BENEFIS COMMUNITY HOSPITALS INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- BENEFIS COMMUNITY HOSPITALS INC (EIN 47-3448483)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-02
- IRS object ID
- 201833069349302303
- Schema version
- 2017v2.3
- 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 D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-02T18:40:31-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 SW BROADWAY SUITE 1200 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 98205 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 473448483 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BENEFIS COMMUNITY HOSPITALS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BENE | BusinessNameControlTxt |
| Phone | 4064552544 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 26TH STREET SOUTH | AddressLine1Txt |
| City | GREAT FALLS | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59405 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LOUIE KING | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 4064552544 | PhoneNum |
| Signature | 2018-09-23 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WENDY CAMPOS | PreparerPersonNm |
| PTIN | P00448102 | PTIN |
| Phone | 5032421447 | PhoneNum |
| Preparation | 2018-09-23 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 50.125.248.56 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-09-23 | IPDt |
| IP Tm | 16:40:40 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 866574987CA565ABE6CC9265146BBE3F5B9624AD | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2018-06-14 16:35:46Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LOUIE KING | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 26TH STREET SOUTH | AddressLine1Txt |
| City | GREAT FALLS | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59405 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,906,061 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://TETONMEDICALCENTER.NET/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2015 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | WE PROVIDE EXCELLENT CARE FOR ALL, HEALING BODY, MIND AND SPIRIT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 105 | TotalEmployeeCnt |
| Total Volunteers | 75 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $111,244 | PYContributionsGrantsAmt |
| CY Contributions Grants | $58,889 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,290,811 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,830,386 | CYProgramServiceRevenueAmt |
| PY Investment Income | $490 | PYInvestmentIncomeAmt |
| CY Investment Income | $341 | CYInvestmentIncomeAmt |
| PY Other Revenue | $94,351 | PYOtherRevenueAmt |
| CY Other Revenue | $16,445 | CYOtherRevenueAmt |
| PY Total Revenue | $7,496,896 | PYTotalRevenueAmt |
| CY Total Revenue | $6,906,061 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $11,530 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $15,172 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,040,059 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,261,928 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,695,265 | PYOtherExpensesAmt |
| CY Other Expenses | $4,407,297 | CYOtherExpensesAmt |
| PY Total Expenses | $9,746,854 | PYTotalExpensesAmt |
| CY Total Expenses | $8,684,397 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,249,958 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,778,336 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,831,954 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,298,859 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,811,953 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,057,194 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $20,001 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,758,335 | NetAssetsOrFundBalancesEOYAmt |
| Mission | BENEFIS COMMUNITY HOSPITALS, INC. (BCH) WAS ORGANIZED IN 2015 FOR THE PURPOSE OF PROVIDING MEDICAL CARE AND TO SERVE AS AN ECONOMIC PILLAR IN RURAL MONTANA COMMUNITIES BY SUPPORTING THE ROLE OF CRITICAL ACCESS HOSPITALS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,304,128 | ExpenseAmt |
| Grant | $15,172 | GrantAmt |
| Revenue | $6,780,453 | RevenueAmt |
| Desc | PROVIDE EMERGENCY SERVICES, OPERATE AN OUTPATIENT CLINIC, ACUTE CARE SERVICES AND ANCILLARY SERVICES INCLUDING: PHYSICAL THERAPY, LABORATORY, RADIOLOGY, ECHOCARDIOGRAPHY, CAROTID ULTRASOUND, MAMMOGRAM, DIABETIC FOOT CARE, BONE DENSITY (DEXA SCAN), TELE-DERMATOLOGY, CAT SCAN AND OCCUPATIONAL THERAPY. | Desc |
