2013-05-15T09:43:33-05:00 2012-12-31 910189318 MOSS ADAMS LLP 805 SW BROADWAY 1200 PORTLAND OR 97205 990 2012-01-01 810431871 BENEFIS SPECTRUM MEDICAL INC BENE 4067279322 1101 26TH STREET SOUTH GREAT FALLS MT 59405 THERESA PREITE 4067279322 2013-05-10 WENDY CAMPOS P00448102 5032421447 2012 2016-02-24 21:20:13Z THERESA PREITE 1101 26TH STREET SOUTH GREAT FALLS MT 59405 15183853 0 X N/A X 1985 MT HOME HEALTH SERVICES AND RELATED PRODUCTS. 5 2 230 7 0 0 0 12461 8293565 11388950 0 0 2017595 2340577 10311160 13741988 0 0 0 0 8068208 9712963 0 0 0 1967587 2356366 10035795 12069329 275365 1672659 9044014 9748243 2859304 1892649 6184710 7855594 X WE PROVIDE EXCELLENT CARE FOR ALL, HEALING BODY, MIND AND SPIRIT. TO PROVIDE HOME HEALTH SERVICES AND PRODUCTS IN COLLABORATION WITH BENEFIS HEALTH SYSTEM, INC., BENEFIS HOSPITALS, INC. AND BENEFIS MEDICAL GROUP, INC. AS PART OF A COLLECTIVE EFFORT TO MEET THE HEALTHCARE NEEDS OF RESIDENTS OF NORTH CENTRAL MONTANA. 0 0 3485840 4167265 PROVIDING HOME AND COMMUNITY BASED SERVICES IN TEN COUNTIES FOR THE ELDERLY, PHYSICALLY DISABLED AND THOSE WITH MENTAL ILLNESS. SERVICES ARE DESIGNED TO PROMOTE INDEPENDENCE, CONSUMER CHOICE AND PARTICIPATION IN THE DELIVERY OF HEALTH CARE IN THE HOME ENVIRONMENT. 3126120 3838878 PROVIDING OXYGEN THERAPY AND ASSOCIATED DURABLE MEDICAL EQUIPMENT PRODUCTS TO PATIENTS IN THE SURROUNDING AREA. 2324722 2961453 PROVIDING LICENSED HOME HEALTH SERVICES TO PATIENTS IN A SIX COUNTY AREA. 1661767 2528267 1661767 2528267 10598449 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 56 0 1 230 1 0 0 0 0 0 0 0 0 0 0 X 5 2 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X DALE BIMLER 4064552565 500 15TH AVENUE SOUTH GREAT FALLS MT 59405 DAVE RICHARDS 2.00 4.00 X X 0 0 0 STEVE BALLOCK 2.00 58.00 X 0 237494 22114 BARRY COHAN MD 2.00 48.00 X 0 247071 6897 BILL MACFADDEN 2.00 X 0 0 0 JAY POTTENGER 2.00 0.00 X 0 122200 8015 WAYNE DUNN 2.00 58.00 X 0 95990 2305 THERESA PREITE 49.00 1.00 X X 0 155725 15162 0 858480 54493 0 0 1 0 JP MORGAN 24819 NETWORK PL CHICAGO IL 60673 COMMERCIAL CARD AND ORDER-TO-PAY SERVICE 106380 1 12461 12461 PATIENT REVENUE 621610 11388950 11388950 11388950 233664 0 233664 233664 233664 3388658 1441865 1946793 1946793 INV. IN SPECTRUM HOME 621610 160120 160120 160120 13741988 13495863 0 233664 8168648 7730056 438592 229390 204368 25022 750986 710664 40322 563939 513626 50313 722821 722821 200901 179752 21149 17176 15907 1269 430244 380440 49804 5010 4520 490 179415 171691 7724 167391 159232 8159 21943 21943 240596 148822 91774 5473 4950 523 OTHER EXPENSES 157925 153738 4187 SUPPLIES 92547 86879 5668 REPAIRS AND MAINTENANCE 69415 66352 3063 BAD DEBT EXPENSE 45509 45509 12069329 10598449 1470880 0 -19866 -58614 3890035 4694415 420078 466712 212750 91231 5934449 1681486 4245815 4252963 295202 301536 9044014 9748243 2431302 1830706 428002 61943 2859304 1892649 X 6184710 7855594 6184710 7855594 9044014 9748243 X 1672659 -735 -1040 X X 0 1 X 1 0 X 12461 12461 10293623 