2016-03-30T13:19:07-05:00 2015-05-31 BKD LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2014-06-01 810233121 St Peter's Community Hospital % JOHN GREEN CFO STPE 4064422480 2475 Broadway Helena MT 59601 JOHN GREEN CFO 4064422480 2016-03-28 true Rita F Worster CPA P00290681 7194714290 2014 2016-08-17 19:52:53Z ST Peter's Hospital NATHAN C OLSON 2475 BROADWAY HELENA MT 59601 251554792 false X STPETES.ORG X 1883 MT PROVIDE EXCEPTIONAL AND COMPASSIONATE HEALTH CARE. 15 12 1481 147 441475 368808 1272510 188857015 191730710 6911026 8198670 74486 2361238 196211335 203563128 0 132777 0 0 88376462 89300453 0 0 507488 93415996 98246328 181792458 187679558 14418877 15883570 270879956 289326725 75692392 79251655 195187564 210075070 X ST. PETERS HOSPITAL PARTNERS WITH OUR PATIENTS, COMMUNITY, AND MEDICAL STAFF TO PROVIDE EXCEPTIONAL AND COMPASSIONATE HEALTH CARE. false false 128889845 132777 154709060 St. Peter's hospital is a 123-bed acute care hospital facility serving residents of lewis and clark county and portions of jefferson, broadwater, meagher and powell counties. St peters was the sole facility in the primary service area during the year ended May 31, 2015. The hospital provided at cost a total of $19,851,733 in community benefit. Of this total, $3,601,217 was for medical services to individuals who were determined unable to purchase such services under the hospitals charity care policy. In addition to free care and/or subsidized care, care is also provided at below cost rates to persons covered by governmental programs. The total operating loss for providing care to Medicaid patients was $2,560,615. The hospital provided $13,194,027 in subsidized health services during the year, including acute patient care for pediatric patients, outpatient pharmacy, pulmonary rehab, clinical nutrition, rehab, hospitalists services, physician clinics and in-home nursing and oxygen services. To fulfill its mission of community service, the organization provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the organization does not pursue collection of amounts determined to qualify as charity care, they are not reported as patient service revenue. 32216657 0 38138030 The hospital operates several physician clinics, employing 66 physicians and physician assistants and nurse practitioners. Without the hospitals assistance, lewis and clark county would be without many needed medical and surgical specialties. Physicians in the specialties of family practice, internal medicine, neurology, rheumatology, gastroenterology, ent, cardiology, general surgery, orthopedic surgery, allergy, nephrology, radiation and medical oncology had approximately 228,888 patient encounters. 161106502 true true false true false false false false false true true false false true true false false true false false true false false false false false true true true false true true false false false false false true false false false false false false false false false true true true false true 148 0 true 1481 true true true false false false false false false false false false X 15 12 false false true false false false false true true true false true true true true true true true true true true MT X JOHN GREEN CFO 4064422480 2475 BROADWAY HELENA MT 59601 NATHAN OLSON CEO 39.0 1.0 X X 599475 0 53517 GUY ALMQUIST TREASURER 1.0 0.0 X X 0 0 0 GEORGE 'RUSS' BELL BOARD MEMBER 1.0 1.0 X 0 0 0 DUANE BRUCE BOARD MEMBER 1.0 0.0 X 0 0 0 JOHN GALT MD BOARD MEMBER/CHIEF OF STAFF 40.0 0.0 X 384298 0 45308 MICHAEL S HAY MD BOARD MEMBER 1.0 0.0 X 0 0 0 MICK ROBINSON BOARD MEMBER 1.0 0.0 X 0 0 0 GAYLE SHIRLEY BOARD MEMBER 1.0 0.0 X 0 0 0 ROGER STONE BOARD MEMBER 1.0 0.0 X 0 0 0 THOMAS A STRIZICH MD - BOARD MEMBER/PAST CHIEF OF STAFF 1.0 0.0 X 12000 0 0 MARK TAYLOR VICE CHAIR 1.0 0.0 X X 0 0 0 KAREN Z HICKS BOARD MEMBER 1.0 0.0 X 0 0 0 ANDREW MALANY MD - BOARD MEMBER/CHIEF OF STAFF - ELECT 1.0 0.0 X 6000 0 0 WILLIAM T NORTHEY CHAIR 1.0 0.0 X X 0 0 0 KELLY PARSLEY BOARD MEMBER 1.0 0.0 X 0 0 0 PATTY NELSON BOARD MEMBER THROUGH 06/2014 1.0 0.0 X 0 0 0 JOHN GREEN CFO 40.0 0.0 X 292057 0 69569 ANN KJOSA COO/CXO 40.0 0.0 X 292736 0 66346 MARIA BRAMAN VP OF MEDICAL STAFF 40.0 0.0 X 358222 0 73648 THOMAS WEINER MD 40.0 0.0 X 1719857 0 62487 MICHAEL LEE MD 40.0 