| Total Program Service Expenses | $6,304,128 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 105 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | 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 | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FORREST EHLINGER | PersonNm |
| Phone | 4254555479 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 26TH STREET SOUTH | AddressLine1Txt |
| City | GREAT FALLS | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59405 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt |
|---|---|---|---|---|---|---|---|
| RON DAUWALDER | |||||||
| CHAIR, VICE CHAIR (THROUGH 11/13) | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAN LINDSETH | |||||||
| DIRECTOR, CHAIR (THROUGH 11/13) | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DALE HANSON | |||||||
| VICE CHAIR, DIRECTOR (THROUGH 11/13) | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JUDY BORLAND MD | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $203,117 | $10,606 | 48.00 | |
| MARCIE MANGOLD | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JACK CONASTER | |||||||
| DIRECTOR (THROUGH 8/14) | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BRIAN MCCOLLOM | |||||||
| DIRECTOR (FROM 9/11) | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| WARD FIFIELD | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| TERRY OLINGER | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $576,742 | $139,047 | 58.00 | |
| LOUIE KING | |||||||
| PRESIDENT | 50.00 | Yes (X) | Yes (X) | $157,944 | $0 | $28,863 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $157,944 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $779,859 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $178,516 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRAIRIE TRAVELERS | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 130 3RD STREET S STE 2 | AddressLine1Txt |
| City | GLASGOW | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59230 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | TRAVELING NURSES/CNAS | ServicesDesc |
| Compensation | $145,074 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $58,889 | AllOtherContributionsAmt |
| Total Contributions | $58,889 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| PATIENT SERVICES | 621990 | $6,627,548 | $6,627,548 | |
| OTHER PROGRAM REVENUE | 621990 | $151,370 | $151,370 | |
| CAFETERIA | 722210 | $49,933 | $49,933 | |
| NORTHCENTRAL MONTANA H | 621990 | $1,535 | $1,535 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,830,386 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $341 | TotalRevenueColumnAmt |
| Exclusion | $341 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $5,938 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $5,938 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,938 | TotalRevenueColumnAmt |
| Exclusion | $5,938 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $10,507 | TotalRevenueColumnAmt |
| Exclusion | $10,507 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $10,507 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,906,061 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,780,453 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $66,719 | 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 | $1,235 | TotalAmt |
| Program Services | $1,235 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,937 | TotalAmt |
| Program Services | $13,937 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,807 | TotalAmt |
| Management And General | $186,807 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,359,549 | TotalAmt |
| Program Services | $2,698,016 | ProgramServicesAmt |
| Management And General | $661,533 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,841 | TotalAmt |
| Program Services | $74,630 | ProgramServicesAmt |
| Management And General | $13,211 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $384,065 | TotalAmt |
| Program Services | $291,765 | ProgramServicesAmt |
| Management And General | $92,300 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $243,666 | TotalAmt |
| Program Services | $197,993 | ProgramServicesAmt |
| Management And General | $45,673 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $729,490 | TotalAmt |
| Management And General | $729,490 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,880 | TotalAmt |
| Management And General | $12,880 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $927,979 | TotalAmt |
| Program Services | $927,979 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,934 | TotalAmt |
