BILLINGS CLINIC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: BILLINGS CLINIC (EIN 81-0231784)
Tax period: 2020-07-01 to 2021-06-30
Filed: 2022-05-04
IRS object ID: 202221249349301147
Schema version: 2020v4.1
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	2022-05-04T12:52:10-05:00	ReturnTs
Tax Period End	2021-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD 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	2020-07-01	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	% PRISCILLA NEEDHAM	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	PRISCILLA NEEDHAM	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	4062382500	PhoneNum
Signature	2022-05-04	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	Priscilla	PersonFirstNm
Person Last	Needham	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

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

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

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	SCOTT ELLNER 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	$2,006,904,998	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 304 BED HOSPITAL, PRIMARY CARE AND OVER 50 MULTI SPECIALTY CLINICS.	ActivityOrMissionDesc
Voting Members Governing Body	10	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	5493	TotalEmployeeCnt
Total Volunteers	65	TotalVolunteersCnt
Total Gross UBI	$23,877,512	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$8,233,032	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$19,789,953	PYContributionsGrantsAmt
CY Contributions Grants	$15,458,311	CYContributionsGrantsAmt
PY Program Service Revenue	$770,932,547	PYProgramServiceRevenueAmt
CY Program Service Revenue	$868,997,644	CYProgramServiceRevenueAmt
PY Investment Income	$23,568,521	PYInvestmentIncomeAmt
CY Investment Income	$60,599,459	CYInvestmentIncomeAmt
PY Other Revenue	$20,883,012	PYOtherRevenueAmt
CY Other Revenue	-$22,449,040	CYOtherRevenueAmt
PY Total Revenue	$835,174,033	PYTotalRevenueAmt
CY Total Revenue	$922,606,374	CYTotalRevenueAmt
PY Grants And Similar Paid	$282,583	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,595,980	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$410,159,852	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$451,108,736	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$368,442,561	PYOtherExpensesAmt
CY Other Expenses	$429,138,637	CYOtherExpensesAmt
PY Total Expenses	$778,884,996	PYTotalExpensesAmt
CY Total Expenses	$881,843,353	CYTotalExpensesAmt
PY Revenues Less Expenses	$56,289,037	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$40,763,021	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,116,696,008	TotalAssetsBOYAmt
Total Assets EOY	$1,329,607,252	TotalAssetsEOYAmt
Total Liabilities BOY	$350,999,223	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$370,498,997	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$765,696,785	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$959,108,255	NetAssetsOrFundBalancesEOYAmt
Mission	BILLINGS CLINIC MISSION IS HEALTH CARE, EDUCATION AND RESEARCH. BILLINGS CLINIC WILL PROVIDE BEST IN NATION CLINICAL QUALITY, PATIENT SAFETY, SERVICE AND VALUE.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$324,049,300	ExpenseAmt
Grant	$729,413	GrantAmt
Revenue	$489,092,755	RevenueAmt
Desc	BILLINGS CLINIC IS A 304 BED HOSPITAL PROVIDING SURGICAL, LABOR AND DELIVERY, PSYCHIATRIC, CANCER CARE, NEONATAL SERVICES AND ACUTE CARE. BILLINGS CLINIC HAD OVER 14,000 ADMISSIONS IN FY21.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$327,136,848	ExpenseAmt
Grant	$736,363	GrantAmt
Revenue	$312,538,155	RevenueAmt
Desc	BILLINGS CLINIC HAS OVER 550 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 87,000 PATIENT VISITS IN FY21.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$57,844,455	ExpenseAmt
Grant	$130,204	GrantAmt
Revenue	$66,204,538	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. OUR STAFF WORKS WITH YOU, YOUR PROVIDER AND YOUR INSURANCE COMPANY TO MAKE SURE YOUR NEEDS ARE MET. OUR GOAL IS TO MAKE BILLINGS CLINIC A ONE-STOP SOLUTION.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$709,030,603	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
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	false	ScheduleORequiredInd
IRP Document	185	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	5493	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	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	10	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	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	PRISCILLA NEEDHAM	PersonNm
Phone	4064352493	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

