2017-02-15T11:06:11-06:00 2016-03-31 810497523 JORDAHL & SLITER PLLC PO BOX 8600 KALISPELL MT 599041600 990 2015-04-01 203752312 THE SUMMIT MEDICAL FITNESS CENTER SUMM 4067564707 310 SUNNYVIEW LANE KALISPELL MT 59901 CHARLES PEARCE CFIO 4067564707 2017-02-07 1 JUSTIN P SLITER P00188996 4067521040 2017-02-06 2015 2021-01-29 14:40:06Z CHARLES PEARCE 310 SUNNYVIEW LANE KALISPELL MT 59901 5666081 0 X WWW.KRH.ORG/SUMMIT X 2005 MT COMMUNITY HEALTH AND WELLNESS EDUCATION AND PRIMARY AND SECONDARY PREVENTION OF CHRONIC DISEASE 4 3 226 0 122387 61808 0 9450 4745810 5182412 0 -11865 235652 295459 4981462 5475456 0 0 0 0 3557507 3758451 0 0 0 1717067 1858239 5274574 5616690 -293112 -141234 5395535 5478040 827935 1051674 4567600 4426366 PROMOTED COMMUNITY HEALTH AND SAFETY THROUGH COMMUNITY ACTIVITIES AND SCHOOL BASED PROGRAMS, INCLUDING EDUCATIONAL SEMINARS, HEALTH SCREENINGS, SAFETY ACTIVITIES, THERAPEUTIC LIFE-STYLE PROGRAMS, AND ATHLETIC PHYSICALS AND TRAINING ACTIVITIES. 0 0 5056219 5182412 PROMOTED COMMUNITY HEALTH AND SAFETY THROUGH COMMUNITY ACTIVITIES AND SCHOOL BASED PROGRAMS, INCLUDING EDUCATIONAL SEMINARS, HEALTH SCREENINGS, SAFETY ACTIVITIES, THERAPEUTIC LIFE-STYLE PROGRAMS, AND ATHLETIC PHYSICALS AND TRAINING ACTIVITIES. 5056219 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 0 0 226 1 1 1 0 0 0 0 0 0 0 0 0 X 4 3 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X CHARLES PEARCE 4067521724 310 SUNNYVIEW LANE KALISPELL MT 59901 VELINDA STEVENS PRESIDENT 0.00 50.00 X X 0 798254 35893 WILSON HIGGS MD TRUSTEE 1.00 X 0 0 0 BARBRA BENNETT TRUSTEE 1.00 X 0 0 0 STEVE PATYK TRUSTEE 1.00 X 0 0 0 CHARLES PEARCE CHIEF FINANCIAL & INFORMA 0.00 50.00 X 0 560413 36005 PATRICK RANKIN CHIEF MEDICAL OFFICER 0.00 50.00 X 0 182019 6133 KAREN LEE CHIEF NURSING OFFICER 0.00 50.00 X 0 393232 25774 DEB WILSON CHIEF OPERATION OFFICER 0.00 50.00 X 0 466210 33114 TONY PATTERSON CHIEF ADMIN OFFICER & GENE 1.00 49.00 X 0 534371 30462 BRAD ROY EXEC. DIRECTOR THE SUMMIT 25.00 25.00 X 0 224458 30176 0 3158957 197557 0 0 1 0 0 9450 9450 9450 MEMBERSHIP DUES 713940 3429299 3429299 PROGRAM ACTIVITIES 900099 1753113 1753113 5182412 128837 10560 0 0 128837 10560 139397 67212 72185 11865 -11865 -11865 -11865 287573 178760 108813 55175 53638 CHILD CARE 624410 46438 46438 CAFETERIA/VENDING 722210 811 811 47249 5475456 5182412 122387 161207 141422 141422 2650270 2381748 268522 101308 31555 69753 668997 658980 10017 196454 169445 27009 12835 12835 66356 66356 264052 237647 26405 236062 236062 18033 13525 4508 552984 552984 20479 20479 REPAIRS & MAINTENANCE 311419 311419 OTHER EXPENSE 204792 204792 PURCHASED SERVICES 158789 158789 BAD DEBTS 12438 12438 5616690 5056219 560471 0 90145 107075 288968 376372 30654 50547 12775 0 13604387 8704840 4961658 4899547 3333 2333 8002 42166 5395535 5478040 422329 615990 405606 435684 827935 1051674 X 4567600 4426366 4567600 4426366 5395535 5478040 -141234 0 X X 0 1 X 1 0 X 2770 13215 9450 25435 3907247 4132243 4451329 4745810 5182412 22419041 27761 20603 21011 44391 47249 161015 3937778 