERRALS AND STABILIZATION SERVICES TO PEOPLE IN NEED 24/7. BILLINGS CLINIC PROVIDES PSYCHIATRIC HOSPITAL ADMISSIONS AT THE ONLY INPATIENT PSYCHIATRIC HOSPITAL FOR CHILDREN, TEENS AND ADULTS IN CENTRAL/EASTERN MONTANA AND NORTHERN WYOMING. PSYCHIATRIC SERVICES ARE SUBSIDIZED AT A SIGNIFICANT SHORTFALL EACH YEAR. IN 2024, THE SHORTFALL TOTALED $5 MILLION. ADDITIONALLY, IN ORDER TO INCREASE ACCESS TO MENTAL HEALTH CARE, BILLINGS CLINIC'S PSYCHIATRIC RESIDENCY PROGRAM STARTED IN JULY 2019 AND IS THE ONLY ONE OF ITS KIND IN THE SURROUNDING REGION. IN ADDITION, WE PROVIDE FINANCIAL DONATIONS TO MULTIPLE MENTAL HEALTH ORGANIZATIONS, INCLUDING THE NATIONAL ALLIANCE ON MENTAL ILLNESS, THE OUT OF THE DARKNESS WALK FOR SUICIDE PREVENTION AND RIMROCK FOUNDATION. NUTRITION AND WEIGHT BILLINGS CLINIC IS A FOUNDING MEMBER OF THE HEALTHY BY DESIGN COALITION WHICH AIMS TO ADDRESS ISSUES OF UNDERINSURED AND UNDERSERVED COMMUNITY MEMBERS. BILLINGS CLINIC IN PARTNERSHIP WITH HEALTHY BY DESIGN, PROVIDED ACCESS TO LOW-COST FRESH FRUITS AND VEGETABLES AT THE HEALTHY BY DESIGN GARDENERS' MARKET BY ACCEPTING WIC AND SNAP FOR PAYMENT. BILLINGS CLINIC PROVIDED FINANCIAL SUPPORT FOR MAJOR EVENTS TO ENCOURAGE THOUSANDS OF INDIVIDUALS AND FAMILIES TO EXERCISE TOGETHER, INCLUDING BIG SKY STATE GAMES, BIG SKY FIT KIDS, SATURDAY LIVE FUN RUN, RUN TURKEY RUN, MONTANA MARATHON, MONTANA WOMEN'S RUN, AND MANY OTHER RUN/WALK FUNDRAISERS FOR LOCAL NONPROFIT ORGANIZATIONS. BILLINGS CLINIC ALSO SUPPORTS LOCAL SCHOOLS IN THE PROMOTION OF PHYSICAL ACTIVITY AND WELLNESS THROUGH THE "SUPERSTAR AWARDS" $100 GRANT AWARDS FOR 10 TEACHERS PER YEAR TO ENCOURAGE PHYSICAL ACTIVITY AND WELLNESS IN THEIR CLASSROOMS, FOR ALL GRADES, IN PARTNERSHIP WITH THE YMCA. DISABLING CONDITIONS- BILLINGS CLINIC OFFERS SUPPORT GROUPS FOR CAREGIVERS OF PERSONS WITH DISABILITIES AND PROVIDES FINANCIAL SUPPORT TO LOCAL NONPROFITS IN ADVANCING HEALTH EQUITY FOR INDIVIDUALS WITH DISABILITIES. RESPIRATORY DISEASES - BILLINGS CLINIC PROVIDES EDUCATION FOR ADULTS AND TEENS ABOUT THE DANGERS OF VAPING AND TOOLS/INFORMATION FOR CESSATION. IN COORDINATION WITH COMMUNITY HEALTH PARTNERS, BILLINGS CLINIC PROVIDES ONGOING COMMUNITY EDUCATION FOR THE PREVENTION AND TREATMENT OF RESPIRATORY ILLNESS. SEXUAL HEALTH- BILLINGS CLINIC CONDUCTS NUMEROUS OUTREACH CLINICS FOR UNDERSERVED POPULATIONS IN RURAL REGIONS IN ADDITION TO FREE EDUCATION FOCUSED ON SEXUAL HEALTH.
PART V, SECTION B, LINE 11	SUBSTANCE ABUSE BILLINGS CLINIC IS A MEMBER OF THE SUBSTANCE ABUSE CONNECT COALITION WHICH FOCUSES ITS WORK ON PREVENTION, EDUCATION, AND DIVERSION TO INCREASE ACCESS TO RESOURCES. BILLINGS CLINIC'S PARTICIPATION IN THE COALITION ALLOWS FOR COORDINATED EFFORTS AND INCREASED IMPACT. IN ADDITION, PROJECT ECHO PROVIDED TRAINING AND SUPPORT TO MENTAL HEALTH PROFESSIONALS, NURSES AND PHYSICIANS ACROSS THE REGION THROUGHOUT THE YEAR IN EDUCATIONAL SESSIONS FOR THE DEPARTMENT OF CORRECTIONS, INTEGRATED ADDICTIONS AND PSYCHIATRY AND PEDIATRIC MENTAL HEALTH AT UNREIMBURSED COST. TOBACCO USE - BILLINGS CLINIC PROVIDES FREE EDUCATION FOR ADULTS AND TEENS ABOUT THE DANGERS OF VAPING, TOBACCO CESSATION SCREENING AND REDUCTION IN INSURANCE PREMIUMS FOR BILLINGS CLINIC EMPLOYEES WHO DON'T USE TOBACCO, AS WELL AS A FREE TOBACCO CESSATION COURSE.BILLINGS CLINIC ADDRESSES THE SOCIAL DETERMINANTS OF HEALTH THROUGH ADVOCACY, IN-KIND LEADERSHIP AND FINANCIAL SUPPORT OF A VARIETY OF ORGANIZATIONS DOING WORK ON IMPORTANT ISSUES THAT AFFECT HEALTH, INCLUDING HOUSING/HOMELESSNESS, SUBSTANCE ABUSE, TRANSPORTATION AND EDUCATION. BILLINGS CLINIC IS A MEMBER OF SEVERAL COALITIONS IN YELLOWSTONE COUNTY WORKING ON SOCIAL DETERMINANTS OF HEALTH, INCLUDING HEALTHY NEIGHBORHOODS, BUILT ENVIRONMENT AND SOCIAL CONNECTIONS (HEALTHY BY DESIGN COALITION AND AGE FRIENDLY BILLINGS); TRANSPORTATION (LED BY MET TRANSIT); AND HOUSING (CONTINUUM OF CARE COALITION, LED BY UNITED WAY AND TUMBLEWEED). BILLINGS CLINIC PROVIDES BOARD LEADERSHIP, IN-KIND AND FINANCIAL SUPPORT FOR ECONOMIC DEVELOPMENT AND SECURITY FOR RESIDENTS OF YELLOWSTONE COUNTY AND OUR SURROUNDING REGION THROUGH BIG SKY ECONOMIC DEVELOPMENT AND THE CHAMBER OF COMMERCE (BILLINGS AND MONTANA STATE CHAMBERS OF COMMERCE).
