CABINET PEAKS MEDICAL CENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- CABINET PEAKS MEDICAL CENTER (EIN 81-0241755)
- Tax period
- 2011-04-01 to 2012-03-31
- Filed
- 2013-02-15
- IRS object ID
- 201340469349301669
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-02-15T11:39:23-06:00 | Timestamp |
| Tax Period End Date | 2012-03-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450250958 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 NICOLLET MALL STE 1300 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 554027033 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-04-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810241755 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST JOHN'S LUTHERAN HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STJO | NameControl |
| Phone | 4062837000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 350 LOUISIANA AVENUE | AddressLine1 |
| City | LIBBY | City |
| State | MT | State |
| ZIP Code | 59923 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRUCE WHITFIELD | Name |
| Title | CEO | Title |
| Phone | 4062837000 | Phone |
| Date Signed | 2013-02-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KIM C HUNWARDSEN | Name |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | Phone |
| Date Prepared | 2013-02-13 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BRUCE WHITFIELD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 350 LOUISIANA AVENUE | AddressLine1 |
| City | LIBBY | City |
| State | MT | State |
| ZIP Code | 59923 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 29153818 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SJLH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1952 | YearFormation |
| State Legal Domicile | MT | StateLegalDomicile |
| Activity Or Mission Description | HEALTHCARE SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 296 | TotalNbrEmployees |
| Total Nbr Volunteers | 61 | TotalNbrVolunteers |
| Total Gross UBI | 41729 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 387427 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 653219 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 26369502 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 28124276 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 79402 | InvestmentIncomePriorYear |
| Investment Income Current Year | 219827 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 65479 | OtherRevenuePriorYear |
| Other Revenue Current Year | 59815 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 26901810 | TotalRevenuePriorYear |
| Total Revenue Current Year | 29057137 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 10559 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 6990 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 15608257 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 16380605 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 214661 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 10673222 | OtherExpensePriorYear |
| Other Expenses Current Year | 11789935 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 26292038 | TotalExpensesPriorYear |
| Total Expenses Current Year | 28177530 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 609772 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 879607 | RevenuesLessExpensesCY |
| Total Assets BOY | 23988097 | TotalAssetsBOY |
| Total Assets EOY | 24457269 | TotalAssetsEOY |
| Total Liabilities BOY | 5067169 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4470720 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 18920928 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 19986549 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE EXCELLENT HEALTH CARE CLOSE TO HOME BY BEING A GREAT PLACE FOR EMPLOYEES TO WORK, PHYSICIANS TO PRACTICE MEDICINE, AND PATIENTS TO RECEIVE CARE. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 22160808 | Expense |
| Grants | 6990 | Grants |
| Revenue | 28124276 | Revenue |