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 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	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd	OfficerOfficerInd	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd
Per Sommer MD
Physician	60.0	0.0	Yes (X)	$1,093,406	$0	$49,320
Alexander Kraev MD
Physician	60.0	0.0	Yes (X)	$1,076,520	$0	$49,909
Brian Rah MD
Physician	60.0	0.0	Yes (X)	$991,488	$0	$49,272
Marlin Richardson MD
Physician	60.0	0.0	Yes (X)	$976,014	$0	$53,622
Zachary Bland MD
Physician	60.0	0.0	Yes (X)	$981,969	$0	$36,746
Connie Prewitt
FORMER Chief Financial Officer	0.0	0.0		$822,880	$0	$42,079	Yes (X)
Scott Ellner
Chief Executive Officer	60.0	2.0		$839,508	$0	$22,157		Yes (X)
John Schallenkamp MD
Physician Board Member	63.0	0.0		$616,865	$0	$55,971			Yes (X)
Robert Merchant
Former CO-CEO	60.0	1.0		$532,281	$0	$48,831	Yes (X)
Robert Pueringer MD
Physician Board Member	62.0	0.0		$395,961	$0	$50,627			Yes (X)
Randall Gibb MD
Former CEO	0.0	0.0		$401,550	$0	$0	Yes (X)
Priscilla Needham
Chief Financial Officer	60.0	0.0		$168,128	$0	$5,413		Yes (X)
David Brown
Former Board Member	5.0	0.0		$16,089	$0	$449	Yes (X)
Joy Ott
Board Chairperson	5.0	0.0		$0	$0	$13,588		Yes (X)	Yes (X)
Penni Nance
Board Vice Chair	5.0	0.0		$6,000	$0	$6,000		Yes (X)	Yes (X)
Lillian Anderson
Board Secretary	5.0	0.0		$6,000	$0	$6,000		Yes (X)	Yes (X)
Keith Cook
Board Member	5.0	1.0		$6,000	$0	$6,000			Yes (X)
Wayne Hirsch
Board Member	5.0	0.0		$6,000	$0	$6,000			Yes (X)
Elizabeth Fulton
Board Treasurer	5.0	0.0		$0	$0	$6,998		Yes (X)	Yes (X)
Craig Bartholomew
Board Member	5.0	0.0		$0	$0	$6,457			Yes (X)
Chelsea Bodnar
Board Member	5.0	0.0		$0	$0	$6,079			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$8,936,659	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$521,518	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	664	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
CERNER CORPORATION
PO BOX 4100	ROCHESTER	MN	55903	IT CONTRACT SERVICES	$14,062,218
MEDEFIS INC
PO BOX 5068	NEW YORK	NY	10087	CONTRACT LABOR	$12,384,753
HAYES LOCUM LLC
PO BOX 88122	CHICAGO	IL	60680	CONTRACT LABOR	$9,587,105
SODEXO INC
2800 10TH AVENUE NORTH	BILLINGS	MT	59101	CONTRACT LABOR	$3,803,851
MAYO COLLABORATIVE SERVICE INC
PO BOX 9416	MINNEAPOLIS	MN	55480	LAB SERVICES	$3,447,165

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	57	CntrctRcvdGreaterThan100KCnt
Related Organizations	$5,145,745	RelatedOrganizationsAmt
Government Grants	$10,312,566	GovernmentGrantsAmt
All Other Contributions	$0	AllOtherContributionsAmt
Total Contributions	$15,458,311	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient Service Revenue	621110	$774,574,464	$774,574,464
340B Payments	621110	$74,976,865	$74,976,865
Reference Lab	621500	$10,043,631		$10,043,631
Income on Equity Investees	900099	$8,905,319	$2,350,435	$6,554,884
Clinical trial Revenue	541900	$497,365	$497,365

Field	Value	IRS element (for citing)
Total Program Service Revenue	$868,997,644	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$13,224,852	TotalRevenueColumnAmt
Unrelated Business Revenue	$99,011	UnrelatedBusinessRevenueAmt
Exclusion	$13,125,841	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	$1,644,213	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$155,728	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$1,488,485	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,488,485	TotalRevenueColumnAmt
Exclusion	$1,488,485	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$1,129,452,264	SecuritiesAmt
Other	$1,804,396	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$1,082,933,268	SecuritiesAmt
Other	$948,785	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$46,518,996	SecuritiesAmt
Other	$855,611	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$47,374,607	TotalRevenueColumnAmt
Exclusion	$47,374,607	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	$652,211	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$260,843	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$391,368	TotalRevenueColumnAmt
Related Or Exempt Func Income	$350,757	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$40,611	UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Service to Other Hospitals	541519	$3,788,041	$3,788,041
IT CMC	541519	$1,224,444	$1,224,444
LOSS ON FORGIVENESS OF DEBT	900099	-$46,616,718		-$46,616,718

