BILLINGS CLINIC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: BILLINGS CLINIC (EIN 81-0231784)
Tax period: 2016-07-01 to 2017-06-30
Filed: 2018-05-04
IRS object ID: 201831249349301908
Schema version: 2016v3.1
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	2018-05-04T16:27:40-05:00	ReturnTs
Tax Period End	2017-06-30	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	2016-07-01	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	% CONNIE PREWITT	InCareOfNm
Business Name Control	BILL	BusinessNameControlTxt
Phone	4062382500	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 Tenth Avenue South	AddressLine1Txt
City	Billings	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59101	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	CONNIE PREWITT	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	4062382500	PhoneNum
Signature	2018-05-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Adam R Smith CPA	PreparerPersonNm
PTIN	P00958966	PTIN
Phone	7194714290	PhoneNum

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Randall Gibb	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 Tenth Avenue South	AddressLine1Txt
City	Billings	CityNm
State Abbreviation	MT	StateAbbreviationCd
ZIP	59101	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,357,539,184	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.BILLINGSCLINIC.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1907	FormationYr
Legal Domicile State	MT	LegalDomicileStateCd
Activity Or Mission	BILLINGS CLINIC IS A NOT-FOR PROFIT MULTI-SPECIALTY Physician GROUP PRACTICE which provides Healthcare, Research and Education.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	4803	TotalEmployeeCnt
Total Volunteers	275	TotalVolunteersCnt
Total Gross UBI	$10,832,324	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$2,024,396	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$6,882,544	PYContributionsGrantsAmt
CY Contributions Grants	$8,616,665	CYContributionsGrantsAmt
PY Program Service Revenue	$644,159,429	PYProgramServiceRevenueAmt
CY Program Service Revenue	$709,548,648	CYProgramServiceRevenueAmt
PY Investment Income	$2,653,118	PYInvestmentIncomeAmt
CY Investment Income	$19,474,531	CYInvestmentIncomeAmt
PY Other Revenue	$11,330,945	PYOtherRevenueAmt
CY Other Revenue	$15,274,456	CYOtherRevenueAmt
PY Total Revenue	$665,026,036	PYTotalRevenueAmt
CY Total Revenue	$752,914,300	CYTotalRevenueAmt
PY Grants And Similar Paid	$520,930	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$422,167	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$351,210,024	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$365,871,574	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$288,444,620	PYOtherExpensesAmt
CY Other Expenses	$312,900,780	CYOtherExpensesAmt
PY Total Expenses	$640,175,574	PYTotalExpensesAmt
CY Total Expenses	$679,194,521	CYTotalExpensesAmt
PY Revenues Less Expenses	$24,850,462	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$73,719,779	CYRevenuesLessExpensesAmt
Total Assets BOY	$711,015,080	TotalAssetsBOYAmt
Total Assets EOY	$776,435,285	TotalAssetsEOYAmt
Total Liabilities BOY	$276,052,936	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$259,698,478	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$434,962,144	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$516,736,807	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	BILLINGS CLINIC MISSION IS HEALTH CARE, EDUCATON 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	Yes (true)	SignificantChangeInd
Expense	$268,063,136	ExpenseAmt
Grant	$211,084	GrantAmt
Revenue	$436,443,917	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 15,700 ADMISSIONS.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$257,340,610	ExpenseAmt
Grant	$202,640	GrantAmt
Revenue	$271,883,096	RevenueAmt
Desc	BILLINGS CLINIC HAS OVER 400 PHYSICIANS AND ADVANCED PRACTITIONERS OFFERING MORE THAN 50 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 800,000 VISITS.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$10,722,526	ExpenseAmt
Grant	$8,443	GrantAmt
Revenue	$7,154,818	RevenueAmt
Desc	ASPEN MEADOWS IS A 90 BED SKILLED NURSING HOME AND 35 BED ASSISTED LIVING FACILITY. ASPEN MEADOWS HAD OVER 34,000 PATIENT DAYS. Aspen Meadows closed during the year.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$536,126,272	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
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
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	Yes (true)	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 With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	154	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	4803	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
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	10	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	false	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	CONNIE PREWITT	PersonNm
Phone	4062382500	PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
NICHOLAS J WOLTER
CEO - Thru January 2017	60.0	5.0	Yes (X)	Yes (X)	$1,219,538	$0	$31,901
DAVID BROWN
Board Member	5.0	0.0	Yes (X)		$0	$0	$10,850
JOY OTT
Board Chair	5.0	5.0	Yes (X)	Yes (X)	$0	$0	$10,368
ELIZABETH FULTON
TREASURER	5.0	0.0	Yes (X)	Yes (X)	$0	$0	$6,993
LIL ANDERSON
SECRETARY	5.0	0.0	Yes (X)	Yes (X)	$6,000	$0	$0
PENNI NANCE
Vice Chair	3.0	0.0	Yes (X)	Yes (X)	$6,000	$0	$0
CLAYTON H MCCRACKEN III MD
PHYSICIAN BOARD MEMBER	60.0	0.0	Yes (X)		$349,721	$0	$55,151
CRAIG BARTHOLOMEW
BOARD MEMBER	5.0	0.0	Yes (X)		$0	$0	$6,139
ROBERT PUERINGER MD
PHYSICIAN BOARD MEMBER	60.0	0.0	Yes (X)		$408,298	$0	$52,127
Bill Ebzery
Board Member	5.0	0.0	Yes (X)		$1,500	$0	$0
Frank Reed
Board Member	5.0	0.0	Yes (X)		$6,000	$0	$0
Keith Cook
Board member	5.0	0.0	Yes (X)		$3,000	$0	$0
Randall Gibb
Interim CEO	60.0	5.0	Yes (X)	Yes (X)	$694,417	$0	$73,764
Wayne Hirsch
Board Member	5.0	0.0	Yes (X)		$0	$0	$0
CONNIE PREWITT
CHIEF FINANCIAL OFFICER	60.0	5.0		Yes (X)	$638,464	$0	$73,520
Scott A Sample
Physician	70.0	0.0			$941,641	$0	$50,955	Yes (X)
Mark P Piedra
Physician	70.0	0.0			$869,893	$0	$33,004	Yes (X)
Barry N Smith
Physician	70.0	0.0			$837,235	$0	$49,647	Yes (X)
Jeffry O Lindenbaum
Physician	70.0	0.0			$821,937	$0	$50,267	Yes (X)
Jared J Lund
Physician	70.0	0.0			$795,415	$0	$51,521	Yes (X)
Darrell Ehrlick
Former Board Member	0.0	0.0			$29,344	$0	$0		Yes (X)
Linda Overstreet
Former Board Member	0.0	0.0			$13,129	$0	$0		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$7,641,532	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$556,207	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	462	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
HAyes Locums
6700 N Andrews Ave STE 600	FORT LAUDERDALE	FL	33309	Physicians Services	$5,170,226
Sodexo
PO BOX 360170	PITTSBURGH	PA	15251	Food Service	$4,270,665
Healthcare OUtsourcing Network
621 17th street ste 1800	DENVER	CO	80293	Early out vendor	$1,972,496
Command health
PO Box 844797	DALLAS	TX	75284	Transcription	$1,835,292
Healtcare Resource Group
12610 East Mirabeau Parkway	SPOKANE WASHINGTON	WA	99216	Denial Resolution	$1,614,137