0.0 X 804038 0 28764 JAMES TARVER MD 40.0 0.0 X 609597 0 45855 KRIS GODLEWSKI MD 40.0 0.0 X 536993 0 45817 JEFFREY GEORGIA MD 40.0 0.0 X 534029 0 48689 THOMAS GREGG FORMER INTERIM CEO 0.0 0.0 X 176144 0 4271 JOHN SOLHEIM FORMER CEO 0.0 0.0 X 317617 0 0 6643063 0 544271 99 true true false HORIZON MENTAL HEALTH MANAGEMENT 1965 LAKE POINT DR SUITE 100 LEWISVILLE TX 75057 MANAGEMENT SERVICES 3213443 WEATHERBY LOCUMS PO BOX 972633 DALLAS TX 753972633 LOCUM COVERAGE 1176093 CAPITAL MEDICAL ANESTHESIA PO BOX 5179 HELENA MT 596045179 ANESTHESIA COVERAGE 699996 GE HEALTHCARE PO BOX 414-SN471 MILWAUKEE WI 53201 BIOMEDICAL SERVICES 842825 SIEMENS MEDICAL SOLUTIONS 51 VALLEY STREAM PARKWAY MALVERN PA 19355 PREV MAINT AGREEMENT 801304 40 X 713073 119566 439871 1272510 PATIENT SERVICE REVENUE 621110 129660027 129660027 PHARMACY 446110 59906531 59787762 118769 INCOME FROM JOINT VENTURES 900099 1258423 1052683 205740 MEANINGFUL USE PAYMENTS 621110 747100 747100 PATIENT CENTERED MEDICAL HOME PAYMENTS 621110 125914 125914 32715 32715 191730710 2309486 2309486 0 0 300606 219243 81363 0 81363 81363 53590837 3700 47667888 37465 5922949 -33765 5889184 5889184 0 0 118489 67068 51421 51421 OTHER INCOME 900099 1026046 853316 103005 69725 CAFETERIA 722514 721862 5771 716091 DAYCARE FOR EMPLOYEES 624110 334448 8190 326258 146098 146098 2228454 203563128 192405615 441475 9443528 132777 132777 0 0 0 2177530 1053730 1123800 0 68799514 56545628 11988115 265771 6622407 5570027 1033826 18554 7167244 5927345 1219492 20407 4533758 3831755 687377 14626 0 342258 7480 334778 67296 67296 54578 54578 0 542333 542333 16853771 13448908 3397909 6954 178637 42231 127804 8602 4257810 3046966 1199956 10888 1573392 460207 1113185 0 2036942 1763596 252598 20748 320342 220117 99554 671 0 265751 162281 100925 2545 1172272 996431 164118 11723 0 9219407 7937967 1188052 93388 2893578 2459541 405101 28936 MEDICAL SUPPLIES/DRUGS 42564762 42564762 BAD DEBT EXPENSE 10865307 10865307 BED TAX 1481650 1481650 LOSS ON DEBT REFINANCE 1070456 1070456 2485786 1517340 964771 3675 187679558 161106502 26065568 507488 X 0 20440051 24245876 4180182 0 0 30653779 29137457 0 12256 0 0 3455205 3004907 3864513 4184063 2737361 2586327 181599685 89541022 92278804 92058663 92410541 110249527 20660730 3239226 0 2597393 0 0 573147 17636673 270879956 289326725 15230433 17777311 0 0 0 0 36816993 34470000 0 0 0 0 0 0 0 0 23644966 27004344 75692392 79251655 X 181554614 195980647 5203325 5591847 8429625 8502576 195187564 210075070 270879956 289326725 X 15883570 -1025944 29880 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false true 50 false false true 200 false true 54578 54828 false SCHEDULE C, PART II-B, LINE 1 DESCRIPTION OF LOBBYING ACTIVITIES: The hospital hired a consultant to provide lobbying services in connection with governmental affairs representation to ensure hospital, community, and employee interests and needs are represented. In addition, a portion of aha/mha dues are attributed to lobbying services. 12693936 127333 369446 88268 13102447 11606682 393168 968936 274850 12693936 10598351 64337 979412 35418 11606682 10709927 489607 -542431 58752 10598351 9692852 127911 1052329 163165 10709927 0.04416 0.64893 0.39523 false true true 3745203 3745203 96583386 31747854 64835532 77525867 57114067 20411800 3745229 679101 3066128 92058663 DUE FROM AFFILIATE 51640 INSURANCE RECEIVABLE 2853959 DEFERRED COMP ASSET 3091 INVESTMENT IN SPH FOUNDATION 14202902 BOND ISSUANCE COSTS 525081 17636673 0 DUE TO MEDICARE 1210856 BOND INTEREST PAYABLE 254854 MALPRACTICE ACCRUAL 4180607 PENSION LIABILITY 21354936 DEFERRED COMP LIABILITY 3091 27004344 190375279 -1025944 494359 -531585 190906864 542333 12113931 12656264 203563128 175487773 286311 286311 175201462 542333 11935763 12478096 187679558 SCHEDULE D, PART V, LINE 4 Describe the intended uses of the organization's endowment funds: ENDOWMENT FUNDS ARE RESTRICTED FOR SUPPORT OF HOSPITAL PROGRAMS AND SERVICES AND FOR CAPITAL PURCHASES AND IMPROVEMENTS IN ACCORDANCE WITH BOARD POLICIES AND/OR DONOR RESTRICTIONS. Schedule D, Part X, Line 2 UNCERTAIN TAX POSITIONS: Management has evaluated their income tax positions under the guidance included in asc 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. SCHEDULE D, PART XI, LINE 