CABINET PEAKS MEDICAL CENTER: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- CABINET PEAKS MEDICAL CENTER (EIN 81-0241755)
- Tax period
- 2015-04-01 to 2016-03-31
- Filed
- 2017-02-14
- IRS object ID
- 201720459349303252
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-02-14T15:43:49-06:00 | ReturnTs |
| Tax Period End | 2016-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810241755 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St John's Lutheran Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STJO | BusinessNameControlTxt |
| Phone | 4062837000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 209 Health Park Drive | AddressLine1Txt |
| City | Libby | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59923 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Brigid Burke | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4062837000 | PhoneNum |
| Signature | 2017-02-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2017-02-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cabinet Peaks Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Bruce Whitfield | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 209 Health Park Drive | AddressLine1Txt |
| City | Libby | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59923 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $33,842,057 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.cabinetpeaks.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1952 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | Healthcare services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 264 | TotalEmployeeCnt |
| Total Volunteers | 58 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $327,607 | PYContributionsGrantsAmt |
| CY Contributions Grants | $199,304 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $29,848,669 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $31,447,750 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,412 | PYInvestmentIncomeAmt |
| CY Investment Income | -$138,195 | CYInvestmentIncomeAmt |
| PY Other Revenue | $11,074 | PYOtherRevenueAmt |
| CY Other Revenue | -$59,056 | CYOtherRevenueAmt |
| PY Total Revenue | $30,188,762 | PYTotalRevenueAmt |
| CY Total Revenue | $31,449,803 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $5,692 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,822 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $16,075,404 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,469,629 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $78,879 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,153,096 | PYOtherExpensesAmt |
| CY Other Expenses | $14,568,439 | CYOtherExpensesAmt |
| PY Total Expenses | $30,234,192 | PYTotalExpensesAmt |
| CY Total Expenses | $30,040,890 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$45,430 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,408,913 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $48,898,801 | TotalAssetsBOYAmt |
| Total Assets EOY | $49,241,777 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $28,271,946 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $27,229,819 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $20,626,855 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $22,011,958 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Committed to quality, compassionate care. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $23,695,121 | ExpenseAmt |
| Grant | $2,822 | GrantAmt |
| Revenue | $31,297,569 | RevenueAmt |
| Desc | Cabinet Peaks Medical Center operates a 25 bed critical access hospital providing medical services to the residents of Lincoln County. Due to the remote location of Lincoln County, Cabinet Peaks serves a critical role in caring for the medical needs of its community, as the next closest emergency room is over 50 miles away and the nearest regional hospital is 90 miles away. As such Cabinet Peaks makes it a priority to provide an Intensive Care Unit, 24/7 Emergency Services, Birthing Services, and extensive Surgery Services. Cabinet Peaks also offers a complement of outpatient services, including a variety of rehab and therapy services, infusion and chemotherapy, imaging, and lab. Continued on Schedule O.Patients often do not have the luxury of time or money or the physical strength necessary to make the 90 mile trip to Kalispell to receive these services, which is why Cabinet Peaks recognizes the value of providing these services close to home. In fiscal year 2016, Cabinet Peaks Medical Center provided services to 9,453 unique patients amounting to a total of 12,596 adjusted patient days. Just over 1,000 surgeries (1,043) were performed. CPMC provided 2,283 patient encounters for rehab services. As Lincoln County consistently has one of the top unemployment rates in the State and is an economically depressed area, many of Cabinet Peaks' patients are uninsured or underinsured, meaning Cabinet Peaks provides a significant amount of uncompensated care.The Hospital provides health care services to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Hospital does not pursue collection of these amounts, they are not reported as patient service revenue. The amounts of charges forgone, based on established rates, were $1,526,203 during the year ended March 31, 2016. The estimated cost of providing these services was approximately $955,000 for the year ended March 31, 2016, calculated by multiplying the ratio of cost to gross charges for the Hospital by the gross uncompensated charges associated with providing charity care to its patients. | Desc |