SCHEDULE H, PART V SECTION B, LINE 16A, 16B AND 16C	HTTPS://WWW.BILLINGSCLINIC.COM/CARE-AT-BILLINGS-CLINIC/YOUR-VISIT/BILLING-INSURANCE--FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE/
SCHEDULE H, PART V SECTION B, LINE 7A AND LINE 10A	HTTPS://WWW.BILLINGSCLINIC.COM/APP/FILES/PUBLIC/1B3E2B5E-CDA6-444F-A14C-8F0A1EE09F54/REPORT_2023CHNA_EXECUTIVESUMMARY_FINAL_20230103-WEB.PDFHTTPS://WWW.BILLINGSCLINIC.COM/APP/FILES/PUBLIC/894CEA1A-AFED-44C6-A7CB-1399F5C4D73E/PLAN_2023-2026YELLOWSTONECOUNTYCHIP_FINAL_063023-WEBRES.PDF

Field	Value	IRS element (for citing)
Facility	17	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (17 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - BILLINGS CLINIC
1045 N 30TH ST	BILLINGS	MT	59101	OUTPATIENT CLINIC
2 - BILLINGS CLINIC MILES CITY
620 S HAYNES AVE	MILES CITY	MT	59301	OUTPATIENT CLINIC
3 - BILLINGS CLINIC HEIGHTS
760 WICKS LN	BILLINGS	MT	59105	OUTPATIENT CLINIC
4 - BILLINGS CLINIC SURGERY CENTER
2929 TENTH AVE N	BILLINGS	MT	59101	OUTPATIENT SURGERY CENTER
5 - BILLINGS CLINIC WEST
2675 CENTRAL AVE	BILLINGS	MT	59102	OUTPATIENT CLINIC
6 - BEHAVIORAL HEALTH CENTER
2800 10TH AVE N	BILLINGS	MT	591010703	OUTPATIENT MENTAL HEALTH CENTER
7 - BILLINGS CLINIC CODY
201 YELLOWSTONE AVE	CODY	WY	92414	OUTPATIENT CLINIC
8 - BILLINGS CLINIC CANCER CENTER
801 N 29TH ST	BILLINGS	MT	59101	CANCER CARE, INFUSION
9 - PSYCHIATRIC CENTER
1020 N 27TH ST	BILLINGS	MT	59101	INPATIENT PSYCHIATRIC CENTER
10 - HOME OXYGEN
1050 S 25TH ST W	BILLINGS	MT	59102	DURABLE MEDICAL EQUIPMENT
11 - BOZEMAN PEDIATRICS
1819 S 22ND ST	BOZEMAN	MT	59715	PEDIATRIC OUTPATIENT CENTER
12 - BILLINGS CLINIC ORTHOPEDICS
2702 8TH AVE N	BILLINGS	MT	59101	ORTHOPEDICS AND SPORTS MEDICINE
13 - BILLINGS CLINIC BOZEMAN
3905 WELLNESS WAY	BOZEMAN	MT	59718	OUTPATIENT CLINIC
14 - BILLINGS CLINIC CODY ORTHOPEDICS
3030 BIG HORN AVE	CODY	MT	82414	ORTHOPEDICS
15 - BILLINGS CLINIC CODY MRI & CT IMAGING
613 YELLOWSTONE AVE	CODY	WY	82414	MRI & CT IMAGING
16 - BILLINGS CLINIC WEST YELLOWSTONE
236 YELLOWSTONE AVE	WEST YELLOWSTONE	WY	59758	OUTPATIENT CLINIC
17 - BILLINGS CLINIC OBGYN
925 HIGHLAND BLVD	BOZEMAN	MT	59715	OBSTETRICS AND GYNECOLOGY CLINIC

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	IN ADDITION TO THE FEDERAL POVERTY GUIDELINES BILLINGS CLINIC ALSO USES ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE.
PART I, LINE 6A:	STILLWATER COMMUNITY HOSPITAL, A RELATED CRITICAL ACCESS HOSPITAL, PREPARES THEIR OWN INDEPENDENT COMMUNITY BENEFIT REPORT.
PART I, LINE 7:	THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A AND 7B. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. BILLINGS CLINIC USES THE SAME COST-TO-CHARGE RATIO THROUGHOUT THE ENTIRE SCHEDULE H TO DETERMINE THE COST OF THOSE ACTIVITIES.
PART I, LINE 7G:	SUBSIDIZED HEALTH SERVICES INCLUDES VARIOUS PHYSICIAN CLINICS IN ORDER TO BETTER SERVE THE MONTANA AREAS. MANY CRITICAL SERVICES WERE NOT FULLY REIMBURSED SUCH AS BEHAVIORAL HEALTH, PEDIATRIC SPECIALTIES, SEXUAL ASSAULT NURSE EXAMINATION AND RURAL OUTREACH CLINICS. PRIMARY CARE CLINICS WERE ONLY INCLUDED IF THEY WERE IN RURAL, UNDERSERVED AREAS OUTSIDE OUR PRIMARY SERVICE AREA. TOTAL COSTS FOR THE SUBSIDIZED SERVICES WERE $59,024,454 AND NET COMMUNITY BENEFIT OF THOSE SERVICES WAS DETERMINED TO BE $18,688,796.
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 $ 23,485,281.
PART II, COMMUNITY BUILDING ACTIVITIES:	BILLINGS CLINIC'S COMMUNITY BUILDING ACTIVITIES INCLUDE COMMUNITY SUPPORT AND ADVOCACY FOR PATIENT CARE.
