STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

ST PETERS HEALTH: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
ST PETERS HEALTH (EIN 81-0233121)
Tax period
2015-06-01 to 2016-05-31
Filed
2017-04-15
IRS object ID
201731059349300518
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-04-15T11:55:03-05:00ReturnTs
Tax Period End2016-05-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1111 South Tejon Suite 800AddressLine1Txt
CityColorado SpringsCityNm
State AbbreviationCOStateAbbreviationCd
ZIP809039848ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN810233121EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1St Peter's Community HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JOHN GREEN CFOInCareOfNm
Business Name ControlSTPEBusinessNameControlTxt
Phone4064422480PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12475 BroadwayAddressLine1Txt
CityHelenaCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59601ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN GREENPersonNm
Person TitleCFOPersonTitleTxt
Phone4064422480PhoneNum
Signature2017-04-18SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDavid S Mason CPAPreparerPersonNm
PTINP00137279PTIN
Phone7194714290PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1ST PETER'S HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerFRED OLSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12475 BroadwayAddressLine1Txt
CityHelenaCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59601ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$270,762,341GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressSTPETES.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1883FormationYr
Legal Domicile StateMTLegalDomicileStateCd
Activity Or MissionPROVIDE EXCEPTIONAL AND COMPASSIONATE HEALTH CARE.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee1520TotalEmployeeCnt
Total Volunteers170TotalVolunteersCnt
Total Gross UBI$550,678TotalGrossUBIAmt
PY Contributions Grants$1,272,510PYContributionsGrantsAmt
CY Contributions Grants$604,080CYContributionsGrantsAmt
PY Program Service Revenue$191,730,710PYProgramServiceRevenueAmt
CY Program Service Revenue$206,562,128CYProgramServiceRevenueAmt
PY Investment Income$8,198,670PYInvestmentIncomeAmt
CY Investment Income$327,669CYInvestmentIncomeAmt
PY Other Revenue$2,361,238PYOtherRevenueAmt
CY Other Revenue$2,021,008CYOtherRevenueAmt
PY Total Revenue$203,563,128PYTotalRevenueAmt
CY Total Revenue$209,514,885CYTotalRevenueAmt
PY Grants And Similar Paid$132,777PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$81,800CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$89,300,453PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$95,328,452CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$383,746CYTotalFundraisingExpenseAmt
PY Other Expenses$98,246,328PYOtherExpensesAmt
CY Other Expenses$107,792,510CYOtherExpensesAmt
PY Total Expenses$187,679,558PYTotalExpensesAmt
CY Total Expenses$203,202,762CYTotalExpensesAmt
PY Revenues Less Expenses$15,883,570PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,312,123CYRevenuesLessExpensesAmt
Total Assets BOY$289,326,725TotalAssetsBOYAmt
Total Assets EOY$298,572,660TotalAssetsEOYAmt
Total Liabilities BOY$79,251,655TotalLiabilitiesBOYAmt
Total Liabilities EOY$87,784,901TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$210,075,070NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$210,787,759NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionST. PETERS HOSPITAL PARTNERS WITH OUR PATIENTS, COMMUNITY, AND MEDICAL STAFF TO PROVIDE EXCEPTIONAL AND COMPASSIONATE HEALTH CARE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$136,817,632ExpenseAmt
Grant$81,800GrantAmt
Revenue$163,527,730RevenueAmt
DescSt. Peter's hospital is a 123-bed acute care hospital facility serving residents of lewis and clark county and portions of jefferson, broadwater, meagher and powell counties. St peters was the sole facility in the primary service area during the year ended May 31, 2016. The hospital provided at cost a total of $16,211,740 in community benefit. Of this total, $3,277,461 was for medical services to individuals who were determined unable to purchase such services under the hospitals charity care policy. In addition to free care and/or subsidized care, care is also provided at below cost rates to persons covered by governmental programs. The total operating loss for providing care to Medicaid patients was $1,605,031. The hospital provided $10,721,673 in subsidized health services during the year, including acute patient care for pediatric patients, outpatient pharmacy, pulmonary rehab, clinical nutrition, rehab, hospitalists services, physician clinics and in-home nursing and oxygen services. To fulfill its mission of community service, the organization provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the organization does not pursue collection of amounts determined to qualify as charity care, they are not reported as patient service revenue.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$35,585,558ExpenseAmt
Grant$0GrantAmt
Revenue$43,746,396RevenueAmt
DescThe hospital operates several physician clinics, employing 66 physicians and physician assistants and nurse practitioners. Without the hospitals assistance, lewis and clark county would be without many needed medical and surgical specialties. Physicians in the specialties of family practice, internal medicine, neurology, rheumatology, gastroenterology, ent, cardiology, general surgery, orthopedic surgery, allergy, nephrology, radiation and medical oncology had approximately 234,574 patient encounters.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$172,403,190TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document194IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1520EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OfYes (true)Form8282PropertyDisposedOfInd
Form8282 Filed1Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressYes (true)OfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldMTStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJOHN GREEN CFOPersonNm
Phone4064422480PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12475 BROADWAYAddressLine1Txt
CityHELENACityNm
State AbbreviationMTStateAbbreviationCd
ZIP59601ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
NATHAN OLSON
CEO39.01.0Yes (X)Yes (X)$688,691$0$1,039,438
GUY ALMQUIST
TREASURER1.00.0Yes (X)Yes (X)$0$0$0
GEORGE 'RUSS' BELL
BOARD MEMBER THROUGH 12/20151.01.0Yes (X)$0$0$0
DUANE BRUCE
BOARD MEMBER1.00.0Yes (X)$0$0$0
JOHN GALT MD
BOARD MEMBER/CHIEF OF STAFF40.00.0Yes (X)$413,152$0$32,666
MICHAEL S HAY MD
BOARD MEMBER THROUGH 03/20161.00.0Yes (X)$19,724$0$0
MICK ROBINSON
BOARD MEMBER1.00.0Yes (X)$0$0$0
GAYLE SHIRLEY
BOARD MEMBER1.00.0Yes (X)$0$0$0
ROGER STONE
BOARD MEMBER THROUGH 12/20151.00.0Yes (X)$0$0$0
THOMAS A STRIZICH MD - BOARD
MEMBER/PAST CHIEF OF STAFF1.00.0Yes (X)$0$0$0
MARK TAYLOR
CHAIR1.00.0Yes (X)Yes (X)$0$0$0
KAREN Z HICKS
BOARD MEMBER1.00.0Yes (X)$1,350$0$0
ANDREW MALANY MD - BOARD
MEMBER/CHIEF OF STAFF - ELECT1.00.0Yes (X)$29,492$0$0
WILLIAM T NORTHEY
