HOLY ROSARY HEALTHCARE: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- HOLY ROSARY HEALTHCARE (EIN 81-0231792)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-15
- IRS object ID
- 201233209349310178
- Schema version
- 2011v1.3
- Note
- A later return for the same period supersedes this one.
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-15T20:53:59-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 190 CARONDELET PLAZA SUITE 1300 | AddressLine1 |
| City | CLAYTON | City |
| State | MO | State |
| ZIP Code | 63105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810231792 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLY ROSARY HEALTHCARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % MARK PETESCH DIR OF FINANCE | InCareOfName |
| Name Control | HOLY | NameControl |
| Phone | 4062373318 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2600 WILSON STREET | AddressLine1 |
| City | MILES CITY | City |
| State | MT | State |
| ZIP Code | 59301 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PAUL LEWIS | Name |
| Title | CFO | Title |
| Date Signed | 2012-11-15 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3142901000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | RON WEBB | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2600 WILSON STREET | AddressLine1 |
| City | MILES CITY | City |
| State | MT | State |
| ZIP Code | 59301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 39712173 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HRH-MT.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1997 | YearFormation |
| State Legal Domicile | MT | StateLegalDomicile |
| Activity Or Mission Description | WE WILL, IN THE SPIRIT OF THE SISTERS OF CHARITY, REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 446 | TotalNbrEmployees |
| Total Nbr Volunteers | 69 | TotalNbrVolunteers |
| Total Gross UBI | 117610 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -3941 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 472754 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 180948 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 36138027 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 39089244 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -46267 | InvestmentIncomePriorYear |
| Investment Income Current Year | -17832 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 487877 | OtherRevenuePriorYear |
| Other Revenue Current Year | 459813 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 37052391 | TotalRevenuePriorYear |
| Total Revenue Current Year | 39712173 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 46119 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 46193 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 20682130 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 20522665 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 17921156 | OtherExpensePriorYear |
| Other Expenses Current Year | 19642049 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 38649405 | TotalExpensesPriorYear |
| Total Expenses Current Year | 40210907 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1597014 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -498734 | RevenuesLessExpensesCY |
| Total Assets BOY | 21970302 | TotalAssetsBOY |
| Total Assets EOY | 21832173 | TotalAssetsEOY |
| Total Liabilities BOY | 3029198 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3406568 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 18941104 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 18425605 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | WE WILL, IN THE SPIRIT OF THE SISTERS OF CHARITY, REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 26894305 | Expense |
| Revenue | 32581410 | Revenue |
| Description | HOLY ROSARY HEALTHCARE PROVIDES INPATIENT AND OUTPATIENT HOSPITAL SERVICES TO THE POPULATIONS OF EASTERN MONTANA. THESE SERVICES INCLUDE SURGICAL, ONCOLOGY, AND MATERNITY SERVICES, AS WELL AS 24- HOUR EMERGENCY ROOM AND DIAGNOSTIC AND THERAPUTIC SERVICES. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2858128 | Expense |
| Revenue | 3757714 | Revenue |
| Description | HOLY ROSARY HEALTHCARE'S EXTENDED CARE UNIT PROVIDES SHORT-TERM TRANSITIONAL CARE AFTER ILLNESS, INJURY, OR SURGERY, AS WELL AS, LONG-TERM CARE FOR THOSE UNABLE TO LIVE INDEPENDENTLY. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3894587 | Expense |
| Revenue | 3207586 | Revenue |
| Description | HOLY ROSARY HEALTHCARE CLINIC PROVIDES PRIMARY CARE SERVICES. THE CLINIC ALSO MAKES AVAILABLE VARIOUS SPECIALTY SERVICES OFFERED BY VISITING PROVIDERS. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 46193 | Expense |
| Description | Mission expenses | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 46193 | TotalOfOtherProgramServiceExp |
| Total Program Service Expense | 33693213 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 80 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 446 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MARK PETESCH DIR OF FINANCE | NamePerson |
| Telephone Number | 4062373318 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 35200 | AddressLine1 |
| City | BILLINGS | City |
| State | MT | State |
| ZIP Code | 591075200 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 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 | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| MONTY LESH | ||||||||
| BOARD CHAIR | 2.0 | X | X | 0 | 0 | 0 | ||
| SISTER MARIE DAMIAN GLATT | ||||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |||
| DR J R GRIERSON | ||||||||
| BOARD VICE CHAIR | 2.0 | X | X | 0 | 0 | 0 | ||
| JANETTE JONES | ||||||||
| BOARD SECRETARY | 2.0 | X | X | 0 | 0 | 0 | ||
| SISTER JUDITH JACKSON | ||||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |||
| TRACI SCHELL | ||||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |||
| RON WEBB | ||||||||
| CEO EX-OFFICIO | 40.0 | X | X | 0 | 240215 | 348323 | ||
| PAUL LEWIS | ||||||||
| CEO EX-OFFICIO | 40.0 | X | X | 0 | 134939 | 35911 | ||
| BILL OFTEDAL | ||||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |||
| RACHEL ARMSTRONG | ||||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |||
| THOMAS BEESON MD | ||||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |||
| SISTER KATHERINE FRANCHETT | ||||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |||