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	92	CntrctRcvdGreaterThan100KCnt
Related Organizations	$8,616,665	RelatedOrganizationsAmt
Total Contributions	$8,616,665	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE	621110	$699,875,405	$699,875,405
REFERENCE LAB	621500	$4,110,286		$4,110,286
INCOME ON EQUITY INVESTEES	900099	$4,281,045	$2,399,380	$1,881,665
CLINICAL TRIAL REVENUE	541900	$415,778	$415,778
MEANINGFUL USE PAYMENTS	621110	$866,134	$866,134

Field	Value	IRS element (for citing)
Total Program Service Revenue	$709,548,648	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,747,323	TotalRevenueColumnAmt
Unrelated Business Revenue	$95,722	UnrelatedBusinessRevenueAmt
Exclusion	$5,651,601	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	$500,435	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$257,801	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$242,634	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$242,634	TotalRevenueColumnAmt
Exclusion	$242,634	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$616,873,031	SecuritiesAmt
Other	$1,153,892	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$603,828,907	SecuritiesAmt
Other	$470,808	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$13,044,124	SecuritiesAmt
Other	$683,084	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$13,727,208	TotalRevenueColumnAmt
Exclusion	$13,727,208	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	$243,676	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$67,368	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$176,308	TotalRevenueColumnAmt
Related Or Exempt Func Income	$176,308	RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
REGIONAL IT SERVICES	541519	$3,005,464	$3,005,464
IT CMC	541519	$1,102,858	$1,102,858
OPTICAL SHOP	446199	$574,039	$574,039

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,173,153	TotalRevenueColumnAmt
Related Or Exempt Func Income	$9,867,161	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$62,290	UnrelatedBusinessRevenueAmt
Exclusion	$243,702	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$14,855,514	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$752,914,300	TotalRevenueColumnAmt
Related Or Exempt Func Income	$713,600,166	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$10,832,324	UnrelatedBusinessRevenueAmt
Exclusion	$19,865,145	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$384,987	TotalAmt
Program Services	$384,987	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$37,180	TotalAmt
Program Services	$37,180	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	$5,423,945	TotalAmt
Program Services	$4,069,586	ProgramServicesAmt
Management And General	$1,354,359	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

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

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$298,782,267	TotalAmt
Program Services	$242,323,939	ProgramServicesAmt
Management And General	$56,458,328	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$13,761,343	TotalAmt
Program Services	$11,632,661	ProgramServicesAmt
Management And General	$2,128,682	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$29,130,510	TotalAmt
Program Services	$17,251,072	ProgramServicesAmt
Management And General	$11,879,438	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$18,773,509	TotalAmt
Program Services	$14,607,667	ProgramServicesAmt
Management And General	$4,165,842	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$40,000	TotalAmt
Management And General	$40,000	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$1,395,436	TotalAmt
Program Services	$4,744	ProgramServicesAmt
Management And General	$1,390,692	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$284,253	TotalAmt
Management And General	$284,253	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$161,509	TotalAmt
Management And General	$161,509	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