PART III, LINE 2:	THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014- 09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.
PART III, LINE 3:	THE ORGANIZATION DOES NOT CONSIDER ANY OF ITS BAD DEBT EXPENSE TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
PART III, LINE 8:	IS THE BEST ESTIMATE OF THE PERCENTAGE OF MONTANA'S MEDICARE POPULATION (65 AND OLDER) WHO ARE AT OR BELOW 200% OF FEDERAL POVERTY LEVEL, BASED ON MEDICARE AND U.S. CENSUS DATA, AND THOSE PATIENTS WOULD QUALIFY FOR FULL FINANCIAL ASSISTANCE. A HIGHER PERCENTAGE WOULD QUALIFY FOR PARTIAL FINANCIAL ASSISTANCE WITH INCOMES FROM 200- 400 PERCENT OF FEDERAL POVERTY LEVEL. FOR THE CALCULATION OF THE UNREIMBURSED COST OF MEDICARE A RATIO OF PATIENT COST-TO CHARGES USING WORKSHEET 2 WAS UTILIZED AND APPLIED TO GROSS MEDICARE CHARGES. WE DO NOT USE THE MEDICARE 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 MEDICARE SHORTFALLS.
PART III, LINE 9B:	ACCOUNTS ARE BILLED WITH INSURANCE INFORMATION SUPPLIED BY THE PATIENT AND WHEN AVAILABLE, VERIFIED BY BILLINGS CLINIC. BILLINGS CLINIC SENDS PATIENT BILLING STATEMENTS THAT INCLUDE THE SUMMARY OF SERVICES PROVIDED, AMOUNTS PENDING INSURANCE AND AMOUNTS OWED BY THE PATIENT. FINANCIAL ASSISTANCE IS OFFERED TO PATIENTS WHO ARE UNINSURED OR UNDERINSURED. BILLINGS CLINIC ASSISTS PATIENTS APPLYING FOR FINANCIAL ASSISTANCE, AND PUBLIC PROGRAMS SUCH AS MEDICAID. BILLINGS CLINIC ALSO ASSISTS PATIENTS WITH PAYMENT PLANS INTEREST FREE FOR 12 MONTHS OR THROUGH AN EXTENDED LOAN OPTION UP TO 60 MONTHS. BILLINGS CLINIC WILL NOT REFER A PATIENT TO COLLECTIONS UNTIL AFTER 120 DAYS OF THE INDIVIDUAL BEING AWARE OF THEIR OPTIONS.
PART VI, LINE 2:	SINCE 1994, BILLINGS CLINIC, RIVERSTONE HEALTH AND ST. VINCENT HEALTHCARE HAVE BEEN WORKING TOGETHER AS THE ALLIANCE, CREATING AND SUSTAINING INNOVATIVE PROGRAMS THAT ADDRESS COMPLEX COMMUNITY-WIDE HEALTH ISSUES. RIVERSTONE HEALTH IS THE PUBLIC HEALTH DEPARTMENT FOR THE YELLOWSTONE COUNTY AND ST. VINCENT HEALTHCARE IS A 501(C)(3) HEALTHCARE ENTITY ALSO SERVING THE BILLINGS AREA.
PART VI, LINE 3:	ALL PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE. INFORMATIONAL BROCHURES WITH ONE-PAGE PLAIN LANGUAGE SUMMARY AND APPLICATION FORMS ARE AVAILABLE AT REGISTRATION DESKS IN THE CLINIC AND THE HOSPITAL, THE EMERGENCY DEPARTMENT DISCHARGE DESK, AND ON OUR WEBSITE AT WWW.BILLINGSCLINIC.COM/FINASSIST. OUR WEBPAGE INCLUDES THE FULL FINANCIAL ASSISTANCE POLICY. PATIENTS CAN ALSO CALL A DIRECT LINE TO TALK TO A PATIENT FINANCIAL REPRESENTATIVE.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 (DISABILITY, MEDICAID, VETERANS ADMINISTRATION, INDIAN HEALTH SERVICES AND WORKERS COMPENSATIONS). APPLICATIONS ARE MAILED TO PATIENTS WHOSE PAYMENT PATTERN INDICATES THAT THEY MAY NEED ASSISTANCE. PATIENT FINANCIAL SERVICES STAFF IS AVAILABLE TO HELP ANY PATIENT NEEDING ASSISTANCE COMPLETING AN APPLICATION. LANGUAGE TRANSLATION SERVICES ARE ALSO AVAILABLE.
PART VI, LINE 4:	BILLINGS CLINIC IS BASED IN BILLINGS, MONTANA AND IS MONTANA'S LARGEST HEALTH CARE ORGANIZATION SERVING A VAST REGION COVERING MUCH OF MONTANA, WYOMING AND NORTH DAKOTA. BILLINGS CLINIC IS ONE OF MONTANA'S LARGEST EMPLOYERS WITH APPROXIMATELY 4,500 EMPLOYEES INCLUDING MORE THAN 600 PHYSICIANS AND ADVANCED PRACTITIONERS OFFERING MORE THAN 80 SPECIALTIES. COMMUNITY BENEFIT INCLUDES HEALTH CARE SERVICES PROVIDED AT BILLINGS CLINIC LOCATIONS, INCLUDING THE HOSPITAL, MAIN CLINIC, BRANCH CLINICS AND OUTREACH CLINICS. BILLINGS CLINIC SPECIALISTS PROVIDE 110 OUTREACH CLINICS PER MONTH AT 21 DIFFERENT REGIONAL LOCATIONS FOR THE RESIDENTS OF MONTANA, WYOMING AND NORTH DAKOTA.