2D REVENUE ON BOOKS, NOT ON RETURN: COST OF GOODS SOLD 67,068 RENTAL EXPENSES NET WITH REVENUE 219,243 MINIMUM PENSION LIABILITY ADJUSTMENT 208,048 TOTAL 494,359 SCHEDULE D, PART XI, LINE 4B REVENUE ON RETURN, NOT ON BOOKS: PROVISION FOR BAD DEBTS NET WITH REVENUE ON FINANCIALS 10,865,307 LOSS ON DEBT REFINANCE RECLASSED TO EXPENSE 1,070,456 CHANGE IN INTEREST IN SPH FOUNDATION 178,168 TOTAL 12,113,931 SCHEDULE D, PART XII, LINE 2D EXPENSE ON BOOKS, NOT ON RETURN: COST OF GOODS SOLD 67,068 RENTAL EXPENSES NET WITH REVENUE 219,243 TOTAL 286,311 SCHEDULE D, PART XII, LINE 4B EXPENSE ON RETURN, NOT ON BOOKS: PROVISION FOR BAD DEBTS NET WITH REVENUE ON FINANCIALS 10,865,307 LOSS ON DEBT REFINANCE RECLASSED TO EXPENSE 1,070,456 TOTAL 11,935,763 Central America and the Caribbean Investments 18371 18371 18371 false false true true false false true true X true true X true true true false true true 7166838 3565621 3601217 0.02010 12587750 10027135 2560615 0.01430 19754588 13592756 6161832 0.03440 559972 216885 343087 0.00190 1500 0 1500 48304806 35110779 13194027 0.07360 151287 0 151287 0.00080 49017565 35327664 13689901 0.07630 68772153 48920420 19851733 0.11070 27242 27242 0.00020 1773 1773 0.00000 29015 29015 0.00020 true 10978826 0 68054564 74197145 -6142581 X true true HELENA SURGICENTER SURGERY CENTER 0.50000 0.06120 0.43880 1 1 St peter's hospital 2475 broadway helena MT 59601 www.stpetes.org 13346 X X X PHYSICIAN CLINICS & URGENT CARE SERVICES 1 st peter's hospital false false true X X X X X X X X X 12 true false false true X www.stpetes.org/CHNA X true 12 true www.stpetes.org/sites/default/files/CHIP-13 false false true X 175. 250. X X X X X true true X X X X true X SEE PART VI SECTION C X SEE PART VI SECTION C X SEE PART VI SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 A consultant was engaged to facilitate the community needs assessment through use of interviews and focus groups. One focus group was held on December 5, 2012. Participants included 15 key informants, with representatives from public health; physicians; other health professionals; social service providers, and other community leaders. A list of recommended participants for the focus group was provided by the sponsors. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Participants included a representative of public health, as well as several individuals who work with low-income, minority or other medically underserved populations, and those who work with persons with chronic disease conditions. Focus group candidates were first contacted by letter to request their participation. Follow-up phone calls were then made to ascertain whether or not they would be able to attend. Confirmation calls were placed the day before the groups were scheduled to ensure a reasonable turnout. SCHEDULE H, PART V, SECTION B, LINE 11 In 2012, St. Peter's conducted a Community Health Needs Assessment (CHNA). With the results of this CHNA, St. Peter's partnered with Lewis and Clark City-County Health Department to analyze and prioritize the identified health improvement opportunities, then jointly developed and implemented a three-year (2013-2016) Community Health Improvement Plan (CHIP) to improve the health of the Helena region. Background: - Retained Professional Research Consultants, Inc., of Omaha, Nebraska (national experts, completed surveys in 300 communities across the United States) to conduct Community Health Needs Assessment (CHNA) - Partnered with Lewis & Clark City-County Health Department to develop Community Health Improvement Plan (CHIP) Project: 400 random-sample telephone interviews - St. Peter's survey area (L&C, Jefferson, Broadwater, Meagher, and Powell counties) - Mid-September through November 2012 - 145 survey items; 20-25 minute interview - 3.7% maximum error One key informant focus group: - Solicited input and buy-in from important community partners (physicians, other health providers, employers, social service professionals, and community leaders), held December 5 - Identified top five health needs for the community: 1. Access to healthcare services 2. Mental Health 3. Obesity, including nutrition and physician activity 4. Substance abuse 5. Health education and prevention Project Goal: - To improve