| Program Services | $12,750 | ProgramServicesAmt |
| Management And General | $11,184 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,636 | TotalAmt |
| Program Services | $5,603 | ProgramServicesAmt |
| Management And General | $84,033 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,444 | TotalAmt |
| Program Services | $136,444 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $209,553 | TotalAmt |
| Program Services | $192,910 | ProgramServicesAmt |
| Management And General | $16,643 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,488 | TotalAmt |
| Program Services | $14,557 | ProgramServicesAmt |
| Management And General | $6,931 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1 | TotalAmt |
| Management And General | $1 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $465,846 | TotalAmt |
| Management And General | $465,846 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $256 | TotalAmt |
| Management And General | $256 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACTUAL ALLOWANCES | $672,261 | $672,261 | |
| PURCHASED SERVICES | $368,353 | $338,875 | $29,478 |
| MEDICAL SUPPLIES | $344,809 | $340,248 | $4,561 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $404,367 | TotalAmt |
| Program Services | $384,925 | ProgramServicesAmt |
| Management And General | $19,442 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,684,397 | TotalAmt |
| Program Services | $6,304,128 | ProgramServicesAmt |
| Management And General | $2,380,269 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $769,078 | BOYAmt |
| EOY | $159,188 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $508,271 | BOYAmt |
| EOY | $773,368 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,608 | BOYAmt |
| EOY | $55,240 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,877 | BOYAmt |
| EOY | $63,590 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,547,487 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,300,014 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,469,120 | BOYAmt |
| EOY | $1,247,473 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,831,954 | BOYAmt |
| EOY | $2,298,859 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,811,953 | BOYAmt |
| EOY | $4,057,194 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,811,953 | BOYAmt |
| EOY | $4,057,194 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,001 | BOYAmt |
| EOY | -$1,758,335 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,001 | BOYAmt |
| EOY | -$1,758,335 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,831,954 | BOYAmt |
| EOY | $2,298,859 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,778,336 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,585 | OtherCostOrOtherBasisAmt |
| Book Value | $14,585 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $916,543 | OtherCostOrOtherBasisAmt |
| Depreciation | $121,903 | DepreciationAmt |
| Book Value | $794,640 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,616,359 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,178,111 | DepreciationAmt |
| Book Value | $438,248 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,247,473 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS COMPRISED OF SEVERAL CORPORATIONS, WHICH ARE EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC, EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515, AND SEVERAL LIMITED LIABILITY COMPANIES. EFFECTIVE JANUARY 1, 2009, THE ORGANIZATION ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2017 OR 2016. | ExplanationTxt |
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 | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,937 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $13,937 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,888,554 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,639,001 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $249,553 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03110 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,902,491 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,639,001 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $263,490 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03280 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,950 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,413 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,413 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,235 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,235 