2017-07-12T18:00:04-05:00 2016-12-31 910189318 MOSS ADAMS LLP 805 SW BROADWAY SUITE 1200 PORTLAND OR 97205 990 2016-01-01 263538104 BENEFIS HEALTH SYSTEM INC BENE 4064552563 1101 26TH STREET SOUTH GREAT FALLS MT 59405 FORREST EHLINGER CHIEF FINANCIAL OFFICER 4064552563 2017-05-12 1 WENDY CAMPOS P00448102 5032421447 2017-05-12 12.129.7.100 2017-05-12 17:29:00 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 866574987CA565ABE6CC9265146BBE3F5B9624AD 2016 2021-01-29 14:40:06Z JOHN GOODNOW 1101 26TH STREET SOUTH GREAT FALLS MT 59405 62621739 0 X WWW.BENEFIS.ORG X 2008 MT PARENT ENTITY OF INTEGRATED HEALTH SYSTEM 13 11 247 11 355543 205957 1832474 1617192 59015250 55674577 260189 1625479 8103041 -545330 69210954 58371918 606901 209382 0 0 18386034 19960450 0 0 0 42942333 48038288 61935268 68208120 7275686 -9836202 626735620 720675923 344634056 442128919 282101564 278547004 X WE PROVIDE EXCELLENT CARE FOR ALL, HEALING BODY, MIND AND SPIRIT. BENEFIS HEALTH SYSTEM, INC. IS ORGANIZED TO OVERSEE, COORDINATE AND DIRECT THE ASSETS AND OPERATIONS OF BENEFITS HOSPITALS, INC., BENEFIS SPECTRUM MEDICAL, INC., BENEFIS MEDICAL GROUP, INC., BENEFIS HEALTH SYSTEM FOUNDATION, INC., BENEFIS SLETTEN HI-LINE CANCER CENTER, BENEFIS SENIOR SERVICES, INC., AND OTHER RELATED ENTITIES AS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SERVING THE RESIDENTS OF NORTH CENTRAL MONTANA. 0 0 59832151 209382 55524800 PROVIDE MANAGEMENT AND ADMINISTRATIVE SERVICES FOR MULTIPLE RELATED HEALTH CARE ENTITIES. N/A N/A 59832151 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 1 52 0 1 247 1 1 1 0 0 0 0 0 0 0 0 0 X 13 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X FORREST EHLINGER 4064555479 1101 26TH STREET SOUTH GREAT FALLS MT 59405 DAVID RICHARDS CHAIR 4.00 4.00 X X 0 0 0 MIKE MILBURN VICE CHAIR 4.00 X X 1265 0 0 WILLIAM BLOEMENDAAL SECRETARY 4.00 46.00 X X 0 106810 186 ED BUTTREY DIRECTOR (FROM 2/1) 4.00 X 0 0 0 BILL BOURRET DIRECTOR 4.00 2.00 X 0 0 0 TANYA CAMERON DIRECTOR 4.00 X 0 0 0 GREG HATLEY DIRECTOR (THROUGH 12/31) 4.00 2.00 X 0 0 0 JOHN KOPPELMAN DIRECTOR 4.00 X 694 0 0 EUGENE MCALLISTER DIRECTOR (FROM 10/18) 4.00 X 0 0 0 WILLIAM MCGREGOR MD DIRECTOR 4.00 3.00 X 0 0 0 SUSAN RAPH DIRECTOR 4.00 2.00 X 0 0 0 GENE THAYER DIRECTOR 4.00 X 0 0 0 DAVID ROHRER MD DIRECTOR (THROUGH 7/15) 4.00 X 617 0 0 JOHN GOODNOW CHIEF EXECUTIVE OFFICER 60.00 X X 1132736 0 46215 FORREST EHLINGER CHIEF FINANCIAL OFFICER 51.00 9.00 X 440655 0 91888 TERRY OLINGER PRESIDENT ACUTE CARE GROUP 4.00 56.00 X 545581 0 123460 AMY BEAMES PRES SR SRVCS & LEGISLATIVE AFFAIRS 20.00 40.00 X 240373 0 30583 PATTY HARRIS DIRECTOR REVENUE CYCLE 50.00 X 196109 0 8442 THERESA PREITE PRESIDENT SPECTRUM MEDICAL 24.00 26.00 X 235552 0 32367 JULIE WALL VICE PRESIDENT