FURP.ORG / PUBLIC DATA EXPLORER

ST PETERS HEALTH: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ST PETERS HEALTH (EIN 81-0233121)
Tax period
2011-06-01 to 2012-05-31
Filed
2013-04-15
IRS object ID
201311069349300416
Schema version
2011v1.5
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)
Timestamp2013-04-15T15:35:08-05:00Timestamp
Tax Period End Date2012-05-31TaxPeriodEndDate

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 Date2011-06-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN810233121EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST PETER'S HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTPENameControl
Phone4064442100Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12475 BROADWAYAddressLine1
CityHELENACity
StateMTState
ZIP Code59601ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN GREENName
TitleCHIEF FINANCIAL OFFICERTitle
Phone4064442100Phone
Date Signed2013-04-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKIM C HUNWARDSENName
PTINP00484560PTIN
Phone6122536500Phone
Date Prepared2013-04-12DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonNATHAN C OLSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12475 BROADWAYAddressLine1
CityHELENACity
StateMTState
ZIP Code59601ZIPCode
FieldValueIRS element (for citing)
Gross Receipts166937667GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.STPETES.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1883YearFormation
State Legal DomicileMTStateLegalDomicile
Activity Or Mission DescriptionPROVIDE EXCEPTIONAL AND COMPASSIONATE HEALTH CARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees1289TotalNbrEmployees
Total Nbr Volunteers82TotalNbrVolunteers
Total Gross UBI61468TotalGrossUBI
Net Unrelated Business Txbl Income-464968NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2080000ContributionsGrantsPriorYear
Contributions Grants Current Year593525ContributionsGrantsCurrentYear
Program Service Revenue Prior Year144987588ProgramServiceRevenuePriorYear
Program Service Revenue CY163534823ProgramServiceRevenueCY
Investment Income Prior Year3813556InvestmentIncomePriorYear
Investment Income Current Year1677614InvestmentIncomeCurrentYear
Other Revenue Prior Year75646OtherRevenuePriorYear
Other Revenue Current Year61533OtherRevenueCurrentYear
Total Revenue Prior Year150956790TotalRevenuePriorYear
Total Revenue Current Year165867495TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year50458GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY14253GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year65776330SalariesEtcPriorYear
Salaries Etc Current Year77313898SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year308911TotalFundrsngExpCurrentYear
Other Expense Prior Year73975436OtherExpensePriorYear
Other Expenses Current Year82984400OtherExpensesCurrentYear
Total Expenses Prior Year139802224TotalExpensesPriorYear
Total Expenses Current Year160312551TotalExpensesCurrentYear
Revenues Less Expenses Prior Year11154566RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5554944RevenuesLessExpensesCY
Total Assets BOY233863046TotalAssetsBOY
Total Assets EOY232092045TotalAssetsEOY
Total Liabilities BOY75498434TotalLiabilitiesBOY
Total Liabilities EOY82889308TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY158364612NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY149202737NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionST. PETER'S HOSPITAL PARTNERS WITH OUR PATIENTS, COMMUNITY, AND MEDICAL STAFF TO PROVIDE EXCEPTIONAL AND COMPASSIONATE HEALTH CARE.MissionDescription
Significant New Program Services1SignificantNewProgramServices
Significant Change0SignificantChange
Expense103430351Expense
Grants14253Grants
Revenue125980041Revenue
DescriptionST. PETER'S HOSPITAL IS A 122-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 SERVICE AREA. DURING THE YEAR ENDED MAY 31, 2012 THE HOSPITAL PROVIDED AT COST A TOTAL OF $16,880,442 IN COMMUNITY BENEFIT. OF THIS TOTAL $4,820,392 WAS FOR MEDICAL SERVICES TO INDIVIDUALS WHO WERE DETERMINED UNABLE TO PURCHASE SUCH SERVICES UNDER THE HOSPITAL'S 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 $1,261,245. THE HOSPITAL PROVIDED $10,282,351 IN SUBSIDIZED HEALTH SERVICES DURING THE YEAR, INCLUDING ACUTE PATIENT CARE FOR MEDICAL, SURGICAL, PEDIATRIC AND BEHAVIORAL HEALTH PATIENTS, OUTPATIENT PHARMACY, PULMONARY REHAB, DIALYSIS, CLINICAL NUTRITION, ANTICOAGULATION, AND 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.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense26930124Expense
Revenue37554782Revenue
DescriptionTHE HOSPITAL OPERATES SEVERAL PHYSICIAN CLINICS, EMPLOYING 55 PHYSICIANS AND PHYSICIAN ASSISTANTS AND NURSE PRACTITIONSERS. WITHOUT THE HOSPITAL'S 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, RADIATION AND MEDICAL ONCOLOGY HAD APPROXIMATELY 93,875 PATIENT ENCOUNTERS.Description
FieldValueIRS element (for citing)
Total Program Service Expense130360475TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
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
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
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 With1096142NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1289NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
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 Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address1OfficerMailingAddress
