BENEFIS HEALTH SYSTEM INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- BENEFIS HEALTH SYSTEM INC (EIN 26-3538104)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-05-03
- IRS object ID
- 201241259349300784
- Schema version
- 2011v1.2
- 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 I
- Schedule J
- Schedule K
- Schedule K
- Schedule K
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-03T17:16:26-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 910189318 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 SW BROADWAY SUITE 1200 | AddressLine1 |
| City | PORTLAND | City |
| State | OR | State |
| ZIP Code | 97205 | 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 | 263538104 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BENEFIS HEALTH SYSTEM INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BENE | NameControl |
| Phone | 4064552563 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 26TH STREET SOUTH | AddressLine1 |
| City | GREAT FALLS | City |
| State | MT | State |
| ZIP Code | 59405 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STEVE BALLOCK | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 4064552563 | Phone |
| Date Signed | 2012-04-26 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WENDY CAMPOS | Name |
| PTIN | P00448102 | PTIN |
| Phone | 5032421447 | 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 | STEVE BALLOCK | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 26TH STREET SOUTH | AddressLine1 |
| City | GREAT FALLS | City |
| State | MT | State |
| ZIP Code | 59405 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 26733280 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.BENEFIS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2008 | YearFormation |
| State Legal Domicile | MT | StateLegalDomicile |
| Activity Or Mission Description | PARENT ENTITY OF INTEGRATED HEALTH SYSTEM. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 149 | TotalNbrEmployees |
| Total Nbr Volunteers | 3 | TotalNbrVolunteers |
| Total Gross UBI | -27022 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -27022 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2092861 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 539628 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 35363378 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 35208081 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1775562 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2589077 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -21772741 | OtherRevenuePriorYear |
| Other Revenue Current Year | -25618276 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 17459060 | TotalRevenuePriorYear |
| Total Revenue Current Year | 12718510 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 648475 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 490916 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 11452480 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10200670 | 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 | 15568903 | OtherExpensePriorYear |
| Other Expenses Current Year | 16046710 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 27669858 | TotalExpensesPriorYear |
| Total Expenses Current Year | 26738296 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -10210798 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -14019786 | RevenuesLessExpensesCY |
| Total Assets BOY | 331908648 | TotalAssetsBOY |
| Total Assets EOY | 420547321 | TotalAssetsEOY |
| Total Liabilities BOY | 56479603 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 166503732 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 275429045 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 254043589 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | WE PROVIDE EXCELLENT CARE FOR ALL, HEALING BODY, MIND AND SPIRIT. BENEFIS HEALTH SYSTEM, INC. IS ORGANIZED TO OVERSEE, COORDINATE AND DIRECT THE ASSETS AND OPERATIONS OF BENEFIS HOSPITALS, INC., BENEFIS SPECTRUM MEDICAL, INC., BENEFIS MEDICAL GROUP, INC., BENEFIS SLETTEN HI-LINE CANCER CENTER, AND OTHER RELATED ENTITIES AS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SERVING THE RESIDENTS OF NORTH CENTRAL MONTANA. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 26738296 | Expense |