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,598 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $19,598 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,922,089 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,639,001 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $283,088 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03520 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $0 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $1,828,229 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $1,865,212 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$36,983 | 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 | BENEFIS TETON MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 915 FOURTH ST NW | AddressLine1Txt |
| City | CHOTEAU | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59422 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://TETONMEDICALCENTER.NET | WebsiteAddressTxt |
| State License | 12766 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | INCLUDING EXTENDED CARE LIVING & RURAL HEALTH CLINIC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BENEFIS TETON MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | 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 | HTTP://TETONMEDICALCENTER.NET | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | WWW.TETONCOMT.ORG | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://TETONMEDICALCENTER.NET | 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 |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://TETONMEDICALCENTER.NET/DEPARTMENTS/BUSINESS-PAYMENT-SERVICES/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://TETONMEDICALCENTER.NET/DEPARTMENTS/BUSINESS-PAYMENT-SERVICES/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://TETONMEDICALCENTER.NET/DEPARTMENTS/BUSINESS-PAYMENT-SERVICES/ | 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 Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Selling Debt | Yes (X) | PermitSellingDebtInd |
| Permit Legal Judicial Process | Yes (X) | PermitLegalJudicialProcessInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| 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 (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BENEFIS TETON MEDICAL CENTER | PART V, SECTION B, LINE 5: BCH, INC COLLABORATED WITH TETON COUNTY HEALTH DEPARTMENT AND TETON COUNTY MENTAL HEALTH LOCAL ADVISORY COUNCIL TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT. A SERIES OF SEVEN FOCUS GROUP DISCUSSIONS WERE HELD IN THREE COMMUNITIES WITHIN THE COUNTY. EACH MEETING TARGETED UNIQUE POPULATION GROUPS, INCLUDING: HIGH SCHOOL STUDENTS, PEOPLE WITH CHRONIC HEALTH CONDITIONS, MENTAL HEALTH PATIENTS AND ADVOCATES, LOW INCOME FAMILIES, FAITH COMMUNITY LEADERS AND SENIOR CITIZENS. A TOTAL OF 65 COMMUNITY MEMBERS PARTICIPATED IN THESE DISCUSSION GROUPS. EACH GROUP WAS ASKED THE SAME 7 QUESTIONS.IN ADDITION, A STAKEHOLDER ADVISORY GROUP (SAG), CONSISTING OF 23 COMMUNITY MEMBERS WITH KNOWLEDGE OF AND A BROAD CONNECTION TO THE COMMUNITY GROUPS AND SPECIAL POPULATIONS, WAS DEVELOPED. THE SAG ATTENDED 7 WEEKLY MEETINGS WITH THE FOLLOWING AGENDA:- DRAFT A VISIONS STATEMENT AND A LIST OF VALUES- REVIEW RESULTS OF FOCUS GROUP MEETINGS- IDENTIFY AND PRIORITIZE IMPORTANT LOCAL HEALTH ISSUES.- DRAFT GOALS, OBJECTIVES AND STRATEGIES FOR ADDRESSING THE TOP 3 MOST IMPORTANT LOCAL HEALTH ISSUES. |
| BENEFIS TETON MEDICAL CENTER | PART V, SECTION B, LINE 6B: TETON COUNTY HEALTH DEPARTMENTTETON COUNTY MENTAL HEALTH LOCAL ADVISORY COUNCIL |
| BENEFIS TETON MEDICAL CENTER | PART V, SECTION B, LINE 11: AN IMPLEMENTATION PLANNING COMMITTEE (IPC) PARTICIPATED IN AN PROCESS TO SYSTEMATICALLY RESPOND TO ALL ISSUES IDENTIFIED IN THE CHNA PROCESS. THE IPC REVIEWED THE PRIORITIES SET BY THE SAG, THEY IDENTIFIED THE AVAILABLE COMMUNITY PARTNERS AND IDENTIFIED THE NEEDS THAT BCH, INC WOULD BE UNABLE TO ADDRESS. THE IPC SELECTED 3 GOALS AND SET STRATEGIES FOR EACH GOAL, INCLUDING ACTIVITIES TO COMPLETE THOSE STRATEGIES. STAFF RESPONSIBLE AND A TIMELINE WERE SET TO ACCOMPLISH THE 3 GOALS. |
| BENEFIS TETON MEDICAL CENTER | PART V, SECTION B, LINE 13H: - HOMELESS- DECEASED WITH NO ESTATE- MENTALLY INCAPACITATED WITH NO ONE TO ACT ON HIS OR HER BEHALF- MEDICAID ELIGIBLE, BUT NOT ON THE DATE OF SERVICE OR FOR NON-COVERED SERVICES- ENROLLED IN ONE OR MORE GOVERNMENTAL PROGRAMS FOR LOW-INCOME INDIVIDUALS HAVING ELIGIBILITY CRITERIA AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES - INCARCERATION IN A PENAL INSTITUTION |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COST TO CHARGE RATIO IS USED TO CALCULATE THE TOTAL COMMUNITY BENEFIT EXPENSE. |