| STEFANI HICSWA MD | ||||||||
| BOARD MEMBER | 2.0 | X | 0 | 0 | 0 | |||
| JASON BARKER | ||||||||
| EX-OFFICIO CEO SVB | 40.0 | X | X | 0 | 437097 | 52347 | ||
| Steve Ballock | ||||||||
| Regional CFO | 40.0 | X | 0 | 245842 | 33952 | |||
| CALVIN CAREY | ||||||||
| CFO | 40.0 | X | 0 | 3920 | 17 | |||
| JAMES MACMILLIAN | ||||||||
| PHYSICIAN | 40.0 | 307250 | 0 | 6288 | X | |||
| JEFF WILLIAMS | ||||||||
| PHYSICIAN | 40.0 | 294685 | 0 | 22632 | X | |||
| DORTHY BRADBURY | ||||||||
| PHYSICIAN | 40.0 | 225368 | 0 | 8157 | X | |||
| DANIEL TAILLEUR | ||||||||
| PHYCICIAN | 40.0 | 210943 | 0 | 15884 | X | |||
| CHRISTOPHER LIEB | ||||||||
| PHYCICIAN | 40.0 | 197296 | 0 | 27862 | X | |||
| JAMES T PAQUETTE | ||||||||
| REGIONAL CEO | 0 | 738527 | 123111 | X | ||||
| RICHARD LOPES | ||||||||
| FORMER CHIEF TRANSFORMA OFFIC | 0 | 420106 | 43091 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1235542 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2220646 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 717575 | TotalOtherCompensation |
| Number Individuals GT100 K | 14 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ARAMARK CORPORATION | |||||
| PO BOX 651009 | CHARLOTTE | NC | 282651009 | FOOD SERVICES | 724198 |
| MEDEFIS INC | |||||
| 10826 OLD MILL ROAD SUITE 101 | OMAHA | NE | 68154 | TEMPORARY STAFFING | 646577 |
| CONIFER HEALTH SOLUTIONS | |||||
| 1500 SOUTH DOUGLASS ROAD | ANAHEIM | CA | 92806 | PATIENT BILLING SERV | 1601142 |
| ROCKY MOUNTAIN HEALTH NETWORK | |||||
| 315 NORTH 25TH STREET | BILLINGS | MT | 59101 | PATIENT BILLING SERV | 247777 |
| HOSPITAL LAUNDRY SERVICES | |||||
| 45 SOUTH 7TH STREET WEST | BILLINGS | MT | 59102 | LAUNDRY SERVICE | 181391 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 10 | NumberOfContractorsGT100K |
| Related Organizations | 180948 | RelatedOrganizations |
| Total Contributions | 180948 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT SERVICE | 900099 | 38973981 | 38973981 | |
| PROGRAM SERVICE RENTAL INCOME | 532000 | 115263 | 115263 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 39089244 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -30774 | TotalRevenueColumn |
| Exclusion | -$30,774 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 12942 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 12942 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12942 | TotalRevenueColumn |
| Exclusion | $12,942 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NON-PATIENT FOOD SERVICES | 722320 | 343636 | 341289 | 2347 |
| DEPARTMENT OTHER OPERATING REVENUE | 900099 | 102295 | 102295 | |
| MANAGEMENT FEES | 900099 | 12422 | 12422 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1460 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1460 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 459813 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 39712173 | TotalRevenueColumn |
| Related Or Exempt Function Income | 39431447 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 117610 | UnrelatedBusinessRevenue |
| Exclusion | -$17,832 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46193 | Total |
| Program Services | 46193 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1532563 | Total |
| Management And General | 1532563 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15082980 | Total |
| Program Services | 14764771 | ProgramServices |
| Management And General | 318209 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 726595 | Total |
| Program Services | 726595 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2092203 | Total |
| Program Services | 2092203 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1088324 | Total |
| Program Services | 976253 | ProgramServices |
| Management And General | 112071 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3681476 | Total |
| Program Services | 2165426 | ProgramServices |
| Management And General | 1516050 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87243 | Total |
| Management And General | 87243 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1656 | Total |
| Management And General | 1656 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1699 | Total |
| Management And General | 1699 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3486245 | Total |
| Program Services | 2895075 | ProgramServices |
| Management And General | 591170 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 131019 | Total |
| Management And General | 131019 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1153451 | Total |
| Program Services | 934814 | ProgramServices |
| Management And General | 218637 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1078607 | Total |
| Management And General | 1078607 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 654152 | Total |
| Program Services | 605857 | ProgramServices |
| Management And General | 48295 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 205858 | Total |
| Program Services | 95750 | ProgramServices |
| Management And General | 110108 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2099619 | Total |
| Program Services | 2099619 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 321007 | Total |
| Program Services | 321007 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBTS | 1830714 | 1830714 | |
| MEDICAID PROVIDER TAXES | 409659 | 409659 | |
| RECRUITING EXPENSES | 173129 | 48792 | 124337 |
| MEDICAL EXPENSES | 4010038 | 4009350 | 688 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 316477 | Total |
| Program Services | 80794 | ProgramServices |
| Management And General | 235683 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40210907 | Total |
| Program Services | 33693213 | ProgramServices |
| Management And General | 6517694 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -1603867 | BOY |
| EOY | -754125 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 217457 | BOY |
| EOY | 219612 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5578927 | BOY |
| EOY | 4565306 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 22783 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 816603 | BOY |
| EOY | 902468 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 376160 | BOY |