| Revenue | 20265867 | Revenue |
| Description | PROVIDE MANAGEMENT AND ADMINISTRATIVE SERVICES FOR MULTIPLE RELATED HEALTH CARE ENTITIES. | Description |
| Total Program Service Expense | 26738296 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 1 | 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 | 0 | 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 | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 1 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 93 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 149 | 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 |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Taxable Distributions | 0 | TaxableDistributions |
| Distribution To Donor | 0 | DistributionToDonor |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | 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 | 1 | 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 | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DALE BIMLER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4064552565 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 26TH STREET SOUTH | AddressLine1 |
| City | GREAT FALLS | City |
| State | MT | State |
| ZIP Code | 59405 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (26 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| BILL BLOEMENDAAL MD | |||||||
| DIRECTOR | 3.00 | X | 0 | 0 | 0 | ||
| BILL BOURRET | |||||||
| DIRECTOR | 6.00 | X | 0 | 0 | 0 | ||
| JIM CUMMINGS | |||||||
| SECRETARY | 3.00 | X | 0 | 0 | 0 | ||
| CHRIS EBELING | |||||||
| DIRECTOR | 3.00 | X | 0 | 0 | 0 | ||
| RICK EVANS | |||||||
| VICE CHAIR | 3.00 | X | 0 | 0 | 0 | X | |
| JOHN GOODNOW | |||||||
| CEO | 59.00 | X | 794254 | 0 | 95989 | X | |
| MILES HAMILTON | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| GREG HATLEY | |||||||
| DIRECTOR | 3.00 | X | 0 | 0 | 0 | ||
| JAMES HINDE MD | |||||||
| DIRECTOR | 3.00 | X | 0 | 0 | 0 | ||
| SUSAN HUMBLE | |||||||
| DIRECTOR | 3.00 | X | 0 | 0 | 0 | ||
| WILLIAM MCGREGOR MD | |||||||
| CHAIR | 4.50 | X | 0 | 0 | 0 | X | |
| MARY SHEEHY MOE | |||||||
| DIRECTOR | 3.00 | X | 0 | 0 | 0 | ||
| DAVID RICHARDS | |||||||
| DIRECTOR | 3.00 | X | 0 | 0 | 0 | ||
| MIKE MILBURN | |||||||
| DIRECTOR | 3.00 | X | 0 | 0 | 0 | ||
| DAVID A ROHRER MD | |||||||
| DIRECTOR | 3.00 | X | 0 | 0 | 0 | ||
| DAVE WILSEY | |||||||
| DIRECTOR | 3.00 | X | 0 | 0 | 0 | ||
| DOUGLAS DAVENPORT | |||||||
| FORMER CFO | 53.00 | 252229 | 0 | 17688 | X | ||
| WAYNE DUNN | |||||||
| SPECIAL PROJECTS ADMIN | 56.00 | 227531 | 0 | 4132 | X | ||
| LAURA GOLDHAHN | |||||||
| HOSPITAL PRESIDENT | 3.00 | 383185 | 0 | 79882 | X | ||
| TERRY OLINGER | |||||||
| CHRO/VP HR | 54.00 | 301124 | 0 | 56906 | X | ||
| LEE ROATH | |||||||
| CIO | 57.00 | 139332 | 0 | 13321 | X | ||
| KATHIE AVIS | |||||||
| CHIEF ADMIN OFFICER | 60.00 | 162222 | 0 | 7394 | X | ||
| JOSE GUEVARA | |||||||
| REVENUE CYCLE DIRECTOR | 60.00 | 181762 | 0 | 2428 | X | ||
| JUDITH HELD | |||||||
| PRESIDENT BENEFIS HEALTH SYSTEM FOUNDATION | 10.00 | 214935 | 0 | 34865 | X | ||
| THERESA PREITE | |||||||
| PRESIDENT SPECTRUM MEDICAL | 7.00 | 149528 | 0 | 12849 | X | ||
| JERRY SPEER MD | |||||||
| PRESIDENT BENEFIS MEDICAL GROUP | 7.00 | 300365 | 0 | 43717 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3106467 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 369171 | TotalOtherCompensation |
| Number Individuals GT100 K | 16 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SLETTEN CONSTRUCTION INC | |||||
| PO BOX 2467 | GREAT FALLS | MT | 59403 | CONSTRUCTION | 13249919 |
| MOUNTAIN STATES HEALTHCARE | |||||
| 1 LAWSON LANE SUITE 410 | BURLINGTON | VT | 05401 | HEALTHCARE SERVICES | 3416167 |
| GUY TABACCO CONSTRUCTION | |||||
| PO BOX 550 BLACK EAGLE | BLACK EAGLE | MT | 59414 | CONSTRUCTION | 2023311 |
| SFCS INC | |||||
| 305 SOUTH JEFFERSON ST | ROANOKE | VA | 24011 | CONSULTING | 1988773 |
| DEARBORN ADVISORS LLC | |||||
| PO BOX 66391 | CHICAGO | IL | 606660391 | CONSULTING | 1881430 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 27 | NumberOfContractorsGT100K |
| Related Organizations | 539628 | RelatedOrganizations |
| Total Contributions | 539628 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MANAGEMENT FEES | Description |