11761574 13337148 11028187 14777608 61198140 10293623 11761574 13337148 11028187 14790069 61210601 0 0 0 61210601 58352 41096 24270 151726 233664 509108 188937 37905 35624 262466 247289 79001 59894 151726 233664 771574 92150 322368 75444 270800 160120 920882 10633062 12162943 13472486 11450713 15183853 62903057 0.97310 0.97150 0.01230 0.01310 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2458038 240161 2217877 1754219 207807 1546412 1722192 1233518 488674 4252963 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. EFFECTIVE JANUARY 1, 2009, THE ORGANIZATION ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2012 OR 2011. X X X X 0 1 0 0 0 0 0 1 0 STEVE BALLOCK 0 179654 0 33600 0 24240 0 17063 0 5051 0 259608 0 0 BARRY COHAN MD 0 226383 0 20000 0 688 0 0 0 6897 0 253968 0 0 THERESA PREITE 0 134617 0 17508 0 3600 0 8600 0 6562 0 170887 0 0 PART I, LINE 4B THE ORGANIZATION PROVIDES A SECTION 457 NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EMPLOYEES. PART I, LINE 7 BENEFIS HEALTH SYSTEM, INC. AND ITS AFFILIATES (INCLUDING THE ORGANIZATION) MAINTAIN AN INCENTIVE COMPENSATION PLAN THAT INCORPORATES BOTH SHARED AND INDIVIDUAL GOALS FOR MEMBERS OF THE EXECUTIVE AND MANAGEMENT LEADERSHIP TEAM (INCLUDING MR. BALLOCK AND MS. PREITE) AND IS SUBJECT TO A PRECONDITION THAT THE SYSTEM MUST ACHIEVE BUDGETED OPERATING PERFORMANCE. IN 2010, THE SYSTEM ADOPTED SHARED PERFORMANCE OBJECTIVES INCLUDING SYSTEM GROWTH AS WELL AS MEASURES TIED TO WORKFORCE, PATIENT EXPERIENCE, PATIENT SAFETY, CLINICAL QUALITY, FINANCE/OPERATIONS, AND COMMUNITY BENEFIT. THE INDIVIDUAL PERFORMANCE OBJECTIVES ADOPTED IN 2010 ARE BASED ON AN ARRAY OF QUALITY, FINANCIAL, OPERATIONAL AND STRATEGIC INITIATIVES. INCENTIVE OPPORTUNITY LEVELS ARE CALCULATED BASED ON PREDETERMINED PERCENTAGES OF EACH EXECUTIVE'S BASE SALARY, AND VARY BASED ON THE ACHIEVEMENT OF THRESHOLD, TARGET OR STRETCH LEVELS AS TO EACH PERFORMANCE OBJECTIVE. THE SYSTEM ALSO MAINTAINS A LONG-TERM INCENTIVE PLAN DIRECTED AT RECRUITING AND RETAINING EXECUTIVE LEADERSHIP. PAYMENTS UNDER THE LONG-TERM PLAN ARE CONDITIONED ON AN EXECUTIVE REMAINING EMPLOYED BY THE SYSTEM AND MAINTAINING SATISFACTORY INDIVIDUAL PERFORMANCE. IN ADDITION, THE SYSTEM MUST HAVE MAINTAINED SATISFACTORY OVERALL PERFORMANCE, BASED ON BOTH FINANCIAL CRITERIA AND SATISFACTION OF EMPLOYEES, PATIENTS AND PHYSICIANS. INCENTIVE OPPORTUNITIES UNDER THE LONG-TERM PLAN ARE APPROVED IN ADVANCE BY THE BENEFIS HEALTH SYSTEM, INC. COMPENSATION COMMITTEE, WITH LATER PAYOUTS APPROVED BY THE COMMITTEE BASED ON ACTUAL PERFORMANCE RESULTS. FORM 990, PART VI, SECTION A, LINE 2 CERTAIN OF THE OFFICERS AND DIRECTORS LISTED IN PART VII ALSO HOLD OFFICER AND/OR DIRECTOR POSITIONS IN RELATION TO THE ORGANIZATION'S AFFILIATES (AS IDENTIFIED IN SCHEDULE R) AND, IN THAT REGARD, MAY BE CONSIDERED TO HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER. FORM 990, PART VI, SECTION A, LINE 3 PURSUANT TO A CONTRACTUAL ARRANGEMENT, THE ORGANIZATION