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$17,275,340	TotalRevenueColumnAmt
Related Or Exempt Func Income	$15,047,150	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$2,126,890	UnrelatedBusinessRevenueAmt
Exclusion	$101,300	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	-$24,328,893	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$922,606,374	TotalRevenueColumnAmt
Related Or Exempt Func Income	$867,797,036	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$23,877,512	UnrelatedBusinessRevenueAmt
Exclusion	$15,473,515	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$1,574,235	TotalAmt
Program Services	$1,574,235	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$21,745	TotalAmt
Program Services	$21,745	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	$2,482,902	TotalAmt
Program Services	$1,862,921	ProgramServicesAmt
Management And General	$619,981	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$2,480,638	TotalAmt
Management And General	$2,480,638	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$369,812,814	TotalAmt
Program Services	$301,649,638	ProgramServicesAmt
Management And General	$68,163,176	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$18,028,577	TotalAmt
Program Services	$15,257,163	ProgramServicesAmt
Management And General	$2,771,414	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$35,347,137	TotalAmt
Program Services	$20,949,123	ProgramServicesAmt
Management And General	$14,398,014	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$22,956,668	TotalAmt
Program Services	$17,862,583	ProgramServicesAmt
Management And General	$5,094,085	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

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

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$2,744,224	TotalAmt
Program Services	$9,330	ProgramServicesAmt
Management And General	$2,734,894	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$380,219	TotalAmt
Management And General	$380,219	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$165,280	TotalAmt
Management And General	$165,280	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	$2,363,311	TotalAmt
Management And General	$2,363,311	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$72,758,873	TotalAmt
Program Services	$41,137,867	ProgramServicesAmt
Management And General	$31,621,006	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,727,828	TotalAmt
Program Services	$15,205	ProgramServicesAmt
Management And General	$1,712,623	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$6,129,976	TotalAmt
Program Services	$2,727,226	ProgramServicesAmt
Management And General	$3,402,750	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$26,493,383	TotalAmt
Program Services	$20,373,412	ProgramServicesAmt
Management And General	$6,119,971	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$6,846,302	TotalAmt
Program Services	$5,968,606	ProgramServicesAmt
Management And General	$877,696	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$3,323,397	TotalAmt
Program Services	$2,376,561	ProgramServicesAmt
Management And General	$946,836	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	$19,325	TotalAmt
Management And General	$19,325	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$8,141,706	TotalAmt
Program Services	$6,108,722	ProgramServicesAmt
Management And General	$2,032,984	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$24,783,722	TotalAmt
Program Services	$20,672,103	ProgramServicesAmt
Management And General	$4,111,619	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$4,275,545	TotalAmt
Program Services	$1,837,202	ProgramServicesAmt
Management And General	$2,438,343	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$221,589,373	$221,146,194	$443,179
Repairs and Maintenace	$11,642,102	$11,642,102
Bed Tax	$9,462,227	$7,340,796	$2,121,431
Dues	$7,270,196	$2,880,452	$4,389,744

