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STILLWATER HOSPITAL ASSOCIATION INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
STILLWATER HOSPITAL ASSOCIATION INC (EIN 81-0286525)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-05-03
IRS object ID
201631249349301338
Schema version
2014v6.0
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)
Return2016-05-03T14:08:09-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

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 Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN810286525EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Stillwater Hospital AssociationBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% TERESA GRAYSONInCareOfNm
Business Name ControlSTILBusinessNameControlTxt
Phone4063225316PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1710 N 11th StAddressLine1Txt
CityColumbusCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59019ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKELLEY EVANSPersonNm
Person TitleCHIEF ADMINISTRATIVE OFFICERPersonTitleTxt
Phone4063225316PhoneNum
Signature2016-04-27SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRita F Worster CPAPreparerPersonNm
PTINP00290681PTIN
Phone7194714290PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKELLY EVANS CAOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1710 N 11th StAddressLine1Txt
CityColumbusCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59019ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$9,560,773GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.stillwaterbillingsclinic.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1914FormationYr
Legal Domicile StateMTLegalDomicileStateCd
Activity Or MissionStillwater Hospital Association is a rural integrated health care organization bringing together a physician clinic & hospital svcs to deliver quality coordinated care.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee64TotalEmployeeCnt
Total Volunteers4TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$174,590PYContributionsGrantsAmt
CY Contributions Grants$420,175CYContributionsGrantsAmt
PY Program Service Revenue$7,940,608PYProgramServiceRevenueAmt
CY Program Service Revenue$9,049,799CYProgramServiceRevenueAmt
PY Investment Income$23,751PYInvestmentIncomeAmt
CY Investment Income$43,527CYInvestmentIncomeAmt
PY Other Revenue$29,910PYOtherRevenueAmt
CY Other Revenue$47,272CYOtherRevenueAmt
PY Total Revenue$8,168,859PYTotalRevenueAmt
CY Total Revenue$9,560,773CYTotalRevenueAmt
PY Grants And Similar Paid$6,625PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$5,385CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,620,149PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,691,464CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,084,073PYOtherExpensesAmt
CY Other Expenses$6,096,947CYOtherExpensesAmt
PY Total Expenses$8,710,847PYTotalExpensesAmt
CY Total Expenses$8,793,796CYTotalExpensesAmt
PY Revenues Less Expenses-$541,988PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$766,977CYRevenuesLessExpensesAmt
Total Assets BOY$17,294,868TotalAssetsBOYAmt
Total Assets EOY$17,570,478TotalAssetsEOYAmt
Total Liabilities BOY$14,836,193TotalLiabilitiesBOYAmt
Total Liabilities EOY$14,374,429TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,458,675NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,196,049NetAssetsOrFundBalancesEOYAmt
MissionSTILLWATER HOSPITAL ASSOCIATION IS A RURAL INTEGRATED HEALTH CARE ORGANIZATION BRINGING TOGETHER A PHYSICIAN CLINIC & HOSPITAL SERVICES TO DELIVER QUALITY COORDINATED CARE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$7,063,636ExpenseAmt
Grant$5,385GrantAmt
Revenue$9,089,413RevenueAmt
DescACUTE CARE HOSPITAL AND RURAL HEALTH CLINICDesc
Total Program Service Expenses$7,063,636TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
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 AssetsfalseReportOtherAssetsInd
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 OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
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 EntfalseRelatedOrganizationCtrlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document6IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee64EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
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 Members8GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
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 CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTERESA GRAYSONPersonNm
Phone4066574629PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12800 TENTH AVENUE NAddressLine1Txt
CityBillingsCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59107ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
John Hungerford
President3.00.0Yes (X)Yes (X)$0$0$0
Ron Martinez
Secretary/Treasurer3.00.0Yes (X)Yes (X)$0$0$0
Dr Kent Brown
Director3.00.0Yes (X)$0$0$0
Dr Richard Klee
Physician/Director40.03.0Yes (X)$0$253,666$36,377
Luke Kobold
Director3.040.0Yes (X)$0$150,267$31,737
Michael Matovich
Vice President3.00.0Yes (X)Yes (X)$0$0$0
Mike Follett
Director3.040.0Yes (X)$0$178,438$8,089
Dr Deborah Agnew
Physician/Director3.040.0Yes (X)$0$255,263$39,294
Tim Russell
CEO40.00.0Yes (X)$0$122,885$27,603
Kyle Gee
CFO40.010.0Yes (X)$0$291,232$66,628
Dr David Kane
Physician40.00.0$0$230,038$44,790Yes (X)
Lorraine Ackerman
Nurse Practitioner40.00.0$0$119,679$22,948Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,601,468TotReportableCompRltdOrgAmt
Total Other Compensation$277,466TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
BILLINGS CLINIC
2800 Tenth Avenue NorthBILLINGSMT59101management services$2,497,200
WILDERNESS MEDICAL STAFFING
PO BOX 616HOMERAK99603MEDICAL STAFFING$126,227
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$181,148GovernmentGrantsAmt
All Other Contributions$239,027AllOtherContributionsAmt
Total Contributions$420,175TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
PATIENT SERVICE REVENUE621300$9,042,141$9,042,141
MEALS900099$7,658$7,658
FieldValueIRS element (for citing)
Total Program Service Revenue$9,049,799TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$43,527TotalRevenueColumnAmt
Exclusion$43,527ExclusionAmt