| Description | IN FISCAL YEAR 2012, ST. JOHN'S HOSPITAL PROVIDED SERVICE TO NEARLY 9,600 PATIENTS, MANY OF WHOM ARE UNINSURED/UNDERINSURED AND DO NOT HAVE AN ESTABLISHED PATIENT RELATIONSHIP WITH LOCAL PROVIDERS. THE TOTAL NUMBER OF ADJUSTED PATIENT DAYS AMOUNTED TO 12,442 FOR FISCAL YEAR 2012. THE PROGRAM SERVICES RANGE ANYWHERE FROM ROUTINE INPATIENT SERVICES TO HOME HEALTH TO CARDIAC REHAB, JUST TO NAME A FEW. ALL THESE SERVICES ARE PROVIDED TO A COMMUNITY THAT IS REMOTE IN LOCATION AND OFTEN CONSIDERED UNINSURED OR UNDERINSURED. IN ADDITION, SOME OF THE MAJOR PROGRAMS OFFERED BY THE HOSPITAL INCLUDE EMERGENCY SERVICES, SURGERY, AND PHYSICAL THERAPY. AS A SMALL CRITICAL ACCESS HOSPITAL MORE THAN 90 MILES AWAY FROM THE NEAREST EMERGENCY SERVICES, ST. JOHN'S LUTHERAN HOSPITAL RECOGNIZES THE NEED FOR AROUND THE CLOCK SERVICE AS IT RELATES TO EMERGENCY CARE. THAT IS WHY ST. JOHN'S OPERATES A 24/7 ER DEPARTMENT. DUE TO THE REMOTE LOCATION OF LINCOLN COUNTY, SURGERY IS A VERY IMPORTANT SERVICE FOR THE RESIDENTS OF LINCOLN COUNTY. IT IS NOT PRACTICAL OR ECONOMICAL TO EXPECT THAT PATIENTS MAKE THE 90-MILE TRIP TO KALISPELL FOR THIS SERVICE. THIS IS WHY ST. JOHN'S IS COMMITTED TO PROVIDING SURGICAL SERVICE FOR GENERAL, ORTHOPEDIC, OB/GYN, AND UROLOGY. NEARLY 1,100 SURGERIES WERE PERFORMED AS A RESULT OF THIS SERVICE.PHYSICAL THERAPY SERVICES OFFERED TO RESIDENTS OF LINCOLN COUNTY ENABLE PATIENTS TO RECEIVE SERVICE CLOSE TO HOME WHEN THEY ARE ALREADY STRUGGLING WITH PHYSICAL LIMITATIONS. OUR THERAPY STAFF ARE ABLE TO MAXIMIZE THE PATIENT'S LIMITATIONS FOR THERAPY AND ASSURE THAT THEY ARE ON A WELL-DESIGNED PROGRAM OF RECOVERY. OVER 1,900 PATIENTS WERE CARED FOR IN THIS PROGRAM DURING THE FISCAL YEAR 2012. | Description |
| Total Program Service Expense | 22160808 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 1 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 46 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 296 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | GAYL SMITH CONTROLLER | NamePerson |
| Telephone Number | 4062837139 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 350 LOUISIANA AVENUE | AddressLine1 |
| City | LIBBY | City |
| State | MT | State |
| ZIP Code | 59923 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| KATHY NELSON | |||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| JOHN KONZEN | |||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| SARAH DINNING | |||||||
| SECRETARY/TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| RUSS BARNES | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| KERRY BEASLEY | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| STEVE SORENSON OD | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| CHARI LUCAS | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| BOB CASTANEDA | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| JAY MALONEY MD | |||||||
| TRUSTEE | 36.00 | X | 224339 | 0 | 17304 | ||
| JOHN SCHWANTZ | |||||||
| INTERIM CEO (02/2012 - 08/2012) | 40.00 | X | 0 | 0 | 0 | ||
| STEVEN CHAVEZ | |||||||
| CFO | 40.00 | X | 119067 | 0 | 12077 | ||
| BILL PATTEN | |||||||
| CEO (04/2011 - 02/2012) | 40.00 | X | 199050 | 0 | 20371 | ||
| JOSHUA URVATER | |||||||
| PHYSICIAN | 40.00 | 377739 | 0 | 11270 | X | ||
| ANNE CAMBER | |||||||
| PHYSICIAN | 32.00 | 251049 | 0 | 23400 | X | ||
| MARK SERRA | |||||||
| PHYSICIAN | 36.00 | 267557 | 0 | 12096 | X | ||
| BRIAN BARSTAD | |||||||
| PHYSICIAN | 36.00 | 275374 | 0 | 13540 | X | ||
| LOREN CLAUSEN | |||||||
| RN | 40.00 | 160385 | 0 | 11662 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1874560 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 121720 | TotalOtherCompensation |
| Number Individuals GT100 K | 17 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CTA | |||||
| 1185 GROVE STREET | BOISE | ID | 83702 | ARCHITECTURE CONSULTANT | 671580 |
| KALISPELL REGIONAL HOSPITAL | |||||
| 310 SUNNYVIEW LANE | KALISPELL | MT | 59901 | TECHNOLOGY SERVICES | 428428 |
| XTEND HEALTHCARE LLC | |||||
| 500 WEST MAIN STREET SUITE 14 | HENDERSONVILLE | TN | 37075 | PER DIEM BUSINESS OFFICE STAFF | 207840 |
| PAML | |||||
| PO BOX 2720 | SPOKANE | WA | 99220 | LABORATORY SERVICES | 107922 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Related Organizations | 169600 | RelatedOrganizations |
| Government Grants | 65542 | GovernmentGrants |
| All Other Contributions | 418077 | AllOtherContributions |
| Noncash Contributions | 165000 | NoncashContributions |
| Total Contributions | 653219 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT SERVICE RE | 622110 | 27826306 | 27826306 | |