residents' health status, increase their life spans, and elevate their overall quality of life. - To reduce the health disparities among residents. - To increase accessibility to preventive services for all community residents. Identified Areas of Opportunity: - Access to health services - Difficulty getting a medical appointment - Cervical cancer screening (pap smear) - Routine checkups (children) - Distance/lack of transportation - Insufficient numbers of primary care providers - Cost of medical care - Hearing and other sensory or communication disorders Deafness/trouble hearing - Injury and violence prevention Seat belt usage (adults) Firearms in the home - Mental health and mental disorders Inadequate number of providers and services Lack of child and adolescent services Suicides - Substance abuse Prevalence of drug use Availability of treatment options Early prevention and education Community Health Improvement Plan Priorities: The final Community Health Improvement Plan (CHIP) outlined the following priorities. *Please note: Not all the opportunities identified in the CHNA were addressed in the CHIP. Opportunities not addressed, and reasons why, are noted at the end of this section. 1. Mental Health 2. Substance Abuse 3. Chronic Disease 4. Child and Family Health 5. Access to Health Care *Opportunities not addressed in this plan: - Hearing and other sensory or communication disorders (Did not address due to lack of community-wide support and available resources; need to focus limited resources on top five priorities) - Deafness/trouble hearing - Injury and violence prevention (Did not address due to lack of community-wide support and available resources; need to focus limited resources on top five priorities) - Seat belt usage (adults) - Firearms in the home SCHEDULE H, PART V, SECTION B, LINE 16A-16C THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP WAS AVAILABLE ON THE HOSPITAL'S WEBSITE: https://www.stpetes.org/patient-assistance SCHEDULE H, PART V, SECTION B, LINE 16I PATIENTS RECEIVE NOTIFICATION OF THE FINANCIAL ASSISTANCE POLICY UPON DISCHARGE AS WELL AS IN THEIR PATIENT STATEMENTS. SCHEDULE H, PART V, SECTION B, LINE 22D Uninsured patients are given a 3% discount on their bill prior to determination of qualifying for patient assistance. Upon determination that patients do qualify for patient assistance, a discount is applied based on the qualifying level for a discount between 15% and 100%. The organization updated the sliding scale on an annual basis as the poverty guidelines are published. In the current year, in excess of 75% of the assistance given was at the 100% level. The lowest level of 15% is nearly 190% of the average of the three lowest negotiated commercial insurance rates. 4 HOSPICE & HOMELINK OF ST PETERS HOSPITAL 201 SOUTH CALIFORNIA HELENA MT 59601 HOSPICE AND HOME HEALTH APEX OF ST PETERS HOSPITAL 201 SOUTH CALIFORNIA HELENA MT 59601 HOME OXYGEN SERVICES ST PETER'S MEDICAL GROUP BROADWAY 2550 BROADWAY HELENA MT 59601 PHYSICIAN CLINIC ST PETER'S MEDICAL GROUP NORTH 3330 PTARMIGAN LANE HELENA MT 59602 PHYSICIAN CLINIC SCHEDULE H, PART I, LINE 7 The organization used an internal cost allocation system for lines 7a, 7b and 7g. The cost allocation system addresses all patient segments. The costs are estimated by allocating departmental costs based on direct costs less any other operating revenue, then by doing an allocation of benefits, depreciation and other overhead costs. The information for lines 7e, 7f, and 7i was derived from information in the general ledger and other financial data related specifically to the various types of community benefits. SCHEDULE H, PART I, LINE 7G Subsidized health services include physician clinics that provide care during extended hours and on weekends, as well as provide specialties that are only offered at these locations. The total costs related to the physician clinics included on line 7g are $31,308,338, with direct offsetting revenue of $22,262,832, resulting in a net community benefit expense of $9,045,506. SCHEDULE H, PART I, LINE 7, COLUMN F The amount of bad debt, which also include the organization's share of joint ventures bad debt that are removed from the denominator of this calculation are $10,978,826. SCHEDULE