BILLINGS CLINIC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: BILLINGS CLINIC (EIN 81-0231784)
Tax period: 2022-07-01 to 2023-06-30
Filed: 2024-05-01
IRS object ID: 202411229349302551
Schema version: 2022v5.0
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2024-05-01T19:35:45-05:00	ReturnTs
Tax Period End	2023-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	FORVIS LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 South Tejon Suite 800	AddressLine1Txt
City	Colorado Springs	CityNm
State Abbreviation	CO	StateAbbreviationCd
ZIP	809039848	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	810231784	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BILLINGS CLINIC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% KATHLEEN QUINONES	InCareOfNm
Business Name Control	BILL	BusinessNameControlTxt
Phone	4062382500	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 TENTH AVENUE NORTH	AddressLine1Txt
City	BILLINGS	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59101	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	KATHLEEN QUINONES	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	4062382500	PhoneNum
Signature	2024-05-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	KATHLEEN	PersonFirstNm
Person Last	QUINONES	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Adam R Smith CPA	PreparerPersonNm
PTIN	P00958966	PTIN
Phone	7194714290	PhoneNum
Preparation	2024-05-15	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	CLINT SEGER MD	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 TENTH AVENUE NORTH	AddressLine1Txt
City	BILLINGS	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59101	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$2,515,231,663	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.BILLINGSCLINIC.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1917	FormationYr
Legal Domicile State	MT	LegalDomicileStateCd
Activity Or Mission	BILLINGS CLINIC IS MONTANA'S LARGEST HEALTHCARE ORGANIZATION CONSISTING OF A 336 BED HOSPITAL AND LEVEL 1 TRAUMA CENTER, PRIMARY CARE AND OVER 80 SPECIALTIES.	ActivityOrMissionDesc
Voting Members Governing Body	7	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	5912	TotalEmployeeCnt
Total Volunteers	92	TotalVolunteersCnt
Total Gross UBI	$24,879,462	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$4,938,120	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$26,342,685	PYContributionsGrantsAmt
CY Contributions Grants	$11,112,553	CYContributionsGrantsAmt
PY Program Service Revenue	$946,368,358	PYProgramServiceRevenueAmt
CY Program Service Revenue	$971,557,398	CYProgramServiceRevenueAmt
PY Investment Income	$36,695,349	PYInvestmentIncomeAmt
CY Investment Income	$81,683,280	CYInvestmentIncomeAmt
PY Other Revenue	$27,222,269	PYOtherRevenueAmt
CY Other Revenue	$27,642,818	CYOtherRevenueAmt
PY Total Revenue	$1,036,628,661	PYTotalRevenueAmt
CY Total Revenue	$1,091,996,049	CYTotalRevenueAmt
PY Grants And Similar Paid	$5,325,965	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$277,725	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$488,650,357	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$504,893,175	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$504,815,161	PYOtherExpensesAmt
CY Other Expenses	$596,454,984	CYOtherExpensesAmt
PY Total Expenses	$998,791,483	PYTotalExpensesAmt
CY Total Expenses	$1,101,625,884	CYTotalExpensesAmt
PY Revenues Less Expenses	$37,837,178	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$9,629,835	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,491,215,198	TotalAssetsBOYAmt
Total Assets EOY	$1,374,741,411	TotalAssetsEOYAmt
Total Liabilities BOY	$568,758,735	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$488,326,129	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$922,456,463	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$886,415,282	NetAssetsOrFundBalancesEOYAmt
Mission	BILLINGS CLINIC MISSION IS HEALTH CARE, EDUCATION AND RESEARCH. BILLINGS CLINIC WILL PROVIDE THE BEST IN NATION CLINICAL QUALITY, PATIENT SAFETY, SERVICE AND VALUE.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$416,998,400	ExpenseAmt
Grant	$126,929	GrantAmt
Revenue	$549,289,146	RevenueAmt
Desc	BILLINGS CLINIC IS A 336 BED HOSPITAL PROVIDING SURGICAL, LABOR AND DELIVERY, PSYCHIATRIC, CANCER CARE, NEONATAL SERVICES AND ACUTE CARE. BILLINGS CLINIC HAD APPROXIMATELY 15,000 ADMISSIONS IN FY23.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$420,971,568	ExpenseAmt
Grant	$128,138	GrantAmt
Revenue	$351,004,619	RevenueAmt
Desc	BILLINGS CLINIC HAS NEARLY 600 PHYSICIANS AND ADVANCED PRACTITIONERS OFFERING MORE THAN 80 SPECIALTIES. PRIMARY CARE IS AVAILABLE AT MULTIPLE LOCATIONS INCLUDING BILLINGS CLINIC DOWNTOWN, HEIGHTS, WEST END, CODY WY, MILES CITY AND BOZEMAN. IN ADDITION, BILLINGS CLINIC CONDUCTS SPECIALTY CARE CLINICS FOR MORE THAN 20 REGIONAL LOCATIONS IN MONTANA, WYOMING AND NORTH DAKOTA. BILLINGS CLINIC HAD OVER 880,000 PATIENT VISITS IN FY23.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$74,436,344	ExpenseAmt
Grant	$22,658	GrantAmt
Revenue	$74,352,838	RevenueAmt
Desc	BILLINGS CLINIC SPECIALTY PHARMACY FOCUSES ON THE PHARMACY CARE OF CHRONIC, RARE OR COMPLEX CONDITIONS THAT REQUIRE SPECIALTY MEDICATIONS. SPECIALTY MEDICATIONS TYPICALLY REQUIRE SPECIAL HANDLING, ADMINISTRATION OR MONITORING BEYOND THAT WHICH A TRADITIONAL RETAIL PHARMACY CAN PROVIDE. WE WORK TO ENSURE APPROPRIATE MEDICATION USE AND PROMOTE ADHERENCE. BILLINGS CLINIC SPECIALTY PHARMACY IS PART OF THE LARGEST HEALTH CARE SYSTEM IN THE REGION.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$912,406,312	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (true)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	Yes (true)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	280	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	5912	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	Yes (true)	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	7	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	KATHLEEN QUINONES	PersonNm
Phone	4064356445	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 TENTH AVENUE NORTH	AddressLine1Txt
City	BILLINGS	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59101	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Vance Fredrickson MD
Physician	60.0	0.0	Yes (X)	$1,702,744	$0	$18,703
Scott Ellner
Former CEO - THROUGH 12/22	60.0	2.0		$1,387,318	$0	$199,722	Yes (X)
Anthony Roccisano DO
Physician	60.0	0.0	Yes (X)	$1,333,533	$0	$33,444
Marlin Richardson MD
Physician	60.0	0.0	Yes (X)	$1,061,191	$0	$58,535
William Dresen MD
Physician	60.0	0.0	Yes (X)	$1,055,114	$0	$56,347
Christopher Stewart DO
Physician	60.0	0.0	Yes (X)	$1,049,552	$0	$47,361
Kendrick Trostel MD
PHYSICIAN BOARD MEMBER	5.0	0.0		$630,096	$0	$55,941		Yes (X)
Priscilla Needham
Former CFO - Through 12/22	60.0	0.0		$512,919	$0	$112,740	Yes (X)
Clinton Seger MD
CEO	60.0	2.0		$498,328	$0	$89,760	Yes (X)
Robert Merchant
Former Co-CEO	60.0	0.0		$425,280	$0	$44,825			Yes (X)
Kathleen Quinones
CFO	60.0	0.0		$233,188	$0	$61,344	Yes (X)
Heidi Duncan MD
Physician Board Member	60.0	0.0		$235,915	$0	$47,875		Yes (X)
Shannon Holland
CNO	60.0	0.0		$137,923	$0	$1,460	Yes (X)
Joy Ott
FORMER BOARD SECRETARY	5.0	0.0		$29,882	$0	$8,886			Yes (X)
Keith Cook
Board Chair	5.0	1.0		$12,000	$0	$12,000	Yes (X)	Yes (X)
Wayne Hirsch
BOARD TREASURER	5.0	0.0		$6,000	$0	$6,000	Yes (X)	Yes (X)
Craig Bartholomew
Board Member	5.0	0.0		$0	$0	$7,499		Yes (X)
Eileen McDonald
Board Member	5.0	3.0		$0	$0	$6,187		Yes (X)
Alice Gordon
Board Member	5.0	0.0		$3,000	$0	$3,000		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$10,313,983	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$871,629	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	934	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
HAYES LOCUMS LLC
PO BOX 5068	NEW YORK	NY	10087	CONTRACT PHYSICIANS	$30,047,612
VAYA WORKFORCE SOLUTIONS LLC
PO BOX 9416	MINNEAPOLIS	MN	55480	CONTRACT LABOR	$39,290,343
ORACLE AMERICA INC
2300 ORACLE WAY	AUSTIN	TX	78741	IT SERVICES	$14,284,261
SODEXO INC
915 MEETING STREET 15th Floor	NORTH BETHESDA	MD	20852	FOOD SERVICES	$5,452,099
KAUFMAN HALL ASSOCIATES
8610 SOLUTION CENTER	CHICAGO	IL	606778006	CONSULTING	$6,372,609