| OTHER REVENUE | 900099 | 192274 | 150545 | 41729 |
| CAFETERIA | 722210 | 98043 | 98043 | |
| AUXILIARY REVENUE | 900099 | 7653 | 7653 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 28124276 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 71084 | TotalRevenueColumn |
| Exclusion | $71,084 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 66660 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 6845 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 59815 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 59815 | TotalRevenueColumn |
| Exclusion | $59,815 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 52471 | Securities |
| Other | 186108 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 35184 | Securities |
| Other | 54652 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 17287 | Securities |
| Other | 131456 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 148743 | TotalRevenueColumn |
| Exclusion | $148,743 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 29057137 | TotalRevenueColumn |
| Related Or Exempt Function Income | 28082547 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 41729 | UnrelatedBusinessRevenue |
| Exclusion | $279,642 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6990 | Total |
| Program Services | 6990 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 342240 | Total |
| Management And General | 342240 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 120126 | Total |
| Program Services | 120126 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12865072 | Total |
| Program Services | 10264267 | ProgramServices |
| Management And General | 2475424 | ManagementAndGeneral |
| Fundraising | 125381 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 454037 | Total |
| Program Services | 364221 | ProgramServices |
| Management And General | 85418 | ManagementAndGeneral |
| Fundraising | 4398 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1693677 | Total |
| Program Services | 1372360 | ProgramServices |
| Management And General | 304938 | ManagementAndGeneral |
| Fundraising | 16379 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 905453 | Total |
| Program Services | 677346 | ProgramServices |
| Management And General | 218809 | ManagementAndGeneral |
| Fundraising | 9298 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 292074 | Total |
| Program Services | 292074 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48645 | Total |
| Management And General | 48645 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46750 | Total |
| Management And General | 46750 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1771800 | Total |
| Program Services | 983711 | ProgramServices |
| Management And General | 779849 | ManagementAndGeneral |
| Fundraising | 8240 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66505 | Total |
| Program Services | 1385 | ProgramServices |
| Management And General | 65120 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 510301 | Total |
| Program Services | 415859 | ProgramServices |
| Management And General | 89399 | ManagementAndGeneral |
| Fundraising | 5043 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 332852 | Total |
| Program Services | 178181 | ProgramServices |
| Management And General | 154671 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 279533 | Total |
| Program Services | 230360 | ProgramServices |
| Management And General | 46362 | ManagementAndGeneral |
| Fundraising | 2811 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27907 | Total |
| Program Services | 20669 | ProgramServices |
| Management And General | 7238 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 130948 | Total |
| Management And General | 130948 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1251399 | Total |
| Program Services | 1251399 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 343564 | Total |
| Management And General | 343564 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| BAD DEBTS | 2530900 | 2530900 | ||
| MEDICAL SUPPLIES | 1960937 | 1952619 | 8318 | |
| REPAIRS AND MAINTENANCE | 1016926 | 724668 | 289871 | 2387 |
| LICENSES AND TAXES | 197690 | 23765 | 173925 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 981204 | Total |
