2017-04-15T11:55:03-05:00 2016-05-31 BKD LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2015-06-01 810233121 St Peter's Community Hospital % JOHN GREEN CFO STPE 4064422480 2475 Broadway Helena MT 59601 JOHN GREEN CFO 4064422480 2017-04-18 true David S Mason CPA P00137279 7194714290 2015 2021-01-29 14:40:06Z ST PETER'S HOSPITAL FRED OLSON 2475 Broadway Helena MT 59601 270762341 false X STPETES.ORG X 1883 MT PROVIDE EXCEPTIONAL AND COMPASSIONATE HEALTH CARE. 13 10 1520 170 550678 1272510 604080 191730710 206562128 8198670 327669 2361238 2021008 203563128 209514885 132777 81800 0 0 89300453 95328452 0 0 383746 98246328 107792510 187679558 203202762 15883570 6312123 289326725 298572660 79251655 87784901 210075070 210787759 X ST. PETERS HOSPITAL PARTNERS WITH OUR PATIENTS, COMMUNITY, AND MEDICAL STAFF TO PROVIDE EXCEPTIONAL AND COMPASSIONATE HEALTH CARE. false false 136817632 81800 163527730 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 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. 35585558 0 43746396 The 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. 172403190 true true false true false false false false false true true false false true true false false true false false false false false false false false true true true false true true false false false false false false false false true false false false false false false true true true false true 194 0 true 1520 true true true false false false false false true 1 false false false X 13 10 false false false false false false false true true true false true true true true true true true true true true MT X JOHN GREEN CFO 4064422480 2475 BROADWAY HELENA MT 59601 X NATHAN OLSON CEO 39.0 1.0 X X 688691 0 1039438 GUY ALMQUIST TREASURER 1.0 0.0 X X 0 0 0 GEORGE 'RUSS' BELL BOARD MEMBER THROUGH 12/2015 1.0 1.0 X 0 0 0 DUANE BRUCE BOARD MEMBER 1.0 0.0 X 0 0 0 JOHN GALT MD BOARD MEMBER/CHIEF OF STAFF 40.0 0.0 X 413152 0 32666 MICHAEL S HAY MD BOARD MEMBER THROUGH 03/2016 1.0 0.0 X 19724 0 0 MICK ROBINSON BOARD MEMBER 1.0 0.0 X 0 0 0 GAYLE SHIRLEY BOARD MEMBER 1.0 0.0 X 0 0 0 ROGER STONE BOARD MEMBER THROUGH 12/2015 1.0 0.0 X 0 0 0 THOMAS A STRIZICH MD - BOARD MEMBER/PAST CHIEF OF STAFF 1.0 0.0 X 0 0 0 MARK TAYLOR CHAIR 1.0 0.0 X X 0 0 0 KAREN Z HICKS BOARD MEMBER 1.0 0.0 X 1350 0 0 ANDREW MALANY MD - BOARD MEMBER/CHIEF OF STAFF - ELECT 1.0 0.0 X 29492 0 0 WILLIAM T NORTHEY PAST CHAIR 1.0 0.0 X 1024 0 0 KELLY PARSLEY BOARD MEMBER 1.0 0.0 X 0 0 0 RANDY RILEY BOARD MEMBER 1.0 0.0 X 0 0 0 JOHN GREEN CFO 40.0 0.0 X 315648 0 60318 ANN KJOSA COO/CXO 40.0 0.0 X 291459 0 59215 MARIA BRAMAN - VP OF MEDICAL STAFF THROUGH 03/2016 40.0 0.0 X 337446 0 23001 THOMAS WEINER MD 40.0 0.0 X 1763986 0 39635 MICHAEL LEE MD 40.0 0.0 X 697662 0 13473 JAMES TARVER MD 40.0 0.0 X 542709 0 310674 EDWARD CURRY MD 40.0 0.0 X 519247 0 22805 JUSTIN THOMAS MD 40.0 0.0 X 583733 0 42691 6205323 0 1643916 92 false true false HORIZON MENTAL HEALTH MANAGEMENT 1965 LAKE POINT DR SUITE 100 LEWISVILLE TX 75057 MANAGEMENT SERVICES 3516298 ARUP LABORATORIES PO BOX 27964 SALT LAKE CITY UT 84127 REFERENCE LAB 682921 CAPITAL MEDICAL ANESTHESIA PO BOX 5179 HELENA MT 596045179 ANESTHESIA COVERAGE 701230 GE HEALTHCARE PO BOX 414-SN471 