H, PART II The Hospital provided the following community building activities during the year. Line 3 Community support: Lewis & Clark County Fairgrounds - Donation allows for continued operation of the fairgrounds facilities for a variety of community events, particularly events to raise awareness and funds for various health-related causes and events. The fairgrounds facilities are able to accommodate events with attendance of 1,000+, including events for The Friendship Center (domestic abuse and sexual assault), Florence Crittendon (pregnancy support for teen mothers), YWCA (transitional housing for women and children experiencing homelessness), and St. Peter's Foundation (medical care to benefit residents of the Helena region) among others. Donations to the Schools - Donations provide support for physical education and athletics programs to promote healthy lifestyles and physical activity to our community's youth. Figure Skating club - Donation provides support for athletics programs to promote healthy lifestyles and physical activity to our community's youth. Rotary - Donation provides support for Rotary activities in our community that support health and wellness, specifically educational opportunities for community's youth. Townsend Heritage Gardens - Donation supports costs to build and develop section of garden designed to provide fresh produce for Townsend-based nutrition and food share efforts for Townsend area residents. Fusion Robotics Association - Donation supports education and development of local students in pursuit of medical careers through STEM (science, technology, engineering, math) programs. Such programs are used to expose students to careers and work in the medical field. Symphony Under the Stars - Donation supports production of one of Helena's largest summertime events, used to raise awareness of and donation of non-perishable foods for Helena region residents. The event collected more than 40,000 lbs of food for people experiencing hunger in our community. Helena Chamber of Commerce - Donation supports development of community-wide initiatives to increase prosperity of Helena region. The Chamber hosts events including legislative events (including debates/perspectives on Medicaid Expansion) to business networking events that expose a cross-section of local industry leaders to the health services offered by St. Peter's. Line 9 Other: Meeting room space - Donation of meeting room space to various health-related community groups provides a venue for planning, implementing, and monitoring various community health initiatives. Groups using space include cancer caregiver support groups to community-wide meetings for development of Community Health Improvement Plan. SCHEDULE H, PART III, Section A, LINE 2 Bad debt expense is reported at charges as recorded by the organization. Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year. SCHEDULE H, PART III, Section A, LINE 4 The footnote to the organization's financial statements that describes bad debt expenses is located in footnote 1 on page 10 of the attached financial statements. SCHEDULE H, PART III, Section B, LINE 8 No allocation of the Medicare shortfall was treated as a community benefit. SCHEDULE H, PART III, Section C, LINE 9b St. peter's hospital recognizes its responsibility to render necessary health care services to all persons in need of such care, regardless of race, creed, color or economic circumstances. St. peter's hospital recognizes that payment for services rendered is due and payable at the time of service. The hospital accepts insurance assignments and some other approved arrangements for delayed payment. Financial assistance is available for all qualified patients. Patients not covered by insurance or unable to pay in full for services rendered must contact the appropriate patient account representative who will assist the patient and/or family in determining if he/she qualifies for patient assistance. Collection activity will be suspended while a financial assistance application is under review. SCHEDULE H, PART VI, LINE 2 Need Assessment: St. Peter's Hospital conducts a community survey every three years. The community survey is performed by an independent contractor that selects an adequate sample