QUALITY AND INFECTION CONTROL 50.00 X 197716 0 18931 CARL BRUESCH DIRECTOR FINANCIAL ANALYSIS 25.00 25.00 X 177266 0 6467 BRUCE HOULIHAN CONTROLLER 50.00 X 225640 0 10413 SAM NORTON CHIEF INFORMATION OFFICER (FORMER) 0.00 X 179862 0 9760 3574066 106810 378712 19 1 1 0 GUY TABACCO CONSTRUCTION PO BOX 550 BLACK EAGLE MT 59414 CONSTRUCTION 1521632 RUBIN & RAINE LLC 409 BEARDEN PARK CIRCLE KNOXVILE TN 37919 BILLING COLLECTIONS 1465378 NELSON ARCHITECTS LLC 621 2ND AVE N GREAT FALLS MT 59401 ARCHITECT SERVICES 855225 DRINKER BIDDLE & REATH LLP 18TH CHERRY ST STE 2000 PHILADELPHIA PA 19103 LEGAL SERVICES 810204 THE CLARO GROUP LLC 321 N CLARK ST STE 1200 CHICAGO IL 60654 HEALTHCARE LEGAL CONSULTING 732053 37 1266046 351146 1617192 MANAGEMENT FEES 541610 56922978 56773201 149777 OTHER PROGRAM REVENUE 621990 92835 92835 PATIENT SERVICE REVENU 621400 55563 55563 JOINT VENTURE LOSS 621990 -15527 -15527 SUBSIDIARY LOSS 621990 -1381272 -1381272 55674577 2248126 2248126 4197985 3627174 570811 570811 570811 622647 -622647 -622647 -622647 SUBSIDIARY INCOME 621990 133000 205766 -72766 VENDOR REBATES/DISCOUN 900099 119191 119191 OTHER LOSS 621990 -1368332 -1368332 -1116141 58371918 55524800 355543 874383 209382 209382 2654067 2654067 11446379 11446379 366202 366202 4620273 4620273 873529 873529 931669 931669 254664 254664 51447 51447 6311214 6311214 1452773 1452773 964516 964516 6166218 6166218 1042708 1042708 201785 201785 3166500 3166500 11523069 11523069 3373063 3373063 UBI TAX 341978 341978 LOSS ON BOND REFUNDING 8375969 8375969 COMMUNITY OUTREACH 1429948 1429948 MINOR EQUIPMENT 823496 823496 1627271 1627271 68208120 59832151 8375969 0 64281197 68591093 194115850 237083832 250000 0 1390705 2879709 401683680 208878470 196000562 192805210 146816505 195690464 12319761 11061594 11561040 12564021 626735620 720675923 254222153 235560037 185820 154108 56041309 173885836 30022214 29121410 4162560 3407528 344634056 442128919 X 282101564 278547004 282101564 278547004 626735620 720675923 X -9836202 6281642 X 0 1 X 1 1 1 X X X 3 BENEFIS HOSPITALS INC 810232122 3 1 0 54644472 BENEFIS MEDICAL GROUP INC 263538192 3 1 0 0 BENEFIS SPECTRUM MEDICAL INC 810431871 10 1 0 1497080 3 0 56141552 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 PART IV, SECTION E, LINE 3A: BENEFIS HEALTH SYSTEM, INC. (BHS) SERVES AS THE PARENT ENTITY OF AN INTEGRATED SYSTEM OF PROVIDER ORGANIZATIONS ADDRESSING THE HEALTH NEEDS OF PERSONS THROUGHOUT NORTH CENTRAL MONTANA. BHS HOLDS VARIOUS RESERVED POWERS IN RELATION TO EACH OF THE SUPPORTED ORGANIZATIONS, INCLUDING THE AUTHORITY TO ELECT ITS BOARD OF DIRECTORS. PART IV, SECTION E, LINE 3B: BHS PROVIDES CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES TO ITS SUPPORTED ORGANIZATIONS. BHS PROVIDES THESE SERVICES