| Total Program Service Expenses | $23,695,121 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 80 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 264 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Gayl Smith Controller | PersonNm |
| Phone | 4062837139 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 209 Health Park Drive | AddressLine1Txt |
| City | Libby | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59923 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 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 |
|---|---|---|---|---|---|---|---|---|
| Steve Sorenson OD | ||||||||
| Chair | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| John Konzen | ||||||||
| Vice Chair | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Sarah Sorensen | ||||||||
| Secretary/Treasurer | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Russ Barnes | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Kerry Beasley | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Kathy Nelson | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Manuel Castaneda | ||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Joseph Nicoletto MD | ||||||||
| Trustee | 31.00 | 0.00 | Yes (X) | $197,100 | $0 | $46,878 | ||
| Bruce Whitfield | ||||||||
| CEO | 40.00 | 1.00 | Yes (X) | $264,282 | $0 | $101,195 | ||
| Brigid Burke | ||||||||
| CFO | 40.00 | 0.00 | Yes (X) | $115,396 | $0 | $63,837 | ||
| Anita Ivankovig | ||||||||
| CNO | 40.00 | 0.00 | Yes (X) | $139,752 | $0 | $30,666 | ||
| Kathryn Cockerham MD | ||||||||
| ER Physician | 39.00 | 0.00 | $275,505 | $0 | $37,952 | Yes (X) | ||
| Mark Serra DO | ||||||||
| ER Physician | 50.00 | 0.00 | $350,325 | $0 | $33,405 | Yes (X) | ||
| Raymond Zurcher MD | ||||||||
| ER Physician | 33.00 | 0.00 | $225,178 | $0 | $37,184 | Yes (X) | ||
| Jay Maloney MD | ||||||||
| ER Physician | 40.00 | 0.00 | $294,458 | $0 | $43,734 | Yes (X) | ||
| Judy Marshall | ||||||||
| HR Manager (thru July 2015) | 40.00 | 0.00 | $183,372 | $0 | $21,508 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,045,368 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $416,359 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 18 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Kalispell Regional Medical Center | |||||
| 310 Sunnyview Lane | Kalispell | MT | 59901 | Software maintenance & support, lab & di | $1,430,480 |
| Cardinal Health | |||||
| 21377 Network Place | Chicago | IL | 60673 | Pharmacy management services | $394,962 |
| GE Healthcare | |||||
| PO Box 96483 | Chicago | IL | 60693 | Diagnostic imaging equipment maintenance | $216,535 |
| Thomas Cuisine Management | |||||
| 700 E Franklin Rd | Meridian | ID | 83642 | Cafeteria and diabetes and nutrition man | $144,547 |
| Comphealth | |||||
| PO Box 972651 | Dallas | TX | 75397 | Staffing services | $122,849 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $5,450 | RelatedOrganizationsAmt |
| Government Grants | $68,804 | GovernmentGrantsAmt |
| All Other Contributions | $125,050 | AllOtherContributionsAmt |
| Total Contributions | $199,304 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Service Revenue | 622110 | $30,407,978 | $30,407,978 |
| Other Revenue | 900099 | $597,614 | $597,614 |
| Cafeteria | 722210 | $279,252 | $279,252 |
| Change in Interest in Foundation | 900099 | $150,181 | $150,181 |
| Auxiliary Revenue | 900099 | $12,725 | $12,725 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $31,447,750 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,277 | TotalRevenueColumnAmt |
| Exclusion | $26,277 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $122,894 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $181,950 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$59,056 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$59,056 | TotalRevenueColumnAmt |
| Exclusion | -$59,056 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,045,832 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,032,304 | SecuritiesAmt |
| Other | $178,000 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $13,528 | SecuritiesAmt |
| Other | -$178,000 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$164,472 | TotalRevenueColumnAmt |
| Exclusion | -$164,472 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,449,803 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $31,447,750 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$197,251 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,822 | TotalAmt |
| Program Services | $2,822 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $950,421 | TotalAmt |