| PART I, LINE 7, COLUMN (F) | THE CONTRACTUAL ALLOWANCES INCLUDED ON THE FORM 990, PART IX, LINE 24(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $672,261. |
| PART III, LINE 4: | SEE NOTE 2 ON PAGE 10 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE ORGANIZATION DOES NOT BELIEVE THAT ANY SHORTFALL REPORTED IN LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT.THE ORGANIZATION USED ITS COST TO CHARGE RATIO TO OBTAIN THE MEDICARE ALLOWABLE COST REPORTED IN PART III, SECTION B. THE ORGANIZATION HAS A CONSIDERABLE POPULATION OF MEDICARE PATIENTS, AND IS PAID LESS THAN ITS COSTS DUE TO THE REIMBURSEMENT METHODOLOGY USED BY MEDICARE.RECONCILIATION OF MEDICARE COST REPORT TO TOTAL MEDICARE REVENUE & EXPENSES:$1,828,229 MEDICARE NET REVENUE AS REPORTED ON PART III, SECTION B, LINE 5 $84,513 MEDICARE CLAIMS PAID BUT EXCLUDED FROM COST REPORT (OUTPATIENT FEE SCHEDULE, PHYSICIANS & OTHER MISCELLANEOUS)$1,912,742 TOTAL MEDICARE NET REVENUE$1,865,212 MEDICARE ALLOWABLE COSTS AS REPORTED ON PART III, SECTION B, LINE 6 $593,937 MEDICARE COST DEPARTMENTS EXCLUDED FROM COST REPORT (OUTPATIENT FEE SCHEDULE, PHYSICIANS & OTHER MISCELLANEOUS) $178,905 MEDICARE COST REPORT REVENUE AND EXPENSE ADJUSTMENTS$2,638,054 TOTAL MEDICARE COSTS($725,312) TOTAL SHORTFALL ON MEDICARE |
| PART III, LINE 9B: | PERSONS DETERMINED TO BE ELIGIBLE FOR 100 % CHARITY CARE SHALL NOT RECEIVEA BILL FOR SERVICES OR BE SUBJECT TO COLLECTION PROCEDURES. PERSONS DETERMINED TO BE ELIGIBLE FOR A REDUCTION OF A PERCENTAGE OF CHARGES UNDER THE CHARITY CARE PROGRAM LESS THAN 100% SHALL NOT BE BILLEDOR SUBJECT TO COLLECTION PROCEDURES FOR THE PORTION OF THE BILL THAT ISREDUCED UNDER THE SLIDING FEE SCALE, ONLY THE OUT OF POCKET RESPONSIBILITY. |
| PART VI, LINE 2: | HISTORICALLY, BENEFIS COMMUNITY HOSPITALS, INC. HAS ASSESSED THE HEALTH NEEDS OF THE COMMUNITIES WITHIN ITS SERVICE AREA THROUGH DIRECT OBSERVATION AND EXPERIENCE, AS WELL AS THROUGH THE USE OF CERTAIN SECONDARY DATA COMPILED BY INDEPENDENT SOURCES. IN 2017, BENEFIS COMMUNITY HOSPITALS, INC. CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR ITS SERVICE AREA IN TETON COUNTY, MONTANA, AS CONTEMPLATED BY IRC SECTION 501(R). THE ORGANIZATION WORKED COLLABORATIVELY WITH TETON COUNTY MENTAL HEALTH LOCAL ADVISORY COUNCIL (LAC) AND TETON COUNTY HEALTH DEPARTMENT TO IDENTIFY THE NEEDS OF ITS COMMUNITY THROUGH STAKEHOLDER SURVEYS, COMMUNITY FOCUS GROUPS, AND RESEARCH USING REGIONAL AND STATE HEALTH DATA. SIGNIFICANT HEALTH NEEDS OF TETON COUNTY AREA RESIDENTS WERE IDENTIFIED AND PRIORITIZED THROUGH THE SURVEY PROCESS AND DATA ANALYSIS. ALL COLLECTED INFORMATION HAS BEEN COMPILED INTO A CHNA REPORT. AFTER THE REPORT'S PUBLIC PRESENTATION, THE ORGANIZATION DEVELOPED AN IMPLEMENTATION STRATEGY FOR EACH OF THE HEALTH NEEDS IDENTIFIED IN THE ASSESSMENT REPORT. BOTH THE ORGANIZATION'S CHNA REPORT AND ITS IMPLEMENTATION PLAN ARE AVAILABLE FREE OF CHARGE TO THE PUBLIC AS WELL AS DIGITALLY ON ITS WEBSITE AT THE FOLLOWING ADDRESS HTTP://TETONMEDICALCENTER.NET. |
| PART VI, LINE 3: | THE ORGANIZATION HAS POSTED IN REGISTRATION AREAS, EMERGENCY ROOMS, AND FINANCIAL ASSISTANCE AREAS A SUMMARY OF ITS FINANCIAL ASSISTANCE POLICY ALONG WITH BROCHURES THAT DEFINE THE POLICY. THE POLICY AND APPLICATION IS AVAILABLE ONLINE AT HTTP://TETONMEDICALCENTER.NET/DEPARTMENTS/BUSINESS-PAYMENT-SERVICES AND IS MAILED TO EACH PATIENT ALONG WITH THEIR BILLING STATEMENT. |
| PART VI, LINE 4: | THROUGH SEPTEMBER 30, 2017 THE HOSPITAL WAS A 10 BED CRITICAL ACCESS HOSPITAL WITH A 36 BED NURSING HOME, LOCATED IN CHOTEAU, TETON COUNTY, MT. EFFECTIVE OCTOBER 1, 2017 THE HOSPITAL BECAME A 25 BED CRITICAL ACCESS HOSPITAL AND 0 BED NURSING HOME AS THE NURSING HOME LICENSURE WAS RELINQUISHED. THE HOSPITAL'S SERVICE AREA IS 2,293 SQUARE MILES. TETON COUNTY IS A FRONTIER COMMUNITY LOCATED ALONG THE ROCKY MOUNTAIN FRONT WITH A POPULATION DENSITY OF 3/SQUARE MILE. THE POPULATION IN CHOTEAU, MT IS 1,714 WITH TETON COUNTY'S POPULATION BEING 6,085. 14.1% OF THE RESIDENTS ARE AT OR BELOW 200% FEDERAL POVERTY LEVEL. TETON COUNTY IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA AND A PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA. |