| Business Code | 541610 | BusinessCode |
| Total Revenue Column | 35208081 | TotalRevenueColumn |
| Related Or Exempt Function Income | 35186437 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 21644 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 35208081 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1491526 | TotalRevenueColumn |
| Exclusion | $1,491,526 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 3433272 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 14014770 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -10581498 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -10581498 | TotalRevenueColumn |
| Unrelated Business Revenue | 67542 | UnrelatedBusinessRevenue |
| Exclusion | -$10,649,040 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1097551 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1097551 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1097551 | TotalRevenueColumn |
| Exclusion | $1,097,551 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| JOINT VENTURE INCOME | 621990 | 1560261 | 1560261 | |
| OTHER INCOME | 621990 | 101424 | 101424 | |
| SUBSIDIARY INCOME | 621990 | -16698463 | -16582255 | -116208 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | -15036778 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12718510 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20265867 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | -27022 | UnrelatedBusinessRevenue |
| Exclusion | -$8,059,963 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 490916 | Total |
| Program Services | 490916 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2365571 | Total |
| Program Services | 2365571 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5568688 | Total |
| Program Services | 5568688 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 680419 | Total |
| Program Services | 680419 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1152313 | Total |
| Program Services | 1152313 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 433679 | Total |
| Program Services | 433679 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1216659 | Total |
| Program Services | 1216659 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 231332 | Total |
| Program Services | 231332 | ProgramServices |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17205 | Total |
| Program Services | 17205 | ProgramServices |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62941 | Total |
| Program Services | 62941 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1816084 | Total |
| Program Services | 1816084 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1451557 | Total |
| Program Services | 1451557 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 675846 | Total |
| Program Services | 675846 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2777717 | Total |
| Program Services | 2777717 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2419999 | Total |
| Program Services | 2419999 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 784125 | Total |
| Program Services | 784125 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2569166 | Total |
| Program Services | 2569166 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2024079 | Total |
| Program Services | 2024079 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26738296 | Total |
| Program Services | 26738296 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7662530 | BOY |
| EOY | 16044192 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9988141 | BOY |
| EOY | 61453024 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 356762 | BOY |
| EOY | 29359063 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 355630282 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 135915587 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 224311889 | BOY |
| EOY | 219714695 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68599000 | BOY |
| EOY | 75708248 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20990326 | BOY |
| EOY | 18268099 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 331908648 | BOY |
| EOY | 420547321 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20024603 | BOY |
