NORTHERN MONTANA HEALTH CARE INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
NORTHERN MONTANA HEALTH CARE INC (EIN 81-0428854)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-16
IRS object ID
201121369349302362
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-16T09:45:19-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1401N 31ST ST SUITE 1120 PO BOX 7112AddressLine1
CityBILLINGSCity
StateMTState
ZIP Code591037112ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN810428854EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Northern Montana Health Care IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone4062652211Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1231AddressLine1
CityHavreCity
StateMTState
ZIP Code59501ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDavid HenryName
TitlePresident/CEOTitle
Phone4062652211Phone
Date Signed2011-05-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSteve MarkovichName
Phone4068962400Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDavid HenryNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO Box 1231AddressLine1
CityHavreCity
StateMTState
ZIP Code59501ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3948656GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.nmhcare.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicileMTStateLegalDomicile
Activity Or Mission DescriptionProvision of Healthcare ServicesActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers150TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year508325ContributionsGrantsPriorYear
Contributions Grants Current Year8576ContributionsGrantsCurrentYear
Program Service Revenue Prior Year58580ProgramServiceRevenuePriorYear
Program Service Revenue CY3074563ProgramServiceRevenueCY
Investment Income Prior Year140802InvestmentIncomePriorYear
Investment Income Current Year80758InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year707707TotalRevenuePriorYear
Total Revenue Current Year3163897TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year2500GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1833185OtherExpensePriorYear
Other Expenses Current Year1762365OtherExpensesCurrentYear
Total Expenses Prior Year1835685TotalExpensesPriorYear
Total Expenses Current Year1762365TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1127978RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1401532RevenuesLessExpensesCY
Total Assets BOY60498953TotalAssetsBOY
Total Assets EOY61580656TotalAssetsEOY
Total Liabilities BOY11058147TotalLiabilitiesBOY
Total Liabilities EOY10118731TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY49440806NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY51461925NetAssetsOrFundBalancesEOY
Mission DescriptionTo deliver high quality comprehensive health care services to the hi-line communities.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense1426104Expense
Revenue3480070Revenue
DescriptionNorthern Montana Health Care, Inc. (NMHC) supports and encourages health care services by providing financial and managerial consulting assistance to the following controlled health care organizations:1) Northern Montana Hospital, ID# 81-02317872) North Care Corporation, ID# 81-04476383) Northern Montana Health Care Foundation, ID# 36-3464641NMHC provides overall directions and coordinates the policy making and long-range planning for its subsidiaries. It is organized solely to carry out the purposes of its tax-exempt subsidiaries. Some of the services NMHC furnishes to its subsidiaries are: accounting services, negotiation assistance with rental agreements, management and healthcare consulting, and other miscellaneous services.Description
Total Program Service Expense1426104TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Excess Business Holdings0ExcessBusinessHoldings
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1KIM LUCKE VP OF FINANCEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4062652211TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1231AddressLine1
CityHavreCity
StateMTState
ZIP Code59501ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
DAVID C HENRY
PRESIDENT/CEO1.00XX03540000
ALAN PEARSON
TREASURER1.00XX000
JUDY GREENWOOD
SECRETARY1.00XX000
MILES HAMILTON
CHAIRMAN1.00XX000
Bruce Richardson MD
VICE CHAIRMAN1.00XX032325314671
Paul Tuss
TRUSTEE1.00X000
MIKE INMAN
TRUSTEE1.00X000
DAVID LEEDS
TRUSTEE1.00X000
TOM PATRICK
TRUSTEE1.00X000
SUZANNE SWIETNICKI MD
Chief of Medical Staff1.00X024491919755
Michael Nolan MD
Trustee - IPD Member1.00X02598443748
JOSEPH P MARINO DPM
Medical Director1.00X017080816908
KAREN POLLINGTON
VICE PRESIDENT1.00X08778616960
KIM LUCKE
VP of Finance1.00X06949912838
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1510109TotalReportableCompFrmRltdOrgs
Total Other Compensation84880TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1NORTHERN MONTANA HOSPITALBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1231AddressLine1
CityHAVRECity
StateMTState
ZIP Code59501ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesCONTRACT LABORDescriptionOfServices
Compensation278460Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Government Grants8576GovernmentGrants
Total Contributions8576TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Income from affiliates90009917991731799173
Rental income from exe53200012753901275390
FieldValueIRS element (for citing)
Total Program Service Revenue3074563TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column133138TotalRevenueColumn
Exclusion$133,138ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities732379Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities784759Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-52380Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-52380TotalRevenueColumn
Exclusion-$52,380ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3163897TotalRevenueColumn
Related Or Exempt Function Income3074563RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$80,758ExclusionAmount

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total278460Total
Program Services208845ProgramServices
Management And General69615ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total11319Total
Management And General11319ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total76503Total
Program Services57377ProgramServices
Management And General19126ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3272Total
Program Services2454ProgramServices
Management And General818ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total7421Total
Program Services1606ProgramServices
Management And General5815ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total129043Total
Program Services72759ProgramServices
Management And General56284ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1530Total
Program Services1206ProgramServices
Management And General324ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total489381Total
Program Services489381ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total683546Total
Program Services551150ProgramServices
Management And General132396ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total34112Total
Program Services15646ProgramServices
Management And General18466ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Miscellaneous301201459315527
Pest control and mainte1158265305052
Bank charges607645571519