| EOY | 436985 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 40188110 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 26745928 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14967086 | BOY |
| EOY | 13442182 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 780897 | BOY |
| EOY | 662381 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 837039 | BOY |
| EOY | 2334581 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21970302 | BOY |
| EOY | 21832173 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3029198 | BOY |
| EOY | 3406568 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3029198 | BOY |
| EOY | 3406568 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18941104 | BOY |
| EOY | 18425605 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18941104 | BOY |
| EOY | 18425605 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21970302 | BOY |
| EOY | 21832173 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -498734 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -16765 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | true | DirectContactLegislators |
| Direct Contact Legislators | $1,656 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 1656 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule C, Part II-B | Identifier |
| Return Reference | Lobbying Activity Explanation | ReturnReference |
| Explanation | Holy Rosary Healthcare pays dues to the Montana Hospital Association, of which $1,656 is charged for lobbying. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 152032 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 8504 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2500 | GrantsOrScholarships |
| Administrative Expenses | 600 | AdministrativeExpenses |
| End Of Year Balance | 157436 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 170256 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -15721 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2500 | GrantsOrScholarships |
| Administrative Expenses | 3 | AdministrativeExpenses |
| End Of Year Balance | 152032 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 126507 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 46785 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 3000 | GrantsOrScholarships |
| Administrative Expenses | 36 | AdministrativeExpenses |
| End Of Year Balance | 170256 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 152571 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -23564 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2500 | GrantsOrScholarships |
| End Of Year Balance | 126507 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | true | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | true | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 135511 | OtherCostOrOtherBasis |
| Book Value | 135511 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13590797 | OtherCostOrOtherBasis |
| Depreciation | 6522937 | Depreciation |
| Book Value | 7067860 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 24745590 | OtherCostOrOtherBasis |
| Depreciation | 18882109 | Depreciation |
| Book Value | 5863481 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1716212 | OtherCostOrOtherBasis |
| Depreciation | 1340882 | Depreciation |
| Book Value | 375330 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 13442182 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER RECEIVABLES | Description |
| Book Value | 2162851 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2162851 | TotalBookValueOtherAssets |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCH. D, PART V, LINE 4 | Identifier |
| Return Reference | ENDOWMENT FUNDS | ReturnReference |
| Explanation | THE INTENDED USE FOR THE KENNETH HOM TRUST ENDOWMENT FUND IS TO PROVIDE NURSING SCHOLARSHIPS. EACH YEAR A SCHOLARSHIP IS AWARDED TO AN INDIVIDUAL WITH EASTERN MONTANA TIES WHO IS PURSUING HIS OR HER NURSING EDUCATION. IN 2011, ONE SCHOLARSHIP WAS AWARDED. Endowment funds are held by the Holy Rosary Healthcare Foundation. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 393 | PersonsServed |
| Total Community Benefit Expense | 1699001 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1699001 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04430 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 393 | PersonsServed |
| Total Community Benefit Expense | 1699001 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1699001 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04430 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 30 | NumberOfActivitiesOrPrograms |
| Persons Served | 3980 | PersonsServed |
| Total Community Benefit Expense | 257277 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22762 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 234515 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00610 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 13 | NumberOfActivitiesOrPrograms |
| Persons Served | 428 | PersonsServed |
| Total Community Benefit Expense | 171081 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 171081 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00450 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 151249 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 151249 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00390 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 11 | NumberOfActivitiesOrPrograms |
| Persons Served | 2208 | PersonsServed |
| Total Community Benefit Expense | 31904 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 31904 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 56 | NumberOfActivitiesOrPrograms |
| Persons Served | 6616 | PersonsServed |
| Total Community Benefit Expense | 611511 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22762 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 588749 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01530 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 56 | NumberOfActivitiesOrPrograms |
| Persons Served | 7009 | PersonsServed |
| Total Community Benefit Expense | 2310512 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22762 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2287750 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05960 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 1 | PersonsServed |