TO ITS SUBSIDIARY TAX-EXEMPT OPERATING ENTITIES ON A CENTRALIZED BASIS. THE SERVICES INCLUDE THE FOLLOWING: - MANAGEMENT OF HUMAN RESOURCES INCLUDING POLICIES AND PRACTICES - MANAGEMENT, PLANNING, BUDGETING AND REPORTING OF FINANCIAL OPERATIONS - MANAGEMENT OF BILLING AND COLLECTIONS POLICIES AND FUNCTIONS - MANAGEMENT OF INFORMATION TECHNOLOGY SERVICES - OVERSIGHT OF QUALITY STANDARDS, COMPLIANCE AND RISK MANAGEMENT - MANAGEMENT OF REGIONAL, COMMUNITY AND GOVERNMENT RELATIONS AND MARKETING - MANAGEMENT OF GRANTS DEVELOPMENT THE BOARD OF DIRECTORS OF BHS ALSO GENERALLY OVERSEES THE GOVERNANCE FUNCTIONS CARRIED ON BY THE BOARDS OF THE SUPPORTED ORGANIZATIONS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 7500 1 51447 0 0 58947 0 PART II-B, LINE 1: BENEFIS PAYS AN ATTORNEY GROUP, TAYLOR LUTHER GROUP, PLLC, TO ADVOCATE ON OUR BEHALF IN THE POLITICAL DECISION MAKING PROCESS. BENEFIS ALSO MADE A CONTRIBUTION IN 2016 TO YES FOR GREAT FALLS KIDS IN SUPPORT OF A FUND BALLOT INITIATIVE TO SUPPORT LOCAL SCHOOLS. 22996491 892498 1484716 1193582 24180123 23231923 642703 -344101 534034 22996491 22163339 546843 912332 390591 23231923 19058513 1274865 2278824 343934 104929 22163339 15998563 1253995 2099380 205187 88238 19058513 0.12280 0.69220 0.18500 0 1 1 9019234 9019234 226075913 90210311 135865602 118027533 84417417 33610116 38659003 29278049 9380954 9901997 4972693 4929304 192805210 11569840 C PUBLICLY TRADED SECURITIES 184120624 F 195690464 INTEREST RATE SWAP LIABILITY 2429254 EXECUTIVE BENEFIT PLAN LIABILITY 978274 3407528 X PART V, LINE 4: ENDOWMENT FUNDS ARE RELATED TO BENEFIS HEALTH SYSTEM FOUNDATION, INC. PART X, LINE 2: THE ORGANIZATION IS A NOTFORPROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE IRC. THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. EFFECTIVE JANUARY 1, 2009, THE ORGANIZATION ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2016 OR 2015. 1 MSU GREAT FALLS COLLEGE 2100 16TH AVE SOUTH GREAT FALLS MT 59405 810522790 GOVERNMENT 112000 NURSING AND SURGICAL TECH PROGRAMS - SUPPORT MONTANA PRIMARY CARE ASSOCIATION 1805 EUCLID AVE BILLINGS MT 59601 810454697 501C3 20000 OUTREACH SUPPORT FOR COVER MONTANA ALZHEIMER'S ASSOCIATIONMONTANA CHAPTER 3010 11TH AVE NORTH BILLINGS MT 59101 133039601 501C3 10000 ALZHEIMERS WALK TO END ALZHEIMERS - SPONSORSHIP GREAT FALLS FOOD BANK 1620 12TH AVE NORTH GREAT FALLS MT 59401 363540471 501C3 10000 PROGRAM SUPPORT NORTHERN TRANSIT INTERLOCAL 226 1ST ST SOUTH SHELBY MT 59474 816001438 GOVERNMENT 10000 SUPPORT TO FUND PATIENT TRANSPORTS CENTER FOR MENTAL HEALTH 915 FIRST AVE SOUTH GREAT FALLS MT 59403 810347441 501C3 7500 EVENT SPONSORSHIP YES FOR GREAT FALLS KIDS 3101 4TH AVE N GREAT FALLS MT 59405 812694887 GOVERNMENT 7500 SUPPORT FOR FUND