4152846 4485555 4790201 5239111 22605491 0 0 0 22605491 90140 46687 62506 60758 72185 332276 21771 92378 103503 91653 111935 421240 111911 139065 166009 152411 184120 753516 4049689 4291911 4651564 4942612 5423231 23359007 0.96770 0.96820 0.03230 0.03180 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 541728 541728 6291882 3877997 2413885 4618986 3603212 1015774 1319369 709407 609962 832422 514224 318198 4899547 X 5453568 0 5453568 21888 21888 5475456 5604252 0 5604252 12438 12438 5616690 PART X, LINE 2: THE CORPORATION ADOPTED THE PROVISIONS OF ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. ASC 740 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE ASC AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT STANDARD FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF AN INCOME TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE CORPORATION HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN TAX YEARS AND HAS CONCLUDED NO RESERVES ARE REQUIRED. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT RECORDED AS AN ADJUSTMENT TO REVENUE 12,438. CONTRIBUTION BOOKED TO EQUITY 9,450. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT RECORDED AS AN ADJUSTMENT TO REVENUE 12,438. X X X 1 1 X 0 1 0 0 0 0 0 1 0 VELINDA STEVENS PRESIDENT 0 506817 0 125773 0 165664 0 15000 0 20893 0 834147 0 0 CHARLES PEARCE CHIEF FINANCIAL & INFORMA 0 332533 0 97781 0 130099 0 15000 0 21005 0 596418 0 0 PATRICK RANKIN CHIEF MEDICAL OFFICER 0 163079 0 0 0 18940 0 0 0 6133 0 188152 0 0 KAREN LEE CHIEF NURSING OFFICER 0 233328 0 68702 0 91202 0 15000 0 10774 0 419006 0 0 DEB WILSON CHIEF OPERATION OFFICER 0 278247 0 82505 0 105458 0 15000 0 18114 0 499324 0 0 TONY PATTERSON CHIEF ADMIN OFFICER & GENE 0 361656 0 106199 0 66516 0 15000 0 15462 0 564833 0 0 BRAD ROY EXEC. DIRECTOR THE SUMMIT 0 155218 0 29894 0 39346 0 9703 0 20473 0 254634 0 0 PART I, LINE 1A FIRST CLASS OR CHARTER TRAVEL - SMFC DOES NOT PROVIDE FIRST CLASS TRAVEL. CHARTER TRAVEL IS UTILIZED FOR THESE INDIVIDUALS WHEN A GROUP IS FLYING TOGETHER TO A CONFERENCE OR MEETING AND IT IS LESS EXPENSIVE THAN FLYING COMMERCIAL OR NO COMMERCIAL FLIGHT IS AVAILABLE. THIS WAS NOT INCLUDED AS TAXABLE COMPENSATION AS IT WAS BUSINESS RELATED. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - THE MEMBERS OF THE EXECUTIVE TEAM RECEIVED A 457 PLAN CONTRIBUTION OF $23,500 AND MEMBERS OF THE ADMINISTRATIVE TEAM RECEIVED A 457 PLAN CONTRIBUTION OF $18,000 FOR 2015. THE EXECUTIVE TEAM INCLUDES: PRESIDENT, CFIO, CNO, CMO, COO, AND CAO. THE ADMINISTRATIVE TEAM INCLUDES THE EXEC. DIRECTOR THE SUMMIT. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES - ALL EXECUTIVE AND ADMINISTRATIVE TEAM MEMBERS RECEIVE A FREE MEMBERSHIP TO THE SUMMIT. PART I, LINE 4B THE MEMBERS OF THE EXECUTIVE TEAM RECEIVED A 457 PLAN CONTRIBUTION OF $23,000 AND MEMBERS OF THE ADMINISTRATIVE TEAM RECEIVED A 457 PLAN CONTRIBUTION OF $18,000 FOR 2015. THE EXECUTIVE TEAM INCLUDES: PRESIDENT, CFIO, CNO, CMO, COO, AND CAO. THE ADMINISTRATIVE TEAM INCLUDES THE EXEC. DIRECTOR THE