| Program Services | 749908 | ProgramServices |
| Management And General | 190572 | ManagementAndGeneral |
| Fundraising | 40724 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28177530 | Total |
| Program Services | 22160808 | ProgramServices |
| Management And General | 5802061 | ManagementAndGeneral |
| Fundraising | 214661 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 943413 | BOY |
| EOY | 1322522 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5110980 | BOY |
| EOY | 4582442 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4500 | BOY |
| EOY | 4861 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 661432 | BOY |
| EOY | 606414 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 500958 | BOY |
| EOY | 528886 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 21894698 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 12245601 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9590823 | BOY |
| EOY | 9649097 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4760504 | BOY |
| EOY | 4842388 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23396 | BOY |
| EOY | 64482 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2392091 | BOY |
| EOY | 2856177 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23988097 | BOY |
| EOY | 24457269 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3080042 | BOY |
| EOY | 2371747 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33050 | BOY |
| EOY | 58988 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1954077 | BOY |
| EOY | 2039985 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5067169 | BOY |
| EOY | 4470720 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16878060 | BOY |
| EOY | 17749152 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1149377 | BOY |
| EOY | 1343906 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 893491 | BOY |
| EOY | 893491 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18920928 | BOY |
| EOY | 19986549 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23988097 | BOY |
| EOY | 24457269 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 879607 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 186014 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 1 | AgentTrusteeEtc |
| Beginning Balance | 11218 | BeginningBalance |
| Additions During Year | 13146 | AdditionsDuringYear |
| Distributions During Year | 15279 | DistributionsDuringYear |
| Ending Balance | 9085 | EndingBalance |
| Included On FS | 0 | IncludedOnFS |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 372000 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 603017 | OtherCostOrOtherBasis |
| Book Value | 975017 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6819437 | OtherCostOrOtherBasis |
| Depreciation | 3914084 | Depreciation |
| Book Value | 2905353 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10411584 | OtherCostOrOtherBasis |
| Depreciation | 7793986 | Depreciation |
| Book Value | 2617598 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3688660 | OtherCostOrOtherBasis |
| Depreciation | 537531 | Depreciation |
| Book Value | 3151129 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 9649097 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| INTEREST IN NET ASSETS OF FOUNDATION | 2452616 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | 403561 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2856177 | TotalBookValueOtherAssets |
| Total Revenue | 29057137 | TotalRevenue |
| Total Expenses | 28177530 | TotalExpenses |
| Excess Or Deficit For Year | 879607 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 28362 | NetUnrealizedGLOnInvestments |
| Other | $157,652 | OtherAmount |
| Total Adjustments | 186014 | TotalAdjustments |
| Excess Or Deficit Per FS | 1065621 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 29055884 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 11000 | OtherRevenues |
| Revenue Not Rptd F990 | 11000 | RevenueNotRptdF990 |
| Revenue Subtotal | 29044884 | RevenueSubtotal |
| Other Revenues Not Included | 12253 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 12253 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 29057137 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 28174144 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 28174144 | ExpensesSubtotal |