| Program Services | $396,512 | ProgramServicesAmt |
| Management And General | $553,909 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,822 | TotalAmt |
| Program Services | $64,822 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,333,219 | TotalAmt |
| Program Services | $9,001,963 | ProgramServicesAmt |
| Management And General | $2,292,016 | ManagementAndGeneralAmt |
| Fundraising | $39,240 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $355,466 | TotalAmt |
| Program Services | $319,650 | ProgramServicesAmt |
| Management And General | $34,409 | ManagementAndGeneralAmt |
| Fundraising | $1,407 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,952,904 | TotalAmt |
| Program Services | $1,583,505 | ProgramServicesAmt |
| Management And General | $362,475 | ManagementAndGeneralAmt |
| Fundraising | $6,924 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $812,797 | TotalAmt |
| Program Services | $626,194 | ProgramServicesAmt |
| Management And General | $183,885 | ManagementAndGeneralAmt |
| Fundraising | $2,718 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,575 | TotalAmt |
| Management And General | $44,575 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,981,207 | TotalAmt |
| Program Services | $2,450,366 | ProgramServicesAmt |
| Management And General | $524,089 | ManagementAndGeneralAmt |
| Fundraising | $6,752 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,046 | TotalAmt |
| Program Services | $7,768 | ProgramServicesAmt |
| Management And General | $78,188 | ManagementAndGeneralAmt |
| Fundraising | $90 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $807,639 | TotalAmt |
| Program Services | $616,814 | ProgramServicesAmt |
| Management And General | $187,060 | ManagementAndGeneralAmt |
| Fundraising | $3,765 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $270,337 | TotalAmt |
| Program Services | $232,753 | ProgramServicesAmt |
| Management And General | $37,584 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,911 | TotalAmt |
| Program Services | $121,737 | ProgramServicesAmt |
| Management And General | $42,174 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,450 | TotalAmt |
| Management And General | $3,450 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $945,086 | TotalAmt |
| Management And General | $945,086 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,980,943 | TotalAmt |
| Program Services | $2,980,943 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $454,604 | TotalAmt |
| Management And General | $454,604 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $2,863,849 | $2,857,012 | $6,837 |
| Bad Debts | $1,637,206 | $1,637,206 | |
| Repairs and Maintenance | $1,006,551 | $709,808 | $296,743 |
| Licenses and taxes | $151,641 | $14,296 | $137,345 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,394 | TotalAmt |
| Program Services | $70,950 | ProgramServicesAmt |
| Management And General | $82,461 | ManagementAndGeneralAmt |
| Fundraising | $17,983 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,040,890 | TotalAmt |
| Program Services | $23,695,121 | ProgramServicesAmt |
| Management And General | $6,266,890 | ManagementAndGeneralAmt |
| Fundraising | $78,879 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,472,718 | BOYAmt |
| EOY | $6,750,477 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,349,931 | BOYAmt |
| EOY | $5,281,195 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $659,076 | BOYAmt |
| EOY | $654,268 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $501,224 | BOYAmt |
| EOY | $519,180 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $50,999,099 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $20,003,854 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,009,953 | BOYAmt |
| EOY | $30,995,245 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,029,465 | BOYAmt |
| EOY | $3,082,873 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,539,230 | BOYAmt |
| EOY | $1,689,411 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $337,204 | BOYAmt |
| EOY | $269,128 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,898,801 | BOYAmt |
| EOY | $49,241,777 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,882,982 | BOYAmt |
| EOY | $2,651,329 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $175,351 | BOYAmt |
| EOY | $36,859 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,213,613 | BOYAmt |
| EOY | $24,541,631 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,271,946 | BOYAmt |
| EOY | $27,229,819 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,537,990 | BOYAmt |
| EOY | $20,800,324 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,094 | BOYAmt |
| EOY | $363,606 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $890,771 | BOYAmt |
| EOY | $848,028 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,626,855 | BOYAmt |
| EOY | $22,011,958 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,898,801 | BOYAmt |
