NORTHERN MONTANA HEALTH CARE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
NORTHERN MONTANA HEALTH CARE INC (EIN 81-0428854)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-02
IRS object ID
201421229349300907
Schema version
2012v2.1
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-02T11:10:02-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN450250958EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1
CityMinneapolisCity
StateMNState
ZIP Code554027033ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN810428854EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Northern Montana Health Care IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone4062652211Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1231AddressLine1
CityHavreCity
StateMTState
ZIP Code59501ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDavid HenryName
TitlePresident/CEOTitle
Phone4062652211Phone
Date Signed2014-05-01DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKim C HunwardsenName
PTINP00484560PTIN
Phone6122536500Phone
Date Prepared2014-05-01DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDavid HenryNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO Box 1231AddressLine1
CityHavreCity
StateMTState
ZIP Code59501ZIPCode
FieldValueIRS element (for citing)
Gross Receipts11333110GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.nmhcare.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicileMTStateLegalDomicile
Activity Or Mission DescriptionProvision of healthcare services.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers130TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year8398ContributionsGrantsPriorYear
Contributions Grants Current Year8439ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1397670ProgramServiceRevenuePriorYear
Program Service Revenue CY6878652ProgramServiceRevenueCY
Investment Income Prior Year132225InvestmentIncomePriorYear
Investment Income Current Year896052InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year1347618OtherRevenueCurrentYear
Total Revenue Prior Year1538293TotalRevenuePriorYear
Total Revenue Current Year9130761TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year6763826OtherExpensePriorYear
Other Expenses Current Year1654097OtherExpensesCurrentYear
Total Expenses Prior Year6763826TotalExpensesPriorYear
Total Expenses Current Year1654097TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-5225533RevenuesLessExpensesPriorYear
Revenues Less Expenses CY7476664RevenuesLessExpensesCY
Total Assets BOY61425889TotalAssetsBOY
Total Assets EOY68302269TotalAssetsEOY
Total Liabilities BOY9004427TotalLiabilitiesBOY
Total Liabilities EOY8355648TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY52421462NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY59946621NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTo deliver high quality comprehensive health care services to the hi-line communities.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense1275006Expense
Revenue6878652Revenue
DescriptionNorthern Montana Health Care, Inc. (NMHC) supports and encourages health care services by providing financial and managerial consulting assistance to the following controlled health care organizations:1) Northern Montana Hospital, ID# 81-02317872) North Care Corporation, ID# 81-04476383) Northern Montana Health Care Foundation, ID# 36-3464641NMHC provides overall direction and coordinates the policy making and long-range planning for its subsidiaries. It is organized solely to carry out the purposes of its tax-exempt subsidiaries. Some of the services NMHC furnishes to its subsidiaries are: accounting services, negotiation assistance with rental agreements, management and healthcare consulting, and other miscellaneous services.Description
Total Program Service Expense1275006TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Kim Lucke VP of FinanceBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4062652211TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 1231AddressLine1
CityHavreCity
StateMTState
ZIP Code59501ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
David C Henry
President/CEO1.0042.00XX000
Miles Hamilton
Chairman1.001.00XX000
Bruce Richardson MD
Vice Chairman1.0040.00XX032684920318
David Leeds
Treasurer1.001.00XX000
Judy Greenwood
Secretary1.001.00XX000
Paul Tuss
Trustee1.001.00X000
Julie Holt
Trustee1.001.00X000
Andrew Carlson
Trustee1.001.00X000
Tom Patrick
Trustee1.001.00X000
Margaret Dow MD
Trustee - IPD Member1.0040.00X027742523738
Michael Nolan MD
Trustee - IPD Member1.0040.00X02761585000
Stephen Bechdolt MD
Chief of Medical Staff1.0040.00X02911199430
Karen Pollington
Vice President - retired May 20131.0040.00X09234119282
Kim Lucke
VP of Finance1.0048.00X07328918143
Julie Mariani
Vice President - commenced June 20131.0040.00X09401423234
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1431195TotalReportableCompFrmRltdOrgs
Total Other Compensation119145TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Northern Montana HospitalBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 1231AddressLine1
CityHavreCity
StateMTState
ZIP Code59501ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesContract LaborDescriptionOfServices
Compensation387075Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions8439AllOtherContributions
Total Contributions8439TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Income from affiliates90009968702526870252
Supporting revenue90009984008400
FieldValueIRS element (for citing)
Total Program Service Revenue6878652TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column152548TotalRevenueColumn
Exclusion$152,548ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1347618Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1347618Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1347618TotalRevenueColumn
Exclusion$1,347,618ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other2945853Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other2202349Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other743504Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column743504TotalRevenueColumn
Exclusion$743,504ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column9130761TotalRevenueColumn
Related Or Exempt Function Income6878652RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,243,670ExclusionAmount