MILWAUKEE WI 53201 BIOMEDICAL SERVICES 1099366 SIEMENS MEDICAL SOLUTIONS 51 VALLEY STREAM PARKWAY MALVERN PA 19355 PREV MAINT AGREEMENT 2081264 45 347427 151353 105300 604080 PATIENT SERVICE REVENUE 621110 133134516 133134516 PHARMACY 446110 71775155 71618059 157096 INCOME FROM JOINT VENTURES 900099 1312440 1043200 269240 MEANINGFUL USE PAYMENTS 621110 204946 204946 PATIENT CENTERED MEDICAL HOME PAYMENTS 621110 102356 102356 32715 32715 206562128 2631914 2631914 0 0 298462 186320 112142 0 112142 112142 57969870 721079 60006194 989000 -2036324 -267921 -2304245 -2304245 0 0 118732 65942 52790 52790 OTHER INCOME 900099 618223 448045 102941 67237 CAFETERIA 722514 808181 15658 792523 DAYCARE FOR EMPLOYEES 624110 290061 5743 284318 139611 139611 1856076 209514885 206723448 550678 1636679 81800 81800 0 0 0 3614245 1545707 2068538 0 40805 40805 72245674 58879086 13174479 192109 6792419 5699767 1078468 14184 7758444 6381444 1363366 13634 4876865 4083249 785157 8459 0 276501 276501 66610 66610 67143 67143 0 597142 597142 21197751 14764002 6428506 5243 226045 67385 149194 9466 4556118 3244216 1303490 8412 19666 4790 14876 0 1954071 1688409 245798 19864 237676 128669 108267 740 0 299988 172132 127856 769248 653861 107695 7692 0 9825913 8441286 1285318 99309 2712968 2534394 177667 907 MEDICAL SUPPLIES/DRUGS 49217042 49217042 BAD DEBT EXPENSE 11641686 11641686 BED TAX 1545300 1545300 CAFETERIA/FOOD 909763 797286 108968 3509 1671879 831679 839982 218 203202762 172403190 30415826 383746 X 20440051 28079540 4180182 7991682 0 0 29137457 30445906 12256 0 0 0 3007998 3315074 4184063 4199383 2586327 4321631 185245778 96595993 92058663 88649785 110249527 103137359 3239226 8194087 2597393 2087330 0 0 17633582 18150883 289326725 298572660 19246112 23237323 0 0 0 0 34470000 32705000 0 0 0 0 0 0 0 0 25535543 31842578 79251655 87784901 X 195980647 196607823 5591847 5724253 8502576 8455683 210075070 210787759 289326725 298572660 X 6312123 220289 -5819723 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false true 100 false false true 900 false true 66143 67143 false SCHEDULE C, PART II-B, LINE 1 DESCRIPTION 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. 13102447 55722 -120076 -16531 13054624 12693936 127333 369446 88268 13102447 11606682 393168 968936 274850 12693936 10598351 64337 979412 35418 11606682 10709927 489607 -542431 58752 10598351 0.05480 0.40710 0.64770 false true true 2961630 2961630 97242765 35059062 62183703 81858197 60781025 21077172 3183186 755906 2427280 88649785 DUE FROM AFFILIATE 19969 INSURANCE RECEIVABLE 3600674 INVESTMENT IN SPH FOUNDATION 14055424 BOND ISSUANCE COSTS 474816 18150883 0 MALPRACTICE ACCRUAL 5267065 PENSION LIABILITY 26575513 31842578 191933385 220289 4500 252262 477051 191456334 597142 17461409 18058551 209514885 191220696 4500 252262 256762 190963934 597142 11641686 12238828 203202762 SCHEDULE D, PART V, LINE 4 Describe 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 2 UNCERTAIN TAX POSITIONS: Management has evaluated their income tax positions under the guidance included in asc 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. SCHEDULE D, PART XI, LINE 2D REVENUE ON BOOKS, NOT ON RETURN: COST OF GOODS SOLD 65,942 RENTAL EXPENSES