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	48	CntrctRcvdGreaterThan100KCnt
Related Organizations	$5,259,418	RelatedOrganizationsAmt
Government Grants	$5,849,893	GovernmentGrantsAmt
All Other Contributions	$3,242	AllOtherContributionsAmt
Total Contributions	$11,112,553	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE	621110	$870,103,327	$870,103,327
RETAIL PHARMACY	621110	$86,401,016	$86,401,016
REFERENCE LAB	621500	$6,500,886		$6,500,886
INCOME ON EQUITY INVESTEES	900099	$7,874,920	$2,120,076	$5,754,844
CLINICAL TRIAL REVENUE	541900	$677,249	$677,249

Field	Value	IRS element (for citing)
Total Program Service Revenue	$971,557,398	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$19,577,581	TotalRevenueColumnAmt
Unrelated Business Revenue	$260,377	UnrelatedBusinessRevenueAmt
Exclusion	$19,317,204	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$257,900	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$408,344	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$150,444	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$150,444	TotalRevenueColumnAmt
Exclusion	-$150,444	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$1,484,394,757	SecuritiesAmt
Other	$364,749	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$1,422,524,242	SecuritiesAmt
Other	$129,565	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$61,870,515	SecuritiesAmt
Other	$235,184	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$62,105,699	TotalRevenueColumnAmt
Exclusion	$62,105,699	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$558,430	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$173,463	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$384,967	TotalRevenueColumnAmt
Related Or Exempt Func Income	$343,404	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$41,563	UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
SERVICE TO OTHER HOSPITALS	541519	$5,228,501	$5,228,501
IT CMC	541519	$1,220,217	$1,220,217
REGIONAL PAHRMACY SALES	621110	$5,873,074	$5,873,074

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$15,086,503	TotalRevenueColumnAmt
Related Or Exempt Func Income	$15,001,531	RelatedOrExemptFuncIncomeAmt
Exclusion	$84,972	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$27,408,295	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,091,996,049	TotalRevenueColumnAmt
Related Or Exempt Func Income	$974,646,603	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$24,879,462	UnrelatedBusinessRevenueAmt
Exclusion	$81,357,431	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$265,113	TotalAmt
Program Services	$265,113	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$12,612	TotalAmt
Program Services	$12,612	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,120,015	TotalAmt
Program Services	$1,590,647	ProgramServicesAmt
Management And General	$529,368	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$3,013,844	TotalAmt
Management And General	$3,013,844	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$418,866,667	TotalAmt
Program Services	$341,510,303	ProgramServicesAmt
Management And General	$77,356,364	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$17,158,535	TotalAmt
Program Services	$14,797,931	ProgramServicesAmt
Management And General	$2,360,604	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$37,553,138	TotalAmt
Program Services	$22,280,351	ProgramServicesAmt
Management And General	$15,272,787	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$26,180,976	TotalAmt
Program Services	$20,371,417	ProgramServicesAmt
Management And General	$5,809,559	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$45,800	TotalAmt
Management And General	$45,800	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$3,786,130	TotalAmt
Program Services	$12,873	ProgramServicesAmt
Management And General	$3,773,257	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$395,299	TotalAmt
Management And General	$395,299	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$155,376	TotalAmt
Management And General	$155,376	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$1,435,691	TotalAmt
Management And General	$1,435,691	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$156,295,257	TotalAmt
Program Services	$127,298,049	ProgramServicesAmt
Management And General	$28,997,208	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$3,030,918	TotalAmt
Program Services	$26,121	ProgramServicesAmt
Management And General	$3,004,797	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$12,806,583	TotalAmt
Program Services	$5,697,649	ProgramServicesAmt
Management And General	$7,108,934	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$31,500,115	TotalAmt
Program Services	$24,223,588	ProgramServicesAmt
Management And General	$7,276,527	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$7,816,338	TotalAmt
Program Services	$6,814,283	ProgramServicesAmt
Management And General	$1,002,055	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$4,877,772	TotalAmt
Program Services	$3,488,095	ProgramServicesAmt
Management And General	$1,389,677	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$156,759	TotalAmt
Management And General	$156,759	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$12,243,553	TotalAmt
Program Services	$9,186,338	ProgramServicesAmt
Management And General	$3,057,215	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$31,785,052	TotalAmt
Program Services	$26,511,912	ProgramServicesAmt
Management And General	$5,273,140	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$4,112,012	TotalAmt
Program Services	$1,766,932	ProgramServicesAmt
Management And General	$2,345,080	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$279,208,047	$278,649,631	$558,416
REPAIRS AND MAINTENANCE	$12,521,905	$12,521,905
BED TAX	$9,706,504	$7,530,306	$2,176,198
DUES	$5,480,706	$2,171,456	$3,309,250

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$19,095,167	TotalAmt
Program Services	$5,678,800	ProgramServicesAmt
Management And General	$13,416,367	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,101,625,884	TotalAmt
Program Services	$912,406,312	ProgramServicesAmt
Management And General	$189,219,572	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$52,290,499	BOYAmt
EOY	$16,079,651	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$227,424,381	BOYAmt
EOY	$240,857,717	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,191,686	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$128,422,078	BOYAmt
EOY	$147,576,315	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$1,255,349	BOYAmt
EOY	$1,077,350	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$20,259,447	BOYAmt
EOY	$23,262,216	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$10,981,071	BOYAmt
EOY	$12,022,494	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$757,553,883	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$396,728,994	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$345,620,442	BOYAmt
EOY	$360,824,889	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$528,132,772	BOYAmt
EOY	$393,528,818	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$32,643,714	BOYAmt
EOY	$38,197,490	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,937,359	BOYAmt
EOY	$2,595,143	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$140,056,400	BOYAmt
EOY	$138,719,328	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,491,215,198	BOYAmt
EOY	$1,374,741,411	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$92,113,658	BOYAmt
EOY	$86,164,548	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$8,201,223	BOYAmt
EOY	$688,976	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$231,416,021	BOYAmt
EOY	$172,378,620	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$193,847,648	BOYAmt
EOY	$190,130,457	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$43,180,185	BOYAmt
EOY	$38,963,528	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$568,758,735	BOYAmt
EOY	$488,326,129	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$855,060,575	BOYAmt
EOY	$814,969,320	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$67,395,888	BOYAmt
EOY	$71,445,962	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$922,456,463	BOYAmt
EOY	$886,415,282	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,491,215,198	BOYAmt
EOY	$1,374,741,411	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$9,629,835	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$34,731,117	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$8,319,771	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

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)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp

Total Direct Lobbying TotalDirectLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$278,299	FilingOrganizationsTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$278,299	FilingOrganizationsTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,101,347,585	FilingOrganizationsTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,101,625,884	FilingOrganizationsTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,000,000	FilingOrganizationsTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$250,000	FilingOrganizationsTotalAmt

Field	Value	IRS element (for citing)
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Form4720 Filed	false	Form4720FiledInd

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$1,000,000	CurrentYearMinus3Amt
Current Year Minus2	$1,000,000	CurrentYearMinus2Amt
Current Year Minus1	$1,000,000	CurrentYearMinus1Amt
Current Year	$1,000,000	CurrentYearAmt
Total	$4,000,000	TotalAmt

Field	Value	IRS element (for citing)
Lobbying Ceiling	$6,000,000	LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$158,719	CurrentYearMinus3Amt
Current Year Minus2	$165,280	CurrentYearMinus2Amt
Current Year Minus1	$264,515	CurrentYearMinus1Amt
Current Year	$278,299	CurrentYearAmt
Total	$866,813	TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$250,000	CurrentYearMinus3Amt
Current Year Minus2	$250,000	CurrentYearMinus2Amt
Current Year Minus1	$250,000	CurrentYearMinus1Amt
Current Year	$250,000	CurrentYearAmt
Total	$1,000,000	TotalAmt