| Total Community Building Expense | 149 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 149 | NetCommunityBuildingExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 164 | PersonsServed |
| Total Community Building Expense | 1357 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1357 | NetCommunityBuildingExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 960 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 960 | NetCommunityBuildingExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 17 | PersonsServed |
| Total Community Building Expense | 781 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 781 | NetCommunityBuildingExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 7 | PersonsServed |
| Total Community Building Expense | 143 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 143 | NetCommunityBuildingExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 116 | PersonsServed |
| Total Community Building Expense | 111741 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 111741 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 588 | PersonsServed |
| Total Community Building Expense | 6811 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6811 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 12 | NumberOfActivitiesOrPrograms |
| Persons Served | 893 | PersonsServed |
| Total Community Building Expense | 121942 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 121942 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00310 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $1,159,888 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 11329749 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 15793030 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -4463281 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | 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 | Holy Rosary Healthcare | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2600 Wilson Street | AddressLine1 |
| City | Miles City | City |
| State | MT | State |
| ZIP Code | 59301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Holy Rosary Healthcare | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 400. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Lowest Negotiated Rates | X | LowestNegotiatedRates |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | POWDER RIVER MEDICAL CLINIC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 507 NORTH LINCOLN AVENUE | AddressLine1 |
| City | BROADUS | City |
| State | MT | State |
| ZIP Code | 59317 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | AMBULATORY CARE CLINIC | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE H, PART VI | Identifier |
| Return Reference | SUPPLEMENTAL INFORMATION | ReturnReference |
| Explanation | PART I, LINE 3C ELIGIBILITY IS BASED ON FEDERAL POVERTY GUIDELINES. PART I, LINE 6A THE ANNUAL COMMUNITY BENEFIT REPORT IS INCLUDED IN THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM REPORT TO THE COMMUNITY. WE SUBMIT COMMUNITY BENEFIT ACTIVITIES AS NEWS TO LOCAL MEDIA AND REPORT THEM ON OUR WEBSITE AS THEY OCCUR. A SEPARATE PUBLICATION SPECIFICALLY DEDICATED TO COMMUNITY BENEFIT WAS NOT RELEASED IN 2011. PART I, LINE 7G PHYSICIAN CLINICS ACCOUNT FOR $31,649 OF TOTAL SUBSIDIZED SERVICE EXPENSE; THIS IS A CLINIC IN A REMOTE RURAL AREA WITH NO OTHER ACCESS TO HEALTHCARE WITHIN AN 80 MILE RADIUS. PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT EXPENSE DELETED FROM THE DENOMINATOR BEFORE CALCULATING PERCENTAGES IN COLUMN (F) IS $1,830,714. PART I, LINE 7 COST TO CHARGE RATIO IS USED FOR ALL REMAINING CATEGORIES OF COMMUNITY BENEFIT. THE COST TO CHARGE RATIO USED WAS DERIVED FROM WORKSHEET 2. PART II THE MOST SIGNIFICANT EXPENSE IN COMMUNITY BUILDING ACTIVITIES IS THE COST OF PHYSICIAN RECRUITMENT TO OUR MEDICALLY UNDERSERVED AREA. PART III, LINE 4 DISCOUNTS AND PAYMENTS APPLIED TO ACCOUNTS REDUCE BAD DEBT EXPENSE. NO METHOD IS USED TO DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE, HOWEVER, THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY ALLOWS FINANCIAL ASSISTANCE AWARDS TO BE MADE PRESUMPTIVELY TO INDIVIDUALS WHO HAVE NOT ADEQUATELY COMPLETED THE APPLICATION PROCESS IF THE INDIVIDUAL IS HOMELESS OR IF THE INDIVIDUAL IS NON-RESPONSIVE AND HAS A CREDIT SCORE LESS THAN 600. BAD DEBT EXPENSES INCLUDE ACTUAL WRITE OFFS AND ANY ASSOCIATED ACCRUAL BASED ON ACCOUNTS RECEIVABLE. THE COSTING METHODOLOGY USED TO CALCULATE THE COST OF BAD DEBT INCLUDED ON PART III LINE 2 WAS THE COST TO CHARGE RATIO DERIVED USING THE METHODOLOGY FROM WORKSHEET 2. PART III, LINE 8 THE ORGANIZATION DOES NOT BELIEVE THAT MEDICARE SHORTFALLS SHOULD BE INCLUDED AS COMMUNITY BENEFIT. MEDICARE ALLOWABLE COSTS WERE DERIVED FROM THE MEDICARE COST REPORT'S SCHEDULE D PART V, PART VI AND SCHEDULE D-1. PART III, 9B AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST, AND TO ENSURE THAT WE MANAGE OUR RESOURCES SO THAT WE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. HOLY ROSARY HEALTHCARE NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION, DISCHARGE AND IN COMMUNICATION REGARDING PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. NEEDS ASSESSMENT: AS PART OF OUR ORGANIZATIONAL MISSION TO RESPOND TO THE HEALTH NEEDS OF THE PEOPLE AND COMMUNITIES SERVED, WE TAKE STEPS TO DETERMINE WHERE THERE IS THE MOST NEED IN ORDER TO PROVIDE THE GREATEST GOOD. HOLY ROSARY HEALTHCARE HAS REGULARLY PARTICIPATED IN COMMUNITY HEALTH NEEDS ASSESSMENT SURVEYS TO IDENTIFY THE ONGOING AND CHANGING NEEDS OF THE COMMUNITY. THE MOST RECENT SURVEY WAS CONDUCTED IN 2011. THIS ASSESSMENT STUDIED MILES CITY, MONTANA, AND THE NINE-COUNTY SURROUNDING AREA SERVED BY HOLY ROSARY HEALTHCARE. THE ASSESSMENT, COMPLETED BY A THIRD-PARTY RESEARCH FIRM SPECIALIZING IN RURAL COMMUNITY RESEARCH, INCLUDES COLLABORATIVE PARTNERSHIPS WITH LOCAL GOVERNMENT AND SOCIAL AGENCIES; COMBINING EFFORTS WITH OTHER LOCAL HOSPITALS AND HEALTH CARE ORGANIZATIONS; AND CONDUCTING SURVEYS, FOCUS GROUPS, AND ASSESSMENTS WITH THE ASSISTANCE OF THE OFFICE OF RURAL HEALTH. COMMUNITY EDUCATION WAS COMPLETED UTILIZING THE MEDIA, INTERNET, AND MAILINGS TO BUILD AWARENESS AND ENCOURAGE PARTICIPATION IN THIS PROJECT. RESULTS WERE RECEIVED IN EARLY 2012, INFORMATION SHARED WITH KEY STAKEHOLDER GROUPS IN THE COMMUNITY AND REGION, AND RESPECTIVE PRIORITIES IDENTIFIED AND ACTION PLANS PURSUED. IN 2011, WE ADDED A NEW APPROACH TO IDENTIFY COMMUNITY HEALTH NEEDS BY CREATING THE CONSENSUS BUILDING FORUM: IDENTIFYING PRIORITIES IN HEALTHCARE DELIVERY IN EASTERN MONTANA. THIS IS PROVING TO BE AN INFORMATIVE APPROACH TO IDENTIFYING ISSUES AND PRIORITIZING SOLUTIONS. WE ALSO CONTINUOUSLY ASSESS THE NEEDS OF THE COMMUNITY THROUGH CLOSE WORKING RELATIONSHIPS AND PARTNERSHIPS WITH SERVICE AGENCIES IN THE COMMUNITY, AND BY EVALUATING STATE AND COUNTY HEALTH STATISTICS. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: HOLY ROSARY HEALTHCARE TREATS PATIENTS WITH RESPECT AND DIGNITY REGARDLESS OF THEIR ABILITY TO PAY. HOLY ROSARY HEALTHCARE HAS A WRITTEN FINANCIAL ASSISTANCE POLICY THAT EXPLAINS ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE AT VARIOUS LEVELS, INCLUDING A 100% DISCOUNT, AND IS BASED ON FEDERAL POVERTY GUIDELINES. WE WORK WITH PATIENTS TO HELP THEM UNDERSTAND THEIR FINANCIAL RESPONSIBILITY FOR CARE RECEIVED, FINANCIAL ASSISTANCE AVAILABLE TO THEM, AND TO ESTABLISH PAYMENT PROGRAMS IN DEMONSTRATION OF OUR CORE VALUE OF RESPECT. AS PART OF OUR RESPONSIBILITY TO EDUCATE, WE INFORM OUR PATIENTS AND THEIR FAMILIES OF THE AVAILABILITY OF ASSISTANCE, INCLUDING GOVERNMENT PROGRAMS. WE COMMUNICATE THIS IN A VARIETY OF WAYS TO ENSURE THAT MESSAGES REACH MULTIPLE AUDIENCES. BEFORE, DURING AND/OR AFTER ADMISSION, WE ENCOURAGE OUR SELF PAY PATIENTS TO VISIT WITH A FINANCIAL COUNSELOR TO DISCUSS QUALIFICATIONS FOR FINANCIAL ASSISTANCE. THE FINANCIAL COUNSELOR WORKS WITH THE PATIENT TO COMPLETE A FINANCIAL ASSISTANCE FORM TO DETERMINE THE LEVEL OF DISCOUNT FOR WHICH THE PATIENT MAY BE ELIGIBLE. WE POST FINANCIAL ASSISTANCE INFORMATION IN EMERGENCY AND ADMISSIONS AREAS, ON BILLING INVOICES, IN VARIOUS AREAS AROUND THE HOSPITAL AND CLINIC SITES AND ON THE HOSPITAL WEBSITE. WE PROVIDE WRITTEN MATERIALS TO PATIENTS THAT DETAIL OUR FINANCIAL ASSISTANCE POLICY AND HOW IT IS ADMINISTERED. THIS COVERS ELIGIBILITY, STEPS TO FOLLOW TO DETERMINE IF A PATIENT QUALIFIES FOR ASSISTANCE, TYPICAL CHARGES A PATIENT MAY EXPECT FOR ROUTINE PROCEDURES, AND ASSISTANCE AVAILABLE BASED ON A PATIENT'S INCOME LEVEL. WE PROVIDE MATERIALS AND EDUCATION WHEN PATIENTS ARE DISCHARGED, AND INCLUDE INFORMATION IN BILLING STATEMENTS, INCLUDING PHONE NUMBERS AND OTHER METHODS TO CONTACT US WITH QUESTIONS. WE ENSURE THAT OUR FINANCIAL COUNSELORS, ADMISSION EMPLOYEES, SOCIAL WORKERS AND OTHER EMPLOYEES UNDERSTAND OUR POLICIES TO BE ABLE TO ASSIST PATIENTS IN THE MOST APPROPRIATE WAY. COMMUNITY INFORMATION: HOLY ROSARY HEALTHCARE - THE LARGEST HEALTHCARE FACILITY BETWEEN BILLINGS, MONTANA, AND BISMARCK, NORTH DAKOTA - PROVIDES A COMPLETE CONTINUUM OF CARE THROUGH OUR 25-BED ACUTE CARE HOSPITAL, 87-BED EXTENDED CARE LIVING COMMUNITY, OUTPATIENT MEDICAL ARTS CENTER, AND HOSPICE AND PALLIATIVE CARE PROGRAMS. WHILE THE ORGANIZATION DRAWS PATIENTS FROM A 13-COUNTY REGION IN THE STRONGEST SERVICE-LINES, HOLY ROSARY HEALTHCARE'S PRIMARY AND SECONDARY SERVICE AREAS INCLUDE A NINE-COUNTY CORE REGION WITH APPROXIMATELY 45,000 PEOPLE. THE DEMOGRAPHIC MAKE-UP OF OUR PRIMARY AND SECONDARY SERVICE AREAS INCLUDES: - OVERALL DECLINING POPULATION OF 3% IN MOST COUNTIES WIH THE EXCEPTION OF TWO, ROSEBUD AND FALLON COUNTIES. - LARGE GEOGRAPHIC AREA WITH SPARSE POPULATION, AVERAGING 1.4 PEOPLE/SQUARE MILE. - AGING POPULATION WITH AVERAGE AGE OF 43 AND AVERAGE LIFE EXPECTANCY OF 79; EXCEPTION IS ROSEBUD COUNTY WITH AVERAGE AGE OF 36. - PRIMARY INDUSTRIES ARE AGRICULTURE, STATE/LOCAL GOVERNMENT, AND RETAIL. AVERAGE HOUSEHOLD INCOME IS $49,000, $20,000 BELOW THE NATIONAL AVERAGE. PROMOTION OF COMMUNITY HEALTH: WE EXTEND OUR CARE BEYOND OUR HOSPITAL'S WALLS IN ORDER TO IMPROVE THE HEALTH OF OUR COMMUNITY. OUR COMMUNITY BUILDING ACTIVITIES DEMONSTRATE THIS COMMITMENT. IN 2011, THE MOST SIGNIFICANT EXPENSE IN COMMUNITY BUILDING ACTIVITIES IS THE COST OF PHYSICIAN RECRUITMENT TO OUR MEDICALLY UNDERSERVED AREA. WE ARE ALSO INVOLVED IN MANY COMMUNITY ORGANIZATIONS THAT VARY IN SCOPE INCLUDING CRITICAL INCIDENT STRESS MANAGEMENT, COMMUNITY HEALTH ALLIANCE (WHICH PARTNERS WITH ALL LOCAL HEALTH ORGANIZATION TO CREATE COMMUNITY HEALTH IMPROVEMENT), AND OTHER CIVIC MINDED ORGANIZATIONS. WE ARE AN IMPORTANT PART OF OUR COMMUNITY AND SERVE IN MANY WAYS, FROM DELIVERING CORE HEALTH CARE TO PREVENTIVE CARE TO SUPPORT OF OTHER CIVIC GROUPS. OUR BOARD OF DIRECTORS REPRESENTS MEDICAL AND BUSINESS PROFESSIONALS, AND ALL PROVIDE HOURS OF SERVICE IN SUPPORT OF OUR HOSPITAL. THEY ARE DEEPLY INVOLVED IN OUR NEEDS ASSESSMENT PROCESS, BUILDING PROGRAMS AND SERVICES, AND COMMUNITY OUTREACH TO ENSURE THAT PEOPLE KNOW ABOUT SERVICES AVAILABLE TO THEM THROUGH OUR HOSPITAL. WHEN HOLY ROSARY HEALTHCARE HAS EXCESS REVENUE OVER OPERATING EXPENSES, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTH CARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CA | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLY ROSARY FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2600 WILSON | AddressLine1 |
| City | MILES CITY | City |
| State | MT | State |
| ZIP Code | 59301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 202270238 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 34466 | AmountOfCashGrant |
| Purpose Of Grant | ASSIST IN CHARITABLE EXEMPT PURPOSE | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of Organization's Procedures for Monitoring the Use of Grants | Identifier |
| Return Reference | Form 990, Schedule I, Part I, Line 2 | ReturnReference |
| Explanation | GRANTS ARE MONITORED THROUGH THE HOLY ROSARY HEALTHCARE FOUNDATION. THE FOUNDATION FOLLOWS A TWO-STEP PROCESS IN PREPARING THE SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS (SEFA). THE GRANT PROJECT DIRECTOR IS RESPONSIBLE TO SUBMIT THE INVOICES FOR EACH MONTH'S ACTIVITY TO THE FOUNDATION DIRECTOR. THESE ARE THEN REVIEWED FOR COMPLIANCE WITH FEDERAL STANDARDS AND GUIDELINES AND ARE SUBMITTED TO THE FEDERAL GOVERNMENT FOR REIMBURSEMENT OR APPLIED TO GRANT IF AWARDED UPFRONT. THE AMOUNTS ARE THEN DRAWN DOWN BY THE FOUNDATION ADMINISTRATOR AND THE MONEY IS WIRED TO THE FOUNDATION'S BANK ACCOUNT OR REIMBURSED TO THE HOSPITAL IF THE EXPENDITURES WERE PAID BY THE HOSPITAL AND THE FUNDS MADE AVAILABLE TO THE FOUNDATION IN ADVANCE. THIS INFORMATION IS COMPILED QUARTERLY BY THE DIRECTOR OF FINANCE AND IS TRACKED BY GRANT NAME AND CEDA NUMBER. THE FOUNDATION DIRECTOR ALSO PROVIDES THE FINANCE DIRECTOR WITH THE AWARD LETTER AND ANY COMMUNICATIONS RELATED TO THE GRANT AS WELL AS SUPPORTING INVOICES AND EXPENDITURES. AT THE END OF THE YEAR, QUARTERLY WORKSHEETS ARE USED TO PREPARE THE SEFA. THE SEFA IS PREPARED BY THE DIRECTOR OF FINANCE, REVIEWED BY THE GRANTS ADMINISTRATOR AND FORWARDED TO THE SYSTEM OFFICE AND ERNST AND YOUNG CPA FIRM. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RON WEBB | |||||||||||||