NET WITH REVENUE 186,320 TOTAL 252,262 SCHEDULE D, PART XI, LINE 4B REVENUE 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 2D EXPENSE 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 4B EXPENSE ON RETURN, NOT ON BOOKS: PROVISION FOR BAD DEBTS NET WITH REVENUE ON FINANCIALS 11,641,686 true true X true true X true true true false true true 7413 8276338 4998877 3277461 0.01690 23636 16154069 14549038 1605031 0.00830 31049 24430407 19547915 4882492 0.02520 6192 929589 431751 497838 0.00260 1 1500 0 1500 205369 54091324 43369651 10721673 0.05530 35034 108237 0 108237 0.00060 246596 55130650 43801402 11329248 0.05850 277645 79561057 63349317 16211740 0.08370 true 11761196 69052569 82132038 -13079469 X true true HELENA SURGICENTER SURGERY CENTER 0.5 0.066 0.434 1 1 St peter's hospital 2475 broadway helena MT 59601 www.stpetes.org 13346 X X X PHYSICIAN CLINICS & URGENT CARE SERVICES 1 st peter's hospital false false true X X X X X X X X X 15 true false true true X https://www.stpetes.org/CHNA X true 15 true https://www.stpetes.org/CHIP false false true X 175. 250. X X true true X X true X SEE PART VI SECTION C FOR URL X SEE PART VI SECTION C FOR URL X SEE PART VI SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 A 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 11 St. 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-16C THE 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 16I PATIENTS RECEIVE NOTIFICATION OF THE FINANCIAL ASSISTANCE POLICY UPON DISCHARGE AS WELL AS IN THEIR PATIENT STATEMENTS. SCHEDULE H, PART V, SECTION B, LINE 22D Patients 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 6B ST. PETER'S HOSPITAL COLLABORATED WITH LEWIS AND CLARK PUBLIC HEALTH TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT. 4 HOSPICE & HOMELINK OF ST PETERS HOSPITAL 201 SOUTH CALIFORNIA HELENA MT 59601 HOSPICE AND HOME HEALTH APEX OF ST PETERS HOSPITAL 201 SOUTH CALIFORNIA HELENA MT 59601 HOME OXYGEN SERVICES ST PETER'S MEDICAL GROUP BROADWAY 2550 BROADWAY HELENA MT 59601 PHYSICIAN CLINIC ST PETER'S MEDICAL GROUP NORTH 3330 PTARMIGAN LANE HELENA MT 59602 PHYSICIAN CLINIC SCHEDULE H, PART I, LINE 7 The 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 7G Subsidized 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 F The 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 2 The 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 4 The 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 8 No 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 9b St. 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 2 Need 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 3 Patient 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 4 Community 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 5 Promotion 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. true ST PETERS HOSPITAL FOUNDATION 2475 BROADWAY HELENA MT 59601 810392270 501(c)(3) 24000 Carroll College 1601 North Benton Avenue Helena MT 59625 810231774 501(c)(3) 20000 HELENA POLICE DEPARTMENT 221 BRECKENRIDGE HELENA MT 59601 816001276 govt 10000 HELENA FOOD SHARE 1616 Lewis Street HELENA MT 59624 363507623 501(c)(3) 20000 4 0 Schedule I, Part I, Question 2 