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

Rental Income Or Loss RentalIncomeOrLossGrp

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

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

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

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

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

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS INCOMEDesc
Business900099BusinessCd
Total Revenue Column$47,272TotalRevenueColumnAmt
Related Or Exempt Func Income$47,272RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$47,272OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,560,773TotalRevenueColumnAmt
Related Or Exempt Func Income$9,089,413RelatedOrExemptFuncIncomeAmt
Exclusion$51,185ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$5,385TotalAmt
Program Services$5,385ProgramServicesAmt

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$464,503TotalAmt
Program Services$416,874ProgramServicesAmt
Management And General$47,629ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,877,616TotalAmt
Program Services$1,518,381ProgramServicesAmt
Management And General$359,235ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$22,779TotalAmt
Program Services$18,238ProgramServicesAmt
Management And General$4,541ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$179,418TotalAmt
Program Services$144,076ProgramServicesAmt
Management And General$35,342ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$147,148TotalAmt
Program Services$109,902ProgramServicesAmt
Management And General$37,246ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,779,368TotalAmt
Program Services$1,442,845ProgramServicesAmt
Management And General$336,523ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$679,603TotalAmt
Program Services$520,578ProgramServicesAmt
Management And General$159,025ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$25,290TotalAmt
Program Services$1,492ProgramServicesAmt
Management And General$23,798ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$214,790TotalAmt
Program Services$144,858ProgramServicesAmt
Management And General$69,932ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$228,568TotalAmt
Program Services$146,751ProgramServicesAmt
Management And General$81,817ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$64,332TotalAmt
Program Services$16,325ProgramServicesAmt
Management And General$48,007ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$836,098TotalAmt
Program Services$644,297ProgramServicesAmt
Management And General$191,801ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$962,080TotalAmt
Program Services$749,852ProgramServicesAmt
Management And General$212,228ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$103,264TotalAmt
Program Services$83,507ProgramServicesAmt
Management And General$19,757ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PROVISION FOR BAD DEBT$676,659$676,659
MEDICAL SUPPLIES$357,358$357,358
DIETARY$39,232$39,232
REPAIRS & MAINTENANCE$32,286$3,175$29,111

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$98,019TotalAmt
Program Services$23,851ProgramServicesAmt
Management And General$74,168ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,793,796TotalAmt
Program Services$7,063,636ProgramServicesAmt
Management And General$1,730,160ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$227,391BOYAmt
EOY$1,768,459EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$566,037BOYAmt
EOY$821,380EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,945,027BOYAmt
EOY$1,259,998EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$152,657BOYAmt
EOY$166,162EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$153,331BOYAmt
EOY$158,943EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$16,098,630LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,207,658LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$13,726,851BOYAmt
EOY$12,890,972EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$502,932BOYAmt
EOY$466,691EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$20,642BOYAmt
EOY$37,873EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$17,294,868BOYAmt
EOY$17,570,478EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$309,576BOYAmt
EOY$312,024EOYAmt