| EOY | 85985363 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 112279 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 59011090 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31655000 | BOY |
| EOY | 17395000 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4800000 | BOY |
| EOY | 4000000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56479603 | BOY |
| EOY | 166503732 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 266044193 | BOY |
| EOY | 254043589 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2273578 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7111274 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 275429045 | BOY |
| EOY | 254043589 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 331908648 | BOY |
| EOY | 420547321 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -14019786 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -7365670 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type3 Func Int | X | SupportingOrg509a3Type3FuncInt |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (3 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| BENEFIS HOSPITALS INC | |||||
| 810232122 | 3 | 1 | 1 | 1 | $29,822,025 |
| BENEFIS MEDICAL GROUP INC | |||||
| 263538192 | 3 | 1 | 1 | 1 | $4,816,302 |
| BENEFIS SPECTRUM MEDICAL INC | |||||
| 810431871 | 9 | 1 | 1 | 1 | $557,570 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 3 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 35195897 | SumOfAmounts |
| General Explanation | SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: PART 1, LINE 11H: THE ORGANIZATION SUPPORTS AND BENEFITS EACH OF THE DESIGNATED SUPPORTED ORGANIZATIONS BY PROVIDING STRATEGIC OVERSIGHT AND DIRECTION, AS WELL AS A RANGE OF ADMINISTRATIVE SERVICES, ON A CENTRALIZED BASIS FOR THEIR COLLECTIVE BEHALF. | GeneralExplanation |
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) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $32,764 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 32764 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | THE ORGANIZATION PARTICIPATES IN THE AMERICAN HOSPITAL AND MONTANA HOSPITAL ASSOCIATIONS. A PORTION OF ASSOCIATION DUES AND STAFF SALARIES ARE RELATED TO LOBBYING FOR VARIOUS HEALTH CARE ISSUES. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 9384851 | BeginningOfYearBalance |
| Contributions | 6844397 | Contributions |
| Investment Earnings Or Losses | 39106 | InvestmentEarningsOrLosses |
| Other Expenditures | 180722 | OtherExpenditures |
| Administrative Expenses | 89069 | AdministrativeExpenses |
| End Of Year Balance | 15998563 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | 9606866 | Contributions |
| Investment Earnings Or Losses | 313085 | InvestmentEarningsOrLosses |
| Other Expenditures | 535100 | OtherExpenditures |
| End Of Year Balance | 9384851 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.13880 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.84960 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.01160 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9019234 | OtherCostOrOtherBasis |
| Book Value | 9019234 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 206372756 | OtherCostOrOtherBasis |
| Depreciation | 55866657 | Depreciation |
| Book Value | 150506099 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 100145757 | OtherCostOrOtherBasis |
| Depreciation | 64298340 | Depreciation |
| Book Value | 35847417 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 22333106 | OtherCostOrOtherBasis |
| Depreciation | 12735605 | Depreciation |
| Book Value | 9597501 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17759429 | OtherCostOrOtherBasis |
| Depreciation | 3014985 | Depreciation |
| Book Value | 14744444 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 219714695 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (4 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| RBC INVESTMENTS | 50860995 | F |
| DA DAVIDSON INVESTMENTS | 22250201 | F |
| WELLS FARGO INVESTMENTS | 2866673 | F |