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

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$1,105,350	TotalAmt
Management And General	$1,105,350	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$58,713,153	TotalAmt
Program Services	$33,196,417	ProgramServicesAmt
Management And General	$25,516,736	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$2,410,774	TotalAmt
Program Services	$20,827	ProgramServicesAmt
Management And General	$2,389,947	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,574,500	TotalAmt
Program Services	$2,480,095	ProgramServicesAmt
Management And General	$3,094,405	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$14,109,344	TotalAmt
Program Services	$10,850,086	ProgramServicesAmt
Management And General	$3,259,258	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$7,744,110	TotalAmt
Program Services	$6,751,315	ProgramServicesAmt
Management And General	$992,795	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$4,091,218	TotalAmt
Program Services	$2,925,630	ProgramServicesAmt
Management And General	$1,165,588	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	$117,788	TotalAmt
Management And General	$117,788	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$6,687,675	TotalAmt
Program Services	$5,017,763	ProgramServicesAmt
Management And General	$1,669,912	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$24,946,165	TotalAmt
Program Services	$20,807,596	ProgramServicesAmt
Management And General	$4,138,569	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$5,643,607	TotalAmt
Program Services	$128,836	ProgramServicesAmt
Management And General	$5,514,771	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$123,808,478	$123,560,861	$247,617
BAD DEBT EXPENSE	$23,958,950	$23,958,950
REPAIRS AND MAINTENANCE	$8,647,915	$6,709,052	$1,938,863
BED TAX	$3,963,688	$3,963,688

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$19,496,867	TotalAmt
Program Services	$5,443,320	ProgramServicesAmt
Management And General	$14,053,547	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$679,194,521	TotalAmt
Program Services	$536,126,272	ProgramServicesAmt
Management And General	$143,068,249	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$16,701,241	BOYAmt
EOY	$17,873,039	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$6,411,982	BOYAmt
EOY	$48,393,488	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$90,707,342	BOYAmt
EOY	$119,635,287	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	$194,177	BOYAmt
EOY	$87,408	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$9,544,802	BOYAmt
EOY	$8,459,783	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$9,222,003	BOYAmt
EOY	$5,101,151	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$542,886,144	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$297,563,745	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$231,690,027	BOYAmt
EOY	$245,322,399	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$245,865,238	BOYAmt
EOY	$231,840,570	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	$18,397,884	BOYAmt
EOY	$21,935,675	EOYAmt

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$82,280,384	BOYAmt
EOY	$77,786,485	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$711,015,080	BOYAmt
EOY	$776,435,285	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$59,230,375	BOYAmt
EOY	$68,984,857	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	$29,008	BOYAmt
EOY	$1,835,612	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$152,171,468	BOYAmt
EOY	$147,820,075	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	$722,468	BOYAmt
EOY	$0	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	$63,899,617	BOYAmt
EOY	$41,057,934	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$276,052,936	BOYAmt
EOY	$259,698,478	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$395,690,325	BOYAmt
EOY	$479,607,300	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$15,144,652	BOYAmt
EOY	$11,770,866	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$24,127,167	BOYAmt
EOY	$25,358,641	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$434,962,144	BOYAmt
EOY	$516,736,807	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$711,015,080	BOYAmt
EOY	$776,435,285	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$73,719,779	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$4,025,475	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$4,029,409	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)
Consol And Sep Basis Fincl Stmt	Yes (X)	ConsolAndSepBasisFinclStmtInd

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

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	$161,509	FilingOrganizationsTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$161,509	FilingOrganizationsTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$679,033,012	FilingOrganizationsTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$679,194,521	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	$1,000,000	CurrentYearAmt
Total	$1,000,000	TotalAmt

Field	Value	IRS element (for citing)
Lobbying Ceiling	$1,500,000	LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year	$161,509	CurrentYearAmt
Total	$161,509	TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Current Year	$250,000	CurrentYearAmt
Total	$250,000	TotalAmt

Field	Value	IRS element (for citing)
Grassroots Ceiling	$375,000	GrassrootsCeilingAmt

Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp

Field	Value	IRS element (for citing)
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	$46,940,725	BeginningYearBalanceAmt
Contributions	$1,430,705	ContributionsAmt
Investment Earnings Or Losses	$1,962,519	InvestmentEarningsOrLossesAmt
Other Expenditures	$449,773	OtherExpendituresAmt
End Year Balance	$49,884,176	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$45,241,517	BeginningYearBalanceAmt
Contributions	$808,522	ContributionsAmt
Investment Earnings Or Losses	$1,194,556	InvestmentEarningsOrLossesAmt
Other Expenditures	$303,870	OtherExpendituresAmt
End Year Balance	$46,940,725	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$25,855,937	BeginningYearBalanceAmt
Contributions	$17,610,002	ContributionsAmt
Investment Earnings Or Losses	$1,990,724	InvestmentEarningsOrLossesAmt
Other Expenditures	$215,146	OtherExpendituresAmt
End Year Balance	$45,241,517	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$23,259,946	BeginningYearBalanceAmt
Contributions	$551,706	ContributionsAmt
Investment Earnings Or Losses	$2,064,279	InvestmentEarningsOrLossesAmt
Other Expenditures	$19,994	OtherExpendituresAmt
End Year Balance	$25,855,937	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$21,981,852	BeginningYearBalanceAmt
Contributions	$415,028	ContributionsAmt
Investment Earnings Or Losses	$1,054,443	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$201,010	GrantsOrScholarshipsAmt
Other Expenditures	-$12,633	OtherExpendituresAmt
End Year Balance	$23,262,946	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.39800	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.50800	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.09400	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	$9,897,742	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$23,916,839	OtherCostOrOtherBasisAmt
Book Value	$33,814,581	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$198,030,826	OtherCostOrOtherBasisAmt
Depreciation	$85,704,322	DepreciationAmt
Book Value	$112,326,504	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,380,430	OtherCostOrOtherBasisAmt
Depreciation	$1,704,039	DepreciationAmt
Book Value	$676,391	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$290,042,714	OtherCostOrOtherBasisAmt
Depreciation	$199,915,602	DepreciationAmt
Book Value	$90,127,112	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$18,617,593	OtherCostOrOtherBasisAmt
Depreciation	$10,239,782	DepreciationAmt
Book Value	$8,377,811	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$245,322,399	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (10 entries)

DescDesc	Book ValueBookValueAmt
NOTES RECEIVABLE FROM NEW WEST	$42,367,660
DUE FROM RELATED PARTY	$4,584,885
DUE FROM JV	$8,706
DEPOSIT	$27,400
INTEREST IN FOUNDATION	$70,257,800
INTEREST IN NEW WEST	-$44,616,927
INTEREST IN STILLWATER	$3,845,126
INTEREST IN EXPRESSCARE	-$3,288,805
INTEREST IN MHI	$4,002,493
ACCRUED INTEREST	$598,147

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$77,786,485	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
DUE TO MDOR	$572,324
DEPOSITS	$23,640
INTEREST RATE SWAP AGREEMENT	$21,478,827
ESTIMATED CLAIMS LIABILITY	$8,803,060
ACCRUED INTEREST	$846,518
PROVISION FOR UNPAID CLAIMS	$9,048,065
UNEARNED PREMIUMS	$285,500

Field	Value	IRS element (for citing)
Total Liability	$41,057,934	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$734,437,594	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$4,025,475	NetUnrealizedGainsInvstAmt
Other Revenue	$4,019,411	OtherRevenueAmt
Revenue Not Reported	$8,044,886	RevenueNotReportedAmt
Revenue Subtotal	$726,392,708	RevenueSubtotalAmt
Investment Expenses Not Incld	$1,105,350	InvestmentExpensesNotIncldAmt
Other Revenues Not Included	$25,416,242	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$26,521,592	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$752,914,300	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$652,314,410	TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal	$652,314,410	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$1,105,350	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$25,774,761	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$26,880,111	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$679,194,521	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4	THE ORGANIZATION'S ENDOWMENT CONSISTS OF APPROXIMATELY 80 INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. 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 D, Part XI, Line 2d	Revenue on books, not on return: Change in fair value of interest rate swap 8,335,437 Change in interest in foundation 2,428,981 Change in interest of Affiliates (6,745,007) Total 4,019,411
Schedule D, Part XI, Line 4b	Revenue on Return, Not on Books: Bad Debt reclassed to expense 23,958,950 MHI Revenue 1,457,292 Total 25,416,242
Schedule D, Part XII, Line 4b	Expense on Return, Not on Books: Bad Debt reclassed to expense 23,958,950 MHI Expenses 1,815,811 Total 25,774,761

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	false	ExpensesExceedBudgetInd
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	$6,210,582	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,210,582	NetCommunityBenefitExpnsAmt
Total Expense	0.00940	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$81,439,399	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$87,537,999	DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$87,649,981	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$87,537,999	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,210,582	NetCommunityBenefitExpnsAmt
Total Expense	0.00940	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,307,948	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$164,460	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,143,488	NetCommunityBenefitExpnsAmt
Total Expense	0.00480	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,899,133	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,738,905	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,160,227	NetCommunityBenefitExpnsAmt
Total Expense	0.00940	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$40,689,695	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$31,537,877	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,151,817	NetCommunityBenefitExpnsAmt
Total Expense	0.01390	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,946,725	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$812,305	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,134,420	NetCommunityBenefitExpnsAmt
Total Expense	0.00170	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,566,555	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$784,763	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,781,792	NetCommunityBenefitExpnsAmt
Total Expense	0.00420	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$58,410,056	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$36,038,310	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$22,371,744	NetCommunityBenefitExpnsAmt
Total Expense	0.03400	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$146,060,037	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$123,576,309	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$28,582,326	NetCommunityBenefitExpnsAmt
Total Expense	0.04340	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,151	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,151	NetCommunityBenefitExpnsAmt