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$0BOYAmt
EOY$0EOYAmt

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$14,031,865BOYAmt
EOY$13,654,273EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$494,752BOYAmt
EOY$408,132EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,836,193BOYAmt
EOY$14,374,429EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,433,686BOYAmt
EOY$2,977,018EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,989BOYAmt
EOY$199,031EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,000BOYAmt
EOY$20,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,458,675BOYAmt
EOY$3,196,049EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,294,868BOYAmt
EOY$17,570,478EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$766,977ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$29,603NetUnrlzdGainsLossesInvstAmt
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 RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

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 D IRS990ScheduleD

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

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$33,990BeginningYearBalanceAmt
Contributions$194,042ContributionsAmt
Investment Earnings Or Losses$87InvestmentEarningsOrLossesAmt
End Year Balance$228,119EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$33,903BeginningYearBalanceAmt
Investment Earnings Or Losses$87InvestmentEarningsOrLossesAmt
End Year Balance$33,990EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$33,802BeginningYearBalanceAmt
Investment Earnings Or Losses$101InvestmentEarningsOrLossesAmt
End Year Balance$33,903EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$0BeginningYearBalanceAmt
Contributions$34,397ContributionsAmt
Other Expenditures$595OtherExpendituresAmt
End Year Balance$33,802EndYearBalanceAmt
FieldValueIRS element (for citing)
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
Board Designated Balance EOY0.03980BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.08770PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.87250TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$558,194OtherCostOrOtherBasisAmt
Book Value$558,194BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,088,220OtherCostOrOtherBasisAmt
Depreciation$1,617,771DepreciationAmt
Book Value$10,470,449BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,449,482OtherCostOrOtherBasisAmt
Depreciation$1,332,746DepreciationAmt
Book Value$1,116,736BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,002,734OtherCostOrOtherBasisAmt
Depreciation$257,141DepreciationAmt
Book Value$745,593BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,890,972TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO RELATED ORGANIZATION$208,132
DUE TO MEDICARE$200,000
FieldValueIRS element (for citing)
Total Liability$408,132TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$8,885,960TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$29,603NetUnrealizedGainsInvstAmt
Other Revenue$31,449OtherRevenueAmt
Revenue Not Reported$1,846RevenueNotReportedAmt
Revenue Subtotal$8,884,114RevenueSubtotalAmt
Other Revenues Not Included$676,659OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$676,659RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$9,560,773TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$8,134,368TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$17,231OtherExpensesIncludedAmt
Expenses Not Reported$17,231ExpensesNotReportedAmt
Expenses Subtotal$8,117,137ExpensesSubtotalAmt
Other Expenses Not Included$676,659OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$676,659ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$8,793,796TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part V, line 4DESCRIBE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS: The endowment includes both donor-restricted endowment funds and funds designated by the governing body to function as endowments (board-designated endowment funds). As required by accounting principles generally accepted in the United States of America GAAP), net assets associated with endowment funds, including board-designated endowment funds, are classified and reported based on the existence or absence of donor-imposed 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 4BREVENUE ON RETURN, NOT ON BOOKS PROVISION FOR BAD DEBT NET WITH REVENUE ON FINANCIALS, TREATED AS EXPENSE ON RETURN 676,659
SCHEDULE D, PART XII, LINE 4BEXPENSE ON RETURN, NOT ON BOOKS PROVISION FOR BAD DEBT NET WITH REVENUE ON FINANCIALS, TREATED AS EXPENSE ON RETURN 676,659
SCHEDULE D, PART XI, LINE 2DREVENUE ON BOOKS, NOT ON RETURN: ACTIVITY OF STILLWATER FOUNDATION CONSOLIDATED IN FINANCIALS, EXCLUDED FOR TAX RETURN 31,449
SCHEDULE D, PART XI, LINE 2DEXPENSE ON BOOKS, NOT ON RETURN: ACTIVITY OF STILLWATER FOUNDATION CONSOLIDATED IN FINANCIALS, EXCLUDED FOR TAX RETURN 17,231