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total310080Total
Program Services232560ProgramServices
Management And General77520ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total6671Total
Management And General6671ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total12410Total
Management And General12410ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total93891Total
Program Services61947ProgramServices
Management And General31944ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total4794Total
Program Services3596ProgramServices
Management And General1198ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total22175Total
Program Services13659ProgramServices
Management And General8516ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total137165Total
Program Services72839ProgramServices
Management And General64326ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total763Total
Program Services587ProgramServices
Management And General176ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total316832Total
Program Services316832ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total690709Total
Program Services557405ProgramServices
Management And General133304ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total34841Total
Program Services1929ProgramServices
Management And General32912ManagementAndGeneral

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total23766Total
Program Services13652ProgramServices
Management And General10114ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1654097Total
Program Services1275006ProgramServices
Management And General379091ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1065852BOY
EOY1298997EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY85207BOY
EOY67670EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY1952893EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY28285BOY
EOY25595EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis18854657LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec9507928LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY9934940BOY
EOY9346729EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6958626BOY
EOY7170236EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY43198657BOY
EOY48329037EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY154322BOY
EOY111112EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY61425889BOY
EOY68302269EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY386283BOY
EOY352654EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY6156442BOY
EOY5335001EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1233465BOY
EOY887970EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1228237BOY
EOY1780023EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY9004427BOY
EOY8355648EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY52421462BOY
EOY59946621EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY52421462BOY
EOY59946621EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY61425889BOY
EOY68302269EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses7476664ReconcilationRevenueExpenses
Reconciliation Unrealized Invest48495ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (3 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocAmountAmount
Northern Montana Hospital
81023178731$1,184,882
North Care Corporation
81044763831$0
Northern Montana Health Care Foundation Inc
36346464170$90,124
FieldValueIRS element (for citing)
Total Number Of Supported Orgs3TotalNumberOfSupportedOrgs
Sum Of Amounts1275006SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis100000OtherCostOrOtherBasis
Book Value100000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis18058874OtherCostOrOtherBasis
Depreciation9196202Depreciation
Book Value8862672BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis129528OtherCostOrOtherBasis
Depreciation127437Depreciation
Book Value2091BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis566255OtherCostOrOtherBasis
Depreciation184289Depreciation
Book Value381966BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings9346729TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionInvestment in AffiliatesDescription
Book Value48329037BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities48329037TotalOfBookValueSecurities

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDue from AffiliatesDescription
Amount$1,780,023Amount
FieldValueIRS element (for citing)
Total Of Amounts1780023TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDescription of Uncertain Tax Positions Under FIN 48:Identifier
Return ReferencePart X, Line 2:ReturnReference
ExplanationThe Organization and its three nonprofit affiliates are entities organized as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. The Organization also has a taxable affiliate, which is inactive and had no taxable income in 2013 and 2012. The Organization and its affiliates are annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Organization is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Organization files an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report its unrelated business taxable income. The Organization believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. The Organization's federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2010.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs1CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Bruce Richardson MD
Vice Chairman0324837000201200022923034977200
Margaret Dow MD
Trustee - IPD Member027724500018000026005030343000
Michael Nolan MD
Trustee - IPD Member027469500014630007172028333000
Stephen Bechdolt MD
Chief of Medical Staff0289931000118800011708030282700

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 5Margaret Dow and Michael Nolan are compensated as a percentage of the prior three months' average gross revenue earned for the hospital by the physician, with the percentage being based on their specialty.
Part IIIPart I, Line 3: CEO/President is compensated by an unrelated management company. A related organization and the management company have a process in place to determine the CEO's compensation using the Form 990 of other organizations, a written employment contract, a compensation survey or study, and the approval by the board or compensation committee. Part II: Individuals listed on Schedule J, Part II, other than the CEO, are compensated by a related organization for their services provided to that organization. They are not compensated for their services as board members. The related organization has procedures in place to determine their compensation.Supplemental Information

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Montana Facility Finance Authority
A810302402612043DM82006-03-016843295Refund bonds issued 11/9/1995 and 12/15/1995.000
City of Havre Montana
B8160012742007-11-303186968Fund new medical building000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindCapital ExpendituresCapitalExpenditures
A44950006843295667000136846603944920061011
B318696818185661698200800112943162

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A00000.000000.000000.00000000
B00000.000000.000000.00000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A000100000
B000000000