| 0 | 187500 | 0 | 0 | 0 | 52715 | 0 | 337237 | 0 | 11086 | 0 | 588538 | 0 | 0 |
| PAUL LEWIS | |||||||||||||
| 0 | 134023 | 0 | 0 | 0 | 916 | 0 | 20458 | 0 | 15453 | 0 | 170850 | 0 | 0 |
| JASON BARKER | |||||||||||||
| 0 | 408132 | 0 | 0 | 0 | 28965 | 0 | 42237 | 0 | 10110 | 0 | 489444 | 0 | 0 |
| Steve Ballock | |||||||||||||
| 0 | 214525 | 0 | 0 | 0 | 31317 | 0 | 18210 | 0 | 15742 | 0 | 279794 | 0 | 0 |
| JAMES T PAQUETTE | |||||||||||||
| 0 | 418351 | 0 | 0 | 0 | 320176 | 0 | 107885 | 0 | 15226 | 0 | 861638 | 0 | 0 |
| RICHARD LOPES | |||||||||||||
| 0 | 304166 | 0 | 0 | 0 | 115940 | 0 | 36475 | 0 | 6616 | 0 | 463197 | 0 | 0 |
| JAMES MACMILLIAN | |||||||||||||
| 307250 | 0 | 0 | 0 | 0 | 0 | 6145 | 0 | 143 | 0 | 313538 | 0 | 0 | 0 |
| JEFF WILLIAMS | |||||||||||||
| 294685 | 0 | 0 | 0 | 0 | 0 | 17093 | 0 | 5539 | 0 | 317317 | 0 | 0 | 0 |
| DORTHY BRADBURY | |||||||||||||
| 196798 | 0 | 28570 | 0 | 0 | 0 | 4507 | 0 | 3650 | 0 | 233525 | 0 | 0 | 0 |
| DANIEL TAILLEUR | |||||||||||||
| 112405 | 0 | 98538 | 0 | 0 | 0 | 4219 | 0 | 11665 | 0 | 226827 | 0 | 0 | 0 |
| CHRISTOPHER LIEB | |||||||||||||
| 196496 | 0 | 800 | 0 | 0 | 0 | 12232 | 0 | 15630 | 0 | 225158 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, SCHEDULE J, PART I, LINE 3 | SEE FORM 990, SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, LINES 15A & B REGARDING THE PROCESS USED BY SCLHS TO DETERMINE EXECUTIVE COMPENSATION WHICH IS RELIED UPON BY THIS ORGANIZATION. | |
| FORM 990, SCHEDULE J, PART I, LINE 4A | THE AMOUNTS PAID FOR SEVERANCE IN 2011 WERE: RONALD W. WEBB-$40,000 | SEVERANCE PAYMENTS |
| FORM 990, SCHEDULE J, PART I, LINE 4B | OTHER REPORTABLE COMPENSATION SHOWN IN SCHEDULE J PART II COLUMN (B) (III) CONTAINS AN ANNUAL REPORTING ADJUSTMENT FOR CERTAIN EMPLOYEES WHO PARTICIPATE IN THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. SCLHS PROVIDES NONQUALIFIED RETIREMENT PLANS FOR EXECUTIVES TO COMPENSATE FOR IRS IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. ON THE ADVICE OF COUNSEL, SCLHS HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THEY ARE EARNED AND VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE ACCRUED AND VESTED IN THE CURRENT YEAR, ARE NOW CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. AN AMOUNT EQUAL TO THE PARTICIPANT'S EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANT'S ACCOUNT AND REMITTED TO THE IRS AS WITHHOLDING ON THE TAXABLE BENEFIT. THE AMOUNTS WITHDRAWN FROM THE PLAN FOR TAXES IN 2011 WERE: JAMES T. PAQUETTE-$105,270 STEVEN A. BALLOCK-$9,198 RICHARD T. LOPES-$27,413 | PAYMENTS FROM NONQUALIFIED RETIREMENT PLAN |
| FORM 990, SCHEDULE J, PART I, LINE 7 (NON-FIXED PAYMENTS) | SCLHS HAS MANAGEMENT INCENTIVE PLANS WHICH ARE BASED ON A COMBINATION OF MEASURES. MANAGEMENT AND SENIOR LEADERSHIP ARE ELIGIBLE FOR THE INCENTIVE COMPENSATION. PERFORMANCE CATEGORIES ARE MADE UP OF A COMBINATION OF CLINICAL QUALITY MEASURES AND OPERATING INCOME. THE OPERATING INCOME CATEGORY IS GENERALLY RELATED TO THE NET EARNINGS OF THE CARE SITE IN WHICH THE INDIVIDUAL WORKS, OR IN THE CASE OF SCLHS SENIOR MANAGEMENT, THE NET EARNINGS OF SCLHS. | |
| FORM 990 SCHEDULE J, PART II AND FORM 990 PART VII | THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) CONSISTS OF ELEVEN HOSPITALS AND FOUR CLINICS (AFFILIATES) IN FOUR STATES INCLUDING HOLY ROSARY HEALTHCARE (HOLY ROSARY) IN MILES CITY, MONTANA. SCLHS AND ITS AFFILIATES ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. JASON L. BARKER IS PRESIDENT AND CHIEF EXECUTIVE OFFICER FOR ST. VINCENT HEALTHCARE. HE FORMERLY SERVED AS A MEMBER OF HOLY ROSARY HEALTHCARE'S BOARD. STEVEN A. BALLOCK IS VICE PRESIDENT, CHIEF FINANCIAL OFFICER FOR ST. VINCENT HEALTHCARE. THEY ALSO SERVE AS MEMBERS OF HOLY ROSARY HEALTHCARE'S BOARD. THE COMPENSATION REFLECTED IS THAT OF MR. BARKER'S AND MR. BALLOCK'S POSITIONS AS ST. VINCENT HEALTHCARE EXECUTIVES AND IS NOT RELATED TO HOLY ROSARY HEALTHCARE. JAMES T. PAQUETTE IS A SYSTEM PROJECT LEADER OF SCLHS IN DENVER, COLORADO. HE FORMERLY SERVED AS PRESIDENT AND CHIEF EXECUTIVE OFFICER OF ST. VINCENT HEALTHCARE AND ON THE HOLY ROSARY HEALTHCARE BOARD. THE COMPENSATION REFLECTED IS THAT OF MR. PAQUETTE'S POSITION AS AN SCLHS SYSTEM PROJECT LEADER AND IS NOT RELATED TO HOLY ROSARY HEALTHCARE. RICHARD T. LOPES IS SENIOR VICE PRESIDENT AND CHIEF TRANSFORMATION OFFICER AT SCLHS. AS A FORMER OFFICER OF HOLY ROSARY HEALTHCARE, THIS DISCLOSURE IS REQUIRED FOR 990 REPORTING PURPOSES ONLY. THE COMPENSATION REFLECTED IS THAT OF MR. LOPES' POSITION AS AN SCLHS EXECUTIVE AND IS NOT RELATED TO HOLY ROSARY HEALTHCARE. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON SCLHS OR AFFILIATE BOARDS IS COMPENSATED FOR THAT SERVICE. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DISCLOSURES | Identifier |
| Explanation | FORM 990, PART III, LINE 4D PROGRAM SERVICE ACCOMPLISHEMENTS HOLY ROSARY HEALTHCARE (HOSPITAL) PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR ABILITY TO PAY. THE HOSPITAL PROVIDES CARE TO INDIVIDUALS COVERED BY GOVERNMENTAL PROGRAMS, OTHER BENEFITS, AND ACCOMPLISHMENTS INCLUDE: -ASSISTING EDUCATORS BY WORKING WITH HEALTHCARE INTERNS -PRESENT SPEAKING ENGAGEMENTS TO THE COMMUNITY COVERING HEALTHCARE ISSUES SUCH AS TELEMEDICINE, ARTHRITIS, HOSPICE PROGRAM, SLEEP DISORDERS, ETHICS, JOINT SEMINARS, EAR, NOSE, AND THROAT ISSUES, PSYCHOLOGY, AND DIABETES -PARTICIPATED IN HEALTH FAIRS TO PROMOTE HEALTH EDUCATION AND FOSTER PREVENTION TECHNIQUES -PROVIDE HOSPICE PROGRAM TO COMMUNITY -PROVIDE DENTAL CARE FOR CHILDREN THROUGH SMILE SAVERS -PROVIDE HEALTH RELATED ARTICLES TO LOCAL PRESS TO EDUCATE PUBLIC ON VARIOUS TOPICS -PROVIDE WELLNESS SCREENS TO SCHOOL DISTRICT AT DISCOUNTED RATE -PROVIDE FREE TOURS TO AREA SCHOOL CHILDREN AND OTHER COMMUNITY GROUPS TO TEACH THEM ABOUT THE HOSPITAL -PROVIDE MEDICAL EXPLORERS PROGRAM TO PROMOTE CAREERS IN HEALTHCARE -SPONSOR AFFORDABLE ACCESS ADVANTAGE FOR OUR EMPLOYEES -SPONSOR BLOOD DRIVES, CHARITY WALKS, 55 ALIVE, SCHOOL NURSE PROGRAM, AND OTHER GROUPS FORM 990 PART