| EOY | $49,241,777 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,408,913 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$28,402 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $4,592 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $14,097 | BeginningBalanceAmt |
| Additions During Year | $12,725 | AdditionsDuringYearAmt |
| Distributions During Year | $17,317 | DistributionsDuringYearAmt |
| Ending Balance | $9,505 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $194,000 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $867,280 | OtherCostOrOtherBasisAmt |
| Book Value | $1,061,280 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,067,122 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,260,434 | DepreciationAmt |
| Book Value | $22,806,688 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,477,560 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,644,672 | DepreciationAmt |
| Book Value | $4,832,888 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,393,137 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,098,748 | DepreciationAmt |
| Book Value | $2,294,389 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $30,995,245 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $29,813,288 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$1,637,206 | OtherRevenueAmt |
| Revenue Not Reported | -$1,637,206 | RevenueNotReportedAmt |
| Revenue Subtotal | $31,450,494 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$691 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$691 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $31,449,803 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $28,565,607 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $179,240 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $179,240 | ExpensesNotReportedAmt |
| Expenses Subtotal | $28,386,367 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,654,523 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,654,523 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $30,040,890 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Line 1b: | The assets of St. John's Hospital Auxiliary are held by Cabinet Peaks Medical Center. The auxiliary account balances were not included in the balance sheet as they are not recorded for audit purposes. |
| Part X, Line 2: | The Hospital is a Montana nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Section 501(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Oraganization files an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report its unrelated business taxable income. The hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. The Hospital's federal Form 990T filings are no longer subject to federal tax examinations by tax authorities for years before 2012. |
| Part XI, Line 2d - Other Adjustments: | Provision for bad debts included in revenue on financial statements -1,637,206. |
| Part XI, Line 4b - Other Adjustments: | Contribution from Foundation recorded in fund balance on financial statement 15,643. Auxiliary revenue not included in financial statements 12,725. Rent expenses recorded in expenses on financial statements -179,240. Change in interest in net assets of Foundation in fund balance on financials 150,181. |
| Part XII, Line 2d - Other Adjustments: | Rent expenses included in revenue on financial statements 179,240. |
| Part XII, Line 4b - Other Adjustments: | Provision for bad debts included in revenue on financial statements 1,637,206. Auxiliary expenses not included in financial statements 17,317. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 280.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $955,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $955,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03360 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,749,265 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,203,885 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $545,380 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01920 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,704,265 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,203,885 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,500,380 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05280 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 1002 | PersonsServedCnt |
| Total Community Benefit Expns | $35,786 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $35,786 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,550,349 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,142,670 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $407,679 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01440 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $542 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $542 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Persons Served | 1002 | PersonsServedCnt |
| Total Community Benefit Expns | $4,586,677 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,142,670 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $444,007 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01570 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Persons Served | 1002 | PersonsServedCnt |