size for the area. The homes of St. Peter's Hospital employees are excluded from the survey. The survey includes questions related to evaluating the community's experience and ability to access healthcare. The survey helps to identify specialty areas of concern. The results of the surveys are reviewed by the senior management team as well as the Board to identify the areas of focus. In 2014, the St. Peter's Board of Directors, made up of community members, physicians, and senior management, and worked with a consultant to develop St. Peter's Community Health Improvement Plan (CHIP). Based on the findings of the Community Health Needs Assessment (CHNA), the Board and its Community Relations Committee prioritized community health needs for the organization. The Community Relations Committee represents a broad range of community interests and gives final approval of the CHNA and CHIP. The Public Relations and Marketing Department is responsible for the facilitation and implementation of the CHNA and CHIP. During 2014, the combined community and committee continued to work on the various aspects of the report. SCHEDULE H, PART VI, LINE 3 Patient Education Eligibility for assistance: St. Peter's Hospital (1) posts its Charity Care Policy on its website as well as at the admitting desk, emergency room, on the monthly statements and cashier areas in which eligible patients are likely to be present, (2) offers a summary of our policy and application to self-pay patients with contact information to patients as part of the intake process, (3) provides a copy of financial assistance contact information to patients with discharge materials, (4) Financial Counselors discuss with patients expecting to owe more than $500, the availability of patient assistance and various Government benefits, such as Medicaid or State Programs, and assists the patient with qualification for such programs, where applicable. SCHEDULE H, PART VI, LINE 4 Community Information: St. Peter's Hospital is a 123-bed Acute Care Hospital Facility serving residents of Lewis and Clark County and portions of Jefferson, Broadwater, Meagher, and Powell Counties. St. Peter's is the sole facility in the primary services area. The Hospital Financial Payor Mix consisted of 5.6% self-pay patients, 7.1% of Medicaid patients and 47.4% Medicare patients. Approximately 15.6% of the population is age 65 and older. The average per capita income is $29,785 and approximately 13.5% of the population is below the Federal Poverty Level. The nearest hospital in the area is approximately 35 miles from the St. Peter's Campus. SCHEDULE H, PART VI, LINE 5 Promotion of community health: The Organization's Governing Body Members reside in the community. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are used to make capital purchases and upgrades to the Facilities. St. Peter's Hospital is the sole Acute Care Provider in the Primary Service Area, and operates an emergency room and two urgent care clinics. The primary service area is made up of Lewis and Clark County and the Northern portion of Jefferson County. There is a population of approximately 76,850. Out-Migration is generally limited to tertiary services not available at St. Peter's Hospital including, Cardiac Surgery and Neo-Natal Care. St. Peter's Hospital provides care to all patients regardless of their ability to pay. St. Peter's Hospital maintains charges as one of the lowest hospitals within the state depending on the services being provided. St. Peter's Hospital sponsors several wellness screenings, health fairs, and educational lectures, classes, and events throughout the year to promote better living, nutrition and good health. St. Peter's (SPH) ensures that its patients, their families and personnel have spiritual care available to them. SPH respects Native-American culture and the ceremonies that are important to meet the spiritual and cultural needs and promote optimal healing of Native- American patients. In order to ensure a patient's right to access these ceremonies, a procedure has been put in place. Continuing education is also provided to members of the medical community on an on-going basis. In addition, St. Peter's Hospital had 14,175 volunteer hours from the community assisting