PART VI, LINE 5:	AS A NOT-FOR PROFIT COMMUNITY-GOVERNED ORGANIZATION, WORKING WITH OTHER ORGANIZATIONS IN THE COMMUNITY TO ADDRESS THE HEALTH CARE NEEDS IS AN IMPORTANT PART OF OUR MISSION. BILLINGS CLINIC HAS BEEN INVOLVED IN MEETING THE NEEDS OF INDIVIDUALS AND COMMUNITIES THROUGH COOPERATIVE EFFORTS WITH OTHER ORGANIZATIONS IN YELLOWSTONE COUNTY AND IN OUR REGION.COMMUNITY HEALTH COLLABORATION SINCE 1994, BILLINGS CLINIC, RIVERSTONE HEALTH AND ST. VINCENT HEALTHCARE HAVE BEEN WORKING TOGETHER, CREATING AND SUSTAINING INNOVATIVE PROGRAMS THAT ADDRESS COMPLEX COMMUNITY-WIDE HEALTH ISSUES. THEIR PURPOSE IS TO CREATE SUSTAINED CHANGE IN HOW OUR COMMUNITY RESPONDS TO THE CHALLENGE OF THE HIGH COST OF PRESCRIPTION DRUGS FOR THE UNINSURED AND THE POPULATION LIFESTYLE ISSUES OF OBESITY, POOR NUTRITION AND PHYSICAL ACTIVITY HABITS. THESE ARE EXAMPLES OF THE PAST AND FUTURE SUCCESSES OF THE ALLIANCE'S EFFORTS. COMMUNITY CRISIS CENTER - THE COMMUNITY CRISIS CENTER (CCC), ENHANCES\ACCESS TO BEHAVIORAL HEALTH CARE IN BILLINGS. THE CCC HAS SUCCESSFULLY REDUCED INAPPROPRIATE UTILIZATION OF LOCAL EMERGENCY DEPARTMENTS, DECREASED THE NUMBER OF SHORT-TERM INPATIENT HOSPITAL ADMISSIONS, AND HAS BEEN A DRIVING FORCE IN REDUCING THE INMATE POPULATION AT THE YELLOWSTONE COUNTY DETENTION FACILITY. MEDICATION ASSISTANCE PROGRAM (MAP) - MAP HELPS PATIENTS AFFORD THE PRESCRIPTION DRUGS THEY NEED BY CONNECTING INDIVIDUALS WITH AVAILABLE PATIENT ASSISTANCE PROGRAMS OFFERING DISCOUNTED OR FREE PRESCRIPTION MEDICATION. MAP ASSISTS LOW INCOME, UNINSURED OR UNDER INSURED PEOPLE IN GETTING THE MEDICATIONS THEY NEED, BUT CAN'T AFFORD.HEALTHY BY DESIGN - TO HELP RECOGNIZE ORGANIZATIONS IN YELLOWSTONE COUNTY COMMITTED TO IMPROVING OUR COMMUNITY'S HEALTH, BILLINGS CLINIC, RIVERSTONE HEALTH, AND ST. VINCENT HEALTHCARE LAUNCHED A COMMUNITY HEALTH COALITION CALLED HEALTHY BY DESIGN. HEALTHY BY DESIGN ENCOURAGES, RECOGNIZES, EDUCATES AND CREATES A STANDARD OF EXCELLENCE FOR PROMOTING HEALTHY LIFESTYLES BY ENCOURAGING ACTIVE LIVING AND HEALTHY CHOICES THAT SHAPE THE FUTURE OF THE COMMUNITY. FOR PROMOTING HEALTHY LIFESTYLES BY ENCOURAGING ACTIVE LIVING AND HEALTHY CHOICES THAT SHAPE THE FUTURE OF THE COMMUNITY.
PART VI, LINE 6:	MTWY HEALTH (MTWY) IS A MONTANA NONPROFIT ORGANIZATION THAT IS THE SOLE MEMBER OF BOTH BILLINGS CLINIC AND LOGAN HEALTH EFFECTIVE ON SEPTEMBER 1, 2023. THE ORGANIZATIONS BELIEVE THAT THE COMBINED, INDEPENDENT HEALTH SYSTEM WILL BE BETTER EQUIPPED TO SUSTAIN AND GROW SERVICES TO MEET THE PATIENT NEEDS IN MONTANA AND WYOMING.BELOW IS A LIST OF ORGANIZATIONS THAT ARE PART OF MTWY HEALTH. BILLINGS CLINIC (BC) IS A MONTANA NONPROFIT ORGANIZATION, WHICH IS STRUCTURED AS A MEDICAL FOUNDATION. BC OPERATES A 336-LICENSED-BED ACUTE CARE HOSPITAL LOCATED IN BILLINGS, MONTANA; A MULTI-SPECIALTY PHYSICIAN GROUP, INCLUDING MORE THAN 500 PHYSICIANS AND ADVANCED PRACTITIONERS BASED IN BILLINGS WITH BRANCH CLINICS IN MILES CITY AND BOZEMAN, MONTANA AND CODY, WYOMING. BC ALSO MANAGES A NUMBER OF CRITICAL ACCESS HOSPITALS IN MONTANA AND WYOMING.BILLINGS CLINIC FOUNDATION (THE FOUNDATION), WHOSE PRINCIPAL ACTIVITY IS THE SOLICITATION OF FUNDS FROM THE GENERAL PUBLIC FOR BC AND THE NONPROFIT AFFILIATES OF BC. THE OPERATIONS OF THE FOUNDATION ARE FINANCED PRINCIPALLY FROM CONTRIBUTIONS AND INVESTMENT INCOME. MONTANA HEALTHCARE INDEMNITY, LLC (MHI), WHOSE PRINCIPAL ACTIVITY IS TO ACT AS A CAPTIVE INSURANCE COMPANY FOR GENERAL AND PROFESSIONAL LIABILITY COVERAGE FOR BC, LOGAN HEALTH AND OTHER AFFILIATED HEALTHCARE FACILITIES LOCATED IN MONTANA AND WYOMING. STILLWATER HOSPITAL ASSOCIATION, INC., WHICH OWNS AND OPERATES STILLWATER BILLINGS CLINIC (SBC). SBC IS A NONPROFIT ACUTE CARE HOSPITAL LOCATED IN COLUMBUS, MONTANA. THE FACILITY HAS 16 ACUTE CARE AND SWING BEDS AND HAS BEEN GRANTED CRITICAL ACCESS STATUS FOR MEDICARE