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1762365Total
Program Services1426104ProgramServices
Management And General336261ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2559222BOY
EOY592864EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY545621BOY
EOY76410EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY25089BOY
EOY24280EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis18560523LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec7516214LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY11311924BOY
EOY11044309EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY4319881BOY
EOY6460431EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY41455963BOY
EOY43137471EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY281253BOY
EOY244891EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY60498953BOY
EOY61580656EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY521121BOY
EOY580778EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY8390079BOY
EOY7676351EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2146947BOY
EOY1861602EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY11058147BOY
EOY10118731EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY49440806BOY
EOY51461925EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY49440806BOY
EOY51461925EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY60498953BOY
EOY61580656EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (3 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
Northern Montana Hospital
8102317873111$867,360
North Care Corporation
8104476383111$0
Northern Montana Health Care Foundation Inc
3634646417011$94,493
FieldValueIRS element (for citing)
Total Number Of Supported Orgs3TotalNumberOfSupportedOrgs
Sum Of Amounts961853SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis100000OtherCostOrOtherBasis
Book Value100000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis17513559OtherCostOrOtherBasis
Depreciation7241065Depreciation
Book Value10272494BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis129528OtherCostOrOtherBasis
Depreciation123642Depreciation
Book Value5886BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis817436OtherCostOrOtherBasis
Depreciation151507Depreciation
Book Value665929BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings11044309TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
Investment in Mutual Benefit Corporation2250000C
Investment in affiliates40887471F
FieldValueIRS element (for citing)
Total Of Book Value Securities43137471TotalOfBookValueSecurities
Total Revenue3163897TotalRevenue
Total Expenses1762365TotalExpenses
Excess Or Deficit For Year1401532ExcessOrDeficitForYear
Net Unrealized GL On Investments214607NetUnrealizedGLOnInvestments
Other$404,980OtherAmount
Total Adjustments619587TotalAdjustments
Excess Or Deficit Per FS2021119ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt3784011TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments214607NetUnrealizedGainsInvestments
Other Revenues405507OtherRevenues
Revenue Not Rptd F990620114RevenueNotRptdF990
Revenue Subtotal3163897RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9903163897TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt1762365TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal1762365ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9901762365TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part X:Description of Uncertain Tax Positions Under FIN 48:The Company undergoes an annual analysis of its various tax positions, assessing the likelihood of those positions being upheld upon examination with relevant tax authorities. As of June 30, 2010 and 2009, the unrecognized tax benefit accrual is zero.
Part XI, Line 8 - Other Adjustments:Change in net assets not included for tax return in prior year: -527. Net Transfers with related organizations: 405507.
Part XII, Line 2d - Other Adjustments:Net Transfers with related organizations netted with revenue for f/s: 405507.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DAVID C HENRY
0273000081000000000035400000
Bruce Richardson MD
0322065000118800017564034081700
SUZANNE SWIETNICKI MD
024450500041400022000026691900
Michael Nolan MD
025865600011880006042026588600
JOSEPH P MARINO DPM
017035900044900018477018928500

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 5Four physicians listed in Part VII of the Form 990 are compensated as a percentage of the prior three months' average gross revenue earned for the Hospital by the Physician, with the percentage being based on their specialty.
Part IIISchedule J, Part I, Line 3: CEO/President is compensated by an unrelated management company. A related organization and the management company have a process in place to determine the CEO's compensation using procedures noted in Schedule J, line 3. Schedule J, Part II: Individuals listed on Schedule J, Part II, other than the CEO, are compensated by a related organization for their services provided to that organization. They are not compensated for their services as board members. The related organization has procedures in place to determine their compensation.Supplemental Information

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
Montana Facility Finance Authority
810302402612043DM82006-03-016843295Refinance outstanding bonds00
City of Havre Montana
816001274NoneAvail2007-11-303186968Fund new medical building00

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount UnspentAmountUnspentCapital ExpendituresCapitalExpenditures
684329566700013684620061011
318696861968200800011818382943162

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000010.000000.000000.000001
010010.000000.000000.000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