SUMMIT. PART I, LINE 7 BONUS PLANS ADMIN AND MGMT-BASED ON A NUMBER OF FACTORS INCLUDING BUT NOT LIMITED TO: QUALITY AND FINANCIAL INDICATORS INCLUDING DEPARTMENT SPECIFIC GOALS AND INITIATIVES, PATIENT SATISFACTION, PRODUCTIVITY, EMPLOYEE SATISFACTION, AND EMPLOYEE EVALUATION TIMELINESS. SUCCESSFUL IMPLEMENTATION OF COMPANY FISCAL YEAR ACTION PLANS AND THE OVERALL FINANCIAL HEALTH AND STABILITY OF THE ORGANIZATION. PART I, QUESTION 3 THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT IS DETERMINED BY THE COMPENSATION COMMITTEE OF ITS PARENT ORGANIZATION, KALISPELL REGIONAL HEALTHCARE SYSTEM, AND APPROVED BY ITS BOARD OF TRUSTEES. THE COMPENSATION COMMITTEE UTILIZES VARIOUS RESOURCES IN ESTABLISHING THE COMPENSATION OF THE PRESIDENT, INCLUDING FORM 990 OF OTHER ORGANIZATIONS, A WRITTEN EMPLOYMENT CONTRACT, AND REVIEW OF COMPENSATION SURVEYS OR STUDIES. STUART ROY SON OF CURRENT TRUSTEE 13992 SALARY 0 FORM 990, PART VI, SECTION A, LINE 6 THE SUMMIT MEDICAL FITNESS CENTER HAS ONE MEMBER, KALISPELL REGIONAL HEALTHCARE SYSTEM. FORM 990, PART VI, SECTION A, LINE 7B TO BE EFFECTIVE, SIGNIFICANT DECISIONS OF THE GOVERNING BOARD MUST BE APPROVED BY ITS MEMBER, KALISPELL REGIONAL HEALTHCARE SYSTEM. SIGNIFICANT DECISIONS INCLUDE CHANGES TO THE BOARD OF DIRECTORS, CONFIRMATION OF THE ANNUAL BUDGETS, ENTERING INTO LARGE CONTRACTS, AND REORGANIZATION OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS MAILED TO ALL BOARD MEMBERS WITH THE FEBRUARY BOARD PACKET. THE BOARD MEMBERS HAVE A CHANCE TO REVIEW THE FORM BEFORE THE BOARD MEETING WHERE A PRESENTATION ON THE FORM 990 IS DONE AND A QUESTION AND ANSWER SESSION HELD. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS ALL TRUSTEES, DIRECTORS, OFFICERS, AND KEY EMPLOYEES. THE COMPLIANCE OFFICE REVIEWS THEM, IDENTIFIES POTENTIAL CONFLICTS, AND FORWARDS TO THE ADMINISTRATIVE TEAM IF A POTENTIAL CONFLICT EXISTS, AS OUTLINED IN THE ORGANIZATIONAL POLICY. FORM 990, PART VI, SECTION B, LINE 15 KALISPELL REGIONAL HEALTHCARE SYSTEM HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL ITS EMPLOYEES, INCLUDING THE SENIOR EXECUTIVES. SALARY AND BENEFITS FOR THE PRESIDENT/CHIEF EXECUTIVE OFFICER ARE DETERMINED BY THE KALISPELL REGIONAL HEALTHCARE SYSTEM BOARD OF DIRECTORS EXECUTIVE COMPENSATION COMMITTEE AND REPORTED TO THE KALISPELL REGIONAL HEALTHCARE SYSTEM BOARD. THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD REVIEWS BASE SALARY AND TOTAL COMPENSATION DATA FROM AN ARRAY OF COMPENSATION SURVEYS OF HOSPITALS THAT ARE SIMILAR IN SIZE AND COMPLEXITY TO KALISPELL REGIONAL HEALTHCARE SYSTEM. THESE REPORTS ARE CONSIDERED BY THE COMMITTEE, AND A DETERMINATION IS MADE AS TO THE STATUS OF THE BASE SALARY, BENEFITS, AND TOTAL COMPENSATION FOR THE PRESIDENT/CEO. THE BOARD AND EXECUTIVE COMPENSATION COMMITTEE EMBRACE THE PHILOSOPHY OF MAINTAINING A COMPENSATION LEVEL WHICH WILL FAVOR RETENTION OF KEY LEADERSHIP IN ORDER TO MAINTAIN STABILITY IN KEY INITIATIVES. ADDITIONALLY, THE PRESIDENT/CEO UTILIZES THE PERIODIC RETENTION OF A COMPENSATION CONSULTANT AND