Field	Value	IRS element (for citing)
Grassroots Ceiling	$1,500,000	GrassrootsCeilingAmt

Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year Minus2	$0	CurrentYearMinus2Amt
Total	$0	TotalAmt

Field	Value	IRS element (for citing)
Direct Contact Legislators	$278,299	DirectContactLegislatorsAmt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$73,071,314	BeginningYearBalanceAmt
Contributions	$1,346,174	ContributionsAmt
Investment Earnings Or Losses	$414,941	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$1,736,632	GrantsOrScholarshipsAmt
End Year Balance	$73,095,797	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$70,534,237	BeginningYearBalanceAmt
Contributions	$1,143,430	ContributionsAmt
Investment Earnings Or Losses	$3,769,220	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$2,375,573	GrantsOrScholarshipsAmt
End Year Balance	$73,071,314	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$63,959,649	BeginningYearBalanceAmt
Contributions	$427,564	ContributionsAmt
Investment Earnings Or Losses	$6,900,818	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$753,794	GrantsOrScholarshipsAmt
End Year Balance	$70,534,237	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$59,205,624	BeginningYearBalanceAmt
Contributions	$2,802,581	ContributionsAmt
Investment Earnings Or Losses	$2,753,070	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$801,626	GrantsOrScholarshipsAmt
End Year Balance	$63,959,649	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$54,329,816	BeginningYearBalanceAmt
Contributions	$1,912,723	ContributionsAmt
Investment Earnings Or Losses	$3,092,661	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$129,576	GrantsOrScholarshipsAmt
End Year Balance	$59,205,624	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.36980	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.47690	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.15330	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$9,206,385	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$30,165,000	OtherCostOrOtherBasisAmt
Book Value	$39,371,485	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$284,320,491	OtherCostOrOtherBasisAmt
Depreciation	$119,598,514	DepreciationAmt
Book Value	$164,721,977	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,017,777	OtherCostOrOtherBasisAmt
Depreciation	$1,059,980	DepreciationAmt
Book Value	$957,797	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$397,272,928	OtherCostOrOtherBasisAmt
Depreciation	$262,460,257	DepreciationAmt
Book Value	$134,812,671	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$34,571,202	OtherCostOrOtherBasisAmt
Depreciation	$13,610,243	DepreciationAmt
Book Value	$20,960,959	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$360,824,889	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
DUE FROM RELATED PARTY	$6,821,573
DUE FROM JV	$2,096,892
INTEREST IN FOUNDATION	$123,204,757
RIGHT-OF-USE-ASSETS OPER LEASE	$6,596,106

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$138,719,328	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
DUE TO MDOR	$352,424
DEPOSITS	$7,890
INTEREST RATE SWAP AGREEMENT	$3,452,487
ESTIMATED CLAIMS LIABILITY	$11,772,707
ACCRUED INTEREST	$4,292,288
UNEARNED PREMIUMS	$12,419,123
RIGHT OF USE LEASE LIABILITIES	$6,666,609