OBTAINS CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES FROM ITS PARENT ENTITY, BENEFIS HEALTH SYSTEM, INC. (BHS). BHS PROVIDES THESE SERVICES TO ITS SUBSIDIARY TAX-EXEMPT OPERATING ENTITIES ON A CENTRALIZED BASIS. THE SERVICES INCLUDE THE FOLLOWING: - MANAGEMENT OF HUMAN RESOURCES INCLUDING POLICIES AND PRACTICES - MANAGEMENT, PLANNING, BUDGETING AND REPORTING OF FINANCIAL OPERATIONS - INFORMATION SYSTEMS COORDINATION - OVERSEES QUALITY STANDARDS, COMPLIANCE AND RISK MANAGEMENT - MANAGES REGIONAL, COMMUNITY AND GOVERNMENT RELATIONS AND MARKETING - MANAGEMENT OF GRANTS DEVELOPMENT THE BOARD OF DIRECTORS OF BHS ALSO OVERSEES ALL OF THE ORGANIZATION'S BOARD ACTIVITIES. THE FOLLOWING PERSONS LISTED IN PART VII WERE COMPENSATED BY BHS: STEVE BALLOCK - $237,494 (COMPENSATION FOR SERVICES AS OFFICER OF BHS) JAY POTTENGER - $122,200 (COMPENSATION FOR EMPLOYMENT SERVICES WITH AN UNRELATED ORGANIZATION TO SMI FOR WHICH BHS ALSO PROVIDES MANAGEMENT SERVICES) TERESA PREITE - $155,725 WAYNE DUNN - $95,990 (COMPENSATION FOR SERVICES AS OFFICER OF BHS) FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS BENEFIS HEALTH SYSTEM, INC., A MONTANA NON-PROFIT PUBLIC BENEFIT CORPORATION THAT HAS BEEN RECOGNIZED BY THE IRS AS DESCRIBED IN IRC SECTION 501(C)(3). FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, BENEFIS HEALTH SYSTEM, INC. (ACTING THROUGH ITS OWN GOVERNING BODY) ELECTS THE BOARD OF DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, BENEFIS HEALTH SYSTEM, INC. RETAINS CERTAIN RESERVED POWERS WITH RESPECT TO THE ORGANIZATION, INCLUDING AUTHORITY OVER MATTERS SUCH AS (WITHOUT LIMITATION) THE ORGANIZATION'S MISSION AND VISION STATEMENTS, STRATEGIC AND LONG-TERM PLANS, ELECTION OF ITS DIRECTORS AND OFFICERS, ANNUAL CAPITAL AND OPERATING BUDGETS, CHARITY CARE AND COMMUNITY BENEFIT POLICIES, AND ANY AMENDMENTS TO ITS ARTICLES OF INCORPORATION AND BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 THIS FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT PERSONNEL OF BENEFIS HEALTH SYSTEM, INC. IN COLLABORATION WITH ITS ACCOUNTING FIRM. PRIOR TO FILING, A COPY OF THIS FORM 990 WAS DISTRIBUTED TO ALL MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS, WITH A PRESENTATION TO SUCH BOARD BY THE ACCOUNTING FIRM. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ANNUALLY COMPLETE A FORM TO DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. IN ADDITION, AT THE START OF EACH BOARD MEETING, MEMBERS ARE ASKED TO INDICATE WHETHER THEY HAVE A CONFLICT OF INTEREST WITH RESPECT TO ANY ITEMS ON THE AGENDA FOR THE MEETING. CONSISTENT WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY, BOARD MEMBERS ARE PROHIBITED FROM PARTICIPATING ON ANY MATTERS AS TO WHICH THEY HAVE A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE PRESIDENT WAS SET BY THE INDEPENDENT COMPENSATION COMMITTEE OF BENEFIS HEALTH SYSTEM, INC., WHICH IS CHARGED WITH ADMINISTERING THE SYSTEM'S EXECUTIVE COMPENSATION PHILOSOPHY, POLICIES AND PROGRAMS IN THE MANNER SET FORTH IN THE COMMITTEE'S WRITTEN CHARTER. THE COMMITTEE'S RESPONSIBILITIES INCLUDE (I) DETERMINING APPROPRIATE COMPENSATION FOR ALL EXECUTIVES AND OTHER KEY EMPLOYEES, (II) EVALUATING AND ADOPTING EXECUTIVE COMPENSATION PLANS, POLICIES AND PROGRAMS, (III) REVIEWING AND APPROVING EXECUTIVE BENEFIT PLANS, AND (IV) VERIFYING THAT COMPENSATION IS APPROPRIATELY AND FULLY DISCLOSED AND REPORTED. THE COMMITTEE HAS ENGAGED AN INDEPENDENT COMPENSATION CONSULTING FIRM TO ASSIST IN ENSURING THAT AMOUNTS PAID TO THE SYSTEM'S EXECUTIVES ARE CONSISTENT WITH REASONABLE, FAIR MARKET LEVELS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. THE COMPENSATION OF THE ORGANIZATION'S OTHER OFFICERS, KEY EMPLOYEES AND MANAGERS WAS SET BY THEIR RESPECTIVE SUPERVISORY EXECUTIVES IN CONSULTATION WITH BENEFIS HEALTH SYSTEM, INC.'S HUMAN RESOURCES DEPARTMENT AND EXECUTIVE LEADERSHIP, BASED ON A REVIEW OF INDEPENDENT DATA AS TO AMOUNTS PAID BY SIMILARLY-SITUATED ORGANIZATIONS FOR PERSONS PERFORMING COMPARABLE SERVICES. FORM 990, PART VI, SECTION C, LINE 19 BENEFIS SPECTRUM MEDICAL, INC. PROVIDES COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, FINANCIALS STATEMENTS, AND FORM 990 TO THE PUBLIC UPON REQUEST DURING NORMAL BUSINESS HOURS. FORM 990, PART VI, SECTION A, LINE 1B: THE ORGANIZATION IS AN AFFILIATE OF BENEFIS HEALTH SYSTEM, INC. (BHS), A TAX EXEMPT MONTANA NONPROFIT CORPORATION SERVING AS THE PARENT ENTITY OF AN INTEGRATED SYSTEM OF PROVIDER ORGANIZATIONS ADDRESSING THE HEALTH NEEDS OF PERSONS THROUGHOUT NORTH CENTRAL MONTANA. AS THE CORPORATE MEMBER OF THE ORGANIZATION, BHS HOLDS VARIOUS RESERVED POWER IN RELATION TO THE ORGANIZATION, INCLUDING THE AUTHORITY TO ELECT ITS BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OF THE ORGANIZATION INCLUDES CERTAIN INDIVIDUALS WHO ARE EMPLOYED BY THE ORGANIZATION OR ITS AFFILIATES, AND WHO MAY NOT BE CONSIDERED "INDEPENDENT" FOR PURPOSES OF FORM 990. HOWEVER, AS ACKNOWLEDGED BY THE IRS IN ITS "CPE TEXT FOR FISCAL YEAR 1997", IN A MULTI-ENTITY HOSPITAL SYSTEM, THE BOARD OF A SUBSIDIARY NON-PROFIT HEALTH CARE ORGANIZATION IS CONSIDERED TO BE COMPRISED OF INDEPENDENT COMMUNITY MEMBERS IF IT IS CONTROLLED BY AN EXEMPT ORGANIZATION WHOSE OWN BOARD IS COMPRISED OF A MAJORITY OF VOTING MEMBERS WHO ARE INDEPENDENT COMMUNITY MEMBERS. THE ORGANIZATION MEETS THIS STANDARD BECAUSE IT IS A CONTROLLED SUBSIDIARY OF BHS, AND BHS'S OWN GOVERNING BOARD INCLUDES INDEPENDENT COMMUNITY MEMBERS AS A MAJORITY THEREOF. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: TAX VS. BOOK INCOME FROM SPECTRUM HOME SOLUTIONS K-1 -1,040. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S FINANCIAL RESULTS ARE REPORTED AS PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF BENEFIS HEALTH SYSTEM, INC. AND AFFILIATES. THE AUDIT COMMITTEE OF BENEFIS HEALTH SYSTEM, INC. IS RESPONSIBLE FOR SELECTION OF THE INDEPENDENT AUDIT FIRM AND OVERSEEING THE AUDIT. 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