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$19,021,648	TotalAmt
Program Services	$5,617,417	ProgramServicesAmt
Management And General	$13,404,231	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$881,843,353	TotalAmt
Program Services	$709,030,603	ProgramServicesAmt
Management And General	$172,812,750	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$46,394,067	BOYAmt
EOY	$54,964,080	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$105,567,623	BOYAmt
EOY	$56,012,446	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$334,509	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$97,526,684	BOYAmt
EOY	$112,809,045	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	$93,263	BOYAmt
EOY	$869,706	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$10,776,951	BOYAmt
EOY	$12,146,160	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$8,491,795	BOYAmt
EOY	$8,890,182	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$661,437,579	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$366,879,546	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$247,083,128	BOYAmt
EOY	$294,558,033	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$467,298,945	BOYAmt
EOY	$612,971,180	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	$30,060,299	BOYAmt
EOY	$30,380,374	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$3,279,576	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$103,403,253	BOYAmt
EOY	$142,391,961	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,116,696,008	BOYAmt
EOY	$1,329,607,252	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$76,019,615	BOYAmt
EOY	$91,549,020	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	$4,794,456	BOYAmt
EOY	$4,520,455	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$177,650,178	BOYAmt
EOY	$175,225,677	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	$41,160,000	BOYAmt
EOY	$47,440,566	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	$51,374,974	BOYAmt
EOY	$51,763,279	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$350,999,223	BOYAmt
EOY	$370,498,997	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	$714,828,874	BOYAmt
EOY	$901,581,429	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$50,867,911	BOYAmt
EOY	$57,526,826	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$765,696,785	BOYAmt
EOY	$959,108,255	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,116,696,008	BOYAmt
EOY	$1,329,607,252	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$40,763,021	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$71,392,735	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$81,255,714	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

Total Grassroots Lobbying TotalGrassrootsLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$0	FilingOrganizationsTotalAmt

Total Direct Lobbying TotalDirectLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$165,280	FilingOrganizationsTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$165,280	FilingOrganizationsTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$880,874,659	FilingOrganizationsTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$881,039,939	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	$161,410	CurrentYearMinus3Amt
Current Year Minus2	$710,510	CurrentYearMinus2Amt
Current Year Minus1	$158,719	CurrentYearMinus1Amt
Current Year	$165,280	CurrentYearAmt
Total	$1,195,919	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 Minus3	$0	CurrentYearMinus3Amt
Current Year Minus2	$0	CurrentYearMinus2Amt
Current Year	$0	CurrentYearAmt
Total	$0	TotalAmt

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	$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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$49,769,710	BeginningYearBalanceAmt
Contributions	$1,714,498	ContributionsAmt
Investment Earnings Or Losses	$3,137,865	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$292,257	GrantsOrScholarshipsAmt
End Year Balance	$54,329,816	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$46,920,995	BeginningYearBalanceAmt
Contributions	$753,521	ContributionsAmt
Investment Earnings Or Losses	$1,360,860	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$497,141	GrantsOrScholarshipsAmt
End Year Balance	$48,538,235	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.35430	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.46890	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.17680	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	$9,206,384	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$28,227,025	OtherCostOrOtherBasisAmt
Book Value	$37,433,409	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$225,816,308	OtherCostOrOtherBasisAmt
Depreciation	$105,142,197	DepreciationAmt
Book Value	$120,674,111	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,239,713	OtherCostOrOtherBasisAmt
Depreciation	$1,006,779	DepreciationAmt
Book Value	$1,232,934	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$331,398,530	OtherCostOrOtherBasisAmt
Depreciation	$248,677,338	DepreciationAmt
Book Value	$82,721,192	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$64,549,619	OtherCostOrOtherBasisAmt
Depreciation	$12,053,232	DepreciationAmt
Book Value	$52,496,387	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$294,558,033	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (7 entries)

DescDesc	Book ValueBookValueAmt
Due from related party	$13,424,755
Due From JV	$1,227,270
Interest in Foundation	$115,466,915
INTEREST IN STILLWATER	$7,573,833
INTEREST IN EXPRESS CARE	-$5,581,632
Interest in BC Broadwater	$4,879,785
LEASE	$5,401,035

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$142,391,961	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
Due to MDOR	$473,792
Deposits	$7,890
Interest rate Swap Agreement	$18,427,383
Estimated Claims Liability	$13,104,842
Accrued Interest	$1,930,888
Unearned Premiums	$12,382,021
RIGHT-OF-USE LEASE LIABILITY	$5,436,463