VI, SEC A, LINE 3 MANAGEMENT COMPANIES MANAGEMENT DUTIES DELEGATED BY HOLY ROSARY HEALTHCARE TO MANAGEMENT COMPANIES WERE IN THE FOLLOWING AREAS: (1) CONIFER HEALTH SOLUTIONS: REVENUE CYCLE SERVICES THAT INCLUDES PATIENT ACCESS, CHARGE CAPTURE AND ACCOUNTS RECEIVABLE MANAGEMENT (2) ARAMARK CORPORATION: FOOD SERVICES (3) BROADLANE: SUPPLY CHAIN MANAGEMENT FORM 990 PART VI, SEC A, LINES 6, 7A & 7B CLASS OF MEMBER, NATURE OF RIGHTS, ELECTION OF BOARD MEMBERS, DECISIONS SUBJECT TO APPROVAL THE SOLE MEMBER AND CONTROLLING MEMBER OF THE HOLY ROSARY HEALTHCARE (HRH) CORPORATION IS THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC (SCLHS), A KANSAS NON-FOR-PROFIT CORPORATION. SOME OF THE EXCLUSIVE POWERS OF SCLHS INCLUDE: - TO APPOINT, AFTER CONSULTATION WITH THE HRH CORPORATE BOARD, THE BOARD OF DIRECTORS OF HRH AND APPOINT MEMBERS OF SCLHS TO THE HRH BOARD OF DIRECTORS; - TO REMOVE, WITH OR WITHOUT CAUSE, AFTER CONSULTATION WITH THE HRH CORPORATE BOARD, ANY MEMBER OF THE HRH BOARD OF DIRECTORS; - TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE CHIEF EXECUTIVE OFFICER AND THE CHIEF ADMINISTRATIVE OFFICER OF HRH; - TO IMPLEMENT CORPORATE GOALS, POLICIES, AND PROCEDURES OF HRH; - TO APPROVE FOR HRH THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS, OR THE LEASE, SALE, TRANSFER, ASSUMPTION, OR ENCUMBERING OF HRH ASSETS; - TO APPROVE THE MERGER, DISSOLUTION, OR CORPORATE RESTRUCTURING OF HRH; AND - TO APPROVE HRH ANNUAL STRATEGIC PLANS AND OPERATING AND CAPITAL BUDGETS. THE HRH BOARD OF DIRECTORS HAVE THE POWERS TO EXERCISE GENERAL MANAGEMENT AND CONTROL OF THE BUSINESS AFFAIRS OF HRH WITH DUE REGARD FOR THE POWERS RESERVED BY SCLHS. THE POWERS OF THE HRH BOARD OF DIRECTORS INCLUDE NOMINATION OF BOARD MEMBERS FOR APPOINTMENT BY SCLHS. FORM 990 PART VI, SEC B, LINE 11B PROCESS THE ORGANIZATION USES TO REVIEW FORM 990 THE 990 FOR HOLY ROSARY HEALTHCARE WILL BE REVIEWED AT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM AND THE HOLY ROSARY HEALTHCARE BOARD MEETINGS BEFORE THE RETURN IS FILED WITH THE IRS. THE 990 TAX RETURN IS REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. FORM 990, PART VI, SEC B, LINE 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST ALL HOLY ROSARY HEALTHCARE EXECUTIVES, DIRECTORS, AND MANAGERS, BOARD MEMBERS AND BOARD COMMITTEE MEMBERS, MEDICAL EXECUTIVE COMMITTEE (MEC) MEMBERS AND OTHER PHYSICIANS IN DECISION MAKING ROLES OR SERVING ON HRH COMMITTEES, COMPLETE A NEW CONFLICT OF INTEREST (COI) DISCLOSURE FORM ANNUALLY. A COPY OF THE POLICY IS DISTRIBUTED ALONG WITH THE COI FORMS. IN THE EVENT OF A CHANGE OF CIRCUMSTANCE, EACH INDIVIDUAL WHO HAS ALREADY SIGNED A COI IS EXPECTED TO NOTIFY THE ORGANIZATION OF THE CHANGE AND UPDATE THE CONFLICT OF INTEREST INFORMATION. THE STATEMENTS ARE REVIEWED AND COI ISSUES ARE ADDRESSED BY THE ORGANIZATION RESPONSIBILITY OFFICER (ORO) AND LEADERSHIP AT THE APPROPRIATE LEVEL: - BOARD BY BOARD CHAIR - PHYSICIANS BY THE MEC PRESIDENT - HRH DIRECTORS AND MANAGERS BY THE HRH ADMINISTRATION - HRH EXECUTIVES BY THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM THE SIGNED COI FORMS ARE MAINTAINED IN HRH ADMISTRATION. THE CONFLICT OF INTEREST DISCLOSURE STATEMENTS FOR HRH EXECUTIVES ARE MAINTAINED AT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AT THE BEGINNING OF BOARD AND BOARD COMMITTEE MEETINGS, THE QUESTION OF COI IS ASKED OF THOSE IN ATTENDANCE. WHEN AN ACTUAL CONFLICT IS IDENTIFIED, THE INDIVIDUAL ASKS TO BE EXCUSED FROM PARTICIPATING IN THE DISCUSSIONS AND DECISION-MAKING. FORM 990, PART VI, LINES 15A & B SCLHS EMPLOYS THE EXECUTIVE TEAM AT EACH OF ITS HOSPITAL AFFILIATES. AS PART OF ITS ANNUAL REVIEW PROCESS, SCLHS USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF THOSE IN THESE POSITIONS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -WRITTEN EMPLOYMENT CONTRACTS -COMPENSATION SURVEYS AND STUDIES -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS EXECUTIVES (OFFICERS, KEY EMPLOYEES, ETC.) IS CONSISTENT WITH MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. THE PAY PHILOSOPHY SET BY THE BOARD IS TO PAY AT THE MIDDLE OF THE MARKET FOR EXECUTIVES OF SIMILAR SIZED ORGANIZATIONS OVERALL. SCLHS' EXECUTIVE COMPENSATION IS COMPARABLE TO THAT PROVIDED IN SIMILAR, NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS. FORM 990 PART VI, SEC C, LINE 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE AT HOSPITAL ADMINISTRATION UPON REQUEST. THE SISTERS OF CHARITY CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE ON THE SISTERS OF CHARITY WEBSITE WWW.SCLHEALTHSYSTEM.ORG. FORM 990, PART VII AND SCHEDULE J, PART II AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS ESTIMATE OF AVERAGE HOURS PER WEEK, IF ANY, DEVOTED TO RELATED ORGANIZATIONS FOR WHICH COMPENSATION WAS REPORTED IN COLUMNS (E) OR (F) OF PART VII: - JAMES PAQUETTE 36 HOURS/WEEK ON RELATED ORGANIZATIONS - STEVE BALLOCK 35 HOURS/WEEK ON RELATED ORGANIZATIONS - RON WEBB 1 HOUR/WEEK ON WORK FOR HRH FOUNDATION - RICHARD LOPES 1 HOUR/WEEK ON WORK FOR HRH FOUNDATION - PAUL LEWIS 1 HOUR/WEEK ON WORK FOR HRH FOUNDATION FORM 990, PART XI, LINE 5 RECONCILIATION OF NET ASSETS THE CHANGES IN NET ASSETS SHOWN ON LINE 5 OF PART XI ($16,765) STEM FROM THE UNREALIZED LOSS ON INVESTMENTS NOT RECORDED IN THE TAX RETURN STATEMENT OF CONTROLLED FOREIGN CORPORATION HOLY ROSARY HEALTHCARE, PARTICIPATION CORPORATION EIN: 81-0231792 FOR THE TAX YEAR ENDED DECEMBER 31, 2011 THIS STATEMENT IS BEING FILED PURSUANT TO TREAS. REG. 1.6038-2(J)(3). HOLY ROSARY HEALTHCARE'S FILING REQUIREMENT FOR FORM 5471 FOR THE CONTROLLED FOREIGN CORPORATIONS LISTED BELOW HAS BEEN SATISFIED BY SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (FEIN:23-7379161). SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM HAS INCLUDED THE FORM 5471 WITH ITS FORM 990 WHICH WAS FILED ELECTRONICALLY. LEAVEN INSURANCE COMPANY, LTD. 98-0370522 23 LIMETREE BAY AVE., PO BOX 1051 GEORGE TOWN, GRAND CAYMAN KY1-1102 CJ RIVERVIEW MULTI-SERIES FUND SPC, LTD. 510 THORNALL STREET, SUITE 220 EDISON, NJ 08837 AUSTIN CAPITAL SAFE HARBOR OFFSHORE FUND, LTD. PO BOX 31106, 89 NEXUS WAY, 2ND FLOOR CAMANA BAY GEORGE TOWN, GRAND CAYMAN KY1-1205 CJ JP MORGAN HEDGE FUND SPC-ACCESS MAR09 SEGREGATED 98-0680591 %INT'L FUND SVCS LTD, 78 SIR JOHN ROGERSON'S QUAY DUBLIN, IRELAND 2 EI JP MORGAN HEDGE FUND SPC-ACCESS JUN09 SEGREGATED 98-0680582 %INT'L FUND SVCS LTD, 78 SIR JOHN ROGERSON'S QUAY DUBLIN, IRELAND 2 EI | Explanation |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (28 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| SISTERS OF CHARITY LEAVENWORTH HLTH SYST | ||||||||||