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 CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JOHN GREEN CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4064442100TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12475 BROADWAYAddressLine1
CityHELENACity
StateMTState
ZIP Code59601ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
RICK HAYES
CHAIR1.00XX000
MARIA BRAMAN
VICE CHAIR1.00XX000
PATTY NELSON
TREASURER1.00XX000
JOHN FLINK
SECRETARY1.00XX000
JOHN SOLHEIM
PRESIDENT/CEO (THRU APRIL 2012)40.00XX517170034306
WILLIAM NORTHEY
BOARD MEMBER1.00X000
DR THOMAS WEINER
BOARD/CHIEF OF STAFF/PHYSICIAN40.00X1400041020095
CANDACE CAIN
BOARD MEMBER1.00X000
MARK TAYLOR
BOARD MEMBER1.00X000
KATE MCIVOR
BOARD MEMBER1.00X000
TOM STRIZICH
BOARD MEMBER1.00X000
MARY SHEEHY-MOE
BOARD MEMBER1.00X000
SHEILA HOGAN
BOARD MEMBER1.00X000
RYAN SCRENAR
BOARD MEMBER1.00X000
ROGER STONE
BOARD MEMBER1.00X000
TOM GREGG
INTERIM CEO40.00XX206683015052
JOHN GREEN
CFO40.00X241899018160
DR MICHAEL LEE
PHYSICIAN40.00872754012259X
DR JOHN RIBIC
PHYSICIAN40.00500981010468X
DR MATTHEW MCLAREN
PHYSICIAN40.0056374507023X
DR SCOTT PARGOT
PHYSICIAN40.00558426013912X
DR KRIS GODLEWSKI
PHYSICIAN40.00502523012746X
DR DAVID LECHNER
FORMER PRESIDENT40.0012783906207X
FieldValueIRS element (for citing)
Total Reportable Comp From Org5492061TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation150228TotalOtherCompensation
Number Individuals GT100 K79NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HORIZON MENTAL HEALTH MANAGEMENT
PO BOX 840839DALLASTX75284PSYCHIATRIC SERVICES2480186
DICK ANDERSON CONSTRUCTION
3424 HIGHWAY 12 EHELENAMT59601GENERAL CONTRACTOR1204395
CAPITAL MEDICAL ANESTHESIA
PO BOX 5179HELENAMT59601ANESTHESIA SERVICES705000
GE HEALTHCARE
PO BOX 414-SN471MILWAUKEEWI53201BIOMEDICAL SERVICES698460
ARUP LABORATORIES
500 CHIPETA WAYSALT LAKE CITYUT84108LAB TESTING SERVICES661659
FieldValueIRS element (for citing)
Number Of Contractors GT100 K44NumberOfContractorsGT100K
Related Organizations480111RelatedOrganizations
Government Grants98414GovernmentGrants
All Other Contributions15000AllOtherContributions
Total Contributions593525TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE REVENU622110114261203114261203
PHARMACY4461104716300547163005
OTHER SERVICES9000991001603618982382621
CAFETERIA72221063425562395010305
PETE'S PLACE624410321254321254

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column153503TotalRevenueColumn
Related Or Exempt Function Income484961RelatedOrExemptFunctionIncome
Unrelated Business Revenue-331458UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue163534823TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2449465TotalRevenueColumn
Exclusion$2,449,465ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real244059Real
Personal115795Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real239167Real
Personal59154Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real4892Real
Personal56641Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column61533TotalRevenueColumn
Exclusion$61,533ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other771851Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-771851Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-771851TotalRevenueColumn
Exclusion-$771,851ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column165867495TotalRevenueColumn
Related Or Exempt Function Income163473355RelatedOrExemptFunctionIncome
Unrelated Business Revenue61468UnrelatedBusinessRevenue
Exclusion$1,739,147ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total14253Total
Program Services14253ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3572375Total
Program Services1409180ProgramServices
Management And General2163195ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total50997Total
Program Services25499ProgramServices
Management And General25498ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total58563540Total
Program Services48631361ProgramServices
Management And General9692920ManagementAndGeneral
Fundraising239259Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4898410Total
Program Services3758205ProgramServices
Management And General1132695ManagementAndGeneral
Fundraising7510Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6346581Total
Program Services4925012ProgramServices
Management And General1409038ManagementAndGeneral
Fundraising12531Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3881995Total
Program Services2965366ProgramServices
Management And General900226ManagementAndGeneral
Fundraising16403Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total673580Total
Program Services69445ProgramServices
Management And General604135ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total70169Total
Management And General70169ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total48104Total
Management And General48104ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total402592Total
Management And General402592ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total12819184Total
Program Services9332451ProgramServices
Management And General3479535ManagementAndGeneral
Fundraising7198Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total341147Total
Program Services81478ProgramServices
Management And General247059ManagementAndGeneral
Fundraising12610Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1358155Total
Program Services611274ProgramServices
Management And General740400ManagementAndGeneral