| PART VI, LINE 5: | THE ORGANIZATION HELPS DEVELOP THE COMMUNITY THROUGH PARTICIPATION IN COMMUNITY LEADERSHIP ACTIVITIES, IMPROVED HEALTH ADVOCACY WITH COMMUNITY CLINICS, HEALTH FAIRS AND SUPPORT OF GENERAL HEALTH CLINICS. THE ORGANIZATION PROVIDES SUPPORT TO INDIAN HEALTH FACILITY CLINICS AND PROVIDES ECONOMIC FUNDING FOR COMMUNITY HEALTH CLINICS TO PROVIDE LOCUM DOCTORS TO COME DURING PLANNED AND UNPLANNED ABSENCES. BENEFIS HOSPITALS, INC. PROMOTES THE HEALTH OF PERSONS RESIDING THROUGHOUT ITS SERVICE AREA. THE HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS, WITHOUT REGARD TO ABILITY TO PAY, AND PARTICIPATES IN GOVERNMENT SPONSORED HEALTHCARE PAYMENT PROGRAMS. THE HOSPITAL USES ANY SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND OR IMPROVE ITS FACILITIES, AND ADVANCE ITS MEDICAL TRAINING, EDUCATION, AND RESEARCH PROGRAMS. THE HOSPITAL'S BOARD OF DIRECTORS (AND THAT OF BENEFIS HEALTH SYSTEM, ITS SOLE CORPORATE MEMBER) CONSISTS PRIMARILY OF INDIVIDUALS REPRESENTING THE COMMUNITY. THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF, WITH MEMBERSHIP AND PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS AND HEALTHCARE PROFESSIONALS, AS SET FORTH IN THE MEDICAL STAFF BYLAWS, RULES, AND REGULATIONS. IN THESE AND OTHER RESPECTS, THE HOSPITAL IS ORGANIZED AND OPERATED IN A MANNER THAT PROMOTES THE HEALTH OF THE COMMUNITY AND THEREFORE FULFILLS CHARITABLE PURPOSES WITHIN THE MEANING OF INTERNAL REVENUE CODE SECTION 501(C)(3). |
| PART VI, LINE 6: | THE ORGANIZATION IS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM AND AS SUCH COORDINATES EFFORTS BETWEEN ALL SYSTEM ENTITIES TO REDUCE DUPLICATION AND PROMOTE THE BROADEST OFFERING OF SERVICES. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | CHARITY HEALTH CARE SERVICES | GrantTypeTxt |
| Recipient | 24 | RecipientCnt |
| Cash Grant | $13,937 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION HAS A FINANCIAL ASSISTANCE POLICY IN PLACE THAT LINES OUT WHO MAY BE ELIGIBLE FOR FREE OR DISCOUNTED CARE. IN ORDER TO QUALIFY A PATIENT MUST COMPLETE AND SUBMIT A FINANCIAL ASSISTANCE APPLICATION. THE ORGANIZATION ACQUIRES DOCUMENTS WITH THE APPLICATION TO VERIFY CLAIMS THE APPLICANT'S QUALIFICATIONS FOR ASSISTANCE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JUDY BORLAND MD | ||||||||||||||
| DIRECTOR | $0 | $203,117 | $0 | $0 | $0 | $0 | $0 | $10,135 | $0 | $471 | $0 | $213,723 | $0 | $0 |
| TERRY OLINGER | ||||||||||||||
| DIRECTOR | $0 | $389,630 | $0 | $107,260 | $0 | $79,852 | $0 | $138,433 | $0 | $614 | $0 | $715,789 | $0 | $71,692 |
| LOUIE KING | ||||||||||||||
| PRESIDENT | $129,350 | $0 | $22,594 | $0 | $6,000 | $0 | $17,828 | $0 | $11,035 | $0 | $186,807 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | BENEFIS HEALTH SYSTEM, INC. PROVIDES A SECTION 457 NONQUALIFIED DEFERRED COMPENSATION PLAN FOR MR. KING AND MR. OLINGER WHO MEET THE REQUIREMENTS. MR. OLINGER RECEIVED A PAYOUT FROM THE PLAN IN 2017. |
| PART I, LINE 7 | BENEFIS HEALTH SYSTEM, INC. AND ITS AFFILIATES (INCLUDING THE ORGANIZATION) MAINTAIN AN INCENTIVE COMPENSATION PLAN THAT INCORPORATES BOTH SHARED AND INDIVIDUAL GOALS FOR MEMBERS OF THE EXECUTIVE AND MANAGEMENT LEADERSHIP TEAM. PAYMENTS PURSUANT TO THE INCENTIVE PLAN ARE SUBJECT TO A PRECONDITION THAT THE SYSTEM MUST ACHIEVE BUDGETED OPERATING PERFORMANCE. THE SYSTEM HAS ADOPTED SHARED PERFORMANCE OBJECTIVES INCLUDING SYSTEM GROWTH AS WELL AS MEASURES TIED TO WORKFORCE, PATIENT EXPERIENCE, PATIENT SAFETY, CLINICAL QUALITY, AND FINANCE/OPERATIONS. THE INDIVIDUAL PERFORMANCE OBJECTIVES ADOPTED ARE BASED ON AN ARRAY OF QUALITY, FINANCIAL, OPERATIONAL AND STRATEGIC INITIATIVES. INCENTIVE OPPORTUNITY LEVELS ARE CALCULATED BASED ON PREDETERMINED PERCENTAGES OF EACH EXECUTIVE'S AND MANAGER'S BASE SALARY, AND VARY BASED ON THE ACHIEVEMENT OF THRESHOLD, TARGET OR STRETCH LEVELS AS TO EACH PERFORMANCE OBJECTIVE. THE SYSTEM ALSO MAINTAINS A LONG-TERM INCENTIVE PLAN DIRECTED AT RECRUITING AND RETAINING EXECUTIVE LEADERSHIP. PAYMENTS UNDER THE LONG-TERM INCENTIVE PLAN ARE CONDITIONED ON AN EXECUTIVE REMAINING EMPLOYED BY THE SYSTEM AND MAINTAINING SATISFACTORY OVERALL PERFORMANCE. INCENTIVE OPPORTUNITIES UNDER THE LONG-TERM PLAN ARE APPROVED IN ADVANCE BY THE BENEFIS HEALTH SYSTEM, INC. COMPENSATION COMMITTEE, WITH LATER PAYOUTS APPROVED BY THE COMMITTEE BASED ON ACTUAL PERFORMANCE RESULTS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE ORGANIZATION IS AN AFFILIATE OF BENEFIS HEALTH SYSTEM, INC. (BHS), A TAX EXEMPT MONTANA NONPROFIT CORPORATION SERVING AS THE PARENT ENTITY OF AN INTEGRATED SYSTEM OF PROVIDER ORGANIZATIONS ADDRESSING THE HEALTH NEEDS OF PERSONS THROUGHOUT NORTH CENTRAL MONTANA. AS THE CORPORATE MEMBER OF THE ORGANIZATION, BHS HOLDS VARIOUS RESERVED POWERS IN RELATION TO THE ORGANIZATION, INCLUDING THE AUTHORITY TO APPROVE THE ELECTION OF INDIVIDUALS TO ITS BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF THE ORGANIZATION INCLUDES CERTAIN INDIVIDUALS WHO ARE EMPLOYED BY THE ORGANIZATION OR ITS AFFILIATES, AND WHO MAY NOT BE CONSIDERED "INDEPENDENT" FOR PURPOSES OF FORM 990. HOWEVER, AS ACKNOWLEDGED BY THE IRS IN ITS "CPE TEXT FOR FISCAL YEAR 1997", IN A MULTI-ENTITY HOSPITAL SYSTEM, THE BOARD OF A SUBSIDIARY NON-PROFIT HEALTH CARE ORGANIZATION IS CONSIDERED TO BE COMPRISED OF INDEPENDENT COMMUNITY MEMBERS IF IT IS CONTROLLED BY AN EXEMPT ORGANIZATION WHOSE OWN BOARD IS COMPRISED OF A MAJORITY OF VOTING MEMBERS WHO ARE INDEPENDENT COMMUNITY MEMBERS. THE ORGANIZATION MEETS THIS STANDARD BECAUSE IT IS A CONTROLLED SUBSIDIARY OF BHS, AND BHS' OWN GOVERNING BOARD INCLUDES INDEPENDENT COMMUNITY MEMBERS AS A MAJORITY THEREOF. |
| FORM 990, PART VI, SECTION A, LINE 2 | CERTAIN OFFICERS AND DIRECTORS LISTED IN PART VII ALSO HOLD OFFICER AND/OR DIRECTOR POSITIONS IN RELATION TO THE ORGANIZATION'S AFFILIATES (AS IDENTIFIED IN SCHEDULE R) AND, IN THAT REGARD, MAY BE CONSIDERED TO HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER. SUCH BUSINESS RELATIONSHIPS ARE UNDERTAKEN IN THE ORDINARY COURSE OF BUSINESS. |
| FORM 990, PART VI, SECTION A, LINE 3 | PURSUANT TO A CONTRACTUAL ARRANGEMENT, THE ORGANIZATION OBTAINS CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES FROM ITS PARENT ENTITY, BENEFIS HEALTH SYSTEM, INC. (BHS). BHS, AS THE PARENT AND SYSTEM ENTITY, PROVIDES THE SERVICES TO ITS SUBSIDIARY TAX-EXEMPT NON-PROFIT CORPORATE ENTITIES ON A CENTRALIZED BASIS. THE SERVICES INCLUDE THE FOLLOWING: - MANAGEMENT OF HUMAN RESOURCES INCLUDING POLICIES AND PRACTICES - MANAGEMENT, PLANNING, BUDGETING AND REPORTING OF FINANCIAL OPERATIONS - MANAGEMENT OF BILLING AND COLLECTIONS POLICIES AND FUNCTIONS - MANAGEMENT OF INFORMATION TECHNOLOGY SERVICES - OVERSIGHT OF QUALITY STANDARDS, COMPLIANCE AND RISK MANAGEMENT - MANAGEMENT OF REGIONAL, COMMUNITY AND GOVERNMENT RELATIONS AND MARKETING - MANAGEMENT OF GRANTS DEVELOPMENT THE FOLLOWING PERSONS LISTED IN PART VII WERE COMPENSATED BY BHS: TERRY OLINGER - $715,789 (COMPENSATION FOR SERVICES AS OFFICER OF BHS, BENEFIS MEDICAL GROUP, INC. AND BENEFIS HOSPITALS, INC.) |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS BENEFIS HEALTH SYSTEM,INC., A MONTANA NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATION THAT HAS BEEN RECOGNIZED BY THE IRS AS DESCRIBED IN IRC SECTION 501(C)(3). |
| FORM 990, PART VI, SECTION A, LINE 7A | AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, BENEFIS HEALTH SYSTEM, INC. (ACTING THROUGH ITS OWN GOVERNING BODY) ELECTS THE BOARD OF DIRECTORS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, BENEFIS HEALTH SYSTEM, INC. RETAINS CERTAIN RESERVED POWERS WITH RESPECT TO THE ORGANIZATION, INCLUDING AUTHORITY OVER MATTERS SUCH AS (WITHOUT LIMITATION) THE ORGANIZATION'S MISSION AND VISION STATEMENTS, STRATEGIC AND LONG-TERM PLANS, ELECTION OF ITS DIRECTORS AND OFFICERS, ANNUAL CAPITAL AND OPERATING BUDGETS, CHARITY CARE AND COMMUNITY BENEFIT POLICIES, AND ANY AMENDMENTS TO ITS ARTICLES OF INCORPORATION AND BYLAWS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THIS FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT PERSONNEL OF BENEFIS HEALTH SYSTEM, INC. IN COLLABORATION WITH ITS ACCOUNTING FIRM. PRIOR TO FILING, A COPY OF THIS FORM 990 WAS PRESENTED TO THE BENEFIS HEALTH SYSTEM, INC. BOARD BY THE ACCOUNTING FIRM. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS ANNUALLY COMPLETE A FORM TO DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. IN ADDITION, AT THE START OF EACH BOARD MEETING, MEMBERS ARE ASKED TO INDICATE WHETHER THEY HAVE A CONFLICT OF INTEREST WITH RESPECT TO ANY ITEMS ON THE AGENDA FOR THE MEETING. CONSISTENT WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY, BOARD MEMBERS ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND VOTING ON ANY MATTERS AS TO WHICH THEY HAVE A CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE EXECUTIVE TEAM, INCLUDING THE PRESIDENT, WAS SET BY THE INDEPENDENT COMPENSATION COMMITTEE OF BENEFIS HEALTH SYSTEM, INC., WHICH IS CHARGED WITH ADMINISTERING THE SYSTEM'S EXECUTIVE COMPENSATION PHILOSOPHY, POLICIES AND PROGRAMS IN THE MANNER SET FORTH IN THE COMMITTEE'S WRITTEN CHARTER. THE COMMITTEE'S RESPONSIBILITIES INCLUDE (I) DETERMINING APPROPRIATE COMPENSATION FOR ALL EXECUTIVES AND OTHER KEY EMPLOYEES, (II) EVALUATING AND ADOPTING EXECUTIVE COMPENSATION PLANS, POLICIES AND PROGRAMS, (III) REVIEWING AND APPROVING EXECUTIVE BENEFIT PLANS, AND (IV) VERIFYING THAT COMPENSATION IS APPROPRIATELY AND FULLY DISCLOSED AND REPORTED. THE COMMITTEE HAS ENGAGED AN INDEPENDENT COMPENSATION CONSULTING FIRM TO ASSIST IN ENSURING THAT AMOUNTS PAID TO THE SYSTEM'S EXECUTIVES ARE CONSISTENT WITH REASONABLE, FAIR MARKET LEVELS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. THIS PROCESS IS COMPLETED ON AN ANNUAL BASIS. THE COMPENSATION OF THE ORGANIZATION'S KEY EMPLOYEES AND MANAGERS WAS SET BY THEIR RESPECTIVE SUPERVISORY EXECUTIVES IN CONSULTATION WITH BENEFIS HEALTH SYSTEM, INC.'S HUMAN RESOURCES DEPARTMENT AND EXECUTIVE LEADERSHIP, BASED ON A REVIEW OF INDEPENDENT DATA AS TO AMOUNTS PAID BY SIMILAR SITUATED ORGANIZATIONS FOR PERSONS PERFORMING COMPARABLE SERVICES. |
| FORM 990, PART VI, SECTION C, LINE 19 | BENEFIS COMMUNITY HOSPITALS, INC. PROVIDES COPIES OF AUDITED FINANCIALS STATEMENTS AND FORM 990 TO THE PUBLIC UPON REQUEST DURING NORMAL BUSINESS HOURS. |
| FORM 990, PART IX, LINE 11G | PROVIDER CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 927,979. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 927,979. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|
| BBB LLC | |||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 263652926 | MEDICAL BUILDING | MT | BENEFIS HEALTH SYSTEM INC |
| BENEFIS CASCADE RIDGE LLC | |||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 274602798 | REAL ESTATE | MT | BENEFIS HEALTH SYSTEM INC |
| BENEFIS HEALTH SYSTEM FOUNDATION PROPERTIES LLC | |||||||
| PO BOX 7008 | GREAT FALLS | MT | 59406 | 272514629 | HOLDS REAL ESTATE PROPERTY DONATED TO THE FOUNDATION | MT | BENEFIS HEALTH SYSTEM FOUNDATION |
| BENEFIS SLETTEN HI-LINE CANCER CENTER LLC | |||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 263144419 | MEDICAL CARE | MT | BENEFIS HEALTH SYSTEM INC |
| WALK IN EXPRESS LLC | |||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 320481028 | OUTPATIENT CLINIC | MT | BENEFIS HEALTH SYSTEM INC |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| BENEFIS SPECTRUM MEDICAL INC | ||||||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 810431871 | HOME HEALTH AND RELATED PRODUCTS | MT | 501(C)(3) | LINE 10 | BENEFIS HEALTH SYSTEM INC | 0 |
| BENEFIS HEALTH SYSTEM FOUNDATION INC | ||||||||||
| PO BOX 7008 | GREAT FALLS | MT | 59406 | 810480587 | FOUNDATION | MT | 501(C)(3) | LINE 7 | BENEFIS HEALTH SYSTEM INC | 0 |
| BENEFIS HEALTH SYSTEM INC | ||||||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 263538104 | MANAGEMENT AND SUPPORT SERVICES | MT | 501(C)(3) | LINE 12C, III-FI | 0 | |
| BENEFIS HEALTHCARE EES HEALTH PLAN AND TRUST | ||||||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 363386166 | BENEFIT PLAN | MT | 501(C)(9) | BENEFIS HEALTH SYSTEM INC | 0 | |
| BENEFIS MEDICAL GROUP INC | ||||||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 263538192 | PHYSICIAN SERVICES | MT | 501(C)(3) | LINE 3 | BENEFIS HEALTH SYSTEM INC | 0 |
| BENEFIS SENIOR SERVICES INC | ||||||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 461344408 | SENIOR SERVICES/CCRC | MT | 501(C)(3) | LINE 10 | BENEFIS HEALTH SYSTEM INC | 0 |
| BENEFIS HOSPITALS INC | ||||||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 810232122 | HOSPITAL | MT | 501(C)(3) | LINE 3 | BENEFIS HEALTH SYSTEM INC | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| GREAT FALLS ATHLETIC CLUB LLC | ||||||||||
| 1800 BENEFIS COURT | GREAT FALLS | MT | 59405 | 912081505 | FITNESS CLUB | MT | N/A | N/A | 0 | 0 |
| SPECTRUM HOME SOLUTIONS | ||||||||||
| 2509 7TH AVE SOUTH | GREAT FALLS | MT | 59405 | 810431871 | IV THERAPY | MT | N/A | N/A | 0 | 0 |
| TREASURE STATE HEALTHCARE NETWORK LLC | ||||||||||
| 500 15TH AVENUE SOUTH | GREAT FALLS | MT | 59405 | 810534714 | HEALTHCARE SERVICES | MT | N/A | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BHS 2017 TRUST | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 HOWARD STREET | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 306559361 | EIN |
| Primary Activities | INVESTMENT TRUST | PrimaryActivitiesTxt |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | T | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | 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 | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BENEFIS HEALTHCARE EES HEALTH PLAN AND TRUST | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionTypeTxt |
| Involved | $393,903 | InvolvedAmt |
| Method Of Amount Determination | PLAN CONTRIBUTION | MethodOfAmountDeterminationTxt |
Comments