| Total Community Benefit Expns | $9,290,942 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,346,555 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,944,387 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06850 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $153 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $153 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $153 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $153 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,637,206 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,826,944 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,866,923 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$39,979 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | Cabinet Peaks Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 209 Health Park Drive | AddressLine1Txt |
| City | Libby | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59923 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.cabinetpeaks.org | WebsiteAddressTxt |
| State License | 13545 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | 1 provider based clinic | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cabinet Peaks Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 14 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.cabinetpeaks.org | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.cabinetpeaks.org | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 280.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.cabinetpeaks.org | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.cabinetpeaks.org | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.cabinetpeaks.org | 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Cabinet Peaks Medical Center | Part V, Section B, Line 5: In September 2014, surveys were mailed out to the residents in Cabinet Peak Medical Center's service area. Additionally, two focus groups were held to identify the motives of local residents when selecting healthcare providers and to discover reasons why people may leave the Libby area to seek healthcare services. A Steering Committee was convened to assist Cabinet Peaks Medical Center in conducting the CHSD assessment process. A diverse group of community members representing various organizations and populations within the community (ex. public health, elderly, uninsured) came together in August 2014. The Steering Committee met twice during the CHSD process; first to discuss health concerns in the community and offer their perspective in designing the survey instrument and again to review results of the survey and focus groups.The Steering Committee was comprised of public leaders including members of other healthcare organizations, law enforcement, school system, athletic clubs, local politicians, governmental organizations, community service organizations, etcAn Implementation Planning Committee was comprised of Cabinet Peaks Medical Center's leadership team. |
| Cabinet Peaks Medical Center | Part V, Section B, Line 11: Goal 1: Improve access to healthcare in the Cabinet Peaks Medical Center service area. In April of 2015, CPMC staff attended a 3RNet seminar and have begun utilizing their recruitment tools for physician recruitment. In March 2016, CPMC hired two primary care providers. CPMC continues to support family medicine residencies and remains a NHSC certified location. Additionally, CPMC researched and began the process of applying for Rural Health Clinic designation for primary care services.Goal 2: Continually improve the quality of care provided at Cabinet Peaks Medical Center. PEAK Team staff Education & Reward Program for PROMISE standards formally started in June 2014 and ended in October of 2015. Inservices were completed in Aug 2015 & recorded inservices were made available for all new employees. CPMC completed 1x1 education of a majority of the nursing staff on HCAHPS in May 2015. As of September 2015, all future managers and providers will receive HCAHPS education as part of their orientation.CPMC continues to track and improve upon our HCAHPS scores. CPMC completed Code Blue Training of Charge nurses in September 2015. Evac Chair training was offered November and December 2015. Dosage Calculation Competency for RNs was completed January 2016. CPMC continues to offer CMEs. CPMC coordinated with KRMC for CEU education via telemed January 2016 for Peds update. CPMC continued its training for new hires on Team STEPPS. Core staff have also been trained. CPMC continues to participate in LEAN projects. CPMC held its first PFAC Focus Group on July 28, 2015 and the second PFAC Focus Group on Feb. 16, 2016.Goal 3: Improve access to healthcare services through increased awareness of hospital services available. CPMC developed scripts for a letter to the editor, patient satisfaction survey, and referrals to friends and family. In September of 2015, CPMC ran a page ad to share highlights from community benefit report. CPMC continued its sponsorship of community initiatives and activities. CPMC started a high school medical mentorship program. 