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
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
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)
Total Community Benefit Expns$88,578TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$88,578NetCommunityBenefitExpnsAmt
Total Expense0.01090TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$335,260TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$315,804DirectOffsettingRevenueAmt
Net Community Benefit Expns$19,456NetCommunityBenefitExpnsAmt
Total Expense0.00240TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$423,838TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$315,804DirectOffsettingRevenueAmt
Net Community Benefit Expns$108,034NetCommunityBenefitExpnsAmt
Total Expense0.01330TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$78,594TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$31,298DirectOffsettingRevenueAmt
Net Community Benefit Expns$47,296NetCommunityBenefitExpnsAmt
Total Expense0.00580TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,974TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,881DirectOffsettingRevenueAmt
Net Community Benefit Expns$93NetCommunityBenefitExpnsAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,985TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,985NetCommunityBenefitExpnsAmt
Total Expense0.00180TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$97,553TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$35,179DirectOffsettingRevenueAmt
Net Community Benefit Expns$62,374NetCommunityBenefitExpnsAmt
Total Expense0.00760TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$521,391TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$350,983DirectOffsettingRevenueAmt
Net Community Benefit Expns$170,408NetCommunityBenefitExpnsAmt
Total Expense0.02090TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$676,659BadDebtExpenseAmt
Reimbursed By Medicare$2,668,139ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$2,597,167CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$70,972MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost Accounting SystemYes (X)CostAccountingSystemInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Stillwater Hospital AssociationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1710 N 11th StAddressLine1Txt
CityColumbusCityNm
State AbbreviationMTStateAbbreviationCd
ZIP59019ZIPCd
FieldValueIRS element (for citing)
Website Addressstillwaterbillingsclinic.comWebsiteAddressTxt
State License13418StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Emergency Room OtherYes (X)EmergencyRoomOtherInd
OtherPHYSICIAN CLINICOtherDesc
Facility Reporting Group1FacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Stillwater Hospital AssociationBusinessNameLine1Txt
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 Conducted12CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLwww.stillwaterbillingsclinic.comOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt12ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLWWW.STILLWATERBILLINGSCLINIC.COMStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLsee part v section c for full urlFAPAppAvailableOnWebsiteURLTxt
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
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
None MadeYes (X)NoneMadeInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Average Negotiated RatesYes (X)AverageNegotiatedRatesInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5DESCRIBE HOW THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY: SURVEYS AND COMMUNITY MEETINGS WERE HELD, INCLUDING CORRESPONDENCE WITH PUBLIC HEALTH NURSE, SCHOOL NURSES, AND AMBULANCE CREW MEMBERS. Individuals from the following groups represented the community: Columbus EMS, Faith Community, Columbus Fire Department, Stillwater Chamber of Commerce, Stillwater County Mental Health Center, Stillwater/Sweet Grass Co-op, Stillwater Billings Clinic Community Health; Stillwater Co. Public Health Nurse, & Stillwater Billings Clinic Administration. THE MONTANA STATE UNIVERSITY OFFICE OF RURAL HEALTH EDUCATION CENTER ACCESSED AND ANALYZED THE DATA.
SCHEDULE H, PART V, SECTION B, LINE 11Stillwater Hospital Association continues to follow the Implementation Plan established in the 2013 Community Health Needs Assessment, in the following areas: 1. Ensuring access to Primary Care, but continued recruiting efforts for another Primary Care Physician and/or a Mid-level. The Hospital was successful in recently recruiting a full-time Physician Assistant with interests in Diabetes management and Preventive Care. 2. Working with Billings Clinic regarding increased scope and services for Specialty clinics, notably in General Surgery and Endoscopy. 3. Continued Healthier lifestyle awareness and education in the community, including event sponsorships and educational opportunities. 4. Working with Providers and the community on various topics including Diabetes management, education and training. Also, the hospital has a permanent Registered Dietitian who provides nutritional classes and education regularly. Needs not addressed in most recently conducted CHNA: The following needs were identified in the CHNA and were not able to be addressed due to lack of resources or budgetary limitations: Recruit a primary care provider to ensure access to primary care in the Stillwater County and the surrounding areas. Interviews are ongoing and previously interviewed candidates have declined this position. Create a communication/marketing strategy for targeted populations in the hospital's service area. This need has not been addressed as the marketing and social work position is still vacant. Explore sponsoring a "lunch and learn" program for community members on various health costs and insurance topics. The lunch and learn programs are still in the development phase.
SCHEDULE H, PART V, SECTION B, LINE 16bwebsite URL for FAP application form: http://stillwaterbillingsclinic.com/wp-content/uploads/Charity-care.pdf