| Other Expenses Not Included | 3386 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 3386 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 28177530 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART IV, LINE 1B: | THE ASSETS OF ST. JOHN'S HOSPITAL AUXILIARY ARE HELD BY ST. JOHN'S LUTHERAN HOSPITAL. THE AUXILIARY ACCOUNT BALANCES WERE NOT INCLUDED IN THE BALANCE SHEET AS THEY ARE NOT RECORDED FOR AUDIT PURPOSES. | |
| PART X: | THE HOSPITAL IS A MONTANA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3). THE HOSPITAL IS 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 ORAGANIZATION FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. THE HOSPITAL 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 HOSPITAL 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 HOSPITAL'S FEDERAL FORM 990T FILINGS ARE NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2009. | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: |
| CHANGE IN UNRESTRICTED INVESTMENT IN NET ASSETS OF FOUNDATION -72,445. CHANGE IN TEMPORARILY RESTRICTED INVESTMENT IN FOUNDATION 227,970. ROUNDING -6. CHANGE IN ST. JOHN'S HOSPITAL AUXILIARY ASSETS 2,133. TOTAL TO SCHEDULE D, PART XI, LINE 8: 157,652. | PART XI, LINE 8 - OTHER ADJUSTMENTS: | |
| DONATION FROM AUXILIARY ELIMINATED FOR TAX RETURN PURPOSES 11,000. | PART XII, LINE 2D - OTHER ADJUSTMENTS: | |
| FUNDRAISING INCOME FROM AUXILIARY 4,600. REVENUE FROM AUXILIARY NOT RECORDED IN AUDITED FINANCIAL STATEMENTS 7,653. | PART XII, LINE 4B - OTHER ADJUSTMENTS: | |
| ST. JOHN'S HOSPITAL AUXILIARY EXPENSES INCLUDED ON FORM 990 3,386. | PART XIII, LINE 4B - OTHER ADJUSTMENTS: |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 532000 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 532000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02070 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2764659 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1989845 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 774814 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03020 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3296659 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1989845 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1306814 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05090 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 18 | NumberOfActivitiesOrPrograms |
| Persons Served | 4139 | PersonsServed |
| Total Community Benefit Expense | 88843 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7060 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 81783 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00320 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 159 | PersonsServed |
| Total Community Benefit Expense | 303 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 303 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 250 | PersonsServed |
| Total Community Benefit Expense | 2804167 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1414299 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1389868 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05420 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 14504 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 500 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 14004 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 23 | NumberOfActivitiesOrPrograms |
| Persons Served | 4548 | PersonsServed |
| Total Community Benefit Expense | 2907817 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1421859 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1485958 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05790 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 23 | NumberOfActivitiesOrPrograms |
| Persons Served | 4548 | PersonsServed |
| Total Community Benefit Expense | 6204476 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3411704 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2792772 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10880 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 3040 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3040 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 871 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 871 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 64675 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 64675 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00250 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 68586 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 68586 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00260 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $2,530,900 | BadDebtExpenseAmount |