Field	Value	IRS element (for citing)
Total Liability	$38,963,528	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4	THE ENDOWMENT INCLUDES BOTH DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE GOVERNING BODY TO FUNCTION AS ENDOWMENTS. ENDOWMENT FUNDS ARE INVESTED AND HELD TO PROVIDE GROWTH OVER THE LONG-TERM.
Schedule D, Part X, Line 2	UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$19,404,948	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$19,404,948	NetCommunityBenefitExpnsAmt
Total Expense	0.01940	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$146,833,485	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$138,018,293	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,815,193	NetCommunityBenefitExpnsAmt
Total Expense	0.00880	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$166,238,433	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$138,018,293	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$28,220,141	NetCommunityBenefitExpnsAmt
Total Expense	0.02820	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,939,332	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,175,201	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,764,131	NetCommunityBenefitExpnsAmt
Total Expense	0.00380	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$13,551,983	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,759,429	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,792,554	NetCommunityBenefitExpnsAmt
Total Expense	0.00780	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$56,489,462	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$34,635,115	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$21,854,347	NetCommunityBenefitExpnsAmt
Total Expense	0.02190	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,849,013	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$276,764	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,572,249	NetCommunityBenefitExpnsAmt
Total Expense	0.00360	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,457,590	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$11,457,590	NetCommunityBenefitExpnsAmt
Total Expense	0.01140	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$91,287,380	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$42,846,509	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$48,440,871	NetCommunityBenefitExpnsAmt
Total Expense	0.04850	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$257,525,813	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$180,864,802	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$76,661,012	NetCommunityBenefitExpnsAmt
Total Expense	0.07670	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,014	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,014	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$292,791	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$292,791	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$297,805	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$297,805	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$17,125,568	BadDebtExpenseAmt
Reimbursed By Medicare	$315,303,218	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$427,231,476	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$111,928,258	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BILLINGS CLINIC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 TENTH AVE N	AddressLine1Txt
City	BILLINGS	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59101	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.BILLINGSCLINIC.COM	WebsiteAddressTxt
State License	13345	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Research Facility	Yes (X)	ResearchFacilityInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Facility Reporting Group	1	FacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	BILLINGS CLINIC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	22	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C FOR URL	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	WWW.HEALTHYBYDESIGNYELLOWSTONE.ORG	OtherWebsiteURLTxt
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C FOR URL	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWW.BILLINGSCLINIC.COM/FINASSIST	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.BILLINGSCLINIC.COM/FINASSIST	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	See Part V,Section C for URL	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	THE 2019-20 YELLOWSTONE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS A COMPREHENSIVE, DATA-DRIVEN ASSESSMENT OF THE OVERALL HEALTH STATUS, HEALTH BEHAVIORS, AND HEALTH ISSUES WITHIN OUR COMMUNITY. THE CHNA EVALUATES AND INFORMS DECISIONS RELATED TO RESOURCES AND EFFORTS THAT IMPROVE HEALTH AT THE COMMUNITY LEVEL. PRIMARY DATA ONLINE KEY INFORMANT SURVEY - COMMUNITY STAKEHOLDER INPUT - 154 REPRESENTATIVES FROM HEALTHCARE, PUBLIC HEALTH, SOCIAL EDUCATION, GOVERNMENT, AND MORE - BASED ON THEIR EXPERIENCES, THE POPULATIONS THEY SERVE CUSTOMIZED LOCAL HEALTH SURVEY - STATISTICALLY SIGNIFICANT, RANDOMIZED SURVEY OF 400 HOUSEHOLDS - TARGETS HEALTH STATUS, EXPERIENCE, BEHAVIORS - CONDUCTED VIA LANDLINE AND CELL PHONES STREETWYZE USER FEEDBACK - COMMUNITY STAKEHOLDER INPUT - 120 USERS AND 428 COMMENTS - BASED ON USER EXPERIENCES - WEB-BASED PLATFORM OPEN TO THE GENERAL PUBLIC - ADMINISTERED BY HEALTHY BY DESIGN AND ISEEED (STREETWYZE FOUNDER) SECONDARY DATA - COUNTY-LEVEL DATA - CENSUS DATA, VITAL STATISTICS, OTHER HEALTH RELATED DATA
SCHEDULE H, PART V, SECTION B, LINE 6A & 6b	Billings Clinic's community health needs assessment was conducted in a pre-existing community health partnership, the Healthy by Design alliance, with St. Vincent Healthcare (hospital organization) and RiverStone Health (public health department for city and county). The alliance also conducted a CHNA in 2006, 2011, 2014, 2017 and 2020.
SCHEDULE H, PART V, SECTION B, LINE 7A	https://www.billingsclinic.com/app/files/public/309799de-f98c-4977-b8dc-f5 1b10d7d168/2023-PRC-CHNA-Report-Yellowstone-County-MT-WEB.pdf
SCHEDULE H, PART V, SECTION B, LINE 11	The 2020 CHNA identified 13 areas of opportunity after consideration of various criteria, including a comparison with benchmark data and historical trends, analysis of the number of persons affected and significance of findings. These areas of opportunity identified included access to health care, cancer, diabetes, heart disease and stroke, infant health, injury and violence, mental health, nutrition and physical activity, potentially disabling conditions, respiratory diseases, sexual health, substance abuse and tobacco use. Prioritization ranked three priorities as the top needs: 1) mental health; 2) substance abuse; and 3) nutrition, physical activity and weight. Billings Clinic addresses these CHNA-identified needs at the organizational level with efforts to improve awareness and education, as well as to remove barriers to care. Work is done with clinical departments, service lines, nursing and medical education, community relations, population health, care management, city/county health department, and the state and federal government. Billings Clinic is part of several community-wide coalitions to address community health needs in a collaborative way. Access to health care - Billings Clinic participated in improving access to health care through appointment availability, transportation from appointments, cost of prescriptions and increased telemedicine offerings in rural communities. This year, more than 100 Billings Clinic physicians in 28 specialties traveled in excess of 260,000 miles to provide specialty care for residents of rural Montana, Wyoming, and North Dakota. Billings Clinic is the home office of the Eastern Montana Telemedicine Network, which provided more than 4,800 telemedicine appointments with medical specialists, as well as administrative and operational support to people attending education and meetings through 40 partner sites in Montana, western North Dakota, and northern Wyoming. Billings Clinic supports medical careers classes in local high schools, clinical rotations for nursing students, dietary students and pharmacy students each year to help increase students in the healthcare rural workforce pipeline. Billings Clinic provides free transportation for patients who are financially unable to get home from outpatient and inpatient stays, for a total, unreimbursed cost of $38,000. For the last 18 years, Billings Clinic has offered HealthLine, which is a free service available to all community members to ask health-related questions to medical professionals, twenty-four