BALLOT INITIATIVE GREAT FALLS PUBLIC SCHOOLS FOUNDATION PO BOX 2429 GREAT FALLS MT 59403 272577990 501C3 12000 PROGRAM SUPPORT 8 PART I, LINE 2: BENEFIS HAS A FULL-TIME GRANTS MANAGER, WHO OVERSEES INTERNAL CONTROLS. A GRANTS HANDBOOK DETAILING PROCEDURES ALONG WITH ROLES/RESPONSIBILITIES FOR BOTH PRE AND POST AWARD HAS BEEN DEVELOPED, APPROVED BY ADMINISTRATION, AND IS IN PLACE. THE GRANTS MANAGER ENSURES STAFF MEMBERS INVOLVED WITH A GRANT-FUNDED PROJECT ARE AWARE OF THESE PROCEDURES AND THEIR RESPECTIVE RESPONSIBILITIES. THE GRANTS MANAGER MONITORS ALL GRANT-RELATED ACTIVITIES TO ENSURE PROTOCOLS ARE FOLLOWED. FOR EXAMPLE, THE GRANTS MANAGER MEETS WITH THE PROJECT DIRECTOR AT LEAST MONTHLY TO REVIEW PROJECT PROGRESS ALONG WITH GOALS, ACTIVITIES, AND EXPENDITURES. THE GRANTS MANAGER ALSO MEETS WITH ACCOUNTING MONTHLY TO REVIEW THE DETAIL TRIAL BALANCE AND ENSURE GRANT CHARGES ARE APPROPRIATE PRIOR TO APPROVING DRAWING DOWN FEDERAL FUNDS. THE GRANTS MANAGER OVERSEES ALL REPORTS AND DELIVERABLES AND MAKES SURE THEY ARE SUBMITTED AS REQUIRED. THE GRANTS MANAGER SERVES AS THE LIAISON WITH THE FEDERAL GOVERNMENT ON ALL GRANT AWARDS AND WORKS DIRECTLY WITH THE FEDERAL PROJECT OFFICER AND FEDERAL GRANTS MANAGEMENT AS INDICATED. WHEN BENEFIS PASSES THROUGH OR SUBAWARDS GRANT FUNDS TO ANOTHER ORGANIZATION, THE GRANTS MANAGER ENSURES THE ORGANIZATION IS ELIGIBLE TO RECEIVE FEDERAL FUNDS BY CONFIRMING IT IS NOT AN EXCLUDED PARTY AND THAT THE ORGANIZATION HAS A TAX IDENTIFICATION NUMBER AND DUNS NUMBER IF APPLICABLE. ALL SUBAWARDS ARE MONITORED BY THE GRANTS MANAGER AND PROJECT DIRECTOR THROUGH ONGOING MEETINGS AND REPORTS INCLUDING A COPY OF THE RECIPIENT'S ANNUAL AUDIT REPORT, WHEN AVAILABLE. X X 1 1 X X X X 1 1 0 0 0 0 0 1 0 JOHN GOODNOW CHIEF EXECUTIVE OFFICER 640147 0 174699 0 317890 0 39283 0 6932 0 1178951 0 0 0 FORREST EHLINGER CHIEF FINANCIAL OFFICER 347865 0 86290 0 6500 0 80973 0 10915 0 532543 0 0 0 TERRY OLINGER PRESIDENT ACUTE CARE GROUP 376522 0 102791 0 66268 0 122856 0 604 0 669041 0 58350 0 AMY BEAMES PRES SR SRVCS & LEGISLATIVE AFFAIRS 195932 0 44441 0 0 0 24090 0 6493 0 270956 0 0 0 PATTY HARRIS DIRECTOR REVENUE CYCLE 169056 0 27053 0 0 0 0 0 8442 0 204551 0 0 0 THERESA PREITE PRESIDENT SPECTRUM MEDICAL 191356 0 38196 0 6000 0 25875 0 6492 0 267919 0 0 0 JULIE WALL VICE PRESIDENT QUALITY AND INFECTION 165186 0 32530 0 0 0 8677 0 10254 0 216647 0 0 0 CARL BRUESCH DIRECTOR FINANCIAL ANALYSIS 159871 0 17395 0 0 0 0 0 6467 0 183733 0 0 0 BRUCE HOULIHAN CONTROLLER 165733 0 33485 0 26422 0 712 0 9701 0 236053 0 0 0 SAM NORTON CHIEF INFORMATION OFFICER (FORMER) 0 0 0 0 179862 0 9382 0 378 0 189622 0 0 0 PART I, LINE 1A TRAVEL FOR COMPANIONS AND SOCIAL CLUB DUES THAT BENEFIS HEALTH SYSTEM PAYS FOR ITS OFFICERS