Field	Value	IRS element (for citing)
Total Liability	$51,763,279	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	$19,619,127	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$19,619,127	NetCommunityBenefitExpnsAmt
Total Expense	0.02510	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$134,481,507	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$124,509,576	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,971,931	NetCommunityBenefitExpnsAmt
Total Expense	0.01280	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$154,100,634	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$124,509,576	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$29,591,058	NetCommunityBenefitExpnsAmt
Total Expense	0.03790	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,172,220	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$914,135	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,258,084	NetCommunityBenefitExpnsAmt
Total Expense	0.00420	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,709,996	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,266,936	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,443,060	NetCommunityBenefitExpnsAmt
Total Expense	0.00820	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$38,462,115	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$23,902,998	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$14,559,117	NetCommunityBenefitExpnsAmt
Total Expense	0.01860	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,833,610	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$470,942	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,362,668	NetCommunityBenefitExpnsAmt
Total Expense	0.00170	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,360,607	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,360,607	NetCommunityBenefitExpnsAmt
Total Expense	0.00170	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$57,538,548	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$30,555,011	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$26,983,536	NetCommunityBenefitExpnsAmt
Total Expense	0.03440	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$211,639,182	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$155,064,587	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$56,574,594	NetCommunityBenefitExpnsAmt
Total Expense	0.07230	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$33,200	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$33,200	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$17,290	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$17,290	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$206,231	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$206,231	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$256,721	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$256,721	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$13,196,127	BadDebtExpenseAmt
Reimbursed By Medicare	$227,129,553	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$272,761,401	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$45,631,848	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 AVENUE NORTH	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	19	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
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
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 (7 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	SINCE 1994, BILLINGS CLINIC, RIVERSTONE HEALTH, AND ST. VINCENT HEALTHCARE, OFTEN REFERRED TO AS THE ALLIANCE, HAVE COLLABORATED TO ADDRESS COMPLEX COMMUNITY HEALTH INITIATIVES IN YELLOWSTONE COUNTY, MONTANA.
SCHEDULE H, PART V, SECTION B, LINE 7A	https://www.billingsclinic.com/about-us/community-health-needs-assessments -and-community-health-improvem/
SCHEDULE H, PART V, SECTION B, LINE 10A	DIRECT URL FOR IMPLEMENTATION STRATEGY: HTTPS://WWW.BILLINGSCLINIC.COM/APP/FILES/PUBLIC/5D8A9FB2-7968-4E91-9405-D6 CAA64F123C/CHIP-COMMUNITY-BENEFIT-2020-2023.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 HEALTHCARE, 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 52 BILLINGS CLINIC PHYSICIANS IN 22 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 5,500 TELEMEDICINE APPOINTMENTS WITH MEDICAL SPECIALISTS, AS WELL AS ADMINISTRATIVE AND OPERATIONAL SUPPORT TO MORE 4,000 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 $110,000. FOR THE LAST 15 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 $662,000 ON HEALTHLINE-RELATED COSTS TO ENSURE THAT THIS SERVICE IS AVAILABLE TO THE COMMUNITY. BILLINGS CLINIC MEDICATION ASSISTANCE PROGRAM SERVED 4,814 UNINSURED AND UNDERINSURED PATIENTS WITH MORE THAN 22,305 PRESCRIPTIONS PROCESSED IN 2021, INCLUDING FINANCIAL ASSISTANCE FOR NECESSARY MEDICATIONS. THE TOTAL VALUE OF THE DONATED MEDICATIONS WAS OVER $657,400. CANCER - BILLINGS CLINIC PROVIDES FINANCIAL AND IN-KIND SUPPORT FOR THE AMERICAN CANCER SOCIETY, 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 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 MORE THAN 140 CHILDREN, TEENS AND ADULTS ANNUALLY WHO WERE VICTIMS OF SEXUAL ASSAULT AT A COST OF $267,000. BILLINGS CLINIC ALSO SUBSIDIZED THE HOURS FOR A FAMILY MEDICINE 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 $4.5M. 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 - AN AVERAGE OF 211 PEOPLE ATTENDED THE MARKET EVERY WEEK IN 2021. 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 $73,250. TOBACCO USE - BILLINGS CLINIC PROVIDES FREE EDUCATION FOR ADULTS AND
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 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	13	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (13 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
BILLINGS CLINIC
1045 N 30TH STREET	BILLINGS	MT	59101	OUTPATIENT CLINIC
BILLINGS CLINIC MILES CITY
620 SOUTH HAYNES AVENUE	MILES CITY	MT	59301	OUTPATIENT CLINIC
BILLINGS CLINIC HEIGHTS
760 WICKS LANE	BILLINGS	MT	59105	OUTPATIENT CLINIC
BOZEMAN OBGYN
925 HIGHLAND BLVD	BOZEMAN	MT	59715	OBSTETRICS AND GYNECOLOGY CLIN
BILLINGS CLINIC SURGERY CENTER
2929 TENTH AVENUE NORTH	BILLINGS	MT	59101	OUTPATIENT SURGERY CENTER
BILLINGS CLINIC WEST
2675 CENTRAL AVENUE	BILLINGS	MT	59102	OUTPATIENT CLINIC
BEHAVIORAL HEALTH CENTER
1020 NORTH 27TH STREET 4TH FL	BILLINGS	MT	59101	OUTPATIENT MENTAL HEALTH Center
BILLINGS CLINIC CODY
201 YELLOWSTONE AVENUE	CODY	WY	92414	OUTPATIENT CLINIC
BILLINGS CLINIC CANCER CENTER
801 NORTH 29TH STREET	BILLINGS	MT	59101	CANCER CARE, INFUSION,
PSYCHIATRIC CENTER
1020 NORTH 27TH STREET	BILLINGS	MT	59101	INPATIENT PSYCHIATRIC CENTER
HOME OXYGEN
801 N 27TH STREET	BILLINGS	MT	59101	DURABLE MEDICAL EQUIPMENT Medicine
BOZEMAN PEDIATRICS
1819 S 22ND STREET	BOZEMAN	MT	59715	PEDIATRIC OUTPATIENT CENTER
BILLINGS CLINIC ORTHOPEDICS
2702 8TH AVENUE NORTH	BILLINGS	MT	59101	ORTHOPEDICS AND SPORTS