ORGANIZATION'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. X X true true X X X X X true false false false false false false true false NATHAN OLSON CEO 487457 0 199648 0 1586 0 1033902 0 5536 0 1728129 0 0 0 JOHN GREEN CFO 230800 0 62379 0 22469 0 49633 0 10685 0 375966 0 22081 0 ANN KJOSA COO/CXO 228035 0 62836 0 588 0 49484 0 9731 0 350674 0 21233 0 JOHN GALT MD BOARD MEMBER/CHIEF OF STAFF 410837 0 2000 0 315 0 23892 0 8774 0 445818 0 0 0 THOMAS WEINER MD 1763986 0 0 0 0 0 30449 0 9186 0 1803621 0 0 0 MICHAEL LEE MD 641963 0 55417 0 282 0 9428 0 4045 0 711135 0 0 0 JAMES TARVER MD 542427 0 0 0 282 0 15900 0 294774 0 853383 0 0 0 EDWARD CURRY MD 518965 0 0 0 282 0 15900 0 6905 0 542052 0 0 0 JUSTIN THOMAS MD 581318 0 2100 0 315 0 33900 0 8791 0 626424 0 0 0 MARIA BRAMAN - VP OF MEDICAL STAFF THROUGH 03/2016 235377 0 30000 0 72069 0 14600 0 8401 0 360447 0 27678 0 SCHEDULE J, PART I, LINE 1A INFORMATION 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 4A SEVERANCE: 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 7 NON-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 A MONTANA FACILITY FINANCE AUTHORITY 364615155 2013-03-13 21435000 REFINANCE 2004 BOND SERIES false false false B MONTANA FACILITY FINANCE AUTHORITY 364615155 2015-04-29 14945000 REFINANCE 2007 BOND SERIES false false false A 3675000 0 21435064 0 0 0 349297 0 0 0 21085767 0 2013 false true true true B 0 0 14945000 0 0 14691787 253213 0 0 0 0 0 2015 false true true true A false true false false 0.00000 0.00000 0.00000 false false 0.00000 false true B false true false false 0.00000 0.00000 0.00000 false false 0.00000 false true A false true false false 0 false 0 false true B false true false false false false 0 false 0 false true A true B true SCHEDULE K, PART IV, LINE 2C THE 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 & 5 THERE 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. 0 FAITH KJOSA SEE PART V 40805 EMPLOYMENT WAGES false SCHEDULE L, PART IV, COLUMN B RELATIONSHIP 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. FORM 990, PART VI, SECTION A, LINE 9 Addresses 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 11B Process 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 12C Process 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 & 15B Review 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 19 Governing 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 9 OTHER CHANGES IN NET ASSETS: CHANGE IN INTEREST IN SPH FOUNDATION 147,478 MINIMUM PENSION LIABILITY ADJUSTMENT 5,672,245 TOTAL 5,819,723 ST PETERS HOSPITAL FOUNDATION 2475 BROADWAY HELENA MT 59601 810392270 FUNDRAISING MT 501(C)(3) line 7 SPCH true PEAK HEALTH LLC 2475 BROADWAY HELENA MT 59601 271863807 HEALTH CLUB MT SPCH UNRELATED 8882 2030522 false 0 false 0.65000 PEAK HEALTH REALTY LLC 2475 BROADWAY HELENA MT 59601 272492966 RENTAL PROPERTY MT SPCH UNRELATED -101397 5181347 false 0 false 0.65000 PEAK HEALTH HELENA LLC 2475 BROADWAY HELENA MT 59601 272493096 HEALTH CLUB MT SPCH UNRELATED 370648 480037 false 0 false 0.65000 false true true true false false false false false false true false true true true true false false true ST PETERS HOSPITAL FOUNDATION C 351927 INTERCO AMOUNT