ARE TREATED AS TAXABLE INCOME TO THE INDIVIDUAL ACCORDINGLY. PART I, LINES 4A-B SEVERANCE WAS PAID TO SAM NORTON IN 2016. THE ORGANIZATION PROVIDES A SECTION 457F NONQUALIFIED DEFERRED COMPENSATION PLAN FOR MR. GOODNOW, MR. OLINGER, MS. BEAMES, MR. EHLINGER AND MS. PREITE, WHOM ALL MEET THE REQUIREMENTS OF THE PLAN. MR. OLINGER RECEIVED A PAYOUT FROM THE PLAN IN 2016. PART I, LINE 7 BENEFIS HEALTH SYSTEM, INC. AND ITS AFFILIATES (INCLUDING THE ORGANIZATION) MAINTAIN AN INCENTIVE COMPENSATION PLAN THAT INCORPORATES BOTH SHARED AND INDIVIDUAL GOALS FOR MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM. PAYMENTS PURSUANT TO THE INCENTIVE PLAN ARE SUBJECT TO A PRECONDITION THAT THE SYSTEM MUST ACHIEVE BUDGETED OPERATING PERFORMANCE. THE SYSTEM HAS ADOPTED SHARED PERFORMANCE OBJECTIVES INCLUDING SYSTEM GROWTH AS WELL AS MEASURES TIED TO WORKFORCE, PATIENT EXPERIENCE, PATIENT SAFETY, CLINICAL QUALITY, FINANCE/OPERATIONS, AND COMMUNITY BENEFIT. THE INDIVIDUAL PERFORMANCE OBJECTIVES ARE BASED ON AN ARRAY OF QUALITY, FINANCIAL, OPERATIONAL AND STRATEGIC INITIATIVES. INCENTIVE OPPORTUNITY LEVELS ARE CALCULATED BASED ON PREDETERMINED PERCENTAGES OF EACH EXECUTIVE'S BASE SALARY, AND VARY BASED ON THE ACHIEVEMENT OF THRESHOLD, TARGET OR STRETCH LEVELS AS TO EACH PERFORMANCE OBJECTIVE. THE SYSTEM ALSO MAINTAINS A LONG-TERM INCENTIVE PLAN DIRECTED AT RECRUITING AND RETAINING EXECUTIVE LEADERSHIP. PAYMENTS UNDER THE LONG-TERM INCENTIVE PLAN ARE CONDITIONED ON AN EXECUTIVE REMAINING EMPLOYED BY THE SYSTEM AND MAINTAINING SATISFACTORY OVERALL PERFORMANCE. INCENTIVE OPPORTUNITIES UNDER THE LONG-TERM PLAN ARE APPROVED IN ADVANCE BY THE BENEFIS HEALTH SYSTEM, INC. COMPENSATION COMMITTEE, WITH LATER PAYOUTS APPROVED BY THE COMMITTEE BASED ON ACTUAL PERFORMANCE RESULTS. A MONTANA FACILITY FINANCE AUTHORITY 364615155 2016-11-10 161550995 CONSTRUCTION/ EXPANSION OF HEALTHCARE FACILITY 0 0 0 B MONTANA FACILITY FINANCE AUTHORITY 364615155 2011-05-25 17605000 CONSTRUCTION/ EXPANSION OF HEALTHCARE FACILITY 0 0 0 A 161550995 1560101 137449364 402999 22138532 1 1 0 1 B 3340000 17607221 221822 17383178 2011 1 0 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0 0 1 A 0 1 0 0 0 0 1 0 0 1 B 0 0 0 1 1 1 DEUTSCHE BANK 19.000000000000 1 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: MONTANA FACILITY FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 05/01/2016 FORM 990, PART VI, SECTION A, LINE 2 CERTAIN OFFICERS AND DIRECTORS LISTED IN PART VII ALSO HOLD OFFICER AND/OR DIRECTOR POSITIONS IN RELATION TO THE ORGANIZATION'S AFFILIATES (AS IDENTIFIED IN SCHEDULE R) AND, IN THAT REGARD, MAY BE CONSIDERED TO HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER. SUCH BUSINESS RELATIONSHIPS ARE UNDERTAKEN IN THE ORDINARY COURSE OF BUSINESS. FORM 990, PART VI, SECTION B, LINE 11B THIS FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT PERSONNEL OF BENEFIS HEALTH SYSTEM, INC. IN COLLABORATION WITH ITS ACCOUNTING FIRM. PRIOR TO FILING, A COPY OF THIS FORM 990 INCLUDING SCHEDULE B WAS MADE AVAILABLE TO ALL MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS AND WAS PRESENTED TO THE BHS BOARD BY THE ACCOUNTING FIRM. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ANNUALLY COMPLETE A FORM TO DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. IN ADDITION, AT THE START OF EACH BOARD MEETING, MEMBERS ARE ASKED TO INDICATE WHETHER THEY HAVE A CONFLICT OF INTEREST WITH RESPECT TO ANY ITEMS ON THE AGENDA FOR THE MEETING. CONSISTENT WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY, BOARD MEMBERS ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND VOTING ON ANY MATTERS AS TO WHICH THEY HAVE A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE EXECUTIVE TEAM, INCLUDING THE CEO, CFO, PRESIDENT OF ACUTE CARE GROUP AND PRESIDENT, SENIOR SERVICES & LEGISLATIVE AFFAIRS, WAS SET BY THE INDEPENDENT COMPENSATION COMMITTEE OF BENEFIS HEALTH SYSTEM, INC., WHICH IS CHARGED WITH ADMINISTERING THE SYSTEM'S EXECUTIVE COMPENSATION PHILOSOPHY, POLICIES AND PROGRAMS IN THE MANNER SET FORTH IN THE COMMITTEE'S WRITTEN CHARTER. THE COMMITTEE'S RESPONSIBILITIES INCLUDE (I) DETERMINING APPROPRIATE COMPENSATION FOR ALL EXECUTIVES AND OTHER KEY EMPLOYEES, (II) EVALUATING AND ADOPTING EXECUTIVE COMPENSATION PLANS, POLICIES AND PROGRAMS, (III) REVIEWING AND APPROVING EXECUTIVE BENEFIT PLANS, AND (IV) VERIFYING THAT COMPENSATION IS APPROPRIATELY AND FULLY DISCLOSED AND REPORTED. THE COMMITTEE HAS ENGAGED AN INDEPENDENT COMPENSATION CONSULTING FIRM TO ASSIST IN ENSURING THAT AMOUNTS PAID TO THE SYSTEM'S EXECUTIVES ARE CONSISTENT WITH REASONABLE, FAIR MARKET LEVELS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. THIS PROCESS IS COMPLETED ON AN ANNUAL BASIS. THE COMPENSATION OF THE ORGANIZATION'S KEY EMPLOYEES AND MANAGERS WAS SET BY THEIR RESPECTIVE SUPERVISORY EXECUTIVES IN CONSULTATION WITH BENEFIS HEALTH SYSTEM'S HUMAN RESOURCES DEPARTMENT AND EXECUTIVE LEADERSHIP, BASED ON A REVIEW OF INDEPENDENT DATA AS TO AMOUNTS PAID BY SIMILAR SITUATED ORGANIZATIONS FOR PERSONS PERFORMING COMPARABLE SERVICES. FORM 990, PART VI, SECTION C, LINE 19 BENEFIS HEALTH SYSTEM, INC. PROVIDES COPIES OF AUDITED FINANCIAL STATEMENTS AND FORM 990 TO THE PUBLIC UPON REQUEST DURING NORMAL BUSINESS HOURS. FORM 990, PART XI, LINE 9: BOOK/TAX DIFFERENCE IN SUBSIDIARY AND JV INCOME 13,329. CHANGE IN VALUE OF CHARITABLE GIFT ANNUITIES 5,262,255. GAIN ON INTEREST RATE SWAP AGREEMENT 1,006,058. BENEFIS SLETTEN HI-LINE CANCER CENTER LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 