hours a day, seven days a week. Last year, Billings Clinic spent $433,000 on HealthLine-related costs to ensure that this service is available to the community. Billings Clinic Medication Assistance Program served thousands of uninsured and underinsured patients with tens of thousands of prescriptions processed in 2023, including financial assistance for necessary medications. The total value of the donated medications was over $1 million. Cancer - Billings Clinic provides financial and in-kind support for the American Cancer Society, Montana Women's Run, cancer research and screenings. Free or low-cost screenings for cancer are coordinated and reported on through the Cancer Committee's community outreach task group. Cancer Care Navigators help with non-clinical needs to impact patient care. Diabetes - Billings Clinic provides financial and in-kind support for Diabetes Camp for Kids in addition to diabetes prevention and self-management education at no or low charge (subsidized). Heart disease and stroke - Billings Clinic makes annual financial donations and provides in-kind leadership, health policy advocacy, special event and committee support for organizations supporting prevention, research and advocacy for many chronic diseases, including the American Heart Association. Billings Clinic also partners with the Alliance for Healthy Montanans to advocate for health policies that benefit persons with chronic diseases, including support for Medicaid expansion. In addition, Billings Clinic offers free community education during Heart Month and throughout the year including awareness for the signs and symptoms of heart attack and through our cardiac rehabilitation program. Infant health- Billings Clinic provides parental education resources and free lactation education and consultations for new moms. Injury and violence - Trauma and Injury Prevention is subsidized at a 0.5 (half time) position in the Emergency and Trauma Center by a registered nurse who provided education for safe driving, falls prevention, brain and spinal cord injury prevention, helmet safety and more. The Sexual Assault Nursing Exam (SANE) program provides subsidized medical treatment and emotional support to children, teens and adults annually who were victims of sexual assault at a cost of more than $100,000. Billings Clinic also subsidized the hours for a physician to serve as the medical director of the SANE program and to provide free follow-up care for children under 18. The SANE staff and volunteers also provide training in the region. Billings Clinic also provides in-kind time support for local organizations and the city to address public safety. Mental health - Billings Clinic is a founding member of the Community Crisis Center which is a point of access for people in our community seeking crisis stabilization services for mental health, substance abuse and/or social service needs regardless of their ability to pay. We support the Community Crisis Center for people with co-occurring disorders of mental health and substance use through financial support, leadership and staffing of mental health workers and social workers, as well as board membership by our Director of Psychiatric Services. The Community Crisis Center serves thousands of individuals with assessments, case management, group therapy, addiction counseling, referrals and stabilization services to people in need 24/7. Billings Clinic provides psychiatric hospital admissions at the only inpatient psychiatric hospital for children, teens and adults in central/eastern Montana and northern Wyoming. Psychiatric services are subsidized at a multi-million-dollar shortfall each year. Last year, the shortfall totaled $4.8M. Our latest project to increase access to mental health care is Billings Clinic's new Psychiatric Residency Program, which started in July 2019 and is the only one of its kind in the surrounding region. In addition, we provide financial donations to several mental health organizations, including the Out of the Darkness walk for suicide prevention and Rimrock Foundation. Nutrition and weight - Billings Clinic is a founding member of the Healthy By Design Coalition which aims to address issues of underinsured and underserved community members. Billings Clinic in partnership with Healthy By Design, provided access to low-cost fresh fruits and vegetables at the Healthy By Design Gardeners' Market by accepting WIC and SNAP for payment. Billings Clinic provided financial support for major events to encourage thousands of individuals and families to exercise together, including Big Sky State Games, Big Sky Fit Kids, Saturday Live Fun Run, Run Turkey Run, Montana Marathon, Montana Women's Run, and many other run/walk fundraisers for local nonprofit organizations. Billings Clinic also supports local schools in the promotion of physical activity and wellness through the "Superstar Awards" $100 grant awards for 10 teachers per year to encourage physical activity and wellness in their classrooms, for all grades, in partnership with the YMCA. Disabling conditions- Billings Clinic offers support groups for caregivers of persons with disabilities and provides financial support to local nonprofits in advancing health equity for individuals with disabilities. Respiratory diseases- Billings Clinic provides education for adults and teens about the dangers of vaping and tools/information for cessation. In coordination with community health partners, Billings Clinic provides ongoing community education for the prevention and treatment of respiratory illness. Sexual health- Billings Clinic conducts numerous outreach clinics for underserved populations in rural regions in addition to free education focused on sexual health. Substance abuse - Billings Clinic is a member of the Substance Abuse Connect Coalition which focuses its work on prevention, education, and diversion to increase access to resources. Billings Clinic's participation in the coalition allows for coordinated efforts and increased impact. In addition, Project ECHO provided training and support to mental health professionals, nurses and physicians across the region throughout the year in educational sessions for the Department of Corrections, Integrated Addictions and Psychiatry and Pediatric Mental Health at an unreimbursed cost of $5,000. Tobacco use - Billings Clinic provides free education for adults and teens about the dangers of vaping, tobacco
SCHEDULE H, PART V, SECTION B, LINE 16c	DIRECT URL FOR PLAIN LANGUAGE SUMMARY: https://www.billingsclinic.com/app/files/public/61391694-7adb-4551-9b3c-39 cf4c9c9150/Financial-Assistance-Policy-Summary.pdf
Schedule H, Part V, Section B, Line 16I	TRANSLATION OF FAP FOR LEP POPULATIONS: BILLINGS CLINIC HAS CONSIDERED THE NEED FOR A PLAIN LANGUAGE SUMMARY FOR THOSE WITH LIMITED ENGLISH PROFICIENCY. WE HAVE TRANSLATION OF MOST LANGUAGES AVAILABLE TO PATIENTS THROUGH OUR MARTTI TRANSLATION SERVICES, ONLINE OR BY PHONE TRANSLATION FOR DISCUSSING AND TRANSLATING FINANCIAL ASSISTANCE MATERIALS.

Field	Value	IRS element (for citing)
Facility	17	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (17 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
BILLILNGS CLINIC
1045 N 30TH ST	BILLINGS	MT	59101	OUTPATIENT CLINIC
BILLINGS CLINIC MILES CITY
620 S HAYNES AVE	MILES CITY	MT	59301	OUTPATIENT CLINIC
BILLINGS CLINIC HEIGHTS
760 WICKS LN	BILLINGS	MT	59105	OUTPATIENT CLINIC
BILLINGS CLINIC OBGYN
925 HIGHLAND BLVD	BOZEMAN	MT	59715	OBSTETRICS AND GYNECOLOGY CLIN
BILLINGS CLINIC SURGERY CENTER
2929 TENTH AVE N	BILLINGS	MT	59101	OUTPATIENT SURGERY CENTER
BILLINGS CLINIC WEST
2675 CENTRAL AVE	BILLINGS	MT	59102	OUTPATIENT CLINIC
BEHAVIORAL HEALTH CENTER
2800 10TH AVE N	BILLINGS	MT	591010703	OUTPATIENT MENTAL HEALTH Center
BILLINGS CLINIC CODY
201 YELLOWSTONE AVE	CODY	WY	92414	OUTPATIENT CLINIC
BILLINGS CLINIC CANCER CENTER
801 N 29TH ST	BILLINGS	MT	59101	CANCER CARE, INFUSION
PYSCHIATRIC CENTER
1020 N 27TH ST	BILLINGS	MT	59101	INPATIENT PSYCHIATRIC CENTER
HOME OXYGEN
1050 S 25TH ST W	BILLINGS	MT	59102	DURABLE MEDICAL EQUIPMENT
BOZEMAN PEDIATRICS
1819 S 22ND ST	BOZEMAN	MT	59715	PEDIATRIC OUTPATIENT CENTER
BILLINGS CLINIC ORTHOPEDICS
2702 8TH AVE N	BILLINGS	MT	59101	ORTHOPEDICS AND SPORTS MEDICIN
BILLINGS CLINIC BOZEMAN
3905 WELLNESS WAY	BOZEMAN	MT	59718	OUTPATIENT CLINIC
BILLINGS CLINIC CODY ORTHOPEDICS
3030 BIG HORN AVE	CODY	WY	82414	ORTHOPEDICS
BILLINGS CLINIC CODY MRI & CT IMAGING
613 YELLOWSTONE AVE	CODY	WY	82414	MRI & CT IMAGING
BILLINGS CLINIC WEST YELLOWSTONE
236 YELLOWSTONE AVE	WEST YELLOWSTONE	WY	59758	OUTPATIENT CLINIC

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3C	DESCRIPTION OF ADDITIONAL CRITERIA TO DETERMINE FINANCIAL ASSISTANCE: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES BILLINGS CLINIC ALSO USES ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE.
SCHEDULE H, PART I, LINE 6A	RELATED ORGANIZATION ANNUAL COMMUNITY BENEFIT REPORT: STILLWATER COMMUNITY HOSPITAL, A RELATED CRITICAL ACCESS HOSPITAL, PREPARES THEIR OWN INDEPENDENT COMMUNITY BENEFIT REPORT.
SCHEDULE H, PART I, LINE 7	COSTING METHODOLOGY: THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A AND 7B. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. BILLINGS CLINIC USED THE SAME COST-TO-CHARGE RATIO THROUGHOUT THE ENTIRE SCHEDULE TO DETERMINE THE COST OF THOSE ACTIVITIES.
SCHEDULE H, PART I, LINE 7G	SUBSIDIZED HEALTH SERVICE COSTS: SUBSIDIZED HEALTH SERVICES INCLUDES VARIOUS PHYSICIAN CLINICS IN ORDER TO BETTER SERVE THE MONTANA AREAS. MANY CRITICAL SERVICES WERE NOT FULLY REIMBURSED SUCH AS BEHAVIORAL HEALTH, PEDIATRIC SPECIALTIES, SEXUAL ASSAULT NURSE EXAMINATION AND RURAL OUTREACH CLINICS. PRIMARY CARE CLINICS WERE ONLY INCLUDED IF THEY WERE IN RURAL, UNDERSERVED AREAS OUTSIDE OUR PRIMARY SERVICE AREA. TOTAL COSTS FOR THE SUBSIDIZED SERVICES WERE $56,489,462 AND NET COMMUNITY BENEFIT OF THOSE SERVICES WAS DETERMINED TO BE $21,854,347.
SCHEDULE H, PART III, SECTION A, LINE 2	THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.
SCHEDULE H, PART III, SECTION A, LINE 3	BAD DEBT AS COMMUNITY BENEFIT: THE ORGANIZATION DOES NOT CONSIDER ANY OF ITS BAD DEBT EXPENSE TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
SCHEDULE H, PART III, SECTION B, LINE 8	IS THE BEST ESTIMATE OF THE PERCENTAGE OF MONTANA'S MEDICARE POPULATION (65 AND OLDER) WHO ARE AT OR BELOW 200% OF FEDERAL POVERTY LEVEL, BASED ON MEDICARE AND U.S. CENSUS DATA, AND THOSE PATIENTS WOULD QUALIFY FOR FULL FINANCIAL ASSISTANCE. A HIGHER PERCENTAGE WOULD QUALIFY FOR PARTIAL FINANCIAL ASSISTANCE WITH INCOMES FROM 200- 400 PERCENT OF FEDERAL POVERTY LEVEL. FOR THE CALCULATION OF THE UNREIMBURSED COST OF MEDICARE A RATIO OF PATIENT COST-TO CHARGES USING WORKSHEET 2 WAS UTILIZED AND APPLIED TO GROSS MEDICARE CHARGES. WE DO NOT USE THE MEDICARE COST REPORT FOR THIS NUMBER. THE COST REPORT ONLY CAPTURES REVENUE RELATED TO THE FACILITY AND DOES NOT CAPTURE REVENUE/LOSSES RELATED TO CLINICAL PROFESSIONAL SERVICES, WHICH ARE A SUBSTANTIAL PORTION OF MEDICARE SHORTFALLS.
SCHEDULE H, PART III, SECTION C, LINE 9B	COLLECTION PRACTICES: ACCOUNTS ARE BILLED WITH INSURANCE INFORMATION SUPPLIED BY THE PATIENT AND WHEN AVAILABLE, VERIFIED BY BILLINGS CLINIC. BILLINGS CLINIC SENDS PATIENT BILLING STATEMENTS THAT INCLUDE THE SUMMARY OF SERVICES PROVIDED, AMOUNTS PENDING INSURANCE AND AMOUNTS OWED BY THE PATIENT. FINANCIAL ASSISTANCE IS OFFERED TO PATIENTS WHO ARE UNINSURED OR UNDERINSURED. BILLINGS CLINIC ASSISTS PATIENTS APPLYING FOR FINANCIAL ASSISTANCE, AND PUBLIC PROGRAMS SUCH AS MEDICAID. BILLINGS CLINIC ALSO ASSISTS PATIENTS WITH PAYMENT PLANS INTEREST FREE FOR 12 MONTHS OR THROUGH AN EXTENDED LOAN OPTION UP TO 60 MONTHS. BILLINGS CLINIC WILL NOT REFER A PATIENT TO COLLECTIONS UNTIL AFTER 120 DAYS OF THE INDIVIDUAL BEING AWARE OF THEIR OPTIONS.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT: SINCE 1994, BILLINGS CLINIC, RIVERSTONE HEALTH AND ST. VINCENT HEALTHCARE HAVE BEEN WORKING TOGETHER AS THE ALLIANCE, CREATING AND SUSTAINING INNOVATIVE PROGRAMS THAT ADDRESS COMPLEX COMMUNITY-WIDE HEALTH ISSUES. RIVERSTONE HEALTH IS THE PUBLIC HEALTH DEPARTMENT FOR THE YELLOWSTONE COUNTY AND ST. VINCENT HEALTHCARE IS A 501(C)(3) HEALTHCARE ENTITY ALSO SERVING THE BILLINGS AREA.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY ASSISTANCE: ALL PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE. INFORMATIONAL BROCHURES WITH ONE-PAGE PLAIN LANGUAGE SUMMARY AND APPLICATION FORMS ARE AVAILABLE AT REGISTRATION DESKS IN THE CLINIC AND THE HOSPITAL, THE EMERGENCY DEPARTMENT DISCHARGE DESK, AND ON OUR WEBSITE AT WWW.BILLINGSCLINIC.COM/FINASSIST. OUR WEBPAGE INCLUDES THE FULL FINANCIAL ASSISTANCE POLICY. PATIENTS CAN ALSO CALL A DIRECT LINE TO TALK TO A PATIENT FINANCIAL REPRESENTATIVE. INFORMATION ABOUT FINANCIAL ASSISTANCE IS PRINTED ON THE BACK OF PATIENT BILLS. PATIENTS HOSPITALIZED WITHOUT IDENTIFIYING A THIRD PARTY PAYER SOURCE ARE SCREENED FOR COVERAGE/ASSISTANCE (DISABILITY, MEDICAID, VETERANS ADMINSTRATION, INDIAN HEALTH SERVICES AND WORKERS COMPENSATIONS). APPLICATIONS ARE MAILED TO PATIENTS WHOSE PAYMENT PATTERN INDICATES THAT THEY MAY NEED ASSISTANCE. PATIENT FINANCIAL SERVICES STAFF IS AVAILABLE TO HELP ANY PATIENT NEEDING ASSISTANCE COMPLETING AN APPLICATION. LANGUAGE TRANSLATION SERVICES ARE ALSO AVAILABLE.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION: BILLINGS CLINIC IS BASED IN BILLINGS, MONTANA AND IS MONTANA'S LARGEST HEALTH CARE ORGANIZATION SERVING A VAST REGION COVERING MUCH OF MONTANA, WYOMING AND NORTH DAKOTA. BILLINGS CLINIC IS ONE OF MONTANA'S LARGEST EMPLOYERS WITH APPROXIATELY 4,500 EMPLOYEES INCLUDING MORE THAN 600 PHYSICIANS AND ADVANCED PRACTITIONERS OFFERING MORE THAN 80 SPECIALTIES. COMMUNITY BENEFIT INCLUDES HEALTH CARE SERVICES PROVIDED AT BILLINGS CLINIC LOCATIONS, INCLUDING THE HOSPITAL, MAIN CLINIC, BRANCH CLINICS AND OUTREACH CLINICS. BILLINGS CLINIC SPECIALISTS PROVIDE 110 OUTREACH CLINICS PER MONTH AT 21 DIFFERENT REGIONAL LOCATIONS FOR THE RESIDENTS OF MONTANA, WYOMING AND NORTH DAKOTA.
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: AS A NOT-FOR PROFIT COMMUNITY-GOVERNED ORGANIZATION, WORKING WITH OTHER ORGANIZATIONS IN THE COMMUNITY TO ADDRESS THE HEALTH CARE NEEDS IS AN IMPORTANT PART OF OUR MISSION. BILLINGS CLINIC HAS BEEN INVOLVED IN MEETING THE NEEDS OF INDIVIDUALS AND COMMUNITIES THROUGH COOPERATIVE EFFORTS WITH OTHER ORGANIZATIONS IN YELLOWSTONE COUNTY AND IN OUR REGION. COMMUNITY HEALTH COLLABORATION SINCE 1994, BILLINGS CLINIC, RIVERSTONE HEALTH AND ST. VINCENT HEALTHCARE HAVE BEEN WORKING TOGETHER, CREATING AND SUSTAINING INNOVATIVE PROGRAMS THAT ADDRESS COMPLEX COMMUNITY-WIDE HEALTH ISSUES. THEIR PURPOSE IS TO CREATE SUSTAINED CHANGE IN HOW OUR COMMUNITY RESPONDS TO THE CHALLENGE OF THE HIGH COST OF PRESCRIPTION DRUGS FOR THE UNINSURED AND THE POPULATION LIFESTYLE ISSUES OF OBESITY, POOR NUTRITION AND PHYSICAL ACTIVITY HABITS. THESE ARE EXAMPLES OF THE PAST AND FUTURE SUCCESSES OF THE ALLIANCE'S EFFORTS. COMMUNITY CRISIS CENTER - THE COMMUNITY CRISIS CENTER (CCC), ENHANCES\ACCESS TO BEHAVIORAL HEALTH CARE IN BILLINGS. THE CCC HAS SUCCESSFULLY REDUCED INAPPROPRIATE UTILIZATION OF LOCAL EMERGENCY DEPARTMENTS, DECREASED THE NUMBER OF SHORT-TERM INPATIENT HOSPITAL ADMISSIONS, AND HAS BEEN A DRIVING FORCE IN REDUCING THE INMATE POPULATION AT THE YELLOWSTONE COUNTY DETENTION FACILITY. MEDICATION ASSISTANCE PROGRAM (MAP) - MAP HELPS PATIENTS AFFORD THE PRESCRIPTION DRUGS THEY NEED BY CONNECTING INDIVIDUALS WITH AVAILABLE PATIENT ASSISTANCE PROGRAMS OFFERING DISCOUNTED OR FREE PRESCRIPTION MEDICATION. MAP ASSISTS LOW INCOME, UNINSURED OR UNDER INSURED PEOPLE IN GETTING THE MEDICATIONS THEY NEED, BUT CAN'T AFFORD. HEALTHY BY DESIGN - TO HELP RECOGNIZE ORGANIZATIONS IN YELLOWSTONE COUNTY COMMITTED TO IMPROVING OUR COMMUNITY'S HEALTH, BILLINGS CLINIC, RIVERSTONE HEALTH, AND ST. VINCENT HEALTHCARE LAUNCHED A COMMUNITY HEALTH COALITION CALLED HEALTHY BY DESIGN. HEALTHY BY DESIGN ENCOURAGES, RECOGNIZES, EDUCATES AND CREATES A STANDARD OF EXCELLENCE FOR PROMOTING HEALTHY LIFESTYLES BY ENCOURAGING ACTIVE LIVING AND HEALTHY CHOICES THAT SHAPE THE FUTURE OF THE COMMUNITY. FOR PROMOTING HEALTHY LIFESTYLES BY ENCOURAGING ACTIVE LIVING AND HEALTHY CHOICES THAT SHAPE THE FUTURE OF THE COMMUNITY.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM: BILLINGS CLINIC HAS AN AFFILIATED RELATIONSHIP WITH BEARTOOTH BILLINGS CLINIC, STILLWATER HOSPITAL ASSOCIATION AND TOWNSEND HEALTH SYSTEMS, INC. D/B/A BROADWATER BILLINGS CLINIC. EACH HOSPITAL IS A MONTANA NON-PROFIT CORPORATION. BEARTOOTH AND STILLWATER HAVE BEEN AFFILIATES OF BILLINGS CLINIC SINCE 2002 WITH A SHARED MANAGEMENT AGREEMENT. BROADWATER HEALTHCARE BEGAN THEIR AFFILIATION IN 2019. WITHIN THE AGREEMENT BILLINGS CLINIC PROVIDES MANAGEMENT, DIGITAL INFORMATION SYSTEMS, AND ANCILLARY SUPPORT SERVICES TO AREA HOSPITALS AND CLINICS. THE AFFILIATION BRINGS A STRONGER ALIGNMENT DUE TO A DESIRE TO STABILIZE AND ENHANCE THE LEVEL AND SCOPE OF HEALTH CARE SERVICES AVAILABLE IN EACH COMMUNITY. THE AFFILIATION ALLOWED THEM TO STRENGTHEN THEIR COMMITMENT TO QUALITY, PATIENT SAFETY AND SERVICE VALUE.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
COMMUNITY CRISIS CENTER
704 NORTH 30TH STREET	BILLINGS	MT	59101	203231164	501(C)(3)	$81,191	SUPPORT OPERATIONS
ST JOHNS UNITED
2429 MISSION WAY	BILLINGS	MT	59102	810485182	501(C)(3)	$25,000	SUPPORT NURSING PROGRAM
MONTANA RESCUE MISSION
PO BOX 3232	BILLINGS	MT	59103	816013963	501(C)(3)	$10,000	CAPITAL CAMPAIGN
RIMROCK FOUNDATION
P O BOX 30374	BILLINGS	MT	59107	810302870	501(C)(3)	$10,000	SUBSTANCE ABUSE PROGRAMS
BILLINGS CLINIC FOUNDATION
2917 TENTH AVENUE	NORTH BILLINGS	MT	59101	810407289	501(C)(3)	$9,575	SUPPORT PROGRAM
AMERICAN CANCER SOCIETY
PO BOX 20893	BILLINGS	MT	59103	131788491	501(C)(3)	$6,000	SUPPORT OPERATIONS