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 $38,462,115 AND NET COMMUNITY BENEFIT OF THOSE SERVICES WAS DETERMINED TO BE $14,559,117.
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	ALLOWABLE MEDICARE COSTING METHODOLOGY: BILLINGS CLINIC ESTIMATES THAT 45 PERCENT OF BILLINGS CLINIC'S MEDICARE SHORTFALLS SHOULD BE COUNTED AS COMMUNITY BENEFIT. OUR RATIONALE IS THAT 45 PERCENT 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 4,300 EMPLOYEES INCLUDING MORE THAN 450 PHYSICIANS AND ADVANCED PRACTITIONERS OFFERING MORE THAN 50 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 122 OUTREACH CLINICS PER MONTH AT 20 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.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM: BILLINGS CLINIC HAS AN AFFILIATED RELATIONSHIP WITH BEARTOOTH BILLINGS CLINIC, STILLWATER HOSPITAL ASSOCIATION AND BROADWATER HEALTHCARE. 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 WITHIN THE GROUP 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 VALUES.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (12 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
COMMUNITY CRISIS CENTER
704 NORTH 30TH STREET	BILLINGS	MT	59101	203231164	501(C)(3)	$81,191	SUPPORT OPERATIONS
RIMROCK FOUNDATION
2429 MISSION WAY	BILLINGS	MT	59101	810485182	501(C)(3)	$10,000	SUBSTANCE ABUSE TREATMENT SUPPORT
ST JOHNS UNITED
2429 MISSION WAY	BILLINGS	MT	59102	810485182	501(C)(3)	$25,000	SUPPORT NURSING PROGRAM
ALBERTA BAIR THEATRE
2801 3RD AVENUE NORTH	BILLINGS	MT	59101	810406157	501(C)(3)	$16,500	CAPITAL CAMPAIGN
ROCKY MOUNTAIN COLLEGE
2917 Tenth Avenue North	BILLINGS	MT	59101	810407289	501(c)(3)	$27,750	METABOLIC CART
BILLINGS CLINIC FOUNDATION
2917 TENTH AVENUE NORTH	BILLINGS	MT	59101	810407289	501(C)(3)	$16,000	SUPPORT PROGRAM
POWELL VALLEY HEALTH CARE INC
777 AVENUE H	POWELL	WY	82435	830300467	501(C)(3)		SUPPORT PATIENT CARE	$1,201,162	FMV	EMR
BILLINGS AREA CHAMBER OF COMMERCE
815 SOUTH 27TH STREET	BILLINGS	MT	59101	810111570	501(C)(6)	$15,320	SUPPORT PROGRAMS - DIVERSITY AND INCLUSION
EDUCATION FOUNDATION FOR BILLINGS
415 NORTH 30TH STREET	BILLINGS	MT	59101	810452904	501(C)(3)	$6,000	SUPPORT PROGRAMS
COMMUNITY HEALTH PARTNERS
214 E MENDENHALL	BOZEMAN	MT	59715	841420492	501(C)(3)	$25,000	CAPITAL CAMPAIGN
METRA PARK (YELLOWSTONE COUNTY MT)
PO BOX 2514	BILLINGS	MT	59103	816001449	YLLWSTN. CNTY.	$25,000	CAPITAL CAMPAIGN
MONTANA RESCUE MISSION
PO BOX 3232	BILLINGS	MT	59103	816013963	501(C)(3)	$10,000	CAPITAL CAMPAIGN