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7, column fBad debt expense included on Form 990, part IX, line 25 but excluded for purposes of calculating percentages in this column equal $676,659.
SCHEDULE H, PART I, LINE 7THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A, 7B AND 7G. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. THE INFORMATION FOR LINES 7E 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 III, Section A, LINE 2Bad debt is estimated by actual write offs plus a reserve calculated using different percentages based on aging category of receivables.
SCHEDULE H, PART III, Section A, LINE 4See page 11 of the attached audited financial statements for the footnote that describes bad debt expense.
SCHEDULE H, PART III, Section C, LINE 9bPatients are screened by the organization's financial counselors to see if they qualify for financial assistance. If they qualify, their account balances are adjusted accordingly. If there is a balance after the adjustment, the organization follows the normal debt collection practice. In unusual situations where the patient's circumstances have changed, the CEO has the authority to grant exceptions to the policy.
SCHEDULE H, PART VI, LINE 2NEEDS ASSESSMENT: The organization assesses the health care needs of the communities it serves through day to day patient care and the work of the community health services department.
SCHEDULE H, PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: The Organization employs a Business office lead who is responsible for administering the Financial Assistance Program, assuring the determination for financial assistance meets the requirements of the policy, and notifying the patient and/or responsible party of the final determination of amounts approved under the policy. Patient representatives work with the patients in completing applications that determine eligibility for financial assistance under the hospital's financial assistance policy. Information is also in printed form on patient bills.
SCHEDULE H, PART VI, LINE 4COMMUNITY INFORMATION: Stillwater County stretches 75 miles of two lane roads from north to south connecting mountain ranges to the lake basins, coulees, and rolling plains. Interstate 90 passes through the County at Columbus. County has population of 9,185 with 6 unincorporated communities and 1 incorporated community of Columbus where the hospital resides. County has a vast array of outdoor recreational opportunities.
SCHEDULE H, PART VI, LINE 5Promotion of community health: Stillwater Hospital Association's Community health services department strives to provide broad-based community health information and services to the residents, facilities and guests of Stillwater County. The board has community members serving.
SCHEDULE H, PART VI, LINE 6Affiliated health care system: Stillwater Billings Clinic is managed by Billings Clinic and works closely with Billings Clinic and other hospitals also managed by Billings Clinic to provide high quality patient care.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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
Dr Richard Klee
Physician/Director$0$214,930$0$1,972$0$36,764$0$21,944$0$14,433$0$290,043$0$0
Luke Kobold
Director$0$140,367$0$9,900$0$0$0$13,040$0$18,697$0$182,004$0
Mike Follett
Director$0$154,082$0$24,356$0$0$0$5,254$0$2,835$0$186,527$0$0
Tim Russell
CEO$0$115,685$0$7,200$0$0$0$8,819$0$18,784$0$150,488$0$0
Kyle Gee
CFO$0$223,417$0$42,985$0$24,830$0$48,713$0$17,915$0$357,860$0$0
Dr David Kane
Physician$0$187,414$0$0$0$42,624$0$20,355$0$24,435$0$274,828$0$0
Dr Deborah Agnew
Physician/Director$0$255,263$0$0$0$0$0$20,231$0$19,063$0$294,557$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3DESCRIBE HOW CEO COMPENSATION IS DETERMINED: COMPENSATION FOR THE CEO IS PAID BY BILLINGS CLINIC, A RELATED ORGANIZATION. PLEASE SEE SCHEDULE O, PART VI, LINE 15A NARRATIVE FOR HOW CEO COMPENSATION IS DETERMINED.
SCHEDULE J, PART I, LINE 4B457(F) PLAN: The Billings Clinic supplemental retirement agreement for senior executives (SERP) is a non-elective 457(f) agreement and provides for annual deferrals, which become vested and payable after 4 years. Vesting will occur on January 1, 2017. Kyle Gee participated in the plan and a payment of $30,000 was made and is included in deferred compensation on Schedule J, Part II, column C.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, Line 6DESCRIBE CIRCUMSTANCES FOR HAVING MEMBERS: Billings Clinic is the sole member of Stillwater Hospital Association.