Field	Value	IRS element (for citing)
Total501c3 Org	7	Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	SCHOLARSHIPS	GrantTypeTxt
Recipient	54	RecipientCnt
Cash Grant	$12,612	CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	DESCRIPTION OF MONITORING PROCESS FOR SCHOLARSHIPS AND GRANTS: BILLINGS CLINIC AWARDS SCHOLARSHIPS TO INDIVIDUALS WHO EXHIBIT A STRONG DESIRE AND POTENTIAL TO EXCEL IN THE HEALTHCARE FIELD. BILLINGS CLINIC ALSO PROVIDES GRANTS TO OTHER HEALTH RELATED ORGANIZATIONS. MONTHLY FINANCIAL REPORTS ARE REVIEWED AND SIGNED BY THE GRANT MANAGER, AND THEN SUBMITTED FOR APPROVAL OF THE DRAWING OF FUNDS FOR GRANTS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt
Scott Ellner
Former CEO - THROUGH 12/22	$972,402	$0	$0	$0	$414,916	$0	$173,695	$0	$26,027	$0	$1,587,040	$0	$381,272
Priscilla Needham
Former CFO - Through 12/22	$505,586	$0	$0	$0	$7,333	$0	$88,076	$0	$24,664	$0	$625,659	$0
Robert Merchant
Former Co-CEO	$370,092	$0	$26,250	$0	$28,938	$0	$26,275	$0	$18,550	$0	$470,105	$0
Heidi Duncan MD
Physician Board Member	$233,241	$0	$240	$0	$2,434	$0	$27,628	$0	$20,247	$0	$283,790	$0
William Dresen MD
Physician	$1,052,668	$0	$0	$0	$2,446	$0	$26,275	$0	$30,072	$0	$1,111,461	$0
Marlin Richardson MD
Physician	$1,058,562	$0	$0	$0	$2,629	$0	$26,275	$0	$32,260	$0	$1,119,726	$0
Clinton Seger MD
CEO	$495,374	$0	$0	$0	$2,954	$0	$72,476	$0	$17,284	$0	$588,088	$0
Kathleen Quinones
CFO	$230,819	$0	$0	$0	$2,369	$0	$27,601	$0	$33,743	$0	$294,532	$0
Kendrick Trostel MD
PHYSICIAN BOARD MEMBER	$623,743	$0	$400	$0	$5,953	$0	$29,290	$0	$26,651	$0	$686,037	$0
Vance Fredrickson MD
Physician	$1,680,160	$0	$20,000	$0	$2,584	$0	$7,625	$0	$11,078	$0	$1,721,447	$0
Anthony Roccisano DO
Physician	$1,330,886	$0	$0	$0	$2,647	$0	$0	$0	$33,444	$0	$1,366,977	$0
Christopher Stewart DO
Physician	$1,027,331	$0	$20,000	$0	$2,221	$0	$18,650	$0	$28,711	$0	$1,096,913	$0
Joy Ott
FORMER BOARD SECRETARY	$0	$0	$0	$0	$29,882	$0	$8,886	$0	$0	$0	$38,768	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 4A	SEVERANCE OR CHANGE OF CONTROL PAYMENTS: SCOTT ELLNER, FORMER BILLINGS CLINIC CEO, RECEIVED A QUALIFYING PAYMENT IN THE AMOUNT OF $20,000 IN 2022. THIS PAYMENT IS INCLUDED IN THE AMOUNT OF OTHER REPORTABLE COMPENSATION REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II.
SCHEDULE J, PART I, LINE 4B	DESCRIPTION OF NON-QUALIFIED RETIREMENT PLAN: THE BILLINGS CLINIC SUPPLEMENTAL RETIREMENT AGREEMENT FOR SENIOR EXECUTIVES (SERP) IS A NON-ELECTIVE 457(F) AGREEMENT AND PROVIDES FOR ANNUAL DEFERRALS, WHICH BECOME VESTED AND PAYABLE AFTER 4 YEARS. THE FOLLOWING INDIVIDUALS ARE PARTICIPANTS IN THE PLAN DURING THE 2022 CALENDAR YEAR WHICH IS INCLUDED IN DEFERRED COMPENSATION ON SCHEDULE J, PART II, COLUMN C: CLINTON SEGER - 46,201 KATHLEEN QUINONES - 27,601 SCOTT ELLNER - 147,472 PRISCILLA NEEDHAM - 61,801 THE FOLLOWING INDIVIDUAL PARTICIPATED IN THE 457(F) PLAN AND RECEIVED A PAYMENT REPORTED IN PART II, COLUMN (F) THAT WAS REPORTED AS DEFERRED COMPENSATION BY BILLINGS CLINIC IN A PRIOR YEAR: SCOTT ELLNER - 381,272
SCHEDULE J, PART I, LINE 7	DESCRIPTION OF NON-FIXED PAYMENTS: THE BOARD OF DIRECTORS ANNUALLY DETERMINES THE INCENTIVE PLAN AMOUNT FOR THE CEO AND THE SENIOR EXECUTIVE TEAM BASED ON AN EXTERNAL COMPENSATION STUDY. THE AVAILABILITY OF THE INCENTIVE IS AWARDED BASED ON FINANCIAL PERFORMANCE AS WELL AS ORGANIZATIONAL PERFORMANCE MEASUREMENTS IN QUALITY, PATIENT SATISFACTION, EMPLOYEE SATISFACTION AND THE INDIVIDUAL GOALS SET EACH YEAR IF THE TARGET IS TRIGGERED. THE INCENTIVE IS PAID ONLY IF TRIGGERED FOLLOWING THE FINANCIAL AUDIT PRESENTATION.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
MONTANA FACILITY FINANCE AUTHORITY
A	364615155	61204KLQ2	2018-10-01	$125,786,085	See Part VI	Yes (true)	false	false
Montana Facility Finance Authority
B	364615155		2018-10-01	$56,580,000	SEE PART VI	false	false	false
Montana Facility Finance Authority
C	364615155	61204KNX5	2022-05-17	$59,605,571	See Part VI	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$67,880,000	$0	$128,688,498	$0	$51,823	$0	$0	$0	$0	$43,389,652	$85,247,023	$0	2022	Yes (true)	false	false	Yes (true)
B	$0	$0	$56,585,075	$0	$91	$0	$0	$0	$0	$75,867	$56,509,118	$0	2022	Yes (true)	false	false	Yes (true)
C	$0	$0	$59,736,796	$0	$0	$0	$194,301	$0	$0	$0	$59,542,495	$0		Yes (true)	false	false	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	Yes (true)	Yes (true)	false	0.00200	0.00200	false	false	false	Yes (true)
B	false	false	Yes (true)	Yes (true)	false	0.00300	0.00300	false	false	false	Yes (true)
C	false	false	Yes (true)	Yes (true)	false	0.00200	0.00200	false	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
A	false	Yes (true)	Yes (true)	false	Yes (true)	false	false	0	Yes (true)	Yes (true)
0
B	false	Yes (true)	Yes (true)	false	Yes (true)	false	false	0	Yes (true)	Yes (true)
0
C	false	Yes (true)	Yes (true)	false	Yes (true)	false	false	0	Yes (true)	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE K, PART I(F), COLUMN A	THE BONDS WERE ISSUED TO FINANCE CAPITAL PROJECTS, TO REISSUE SERIES 2011A BONDS (ISSUED ON OCTOBER 6, 2014) AND TO CURRENT REFUND SERIES 2008 BONDS (ISSUED ON MAY, 30, 2008).
SCHEDULE K, PART II, LINE 3, COLUMN A	THE TOTAL PROCEEDS SHOWN IN PART II, LINE 3 DIFFERS FROM THE ISSUE PRICE SHOWN IN PART I, (E) DUE TO INTEREST EARNINGS ON INVESTED PROCEEDS.
SCHEDULE K, PART III, LINE 7, COLUMN A	AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE.
SCHEDULE K, PART IV, LINE 2(B), COLUMN A	THE REFUNDING PORTION OF THE BONDS HAS MET AN EXCEPTION TO THE REBATE REQUIREMENT.
SCHEDULE K, PART I(F), COLUMN B	THE BONDS WERE ISSUED TO FINANCE CAPITAL PROJECTS AND TO REISSUE SERIES 2011B BONDS (ISSUED ON JUNE 28, 2016).
SCHEDULE K, PART II, LINE 3, COLUMN B	THE TOTAL PROCEEDS SHOWN IN PART II, LINE 3 DIFFERS FROM THE ISSUE PRICE SHOWN IN PART I, (E) DUE TO INTEREST EARNINGS ON INVESTED PROCEEDS.
SCHEDULE K, PART III, LINE 7, COLUMN B	AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE.
SCHEDULE K, PART IV, LINE 2(B), COLUMN B	THE REFUNDING PORTION OF THE BONDS HAS MET AN EXCEPTION TO THE REBATE REQUIREMENT.
SCHEDULE K, PART I(F), COLUMN C	THE BONDS WERE ISSUED TO CURRENT REFUND THE SERIES 2018C BONDS (ISSUED ON OCTOBER 1, 2018).
SCHEDULE K, PART II, LINE 3, COLUMN C	THE TOTAL PROCEEDS SHOWN IN PART II, LINE 3 DIFFERS FROM THE ISSUE PRICE SHOWN IN PART I (E) DUE TO INTEREST EARNING ON INVESTED PROCEEDS.
SCHEDULE K, PART II, LINE 13, COLUMN C	SINCE THE PROCEEDS OF THE BONDS WERE USED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE.
SCHEDULE K, PART III, LINE 7, COLUMN C	AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE.
SCHEDULE K, PART IV, LINE 2(B), COLUMN C	BONDS PROCEEDS HAVE MET AN EXCEPTION TO THE REBATE REQUIREMENT.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
E JAMES DUNCAN
SEE PART V	$415,644	EMPLOYEE COMPENSATION	false
NADINE SEGER
SEE PART V	$384,202	EMPLOYEE COMPENSATION	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule L, Part IV	FormAndLineReferenceDesc
Explanation	Relationship Between Interested Person & the Organization: Line 1, Column B - E. James Duncan has a family relationship with board member Heidi Duncan. Line 2, Column B - Nadine Seger has a family relationship with CEO Clinton Seger.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B	PROCESS TO REVIEW 990: THE 990 REVIEW IS COMPLETED BEFORE THE RETURN IS FILED. IT IS REVIEWED BY THE CONTROLLER, CFO AND THEN THE BOARD OF DIRECTORS
FORM 990, PART VI, SECTION B, LINE 12C	PROCESS TO MONITOR CONFLICT OF INTEREST POLICY: THE COMPLIANCE OFFICER ALONG WITH THE GOVERNANCE AND NOMINATING COMMITTEE OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR MONITORING THE EFFECTIVENESS OF THE CONFLICT OF INTEREST REPORTING AND MANAGEMENT FOR BILLINGS CLINIC. IN ADDITION, BILLINGS CLINIC VICE PRESIDENTS ARE RESPONSIBLE FOR ENSURING THAT THEIR DIRECT REPORTS ARE COMPLYING WITH THIS POLICY.
FORM 990, PART VI, SECTION B, LINE 15A & 15B	PROCESS TO DETERMINE CEO COMPENSATION: BILLINGS CLINIC HAS AN EXECUTIVE COMPENSATION PROGRAM ADMINISTERED ANNUALLY BY INDEPENDENT TRUSTEES FOLLOWING BEST PRACTICES AND THE HIGHEST REGULATORY STANDARDS EXPECTED OF A NOT-FOR PROFIT ORGANIZATION. THEY FOLLOW BOARD APPROVED CHARTER AND OVERALL EXECUTIVE COMPENSATION PHILOSOPHY WHICH DEFINES THE MARKET AS A COMPARABLE SET OF NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. THEY LOOK AT RELEVANT MARKET DATA OF SIMILAR ROLES IN SIMILAR ORGANIZATIONS. ANNUAL DISCLOSURE OF THE COMMITTEE'S ACTIONS AND DECISIONS TO THE FULL BOARD IS REQUIRED. BILLINGS CLINIC ENGAGES SULLIVAN COTTER TO PERFORM REGULAR COMPENSATION REVIEWS FOR EXECUTIVES, MANAGER AND DIRECTORS. SULLIVAN COTTER PERFORMED EXECUTIVE COMPENSATION REVIEWS IN DECEMBER 2022 AND ON AN AD HOC BASIS AS NEEDED.
FORM 990, PART VI, SECTION C, LINE 19	BILLINGS CLINIC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ON AN AS NEEDED BASIS.
FORM 990, PART XI, LINE 9	OTHER CHANGE IN NET ASSETS: 5,276,147 - CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 14,034,662 - CHANGE IN INTEREST OF FOUNDATION (10,991,038) - CHANGE IN INTEREST IN AFFILIATES 8,319,771 - TOTAL
FORM 990 PART IX LINE 11G	DESCRIPTION:AMBULANCE SERVICES TOTAL FEES:145663
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACT LABOR TOTAL FEES:2176001
FORM 990 PART IX LINE 11G	DESCRIPTION:COLLECTIONS TOTAL FEES:1058606
FORM 990 PART IX LINE 11G	DESCRIPTION:CONSULTING TOTAL FEES:1299089
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACT MANAGEMENT TOTAL FEES:174858
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACT SERVICES TOTAL FEES:41795418
FORM 990 PART IX LINE 11G	DESCRIPTION:HEALTH CARE TECH SERVICES TOTAL FEES:10928824
FORM 990 PART IX LINE 11G	DESCRIPTION:MEDICAL TEST SERVICES TOTAL FEES:6787809
FORM 990 PART IX LINE 11G	DESCRIPTION:PHYSICIAN FEES TOTAL FEES:60233850
FORM 990 PART IX LINE 11G	DESCRIPTION:PATIENT CARE SERVICES TOTAL FEES:2196370
FORM 990 PART IX LINE 11G	DESCRIPTION:NURSING TOTAL FEES:24762376
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:4736393