5 Libby senior students participated in the Mentorship for Fall Semester (started 9/2/15). 5 Libby students and 1 Troy student participated in the Mentorship for Spring Semester (started 1/28/16).Goal 4: Improve access to mental health services in the Libby community. In April 2015, CPMC began meeting with MHP, law enforcement, county judge, county officials to work towards developing a crisis center for our community. CPMC worked with local organizations for grant writing assistance. MHP was awarded a grant for mental health services.Goal 5: Raise awareness of alcohol and substance abuse in Lincoln County. CPMC has a staff member on the Board for Unite for Youth, working with the organization to provide ongoing alcohol and substance abuse education to our youth. In January 2015 CPMC hosted a presentation for the community's providers on "An Evidence Based, Systematic Approach to Treating Chronic Pain." |
| Cabinet Peaks Medical Center | Part V, Section B, Line 16i: A summary of the financial assistance policy is provided with billing invoices and is posted in the facility's emergency room and waiting rooms and a summary brochure is also posted on the Hospital's website. |
| Cabinet Peaks Medical Center | Part V, Section B, Line 22d: Amounts generally billed for emergency or other medically necessary care to individuals who have insurance covering that same care. In determining AGB, CPMC has chosen to use the "Look Back Method", in which AGB is based on Medicare fee for service payment amounts and the amounts paid by private health insurers, as outlined in Internal Revenue Code regulations. |
| Cabinet Peaks Medical Center | Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. FAP-eligible patients without insurance may be charged gross charges on elective procedures. |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6a: | The Organization's community benefit report can be found on its website at www.cabinetpeaks.org. |
| Part I, Line 7: | Charity care expense was converted to cost using an overall cost-to-charge ratio addressing all patient segments. Community health improvement services, line 7e, and cash and in-kind contributions, line 7i, are reported based on actual expenses. The cost for subsidized health services on line 7g was determined using the Medicare cost report. |
| Part I, Ln 7 Col(f): | The amount of bad debt expense backed out of total expenses to determine the percentage was $1,637,206. |
| Part II, Community Building Activities: | Cabinet Peaks Medical Center is officially designated as a Health Professions Shortage Area. Members of the facility work with local groups to enhance economic development. Additionally, employees are committed to environmental improvements. |
| Part III, Line 2: | Bad debt is the unpaid obligation for care provided to patients who may be unable or unwilling to pay or who do not qualify for charity care. Prior to any account being classified as bad debt, all payments are applied including contractual allowances and discounts from Medicare, Medicaid, and insurance companies. Accounts from patients qualifying for charity care or the SharePay sliding scale financial assistance program are not written off to bad debt. Every effort is made with the patient in an attempt to collect the outstanding balance. Payments on accounts that were written off as bad debt reduces bad debt expense.The Organization's bad debt is reported as charges incurred during the year. |
| Part III, Line 3: | Cabinet Peaks Medical Center budgets for and monitors the level of charity care it provides. The estimated amount of the Organization's bad debt expense attributable to patients eligible under the Organization's charity care policy cannot be estimated due to the expectation that all eligible individuals would apply for financial assistance. |
| Part III, Line 4: | The footnote to the Organization's financial statements that describes bad debt expenses is located in Footnote 1 on page 8 of the attached financial statements. |
| Part III, Line 8: | The expenses represent an overall shortfall for the Medicare patient population. The costs themselves are a community benefit as the community would not receive these services if we did not provide them.Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. |
| Part III, Line 9b: | There are no collection efforts for patients who are known to qualify for charity care or who qualify for SharePay, a sliding scale financial assistance program designed to meet the medical financial obligations of the uninsured and underinsured. |
| Part VI, Line 2: | A complete community health needs assessment was conducted and completed during the 2015 fiscal year. Cabinet Peaks Medical Center participated in the Community Health Services Development (CHSD) process, a Community Health Needs Assessment (CHNA), conducted by the Montana Office of Rural Health and the National Rural Health Resource Center (NRHRC) in Duluth, Minnesota. The CHNA was funded by the Frontier Medicine Better Health Partnership (FMBHP) Project. Community involvement in steering committee meetings and focus groups enhanced the community's engagement in the assessment process. The hospital also completed and the Board approved our implementation plan with NRHRC for the CHNA in FY15. Throughout FY16, CPMC worked on its implementation plan. |