in a variety of roles within the organization. St. Peter's Hospital made $151,287 of cash and in-kind donations to a variety of organizations within the community. This includes, but is not limited to, The Montana Race for the Cure, Helena YMCA, Florence Critten Home, Montana Senior Olympics, American Cancer Society Relay for Life, Rocky Mountain Development Council, Susan G Komen Foundation, March of Dimes, Carroll College Fitness Center, Helena High School, Lewis and Clark County for Crisis Response Team, Archie Bray Foundation, Helena Police Department for 911 Emergency Training, Carroll College Athletics with Emergency Services at Events, United Way to assist low-income and homeless residents with basic needs, Spirit of Service Campaign by providing supplies and volunteers to help elderly residents and others with special needs improve their homes and yards, Kay McKenna Youth Foundation to provide safe summer youth activities, and Big Brothers and Sisters. The donations were made to assist these community sponsors in their various programs. true ST PETERS HOSPITAL FOUNDATION 2475 BROADWAY HELENA MT 59601 810392270 501(c)(3) 17475 Carroll College 1601 North Benton Avenue Helena MT 59625 810231774 501(c)(3) 20000 HELENA POLICE DEPARTMENT 221 BRECKENRIDGE HELENA MT 59601 816001276 6956 MONTANA MENTAL HEALTH TRUST 2601 BRAODWAY HELENA MT 59601 466395023 501(c)(3) 80000 4 Schedule I, Part I, Question 2 ORGANIZATION'S PROCEDURES FOR MONITORING USE OF GRANT FUNDS: SUPPORT IS PROVIDED TO ST. PETERS HOSPITAL FOUNDATION, A RELATED ORGANIZATION, FOR THE FOUNDATION'S EMPLOYEE EMERGENCY ASSISTANCE FUND. MONITORING IS DONE BY COMMITTEES THAT MEET INFORMALLY WHEN THERE ARE REQUESTS BY STAFF FOR ASSISTANCE. THE REQUESTS ARE REVIEWED BY THE COMMITTEE TO DETERMINE IF THEY ARE ELIGIBLE, WHETHER THEY HAVE FREQUENT REQUESTS, AND IF THE NEED IS SUCH THAT THE FUNDS SHOULD BE GRANTED. THE ORGANIZATION ALSO PROVIDES SUPPORT TO A VARIETY OF ORGANIZATIONS WITHIN THE COMMUNITY TO ASSIST THEM IN THEIR VARIOUS PROGRAMS. X X true true X X X X X true false false false false false false true false NATHAN OLSON CEO 437286 0 160937 0 1252 0 33100 0 20417 0 652992 0 0 0 JOHN GREEN CFO 235245 0 42906 0 13906 0 41285 0 28284 0 361626 0 0 0 THOMAS GREGG FORMER INTERIM CEO 0 0 12708 0 163436 0 0 0 4271 0 180415 0 0 0 JOHN SOLHEIM FORMER CEO 0 0 0 0 317617 0 0 0 0 0 317617 0 0 0 ANN KJOSA COO/CXO 228193 0 63733 0 810 0 35456 0 30890 0 359082 0 0 0 THOMAS WEINER MD 1716688 0 0 0 3169 0 32490 0 29997 0 1782344 0 0 0 MICHAEL LEE MD 802718 0 0 0 1320 0 9350 0 19414 0 832802 0 0 0 JAMES TARVER MD 609432 0 0 0 165 0 15600 0 30255 0 655452 0 0 0 KRIS GODLEWSKI MD 535488 0 0 0 1505 0 25940 0 19877 0 582810 0 0 0 JEFFREY GEORGIA MD 533580 0 0 0 449 0 15600 0 33089 0 582718 0 0 0 MARIA BRAMAN VP OF MEDICAL STAFF 298341 0 53781 0 6100 0 43278 0 30370 0 431870 0 0 0 JOHN GALT MD BOARD MEMBER/CHIEF OF STAFF 382982 0 1316 0 0 0 15247 0 30061 0 429606 0 0 0 SCHEDULE J, PART I, LINE 1A Information Regarding Benefits Provided: THE PRESIDENT/CEO RECEIVES REIMBURSEMENT FOR MEMBERSHIP DUES PAID TO A SOCIAL CLUB. THE PRESIDENT/CEO IS ALSO PROVIDED TRAVEL FOR A COMPANION FOR ONE BUSINESS FUNCTION PER YEAR. ALL AMOUNTS ARE REPORTED AS TAXABLE COMPENSATION. THESE ARE BENEFITS THAT WERE AVAILABLE TO THE CEO, BUT WERE NOT UTILIZED IN 2014. SCHEDULE J, PART I, LINE 4A SEVERANCE: John Solheim and Tom Gregg each received severance for the change in control. These amounts are reported as Other reportable compensation on Schedule J, Part II, column B(iii). THE FINAL PAYMENTS WERE MADE DURING CALENDAR YEAR 2014. SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: THE ORGANIZATION HAS INCENTIVE BONUS POLICIES FOR EXECUTIVES, ALL OF WHICH HAVE SPECIFIC METRICS THAT MUST BE MET IN ORDER TO BE PAID OUT. NOT ALL INCENTIVES THAT ARE ACCRUED AT FYE ARE PAID OUT WITHIN 2.5 MONTHS AFTER YEAR END. THE FOLLOWING INDIVIDUALS DID NOT RECEIVE THEIR INCENTIVE PAYOUTS WITHIN THAT TIME, THEREFORE AN ACCRUAL WAS MADE FOR 7 MONTHS OF THE INCENTIVE WHICH COVERED THE TIMEFRAME 6/1/2014 - 12/31/2014. THE ACCRUAL APPEARS UNDER OTHER DEFERRED COMPENSATION UNDER SCHEDULE, J, PART II, COLUMN C. - JOHN GREEN - ANN KJOSA - MARIA BRAMAN A MONTANA FACILITY FINANCE AUTHORITY 364615155 