Form 990, Part VI, Section A, Line 7aMembers who can elect members of the governing body: The sole member has authority to recommend, approve and reject nominations of board members.
Form 990, Part VI, Section A, Line 7bDecisions of governing body subject to approval by members: The following are Governance decisions of the organization which are subject to approval by the sole member: - Amendments to the organization's articles of incorporation, bylaws, or name; - Dissolution, mergers, or consolidations with or into another entity; - Sale, lease, exchange or dispositions of property of the organization; - Approval of budgets; - Incurrence or debt and purchases made by the organization in amounts exceeding $100,000; - Selection, hiring, primary supervision, discipline and termination of the organization's Chief Executive Officer; - Addition or discontinuance of any service offered to by the organization
Form 990, Part VI, Section B, line 11bProcess to Review the Form 990: The form 990 is prepared by a third party and review is performed by the board of directors. Any changes and comments are provided back to the preparer and the final form 990 is provided to the full board prior to filing. The organization was provided an e-file submission form with the completed return which was signed and submitted for ERO processing.
Form 990, Part VI, Section B, line 12cProcess for Monitoring Compliance with Conflict of Interest Policy: All directors, officers, employees, and members of a committee with board delegated powers are covered by the conflict of interest policy and must provide an annual statement indicating they have reviewed and are in compliance with the policy. The board is charged with periodically reviewing and monitoring the policy to ensure the organization acts in a manner consistent with its charitable purpose. If a potential conflict is identified, the board will investigate any alternatives and determinations as to whether the transaction or arrangement is in the organizations best interest and will establish procedures for violations of the policy.
Form 990, Part VI, Section B, line 15aDescribe process for determining CEO/Executive compensation: Compensation is paid through Billings Clinic, the sole member. Compensation is determined by an annual review of external market data for similar size organizations through use of survey data with MHA and Yaffee & Company, and Rural CAH facilities. Compensation is reviewed and approved by the Board of Directors as recommended by the VP of Regional Services. The review is done at the time of the CEO's annual performance review.
Form 990, Part VI, Section B, line 15bDESCRIBE PROCESS FOR DETERMINING COMPENSATION OF OTHER OFFICERS: Other officer Compensation is paid through Billings Clinic, the sole member. Salaries for the other key officers/leaders in the organization are reviewed for comparison to other similar size organizations through use of external salary survey sources such as MHA and Associated Employers. This review is conducted by Stillwater's HR Generalist and the CEO. Budget recommendations are formulated for review and approval by the VP of Regional Services and for final approval by the Board of Directors/Finance Committee.
Form 990, Part VI, Section C, line 19DESCRIBE HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC: The organizations governing documents, conflict of interest policy, and financials statementS are available upon request.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Billings Clinic
2800 Tenth Avenue NorthBillingsMT59101810231784HOSPITALMT501(c)(3)LINE 3NAfalse
Billing Clinic Foundation
2917 Tenth Avenue NorthBillingsMT59101810407289FUNDRAISINGMT501(c)(3)LINE 7BILLINGSfalse
STILLWATER COMMUNITY HEALTHCARE FDN
710 N 11TH STCOLUMBUSMT59019200748325fundraisingMT501(c)(3)line 7billingsfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxt
New West Health Services
130 Neill AvenueHelenaMT59601841418136Insurance SalesMTBillings ClinicC-Corporation
Billings Clinic Express Care LLC
2800 10th Avenue northBilingsMT59101463355499Outpatient ClinicMTBillings ClinicC-Corporation
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 OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
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 OrgfalseRentalOfFcltsFromOthOrgInd
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 OrgfalseTransferFromOtherOrgInd