MARKET INFORMATION PROVIDED TO DETERMINE RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES AND ENGAGES IN AN ANALYSIS THROUGH USE OF INDEPENDENT SURVEY RESULTS. THE BOARD COMMITTEE ALSO INCLUDES A REVIEW OF PERFORMANCE TARGETS WHICH ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION. THESE MEASURES INCLUDE ORGANIZATIONAL AND INDIVIDUAL GOALS, EFFORTS TO FURTHER THE MISSION AND VISION OF KALISPELL REGIONAL HEALTHCARE SYSTEM, QUALITY INDICATORS, CUSTOMER/PATIENT SATISFACTION, AND FINANCIAL PERFORMANCE OBJECTIVES. THE BOARD COMMITTEE REVIEWS BENEFIT LEVELS AND TOTAL COMPENSATION TO ENSURE APPROPRIATENESS IN THE NOT-FOR-PROFIT HEALTH CARE SECTOR. THE BOARD EXECUTIVE COMPENSATION COMMITTEE MAKES ITS REPORT TO THE KALISPELL REGIONAL HEALTHCARE SYSTEM BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 ONLY FORM 990 IS AVAILABLE. FORM 990, PART XII, LINE 2C: THE ORGANIZATION CHANGED NEITHER ITS OVERSIGHT PROCESS NOR SELECTION PROCESS DURING THE TAX YEAR. FORM 990, PART VII, SECTION A, COLUMN (B) - AVERAGE HOURS PER WEEK THE OFFICERS OF THE SUMMIT MEDICAL FITNESS CENTER DIVIDE THEIR TIME AMONG THE OTHER RELATED ENTITIES FOR WHICH THEY ARE ALSO OFFICERS. THEIR TOTAL AVERAGE WEEKLY HOURS DEVOTED TO ALL OF THE ENTITIES IS IN EXCESS OF 50 HOURS. KALISPELL REGIONAL HEALTHCARE SYSTEM 310 SUNNYVIEW LANE KALISPELL MT 59901 810406485 SUPPORT SUBSIDIARY TAX EXEMPT ORGANIZATIONS MT 501(C)(3) 11, TYPE II N/A 0 KALISPELL REGIONAL HEALTHCARE FOUNDATION 310 SUNNYVIEW LANE KALISPELL MT 59901 311703013 SUPPORTING ORGANIZATION MT 501(C)(3) 11, TYPE I KALISPELL REGIONAL MEDICAL CENTER 1 KALISPELL REGIONAL MEDICAL CENTER INC 310 SUNNYVIEW LANE KALISPELL MT 59901 237293874 OPERATE ACCUTE CARE HOSPITAL MT 501(C)(3) 3 KALISPELL REGIONAL HEALTHCARE SYSTEM 1 NORTHWEST HORIZONS INC 310 SUNNYVIEW LANE KALISPELL MT 59901 810420653 OPERATE LONG TERM AMBULATORY FACILITY MT 501(C)(3) 9 KALISPELL REGIONAL HEALTHCARE SYSTEM 1 KALISPELL REGIONAL MEDICAL CENTER VOLUNTEERS INC 310 SUNNYVIEW LANE KALISPELL MT 59901 273866474 SUPPORTING ORGANIZATION MT 501(C)(3) 9 KALISPELL REGIONAL MEDICAL CENTER 1 MRICT JOINT OPERATING AGREEMENT 310 SUNNYVIEW LANE KALISPELL MT 59901 205010390 DIAGNOSTIC SCREENING MT N/A N/A 0 0 HEALTHCENTER NORTHWEST LLC 310 SUNNYVIEW LANE KALISPELL MT 59901 810540517 ACUTE CARE HOSPITAL MT N/A N/A 0 0 FLATHEAD HOSPITAL DEVELOPMENT COMPANY LLC 310 SUNNYVIEW LANE KALISPELL MT 59901 810541707 COMMERCIAL BUILDING RENTAL MT N/A N/A 0 0 NORTHWEST ORTHOPEDICS & SPORTS MEDICINE LLC 310 SUNNYVIEW LANE KALISPELL MT 59901 371518772 ORTHOPEDIC MEDICINE MT N/A N/A 0 0 APPLIED HEALTH SERVICES INC 310 SUNNYVIEW LANE KALISPELL MT 59901 810413632 HEALTH RELATED MT N/A C 1 1 0 1 0 1 0 0 0 0 1 0 1 1 1 1 1 1 1 0 KALISPELL REGIONAL MEDICAL CENTER A 300432 ACTUAL PAYMENT APPLIED HEALTH SERVICES INC A 119757 ACTUAL PAYMENT KALISPELL REGIONAL MEDICAL CENTER L 798626 ACTUAL PAYMENT APPLIED HEALTH SERVICES INC L 89515 ACTUAL PAYMENT APPLIED HEALTH SERVICES INC M 134763 ACTUAL PAYMENT NORTHWEST HORIZONS INC L 54092 ACTUAL PAYMENT