| Part VI, Line 3: | Brochures are available at the hospital in waiting areas. The Financial Assistance information is also available on the Hospital's website and in patient registration materials. Statements regarding the availability of financial assistance are also included in various billing materials. In addition, the hospital employs a full-time trained patient financial services counselor, who is also a certified Navigator, to assist patients in determining if they qualify for Medicaid as well as free or discounted care and to assist patients in signing up for insurance coverage on the exchange. The counselor also provides hands-on assistance to patients applying for other financial assistance such as CHIP's, heating assistance, Medicaid, and WIC. Applications for charity care are also discussed at registration and discharge and with patients who have bills that are past due. |
| Part VI, Line 4: | Cabinet Peaks Medical Center is located in Libby in northwestern Montana, 72 miles south of the Canadian border, 89 miles northwest of Kalispell, Montana, and 35 miles east of the Idaho border. Libby became the county seat for Lincoln County in 1909, the county being named after President Abraham Lincoln.Helicopter transport services are available to patients requiring specialized care in a larger hospital in Spokane, Kalispell, or Missoula. The closest hospital is Bonner General Hospital about 47 miles from Libby in Sandpoint, ID. The next largest hospital with additional services is Kalispell Regional Medical Center 90 miles from Libby.CPMC has been designated a Medically Underserved Population and a Health Professional Shortage Area due to our economic challenges, lack of resources and remote location. We are a relatively poor county, with 22.8% of Libby population being at or below the poverty level, compared to a state average of 15.2%. |
| Part VI, Line 5: | Cabinet Peaks Medical Center operates a 25 bed critical access hospital providing medical services to the residents of Lincoln County. Due to the remote location of Lincoln County, Cabinet Peaks serves a critical role in caring for the medical needs of its community, as the next closest emergency room is over 50 miles away and the nearest regional hospital is 90 miles away. As such Cabinet Peaks makes it a priority to provide an Intensive Care Unit, 24/7 Emergency Services, Birthing Services, and extensive Surgery Services. Cabinet Peaks also offers a complement of outpatient services, including a variety of rehab and therapy services, infusion and chemotherapy, imaging, and lab. Patients often do not have the luxury of time or money or the physical strength necessary to make the 90 mile trip to Kalispell to receive these services, which is why Cabinet Peaks recognizes the value of providing these services close to home. As Lincoln County consistently has one of the top unemployment rates in the State and is an economically depressed area, many of Cabinet Peaks' patients are uninsured or underinsured, meaning Cabinet Peaks provides a significant amount of uncompensated care. Emergency and other medically necessary services are provided to all persons, regardless of their ability to pay.In addition to the services provided within the Hospital campus, Cabinet Peaks also does a considerable amount of outreach to promote the health of the community. Organizing and funding a community health fair, providing discounted services for mammography, laboratory tests, and x-rays, providing speakers for health lectures, promoting hospital tours for the schools, providing internship opportunities for the schools, and providing support for the recruitment of physicians are just a few ways Cabinet Peaks partners to promote the health of the community. Cabinet Peaks' mission is to provide quality, compassionate, care to its community. Cabinet Peaks' Board of Directors is comprised entirely of residents of Lincoln County, all of whom are considered leaders in the community. With the exception of the Medical Staff representative on the Board, none of the Board members are Cabinet Peak's contractors or employees, meaning they truly do serve the needs of the community. In order to ensure the appropriate medical staff and services are available for patients, Cabinet Peak's medical staff privileges are open to all qualified, licensed physicians in the community and are also extended to physicians who visit Lincoln County in order to offer additional services to our residents. Additionally, in order to ensure the future success of Cabinet Peaks, any and all surplus funds generated by the Hospital are reinvested into operations, capital equipment and infrastructure, including facility upkeep. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Joseph Nicoletto MD | ||||||||||||||