| 2420 WEST 26TH AVE STE 100-D | DENVER | CO | 80211 | 237379161 | SUPPORT MMBRS | KS | 501(C)(3) | 11B-TYPE II | NA | false |
| CARITAS CLINICS INC | ||||||||||
| 818 NORTH 7TH STREET | LEAVENWORTH | KS | 66048 | 481009910 | CLINIC SVCS | KS | 501(C)(3) | 3 | SCLHS | false |
| MARIAN CLINIC INC | ||||||||||
| 1001 SW GARFIELD | TOPEKA | KS | 66604 | 481046905 | CLINIC SVCS | KS | 501(C)(3) | 3 | SCLHS | false |
| MARILLAC CLINIC INC | ||||||||||
| 2333 N 6TH STREET | GRAND JUNCTION | CO | 81501 | 841085822 | CLINIC SVCS | CO | 501(C)(3) | 3 | SCLHS | false |
| PROVIDENCE MEDICAL CENTER | ||||||||||
| 8929 PARALLEL PARKWAY | KANSAS CITY | KS | 66112 | 480784446 | HEALTHCARE | KS | 501(C)(3) | 3 | SCLHS | false |
| ST JOHN HOSPITAL INC | ||||||||||
| 3500 SOUTH FOURTH STREET | LEAVENWORTH | KS | 66048 | 480543768 | HEALTHCARE | KS | 501(C)(3) | 3 | PMC | false |
| BETHANY COMMUNITY PLAZA INC | ||||||||||
| 15 NORTH 12TH STREET | KANSAS CITY | KS | 66102 | 481207407 | HEALTHCARE | KS | 501(C)(3) | 3 | PMC | false |
| PROVIDENCEST JOHN FOUNDATION INC | ||||||||||
| 8929 PARALLEL PARKWAY | KANSAS CITY | KS | 66112 | 480925688 | SUPPORT 501C3 | KS | 501(C)(3) | 7 | PMC | false |
| ST FRANCIS HEALTH CENTER INC | ||||||||||
| 1700 SW 7TH STREET | TOPEKA | KS | 66606 | 480547719 | HEALTHCARE | KS | 501(C)(3) | 3 | SCLHS | false |
| ST FRANCIS HEALTH CENTER FOUNDATION | ||||||||||
| 1700 SW 7TH STREET | TOPEKA | KS | 66606 | 481092520 | SUPPORT 501C3 | KS | 501(C)(3) | 11A-TYPE I | SFHC | false |
| ST MARYS HOSPITAL & MEDICAL CENTER INC | ||||||||||
| 2635 N 7TH STREET | GRAND JUNCTION | CO | 81502 | 840425720 | HEALTHCARE | CO | 501(C)(3) | 3 | SCLHS | false |
| ST MARYS HOSPITAL FOUNDATION | ||||||||||
| 2635 N 7TH STREET | GRAND JUNCTION | CO | 81502 | 237001007 | SUPPORT 501C3 | CO | 501(C)(3) | 11A-TYPE I | SMHMC | false |
| SAINT JOSEPH HOSPITAL FOUNDATION | ||||||||||
| 1835 FRANKLIN STREET | DENVER | CO | 80218 | 840735096 | SUPPORT 501C3 | CO | 501(C)(3) | 11A-TYPE I | SJH | false |
| HOLY ROSARY HEALTHCARE FOUNDATION INC | ||||||||||
| 2600 WILSON | MILES CITY | MT | 59301 | 202270238 | SUPPORT 501C3 | MT | 501(C)(3) | 11A-TYPE I | HRHC | true |
| ST VINCENT HEALTHCARE | ||||||||||
| 1233 NORTH 30TH | BILLINGS | MT | 59101 | 810232124 | HEALTHCARE | MT | 501(C)(3) | 3 | SCLHS | false |
| ST VINCENT HEALTHCARE FOUNDATION | ||||||||||
| PO BOX 35200 | BILLINGS | MT | 59107 | 810468034 | SUPPORT 501C3 | MT | 501(C)(3) | 7 | SVHC | false |
| NORTHWEST RESEARCH & EDUCATION INSTITUTE | ||||||||||
| 315 NORTH 25TH STREET | BILLINGS | MT | 59101 | 201343024 | COMM HLTH RES | MT | 501(C)(3) | 9 | SVHC | false |
| ST JAMES HEALTHCARE | ||||||||||
| 400 SOUTH CLARK STREET | BUTTE | MT | 59701 | 810231785 | HEALTHCARE | MT | 501(C)(3) | 3 | SCLHS | false |
| ST JAMES HEALTHCARE FOUNDATION | ||||||||||
| 400 SOUTH CLARK STREET | BUTTE | MT | 59701 | 651202190 | SUPPORT 501C3 | MT | 501(C)(3) | 11A-TYPE I | SJHC | false |
| SAINT JOHN'S HEALTH CENTER | ||||||||||
| 2121 SANTA MONICA BLVD | SANTA MONICA | CA | 90404 | 951684082 | HEALTHCARE | CA | 501(C)(3) | 3 | SCLHS | false |
| JOHN WAYNE CANCER INSTITUTE | ||||||||||
| 2000 SANTA MONICA BLVD | SANTA MONICA | CA | 90404 | 954291515 | CANCER R&D | CA | 501(C)(3) | 4 | SJHHC | false |
| SAINT JOHNS HOSPITAL & HLTH CENTER FNDTN | ||||||||||
| 2121 SANTA MONICA BLVD | SANTA MONICA | CA | 90404 | 956100079 | SUPPORT 501C3 | CA | 501(C)(3) | 11A-TYPE I | SJHHC | false |
| EXEMPLA INC FKA LUTHERAN HOSPITAL | ||||||||||
| 2420 W 26TH AVE SUITE 100D | DENVER | CO | 80211 | 841103606 | HEALTHCARE | CO | 501(C)(3) | 3 | SCLHS | false |
| EXEMPLA LUTHERAN MEDICAL CENTER FNDTN | ||||||||||
| 2480 W 26TH AVESUITE 360B | DENVER | CO | 80211 | 208846152 | SUPPORT 501C3 | CO | 501(C)(3) | 7 | EXEMPLA INC | false |
| EXEMPLA GOOD SAMARITAN MEDICAL CTR FNDTN | ||||||||||
| 200 EXEMPLA CIRCLE | LAFAYETTE | CO | 80026 | 841649162 | SUPPORT 501C3 | CO | 501(C)(3) | 7 | EXEMPLA INC | false |
| LUTH MED CNTR PRO&GEN LIAB SELF-INS TRST | ||||||||||
| 2480 W 26TH AVESUITE 360B | DENVER | CO | 80211 | 742571584 | INSURANCE | CO | 501(C)(3) | 11A-TYPE I | EXEMPLA INC | false |
| SAINT JOSEPH HOSPITAL | ||||||||||
| 1835 FRANKLIN STREET | DENVER | CO | 80218 | 840417134 | HEALTHCARE | CO | 501(C)(3) | 3 | SCLHS | false |
| MOUNT ST VINCENT HOME INC | ||||||||||
| 4159 LOWELL BOULEVARD | DENVER | CO | 80211 | 840405260 | RESIDENT CARE | CO | 501(C)(3) | 11A-TYPE1 | SCLHS | false |
Form990 Schedule R Part III Form990ScheduleRPartIII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType |
|---|---|---|---|---|---|---|---|---|
| PAVILION IMAGING LLC | ||||||||
| 750 WELLINGTON | GRAND JUNCTION | CO | 81501 | 030516198 | RADIOLOGY | CO | NA | N/A |
| GRAND VALLEY SURGICAL CENTER LLC | ||||||||
| 710 WELLINGTON | GRAND JUNCTION | CO | 81501 | 841505075 | OP SURGERY | CO | NA | N/A |
| SAN JUAN CANCER CENTER LLC | ||||||||
| 600 SOUTH 5TH STREET | MONTROSE | CO | 81401 | 202856331 | OP CANCER | CO | NA | N/A |
| BILLINGS MRI CENTER LLC | ||||||||
| 1041 NORTH 29TH STREET | BILLINGS | MT | 59101 | 810450943 | MRI-PET SCAN | MT | NA | N/A |
| LUTHERAN CAMPUS ASC LLC | ||||||||
| 3455 LUTHRN PKW SUITE 150 | WHEATRIDGE | CO | 800336028 | 020749532 | OP SURGERY | CO | NA | N/A |
| COLORADO SURGICAL VENTURES LLC | ||||||||
| 30 S WACKER DR SUITE 2302 | CHICAGO | IL | 60605 | 208038915 | OP SURGERY | CO | NA | N/A |
| COLORADO SURGICAL HOSPITAL LLC | ||||||||
| 30 S WACKER DR SUITE 2302 | CHICAGO | IL | 60605 | 208038977 | OP SURGERY | CO | NA | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Type Of EntityTypeOfEntity | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARITAS INC AND SUBSIDIARIES | |||||||||||||
| 9801 RENNER BOULEVARD SUITE 100 | LENEXA | KS | 66219 | 480941069 | OTHER MEDICAL | KS | C CORP | ||||||
| LEAVEN INSURANCE COMPANY LTD | |||||||||||||
| 980370522 | INSURANCE | 23 LIME TREE BAY AVE PO BOX 1051 | GEORGETOWN | GRAND CAYMAN | CJ | KY1-1102 | CJ | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| ST VINCENT HEALTHCARE | ||
| O | 156160 | FMV |
| HOLY ROSARY HEALTHCARE FOUNDATION | ||
| C | 180948 | FMV |