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$243,708	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$243,708	NetCommunityBenefitExpnsAmt

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$45	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$45	NetCommunityBenefitExpnsAmt

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$835,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$835,000	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,083,904	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,083,904	NetCommunityBenefitExpnsAmt

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$23,958,950	BadDebtExpenseAmt
Reimbursed By Medicare	$220,872,589	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$235,545,273	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$14,672,684	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	17	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
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	WWW.HEALTHYBYDESIGNYELLOWSTONE.ORG	OtherWebsiteURLTxt
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	17	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	www.healthybydesignyellowstone.org	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 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	Yes (X)	LookBackMedicareInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5	THE 2016-17 COMMUNITY HEALTH NEEDS ASSESSMENT FOR YELLOWSTONE COUNTY IS A SYSTEMATIC, DATA-DRIVEN APPROACH TO DETERMINING THE HEALTH STATUS, BEHAVIORS AND NEEDS OF OUR POPULATION. SUBSEQUENTLY, THIS INFORMATION MAY BE USED TO INFORM DECISIONS AND GUIDE EFFORTS TO IMPROVE COMMUNITY HEALTH AND WELLNESS. THERE ARE THREE COMPONENTS THAT ARE ESSENTIAL IN RENDERING A COMPLETE PICTURE OF THE HEALTH OF YELLOWSTONE COUNTY: (1) THE COMMUNITY HEALTH SURVEY [PRIMARY QUANTITATIVE DATA]; (2) EXISTING DATA [SECONDARY QUANTITATIVE DATA]; AND (3) ONLINE KEY INFORMANT DATA [PRIMARY QUALITATIVE DATA]. THE COMMUNITY HEALTH SURVEY DEVELOPED FOR THIS STUDY GIVES US A COMPLETE AND TIMELY VIEW OF THE HEALTH STATUS AND BEHAVIORS OF AREA RESIDENTS THROUGH A RANDOMIZED TELEPHONE SURVEY OF 400 YELLOWSTONE COUNTY ADULTS. ALL ADMINISTRATION OF THE SURVEYS, DATA COLLECTION AND DATA ANALYSIS WAS CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS, INC. (PRC). THE SAMPLE DRAWN FOR THIS SURVEY IS REPRESENTATIVE OF THE ADULT YELLOWSTONE COUNTY POPULATION IN TERMS OF DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS, AS WELL AS GEOGRAPHICAL LOCATION. THE MAXIMUM ERROR RATE ASSOCIATED WITH THE TOTAL SAMPLE OF 400 IS 4.9% AT THE 95 PERCENT LEVEL OF CONFIDENCE. EXISTING VITAL STATISTICS AND OTHER DATA ARE INCORPORATED INTO THIS ASSESSMENT FOR YELLOWSTONE COUNTY. COMPARISONS ARE ALSO MADE, WHERE AVAILABLE, TO STATE AND NATIONAL BENCHMARKS. FURTHERMORE, WHEREVER POSSIBLE, HEALTH PROMOTION GOALS OUTLINED IN HEALTHY PEOPLE 2020 ARE INCLUDED. TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS ALSO IMPLEMENTED AS PART OF THIS PROCESS. 194 PARTICIPANTS INCLUDED HEALTHCARE PROVIDERS, PUBLIC HEALTH REPRESENTATIVES, GOVERNMENT REPRESENTATIVES, EDUCATORS, BUSINESS LEADERS, AND A VARIETY OF OTHER COMMUNITY LEADERS AND COMMUNITY MEMBERS.
Schedule H, Part V, Section B, Line 6a	THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN 2016-2017 WITH THE FINAL REPORT RELEASED IN 2017. THE ENTIRE CHNA WAS CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS (PRC). BILLINGS CLINIC'S COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN A PRE-EXISTING COMMUNITY HEALTH PARTNERSHIP CALLED "THE ALLIANCE" WITH ST. VINCENT HEALTHCARE (HOSPITAL ORGANIZATION) AND RIVERSTONE HEALTH (PUBLIC HEALTH DEPARTMENT FOR CITY AND COUNTY). THE ALLIANCE ALSO CONDUCTED A CHNA IN 2006, 2011 AND 2014.
Schedule H, Part V, Line 11	BILLINGS CLINIC HAS STARTED TO ADDRESS THE NEEDS THAT WE HAVE THE RESOURCES TO ADDRESS. THE OBJECTIVE OF BILLINGS CLINIC'S COMMUNITY BENEFIT PLAN FOR THE NEXT SEVERAL YEARS IS TO ALIGN, ENHANCE AND DEVELOP PROGRAMS BASED ON A SET OF CRITERIA ESTABLISHED BY OUR COMMUNITY HEALTH IMPROVEMENT COMMITTEE. AT THIS TIME, BILLINGS CLINIC DOES NOT HAVE THE RESOURCES NECESSARY TO ADDRESS ALL NEEDS, INCLUDING LACK OF TRANSPORTATION (ONLY AVAILABLE DURING WEEKDAYS ON A LIMITED BASIS); ACCESS TO DENTAL CARE (WE DO NOT OFFER DENTAL SERVICES); AVAILABILTY OF SUBSTANCE ABUSE TREATMENT (LIMITED).IN SOME AREAS WE DON'T OFFER ANY SERVICES BUT DO ADVOCATE ON POLICY SUCH AS SEAT BELT USAGE, FIREARM SAFETY, AND LACK OF HEALTHCARE COVERAGE. Overview: Strategy 1 - Healthy Food Retail and Healthy Food Procurement Current Situation: While an individual can avoid physical activity by simply not doing it, daily consumption of food is a necessary part of survival. However, Yellowstone County residents experience several barriers to consuming healthy foods, including affordability and availability. What if your morning latte came with a side of fresh fruit or a simple salad? One key strategy for increasing access to healthy foods, such as fruits and vegetables, is to encourage our local food retailers and institutions to stock and promote these items. Activities selected below aim to increase the prevalence of healthy foods throughout our daily lives, so that the healthy choice is the easy choice. Strategy Description: There is strong evidence that a strategy focused on healthy food retail and healthy food procurement methods is an effective approach to improve healthy weight and increased consumption of nutritional foods. Retail environments and institutional meal offerings, including schools, workplaces, neighborhood convenience stores, and coffee shops, can each play a significant role in consumer food choices, for better or worse. This is especially true for residents of neighborhoods that lack access to full service grocery stores, who otherwise may find it easier to find junk food than fruits and vegetables. Examples of proven activities related to this strategy include increasing retail offerings to include nutritious options, intentional product placement and marketing of these foods, while de-emphasizing unhealthy products such as tobacco, alcohol, sugary drinks and other junk foods. Sources: ChangeLab Solutions, US Surgeon General, CDC Winnable Battles, Procurement - City Health Overview: Strategy 2 - Creating and Improving Access to Places, Parks, and Playgrounds for Physical Activity and Creating and Maintaining Safe Neighborhoods Current Situation: Yellowstone County and Billings have several beautiful parks and places for recreation. However, the ability to access these destinations without a car, and safety concerns related to some of these destinations are barriers to their enjoyment. One key strategy for promoting use of existing facilities, including parks and bikeways, is to normalize their use. Activities selected below promote the normalization of active transportation and parks to increase physical activity. The more this infrastructure is utilized, the safer and popular it becomes. Strategy Description: There is strong evidence that a strategy focused on creating and improving access to places for physical activity, maintaining safe neighborhoods, and improving access to parks and playgrounds is an effective approach to improve healthy weight and physical activity. Examples of proven activities related to this strategy include increased access to facilities such as walking trails and exercise spaces, joint and shared use agreements, Complete Streets policies, Complete Parks, safe routes to school and parks, and zoning that promotes accessibility and activity. Overview: Strategy 3 - Provide Space for Organized Activities that Encourage Social Participation and Inclusion Current Situation: Overweight and obese adults are more likely to report a number of adverse health conditions, including fair/poor overall health and fair/poor mental health. Yellowstone County residents are increasingly active, however, disparities persist among lower-income residents and seniors. Key informants noted a lack of supportive built environment that does not always support healthy living as a significant concern. Local senior service and mental health representatives believe identification and development of community gathering places would be beneficial to their respective clients as social isolation and inactivity are often interwoven. A key strategy to promote activity and social engagement is to enhance or create spaces that are welcoming and accessible to all, with organized activities and opportunities for social engagement. Strategy Description: The evidence states this is an effective strategy for improved weight and increased physical activity by creating safe, attractive opportunities for all residents to be active and engaged. Research shows that perceptions of poor safety, unwelcoming spaces, and inaccessibility are all barriers to activity and that social engagement is associated with better health outcomes.
Schedule H, Part V, Section B, Line 16c	Direct URL for Plain Language Summary: WWW.BILLINGSCLINIC.COM/FINASSIST
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	15	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (15 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 & GYNECOLOGY Clinic
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
ASPEN MEADOWS
3155 AVENUE C	Billings	MT	59102	LONG TERM CARE FACILITY And Assisted living
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, Radiation Oncology
Psychiatric Center
1020 North 27th Street	Billings	MT	59101	Inpatient Psychiatric Center
Home Oxygen
801 N 27th Street	Billings	MT	59101	Durable Medical Equipment
Livingston Home Oxygen
1201 US HWY 10 West	Livingston	MT	59047	Durable Medical Equipment
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 Medicine