| PARTNERSHIP INVESTMENTS | -269621 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 75708248 | TotalOfBookValueSecurities |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | ENDOWMENT FUNDS ARE RELATED TO BENEFIS HEALTH SYSTEM FOUNDATION, INC. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. EFFECTIVE JANUARY 1, 2009, THE ORGANIZATION ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2011 OR 2010. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| MCLAUGHLIN RESEARCH INSTITUTE | |||||||
| 1520 23RD ST SOUTH | GREAT FALLS | MT | 59405 | 810459235 | 501(C)(3) | 150000 | MEDICAL RESEARCH |
| MSU - GREAT FALLS COT | |||||||
| 2100 16TH AVE SOUTH | GREAT FALLS | MT | 59405 | 810522790 | 501(C)(3) | 97000 | NURSING SCHOLARSHIP |
| NORTH CENTRAL MONTANA HEALTHCARE ALLIANCE | |||||||
| 1101 26TH ST SOUTH | GREAT FALLS | MT | 59405 | 721587972 | 501(C)(3) | 21359 | EDUCATION |
| MSU FOUNDATION | |||||||
| 1501 S 11TH AVE | BOZEMAN | MT | 59717 | 816001649 | 501(C)(3) | 32000 | SUPPORT |
| GREAT FALLS DEVELOPMENT AUTHORITY | |||||||
| 300 CENTRAL AVE | GREAT FALLS | MT | 59401 | 810465605 | 501(C)(3) | 30000 | SUPPORT |
| AMERICAN CANCER SOCIETY | |||||||
| 3000 15TH AVE SOUTH | GREAT FALLS | MT | 59405 | 131788491 | 501(C)(3) | 5000 | RELAY SPONSORSHIP |
| CITY COUNTY HEALTH DEPARTMENT | |||||||
| 115 4TH STREET SOUTH | GREAT FALLS | MT | 59401 | 816001343 | N/A - GOVT | 73951 | SUPPORT |
| GREAT FALLS PUBLIC SCHOOLS FOUNDATION | |||||||
| PO BOX 2429 | GREAT FALLS | MT | 59405 | 272577990 | 501(C)(3) | 12000 | SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 8 | TotalNbrOf501C3AndGovtGrants |
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: DONATIONS ARE APPROVED BY APPROPRIATE MANAGEMENT IN THE SAME MANNER AS OTHER EXPENDITURES. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | X | TravelForCompanions |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | 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 | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN GOODNOW | |||||||||||||
| 517375 | 0 | 268693 | 0 | 8186 | 0 | 90540 | 0 | 5449 | 0 | 890243 | 0 | 0 | 0 |
| DOUGLAS DAVENPORT | |||||||||||||
| 241272 | 0 | 7912 | 0 | 3045 | 0 | 12250 | 0 | 5438 | 0 | 269917 | 0 | 0 | 0 |
| WAYNE DUNN | |||||||||||||
| 94482 | 0 | 113411 | 0 | 19638 | 0 | 3179 | 0 | 953 | 0 | 231663 | 0 | 0 | 0 |
| LAURA GOLDHAHN | |||||||||||||
| 303153 | 0 | 71185 | 0 | 8847 | 0 | 75653 | 0 | 4229 | 0 | 463067 | 0 | 0 | 0 |
| TERRY OLINGER | |||||||||||||
| 239256 | 0 | 60051 | 0 | 1817 | 0 | 50312 | 0 | 6594 | 0 | 358030 | 0 | 0 | 0 |
| LEE ROATH | |||||||||||||
| 124622 | 0 | 14710 | 0 | 0 | 0 | 7897 | 0 | 5424 | 0 | 152653 | 0 | 0 | 0 |
| KATHIE AVIS | |||||||||||||
| 141704 | 0 | 20518 | 0 | 0 | 0 | 2430 | 0 | 4964 | 0 | 169616 | 0 | 0 | 0 |
| JOSE GUEVARA | |||||||||||||
| 156762 | 0 | 0 | 0 | 25000 | 0 | 2201 | 0 | 227 | 0 | 184190 | 0 | 0 | 0 |
| JUDITH HELD | |||||||||||||
| 141480 | 0 | 8455 | 0 | 65000 | 0 | 26514 | 0 | 8351 | 0 | 249800 | 0 | 0 | 0 |
| THERESA PREITE | |||||||||||||
| 120293 | 0 | 25555 | 0 | 3680 | 0 | 7897 | 0 | 4952 | 0 | 162377 | 0 | 0 | 0 |
| JERRY SPEER MD | |||||||||||||
| 260323 | 0 | 40042 | 0 | 0 | 0 | 38376 | 0 | 5341 | 0 | 344082 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | THE HEALTH CLUB WHERE OFFICERS ARE MEMBERS IS A SUBSIDIARY OF BENEFIS HEALTH SYSTEM, INC (BHS). THROUGH APRIL 2011, HEALTH CLUB DUES THAT BHS PAID FOR ITS OFFICERS WERE TREATED AS TAXABLE INCOME TO THE INDIVIDUAL ACCORDINGLY. OFFICERS AND DEPARTMENT HEADS WERE ELIGIBLE FOR HEALTH CLUB DUES. SUBSTANTIATION WAS REQUIRED BEFORE ANY REIMBURSEMENTS WERE PAID. SUBSEQUENT TO APRIL 2011, DISCOUNTS ONLY ARE OFFERED TO ALL EMPLOYEES OF BENEFIS. TRAVEL FOR COMPANIONS THAT BHS PAYS FOR ITS OFFICERS IS TREATED AS TAXABLE INCOME TO THE INDIVIDUAL ACCORDINGLY. |
| PART I, LINES 4A-B | THE FOLLOWING EMPLOYEES REPORTED ON FORM 990 PART VII RECEIVED SEVERANCE PAYMENTS: JUDITH HELD, FORMER BENEFIS FOUNDATION PRESIDENT = $65,000 JOSE GUEVARA, FORMER REVENUE CYCLE DIRECTOR = $25,000 A PORTION OF JUDITH HELD'S SEVERANCE PACKAGE WAS PAID OUT IN 2011 AND A PORTION IS 2011 DEFERRED COMPENSATION THAT WILL BE PAID OUT IN 2012. THE ORGANIZATION PROVIDES A SECTION 457 NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EMPLOYEES. |