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A0
B0

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSchedule K Part IV, Arbitrage, Line 2cIdentifier
Return ReferenceDate Rebate Computation PerformedReturnReference
ExplanationIssuer Name: Montana Facility Finance Authority Date the Rebate Computation was Performed: 10/01/2010Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Section A, line 2Kim Lucke, Karen Pollington, Bruce Richardson, David C. Henry, David Leeds, Judy Greenwood, Miles Hamilton, Paul Tuss, Julie Holt, Andrew Carlson, Tom Patrick, Margaret Dow, Michael Nolan, Julie Mariani and Stephen Bechdolt have business relationships with each other.
Form 990, Part VI, Section A, line 3David C. Henry, President/CEO is employed by Fundamental Financial Group, an unrelated management company. Northern Montana Hospital (NMH), pays the unrelated management company for David's services provided to the Hospital, Northern Montana Health Care, Inc. and Northern Montana Health Care Foundation. The President/CEO's responsibilities include implemeting decisions and supervising the management, administration and operation of the Hospital and the related, exempt organizations. The amount compensation paid during 2012 was $378,500.
Form 990, Part VI, Section A, line 6Those persons who reside in the area served by Northern Montana Hospital and who have been members of or given money to Northern Montana Hospital at any time from the founding of the hospital to May 1, 1984 shall be invited to become members of the corporation (Northern Montana Health Care, Inc.). The corporation shall only be required to act in good faith and use its best efforts to identify all persons qualifying for such invitation. The initial members shall be those persons invited to be members who agreed in writing to become a member of the corporation. These members shall meet at a place and time designated by the board to take the following action: (1) if their number is less than fifty (50), to elect as many additional members as necessary to bring their total number to fifty (50) and (2) to select the terms of service of each of the members. The terms of one-third (1/3) of the initial members shall expire on the second Tuesday of March of each year, beginning in 1986.
Form 990, Part VI, Section A, line 7bThe members of the corporation shall have the following powers: (i) to approve, or disapprove amendments to the Articles of Incorporation that affect the identity, power and/or duties of the members of the corporation, or mergers or consolidations with another corporation, or sales of all or substantially all of the corporation's assets, (ii) to approve, or disapprove, liquidations of the corporation's mergers or consolidations of the corporation with another corporation, or sales of all or substantially all of the corporation's assets, (iii) to elect the members of the corporation, and (iv) to approve, or disapprove, amendments to the bylaws which affect the identity, power and/or duties of the members of the corporation. The members shall have no other powers with regard to the corporation.
Form 990, Part VI, Section A, line 8bNo subcommittee had the authority to act on behalf of the board during the fiscal year ended June 30, 2013.
Form 990, Part VI, Section B, line 11The Board of Directors receive a copy of the Form 990 via e-mail before it is filed. The VP of Finance reviews the form.
Form 990, Part VI, Section B, line 12cThe conflict of interest policy covers all trustees, directors, officers, and key employees. The Board identifies potential conflicts from annual disclosures. Disclosures are reviewed by administration after all are gathered. A second conflict disclosure letter is sent out annually to all current and former officers, directors, trustees, and key employees to ensure all potential conflicts are identified. The results of this disclosure form are reviewed by the VP of Finance. The board discusses the 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.
The President/CEO is compensated by an unrelated management company. The unrelated management company receives a fee for service from a related organization for the CEO's service provided to this organization and related organizations, Northern Montana Hospital (NMH) and Northern Montana Health Care Foundation, Inc. (NMHCF). In determining the CEO's compensation, the Executive Committee of the board meets and reviews NMH/Northern Montana Health Care, Inc. (NMHC) financial results, CEO's current year priorities, discusses evaluation tools to be used for the CEO's evaluation, how comparative salaries will be obtained and discusses the history of compensation to the CEO. At a second Executive Committee meeting they review non-financial activity of NMH/NMHC and the results of the CEO evaluations completed by the board members. Then they review and discuss a compensation comparative summary of Montana CEO's compensation and a Guidestar CEO Compensation Checkpoint that is prepared specifically for NMH. They agree upon a list of the coming year's priorities for the CEO and proposed compensation, with the compensation set by board vote. This annual process was completed during fiscal year 2013.
Form 990, Part VI, Section C, line 19The organization's governing documents, conflict of interest policy and financial statements are made available to the public upon request.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Northern Montana Hospital
PO Box 1231HavreMT59501810231787Health Care ServicesMT501(c)(3)Line 3Northern Montana Health Care Inc1
Northern Montana Health Care Foundation Inc
PO Box 1231HavreMT59501363464641Support of Northern Montana HospitalMT501(c)(3)Line 7Northern Montana Health Care Inc1
North Care Corporation
30 13th StreetHavreMT59501810447638Health Care ServicesMT501(c)(3)Line 3Northern Montana Health Care Inc1

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Paramount Health Care IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 1231AddressLine1
CityHavreCity
StateMTState
ZIP Code59501ZIPCode
FieldValueIRS element (for citing)
EIN810393353EIN
Primary ActivityHealth Care ServicesPrimaryActivity
Legal Domicile StateMTLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Northern Montana Health Care IncBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Percentage Ownership1.00000PercentageOwnership
Controlled Org1ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Northern Montana Hospital
J867360FMV
Northern Montana Hospital
M310080Cost
Northern Montana Hospital
O73335Cost
Northern Montana Hospital
Q1548210Cost
Northern Montana Health Care Foundation Inc
R90123Cost
Northern Montana Hospital
S500000Cost

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