REPORTING PURPOSES.BILLINGS CLINIC SPECIALTY SUPPLIES AND SERVICES, LLC (SPECIALTY SERVICES) IS LICENSED BY THE STATE OF MONTANA AS A SINGLE MEMBER LIMITED LIABILITY COMPANY AND ITS INCOME IS INCLUDED IN THE TAX RETURN OF BC. SPECIALTY SERVICES FOCUSES ON PROVIDING PHARMACY CARE FOR CHRONIC, RARE OR COMPLEX CONDITIONS THAT REQUIRE SPECIALTY MEDICATION. IT ALSO PROVIDES PHARMACY SERVICES TO RESIDENTS IN A VARIETY OF POST-ACUTE CARE SETTINGS. TOWNSEND HEALTH SYSTEMS, INC., WHICH OWNS AND OPERATES BROADWATER HEALTH CENTER, D/B/A BILLINGS CLINIC BROADWATER (BCB). BCB IS A NONPROFIT CRITICAL ACCESS HOSPITAL LOCATED IN TOWNSEND, MONTANA. THE FACILITY HAS 25 LICENSED ACUTE CARE AND SWING BEDS AND HAS BEEN GRANTED CRITICAL ACCESS STATUS FOR MEDICARE REPORTING PURPOSES. BILLINGS CLINIC ONCALL, LLC (ONCALL) IS LICENSED BY THE STATE OF MONTANA AS A SINGLE MEMBER LIMITED LIABILITY COMPANY WHICH IS TAXED AT THE ENTITY LEVEL. ONCALL PROVIDES TELEHEALTH SERVICES.LOGAN HEALTH (LH), A MONTANA NONPROFIT ORGANIZATION, WAS FORMED IN MAY 1982 AND BEGAN OPERATIONS IN APRIL 1983. THE PRIMARY PURPOSE OF LH IS TO ACT FOR THE BENEFIT OF, AND ON BEHALF OF, ITS SUBSIDIARIES. KALISPELL REGIONAL MEDICAL CENTER, INC. D/B/A LOGAN HEALTH MEDICAL CENTER (LHMC): A MONTANA NONPROFIT ORGANIZATION THAT PROVIDES ACUTE HEALTH CARE SERVICES. LOGAN HEALTH FOUNDATION (THE LH FOUNDATION) IS A MONTANA NONPROFIT ORGANIZATION WHOSE PURPOSE IS TO PROMOTE THE CHARITABLE OBJECTIVES OF LH. ASSIST - FLATHEAD VALLEY (ASSIST) IS A NONPROFIT ORGANIZATION LOCATED IN KALISPELL, MONTANA, WHOSE PRIMARY PURPOSE IS TO IMPROVE THE QUALITY OF LIFE FOR RESIDENTS IN FLATHEAD VALLEY. APPLIED HEALTH SERVICES, INC. (AHS) IS A MONTANA TAXABLE ORGANIZATION THAT OPERATES A DURABLE MEDICAL EQUIPMENT RENTAL OPERATION, TWO RETAIL PHARMACIES AND OTHER SERVICES. SUMMIT MEDICAL FITNESS CENTER, D/B/A LOGAN HEALTH FITNESS CENTER, INC. (LHFC) IS A MONTANA NONPROFIT ORGANIZATION THAT WAS FORMED IN 2006 AND BEGAN OPERATIONS IN APRIL 2007 AS A HEALTH/MEDICAL FITNESS CENTER PROMOTING THE HEALTH OF THE COMMUNITY THROUGH EDUCATION, TRAINING AND RECREATION.MONTANA PEDIATRICS IS A MONTANA NONPROFIT ORGANIZATION THAT PROVIDES TELEHEALTH ALTERNATIVES TO PARENTS REQUIRING PEDIATRIC CARE AFTER HOURS OR IN CIRCUMSTANCES WHERE IN PERSON OFFICE VISITS ARE INCONVENIENT/ UNREALISTIC. LOGAN HEALTH EMERGENCY MEDICAL SERVICES (EMS) IS A MONTANA NONPROFIT ORGANIZATION THAT OPERATES REGIONAL EMS SERVICES.LOGAN HEALTH WHITEFISH (WHITEFISH) IS A MONTANA NONPROFIT CORPORATION THAT PROVIDES ACUTE-CARE GENERAL SERVICES AND BECAME PART OF LH ON MAY 1, 2016 AND IS LOCATED IN WHITEFISH, MONTANA. LOGAN HEALTH SHELBY (SHELBY) IS A MONTANA NONPROFIT ORGANIZATION THAT PROVIDES ACUTE-CARE GENERAL SERVICES AND BECAME PART OF LH ON MAY 6, 2021. SHELBY IS A CRITICAL ACCESS HOSPITAL LOCATED IN SHELBY, MONTANA.LOGAN HEALTH CONRAD (CONRAD) IS A MONTANA NONPROFIT ORGANIZATION THAT PROVIDES ACUTE-CARE GENERAL SERVICES AND BECAME PART OF LH ON JUNE 1, 2021. CONRAD IS A CRITICAL ACCESS HOSPITAL, NURSING FACILITY, AND A RURAL HEALTH CLINIC LOCATED IN CONRAD, MONTANA. LOGAN HEALTH CUT BANK (CUT BANK) IS A MONTANA NONPROFIT ORGANIZATION THAT PROVIDES ACUTE-CARE GENERAL SERVICES AND BECAME PART OF LH ON JUNE 1, 2021. CUT BANK IS A CRITICAL ACCESS HOSPITAL, AND A RURAL HEALTH CLINIC LOCATED IN CUT BANK, MONTANA. LOGAN HEALTH CHESTER (CHESTER) IS A MONTANA NONPROFIT ORGANIZATION THAT PROVIDES ACUTE-CARE GENERAL SERVICES AND BECAME PART OF LH ON JULY 1, 2022. CHESTER IS A CRITICAL ACCESS HOSPITAL AND ASSISTED LIVING FACILITY LOCATED IN CHESTER, MONTANA. NORTHWEST HORIZONS, INC. (NWH) IS A MONTANA NONPROFIT ORGANIZATION ORGANIZED TO ESTABLISH AND ENHANCE INSTITUTIONAL AND NONINSTITUTIONAL HEALTH CARE SERVICES FOR THE AGED. FLATHEAD HOSPITAL DEVELOPMENT COMPANY, LLC (FHDC) IS A MONTANA LIMITED LIABILITY COMPANY. THE