| PART I, LINE 7 | THE ORGANIZATION MAINTAINS AN INCENTIVE COMPENSATION PLAN THAT INCORPORATES BOTH SHARED AND INDIVIDUAL GOALS FOR MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM, AND IS SUBJECT TO A PRECONDITION THAT THE SYSTEM MUST ACHIEVE BUDGETED OPERATING PERFORMANCE. IN 2010, THE ORGANIZATION ADOPTED SHARED PERFORMANCE OBJECTIVES INCLUDING SYSTEM GROWTH AS WELL AS MEASURES TIED TO WORKFORCE, PATIENT EXPERIENCE, PATIENT SAFETY, CLINICAL QUALITY, FINANCE/OPERATIONS, AND COMMUNITY BENEFIT. THE INDIVIDUAL PERFORMANCE OBJECTIVES ADOPTED IN 2010 ARE BASED ON AN ARRAY OF QUALITY, FINANCIAL, OPERATIONAL AND STRATEGIC INITIATIVES. INCENTIVE OPPORTUNITY LEVELS ARE CALCULATED BASED ON PREDETERMINED PERCENTAGES OF EACH EXECUTIVE'S BASE SALARY, AND VARY BASED ON THE ACHIEVEMENT OF THRESHOLD, TARGET OR STRETCH LEVELS AS TO EACH PERFORMANCE OBJECTIVE. THE ORGANIZATION ALSO MAINTAINS A LONG-TERM INCENTIVE PLAN DIRECTED AT RECRUITING AND RETAINING EXECUTIVE LEADERSHIP. PAYMENTS UNDER THE LONG-TERM PLAN ARE CONDITIONED ON AN EXECUTIVE REMAINING EMPLOYED BY THE ORGANIZATION AND MAINTAINING SATISFACTORY INDIVIDUAL PERFORMANCE. IN ADDITION, THE ORGANIZATION MUST HAVE MAINTAINED SATISFACTORY OVERALL PERFORMANCE, BASED ON BOTH FINANCIAL CRITERIA AND SATISFACTION OF EMPLOYEES, PATIENTS AND PHYSICIANS. INCENTIVE OPPORTUNITIES UNDER THE LONG-TERM PLAN ARE APPROVED IN ADVANCE BY THE COMPENSATION COMMITTEE, WITH LATER PAYOUTS APPROVED BY THE COMMITTEE BASED ON ACTUAL PERFORMANCE RESULTS. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KJT9 | 2011-04-01 | 65000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KJU6 | 2011-04-01 | 115000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KJV4 | 2011-04-01 | 160000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KJW2 | 2011-04-01 | 200000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|
| 63906 | 40261 | 1921 | 23645 | 2013 | 0 | 0 | 0 | 1 |
| 113065 | 71231 | 3399 | 41834 | 2013 | 0 | 0 | 0 | 1 |
| 157307 | 99103 | 4729 | 58204 | 2013 | 0 | 0 | 0 | 1 |
| 196634 | 123879 | 5911 | 72755 | 2013 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 1 | 0 | 0 | 0 | 0 | 0 |
| 1 | 0 | 0 | 0 | 0 | 0 |
| 1 | 0 | 0 | 0 | 0 | 0 |
| 1 | 0 | 0 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fed Tax Requirements Compliance | X | FedTaxRequirementsCompliance |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KJX0 | 2011-04-01 | 295000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KJY8 | 2011-04-01 | 1380000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KJZ5 | 2011-04-01 | 980000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KKA8 | 2011-04-01 | 1590000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|
| 290035 | 182722 | 8718 | 107313 | 2013 | 0 | 0 | 0 | 1 |
| 1356775 | 854768 | 40784 | 502007 | 2013 | 0 | 0 | 0 | 1 |
| 963507 | 607009 | 28963 | 356498 | 2013 | 0 | 0 | 0 | 1 |
| 1563241 | 984841 | 46991 | 578400 | 2013 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 1 | 0 | 0 | 0 | 0 | 0 |
| 1 | 0 | 0 | 0 | 0 | 0 |
| 1 | 0 | 0 | 0 | 0 | 0 |
| 1 | 0 | 0 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KKB6 | 2011-04-01 | 1685000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KKC4 | 2011-04-01 | 1785000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KKD2 | 2011-04-01 | 1885000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KKE0 | 2011-04-01 | 1995000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|
| 1656642 | 1043684 | 49798 | 612958 | 2013 | 0 | 0 | 0 | 1 |
| 1754959 | 1105623 | 52754 | 649336 | 2013 | 0 | 0 | 0 | 1 |
| 1853276 | 1167563 | 55709 | 685713 | 2013 | 0 | 0 | 0 | 1 |
| 1961425 | 1235697 | 58960 | 725728 | 2013 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 1 | 0 | 0 | 0 | 0 | 0 |
| 1 | 0 | 0 | 0 | 0 | 0 |
| 1 | 0 | 0 | 0 | 0 | 0 |
| 1 | 0 | 0 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KKF7 | 2011-04-01 | 2110000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 61204KKG5 | 2011-04-01 | 27840000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 |
| BENEFIS HEALTH SYSTEM INC | |||||||
| 263538104 | 2011-06-01 | 17695000 | CONSTRUCTION/EXPANSION OF HEALTHCARE FACILITY | 0 | 0 | 0 | |
Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|
| 2074489 | 1306927 | 62359 | 767562 | 2013 | 0 | 0 | 0 | 1 |
| 27371460 | 17244007 | 822781 | 10127453 | 2013 | 0 | 0 | 0 | 1 |