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, part I, Line 6a	Related Organization annual Community benefit report: STILLWATER COMMUNITY HOSPITAL, A RELATED CRITICAL ACCESS HOSPITAL, PREPARES THIER 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 7, Column (F)	Bad Debt Expense: BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 BUT EXCLUDED FOR PURPOSES OF CALCULATING PERCENTAGES IN THIS COLUMN EQUAL $23,958,950.
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 $40,689,695 AND NET COMMUNITY BENEFIT OF THOSE SERVICES WAS DETERMINED TO BE $9,151,817.
Schedule H, Part II	Community Building Activities: BILLINGS CLINICS COMMUNITY BUILDING ACTIVITIES INCLUDE DISASTER PLANNING, ADVOCACY FOR PATIENT CARE, HEALTH CARE AND COMMUNITY HEALTH; SCIENCE EXPO FOR WORKFORCE DEVELOPMENT; AND THE RECENT STATE OF MONTANA COMMUNITY BENEFIT ASSESSMENT. THE ASSESSMENT FUNDS WERE USED TO IMPLEMENT EARLY CHILDHOOD (PRE-KINDERGARTEN) EDUCATION PROGRAMS FOR UNDERSERVED FAMILIES AROUND THE STATE.
Schedule H, Part III, Section A, Line 2	Bad Debt Expense Methodology: THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS.
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 A, Line 4	Bad debt expense in Financial statements: See page 12 of the attached audited financial statements for the footnote describing bad debt expense.
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 UNREIMBURESED 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 B, Line 9b	Collection Practices: BILLINGS CLINIC HAD A FORMAL, WRITTEN POLICY IN TAX YEAR 2016, (OHA-205 "PATIENT FINANCIAL SERVICES"). WE DID HAVE A COLLECTION PROCESS, WHICH WAS USED TO SCREEN PATIENTS FOR FINANCIAL ASSISTANCE PRIOR TO MAKING PAYMENT ARRANGEMENTS FOR CARE. THE POLICY APPILES EQUALLY TO ALL PATIENTS - INSURED, UNDER-INSURED AND UNINSURED. ONCE A DETERMINATION HAS BEEN MADE AND ADJUSTMENTS APPLIED TO THE ACCOUNT BALANCE, ANY REMAINING BALANCE WOULD FALL INTO THE REGULAR GUIDELINES OF COLLECTION, GIVING PATIENTS FINANCING OPTIONS THAT WILL WORK WITHIN THEIR MONTHLY BUDGET. PATIENTS WHO CANNOT MEET THE REQUIREMENTS OF A PAYMENT ARRANGEMENT SHOULD APPLY FOR FINANCIAL ASSISTANCE. IF THEY DONT QUALIFY FOR FINANCIAL ASSISTANCE, THEY WILL BE OFFERED INTEREST-FREE PAYMENT PLANS FOR 12 MONTHS AND THEN A LOAN.
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 PHYSICIANCS 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 and Stillwater Hospital Association. Each Hospital is a Montana non-profit corporation. Beartooth and Stillwater have been affiliates of Billings Clinic since 2002 with a shared management agreement. 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 (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc	Purpose Of GrantPurposeOfGrantTxt	Cash GrantCashGrantAmt
Billings Clinic Foundation
2917 Tenth Avenue North	Billings	MT	59101	810407289	501(c)(3)	$664,355	Book	Provide Employees	To Support Operations
Community Crisis Center
704 North 30th Street	Billings	MT	59101	203231164	501(c)(3)				To Support Operations	$67,659