PURPOSE OF FHDC IS TO OWN AND LEASE REAL ESTATE ON WHICH IMPROVEMENTS ARE OR WILL BE BUILT AND TO LEASE THAT REAL ESTATE TO THIRD PARTIES. CURRENTLY, THE FHDC OWNS AND LEASES AN ACUTE-CARE GENERAL HOSPITAL FACILITY IN KALISPELL, MONTANA, AND MEDICAL OFFICE BUILDINGS, IN KALISPELL, COLUMBIA FALLS, WHITEFISH, AND POLSON, MONTANA. FHDC IS JOINTLY OWNED 64.2% BY NWH, A SUBSIDIARY OF LH, AND 35.8% BY INDIVIDUAL PHYSICIANS. LOGAN HEALTH ASSISTED LIVING SHELBY (LHAL - SHELBY) IS A NONPROFIT ORGANIZATION THAT PROVIDES ASSISTED LIVING SERVICES AND BECAME A PART OF NWH ON MAY 1, 2018. LHAL - SHELBY IS LOCATED ADJACENT TO SHELBY IN SHELBY, MONTANA.LOGAN HEALTH CARE CENTER - SHELBY (LHLT - SHELBY) IS A NONPROFIT ORGANIZATION THAT PROVIDES SKILLED NURSING SERVICES AND BECAME A PART OF NWH ON MAY 6, 2021. LHLT - SHELBY IS LOCATED ADJACENT TO SHELBY IN SHELBY, MONTANA.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt
COMMUNITY CRISIS CENTER
704 NORTH 30TH STREET	BILLINGS	MT	59101	203231164	501(C)(3)	$81,191	$0	OPERATIONS SUPPORT
BILLINGS CLINIC FOUNDATION
2917 TENTH AVE NORTH PO BOX 31031	BILLINGS	MT	59101	810407289	501(C)(3)	$5,500	$0	SUPPORT OPERATIONS
AMERICAN CANCER SOCIETY
PO BOX 20893	BILLINGS	MT	59104		501(C)(3)	$12,500	$0	RELAY FOR LIFE
BILLINGS PUBLIC SCHOOLS EDUCATION FOUNDATION
415 N 30TH STREET	BILLINGS	MT	59101	810452904	501(C)(3)	$9,000	$0	EDUCATION PROGRAMS
MONTANA STATE UNIVERSITY
121 MONTANA HALL	BOZEMAN	MT	59717		501(C)(3)	$316,000	$0	LAND FOR NURSING SCHOOL BUILDING

Field	Value	IRS element (for citing)
Total501c3 Org	5	Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceDesc
SCHOLARSHIPS	47	$10,194	HEALTHCARE EDUCATION SCHOLARHIPS
CARE AND COMPASSION	343	$175,863	PATIENT CARE AND STAY ASSISTANCE

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	BILLINGS CLINIC AWARDS SCHOLARSHIPS TO INDIVIDUALS WHO EXHIBIT A STRONG DESIRE AND POTENTIAL TO EXCEL IN THE HEALTHCARE FIELD. BILLINGS CLINIC ALSO PROVIDES GRANTS TO OTHER HEALTH RELATED ORGANIZATIONS. MONTHLY FINANCIAL REPORTS ARE REVIEWED AND SIGNED BY THE GRANT MANAGER, AND THEN SUBMITTED FOR APPROVAL OF THE DRAWING OF FUNDS FOR GRANTS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
VANCE FREDRICKSON MD
PHYSICIAN	$2,174,455	$0	$20,000	$0	$1,740	$0	$29,275	$0	$8,656	$0	$2,234,126	$0	$0	$0
ANTHONY RUSSO MD
PHYSICIAN	$1,207,062	$0	$30	$0	$1,001,139	$0	$0	$0	$18,601	$0	$2,226,832	$0	$0	$0
DEAN SUKIN MD
PHYSICIAN	$882,634	$0	$0	$0	$1,000,000	$0	$29,275	$0	$15,552	$0	$1,927,461	$0	$0	$0
ANTHONY ROCCISANO DO
PHYSICIAN	$1,806,693	$0	$60	$0	$2,073	$0	$21,564	$0	$23,202	$0	$1,853,592	$0	$0	$0
SHERVIN DASHTI MD
PHYSICIAN	$1,795,841	$0	$30	$0	$2,320	$0	$0	$0	$23,496	$0	$1,821,687	$0	$0	$0
CRAIG LAMBRECHT MD
SYSTEM CEO (UNTIL 3/11/2024)	$0	$332,474	$0	$263,881	$0	$1,119,114	$0	$20,102	$0	$4,481	$0	$1,740,052	$0	$0
CLINTON SEGER MD
CEO	$1,095,076	$0	$62,909	$0	$5,613	$0	$29,275	$0	$14,019	$0	$1,206,892	$0	$0	$0
GORDON RIHA MD
BOARD MEMBER	$1,128,038	$0	$150	$0	$1,374	$0	$29,275	$0	$22,339	$0	$1,181,176	$0	$0	$0
KEVIN ABEL
SYSTEM CO-CEO	$0	$921,367	$0	$62,103	$0	$2,881	$0	$20,700	$0	$17,883	$0	$1,024,934	$0	$0
WILLIAM GIBSON
CLO	$0	$689,757	$0	$108,695	$0	$2,770	$0	$20,700	$0	$17,923	$0	$839,845	$0	$0
ELLEN LAYTON
CAO	$689,644	$0	$71,017	$0	$10,162	$0	$29,275	$0	$21,920	$0	$822,018	$0	$0	$0
KENDRICK TROSTEL MD
PHYSICIAN/VICE CHAIR	$747,666	$0	$3,444	$0	$5,509	$0	$29,275	$0	$23,161	$0	$809,055	$0	$0	$0
KATHLEEN QUINONES
CFO	$573,714	$0	$60	$0	$5,550	$0	$29,275	$0	$8,821	$0	$617,420	$0	$0	$0
SCOTT ELLNER DO
FORMER CEO	$0	$0	$0	$0	$597,240	$0	$0	$0	$0	$0	$597,240	$0	$0	$0
JUSTIN OTT
CIO	$434,799	$0	$0	$0	$6,513	$0	$25,674	$0	$21,920	$0	$488,906	$0	$0	$0
HEIDI DUNCAN MD
PHYSICIAN/BOARD MEMBER	$264,322	$0	$2,194	$0	$2,724	$0	$22,993	$0	$14,009	$0	$306,242	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART I, LINES 4A-B