| Amount Attributable To | 98000 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 7849158 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 7760550 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 88608 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST JOHN'S LUTHERAN HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 350 LOUISIANA AVE | AddressLine1 |
| City | LIBBY | City |
| State | MT | State |
| ZIP Code | 59923 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | 2 REHAB, 1 OB/GYN, 1 HOME HEALTH,1 HOSPICE | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST JOHN'S LUTHERAN HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 250.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 1 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. UNREIMBURSED MEDICAID ON LINE 7B WAS CALCULATED USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. COMMUNITY HEALTH IMPROVEMENT SERVICES, LINE 7E, AND CASH AND IN-KIND CONTRIBUTIONS, LINE 7I, ARE REPORTED BASED ON THE AMOUNTS COMPILED IN THE CBISA REPORT. THE COST FOR SUBSIDIZED HEALTH SERVICES ON LINE 7G WAS DETERMINED USING THE MEDICARE COST REPORT. TOTAL COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF TOTAL EXPENSE IS 10.88%. | ||
| PART I, LINE 7G: COSTS OF $205,457 TO OPERATE A CLINIC WERE INCLUDED IN SUBSIDIZED HEALTH SERVICES REPORTED ON LINE G. | ||
| PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE BACKED OUT OF TOTAL EXPENSES TO DETERMINE THE PERCENTAGE WAS $2,530,900. | ||
| PART II: ST. JOHN'S LUTHERAN HOSPITAL IS OFFICIALLY DESIGNATED AS A HEALTH PROFESSIONS SHORTAGE AREA. THE COMMUNITY BUILDING WORKFORCE DEVELOPMENT COSTS OF $64,675 INCLUDE RECRUITING EXPENSES AND MOVING EXPENSES FOR THREE PHYSICIANS. | ||
| PART III, LINE 4: THE ORGANIZATION'S BAD DEBT IS REPORTED AS CHARGES INCURRED DURING THE YEAR.BAD DEBT IS THE UNPAID OBLIGATION FOR CARE PROVIDED TO PATIENTS WHO MAY BE UNABLE OR UNWILLING TO PAY OR WHO DO NOT QUALIFY FOR CHARITY CARE. PRIOR TO ANY ACCOUNT BEING CLASSIFIED AS BAD DEBT, ALL PAYMENTS ARE APPLIED INCLUDING CONTRACTUAL ALLOWANCES AND DISCOUNTS FROM MEDICARE, MEDICAID, AND INSURANCE COMPANIES. ACCOUNTS FROM PATIENTS QUALIFYING FOR CHARITY CARE OR THE SHAREPAY SLIDING SCALE FINANCIAL ASSISTANCE PROGRAM ARE NOT WRITTEN OFF TO BAD DEBT. EVERY EFFORT IS MADE WITH THE PATIENT IN AN ATTEMPT TO COLLECT THE OUTSTANDING BALANCE. PAYMENTS ON ACCOUNTS THAT WERE WRITTEN OFF AS BAD DEBT REDUCES BAD DEBT EXPENSE.ST. JOHN'S LUTHERAN HOSPITAL BUDGETS FOR AND MONITORS THE LEVEL OF CHARITY CARE IT PROVIDES, AND DURING FY 2012 THE ORGANIZATION EXCEEDED ITS BUDGETED AMOUNT FOR CHARITY CARE. THE ORGANIZATION STILL PROVIDED FREE OR DISCOUNTED CARE TO PATIENTS WHO WERE ELIGIBLE. THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON AN ESTIMATE OF CHARITY CARE TO GROSS CHARGES.FOOTNOTE TO FINANCIAL STATEMENTS:THE CARRYING AMOUNT OF PATIENT RECEIVABLES IS REDUCED BY A VALUATION ALLOWANCE THAT REFLECTS MANAGEMENT'S ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS AND THIRD-PARTY PAYORS. MANAGEMENT REVIEWS ALL 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: TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. | ||
| PART III, LINE 9B: THERE ARE NO COLLECTION EFFORTS FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR WHO QUALIFY FOR SHAREPAY, A SLIDING SCALE FINANCIAL ASSISTANCE PROGRAM DESIGNED TO MEET THE MEDICAL FINANCIAL OBLIGATIONS OF THE UNINSURED AND UNDERINSURED. | ||
| PART V, SECTION B, LINE 13G: A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS PROVIDED WITH BILLING INVOICES AND IS POSTED IN THE FACILITY'S EMERGENCY ROOM AND WAITING ROOMS. | ST. JOHN'S LUTHERAN HOSPITAL | |
| PART V, SECTION B, LINE 19D: ST. JOHN'S LUTHERAN HOSPITAL, INC. IS IN THE PROCESS OF REVISING THIS POLICY. | ST. JOHN'S LUTHERAN HOSPITAL | |