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	Scholarships	GrantTypeTxt
Recipient	90	RecipientCnt
Cash Grant	$37,180	CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	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 (12 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
NICHOLAS J WOLTER
CEO - Thru January 2017	$731,103	$0	$452,763	$0	$35,672	$0	$23,275	$0	$8,626	$0	$1,251,439	$0	$0	$0
CLAYTON H MCCRACKEN III MD
PHYSICIAN BOARD MEMBER	$344,539	$0	$0	$0	$5,182	$0	$30,632	$0	$24,519	$0	$404,872	$0	$0	$0
ROBERT PUERINGER MD
PHYSICIAN BOARD MEMBER	$405,735	$0	$0	$0	$2,563	$0	$29,414	$0	$22,713	$0	$460,425	$0	$0	$0
CONNIE PREWITT
CHIEF FINANCIAL OFFICER	$477,494	$0	$113,003	$0	$47,967	$0	$53,275	$0	$20,245	$0	$711,984	$0	$0	$0
Randall Gibb
Interim CEO	$552,188	$0	$128,644	$0	$13,585	$0	$53,275	$0	$20,489	$0	$768,181	$0	$0	$0
Scott A Sample
Physician	$937,039	$0	$0	$0	$4,602	$0	$23,275	$0	$27,680	$0	$992,596	$0	$0	$0
Mark P Piedra
Physician	$869,145	$0	$0	$0	$748	$0	$21,910	$0	$11,094	$0	$902,897	$0	$0	$0
Barry N Smith
Physician	$803,193	$0	$29,440	$0	$4,602	$0	$23,275	$0	$26,372	$0	$886,882	$0	$0	$0
Jeffry O Lindenbaum
Physician	$800,060	$0	$16,278	$0	$5,599	$0	$23,275	$0	$26,992	$0	$872,204	$0	$0	$0
Jared J Lund
Physician	$771,461	$0	$20,000	$0	$3,954	$0	$23,275	$0	$28,246	$0	$846,936	$0	$0	$0
Darrell Ehrlick
Former Board Member	$29,344										$29,344		$29,344
Linda Overstreet
Former Board Member	$13,129										$13,129		$13,129