2013-03-13 21435000 REFINANCE 2004 BOND SERIES false false false B MONTANA FACILITY FINANCE AUTHORITY 364615155 2015-04-29 14945000 REFINANCE 2007 BOND SERIES false false false A 1910000 0 21435064 0 0 0 349297 0 0 0 21085767 0 2013 false true true true B 0 0 14945000 0 0 14691787 253213 0 0 0 0 0 2015 false true true true A false true false false 0.00000 0.00000 0.00000 false false 0.00000 false true B false true false false 0.00000 0.00000 0.00000 false false 0.00000 false true A true true false false 0 false 0 false true B false true false false false false 0 false 0 false true A true B true SCHEDULE K, PART III, LINE 2C THE REBATE COMPUTATION FOR THE 2013 BOND ISSUE IN COLUMN A WAS PERFORMED ON JULY 22, 2014 FOR THE PERIOD FROM MARCH 13, 2013 THROUGH JUNE 1, 2014. SCHEDULE K, PART III, LINE 4 & 5 THERE IS A SMALL AMOUNT OF USE OF THE FINANCED PROPERTY BY HEALTH CARE ORGANIZATIONS OTHER THAN A 501(C)(3) ORGANIZATION, BUT THE USE QUALIFIED FOR AN EXCEPTION TO UBI, THEREFORE IS NOT CONSIDERED PRIVATE BUSINESS USE. JAMES TARVER LOAN EMPLOYED MD MORTGAGE X 200000 12256 false false true 12256 JOHN GALT EMPLOYED PHYSICIAN OWNS 6.6002% SURGICENTER FORM 990, PART VI, SECTION A, LINE 4 Changes to Organizational Documents since Prior 990: The organization amended its bylaws in May 2015. The amendments include updating the number of total members to 15, and allowing the past chief of staff to replace the SPMG President as one of the five members that serve by virtue of office. FORM 990, PART VI, SECTION A, LINE 9 Addresses of those Who Cannot be Reached at Organization's Mailing Address: MARIA BRAMAN PO BOX 431 JEFFERSON CITY, MT 59638 FORM 990, PART VI, SECTION B, LINE 11B Process to Review the Form 990: A DRAFT OF THE FORM 990 IS REVIEWED BY THE CEO AND CFO AS WELL AS THE FINANCE COMMITTEE PRIOR TO FULL BOARD APPROVAL OF THE FINAL FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C Process for Monitoring Compliance with Conflict of Interest Policy: THE CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS, OFFICERS, SENIOR ADMINISTRATION AND KEY EMPLOYEES. THE BOARD IDENTIFIES POTENTIAL CONFLICTS AND DETERMINES IF VOTING ON RELATED ITEMS WOULD BE A CONFLICT OF INTEREST. IF A CONFLICT IS DETERMINED TO EXIST, THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE CONFLICTED ITEM. FORM 990, PART VI, SECTION B, LINE 15A Review of CEO or Top Mgmt Official Compensation: AN INDEPENDENT COMPENSATION CONSULTANT PERFORMS A REVIEW OF SALARIES AND BENEFITS USING DATA FROM COMPARABLE HEALTHCARE FACILITIES. A REPORT IS PREPARED AND PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, WHICH USES THE REPORT TO DETERMINE EXECUTIVE COMPENSATION. THE INFORMATION IS THEN REVIEWED WITH THE BOARD OF DIRECTORS. THE ANNUAL PROCESS WAS PERFORMED DURING 2014. FORM 990, PART VI, SECTION B, LINE 15B Review of Other Officer or Key Employees Compensation: AN INDEPENDENT COMPENSATION CONSULTANT PERFORMS A REVIEW OF SALARIES AND BENEFITS USING DATA FROM COMPARABLE HEALTHCARE FACILITIES A REPORT IS PREPARED AND PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, WHICH USES THE REPORT TO DETERMINE OTHER OFFICER AND SENIOR MANAGEMENT COMPENSATION. THE INFORMATION IS THEN REVIEWED WITH THE BOARD OF DIRECTORS. THE ANNUAL PROCESS WAS PERFORMED DURING 2014. FORM 990, PART VI, SECTION C, LINE 19 Governing Documents Available to the Public: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: CHANGE IN INTEREST IN SPH FOUNDATION (178,168) MINIMUM PENSION LIABILITY ADJUSTMENT 208,048 TOTAL 29,880 ST PETERS HOSPITAL FOUNDATION 2475 BROADWAY HELENA MT 59601 810392270 FUNDRAISING MT 501(C)(3) line 7 SPCH true PEAK HEALTH LLC 2475 BROADWAY HELENA MT 59601 271863807 HEALTH CLUB MT SPCH UNRELATED 9676 2021640 false 0 false 0.65000 PEAK HEALTH REALTY LLC 2475 BROADWAY HELENA MT 59601 272492966 RENTAL PROPERTY MT SPCH UNRELATED -78704 5513894 false 0 false 0.65000 PEAK HEALTH HELENA LLC 2475 BROADWAY HELENA MT 59601 272493096 HEALTH CLUB MT SPCH UNRELATED 282010 219383 false 0 false 0.65000 false true true true false false false false false false true false true true true true true false true ST PETERS HOSPITAL FOUNDATION C 713073 INTERCO AMOUNT PEAK HEALTH D 51640 INTERCO AMOUNT ST PETERS HOSPITAL FOUNDATION P 364794 FUNCT ALLOC