PAST CHAIR1.00.0Yes (X)$1,024$0$0
KELLY PARSLEY
BOARD MEMBER1.00.0Yes (X)$0$0$0
RANDY RILEY
BOARD MEMBER1.00.0Yes (X)$0$0$0
JOHN GREEN
CFO40.00.0Yes (X)$315,648$0$60,318
ANN KJOSA
COO/CXO40.00.0Yes (X)$291,459$0$59,215
MARIA BRAMAN - VP OF MEDICAL
STAFF THROUGH 03/201640.00.0$337,446$0$23,001Yes (X)
THOMAS WEINER
MD40.00.0$1,763,986$0$39,635Yes (X)
MICHAEL LEE
MD40.00.0$697,662$0$13,473Yes (X)
JAMES TARVER
MD40.00.0$542,709$0$310,674Yes (X)
EDWARD CURRY
MD40.00.0$519,247$0$22,805Yes (X)
JUSTIN THOMAS
MD40.00.0$583,733$0$42,691Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$6,205,323TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$1,643,916TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K92IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HORIZON MENTAL HEALTH MANAGEMENT
1965 LAKE POINT DR SUITE 100LEWISVILLETX75057MANAGEMENT SERVICES$3,516,298
ARUP LABORATORIES
PO BOX 27964SALT LAKE CITYUT84127REFERENCE LAB$682,921
CAPITAL MEDICAL ANESTHESIA
PO BOX 5179HELENAMT596045179ANESTHESIA COVERAGE$701,230
GE HEALTHCARE
PO BOX 414-SN471MILWAUKEEWI53201BIOMEDICAL SERVICES$1,099,366
SIEMENS MEDICAL SOLUTIONS
51 VALLEY STREAM PARKWAYMALVERNPA19355PREV MAINT AGREEMENT$2,081,264
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K45CntrctRcvdGreaterThan100KCnt
Related Organizations$347,427RelatedOrganizationsAmt
Government Grants$151,353GovernmentGrantsAmt
All Other Contributions$105,300AllOtherContributionsAmt
Total Contributions$604,080TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE621110$133,134,516$133,134,516
PHARMACY446110$71,775,155$71,618,059$157,096
INCOME FROM JOINT VENTURES900099$1,312,440$1,043,200$269,240
MEANINGFUL USE PAYMENTS621110$204,946$204,946
PATIENT CENTERED MEDICAL HOME PAYMENTS621110$102,356$102,356

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$32,715TotalRevenueColumnAmt
Related Or Exempt Func Income$32,715RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$206,562,128TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,631,914TotalRevenueColumnAmt
Exclusion$2,631,914ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$298,462RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$186,320RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$112,142RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$112,142TotalRevenueColumnAmt
Exclusion$112,142ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$57,969,870SecuritiesAmt
Other$721,079OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$60,006,194SecuritiesAmt
Other$989,000OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$2,036,324SecuritiesAmt
Other-$267,921OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$2,304,245TotalRevenueColumnAmt
Exclusion-$2,304,245ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$118,732GrossSalesOfInventoryAmt
Cost Of Goods Sold$65,942CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$52,790TotalRevenueColumnAmt
Exclusion$52,790ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
OTHER INCOME900099$618,223$448,045$102,941$67,237
CAFETERIA722514$808,181$15,658$792,523
DAYCARE FOR EMPLOYEES624110$290,061$5,743$284,318

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$139,611TotalRevenueColumnAmt
Related Or Exempt Func Income$139,611RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,856,076OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$209,514,885TotalRevenueColumnAmt
Related Or Exempt Func Income$206,723,448RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$550,678UnrelatedBusinessRevenueAmt
Exclusion$1,636,679ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$81,800TotalAmt
Program Services$81,800ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,614,245TotalAmt
Program Services$1,545,707ProgramServicesAmt
Management And General$2,068,538ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$40,805TotalAmt
Management And General$40,805ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$72,245,674TotalAmt
Program Services$58,879,086ProgramServicesAmt
Management And General$13,174,479ManagementAndGeneralAmt
Fundraising$192,109FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$6,792,419TotalAmt
Program Services$5,699,767ProgramServicesAmt
Management And General$1,078,468ManagementAndGeneralAmt
Fundraising$14,184FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,758,444TotalAmt
Program Services$6,381,444ProgramServicesAmt
Management And General$1,363,366ManagementAndGeneralAmt
Fundraising$13,634FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,876,865TotalAmt
Program Services$4,083,249ProgramServicesAmt
Management And General$785,157ManagementAndGeneralAmt
Fundraising$8,459FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$276,501TotalAmt
Management And General$276,501ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$66,610TotalAmt
Management And General$66,610ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$67,143TotalAmt
Management And General$67,143ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$597,142TotalAmt
Management And General$597,142ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$21,197,751TotalAmt
Program Services$14,764,002ProgramServicesAmt
Management And General$6,428,506ManagementAndGeneralAmt
Fundraising$5,243FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$226,045TotalAmt
Program Services$67,385ProgramServicesAmt
Management And General$149,194ManagementAndGeneralAmt
Fundraising$9,466FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,556,118TotalAmt
Program Services$3,244,216ProgramServicesAmt
Management And General$1,303,490ManagementAndGeneralAmt
Fundraising$8,412FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$19,666TotalAmt
Program Services$4,790ProgramServicesAmt
Management And General$14,876ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,954,071TotalAmt
Program Services$1,688,409ProgramServicesAmt
Management And General$245,798ManagementAndGeneralAmt
Fundraising$19,864FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$237,676TotalAmt
Program Services$128,669ProgramServicesAmt
Management And General$108,267ManagementAndGeneralAmt
Fundraising$740FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$299,988TotalAmt
Program Services$172,132ProgramServicesAmt
Management And General$127,856ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$769,248TotalAmt
Program Services$653,861ProgramServicesAmt
Management And General$107,695ManagementAndGeneralAmt
Fundraising$7,692FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$9,825,913TotalAmt
Program Services$8,441,286ProgramServicesAmt
Management And General$1,285,318ManagementAndGeneralAmt
Fundraising$99,309FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,712,968TotalAmt
Program Services$2,534,394ProgramServicesAmt
Management And General$177,667ManagementAndGeneralAmt
Fundraising$907FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL SUPPLIES/DRUGS$49,217,042$49,217,042
BAD DEBT EXPENSE$11,641,686$11,641,686
BED TAX$1,545,300$1,545,300
CAFETERIA/FOOD$909,763$797,286$108,968$3,509

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,671,879TotalAmt
Program Services$831,679ProgramServicesAmt