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	EINEIN
MONTANA HEALTHCARE INDEMNITY LLC
2800 TENTH AVENUE NORTH	BILLINGS	MT	59101	INSUR CAPTIVE	MT	$7,704,253	$24,365,028	Billings Cli
BILLINGS CLINIC SPECIALTY SUPPLIES AND S
2800 TENTH AVENUE NORTH	BILLINGS	MT	59101	SPEC SUPPLY	MT	$94,401,807	$16,649,633	Billings Cli	364871868
BILLINGS CLINIC ONCALL LLC
2800 TENTH AVENUE NORTH	BILLINGS	MT	59101	TELEHEALTH	MT	$6,760	$6,375	Billings Cli	873543333

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
BILLINGS CLINIC FOUNDATION
2917 TENTH AVENUE NORTH	BILLINGS	MT	59101	810407289	FUNDRAISING	MT	501(C)(3)	7	BILLINGS CLI	Yes (true)
STILLWATER HOSPITAL ASSOCIATION
710 N 11TH STREET	COLUMBUS	MT	59019	810286525	HOSPITAL	MT	501(C)(3)	3	BILLINGS CLI	Yes (true)
TOWNSEND HEALTH SYSTEMS INC
110 NORTH OAK STREET	TOWNSEND	MT	59644	810398400	HEALTHCARE	MT	501(C)(3)	3	BILLINGS CLI	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	BILLINGS CLINIC INNOVATION FERTILITY LL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	399 KNOLLWOOD ROAD STE 303	AddressLine1Txt
City	WHITE PLAINS	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	10603	ZIPCd

Field	Value	IRS element (for citing)
EIN	881032699	EIN
Primary Activities	FERTILITY CLINIC	PrimaryActivitiesTxt
Legal Domicile State	NY	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Predominant Income Type	NONE	PredominantIncomeTypeTxt
Share Of Total Income	$0	ShareOfTotalIncomeAmt
Share Of EOY Assets	$0	ShareOfEOYAssetsAmt
General Or Managing Partner	false	GeneralOrManagingPartnerInd
Ownership	0.49000	OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	BILLINGS CLINIC EXPRESS CARE	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 TENTH AVENUE NORTH	AddressLine1Txt
City	BILLINGS	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59101	ZIPCd

Field	Value	IRS element (for citing)
EIN	463355499	EIN
Primary Activities	RETAIL HEALTH SVC	PrimaryActivitiesTxt
Legal Domicile State	MT	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	BILLINGS CLINIC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Entity Type	C CORP	EntityTypeTxt
Share Of Total Income	$73,537	ShareOfTotalIncomeAmt
Share Of EOY Assets	$0	ShareOfEOYAssetsAmt
Ownership	1.00000	OwnershipPct
Controlled Organization	Yes (true)	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (13 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
BILLINGS CLINIC EXPRESS CARE
A	$260,377	INTERCO AMOUNT
BILLINGS CLINIC FOUNDATION
C	$5,259,418	INTERCO AMOUNT
BILLINGS CLINIC FOUNDATION
D	$234,439	INTERCO AMOUNT
STILLWATER HOSPITAL ASSOCIATION
D	$3,520,408	INTERCO AMOUNT
BILLINGS CLINIC SPECIALTY SUPPLIES AND SERVIC
D	$343,423	INTERCO AMOUNT
TOWNSEND HEALTH SYSTEMS INC
D	$3,167,410	INTERCO AMOUNT
BILLINGS CLINIC EXPRESS CARE
O	$273,875	INTERCO AMOUNT
STILLWATER HOSPITAL ASSOCIATION
O	$7,020,964	INTERCO AMOUNT
TOWNSEND HEALTH SYSTEMS INC
O	$5,335,228	INTERCO AMOUNT
STILLWATER HOSPITAL ASSOCIATION
Q	$9,617,605	INTERCO AMOUNT
TOWNSEND HEALTH SYSTEMS INC
Q	$6,388,853	INTERCO AMOUNT
BILLINGS CLINIC EXPRESS CARE
R	$10,000	INTERCO AMOUNT
BILLINGS CLINIC SPECIALTY SUPPLIES AND SERVIC
S	$15,021,331	INTERCO AMOUNT