263144419 MEDICAL CARE MT 616122 216076 BENEFIS HEALTH SYSTEM INC BENEFIS CASCADE RIDGE LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 274602798 REAL ESTATE MT 0 592906 BENEFIS HEALTH SYSTEM INC BENEFIS HEALTH SYSTEM FOUNDATION PROPERTIES LLC PO BOX 7008 GREAT FALLS MT 59406 272514629 HOLDS REAL PROPERTY DONATED TO FOUNDATION MT BENEFIS HEALTH SYSTEM FOUNDATION INC BBB LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 263652926 MEDICAL BUILDING MT 2162628 0 BENEFIS HEALTH SYSTEM INC WALK IN EXPRESS LLC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 320481028 OUTPATIENT CLINIC MT 55018 20150 BENEFIS HEALTH SYSTEM INC BENEFIS HOSPITALS INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 810232122 HOSPITAL MT 501(C)(3) LINE 3 BENEFIS HEALTH SYSTEM INC 1 BENEFIS SPECTRUM MEDICAL INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 810431871 HOME HEALTH & RELATED PRODUCTS MT 501(C)(3) LINE 10 BENEFIS HEALTH SYSTEM INC 1 BENEFIS MEDICAL GROUP INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 263538192 PHYSICIAN SERVICES MT 501(C)(3) LINE 3 BENEFIS HEALTH SYSTEM INC 1 BENEFIS HEALTHCARE EES HEALTH PLAN AND TRUST 1101 26TH STREET SOUTH GREAT FALLS MT 59405 363386166 BENEFIT PLAN MT 501(C)(9) BENEFIS HEALTH SYSTEM INC 1 BENEFIS HEALTH SYSTEM FOUNDATION INC PO BOX 7008 GREAT FALLS MT 59406 810480587 FOUNDATION MT 501(C)(3) LINE 7 BENEFIS HEALTH SYSTEM INC 1 BENEFIS SENIOR SERVICES INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 461344408 SENIOR SERVICES/CCRC MT 501(C)(3) LINE 10 BENEFIS HEALTH SYSTEM INC 1 BENEFIS COMMUNITY HOSPITALS INC 1101 26TH STREET SOUTH GREAT FALLS MT 59405 473448483 CRITICAL ACCESS HOSPITAL MT 501(C)(3) LINE 3 BENEFIS HEALTH SYSTEM INC 1 GREAT FALLS ATHLETIC CLUB LLC 1800 BENEFIS COURT GREAT FALLS MT 59405 912081505 FITNESS CLUB MT BENEFIS HEALTH SYSTEM INC UNRELATED 280467 3534965 0 1 0.51000 SPECTRUM HOME SOLUTIONS 2509 7TH AVE SOUTH GREAT FALLS MT 59405 810431871 IV THERAPY MT N/A N/A 0 0 TREASURE STATE HEALTHCARE NETWORK LLC 500 15TH AVENUE SOUTH GREAT FALLS MT 59405 810534714 HEALTHCARE SERVICES MT BENEFIS HEALTH SYSTEM INC RELATED -15527 146007 0 1 0.50000 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 1 BENEFIS HEALTH SYSTEM FOUNDATION INC C 1266043 CONTRIBUTIONS RECEIVED BENEFIS HOSPITALS INC L 54644472 FAIR MARKET VALUE BENEFIS SPECTRUM MEDICAL INC L 1497080 FAIR MARKET VALUE BENEFIS HOSPITALS INC M 259303 FAIR MARKET VALUE BENEFIS HEALTHCARE EES HEALTH PLAN AND TRUST M 1169701 PLAN CONTRIBUTIONS GREAT FALLS ATHLETIC CLUB LLC M 64008 FAIR MARKET VALUE GREAT FALLS ATHLETIC CLUB LLC S 280467 CASH DISTRIBUTIONS BENEFIS HEALTH SYSTEM FOUNDATION INC L 1024568 FAIR MARKET VALUE BENEFIS COMMUNITY HOSPITALS INC L 631646 FAIR MARKET VALUE