| Trustee | $197,100 | $0 | $0 | $0 | $0 | $0 | $13,250 | $0 | $33,628 | $0 | $243,978 | $0 | $0 | $0 |
| Bruce Whitfield | ||||||||||||||
| CEO | $195,282 | $0 | $39,000 | $0 | $30,000 | $0 | $41,076 | $0 | $60,119 | $0 | $365,477 | $0 | $0 | $0 |
| Brigid Burke | ||||||||||||||
| CFO | $103,395 | $0 | $12,001 | $0 | $0 | $0 | $20,066 | $0 | $43,770 | $0 | $179,232 | $0 | $0 | $0 |
| Anita Ivankovig | ||||||||||||||
| CNO | $119,352 | $0 | $14,160 | $0 | $6,240 | $0 | $3,904 | $0 | $26,762 | $0 | $170,418 | $0 | $0 | $0 |
| Kathryn Cockerham MD | ||||||||||||||
| ER Physician | $266,851 | $0 | $0 | $0 | $8,654 | $0 | $2,580 | $0 | $35,372 | $0 | $313,457 | $0 | $0 | $0 |
| Mark Serra DO | ||||||||||||||
| ER Physician | $350,325 | $0 | $0 | $0 | $0 | $0 | $13,250 | $0 | $20,155 | $0 | $383,730 | $0 | $0 | $0 |
| Raymond Zurcher MD | ||||||||||||||
| ER Physician | $219,473 | $0 | $0 | $0 | $5,705 | $0 | $11,550 | $0 | $25,635 | $0 | $262,363 | $0 | $0 | $0 |
| Jay Maloney MD | ||||||||||||||
| ER Physician | $294,418 | $0 | $0 | $0 | $40 | $0 | $13,250 | $0 | $30,484 | $0 | $338,192 | $0 | $0 | $0 |
| Judy Marshall | ||||||||||||||
| HR Manager (thru July 2015) | $61,217 | $0 | $0 | $0 | $122,155 | $0 | $4,079 | $0 | $17,428 | $0 | $204,879 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | Anita Ivankovig also received $240 in gym membership dues. Jay Maloney also received $40 in gym membership dues. |
| Part I, Line 4a | Judy Marshall received a separation settlement in the amount of $106,000. |
| Part I, Line 7 | Bruce Whitfield, Brigid Burke, and Anita Ivankovig have "compensation at risk" that is provided based on performance metrics. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Melanie Courteau | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Daughter of Trustee | RelationshipDescriptionTxt |
| Transaction | $64,822 | TransactionAmt |
| Transaction | Salary and benefits as an employee | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 2 | Cabinet Peaks Family Medicine began offering scheduled and same day appointments in addition to walk in services in March 2016. |
| Form 990, Part III, line 3 | The CPMC Walk In Clinic moved to its new location and merged with Cabinet Peaks Family Medicine at 350 Louisiana Avenue. Cabinet Peaks Family Medicine began offering scheduled and same day appointments. |
| Form 990, Part VI, Section A, line 1 | The Executive Committee has the delegated authority to act on behalf of the Board of Directors. The Executive Committee consists of the Chair, Vice Chair, Secretary/Treasurer, Chief of Staff, Past Chair and one Member at Large. All members of the Executive Committee are also members of the governing body. |
| Form 990, Part VI, Section A, line 2 | Steve Sorensen and Sarah Sorensen have a family relationship. |
| Form 990, Part VI, Section B, line 11 | A draft copy of the Form 990 will be reviewed in detail by the CFO. The entire board is then provided a copy for review prior to filing of the Form 990 return. |
| Form 990, Part VI, Section B, line 12c | The organization reviews the policies for conflict of interest annually for all officers, directors, and key employees along with an annual submission of a conflict of interest form. The board oversees the process and any potential conflicts are discussed by the board. Should a conflict be determined, the conflicted individual abstains from voting on the conflicted issue. |
| Form 990, Part VI, Section B, line 15 | Kalispell Regional Medical Center is the management company for the CEO and CFO however, compensation and benefits are directly passed through to Cabinet Peaks Medical Center. The CEO and CFO are considered common law employees of Cabinet Peaks Medical Center. Administration reviews independent salary surveys and other comparability data to determine fair market compensation amounts and also takes into account local economic factors and specific job responsibilities. This is done on an annual basis as part of the budgeting process, The Board reviews Administration's recommendations for rate adjustments annually during the budget process. The Board also determines compensation for the CEO, CFO and CNO. |
| Form 990, Part VI, Section C, line 19 | Our Mission and Vision statement, conflict of interest policy, and annual financial statements are available to the public upon request. Requests may be in person, by e-mail, in writing, or by telephone. |
| Form 990, Part XI, line 9: | Change in St. John's Hospital Auxiliary assets 4,592. |
Schedule R IRS990ScheduleR
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 | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Cabinet Peaks Medical Center Foundation | |||||||||||
| 350 Louisiana Avenue | Libby | MT | 59923 | 810425832 | Support the development of Cabinet Peaks Medical Center | MT | 501(c)(3) | Line 11b, II | N/A | 0 | |
| St John's Real Estate Corporation | |||||||||||
| 350 Louisiana Avenue | Libby | MT | 59923 | 201538952 | Support the development of Cabinet Peaks Medical Center | MT | 501(c)(2) | N/A | Yes (1) | Cabinet Peaks Medical Center | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |