2018-11-06T18:25:16-06:00 2017-12-31 910189318 MOSS ADAMS LLP 805 SW BROADWAY SUITE 1200 PORTLAND OR 97205 990 2017-01-01 263538104 BENEFIS HEALTH SYSTEM INC BENE 4064552563 1101 26TH STREET SOUTH GREAT FALLS MT 59405 FORREST EHLINGER CHIEF FINANCIAL OFFICER 4064552563 2018-09-24 1 WENDY CAMPOS P00448102 5032421447 2018-09-24 50.125.248.56 2018-09-24 14:26:46 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 866574987CA565ABE6CC9265146BBE3F5B9624AD 2017 2019-02-21 02:37:17Z JOHN GOODNOW 1101 26TH STREET SOUTH GREAT FALLS MT 59405 73790610 0 X WWW.BENEFIS.ORG X 2008 MT PARENT ENTITY OF INTEGRATED HEALTH SYSTEM 13 11 257 11 129072 -88712 1617192 1514168 55674577 63540679 1625479 9863452 -545330 -3993887 58371918 70924412 209382 1583899 0 0 19960450 22790949 0 0 0 48038288 37459242 68208120 61834090 -9836202 9090322 720675923 840058463 442128919 540732732 278547004 299325731 X WE PROVIDE EXCELLENT CARE FOR ALL, HEALING BODY, MIND AND SPIRIT. BENEFIS HEALTH SYSTEM, INC. IS ORGANIZED TO OVERSEE, COORDINATE AND DIRECT THE ASSETS AND OPERATIONS OF BENEFITS HOSPITALS, INC., BENEFIS SPECTRUM MEDICAL, INC., BENEFIS MEDICAL GROUP, INC., BENEFIS HEALTH SYSTEM FOUNDATION, INC., BENEFIS SLETTEN HI-LINE CANCER CENTER, LLC, BENEFIS SENIOR SERVICES, INC., AND OTHER RELATED ENTITIES AS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SERVING THE RESIDENTS OF NORTH CENTRAL MONTANA. 0 0 61834090 1583899 63367301 PROVIDE MANAGEMENT AND ADMINISTRATIVE SERVICES FOR MULTIPLE RELATED HEALTH CARE ENTITIES. N/A N/A 61834090 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 1 0 1 60 0 1 257 1 1 1 0 0 0 0 0 0 0 0 0 X 13 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X FORREST EHLINGER 4064555479 1101 26TH STREET SOUTH GREAT FALLS MT 59405 DAVID RICHARDS CHAIR 4.00 4.00 X X 0 0 0 MIKE MILBURN VICE CHAIR 4.00 2.00 X X 951 0 0 ED BUTTREY SECRETARY 4.00 X X 0 0 0 WILLIAM BLOEMENDAAL DIRECTOR 4.00 46.00 X 0 107468 0 BILL BOURRET DIRECTOR 4.00 X 672 0 0 TANYA CAMERON DIRECTOR 4.00 2.00 X 0 0 0 DON HAMILTON DIRECTOR (FROM 1/1) 4.00 X 672 0 0 JOHN KOPPELMAN DIRECTOR (THROUGH 12/31) 4.00 X 719 0 0 EUGENE MCALLISTER DIRECTOR 4.00 X 982 0 0 WILLIAM MCGREGOR MD DIRECTOR 4.00 3.00 X 839 0 0 SUSAN RAPH DIRECTOR 4.00 2.00 X 0 0 0 GENE THAYER DIRECTOR 4.00 X 0 0 0 JOHN GOODNOW CHIEF EXECUTIVE OFFICER 60.00 X X 1290162 0 23546 FORREST EHLINGER CHIEF FINANCIAL OFFICER 49.00 11.00 X 478385 0 108101 TERRY OLINGER PRESIDENT GREAT FALLS CARE GROUP 4.00 56.00 X 576742 0 139047 AMY BEAMES THROUGH 930 PRESIDENT SR SRVS & PHILANTHROPY 8.00 52.00 X 447371 0 16692 MARK SIMON CHIEF INFORMATION OFFICER 50.00 X 313330 0 39969 PATTY HARRIS DIRECTOR REVENUE CYCLE 50.00 X 206026 0 12733 THERESA PREITE PRESIDENT SPECTRUM AND REGIONAL RELATIONS 16.00 34.00 X 257987 0 36062 JULIE WALL VICE PRES. QUALITY AND INFECTION CONTROL 50.00 X 216433 0 19757 BRUCE HOULIHAN CONTROLLER, DIRECTOR REGIONAL FINANCE 50.00 X 223478 0 22263 CARL BRUESCH DIRECTOR FINANCIAL ANALYSIS 25.00 25.00 X 202604 0 9274 4217353 107468 427444 26 0 1 0 DICK ANDERSON CONSTRUCTION 4610 TRI-HILL FRONTAGE RD GREAT FALLS MT 59404 CONSTRUCTION 3354171 GUY TABACCO CONSTRUCTION COMPANY PO BOX 550 BLACK EAGLE MT 59414 CONSTRUCTION 2963044 AMERICA'S CHOICE INC 6 SPRING RIDGE DRIVE GREAT FALLS MT 59404 CONSTRUCTION 1604654 RMB INC PO BOX 10023 KNOXVILLE TN 37919 COLLECTION SERVICES 1415965 NELSON ARCHITECTS LLC 621 2ND AVE N GREAT FALLS MT 59401 ARCHITECT SERVICES 1199260 40 1351909 162259 480000 1514168 MANAGEMENT FEES 541610 65737672 65564294 173378 JOINT VENTURE INCOME 621990 155166 155166 OTHER PROGRAM REVENUE 621990 115830 115830 SUBSIDIARY LOSS 621990 -2467989 -2467989 63540679 2299061 2299061 1810605 2866198 -1055593 -1055593 -1055593 7288711 275680 0 0 7288711 275680 7564391 7564391 OTHER INCOME 621990 912297 912297 VENDOR REBATES/DISCOUN 900099 64869 64869 SUBSIDIARY LOSS 621990 -3915460 -44306 -3871154 -2938294 70924412 63367301 129072 5913871 1583899 1583899 3438177 3438177 12866022 12866022 389449 389449 5114183 5114183 983118 983118 1288480 1288480 257409 257409 86973 86973 5399855 5399855 1430099 1430099 206819 206819 7315644 7315644 1151121 1151121 169428 169428 2925244 2925244 10798305 10798305 3525079 3525079 UBI TAX 204233 204233 MAINTANCE SERVICE CONTR 772506 772506 MINOR EQUIPMENT 610899 610899 EMPLOYEE REWARDS/RECOGN 410879 410879 906269 906269 61834090 61834090 0 0 68591093 45331532 237083832 310246029 2879709 3126242 376270982 181291221 192805210 194979761 184120624 254954632 11569840 8393651 11061594 8623771 12564021 14402845 720675923 840058463 235560037 336609321 154108 171040 173885836 187189851 29121410 13800934 3407528 2961586 442128919 540732732 X 278547004 299325731 278547004 299325731 720675923 840058463 X 9090322 11024671 663734 X 0 1 X 1 0 X X X 3 BENEFIS HOSPITALS INC 810232122 3 1 0 63109110 BENEFIS MEDICAL GROUP INC 263538192 3 1 0 0 BENEFIS SPECTRUM MEDICAL INC 810431871 10 1 0 1728983 3 0 64838093 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 PART IV, SECTION E, LINE 3A: BENEFIS HEALTH SYSTEM, INC. (BHS) SERVES AS THE PARENT ENTITY OF AN INTEGRATED SYSTEM OF PROVIDER ORGANIZATIONS ADDRESSING THE HEALTH NEEDS OF PERSONS THROUGHOUT NORTH CENTRAL MONTANA. BHS HOLDS VARIOUS RESERVED POWERS IN RELATION TO EACH OF THE SUPPORTED ORGANIZATIONS, INCLUDING THE AUTHORITY TO ELECT ITS BOARD OF DIRECTORS. PART IV, SECTION E, LINE 3B: BHS PROVIDES CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES TO ITS SUPPORTED ORGANIZATIONS. BHS PROVIDES THESE SERVICES TO ITS SUBSIDIARY TAX-EXEMPT OPERATING 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 BOARD OF DIRECTORS OF BHS ALSO GENERALLY OVERSEES THE GOVERNANCE FUNCTIONS CARRIED ON BY THE BOARDS OF THE SUPPORTED ORGANIZATIONS. 0 0 0 0 0 1 5000 1 86973 0 0 91973 0 PART II-B, LINE 1: BHS PAYS AN ATTORNEY GROUP, TAYLOR LUTHER GROUP, PLLC, TO ADVOCATE ON ITS BEHALF IN THE POLITICAL DECISION MAKING PROCESS. BHS ALSO MADE A CONTRIBUTION IN 2017 IN SUPPORT OF GREAT FALLS DEVELOPMENT AUTHORITY IN RELATION TO A COUNTY-WIDE ECONOMIC DEVELOPMENT LEVY. 24180123 612914 2842192 -310922 27946151 22996491 892498 1484716 1193582 24180123 23231923 642703 -344101 534034 22996491 22163339 546843 912332 390591 23231923 19058513 1274865 2278824 343934 104929 22163339 0.12270 0.61980 0.25750 0 1 1 9019234 9019234 223996757 93226842 130769915 81755374 50878104 30877270 41720098 31837008 9883090 19779519 5349267 14430252 194979761 INTEREST RATE SWAP LIABILITY 1915799 EXECUTIVE BENEFIT PLAN LIABILITY 1045787 2961586 X PART V, LINE 4: ENDOWMENT FUNDS ARE RELATED TO BENEFIS HEALTH SYSTEM FOUNDATION, INC. THE ENDOWMENT FUNDS OF THE FOUNDATION CONSIST OF THE FOLLOWING: THE FUNDS IN THE GENERAL ENDOWMENT ARE RESTRICTED BY DONORS AS PERMANENT ENDOWMENT FUNDS BUT HAVE NO SPECIFIC RESTRICTION ON THE DISTRIBUTION OF EARNINGS. THIS DECISION IS THE RESPONSIBILITY OF THE BOARD OF DIRECTORS OF BENEFIS HEALTH SYSTEM FOUNDATION. THE PEACE HOSPICE RESIDENTIAL ENDOWMENT PROVIDES FOR THE OPERATION AND MAINTENANCE OF THE BENEFIS PEACE HOSPICE RESIDENTIAL FACILITY. BENEFIS PEACE HOSPICE IS A SERVICE OF BENEFIS HEALTH SYSTEM. THE DONOR RESTRICTED ENDOWMENT POOL HOLDS GIFTS FROM DONORS FOR PERMANENT ENDOWMENT FUNDS THAT HAVE SPECIFIC DESIGNATIONS FOR THE USE OF THE EARNINGS OF EACH FUND. THESE MAY INCLUDE FUNDS FOR PROGRAMS OR SERVICES OR SCHOLARSHIPS. BENEFIS HEALTH SYSTEM FOUNDATION ISSUES CHARITABLE GIFT ANNUITIES, DEFERRED PAYMENT CHARITABLE GIFT ANNUITIES AND HAS ESTABLISHED A GIFT ANNUITY POOL TO HOLD THESE FUNDS AS REQUIRED UNDER THE MONTANA CHARITABLE GIFT ANNUITY ACT. THE PURPOSES OF THE FUNDS IN THE POOL ARE DEFINED BY THE INDIVIDUAL ANNUITY CONTRACTS. PART X, LINE 2: THE 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. 1 BENEFIS HEALTHCARE FOUNDATION PO BOX 7008 GREAT FALLS MT 59406 810480587 501C3 758399 OPERATIONS SUPPORT GREAT FALLS COLLEGE MSU FOUNDATION 2100 16TH AVE SOUTH GREAT FALLS MT 59405 810522790 501C3 112000 NURSING, SURGERY TECHNICIAN, AND OTHER FACULTY SUPPORT. SPECIAL OLYMPICS MONTANA PO BOX 3507 GREAT FALLS MT 594033507 810367064 501C3 80000 SPONSORSHIP NEIGHBORWORKS 509 1ST AVE SOUTH GREAT FALLS MT 59401 810389825 501C3 50000 ENDOWMENT CAMPAIGN GREAT FALLS COMMUNITY FOOD BANK 1620 12TH AVE NORTH GREAT FALLS MT 59401 363540471 501C3 20000 BACKPACKS FOR KIDS PROGRAM GREAT FALLS PUBLIC SCHOOLS FOUNDATION PO BOX 2429 GREAT FALLS MT 59403 272577990 501C3 15000 GFPS FOUNDATION SUPPORT PROGRAMS ALZHEIMER'S ASSOCIATION 3010 11TH AVE NORTH BILLINGS MT 59101 133039601 501C3 10000 WALK TO END ALZHEIMER'S EVENT SPONSOR NORTHERN TRANSIT INTERLOCAL 226 1ST ST SOUTH SHELBY MT 59474 816001438 GOVERNMENT 10000 OPERATIONS SUPPORT PEOPLE'S PARK AND RECREATION FOUNDATION PO BOX 2106 GREAT FALLS MT 59403 611620753 501C3 8500 PLAYGROUND DONATION - KABOOM INDIAN FAMILY HEALTH CENTER 1220 CENTRAL AVENUE GREAT FALLS MT 59401 810542869 501C3 500000 FMV COMMERCIAL & REAL PROPERTY TO PROVIDED SPACE FOR PATIENT CLINIC, FITNESS ROOM AND BEHAVIORAL HEALTH SERVICES. 10 0 PART I, LINE 2: BENEFIS HAS A FULL-TIME GRANTS MANAGER, WHO OVERSEES INTERNAL CONTROLS. A GRANTS HANDBOOK DETAILING PROCEDURES ALONG WITH ROLES/RESPONSIBILITIES FOR BOTH PRE AND POST AWARD HAS BEEN DEVELOPED, APPROVED BY ADMINISTRATION, AND IS IN PLACE. THE GRANTS MANAGER ENSURES STAFF MEMBERS INVOLVED WITH A GRANT-FUNDED PROJECT ARE AWARE OF THESE PROCEDURES AND THEIR RESPECTIVE RESPONSIBILITIES. THE GRANTS MANAGER MONITORS ALL GRANT-RELATED ACTIVITIES TO ENSURE PROTOCOLS ARE FOLLOWED. FOR EXAMPLE, THE GRANTS MANAGER MEETS WITH THE PROJECT DIRECTOR AT LEAST MONTHLY TO REVIEW PROJECT PROGRESS ALONG WITH GOALS, ACTIVITIES, AND EXPENDITURES. THE GRANTS MANAGER ALSO MEETS WITH ACCOUNTING MONTHLY TO REVIEW THE DETAIL TRIAL BALANCE AND ENSURE GRANT CHARGES ARE APPROPRIATE PRIOR TO APPROVING DRAWING DOWN FEDERAL FUNDS. THE GRANTS MANAGER OVERSEES ALL REPORTS AND DELIVERABLES AND MAKES SURE THEY ARE SUBMITTED AS REQUIRED. THE GRANTS MANAGER SERVES AS THE LIAISON WITH THE FEDERAL GOVERNMENT ON ALL GRANT AWARDS AND WORKS DIRECTLY WITH THE FEDERAL PROJECT OFFICER AND FEDERAL GRANTS MANAGEMENT AS INDICATED. WHEN BENEFIS PASSES THROUGH OR SUBAWARDS GRANT FUNDS TO ANOTHER ORGANIZATION, THE GRANTS MANAGER ENSURES THE ORGANIZATION IS ELIGIBLE TO RECEIVE FEDERAL FUNDS BY CONFIRMING IT IS NOT AN EXCLUDED PARTY AND THAT THE ORGANIZATION HAS A TAX IDENTIFICATION NUMBER AND DUNS NUMBER IF APPLICABLE. ALL SUBAWARDS ARE MONITORED BY THE GRANTS MANAGER AND PROJECT DIRECTOR THROUGH ONGOING MEETINGS AND REPORTS INCLUDING A COPY OF THE RECIPIENT'S ANNUAL AUDIT REPORT, WHEN AVAILABLE. X X 1 1 X X X X 1 1 0 0 0 0 0 1 0 JOHN GOODNOW CHIEF EXECUTIVE OFFICER 663300 0 201209 0 425653 0 16200 0 7346 0 1313708 0 105814 0 FORREST EHLINGER CHIEF FINANCIAL OFFICER 366195 0 105740 0 6450 0 96668 0 11433 0 586486 0 0 0 TERRY OLINGER PRESIDENT GREAT FALLS CARE GROUP 389630 0 107260 0 79852 0 138433 0 614 0 715789 0 71692 0 AMY BEAMES THROUGH 930 PRESIDENT SR SRVS & PHILANTHROPY 191406 0 10950 0 245015 0 11601 0 5091 0 464063 0 0 0 MARK SIMON CHIEF INFORMATION OFFICER 260653 0 52677 0 0 0 33132 0 6837 0 353299 0 0 0 PATTY HARRIS DIRECTOR REVENUE CYCLE 174555 0 31471 0 0 0 3809 0 8924 0 218759 0 0 0 THERESA PREITE PRESIDENT SPECTRUM AND REGIONAL RELA 208268 0 44919 0 4800 0 29259 0 6803 0 294049 0 0 0 JULIE WALL VICE PRES. QUALITY AND INFECTION CON 170469 0 45964 0 0 0 8936 0 10821 0 236190 0 0 0 BRUCE HOULIHAN CONTROLLER, DIRECTOR REGIONAL FINANC 179666 0 43812 0 0 0 11133 0 11130 0 245741 0 0 0 CARL BRUESCH DIRECTOR FINANCIAL ANALYSIS 166867 0 35737 0 0 0 4234 0 5040 0 211878 0 0 0 PART I, LINE 1A TRAVEL FOR COMPANIONS AND SOCIAL CLUB DUES THAT BENEFIS HEALTH SYSTEM PAYS FOR ITS OFFICERS ARE TREATED AS TAXABLE INCOME TO THE INDIVIDUAL ACCORDINGLY. PART I, LINES 4A-B PART I, LINE 4A: AMY BEAMES RECEIVED A SEVERANCE PAYMENT IN 2017. PART I, LINE 4B: THE ORGANIZATION PROVIDES A SECTION 457F NONQUALIFIED DEFERRED COMPENSATION PLAN FOR MR. GOODNOW, MR. OLINGER, MS. BEAMES, MR. EHLINGER AND MS. PREITE, WHOM ALL MEET THE REQUIREMENTS OF THE PLAN. MR. GOODNOW AND MR. OLINGER RECEIVED A PAYOUT FROM THE PLAN IN 2017. MS. BEAMES' PARTICIPATION IN THE PLAN TERMINATED DURING THE YEAR. 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. A MONTANA FACILITY FINANCE AUTHORITY 364615155 2017-06-28 28300000 CONSTRUCTION/ EXPANSION OF HEALTHCARE FACILITY 0 0 0 B MONTANA FACILITY FINANCE AUTHORITY 364615155 2016-11-10 161550995 CONSTRUCTION/ EXPANSION OF HEALTHCARE FACILITY 0 0 0 A 28300000 290401 28009599 1 0 0 1 B 161550995 1560101 43897383 8348075 104192587 3552849 1 1 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 1 DEUTSCHE BANK 19.000000000000 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 X 1 480000 FAIR MARKET VALUE 0 0 0 0 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 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 INCLUDING SCHEDULE B WAS MADE AVAILABLE TO ALL MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS AND WAS PRESENTED TO THE BHS 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 CEO, CFO, PRESIDENT OF ACUTE CARE GROUP AND PRESIDENT, SENIOR SERVICES & LEGISLATIVE AFFAIRS, WAS SET BY THE INDEPENDENT COMPENSATION COMMITTEE OF BENEFIS HEALTH SYSTEM, INC., WHICH IS CHARGED WITH ADMINISTERING THE SYSTEM'S EXECUTIVE COMPENSATION PHILOSOPHY, POLICIES AND PROGRAMS IN THE MANNER SET FORTH IN THE COMMITTEE'S WRITTEN CHARTER. THE COMMITTEE'S RESPONSIBILITIES INCLUDE (I) DETERMINING APPROPRIATE COMPENSATION FOR ALL EXECUTIVES AND OTHER KEY EMPLOYEES, (II) EVALUATING AND ADOPTING EXECUTIVE COMPENSATION PLANS, POLICIES AND PROGRAMS, (III) REVIEWING AND APPROVING EXECUTIVE BENEFIT PLANS, AND (IV) VERIFYING THAT COMPENSATION IS APPROPRIATELY AND FULLY DISCLOSED AND REPORTED. THE COMMITTEE HAS ENGAGED AN INDEPENDENT COMPENSATION CONSULTING FIRM TO ASSIST IN ENSURING THAT AMOUNTS PAID TO THE SYSTEM'S EXECUTIVES ARE CONSISTENT WITH REASONABLE, FAIR MARKET LEVELS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. THIS PROCESS IS COMPLETED ON AN ANNUAL BASIS. THE COMPENSATION OF THE ORGANIZATION'S KEY EMPLOYEES AND MANAGERS WAS SET BY THEIR RESPECTIVE SUPERVISORY EXECUTIVES IN CONSULTATION WITH BENEFIS HEALTH SYSTEM'S HUMAN RESOURCES DEPARTMENT AND EXECUTIVE LEADERSHIP, BASED ON A REVIEW OF INDEPENDENT DATA AS TO AMOUNTS PAID BY SIMILAR SITUATED ORGANIZATIONS FOR PERSONS PERFORMING COMPARABLE SERVICES. FORM 990, PART VI, SECTION C, LINE 19 BENEFIS HEALTH SYSTEM, INC. PROVIDES COPIES OF AUDITED FINANCIAL STATEMENTS AND FORM 990 TO THE PUBLIC UPON REQUEST DURING NORMAL BUSINESS HOURS. FORM 990, PART XI, LINE 9: BOOK/TAX DIFFERENCE IN SUBSIDIARY AND JV INCOME 90,102. GAIN ON INTEREST RATE SWAP AGREEMENT 573,632. BENEFIS SLETTEN HI-LINE CANCER CENTER LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 263144419 MEDICAL CARE MT 265006 481082 BENEFIS HEALTH SYSTEM INC BENEFIS CASCADE RIDGE LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 274602798 REAL ESTATE MT 0 47 BENEFIS HEALTH SYSTEM INC BENEFIS HEALTH SYSTEM FOUNDATION PROPERTIES LLC PO BOX 7008 GREAT FALLS MT 59406 272514629 HOLDS REAL PROPERTY DONATED TO FOUNDATION MT BENEFIS HEALTH SYSTEM FOUNDATION INC BBB LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 263652926 MEDICAL BUILDING MT 0 0 BENEFIS HEALTH SYSTEM INC WALK IN EXPRESS LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 320481028 OUTPATIENT CLINIC MT 275679 0 BENEFIS HEALTH SYSTEM INC BENEFIS COMMUNITY HOSPITALS INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 473448483 CRITICAL ACCESS HOSPITAL MT 501(C)(3) LINE 3 BENEFIS HEALTH SYSTEM INC 1 BENEFIS HEALTH SYSTEM FOUNDATION INC PO BOX 7008 GREAT FALLS MT 59406 810480587 FOUNDATION MT 501(C)(3) LINE 7 BENEFIS HEALTH SYSTEM INC 1 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 1 BENEFIS HOSPITALS INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 810232122 HOSPITAL MT 501(C)(3) LINE 3 BENEFIS HEALTH SYSTEM INC 1 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 1 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 1 BENEFIS SPECTRUM MEDICAL INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 810431871 HOME HEALTH & RELATED PRODUCTS MT 501(C)(3) LINE 10 BENEFIS HEALTH SYSTEM INC 1 GREAT FALLS ATHLETIC CLUB LLC 1800 BENEFIS COURT GREAT FALLS MT 59405 912081505 FITNESS CLUB MT BENEFIS HEALTH SYSTEM INC UNRELATED -44306 4081863 0 1 0.51000 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 BENEFIS HEALTH SYSTEM INC RELATED 155166 176173 0 1 0.50000 BHS 2017 TRUST 400 HOWARD STREET SAN FRANCISCO CA 94105 306559361 INVESTMENT TRUST WA N/A T 241269 17905678 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 1 BENEFIS HEALTH SYSTEM FOUNDATION INC C 1351909 CONTRIBUTIONS RECEIVED BENEFIS HOSPITALS INC L 63109110 FAIR MARKET VALUE BENEFIS SPECTRUM MEDICAL INC L 1728983 FAIR MARKET VALUE BENEFIS HOSPITALS INC M 131509 FAIR MARKET VALUE BENEFIS HEALTHCARE EES HEALTH PLAN AND TRUST M 1236635 PLAN CONTRIBUTIONS GREAT FALLS ATHLETIC CLUB LLC M 63792 FAIR MARKET VALUE GREAT FALLS ATHLETIC CLUB LLC S 216750 CASH DISTRIBUTIONS TREASURE STATE HEALTHCARE NETWORKS S 125000 CASH DISTRIBUTIONS BENEFIS HEALTH SYSTEM FOUNDATION INC L 758400 FAIR MARKET VALUE BENEFIS COMMUNITY HOSPITALS INC L 729490 FAIR MARKET VALUE BHS 2017 TRUST R 17910000 COST