Fundraising6481Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1267351Total
Program Services314732ProgramServices
Management And General952619ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1964198Total
Program Services347640ProgramServices
Management And General1613790ManagementAndGeneral
Fundraising2768Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total272419Total
Program Services116918ProgramServices
Management And General154628ManagementAndGeneral
Fundraising873Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total269226Total
Program Services114477ProgramServices
Management And General154694ManagementAndGeneral
Fundraising55Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total2014730Total
Management And General2014730ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total9062998Total
Program Services6277440ProgramServices
Management And General2785558ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2101371Total
Program Services2080803ProgramServices
Management And General20568ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES, OTHER40079165392645158117132937
BAD DEBT EXPENSE88163748816374
BED TAX12349001234900
OTHER TAXES-66540-10337836838

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total255277Total
Program Services72530ProgramServices
Management And General182461ManagementAndGeneral
Fundraising286Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total160312551Total
Program Services130360475ProgramServices
Management And General29643165ManagementAndGeneral
Fundraising308911Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY18987821BOY
EOY16135251EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY16266602BOY
EOY22948724EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3544429BOY
EOY3613773EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2546358BOY
EOY2961254EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis171833552LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec74434367LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY98702114BOY
EOY97399185EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY69687326BOY
EOY64567768EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY23688744BOY
EOY24048654EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY439652BOY
EOY417436EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY233863046BOY
EOY232092045EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY14234992BOY
EOY16427015EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY44942031BOY
EOY42231476EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY16321411BOY
EOY24230817EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY75498434BOY
EOY82889308EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY147252230BOY
EOY138230176EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3384821BOY
EOY3217396EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7727561BOY
EOY7755165EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY158364612BOY
EOY149202737EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY233863046BOY
EOY232092045EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses5554944ReconcilationRevenueExpenses
Reconcilation Other Changes-14716819ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members1MailingsMembers
Mailings Members$50MailingsMembersAmount
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$100DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$48,104OtherActivitiesAmount
Total Lobbying Expenditures IIB48254TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationTHE 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.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance10709927BeginningOfYearBalance
Contributions489607Contributions
Investment Earnings Or Losses-542431InvestmentEarningsOrLosses
Other Expenditures58752OtherExpenditures
End Of Year Balance10598351EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance9692852BeginningOfYearBalance
Contributions127911Contributions
Investment Earnings Or Losses1052329InvestmentEarningsOrLosses
Other Expenditures163165OtherExpenditures
End Of Year Balance10709927EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance7514363BeginningOfYearBalance
Contributions1405761Contributions
Investment Earnings Or Losses928225InvestmentEarningsOrLosses
Other Expenditures155497OtherExpenditures
End Of Year Balance9692852EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance9393554BeginningOfYearBalance
Contributions630667Contributions
Investment Earnings Or Losses-2297705InvestmentEarningsOrLosses
Other Expenditures212153OtherExpenditures
End Of Year Balance7514363EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.73170PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.26830TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3745203OtherCostOrOtherBasis
Book Value3745203BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis97116320OtherCostOrOtherBasis
Depreciation24494833Depreciation
Book Value72621487BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis68550910OtherCostOrOtherBasis
Depreciation48678527Depreciation
Book Value19872383BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2421119OtherCostOrOtherBasis
Depreciation1261007Depreciation
Book Value1160112BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings97399185TotalOfBookValueLandBuildings

Other Securities OtherSecurities (3 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INVESTMENT IN JOINT VENTURES6311132F