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, part i, Line 1a	Description of Charter Travel and travel for COmpanions: Charter travel were provided for Nicholas Wolter, Randall Gibb, Connie Prewitt & Frank Reed. The travel was for board meetings and state legislation related travels. The travel for this purpose was treated as a business expense. Travel for companions was provided for the board members. Any travel for companions was included in a 1099 to the board memeber.
Schedule J, Part I, Line 4b	Description of Non-qualified retirement plan: The billings clinic supplemental retirement agreement for senior executives (SERP) is a non-elective 457(f) agreement and provides for annual deferrals, which become vested and payable after 4 years. the following individuals are participants in the plan during the 2016 calendar year which is included in deferred compensation on Schedule J, part II, Column C: Connie Prewitt - 30,000 Randall Gibb - 30,000 The Following Individuals received a payment during the 2016 calendar year which is included in other reportable compensation on Schedule J, Part II, Column B: Connie Prewitt - 39,741
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 qualtiy, 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 AUTHority
A	364615155	612043FL8	2008-05-30	$60,000,000	CAPITAL PROJECTS	Yes (true)	false	false
Montana Facility Finance Authority
B	364615155	61204MAA5	2011-08-24	$140,000,000	CAPITAL PROJECTS, REFUND 2008 BOND	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	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$35,480,000	$0	$60,000,000	$3,605,872	$0	$0	$1,200,000	$0	$0	$55,194,128	$0	$0	2009	false	false	Yes (true)	Yes (true)
B	$15,345,000	$0	$140,124,100	$0	$0	$0	$858,750	$0	$0	$54,703,676	$84,561,674	$0	2014	Yes (true)	false	false	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	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	0	false	false	false	Yes (true)
B	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	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
A	false	false	false	Yes (true)	false	false	false	0	false	Yes (true)
0
B	false	Yes (true)	false	false	Yes (true)	false	false	0	false	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	AARON SPARBOE	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	See Part V	RelationshipDescriptionTxt
Transaction	$679,208	TransactionAmt
Transaction	RENT	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 - Aaron Sparboe, is a former board member of billings clinic within the last five years and rents two clinics to the organization.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
From 990, Part III, Line 3	Discontinued Program Service: BILLINGS CLINIC SOLD ASPEN MEADOWS SKILLED NURSING AND ASSISTED LIVING CENTER ON JUNE 30, 2017.
Form 990, Part VI, Section A, Line 2	Business or Family Transaction: NICHOLAS WOLTER, CONNIE PREWITT, JOY OTT, AND Randall Gibb 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: THE GOVERNANCE AND NOMINATING COMMITTEE OF THE BOARD OF DIRECTORS, ACCORDING TO THEIR CHARTER, REVIEW ANNUALLY THE DISCLOSURE STATEMENTS OF THE BOARD OF DIRECTORS AND SENIOR EXECUTIVES AND TAKE ACTIONS TO RESOLVE CONFLICTS. A CONFLICT OF INTEREST REVIEW PANEL, CHAIRED BY THE COMPLIANCE OFFICER, AS OUTLINED IN THE ORGANIZATIONAL POLICY, IS RESPONSIBLE FOR REVIEWING DISCLOSED CONFLICTS AND APPROVING NECESSARY CONFLICT MANAGEMENT PLANS OF ALL OTHER INTERESTED PERSONS AT BILLINGS CLINIC.
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.
Form 990, Part VI, Section C, line 19	Describe how Governing documents are made available to the public: 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: Change in Fair Value of INterest Rate Swap 8,335,437 Change in Interest of Affiliates (4,306,028) Total 4,029,409

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	MONTANA HEALTHCARE INDEMNITY LLC	BusinessNameLine1Txt

US Address USAddress

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

Field	Value	IRS element (for citing)
EIN	810231784	EIN
Primary Activities	INSUR CAPTIVE	PrimaryActivitiesTxt
Legal Domicile State	MT	LegalDomicileStateCd
Total Income	$5,018,500	TotalIncomeAmt
End Of Year Assets	$13,343,940	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

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

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 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)

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	$20,897,549	$2,712,750	0.35000	Yes (true)
BILLINGS CLINIC EXPRESS CARE
2800 TENTH AVENUE NORTH	BILLINGS	MT	59101	463355499	OUTPATIENT CLINIC	MT	BILLINGS CLINIC	C CORP	-$762,421	$561,556	1.00000	Yes (true)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	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	Yes (true)	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	Yes (true)	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	Yes (true)	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 (9 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Billings Clinic Foundation
C	$8,616,665	INTERCO AMOUNT
New West Health Services
D	$42,367,660	INTERCO AMOUNT
Billings Clinic FOundation
D	$364,628	Interco Amount
Stillwater Hospital Association
D	$280,934	Interco Amount
Billings Clinic Express Care
D	$3,831,342	Interco Amount
Stillwater Hospital Association
E	$108,081	Interco Amount
Stillwater Hospital Association
L	$1,780,398	InterCo Amount
New West Health Services
M	$9,374,558	INterCo Amount
New West Health Services
M	$10,303,337	Interco Amount