| PART V, SECTION B, LINE 20: ST. JOHN'S LUTHERAN HOSPITAL, INC. IS IN THE PROCESS OF REVISING THIS POLICY. CURRENTLY THE FINANCIAL ASSISTANCE POLICY IS BEING APPLIED TO GROSS CHARGES. | ST. JOHN'S LUTHERAN HOSPITAL | |
| PART V, SECTION B, LINE 21: ST. JOHN'S LUTHERAN HOSPITAL, INC. IS IN THE PROCESS OF REVISING THIS POLICY. | ST. JOHN'S LUTHERAN HOSPITAL | |
| PART VI, LINE 2: A COMPLETE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED AND COMPLETED DURING THE 2011 FISCAL YEAR BY ST. JOHN'S LUTHERAN HOSPITAL IN COOPERATION WITH THE MONTANA OFFICE OF RURAL HEALTH AND THE NATIONAL RURAL HEALTH RESOURCE CENTER. ALL MAJOR MEDICAL ENTITIES IN THE COMMUNITY WERE INVOLVED WITH THE DEVELOPMENT OF THE SURVEY AND DISTRIBUTION OF THE RESULTS. ST. JOHN'S LUTHERAN HOSPITAL IS CURRENTLY WORKING ON A NEW COMMUNITY HEALTH NEEDS ASSESSMENT. | ||
| PART VI, LINE 3: BROCHURES ARE AVAILABLE AT THE HOSPITAL IN WAITING AREAS. IN ADDITION, THE HOSPITAL EMPLOYS A FULL-TIME TRAINED PATIENT FINANCIAL SERVICES COUNSELOR TO ASSIST PATIENTS IN DETERMINING IF THEY QUALIFY FOR MEDICAID AS WELL AS FREE OR DISCOUNTED CARE. THE COUNSELOR ALSO PROVIDES HANDS-ON ASSISTANCE TO PATIENTS APPLYING FOR OTHER FINANICAL ASSISTANCE SUCH AS CHIP'S, HEATING ASSISTANCE, MEDICAID, AND WIC. APPLICATIONS FOR CHARITY CARE ARE ALSO DISCUSSED AT REGISTRATION AND DISCHARGE AND WITH PATIENTS WHO HAVE BILLS THAT ARE PAST DUE. | ||
| PART VI, LINE 4: ST. JOHN'S LUTHERAN HOSPITAL IS LOCATED IN LIBBY IN NORTHWESTERN MONTANA, 72 MILES SOUTH OF THE CANADIAN BORDER, 89 MILES NORTHWEST OF KALISPELL, MONTANA, AND 35 MILES EAST OF THE IDAHO BORDER. LIBBY BECAME THE COUNTY SEAT FOR LINCOLN COUNTY IN 1909, THE COUNTY BEING NAMED AFTER PRESIDENT ABRAHAM LINCOLN. HELICOPTER TRANSPORT SERVICES ARE AVAILABLE TO PATIENTS REQUIRING SPECIALIZED CARE IN A LARGER HOSPITAL IN SPOKANE, KALISPELL OR MISSOULA. THE CLOSEST HOSPITAL IS BONNER GENERAL HOSPITAL ABOUT 47 MILES FROM LIBBY IN SANDPOINT, ID. RESIDENTS WITH INCOME BELOW POVERTY LEVEL IN 2011 WAS 16.3% COMPARED TO 14.6% IN THE STATE OF MONTANA. THE MEDIAN HOUSEHOLD INCOME WAS $30,107, WHICH IS SIGNIFICANTLY BELOW THE STATE AVERAGE. LINCOLN COUNTY IS THE LARGEST PRODUCER OF WOOD PRODUCTS IN MONTANA AND FIRST IN THE STATE IN COMMERCIAL FOREST LAND. UNEMPLOYMENT IN LIBBY WAS 15.1% IN 2011 WHICH IS ABOVE THE STATE AVERAGE. | ||
| PART VI, LINE 5: ST. JOHN'S LUTHERAN HOSPITAL IS A NON-DENOMINATIONAL COMMUNITY HOSPITAL. IT IS A 25 BED FACILITY, 25 ACUTE CARE OF WHICH 3 ARE ICU BEDS, WITH A WIDE RANGE OF SURGICAL SERVICES AND EMERGENCY CARE. ST. JOHN'S LUTHERAN HOSPITAL IS ACTIVELY INVOLVED WITH MANY COMMUNITY PARTNERS TO PROMOTE HEALTH TO THE COMMUNITY. ORGANIZING AND FUNDING A COMMUNITY HEALTH FAIR, PROVIDING DISCOUNTED SERVICES FOR MAMMOGRAPHY, LABORATORY TESTS, AND X-RAYS, PROVIDING SPEAKERS FOR HEALTH LECTURES, AND PROVIDING SUPPORT FOR RECRUITING OF PHYSICIANS ARE JUST A FEW OF THE WAYS ST. JOHN'S HELPS THE COMMUNITY.OUR BOARD OF DIRECTORS IS COMPRISED ENTIRELY OF LOCAL RESIDENTS, NONE OF WHOM ARE EMPLOYEES OR CONTRACTORS. TO MEET THE NEEDS OF THE COMMUNITY, THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED, LICENSED PHYSICIANS IN THE COMMUNITY. SURPLUS FUNDS ARE REINVESTED FOR THE REPLACEMENT/ADDITION OF CAPITAL EQUIPMENT AND FACILITY UPKEEP. | ||
| MT | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
| No Grant More Than5000 | X | NoGrantMoreThan5000 |
| Total Nbr Of501 C3 And Govt Grants | 0 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: THE ORGANIZATION KEEPS ACCOUNTING RECORDS OF THE ORGANIZATIONS THAT RECEIVE ASSISTANCE DURING THE FISCAL YEAR. ORGANIZATIONS INCLUDE OTHER PUBLIC CHARITIES AND COMMUNITY ORGANIZATIONS. ONCE THE FUNDS ARE DISBURSED NO FURTHER MONITORING TAKES PLACE. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discretionary Spending Account | X | DiscretionarySpendingAccount |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 1 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAY MALONEY MD | |||||||||||||
| 201203 | 0 | 0 | 0 | 23136 | 0 | 11317 | 0 | 5988 | 0 | 241644 | 0 | 0 | 0 |
| BILL PATTEN | |||||||||||||
| 144150 | 0 | 0 | 0 | 54900 | 0 | 10259 | 0 | 10112 | 0 | 219421 | 0 | 0 | 0 |
| JOSHUA URVATER | |||||||||||||
| 307576 | 0 | 0 | 0 | 70163 | 0 | 11270 | 0 | 0 | 0 | 389009 | 0 | 0 | 0 |
| ANNE CAMBER | |||||||||||||