CONTRACTUAL PAYMENTS: CRAIG LAMBRECHT - $1,116,784 457(F) CONTRIBUTIONS: CLINTON SEGER - $165,001 KATHLEEN QUINONES - $67,367 JUSTIN OTT - $57,877 WILLIAM GIBSON - $30,500 KEVIN ABEL - $23,000 ELLEN LAYTON - $84,000

PART I, LINE 7

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 AWARDED BASED ON FINANCIAL PERFORMANCE AS WELL AS ORGANIZATIONAL PERFORMANCE MEASUREMENTS IN QUALITY, PATIENT SATISFACTION, EMPLOYEE SATISFACTION AND THE INDIVIDUAL GOALS SET EACH YEAR IF THE TARGET IS TRIGGERED. THE INCENTIVE IS PAID ONLY IF TRIGGERED FOLLOWING THE FINANCIAL AUDIT PRESENTATION. NO INCENTIVES WERE PAID IN THE PERIOD.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
MONTANA FACILITY FINANCE AUTHORITY
A	364615155	61204KLQ2	2018-10-01	$125,786,085	SEE PART VI	Yes (1)	0	0
MONTANA FACILITY FINANCE AUTHORITY
B	364615155		2018-10-01	$56,580,000	SEE PART VI	0	0	0
MONTANA FACILITY FINANCE AUTHORITY
C	364615155	61204KNX5	2022-05-17	$59,605,577	SEE PART VI	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Capitalized InterestCapitalizedInterestAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt
A	$77,945,000	$128,666,648	$51,823	$43,367,802	$85,247,023	2022	Yes (1)	Yes (1)	Yes (1)
B		$56,585,037	$91	$75,828	$56,509,118	2022	Yes (1)	Yes (1)	Yes (1)
C	$2,635,000	$59,736,796			$59,542,495		Yes (1)	0	Yes (1)	$194,301

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	Yes (1)	Yes (1)	0.00200	0.00200	Yes (1)
B	Yes (1)	Yes (1)	0.00300	0.00300	Yes (1)
C	Yes (1)	Yes (1)	0.00200	0.00200	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	0	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)
B	0	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)	0	Yes (1)	Yes (1)	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I(F) - COLUMN A	THE BONDS WERE ISSUED TO FINANCE CAPITAL PROJECTS, TO REISSUE SERIES 2011A BONDS (REISSUED ON OCTOBER 6, 2014), AND TO CURRENT REFUND SERIES 2008 BONDS (ISSUED ON MAY 30, 2008).
PART I(F) - COLUMN B	THE BONDS WERE ISSUED TO FINANCE CAPITAL PROJECTS AND TO REISSUE SERIES 2011B BONDS (REISSUED ON JUNE 28, 2016).
PART I(F) - COLUMN C	THE BONDS WERE ISSUED TO CURRENT REFUND THE SERIES 2018C BONDS (ISSUED ON OCTOBER 1, 2018).
PART II, LINE 3 - COLUMN A	THE TOTAL PROCEEDS SHOWN IN PART II, LINE 3 DIFFERS FROM THE ISSUE PRICE SHOWN IN PART I, (E) DUE TO INTEREST EARNINGS ON INVESTED PROCEEDS.
PART II, LINE 3 - COLUMN B	THE TOTAL PROCEEDS SHOWN IN PART II, LINE 3 DIFFERS FROM THE ISSUE PRICE SHOWN IN PART I, (E) DUE TO INTEREST EARNINGS ON INVESTED PROCEEDS.
PART II, LINE 3 - COLUMN C	THE TOTAL PROCEEDS SHOWN IN PART II, LINE 3 DIFFERS FROM THE ISSUE PRICE SHOWN IN PART I, (E) DUE TO INTEREST EARNINGS ON INVESTED PROCEEDS.
PART III, LINE 7 - COLUMN A	AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE.
PART III, LINE 7 - COLUMN B	AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE.
PART III, LINE 7 - COLUMN C	AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE.
PART IV, LINE 2(B) - COLUMN A	THE REFUNDING PORTION OF THE BONDS HAS MET AN EXCEPTION TO THE REBATE REQUIREMENT.
PART IV, LINE 2(B) - COLUMN B	THE REFUNDING AND NEW MONEY PORTIONS OF THE BONDS HAVE MET EXCEPTIONS TO THE REBATE REQUIREMENT.
PART IV, LINE 2(B) - COLUMN C	BOND PROCEEDS HAVE MET AN EXCEPTION TO THE REBATE REQUIREMENT.
PART IV, LINE 2(C) - COLUMN A	THE MOST RECENT 5TH YEAR REBATE REPORT WAS PREPARED ON OCTOBER 25, 2023.
PART IV, LINE 2(C) - COLUMN B	THE MOST RECENT 5TH YEAR REBATE REPORT WAS PREPARED ON OCTOBER 11, 2023.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
E JAMES DUNCAN
E. JAMES DUNCAN HAS A FAMILY RELATIONSHIP WITH BOARD MEMBER HEIDI DUNCAN	$424,027	EMPLOYEE COMPENSATION	0
NADINE SEGER
NADINE SEGER HAS A FAMILY RELATIONSHIP WITH CEO CLINT SEGER	$418,004	EMPLOYEE COMPENSATION	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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.