INTEREST IN ST. PETER'S FOUNDATION10800250F
LTD CLASS INVESTMENTS6937272F
FieldValueIRS element (for citing)
Total Of Book Value Securities24048654TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ESTIMATED THIRD-PARTY SETTLEMENTS$1,922,157
LIABILITY FOR PENSION BENEFITS$22,308,660
FieldValueIRS element (for citing)
Total Of Amounts24230817TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4: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.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE HOSPITAL AND FOUNDATION ARE MONTANA NONPROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOSPITAL AND THE FOUNDATION ARE ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE HOSPITAL IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE HOSPITAL FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. PEAK HEALTH HELENA, LLC IS A LIMITED LIABILITY COMPANY AND IS TREATED AS A CORPORATION FOR FEDERAL AND STATE INCOME TAX PURPOSES. THERE WAS NO TAXABLE INCOME IN 2012 AND 2011. 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 2009.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense8143137TotalCommunityBenefitExpense
Direct Offsetting Revenue3322745DirectOffsettingRevenue
Net Community Benefit Expense4820392NetCommunityBenefitExpense
Percent Of Total Expense0.03180PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense10072705TotalCommunityBenefitExpense
Direct Offsetting Revenue8811460DirectOffsettingRevenue
Net Community Benefit Expense1261245NetCommunityBenefitExpense
Percent Of Total Expense0.00830PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense18215842TotalCommunityBenefitExpense
Direct Offsetting Revenue12134205DirectOffsettingRevenue
Net Community Benefit Expense6081637NetCommunityBenefitExpense
Percent Of Total Expense0.04010PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense737409TotalCommunityBenefitExpense
Direct Offsetting Revenue263958DirectOffsettingRevenue
Net Community Benefit Expense473451NetCommunityBenefitExpense
Percent Of Total Expense0.00310PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense43003TotalCommunityBenefitExpense
Net Community Benefit Expense43003NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense43588010TotalCommunityBenefitExpense
Direct Offsetting Revenue33305659DirectOffsettingRevenue
Net Community Benefit Expense10282351NetCommunityBenefitExpense
Percent Of Total Expense0.06790PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense134441TotalCommunityBenefitExpense
Net Community Benefit Expense134441NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense44502863TotalCommunityBenefitExpense
Direct Offsetting Revenue33569617DirectOffsettingRevenue
Net Community Benefit Expense10933246NetCommunityBenefitExpense
Percent Of Total Expense0.07220PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense62718705TotalCommunityBenefitExpense
Direct Offsetting Revenue45703822DirectOffsettingRevenue
Net Community Benefit Expense17014883NetCommunityBenefitExpense
Percent Of Total Expense0.11230PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense20053TotalCommunityBuildingExpense
Net Community Building Expense20053NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense7933TotalCommunityBuildingExpense
Net Community Building Expense7933NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense27986TotalCommunityBuildingExpense
Net Community Building Expense27986NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$8,816,374BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare38387826AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare45200007CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-6812181MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 HELENA SURGICENTER LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivitySURGERY CENTERDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.50000OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership0.09150OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership0.05290PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST PETER'S HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12475 BROADWAYAddressLine1
CityHELENACity
StateMTState
ZIP Code59601ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
OtherPHYSICIAN CLINICS & URGENT CARE SERVICESOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST PETER'S HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent150.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent250.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
HOSPICE & HOMELINK OF ST PETER'S HOSP
201 SOUTH CALIFORNIAHELENAMT59601HOSPICE AND HOME HEALTH
APEX OF ST PETER'S HOSPITAL
201 SOUTH CALIFORNIAHELENAMT59601HOME OXYGEN SERVICES

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 6A: THE ORGANIZATION'S COMMUNITY BENEFIT REPORT CAN BE FOUND ON ITS WEBSITE AT WWW.STPETES.ORG.
PART I, LINE 7: CHARITY CARE, UNREIMBURSED MEDICAID AND SUBSIDIZED HEALTH SERVICES ARE CONVERTED TO COST USING THE COST TO CHARGE RATIO DERIVED FROM THE HOSPITAL'S COST ALLOCATION SYSTEM. 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. COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION AND CASH AND IN-KIND CONTRIBUTIONS IS DERIVED FROM THE CBISA PROGRAM.
PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDES $6,175,756 OF COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC.
PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR OF THE CALCULATIONS WAS $8,816,374.
PART III, LINE 4: 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.FINANCIAL STATEMENT FOOTNOTE:PATIENT RECEIVABLES ARE UNCOLLATERALIZED PATIENT AND THIRD-PARTY PAYOR OBLIGATIONS. THE ORGANIZATION CHARGES INTEREST AT 10 PERCENT PER ANNUM ON PAST DUE ACCOUNTS AFTER 90 DAYS. PAYMENTS OF PATIENT RECEIVABLES ARE ALLOCATED TO THE SPECIFIC CLAIMS IDENTIFIED ON THE REMITTANCE ADVICE OR, IF UNSPECIFIED, ARE APPLIED TO THE EARLIEST UNPAID CLAIM. THE CARRYING AMOUNT OF PATIENT RECEIVABLES IS REDUCED BY A VALUATION ALLOWANCE THAT REFLECTS MANAGEMENT'S BEST ESTIMATE OF AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS AND THIRD-PARTY PAYORS. MANAGEMENT REVIEWS PATIENT RECEIVABLES BY PAYOR CLASS AND APPLIES PERCENTAGES TO DETERMINE ESTIMATED AMOUNTS THAT WILL NOT BE COLLECTED FROM THIRD PARTIES UNDER CONTRACTUAL AGREEMENTS AND AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS DUE TO BAD DEBTS. MANAGEMENT CONSIDERS HISTORICAL WRITE OFF AND RECOVERY INFORMATION IN DETERMINING THE ESTIMATED BAD DEBT PROVISION.
PART III, LINE 8: THESE EXPENSES REPRESENT AN OVERALL SHORTFALL OF THE DIRECT MEDICARE PATIENT POPULATION. THE COSTS THEMSELVES ARE THEREFORE A COMMUNITY BENEFIT AS THE COMMUNITY WOULD NOT RECEIVE THESE SERVICES IF WE DID NOT PROVIDE THEM. TOTAL MEDICARE REVENUE AND MEDICARE ALLOWABLE COSTS OF CARE ARE CALCULATED USING A COST ALLOCATION METHOD CONSISTENT WITH THE COST REPORT.
PART III, 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.
PART V, SECTION B, LINE 13G: A COPY OF THE FINANCIAL ASSISTANCE POLICY IS INCLUDED ON THE WEBSITE. ADDITIONALLY, A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE FACILITY'S EMERGENCY ROOM AND WAITING ROOMS AND ADMISSIONS OFFICES. THE SUMMARY IS ALSO PROVIDED TO PATIENTS UPON ADMISSION TO THE HOSPITAL FACILITY.ST. PETER'S HOSPITAL
PART V, SECTION B, LINE 19D: CURRENTLY 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 IS WORKING TO UPDATE THEIR POLICY TO ALIGN WITH THE PROPOSED REGULATIONS.ST. PETER'S HOSPITAL
PART V, SECTION B, LINE 20: CURRENTLY UNINSURED PATIENTS ARE GIVEN A 3% DISCOUNT ON THEIR BILL PRIOR TO DETERMINATION OF QUALIFYING FOR PATIENT ASSISTANCE. THE 3% DISCOUNT HAS BEEN ESTABLISHED AS A MEANS TO REDUCE GROSS CHARGES FOR SELF-PAY PATIENTS TO BE CLOSE TO THE AMOUNT CHARGED TO THOSE WITH INSURANCE. 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 IS WORKING TO UPDATE THEIR POLICY TO ALIGN WITH THE PROPOSED REGULATIONS.ST. PETER'S HOSPITAL
PART VI, LINE 2: 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.
PART VI, LINE 3: ST. PETER'S HOSPITAL (1) POSTS ITS CHARITY CARE POLICY ON ITS WEB SITE 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.
PART VI, LINE 4: ST. PETER'S HOSPITAL IS A 122-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 6.8% SELF PAY PATIENTS, 7.8% OF MEDICAID PATIENTS AND 43.4% MEDICARE PATIENTS. APPROXIMATELY 15.6% OF THE POPULATION IS AGE 65 AND OLDER. THE AVERAGE PER CAPITA INCOME IS $27,583 AND APPROXIMATELY 12.1% OF THE POPULATION IS BELOW THE FEDERAL POVERTY LEVEL. THE NEAREST HOSPITAL IN THE AREA IS APPROXIMATELY 35 MILES FROM ST. PETER'S CAMPUS.
PART VI, LINE 5: 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 MADE UP OF LEWIS & CLARK COUNTY AND THE NORTHERN PORTION OF JEFFERSON COUNTY. THERE IS A POPULATION OF APPROXIMATELY 74,800. 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. CONTINUING EDUCATION IS ALSO PROVIDED TO THE MEMBERS OF THE MEDICAL COMMUNITY ON AN ON-GOING BASIS. IN ADDITION, ST. PETER'S HOSPITAL HAD 14,037 VOLUNTEER HOURS FROM THE COMMUNITY ASSISTING IN A VARIETY OF ROLES WITHIN THE ORGANIZATION.ST. PETER'S HOSPITAL MADE $134,441 OF CASH AND IN-KIND DONATIONS TO A VARIETY OF ORGANIZATIONS WITHIN THE COMMUNITY. THIS INCLUDES BUT IS NOT LIMITED TO CR ANDERSON MIDDLE SCHOOL FOR ITS HONOR STUDENT PROGRAM, ANGEL FUND TO PURCHASE CLOTHING AND SCHOOL SUPPLIES FOR YOUTH, HELENA HIGH SCHOOL FOR SOCCER TENT, LEWIS AND CLARK COUNTY FOR CRISIS RESPONSE TEAM, HEALTHY MOTHER'S/HEALTHY BABIES, HOSA, FRIENDSHIP CENTER, FLORENCE CRITTENTON, YMCA, GOD'S LOVE, CARROLL COLLEGE ATHLETICS WITH EMERGENCY SERVICES AT EVENTS, CARROLL COLLEGE NURSING DEPARTMENT WITH MEDICAL SUPPLIES NEEDED FOR LEARNING LABS, EXPLORATION WORKS WITH MEDICAL SUPPLIES NEEDED FOR STUDENT SCIENCE EXPERIMENTS, 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, ARCHIE BRAY FOUNDATION, HELENA FOOD SHARE PROGRAM FOR BACK PACK PROGRAM IN THE SCHOOLS AND BIG BROTHERS AND SISTERS. THE DONATIONS WERE MADE TO ASSIST THESE COMMUNITY SPONSORS IN THEIR VARIOUS PROGRAMS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantEDUCATION ASSISTANCETypeOfGrant
Number Of Recipients13NumberOfRecipients
Amount Of Cash Grant14253AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: AS DETERMINED BY THE PUBLIC RELATIONS DIRECTOR AND THE CEO, THE ORGANIZATION FINANCIALLY SUPPORTS COMMUNITY INDIVIDUALS PURSUING EDUCATION PROGRAMS THAT ENRICH HEALTH AND SAFETY TO THE COMMUNITY. DUE TO KNOWLEDGE OF THE RECIPIENTS AND THE PURPOSE OF THE GRANTS, FURTHER MONITORING ON THE USE OF THE FUNDS WAS NOT DEEMED NECESSARY.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Discretionary Spending AccountXDiscretionarySpendingAccount
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
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 (10 entries)

Base 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
JOHN SOLHEIM
36875401301410182750147000223920554262000
DR THOMAS WEINER
139819400018470132870680901420137000
TOM GREGG
1607690366140930007057083120222052000
JOHN GREEN
18582104559801048009581085790260059000
DR MICHAEL LEE
87192000083408175040840885013000
DR JOHN RIBIC
499001000198008175022930511449000
DR MATTHEW MCLAREN
563745000000070230570768000
DR SCOTT PARGOT
5584260000010023038890572338000
DR KRIS GODLEWSKI
50157200095107350053960515269000
DR DAVID LECHNER
12149306000034600062070134046000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1APRESIDENT/CEO RECEIVES REIMBURSEMENT FOR MEMBERSHIP DUES PAID TO A SOCIAL CLUB, AN ANNUAL COMMUNITY SUPPORT ALLOWANCE AND A CAR ALLOWANCE. THE PRESIDENT/CEO IS TAXED ON THE PERSONAL MILEAGE THAT HE USES. THE PRESIDENT/CEO IS PROVIDED TRAVEL FOR COMPANIONS FOR BUSINESS FUNCTIONS. ALL AMOUNTS ARE REPORTED AS TAXABLE COMPENSATION.
PART I, LINE 4BJOHN SOLHEIM, TOM WEINER, AND KRIS GODLEWSKI PARTICIPATE IN A NONQUALIFIED RETIREMENT PLAN UNDER 457(F). AMOUNTS FROM THEIR BASE WAGES WERE DEFERRED INTO THEIR PLAN AT THEIR DISCRETION. THE ORGANIZATION DID NOT CONTRIBUTE MONEY INTO THE PLAN ON BEHALF OF THE INDIVIDUALS NAMED ABOVE.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MONTANA FACILITY FINANCE AUTHORITY
81030240261204JBR42004-05-0629748183TO FUND EXPANSION AND RENOVATION OF EXISTING HOSPITAL FACILITY.000
MONTANA FACILITY FINANCE AUTHORITY
81030240261204JBY92007-03-2222826511FUND MED OFFICE BLDG & WOMEN & CHILDREN'S BED WING & REFUND BONDS 1/23/97000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Amount RetiredAmountRetiredTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindRefunding EscrowRefundingEscrowOther Spent ProceedsOtherSpentProceeds
502500029748183224231629735824223462711192520080011
7100000228265112509328465447353863147436082009101171546097154609

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00000.000000.000000.000001
00000.000000.045000.045001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
000000
000000

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSCHEDULE K, PART II, LINE 11(B):Identifier
ExplanationTHE AMOUNT REPORTED AS OTHER SPENT PROCEEDS WAS USED TO REFUND A PRIOR BOND ISSUE.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NEW PROGRAM SERVICESFORM 990, PART III, LINE 2IN 2012 WE PURCHASED AN O-ARM DIGITAL IMAGING SYSTEM FOR THE OPERATING ROOM ALLOWING FOR GREATER DETAIL IN THE IMAGES DURING SURGERY AND REDUCING THE LENGTH OF SURGERY IN INTENSIVE SPINE CASES. ST. PETER'S MEDICAL GROUP RECRUITED AN ADDITIONAL SURGEON, NEPHROLOGIST AND MEDICAL ONCOLOGIST TO THE COMMUNITY EXPANDING THE AVAILABILITY OF APPOINTMENTS WITHIN THE COMMUNITY. IN 2011 WE RECRUITED TWO ORTHOPEDIC SURGEONS TO THE COMMUNITY. IN 2012 THESE INDIVIDUALS APPROACHED ST. PETER'S HOSPITAL TO JOIN ST. PETER'S MEDICAL GROUP AND BECAME EMPLOYED PHYSICIANS.
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD OF DIRECTORS, PAST CHAIR OF THE BOARD PROVIDED HE/SHE CONTINUES TO BE A DIRECTOR, AND THE CHIEF OF STAFF. IF THE PAST CHAIR OF THE BOARD IS UNABLE TO SERVE, THE BOARD CHAIR MAY APPOINT ANOTHER MEMBER TO THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT ANY ACTION DOES NOT CONFLICT WITH THE POLICIES OF THE BOARD OF DIRECTORS AND ALL MATTERS OF MAJOR IMPORTANCE ARE REFERRED TO THE BOARD OF DIRECTORS. SHOULD ANY MATTER OF EXTREME URGENCY ARISE BETWEEN THE REGULAR MEETINGS OF THE BOARD OF DIRECTORS, IT IS THE DUTY OF THE EXECUTIVE COMMITTEE TO REQUEST THE PRESIDENT CALL A SPECIAL MEETING OF THE BOARD OF DIRECTORS. MINUTES OF THE EXECUTIVE COMMITTEE ARE SUBMITTED TO THE BOARD OF DIRECTORS AND ITS ACTIONS ARE SUBJECT TO APPROVAL OR DISAPPROVAL AT THE NEXT REGULAR BOARD MEETING. THE COMMITTEE IS RESPONSIBLE FOR CONDUCTING THE PRESIDENT'S EVALUATION, SETTING THE PRESIDENT'S COMPENSATION AND NEGOTIATING THE TERMS OF THE PRESIDENT'S EMPLOYMENT CONTRACT.
FORM 990, PART VI, SECTION A, LINE 7ATHE NOMINATING COMMITTEE SOLICITS QUALIFIED CANDIDATES FOR MEMBERSHIP ON THE BOARD OF DIRECTORS AND PRESENTS A SLATE TO THE BOARD OF DIRECTORS WITH ONE CANDIDATE FOR EACH POSITION TO BE FILLED. MEMBERS OF THE BOARD OF DIRECTORS MAY SUBMIT THE NAMES OF POTENTIAL CANDIDATES TO THE NOMINATING COMMITTEE FOR THE COMMITTEE'S CONSIDERATION. THE NOMINATING COMMITTEE'S SLATE OF POTENTIAL CANDIDATES IS SUBMITTED TO THE BOARD AT THE BOARD OF DIRECTOR'S ANNUAL MEETING. FIVE MEMBERS OF THE BOARD OF DIRECTORS SERVE BY VIRTUE OF THE OFFICES AND FOR THE DURATION OF THE TIME THEY REMAIN IN OFFICE; THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE HOSPITAL, THE CHIEF-OF-STAFF OF THE HOSPITAL, THE CHIEF-OF-STAFF ELECT OF THE HOSPITAL, THE ST. PETER MEDICAL GROUP PRESIDENT, AND THE ST. PETER'S FOUNDATION CHAIR.
FORM 990, PART VI, SECTION B, LINE 11A ROUGH 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 12CTHE 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 15AN 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 OFFICER AND SENIOR MANAGEMENT COMPENSATION. THE INFORMATION IS THEN REVIEWED WITH THE BOARD OF DIRECTORS. THE ANNUAL PROCESS WAS PERFORMED DURING 2012.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VII:PERCENTAGE OF TIME SPENT BETWEEN RELATED ORGANIZATIONS: JOHN SOLHEIM, HOSPITAL AND FOUNDATION CEO, SPENDS 98% OF HIS TIME ON HOSPITAL BUSINESS AND 2% OF HIS TIME ON FOUNDATION BUSINESS. TOM GREGG, HOSPITAL AND FOUNDATION CEO, SPENDS 98% OF HIS TIME ON HOSPITAL BUSINESS AND 2% OF HIS TIME ON FOUNDATION BUSINESS.
CHANGES IN NET ASSETS OR FUND BALANCES:FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -6,210,353. MINIMUM PENSION LIABILITY ADJUSTMENT -8,542,940. CHANGE IN PERMANENTLY AND TEMPORARILY RESTRICTED NET ASSETS OF FOUNDATION -139,821. BOOK/TAX ADJUSTMENT FOR PARTNERSHIPS 176,295. TOTAL TO FORM 990, PART XI, LINE 5: -14,716,819.
FORM 990, PART VI, SECTION A, LINE 9:JOHN SOLHEIM PO BOX 238 DEERWOOD MN 56444
LISTING OF ALL CUSIP#'S ASSOCIATED WITH BOND ISSUANCESCHEDULE K, PART I, BOND A, CUSIP#'S FOR SERIES 2004 BOND61204J BR4, 61204J AX2, 61204J AY0, 61204J AZ7, 61204J BA1, 61204J BB9, 61204J BC7, 61204J BD5, 61204J BE3, 61204J BF0, 61204J BG8, 61204J BH6, 612047J BL7
LISTING OF ALL CUSIP#'S ASSOCIATED WITH BOND ISSUANCESCHEDULE K, PART I, BOND A, CUSIP#'S FOR SERIES 2007 BOND61204J BY9, 61204J BS2, 61204J BTO, 61204J BU7, 61204J BV5, 61204J BW3
FORM 8621, PART IV:ST. PETER'S HOSPITAL IS FILING FORM 8621 AS A SHAREHOLDER IN PASSIVE FOREIGN INVESTMENT COMPANIES. ST. PETER'S HOSPITAL DISTRIBUTION IS NOT TAXABLE AND THEREFORE NOT INCLUDED ON PART IV OF FORM 8621. THE AMOUNT OF NON-TAXABLE DISTRIBUTION FROM EACH FUND IS IDENTIFIED BELOW. BR PROPERTIES S.A. $4 PSAM GLOBAL EVENT UCITS FUND $2

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1ST PETER'S HOSPITAL FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12475 BROADWAYAddressLine1
CityHELENACity
StateMTState
ZIP Code59601ZIPCode
FieldValueIRS element (for citing)
EIN810392270EIN
Primary ActivitiesRAISE FUNDS TO SUPPORT ST. PETER'S HOSPITALPrimaryActivities
Legal Domicile StateMTLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity StatusLINE 11A, IPublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1ST PETER'S HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Controlled Org1ControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
PEAK HEALTH LLC
2475 BROADWAY AVENUEHELENAMT59601271863807HEALTH CLUBMTN/AUNRELATED45681993685000.65000
PEAK HEALTH REALTY LLC
2475 BROADWAY AVENUEHELENAMT59601272492966RENTAL PROPERTYMTN/AUNRELATED-122552-60115000.65000
PEAK HEALTH HELENA LLC
2475 BROADWAY AVENUEHELENAMT59601271863807HEALTH CLUBMTN/AUNRELATED-302004-318046000.65000
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 Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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 Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
ST PETER'S HOSPITAL FOUNDATION
C480111FMV
ST PETER'S HOSPITAL FOUNDATION
N275703COST
PEAK HEALTH LLC
N181146COST