Management And General$839,982ManagementAndGeneralAmt
Fundraising$218FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$203,202,762TotalAmt
Program Services$172,403,190ProgramServicesAmt
Management And General$30,415,826ManagementAndGeneralAmt
Fundraising$383,746FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$20,440,051BOYAmt
EOY$28,079,540EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,180,182BOYAmt
EOY$7,991,682EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$29,137,457BOYAmt
EOY$30,445,906EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$12,256BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$3,007,998BOYAmt
EOY$3,315,074EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$4,184,063BOYAmt
EOY$4,199,383EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,586,327BOYAmt
EOY$4,321,631EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$185,245,778LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$96,595,993LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$92,058,663BOYAmt
EOY$88,649,785EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$110,249,527BOYAmt
EOY$103,137,359EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$3,239,226BOYAmt
EOY$8,194,087EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$2,597,393BOYAmt
EOY$2,087,330EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$17,633,582BOYAmt
EOY$18,150,883EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$289,326,725BOYAmt
EOY$298,572,660EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$19,246,112BOYAmt
EOY$23,237,323EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$34,470,000BOYAmt
EOY$32,705,000EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$25,535,543BOYAmt
EOY$31,842,578EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$79,251,655BOYAmt
EOY$87,784,901EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$195,980,647BOYAmt
EOY$196,607,823EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,591,847BOYAmt
EOY$5,724,253EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,502,576BOYAmt
EOY$8,455,683EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$210,075,070BOYAmt
EOY$210,787,759EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$289,326,725BOYAmt
EOY$298,572,660EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$6,312,123ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$220,289NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$5,819,723OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersYes (true)MailingsMembersInd
Mailings Members$100MailingsMembersAmt
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (true)DirectContactLegislatorsInd
Direct Contact Legislators$900DirectContactLegislatorsAmt
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$66,143OtherActivitiesAmt
Total Lobbying Expenditures$67,143TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1FormAndLineReferenceDesc
ExplanationDESCRIPTION OF LOBBYING ACTIVITIES: The hospital hired a consultant to provide lobbying services in connection with governmental affairs representation to ensure hospital, community, and employee interests and needs are represented. In addition, a portion of aha/mha dues are attributed to lobbying services.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,102,447BeginningYearBalanceAmt
Contributions$55,722ContributionsAmt
Investment Earnings Or Losses-$120,076InvestmentEarningsOrLossesAmt
Other Expenditures-$16,531OtherExpendituresAmt
End Year Balance$13,054,624EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,693,936BeginningYearBalanceAmt
Contributions$127,333ContributionsAmt
Investment Earnings Or Losses$369,446InvestmentEarningsOrLossesAmt
Other Expenditures$88,268OtherExpendituresAmt
End Year Balance$13,102,447EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$11,606,682BeginningYearBalanceAmt
Contributions$393,168ContributionsAmt
Investment Earnings Or Losses$968,936InvestmentEarningsOrLossesAmt
Other Expenditures$274,850OtherExpendituresAmt
End Year Balance$12,693,936EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,598,351BeginningYearBalanceAmt
Contributions$64,337ContributionsAmt
Investment Earnings Or Losses$979,412InvestmentEarningsOrLossesAmt
Other Expenditures$35,418OtherExpendituresAmt
End Year Balance$11,606,682EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,709,927BeginningYearBalanceAmt
Contributions$489,607ContributionsAmt
Investment Earnings Or Losses-$542,431InvestmentEarningsOrLossesAmt
Other Expenditures$58,752OtherExpendituresAmt
End Year Balance$10,598,351EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.05480BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.40710PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.64770TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,961,630OtherCostOrOtherBasisAmt
Book Value$2,961,630BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$97,242,765OtherCostOrOtherBasisAmt
Depreciation$35,059,062DepreciationAmt
Book Value$62,183,703BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$81,858,197OtherCostOrOtherBasisAmt
Depreciation$60,781,025DepreciationAmt
Book Value$21,077,172BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,183,186OtherCostOrOtherBasisAmt
Depreciation$755,906DepreciationAmt
Book Value$2,427,280BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$88,649,785TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATE$19,969
INSURANCE RECEIVABLE$3,600,674
INVESTMENT IN SPH FOUNDATION$14,055,424
BOND ISSUANCE COSTS$474,816
FieldValueIRS element (for citing)
Total Book Value Other Assets$18,150,883TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
MALPRACTICE ACCRUAL$5,267,065
PENSION LIABILITY$26,575,513
FieldValueIRS element (for citing)
Total Liability$31,842,578TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$191,933,385TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$220,289NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$4,500DonatedServicesAndUseFcltsAmt
Other Revenue$252,262OtherRevenueAmt
Revenue Not Reported$477,051RevenueNotReportedAmt
Revenue Subtotal$191,456,334RevenueSubtotalAmt
Investment Expenses Not Incld$597,142InvestmentExpensesNotIncldAmt
Other Revenues Not Included$17,461,409OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$18,058,551RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$209,514,885TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$191,220,696TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$4,500DonatedServicesUseFcltsAmt
Other Expenses Included$252,262OtherExpensesIncludedAmt
Expenses Not Reported$256,762ExpensesNotReportedAmt
Expenses Subtotal$190,963,934ExpensesSubtotalAmt
Investment Expenses Not Incld2$597,142InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$11,641,686OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$12,238,828ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$203,202,762TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4Describe the intended uses of the organization's endowment funds: ENDOWMENT FUNDS ARE RESTRICTED FOR SUPPORT OF HOSPITAL PROGRAMS AND SERVICES AND FOR CAPITAL PURCHASES AND IMPROVEMENTS IN ACCORDANCE WITH BOARD POLICIES AND/OR DONOR RESTRICTIONS.
Schedule D, Part X, Line 2UNCERTAIN TAX POSITIONS: Management has evaluated their income tax positions under the guidance included in asc 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.
SCHEDULE D, PART XI, LINE 2DREVENUE ON BOOKS, NOT ON RETURN: COST OF GOODS SOLD 65,942 RENTAL EXPENSES NET WITH REVENUE 186,320 TOTAL 252,262
SCHEDULE D, PART XI, LINE 4BREVENUE ON RETURN, NOT ON BOOKS: PROVISION FOR BAD DEBTS NET WITH REVENUE ON FINANCIALS 11,641,686 CHANGE IN INTEREST IN SPH FOUNDATION 147,478 MINIMUM PENSION LIABILITY ADJUSTMENT 5,672,245 TOTAL 17,461,409
SCHEDULE D, PART XII, LINE 2DEXPENSE ON BOOKS, NOT ON RETURN: COST OF GOODS SOLD 65,942 RENTAL EXPENSES NET WITH REVENUE 186,320 TOTAL 252,262
SCHEDULE D, PART XII, LINE 4BEXPENSE ON RETURN, NOT ON BOOKS: PROVISION FOR BAD DEBTS NET WITH REVENUE ON FINANCIALS 11,641,686

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent250Yes (X)Percent250Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served7413PersonsServedCnt
Total Community Benefit Expns$8,276,338TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,998,877DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,277,461NetCommunityBenefitExpnsAmt
Total Expense0.01690TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served23636PersonsServedCnt
Total Community Benefit Expns$16,154,069TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,549,038DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,605,031NetCommunityBenefitExpnsAmt
Total Expense0.00830TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served31049PersonsServedCnt
Total Community Benefit Expns$24,430,407TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$19,547,915DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,882,492NetCommunityBenefitExpnsAmt
Total Expense0.02520TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served6192PersonsServedCnt
Total Community Benefit Expns$929,589TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$431,751DirectOffsettingRevenueAmt
Net Community Benefit Expns$497,838NetCommunityBenefitExpnsAmt
Total Expense0.00260TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Persons Served1PersonsServedCnt
Total Community Benefit Expns$1,500TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,500NetCommunityBenefitExpnsAmt

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served205369PersonsServedCnt
Total Community Benefit Expns$54,091,324TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$43,369,651DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,721,673NetCommunityBenefitExpnsAmt
Total Expense0.05530TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Persons Served35034PersonsServedCnt
Total Community Benefit Expns$108,237TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$108,237NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Persons Served246596PersonsServedCnt
Total Community Benefit Expns$55,130,650TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$43,801,402DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,329,248NetCommunityBenefitExpnsAmt
Total Expense0.05850TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served277645PersonsServedCnt
Total Community Benefit Expns$79,561,057TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$63,349,317DirectOffsettingRevenueAmt
Net Community Benefit Expns$16,211,740NetCommunityBenefitExpnsAmt
Total Expense0.08370TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$11,761,196BadDebtExpenseAmt
Reimbursed By Medicare$69,052,569ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$82,132,038CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$13,079,469MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line1HELENA SURGICENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesSURGERY CENTERPrimaryActivitiesTxt
Org Profit Or Ownership0.5OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership0.066OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership0.434PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1St peter's hospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12475 broadwayAddressLine1Txt
CityhelenaCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59601ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.stpetes.orgWebsiteAddressTxt
State License13346StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherPHYSICIAN CLINICS & URGENT CARE SERVICESOtherDesc
Facility Reporting Group1FacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1st peter's hospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://www.stpetes.org/CHNAOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttps://www.stpetes.org/CHIPStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care175.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care250.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART VI SECTION C FOR URLFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART VI SECTION C FOR URLFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART VI SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5A consultant was engaged to facilitate the community needs assessment through use of an online key informant survey. The key informants represented physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. These key informants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. Through this process, input was gathered from several individuals whose organizations work with low-income, minority populations (including African American, Hispanic and Native Americans, Asians, Chinese, and Korean, the disabled, dual-language learners, the elderly, ESL, ethnic/racial, European, foster children, the homeless, the indigent, those with insurance barriers, Latin Americans, LGBT, low-income, Medicare/Medicaid recipients, mentally ill/disabled, minorities, Nigerians, Pacific Islanders, rural populations, single mothers, uninsured/underinsured, women, youth), or other medically underserved populations (including adolescents residing in local group homes, adults, those with autism, children with special education services, those with chronic health conditions, those in crisis, disabled, elderly, ethnic/racial, foster children, high-risk mothers and infants, the homeless, those in jail, LGBT, low-income/poverty, Medicare/Medicaid, mentally ill/disabled, minorities, Native Americans, neglected children, parents with young children, people visiting community health centers, pre-release citizens, those recovering from addiction, teen mothers, those with trauma, underinsured/uninsured, undocumented, veterans, women, youth). In the online survey, key informants were asked to rate the degree to which various health issues are a problem in their own community. Follow-up questions asked them to describe why they identify problem areas as such, and how these might be better addressed. Final participation included representatives of the organizations outlined below. 5th Avenue Advertising Area IV Agency on Aging AWARE, Inc. Bike Walk Helena Bike Walk Montana Carroll College (and Wellness Center) Child Care Partnerships City of East Helena/City of Helena City of Helena Community Development Department City of Helena Public Works Cooperative HealthHealthcare for the Homeless Department of Community Development and Planning Department of Environmental QualityRemediation Division Disability Rights Montana ExplorationWorks Science Center Family Promise of Greater Helena Florence Crittenton Home and Services Healthy Mothers Healthy Babies, The Montana Coalition Helena Area Chamber of Commerce Helena Business Improvement District Helena Citizens Council Helena College | University of Montana Helena Family YMCA Helena Food Share Helena Housing Authority Helena Police Department Helena Public Schools Helena United Methodist Ministries House of Representatives HPC Kalmore Dental Lewis and Clark Conservation District Montana Independent Living Project Montana Mental Health Ombudsman Office Montana No Kid Hungry Montana Public Health Laboratory Montana School Services Foundation Montana State Legislature Montana United Indian Association Morrison Maierle, Inc. Mountain View Family Health Care MT Head Start Association PureView Health Center Rocky Mountain Development Council Senior Companion Program Safe Routes to School Committee Sodexo School Services K-12 South Hills Internal Medicine SPH Board Member St. Peters Hospital St. Peters Medical Group State of Montana, Department of Environmental Quality The Friendship Center The National Alliance on Mental IllnessHelena United Way of the Lewis and Clark Area Youth Connections Coalition YWCA of Helena
SCHEDULE H, PART V, SECTION B, LINE 11St. Peter's 2015 CHNA identified the following health needs: 1) Access to Health Care Services; 2) Cancer; 3) Heart Disease & Stroke; 4) Injury & Violence; 5) Mental Health; 6) Nutrition, Physical Activity, & Weight; 7) Potentially Disabling Conditions (i.e. back pain, hearing); 8) Respiratory Diseases; and 9) Substance Abuse. Through the 2016 Community Health Improvement Plan (CHIP), developed in partnership with Lewis and Clark County Public Health and other community health partners, all of these priority needs are being addressed by St. Peter's directly or in partnership with other community organizations. 1) Assisting the community with navigating the healthcare system by educating community on advanced practitioners in order to increase utilization; hiring an Emergency Room case manager to help establish a source of primary care for frequent users of the ER; 2) Improve lifestyle and behavioral factors that contribute to cancer through education opportunities, such as chronic disease mgmt, tobacco cessation, Inch by Inch program courses as well as community education through large events, screenings, and lectures; 3) Same as #2; 4) St. Peter's is not addressing directly as SPH does not have resources or programs to effectively address violence issues; however SPH does partner with outside agencies (Public Health, law enforcement, local social welfare agencies) when appropriate for patients; 5) Increasing mental health providers in the county, most recently with additional psychiatrist signed March 2017; 6) Same as #2; 7) Same as #2; 8) Same as #2; 9) St. Peter's Pharmacy actively involved in the creation of the statewide Prescription Drug Registry; also working towards becoming a certified dropoff location for the safe disposal of unused prescription meds in order to prevent prescription drug abuse.
SCHEDULE H, PART V, SECTION B, LINE 16A-16CTHE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP IS MADE AVAILABLE ON THE HOSPITAL'S WEBSITE: https://www.stpetes.org/patient-assistance
SCHEDULE H, PART V, SECTION B, LINE 16IPATIENTS RECEIVE NOTIFICATION OF THE FINANCIAL ASSISTANCE POLICY UPON DISCHARGE AS WELL AS IN THEIR PATIENT STATEMENTS.
SCHEDULE H, PART V, SECTION B, LINE 22DPatients whose family income is above 175% but not more than 250% of the FPL are eligible to receive a discount of 50% of their account balance. This discount exceeds amounts generally billed (AGB) from Medicare, Medicaid and all private insurance. AGB is computed using the look back method utilizing a once a year review of the prior calendar year data and is available upon request. This percentage which was computed in March of 2016 was 55.14%.
SCHEDULE H, PART V, SECTION B, LINE 6BST. PETER'S HOSPITAL COLLABORATED WITH LEWIS AND CLARK PUBLIC HEALTH TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT.
FieldValueIRS element (for citing)
Facility4FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
HOSPICE & HOMELINK OF ST PETERS HOSPITAL
201 SOUTH CALIFORNIAHELENAMT59601HOSPICE AND HOME HEALTH
APEX OF ST PETERS HOSPITAL
201 SOUTH CALIFORNIAHELENAMT59601HOME OXYGEN SERVICES
ST PETER'S MEDICAL GROUP BROADWAY
2550 BROADWAYHELENAMT59601PHYSICIAN CLINIC
ST PETER'S MEDICAL GROUP NORTH
3330 PTARMIGAN LANEHELENAMT59602PHYSICIAN CLINIC

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7The organization used an internal cost allocation system for lines 7a, 7b and 7g. The cost allocation system addresses all patient segments. The costs are estimated by allocating departmental costs based on direct costs less any other operating revenue, then by doing an allocation of benefits, depreciation and other overhead costs. The information for lines 7e, 7f, and 7i was derived from information in the general ledger and other financial data related specifically to the various types of community benefits.
SCHEDULE H, PART I, LINE 7GSubsidized health services include physician clinics that provide care during extended hours and on weekends, as well as provide specialties that are only offered at these locations. The total costs related to the physician clinics included on line 7g are $34,226,724, with direct offsetting revenue of $28,402,364, resulting in a net community benefit expense of $5,824,360.
SCHEDULE H, PART I, LINE 7, COLUMN FThe amount of bad debt, which also include the organization's share of joint ventures bad debt that are removed from the denominator of this calculation are $11,761,196.
SCHEDULE H, PART III, Section A, LINE 2The Hospital analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. Bad debt expense is reported at charges as recorded by the organization. Bad debt expense is reported net of discounts and contractual allowances. A payment on an account previously written off reduces bad debt expense in the current year.
SCHEDULE H, PART III, Section A, LINE 4The footnote to the organization's financial statements that describes bad debt expenses is located in footnote 1 on page 10 of the attached financial statements.
SCHEDULE H, PART III, Section B, LINE 8No allocation of the Medicare shortfall was treated as a community benefit. The organization utilizes an internal cost allocation system. The costs are estimated by allocating departmental costs based on direct costs less any other operating revenue, then by completing an allocation of benefits, depreciation and other overhead costs.
SCHEDULE H, PART III, Section C, LINE 9bSt. peter's hospital recognizes its responsibility to render necessary health care services to all persons in need of such care, regardless of race, creed, color or economic circumstances. St. peter's hospital recognizes that payment for services rendered is due and payable at the time of service. The hospital accepts insurance assignments and some other approved arrangements for delayed payment. Financial assistance is available for all qualified patients. Patients not covered by insurance or unable to pay in full for services rendered must contact the appropriate patient account representative who will assist the patient and/or family in determining if he/she qualifies for patient assistance. Collection activity will be suspended while a financial assistance application is under review.
SCHEDULE H, PART VI, LINE 2Need Assessment: St. Peter's Hospital conducts a community survey every three years. The community survey is performed by an independent contractor that selects an adequate sample size for the area. The homes of St. Peter's Hospital employees are excluded from the survey. The survey includes questions related to evaluating the community's experience and ability to access healthcare. The survey helps to identify specialty areas of concern. The results of the surveys are reviewed by the senior management team as well as the Board to identify the areas of focus. In 2015, the St. Peter's Board of Directors, made up of community members, physicians, and senior management, and worked with a consultant to develop St. Peter's Community Health Improvement Plan (CHIP). Based on the findings of the Community Health Needs Assessment (CHNA), the Board and its Community Relations Committee prioritized community health needs for the organization. The Community Relations Committee represents a broad range of community interests and gives final approval of the CHNA and CHIP. The Public Relations and Marketing Department is responsible for the facilitation and implementation of the CHNA and CHIP. During 2015, the combined community and committee continued to work on the various aspects of the report.
SCHEDULE H, PART VI, LINE 3Patient Education Eligibility for assistance: St. Peter's Hospital (1) posts its Charity Care Policy on its website as well as at the admitting desk, emergency room, on the monthly statements and cashier areas in which eligible patients are likely to be present, (2) offers a summary of our policy and application to self-pay patients with contact information to patients as part of the intake process, (3) provides a copy of financial assistance contact information to patients with discharge materials, (4) Financial Counselors discuss with patients expecting to owe more than $500, the availability of patient assistance and various Government benefits, such as Medicaid or State Programs, and assists the patient with qualification for such programs, where applicable.
SCHEDULE H, PART VI, LINE 4Community Information: St. Peter's Hospital is a 123-bed Acute Care Hospital Facility serving residents of Lewis and Clark County and portions of Jefferson, Broadwater, Meagher, and Powell Counties. St. Peter's is the sole facility in the primary services area. The Hospital Financial Payor Mix consisted of 3.9% self-pay patients, 9.8% of Medicaid patients and 47.9% Medicare patients. Approximately 17.9% of the population is age 65 and older. The average per capita income is $28,165 and approximately 12.34% of the population is below the Federal Poverty Level. The nearest hospital in the area is approximately 35 miles from the St. Peter's Campus.
SCHEDULE H, PART VI, LINE 5Promotion of community health: The Organization's Governing Body Members reside in the community. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are used to make capital purchases and upgrades to the Facilities. St. Peter's Hospital is the sole Acute Care Provider in the Primary Service Area, and operates an emergency room and two urgent care clinics. The primary service area is made up of Lewis and Clark County and the Northern portion of Jefferson County. There is a population of approximately 79,135. Out-Migration is generally limited to tertiary services not available at St. Peter's Hospital including, Cardiac Surgery and Neo-Natal Care. St. Peter's Hospital provides care to all patients regardless of their ability to pay. St. Peter's Hospital maintains charges as one of the lowest hospitals within the state depending on the services being provided. St. Peter's Hospital sponsors several wellness screenings, health fairs, and educational lectures, classes, and events throughout the year to promote better living, nutrition and good health. St. Peter's (SPH) ensures that its patients, their families and personnel have spiritual care available to them. SPH respects Native-American culture and the ceremonies that are important to meet the spiritual and cultural needs and promote optimal healing of Native- American patients. In order to ensure a patient's right to access these ceremonies, a procedure has been put in place. Continuing education is also provided to members of the medical community on an on-going basis. In addition, St. Peter's Hospital had 14,131 volunteer hours from the community assisting in a variety of roles within the organization. St. Peter's Hospital made $108,237 of cash and in-kind donations to a variety of organizations within the community. This includes, but is not limited to, The Montana Race for the Cure, Helena YMCA, Florence Critten Home, Montana Senior Olympics, American Cancer Society Relay for Life, Rocky Mountain Development Council, Susan G Komen Foundation, March of Dimes, Carroll College Fitness Center, Helena Schools,Helena Police Department Training, Carroll College Athletics with Emergency Services at Events, United Way to assist low-income and homeless residents with basic needs, Spirit of Service Campaign by providing supplies and volunteers to help elderly residents and others with special needs improve their homes and yards and Youth Foundation. The donations were made to assist these community sponsors in their various programs.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmt
ST PETERS HOSPITAL FOUNDATION
2475 BROADWAYHELENAMT59601810392270501(c)(3)$24,000
Carroll College
1601 North Benton AvenueHelenaMT59625810231774501(c)(3)$20,000
HELENA POLICE DEPARTMENT
221 BRECKENRIDGEHELENAMT59601816001276govt$10,000
HELENA FOOD SHARE
1616 Lewis StreetHELENAMT59624363507623501(c)(3)$20,000
FieldValueIRS element (for citing)
Total501c3 Org4Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Question 2FormAndLineReferenceDesc
ExplanationORGANIZATION'S PROCEDURES FOR MONITORING USE OF GRANT FUNDS: SUPPORT IS PROVIDED TO ST. PETERS HOSPITAL FOUNDATION, A RELATED ORGANIZATION, FOR THE FOUNDATION'S EMPLOYEE EMERGENCY ASSISTANCE FUND. MONITORING IS DONE BY COMMITTEES THAT MEET INFORMALLY WHEN THERE ARE REQUESTS BY STAFF FOR ASSISTANCE. THE REQUESTS ARE REVIEWED BY THE COMMITTEE TO DETERMINE IF THEY ARE ELIGIBLE, WHETHER THEY HAVE FREQUENT REQUESTS, AND IF THE NEED IS SUCH THAT THE FUNDS SHOULD BE GRANTED. THE ORGANIZATION ALSO PROVIDES SUPPORT TO A VARIETY OF ORGANIZATIONS WITHIN THE COMMUNITY TO ASSIST THEM IN THEIR VARIOUS PROGRAMS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
NATHAN OLSON
CEO$487,457$0$199,648$0$1,586$0$1,033,902$0$5,536$0$1,728,129$0$0$0
JOHN GREEN
CFO$230,800$0$62,379$0$22,469$0$49,633$0$10,685$0$375,966$0$22,081$0
ANN KJOSA
COO/CXO$228,035$0$62,836$0$588$0$49,484$0$9,731$0$350,674$0$21,233$0
JOHN GALT MD
BOARD MEMBER/CHIEF OF STAFF$410,837$0$2,000$0$315$0$23,892$0$8,774$0$445,818$0$0$0
THOMAS WEINER
MD$1,763,986$0$0$0$0$0$30,449$0$9,186$0$1,803,621$0$0$0
MICHAEL LEE
MD$641,963$0$55,417$0$282$0$9,428$0$4,045$0$711,135$0$0$0
JAMES TARVER
MD$542,427$0$0$0$282$0$15,900$0$294,774$0$853,383$0$0$0
EDWARD CURRY
MD$518,965$0$0$0$282$0$15,900$0$6,905$0$542,052$0$0$0
JUSTIN THOMAS
MD$581,318$0$2,100$0$315$0$33,900$0$8,791$0$626,424$0$0$0
MARIA BRAMAN - VP OF MEDICAL
STAFF THROUGH 03/2016$235,377$0$30,000$0$72,069$0$14,600$0$8,401$0$360,447$0$27,678$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1AINFORMATION REGARDING BENEFITS PROVIDED: THE PRESIDENT/CEO RECEIVES REIMBURSEMENT FOR MEMBERSHIP DUES PAID TO A SOCIAL CLUB. THE PRESIDENT/CEO IS ALSO PROVIDED TRAVEL FOR A COMPANION FOR ONE BUSINESS FUNCTION PER YEAR. ALL AMOUNTS ARE REPORTED AS TAXABLE COMPENSATION.
SCHEDULE J, PART I, LINE 4ASEVERANCE: Maria Braman received severance payments in the amount of $47,053 during 2015. This amount is reported as Other reportable compensation on Schedule J, Part II, column B(iii).
SCHEDULE J, PART I, LINE 7NON-FIXED PAYMENTS: THE ORGANIZATION HAS INCENTIVE BONUS POLICIES FOR EXECUTIVES, ALL OF WHICH HAVE SPECIFIC METRICS THAT MUST BE MET IN ORDER TO BE PAID OUT. NOT ALL INCENTIVES THAT ARE ACCRUED AT FYE ARE PAID OUT WITHIN 2.5 MONTHS AFTER YEAR END. THE FOLLOWING INDIVIDUALS DID NOT RECEIVE THEIR INCENTIVE PAYOUTS WITHIN THAT TIME, THEREFORE AN ACCRUAL WAS MADE FOR 7 MONTHS OF THE INCENTIVE WHICH COVERED THE TIMEFRAME 6/1/2015 - 12/31/2015. THE ACCRUAL APPEARS UNDER OTHER DEFERRED COMPENSATION UNDER SCHEDULE, J, PART II, COLUMN C. - JOHN GREEN $27,909 - ANN KJOSA $26,968

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
MONTANA FACILITY FINANCE AUTHORITY
A3646151552013-03-13$21,435,000REFINANCE 2004 BOND SERIESfalsefalsefalse
MONTANA FACILITY FINANCE AUTHORITY
B3646151552015-04-29$14,945,000REFINANCE 2007 BOND SERIESfalsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtUnspentUnspentAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$3,675,000$0$21,435,064$0$0$0$349,297$0$0$0$21,085,767$02013falseYes (true)Yes (true)Yes (true)
B$0$0$14,945,000$0$0$14,691,787$253,213$0$0$0$0$02015falseYes (true)Yes (true)Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndChange In Use Bond Financed PropChangeInUseBondFinancedPropPctRemedial Action TakenRemedialActionTakenIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
AfalseYes (true)falsefalse0.000000.000000.00000falsefalse0.00000falseYes (true)
BfalseYes (true)falsefalse0.000000.000000.00000falsefalse0.00000falseYes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndBusiness Name Line1GICProviderName/BusinessNameLine1TxtGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateInd
0
AfalseYes (true)falsefalsefalse0falseYes (true)
0
Bfalsefalsefalsefalsefalse0falseYes (true)Yes (true)false

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE K, PART IV, LINE 2CTHE REBATE COMPUTATION FOR THE 2013 BOND ISSUE IN COLUMN A WAS PERFORMED ON JULY 22, 2014 FOR THE PERIOD FROM MARCH 13, 2013 THROUGH JUNE 1, 2014.
SCHEDULE K, PART III, LINE 4 & 5THERE IS A SMALL AMOUNT OF USE OF THE FINANCED PROPERTY BY HEALTH CARE ORGANIZATIONS OTHER THAN A 501(C)(3) ORGANIZATION, BUT THE USE QUALIFIED FOR AN EXCEPTION TO UBI, THEREFORE IS NOT CONSIDERED PRIVATE BUSINESS USE.

Schedule L IRS990ScheduleL

FieldValueIRS element (for citing)
Total Balance Due$0TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonFAITH KJOSAPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionSEE PART VRelationshipDescriptionTxt
Transaction$40,805TransactionAmt
TransactionEMPLOYMENT WAGESTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE L, PART IV, COLUMN BFormAndLineReferenceDesc
ExplanationRELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: FAITH KJOSA RECEIVED COMPENSATION FROM THE ORGANIZATION AS AN EMPLOYEE. FAITH IS A FAMILY MEMBER OF ANN KJOSA, WHO IS AN OFFICER OF THE ORGANIZATION.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 9Addresses of those Who Cannot be Reached at Organization's Mailing Address: NATE OLSEN - 2745 HELMSDALE DRIVE COLORADO SPRINGS, CO 80920 ANN KJOSA - 4284 COUNTRY VIEW DRIVE HELENA, MT 59602 MARIA BRAMAN - 205 ROCKRIDGE RD HAZARD, KY 41701
FORM 990, PART VI, SECTION B, LINE 11BProcess to Review the Form 990: A DRAFT OF THE FORM 990 IS REVIEWED BY THE CEO, CFO AND FINANCE COMMITTEE. A COPY OF THE FINAL FORM 990 IS PROVIDED TO THE FULL BOARD FOR APPROVAL PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CProcess for Monitoring Compliance with Conflict of Interest Policy: THE CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS, OFFICERS, SENIOR ADMINISTRATION AND KEY EMPLOYEES. THE BOARD IDENTIFIES POTENTIAL CONFLICTS AND DETERMINES IF VOTING ON RELATED ITEMS WOULD BE A CONFLICT OF INTEREST. IF A CONFLICT IS DETERMINED TO EXIST, THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE CONFLICTED ITEM.
FORM 990, PART VI, SECTION B, LINE 15A & 15BReview of CEO and Other Officer or Key Employees Compensation: AN INDEPENDENT COMPENSATION CONSULTANT PERFORMS A REVIEW OF SALARIES AND BENEFITS USING DATA FROM COMPARABLE HEALTHCARE FACILITIES. A REPORT IS PREPARED AND PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, WHICH USES THE REPORT TO DETERMINE EXECUTIVE AND OTHER OFFICER AND SENIOR MANAGEMENT COMPENSATION. THE INFORMATION IS THEN REVIEWED WITH THE BOARD OF DIRECTORS. THE ANNUAL PROCESS WAS PERFORMED DURING 2015.
FORM 990, PART VI, SECTION C, LINE 19Governing Documents Available to the Public: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS: CHANGE IN INTEREST IN SPH FOUNDATION 147,478 MINIMUM PENSION LIABILITY ADJUSTMENT 5,672,245 TOTAL 5,819,723

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1ST PETERS HOSPITAL FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12475 BROADWAYAddressLine1Txt
CityHELENACityNm
State AbbreviationMTStateAbbreviationCd
ZIP59601ZIPCd
FieldValueIRS element (for citing)
EIN810392270EIN
Primary ActivitiesFUNDRAISINGPrimaryActivitiesTxt
Legal Domicile StateMTLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity Statusline 7PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SPCHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (true)ControlledOrganizationInd

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndUBI Code VUBICodeVAmtGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
PEAK HEALTH LLC
2475 BROADWAYHELENAMT59601271863807HEALTH CLUBMTSPCHUNRELATED$8,882$2,030,522false$0false0.65000
PEAK HEALTH REALTY LLC
2475 BROADWAYHELENAMT59601272492966RENTAL PROPERTYMTSPCHUNRELATED-$101,397$5,181,347false$0false0.65000
PEAK HEALTH HELENA LLC
2475 BROADWAYHELENAMT59601272493096HEALTH CLUBMTSPCHUNRELATED$370,648$480,037false$0false0.65000
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ST PETERS HOSPITAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeCTransactionTypeTxt
Involved$351,927InvolvedAmt
Method Of Amount DeterminationINTERCO AMOUNTMethodOfAmountDeterminationTxt