| 203049 | 0 | 0 | 0 | 48000 | 0 | 11413 | 0 | 11988 | 0 | 274450 | 0 | 0 | 0 |
| MARK SERRA | |||||||||||||
| 225650 | 0 | 0 | 0 | 41907 | 0 | 8108 | 0 | 3988 | 0 | 279653 | 0 | 0 | 0 |
| BRIAN BARSTAD | |||||||||||||
| 246434 | 0 | 0 | 0 | 28940 | 0 | 7037 | 0 | 6504 | 0 | 288915 | 0 | 0 | 0 |
| LOREN CLAUSEN | |||||||||||||
| 141596 | 0 | 0 | 0 | 18789 | 0 | 7837 | 0 | 3824 | 0 | 172046 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | HEALTH CLUB MEMBERSHIP FEES AND SOCIAL CLUB MEMBERSHIP DUES WERE PAID ON BEHALF OF THE CEO AND CFO. AN AUTOMOBILE EXPENSE ALLOWANCE WAS PROVIDED TO THE CEO. ALL SUCH COMPENSATION IS REPORTED AS TAXABLE COMPENSATION. |
| PART I, LINE 5 | THE CEO RECEIVED COMPENSATION BASED ON A SET PERCENTAGE OF NET SERVICE REVENUE, LIMITED TO A MAXIMUM OF $5,000 PER YEAR. |
Schedule L IRS990ScheduleL
Loan Table LoanTable (2 entries)
| Purpose Of LoanPurposeOfLoan | Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|---|
| JOSHUA URVATER | ||||||
| PHYSICIAN SIGN-ON AGREEMENT | X | $45,000 | 0 | 0 | 1 | 1 |
| MARK SERRA | ||||||
| PHYSICIAN SIGN-ON AGREEMENT | X | $35,000 | 4861 | 0 | 1 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 4861 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| FRANK LUCAS | |||
| SPOUSE OF TRUSTEE | 57964 | SALARY AND BENEFITS AS AN EMPLOYEE | 0 |
| LAURIE MALONEY | |||
| SPOUSE OF TRUSTEE | 62162 | SALARY AND BENEFITS AS AN EMPLOYEE | 0 |
Schedule M IRS990ScheduleM
Real Estate Commercial RealEstateCommercial
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 165000 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | LAND VALUATION | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 1 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| NEW PROGRAM SERVICES | FORM 990, PART III, LINE 2 | IN JUNE OF 2011, THE ORGANIZATION BEGAN OFFERING NUC MED AS AN ADDITIONAL SERVICE. |
| FORM 990, PART VI, SECTION A, LINE 8B | NO COMMITTEE HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. | |
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT COPY OF THE FORM 990 AND FORM 990-T WILL BE REVIEWED IN DETAIL BY THE CFO. THE ENTIRE BOARD IS THEN PROVIDED A COPY FOR REVIEW PRIOR TO FILING OF THE FORM 990 AND FORM 990-T RETURNS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES ANNUAL CONFLICT OF INTEREST TRAINING FOR ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES ALONG WITH AN ANNUAL SUBMISSION OF A CONFLICT OF INTEREST FORM. THE BOARD OVERSEES THE PROCESS AND ANY POTENTIAL CONFLICTS ARE DISCUSSED BY THE BOARD. SHOULD A CONFLICT BE DETERMINED, THE CONFLICTED INDIVIDUAL ABSTAINS FROM VOTING ON THE CONFLICTED ISSUE. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD REVIEWS INDEPENDENT SALARY SURVEYS AND OTHER COMPARABILITY DATA TO DETERMINE FAIR MARKET COMPENSATION AMOUNTS FOR OFFICERS AND KEY EMPLOYEES ON AN ANNUAL BASIS, AND THEN TAKES INTO ACCOUNT LOCAL ECONOMIC FACTORS AND SPECIFIC JOB RESPONSIBILITIES. THE PROCESS IS DOCUMENTED AND THE LAST REVIEW WAS PERFORMED IN 2012. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND ANNUAL FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. REQUESTS MAY BE IN PERSON, BY E-MAIL, IN WRITING, OR BY TELEPHONE. | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 28,362. CHANGE IN UNRESTRICTED INVESTMENT IN NET ASSETS OF FOUNDATION -72,445. CHANGE IN TEMPORARILY RESTRICTED INVESTMENT IN FOUNDATION 227,970. ROUNDING -6. CHANGE IN ST. JOHN'S HOSPITAL AUXILIARY ASSETS 2,133. TOTAL TO FORM 990, PART XI, LINE 5: 186,014. |
| FORM 990, PAGE 7, PART VII: | THE FOLLOWING INDIVIDUAL DEVOTED TIME PROVIDING SERVICES TO ST. JOHN'S LUTHERAN HOSPITAL FOUNDATION, A RELATED ORGANIZATION. BILL PATTEN 2.00 HOURS PER WEEK AS DIRECTOR AND CEO |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| ST JOHN'S LUTHERAN HOSPITAL FOUNDATION | ||||||||||
| 350 LOUISIANA AVENUE | LIBBY | MT | 59923 | 810425832 | SUPPORT THE DEVELOPMENT OF ST. JOHN'S LUTHERAN HOSPITAL | MT | 501(C)(3) | 11B | N/A | 0 |
| ST JOHN'S REAL ESTATE CORPORATION | ||||||||||
| 350 LOUISIANA AVENUE | LIBBY | MT | 59923 | 201538952 | SUPPORT THE DEVELOPMENT OF ST. JOHN'S LUTHERAN HOSPITAL | MT | 501(C)(2) | N/A | N/A | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST JOHN'S REAL ESTATE CORPORATION | BusinessNameLine1 |
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