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.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	EINEIN
MONTANA HEALTHCARE INDEMNITY LLC
2800 TENTH AVENUE NORTH	BILLINGS	MT	59101	INSUR CAPTIVE	MT	$10,445,434	$42,106,404	BILLINGS CLINIC
SPECIALTY SUPPLIES AND SERVICES LLC
2800 TENTH AVENUE NORTH	BILLINGS	MT	59101	SPEC SUPPLY	MT	$130,850,840	$21,411,865	BILLINGS CLINIC	364871868
BILLINGS CLINIC ONCALL LLC
2800 TENTH AVENUE NORTH	BILLINGS	MT	59101	TELEHEALTH	MT	$6,783	$13,961	BILLINGS CLINIC	873543333

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (22 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
ASSIST-FLATHEAD VALLEY
310 SUNNYVIEW LANE	KALISPELL	MT	59901	462669324	WELLNESS RESOURCE PROVIDER	MT	501(C)(3)	LINE 10	KALISPELL REGIONAL MEDICAL CENTER	0
BILLINCS CLINIC EMPLOYEE BENEFIT TRUST
2800 TENTH AVENUE NORTH	BILLINGS	MT	59101	810391600	EMPLOYEE BENEFITS	MT	501(C)(9)		BILLINGS CLINIC	Yes (1)
BILLINGS CLINIC FOUNDATION
2917 TENTH AVENUE NORTH	BILLINGS	MT	59101	810407289	FUNDRAISING	MT	501(C)(3)	LINE 7	BILLINGS CLINIC	Yes (1)
KALISPELL REGIONAL HEALTHCARE FOUNDATION
310 SUNNYVIEW LANE	KALISPELL	MT	59901	311703013	SUPPORTING ORGANIZATION	MT	501(C)(3)	LINE 12A, I	KALISPELL REGIONAL MEDICAL CENTER	0
KALISPELL REGIONAL MEDICAL CENTER
310 SUNNYVIEW LANE	KALISPELL	MT	59901	237293874	ACUTE HOSPITAL CARE	MT	501(C)(3)	LINE 3	LOGAN HEALTH	0
KALISPELL REGIONAL MEDICAL CENTER VOLUNTEERS
310 SUNNYVIEW LANE	KALISPELL	MT	59901	273866474	SUPPORTING ORGANIZATION	MT	501(C)(3)	LINE 10	KALISPELL REGIONAL MEDICAL CENTER	0
LIBERTY COUNTY HOSPITAL AND NURSING HOME INC
315 W MADISON AVE	CHESTER	MT	59522	810515463	PROVIDE ACUTE HOSPITAL CARE	MT	501(C)(3)	LINE 3	LOGAN HEALTH	0
LOGAN HEALTH
310 SUNNYVIEW LANE	KALISPELL	MT	59901	810406485	SUPPORT SUBSIDIARY HEALTH ORGANIZATIONS	MT	501(C)(3)	LINE 3	MTWY HEALTH INC	0
LOGAN HEALTH - CONRAD
805 SUNSET BLVD	CONRAD	MT	59425	810232406	PROVIDE ACUTE HOSPITAL CARE	MT	501(C)(3)	LINE 3	LOGAN HEALTH	0
LOGAN HEALTH - CUT BANK
226 9TH AVE SE	CUT BANK	MT	59427	810530457	PROVIDE ACUTE HOSPITAL CARE	MT	501(C)(3)	LINE 3	LOGAN HEALTH	0
LOGAN HEALTH - SHELBY
640 PARK AVE	SHELBY	MT	59474	862327525	PROVIDE ACUTE HOSPITAL CARE	MT	501(C)(3)	LINE 3	LOGAN HEALTH	0
LOGAN HEALTH - WHITEFISH
1600 HOSPITAL WAY	WHITEFISH	MT	59937	810247969	PROVIDE ACUTE HOSPITAL CARE	MT	501(C)(3)	LINE 3	LOGAN HEALTH	0
LOGAN HEALTH ASSISTED LIVING - SHELBY
111 2ND ST S	SHELBY	MT	59474	862394240	RETIREMENT & ASSISTED LIVING	MT	501(C)(3)	LINE 10	NORTHWEST HORIZONS INC	0
LOGAN HEALTH CARE CENTER - SHELBY
630 PARK DRIVE	SHELBY	MT	59474	862346458	LONG-TERM CARE & SKILLED NURSING	MT	501(C)(3)	LINE 10	NORTHWEST HORIZONS INC	0
LOGAN HEALTH EMERGENCY MEDICAL SERVICES
310 SUNNYVIEW LANE	KALISPELL	MT	59901	880538346	EMERGENCY SERVICES	MT	501(C)(3)	LINE 7	LOGAN HEALTH	0
MONTANA PEDIATRICS
259 W FRONT ST STE B	MISSOULA	MT	59802	854133807	AMBULATORY CARE	MT	501(C)(3)	LINE 7	LOGAN HEALTH	0
MTWY HEALTH INC
310 SUNNYVIEW LN	KALISPELL	MT	59901	932584380	SUPPORT	MT	501(C)(3)	LINE 12B, II		0	N/A
NORTH VALLEY HOSPITAL FOUNDATION
1600 HOSPITAL WAY	WHITEFISH	MT	59937	810526541	SUPPORTING ORGANIZATION	MT	501(C)(3)	LINE 12A, I	LOGAN HEALTH - WHITEFISH	0
NORTHWEST HORIZONS INC
310 SUNNYVIEW LANE	KALISPELL	MT	59901	810420653	LONG-TERM AMBULATORY CARE	MT	501(C)(3)	LINE 10	LOGAN HEALTH	0
STILLWATER HOSPITAL ASSOCIATION
710 N 11TH STREET	COLUMBUS	MT	59019	810286525	HOSPITAL	MT	501(C)(3)	LINE 3	BILLINGS CLINIC	Yes (1)
SUMMIT MEDICAL FITNESS CENTER
310 SUNNYVIEW LANE	KALISPELL	MT	59901	203752312	COMMUNITY HEALTH & WELLNESS CENTER	MT	501(C)(3)	LINE 10	LOGAN HEALTH	0
TOWNSEND HEALTH SYSTEMS INC
110 NORTH OAK STREET	TOWNSEND	MT	59644	810398400	HEALTHCARE	MT	501(C)(3)	LINE 3	BILLINGS CLINIC	Yes (1)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (1)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (7 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
BILLINGS CLINIC FOUNDATION
D	$221,140	INTERCOMPANY AMOUNT
STILLWATER HOSPITAL ASSOCIATION
D	$1,383,672	INTERCOMPANY AMOUNT
TOWNSEND HEALTH SYSTEMS INC
D	$2,158,770	INTERCOMPANY AMOUNT
STILLWATER HOSPITAL ASSOCIATION
Q	$9,784,649	INTERCOMPANY AMOUNT
STILLWATER HOSPITAL ASSOCIATION
O	$8,367,995	INTERCOMPANY AMOUNT
TOWNSEND HEALTH SYSTEMS INC
O	$5,928,804	INTERCOMPANY AMOUNT
TOWNSEND HEALTH SYSTEMS INC
Q	$9,002,870	INTERCOMPANY AMOUNT