Field	Value	IRS element (for citing)
Total501c3 Org	11	Total501c3OrgCnt
Total Other Org	1	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	SCHOLARSHIPS	GrantTypeTxt
Recipient	94	RecipientCnt
Non Cash Assistance	$21,745	NonCashAssistanceAmt

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	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount
Randall Gibb MD
Former CEO	$0	$0	$401,550	$0	$0	$0	$401,550	$0
Connie Prewitt
FORMER Chief Financial Officer	$0	$0	$573,444	$0	$0	$0	$864,959	$0	$249,436	$22,126	$19,953
Scott Ellner
Chief Executive Officer	$0	$0	$4,485	$0	$0	$0	$861,665	$0	$797,492		$22,157	$37,531
Priscilla Needham
Chief Financial Officer	$0	$0		$0	$0	$0	$173,541	$0	$123,128		$5,413	$45,000
Robert Merchant
Former CO-CEO	$0	$0	$74,879	$0	$0	$0	$581,112	$0	$457,402	$22,294	$26,537
Robert Pueringer MD
Physician Board Member	$0	$0	$4,174	$0	$0	$0	$446,588	$0	$391,287	$24,775	$25,852	$500
John Schallenkamp MD
Physician Board Member	$0	$0		$0	$0	$0	$672,836	$0	$616,190	$24,775	$31,196	$675
Per Sommer MD
Physician	$0	$0	$3,260	$0	$0	$0	$1,142,726	$0	$1,090,096	$23,001	$26,319	$50
Alexander Kraev MD
Physician	$0	$0	$2,895	$0	$0	$0	$1,126,429	$0	$1,073,125	$24,775	$25,134	$500
Brian Rah MD
Physician	$0	$0	$3,162	$0	$0	$0	$1,040,760	$0	$988,326	$24,775	$24,497
Zachary Bland MD
Physician	$0	$0	$3,114	$0	$0	$0	$1,018,715	$0	$973,855	$22,777	$13,969	$5,000
Marlin Richardson MD
Physician	$0	$0	$2,814	$0	$0	$0	$1,029,636	$0	$972,700	$24,591	$29,031	$500
David Brown
Former Board Member	$0	$0	$16,089	$0	$0	$0	$16,538	$0	$0	$449	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 4A	SEVERANCE OR CHANGE OF CONTROL PAYMENTS: CONNIE PREWITT, FORMER BILLINGS CLINIC CFO, RECEIVED A QUALIFYING PAYMENT OF $262,400 IN 2020. RANDALL GIBB, FORMER BILLINGS CLINIC CEO, RECEIVED A QUALFYING PAYMNET OF $401,550 IN 2020. THESE PAYMENTS ARE 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 RECEIVED A PAYMENT DURING THE 2019 CALENDAR YEAR WHICH IS INCLUDED IN OTHER REPORTABLE COMPENSATION ON SCHEDULE J, PART II, COLUMN B: CONNIE PREWITT - 278,560 ROBERT MERCHANT - 50,660
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 (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
MONTANA FACILITY FINANCE AUTHORUTY
A	364615155	61204KLQ2	2018-10-01	$125,786,085	REFUND 2008/2011A/CAPITAL	false	false	false
Montana Facility Finance Authority
B	364615155		2018-10-01	$56,580,000	REFUND 2008/2011 Issue	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 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	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Substantial CompletionSubstantialCompletionYr
A	$5,310,000	$0	$125,786,085	$7,506,525	$0	$0	$0	$0	$0	$33,106,419	$89,411,541	$0	Yes (true)	false	false	Yes (true)
B	$0	$0	$56,580,000	$0	$0	$0	$0	$0	$0	$0	$56,580,000	$0	Yes (true)	false	false	Yes (true)	2019