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

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 3The President/CEO of the Hospital is employed by an unrelated management company. Related organization, Northern Montana Hospital (NMH), pays the unrelated management company for his services provided to NMH, Northern Montana Health Care, Inc. and Northern Montana Health Care Foundation.
Form 990, Part VI, Section A, line 6Those persons who reside in the area served by Northern Montana Hospital and who have been Members of or given money to Northern Montana Hospital at any time from the founding of the Hospital to May 1, 1984 shall be invited to become Members of the Corporation (Northern Montana Health Care, Inc.). The corporation shall only be required to act in good faith and use its best efforts to identify all persons qualifying for such invitation. The Initial Members shall be those persons invited to be Members who agreed in writing to become a Member of the Corporation. These Members shall meet at a place and time designated by the Board to take the following action: (1) if their number is less than fifty (50), to elect as many additional Members as necessary to bring their total number to fifty (50) and (2) to select the terms of service of each of the Members. the terms of one-third (1/3) of the initial Members shall expire on the second Tuesday of March of each year, beginning in 1986.
Form 990, Part VI, Section A, line 7bThe Members of the Corporation shall have the following powers: (i) to approve, or disapprove, amendments to the Articles of Incorporation that affect the identity, power and/or duties of the Members of the Corporation, or mergers or consolidations with another Corporation, or sales of all or substantially all of the Corporation's assets, (ii) to approve, or disapprove, liquidations of the Corporation's mergers or consolidations of the Corporation with another Corporation, or sales of all or substantially all of the Corporation's assets, (iii) to elect the Members of the Corporation, and (iv) to approve, or disapprove, amendments to the Bylaws which affect the identity, power and/or duties of the Members of the Corporation. The Members shall have no other powers with regard to the Corporation.
Form 990, Part VI, Section A, line 8bNo subcommittee had the authority to act on behalf of the board during the fiscal year ended June 30, 2010.
Form 990, Part VI, Section B, line 11A draft copy of the Form 990 will be reviewed by the VP of Finance, then submitted via e-mail to the board of directors to view before filing.
Form 990, Part VI, Section B, line 12cThe conflict of interest policy covers all trustees, directors, officers, and key employees. The Board identifies potential conflicts from annual disclosures. Disclosures are reviewed by administration after all are gathered. A second conflict disclosure letter is sent out annually to all current and former officer, directors, trustees, and key employees to ensure all potential conflicts are identified. The results of this disclosure form are reviewed by the VP of Finance. The Board discusses the potential conflicts and determines if voting on related items would be a conflict of interest. If a conflict is determined to exist, the conflicted individual is excluded from voting on the conflicted item.
Form 990, Part VI, Line 15: The organization does not compensate board members for their board service and does not have any paid employees. The President/CEO is compensated by an unrelated management company. The unrelated management company receives a fee for service from a related organization for the CEO's service provided to this organization and related organizations, Northern Montana Hospital (NMH) and Northern Montana Health Care Foundation, Inc. (NMHCF). In determining the CEO's compensation, the Executive committee of the board meets and reviews NMH/Northern Montana Health Care, Inc. (NMHC) financial results, CEO's current year priorities, discusses evaluation tools to be used for CEO evaluation, how comparative salaries will be obtained and discusses the history of compensation to the CEO. At a second executive committee meeting they review non-financial activity of NMH/NMHC and the results of the CEO evaluations completed by the board members. Then they review and discuss a compensation comparative summary of Montana CEO's compensation and a Guidestar CEO Compensation Checkpoint that is prepared specifically for NMH. They agree upon a list of the coming year's priorities for the CEO and proposed compensation, with the compensation set by Board Vote. This annual process was completed during 2010.
Form 990, Part VI, Section C, line 19The organization's governing documents, conflict of interest policy and financial statements are made available to the public upon request.
Form 990, Schedule R, Part V, Line 2 Method for Determining Value of Transactions Between Related Entities: The method used by Northern Montana Health Care, Inc. for determining the value of transactions being reported between related entities is either the FMV of the property or actual cost.
Form 990, Part VII, Section ANo individuals are compensated for their board service to either organization, only for their service as employees of the hospital. The following individuals spend 2% of their time on NMHC business and 98% of their time on NMH business: -Vice President of NMHC also serves as the VP of NMH. -The Vice Chair of NMHC also serves as the vice chair and an employed physician of NMH. -Three trustees of NMHC also serve as trustees and employed physicians (including the Medical Director and Chief of Staff) of NMH. The following individuals spend 2% of their time on NMHC business and 2% of their time on NMHCF business and 96% of their time on NMH business: -CEO/President of NMHC also serves as the CEO/President of NMH and NMHCF. -VP of Finance of NMHC also serves as the VP of Finance of NMH and NMHCF. The remaining members of the board of trustees spend 50% of their time on NMHC business and 50% of their time on NMH business. None of them are employed by either organization.Percentage of time spent between related organizations

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1PARAMOUNT HEALTH CARE INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1231AddressLine1
CityHAVRECity
StateMTState
ZIP Code59501ZIPCode
FieldValueIRS element (for citing)
EIN810393353EIN
Primary ActivitiesProvision of Health ServicesPrimaryActivities
Legal Domicile StateMTLegalDomicileState
Total Income0TotalIncome
EOY Assets-575EOYAssets
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
Northern Montana Hospital
PO Box 1231HavreMT59501810231787Health Care ServicesMT501(c)(3)Line 3N/A
Northern Montana Health Care Foundation Inc
pO Box 1231havreMT59501363464641Supporting OrganizationMT501(c)(3)Line 7N/A
North Care Corporation
30 13th StreetHavreMT59501810447638Supporting OrganizationMT501(c)(3)Line 3N/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Northern Montana Hospital
I867360
Northern Montana Hospital
L278460
Northern Montana Hospital
N76503
Northern Montana Hospital
Q2223721
Northern Montana Health Care Foundation Inc
Q94493
Northern Montana Hospital
R500000

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