| 17695000 | 17695000 | 2011 | 0 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate | Term Of HedgeTermOfHedge | Superintegrated HedgeSuperintegratedHedge | Hedge TerminatedHedgeTerminated |
|---|---|---|---|---|---|---|---|---|
| (no name) | ||||||||
| 1 | 0 | 0 | 0 | 0 | 0 | |||
| (no name) | ||||||||
| 1 | 0 | 0 | 0 | 0 | 0 | |||
| DEUTSCHE BANK | ||||||||
| 1 | 1 | 1 | 0 | 0 | 0 | 19.000000000000 | 1 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part III Form990ScheduleLPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Interested Person | CHRIS EBELING | NameOfInterestedPerson |
| Relationship With Organization | DIRECTOR | RelationshipWithOrganization |
| Amount Of Grant | 150000 | AmountOfGrant |
| Type Of Assistance | MEDICAL RESEARCH OPERATIONAL SUPPORT PAID TO MCLAUGHLIN RESEARCH INSTITUTE | TypeOfAssistance |
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ELIZABETH EBELING | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | FAMILY MEMBER OF DIRECTOR | Relationship |
| Amount Of Transaction | 58608 | AmountOfTransaction |
| Description Of Transaction | COMPENSATION FOR EMPLOYMENT AS A NURSE. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| NEW PROGRAM SERVICES | FORM 990, PART III, LINE 2 | IN LATTER 2011, BENEFIS HEALTH SYSTEM FOUNDATION, INC. WAS RESTRUCTURED AND BECAME A DIRECTLY CONTROLLED ENTITY OF BENEFIS HEALTH SYSTEM, INC. |
| FORM 990, PART VI, SECTION A, LINE 2 | CERTAIN OF THE OFFICERS AND DIRECTORS LISTED IN PART VII ALSO HOLD OFFICER AND/OR DIRECTOR POSITIONS IN RELATION TO THE ORGANIZATION'S AFFILIATES (AS IDENTIFIED IN SCHEDULE R) AND, IN THAT REGARD, MAY BE CONSIDERED TO HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER. | |
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT OF FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING. THE DRAFT IS REVIEWED IN DETAIL WITH THE BOARD AND QUESTIONS ARE ANSWERED ON ITEMS OF INTEREST. | |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS ANNUALLY COMPLETE A FORM TO DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. IN ADDITION, AT THE START OF EACH BOARD MEETING, MEMBERS ARE ASKED TO INDICATE WHETHER THEY HAVE A CONFLICT OF INTEREST WITH RESPECT TO ANY ITEMS ON THE AGENDA FOR THE MEETING. CONSISTENT WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY, BOARD MEMBERS ARE PROHIBITED FROM PARTICIPATING ON ANY MATTERS AS TO WHICH THEY HAVE A CONFLICT. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE CHAIR, VICE CHAIR, CEO, CFO, SPECIAL PROJECTS COORDINATOR AND CHRO/VP OF HR WAS SET BY THEIR RESPECTIVE SUPERVISORY EXECUTIVES IN CONSULTATION WITH THE HUMAN RESOURCES DEPARTMENT AND EXECUTIVE LEADERSHIP. THE PROCESS INVOLVED REVIEW BY INDEPENDENT PERSONS WHO CONFIRMED TOTAL COMPENSATION AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. THE PROCESS AND DATA RELIED ON WERE THOROUGHLY AND TIMELY DOCUMENTED. THIS INCLUDES A TOTAL COMPENSATION ASSESSMENT, PROFESSIONAL OPINION ON REASONABLENESS OF COMPENSATION AND REASONABLENESS OF BENEFITS. IN 2011, THE BOARD OF DIRECTORS ESTABLISHED AN INDEPENDENT COMPENSATION COMMITTEE, WHICH IS CHARGED WITH ADMINISTERING THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY, POLICIES AND PROGRAMS IN THE MANNER SET FORTH IN THE COMMITTEE'S WRITTEN CHARTER. THE COMMITTEE'S RESPONSIBILITIES INCLUDE (I) DETERMINING APPROPRIATE COMPENSATION FOR ALL EXECUTIVES AND OTHER KEY EMPLOYEES, (II) EVALUATING AND ADOPTING EXECUTIVE COMPENSATION PLANS, POLICIES AND PROGRAMS, (III) REVIEWING AND APPROVING EXECUTIVE BENEFIT PLANS, AND (IV) VERIFYING THAT COMPENSATION IS APPROPRIATELY AND FULLY DISCLOSED AND REPORTED. THE COMMITTEE HAS ENGAGED AN INDEPENDENT COMPENSATION CONSULTING FIRM TO ASSIST IN ENSURING THAT AMOUNTS PAID TO THE ORGANIZATION'S EXECUTIVES ARE CONSISTENT WITH REASONABLE, FAIR MARKET LEVELS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. | |
| FORM 990, PART VI, SECTION C, LINE 19 | BENEFIS HEALTH SYSTEM, INC. PROVIDES COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST DURING NORMAL BUSINESS HOURS. | |
| FORM 990, PART VI, SECTION A, LINE 2: | CERTAIN OF THE OFFICERS AND DIRECTORS LISTED IN PART VII ALSO HOLD OFFICER AND/OR DIRECTOR POSITIONS IN RELATION TO THE ORGANIZATION'S AFFILIATES (AS IDENTIFIED IN SCHEDULE R) AND IN THAT REGARD, MAY BE CONSIDERED TO HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER. | |
| AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: | FORM 990, PART VII, SECTION A, COLUMN B | DOUGLAS DAVENPORT - 7 HOURS WAYNE DUNN - 4 HOURS CHRIS EBELING - 4 HOURS RICK EVANS - 3 HOURS LAURA GOLDHAHN - 57 HOURS JOHN GOODNOW - 1 HOUR GREG HATLEY - 1 HOUR JUDITH HELD - 50 HOURS TERRY OLINGER - 6 HOURS THERESA PREITE - 53 HOURS DAVID RICHARDS - 6 HOURS H. LEE ROATH - 3 HOURS JERRY SPEER - 53 HOURS |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -2,512,360. NET UNREALIZED GAIN/LOSS ON SWAPS -4,556,970. INTERCOMPANY TRANSFERS -1,578,443. BOOK/TAX DIFFERENCE IN SUBSIDIARY AND JOINT VENTURE INCOME 722,027. CHANGE IN BENEFICAL INTEREST 560,076. TOTAL TO FORM 990, PART XI, LINE 5: -7,365,670. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| BENEFIS SLETTEN HI-LINE CANCER CENTER LLC | |||||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 263144419 | MEDICAL CARE | MT | 468828 | 1675454 | BENEFIS HEALTH SYSTEM INC |
| BENEFIS CASCADE RIDGE LLC | |||||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 274602798 | REAL ESTATE | MT | -104 | -104 | BENEFIS HEALTH SYSTEM INC |
| BENEFIS HEALTH SYSTEM FOUNDATION PROPERTIES LLC | |||||||||
| PO BOX 7008 | GREAT FALLS | MT | 59406 | 272514629 | HOLDS REAL PROPERTY DONATED TO FOUNDATION | MT | BENEFIS HEALTH SYSTEM FOUNDATION INC | ||
Form990 Schedule R Part II Form990ScheduleRPartII (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| BENEFIS HOSPITALS INC | ||||||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 810232122 | HOSPITAL | MT | 501(C)(3) | SCHEDULE A LINE 3 | BENEFIS HEALTH SYSTEM INC | 1 |
| BENEFIS SPECTRUM MEDICAL INC | ||||||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 810431871 | HOME HEALTH & RELATED PRODUCTS | MT | 501(C)(3) | SCHEDULE A LINE 9 | BENEFIS HEALTH SYSTEM INC | 1 |
| BENEFIS MEDICAL GROUP INC | ||||||||||
| 1401 25TH STREET SOUTH | GREAT FALLS | MT | 59405 | 263538192 | PHYSICIAN SERVICES | MT | 501(C)(3) | SCHEDULE A LINE 3 | BENEFIS HEALTH SYSTEM INC | 1 |
| BENEFIS HEALTHCARE EES HEALTH PLAN AND TRUST | ||||||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 363386166 | BENEFIT PLAN | MT | 501(C)(9) | BENEFIS HEALTH SYSTEM INC | 1 | |
| BENEFIS HEALTH SYSTEM FOUNDATION INC | ||||||||||
| PO BOX 7008 | GREAT FALLS | MT | 59405 | 810480587 | FOUNDATION | MT | 501(C)(3) | SCHEDULE A, LINE 7 | BENEFIS HEALTH SYSTEM INC | 1 |
Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BBB LLC | ||||||||||||||
| 1101 26TH STREET SOUTH | GREAT FALLS | MT | 59405 | 263652926 | MEDICAL BUILDING | MT | BENEFIS HEALTH SYSTEM INC | RELATED | -153563 | 8975290 | 0 | 1 | 0.60000 | |
| GREAT FALLS ATHLETIC CLUB LLC | ||||||||||||||
| 1800 BENEFIS COURT | GREAT FALLS | MT | 59405 | 912081505 | FITNESS CLUB | MT | BENEFIS HEALTH SYSTEM INC | UNRELATED | 37355 | 4119591 | 0 | 1 | 0.51000 | |
| SPECTRUM HOME SOLUTIONS | ||||||||||||||
| 2509 7TH AVE SOUTH | GREAT FALLS | MT | 59405 | 810431871 | IV THERAPY | MT | N/A | 0 | 0 | N/A | ||||
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BENEFIS HEALTHCARE PRACTITIONERS PC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 26TH STREET SOUTH | AddressLine1 |
| City | GREAT FALLS | City |
| State | MT | State |
| ZIP Code | 59405 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201383362 | EIN |
| Primary Activity | HEALTHCARE SERVICES | PrimaryActivity |
| Legal Domicile State | MT | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BENEFIS HEALTH SYSTEM INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | 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 | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| BENEFIS MEDICAL GROUP INC | ||
| B | 9050000 | DIRECT ALLOCATION |
| BENEFIS MEDICAL GROUP INC | ||
| A | 1209856 | DIRECT ALLOCATION |
| BENEFIS MEDICAL GROUP INC | ||
| K | 4816302 | DIRECT ALLOCATION |
| BENEFIS HOSPITALS INC | ||
| K | 29822025 | DIRECT ALLOCATION |
| BENEFIS HOSPITALS INC | ||
| R | 17472984 | DIRECT ALLOCATION |
| BENEFIS SPECTRUM MEDICAL INC | ||
| K | 557570 | DIRECT ALLOCATION |
| BBB LLC | ||
| A | 67542 | LAND LEASE |
| BBB LLC | ||
| R | 117000 | CASH DISTRIBUTINS |
| GREAT FALLS ATHLETIC CLUB LLC | ||
| R | 196860 | CASH DISTRIBUTINS |
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