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	false	false	0	false	false	false	Yes (true)
B	false	false	false	false	0	false	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 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	Term Of GICTermOfGICPct	Regulatory Safe Harbor StsfdRegulatorySafeHarborStsfdInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
A	false	Yes (true)	false	false	Yes (true)	false	Yes (true)	BEYERISCHE LANDESBAN	2.875	Yes (true)	false	Yes (true)
0
B	false	Yes (true)	false	false	Yes (true)	false	false	0				Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

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

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	CRAIG BARTHOLOMEW	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	SEE PART V	RelationshipDescriptionTxt
Transaction	$1,840,880	TransactionAmt
Transaction	PURCHASE OF OFFICE SUPPLIES	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

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 - Craig Bartholomew, is a board member of Billings Clinic and owns an office supply company. Billings clinic purchased office supplies from the company. Transactions were conducted at arm's length for fair value with the knowledge and approval of the board.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2	BUSINESS OR FAMILY TRANSACTION: PRISCILLA NEEDHAM, JOY OTT, AND SCOTT ELLNER HAVE A BUSINESS RELATIONSHIP BECAUSE THEY ARE DIRECTORS OR OFFICERS OF THE SUBSIDIARY NEW WEST DISCLOSED ON SCHEDULE R, PART IV.
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 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 ANNUALY 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 2020 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 CHANGES IN NET ASSETS: 5,412,614 - CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 24,349,523 - CHANGE IN INTEREST OF FOUNDATION 51,493,577 - CHANGE IN INTEREST OF AFFILIATES 81,255,714 - TOTAL

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 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	$6,694,047	$20,152,358	BILLINGS CLI
SPECIALTY SUPPLIES AND SERVICES LLC
2800 TENTH AVENUE NORTH	BILLINGS	MT	59101	SPEC. SUPPLY	MT	$64,147,217	$11,188,580	BILLINGS CLI	364871868

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 Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd
NEW WEST HEALTH SERVICES
130 NEILL AVENUE	HELENA	MT	59601	841418136	INSURANCE SALES	MT	BILLINGS CLINIC	C CORP	$46,616,718	$3,608,425	0.65000	Yes (true)
BILLINGS CLINIC EXPRESS CARE
2800 TENTH AVENUE NORTH	BILLINGS	MT	59101	463355499	URGENT CARE	MT	BILLINGS CLINIC	C CORP	-$76,207	$303,946	1.00000	Yes (true)

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	$99,011	INTERCO AMOUNT
NEW WEST HEALTH SERVICES
B	$46,616,718	INTERCO AMOUNT
BILLINGS CLINIC FOUNDATION
C	$5,145,745	INTERCO AMOUNT
BILLINGS CLINIC FOUNDATION
D	$278,802	INTERCO AMOUNT
BILLINGS CLINIC EXPRESS CARE
D	$5,764,814	INTERCO AMOUNT
STILLWATER HOSPITAL ASSOCIATION
D	$1,919,956	INTERCO AMOUNT
TOWNSEND HEALTH SYSTEMS INC
D	$2,798,024	INTERCO AMOUNT
NEW WEST HEALTH SERVICES
D	$2,327,991	INTERCO AMOUNT
STILLWATER HOSPITAL ASSOCIATION
L	$1,135,244	INTERCO AMOUNT
TOWNSEND HEALTH SYSTEMS INC
L	$270,945	INTERCO AMOUNT
STILLWATER HOSPITAL ASSOCIATION
Q	$5,841,292	INTERCO AMOUNT
TOWNSEND HEALTH SYSTEMS INC
Q	$374,511	INTERCO AMOUNT
BILLINGS CLINIC EXPRESS CARE
R	$91,000	INTERCO AMOUNT