BILLINGS CLINIC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: BILLINGS CLINIC (EIN 81-0231784)
Tax period: 2013-07-01 to 2014-06-30
Filed: 2015-05-15
IRS object ID: 201501359349307170
Schema version: 2013v4.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-05-15T16:10:37-05:00	ReturnTs
Tax Period End	2014-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 South Tejon Suite 800	AddressLine1
City	Colorado Springs	City
State	CO	State
ZIP Code	809039848	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	810231784	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Billings Clinic	BusinessNameLine1

Field	Value	IRS element (for citing)
In Care Of	% CONNIE F PREWITT	InCareOfNm
Business Name Control	BILL	BusinessNameControlTxt
Phone	4062382500	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 Tenth Avenue North	AddressLine1
Address Line2	Suite	AddressLine2
City	Billings	City
State	MT	State
ZIP Code	59101	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Connie Prewitt	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	4062382500	PhoneNum
Signature	2015-05-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Rita F Worster CPA	PreparerPersonNm
PTIN	P00290681	PTIN
Phone	4062382500	PhoneNum

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Nicholas Wolter MD	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 Tenth Avenue North	AddressLine1
City	Billings	City
State	MT	State
ZIP Code	59101	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$1,299,990,646	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.billingsclinic.com	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1907	FormationYr
Legal Domicile State	MT	LegalDomicileStateCd
Activity Or Mission	Billings Clinic will be a national leader in providing the best clinical quality, patient safety, service and value.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	4225	TotalEmployeeCnt
Total Volunteers	325	TotalVolunteersCnt
Total Gross UBI	$8,577,231	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$691,062	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$6,635,189	PYContributionsGrantsAmt
CY Contributions Grants	$2,223,188	CYContributionsGrantsAmt
PY Program Service Revenue	$543,532,933	PYProgramServiceRevenueAmt
CY Program Service Revenue	$564,854,800	CYProgramServiceRevenueAmt
PY Investment Income	$6,855,638	PYInvestmentIncomeAmt
CY Investment Income	$15,284,806	CYInvestmentIncomeAmt
PY Other Revenue	$3,171,645	PYOtherRevenueAmt
CY Other Revenue	$11,240,694	CYOtherRevenueAmt
PY Total Revenue	$560,195,405	PYTotalRevenueAmt
CY Total Revenue	$593,603,488	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$759,754	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$299,067,297	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$302,242,677	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$338,073	CYTotalFundraisingExpenseAmt
PY Other Expenses	$246,649,815	PYOtherExpensesAmt
CY Other Expenses	$251,656,215	CYOtherExpensesAmt
PY Total Expenses	$545,717,112	PYTotalExpensesAmt
CY Total Expenses	$554,658,646	CYTotalExpensesAmt
PY Revenues Less Expenses	$14,478,293	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$38,944,842	CYRevenuesLessExpensesAmt
Total Assets BOY	$623,814,849	TotalAssetsBOYAmt
Total Assets EOY	$664,984,296	TotalAssetsEOYAmt
Total Liabilities BOY	$266,575,283	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$262,301,525	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$357,239,566	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$402,682,771	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	Billings Clinic is a not-for-profit, physician-led, multispecialty medical group practice integrated with a hospital and long term care facility, serving the communities of Montana, northern Wyoming and the western Dakotas. Our mission is health care, education and research.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$195,837,676	ExpenseAmt
Revenue	$320,481,062	RevenueAmt
Desc	Hospital patient care inpatient days 70,594	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$208,663,644	ExpenseAmt
Revenue	$224,630,592	RevenueAmt
Desc	Clinic patient care encounters 906,062	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$8,451,724	ExpenseAmt
Revenue	$7,911,010	RevenueAmt
Desc	Nursing home patient care skilled and assisted days 39,511	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$9,527,894	ExpenseAmt
Grant	$759,754	GrantAmt
Revenue	$22,585,905	RevenueAmt
Desc	Research, Regional & Other	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$9,527,894	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant	$759,754	TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue	$22,585,905	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$422,480,938	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (true)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (true)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	Yes (true)	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	167	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	4225	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	MT	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	CONNIE F PREWITT	PersonNm
Phone	4062382134	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 TENTH AVENUE NORTH	AddressLine1
City	Billings	City
State	MT	State
ZIP Code	59101	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Lil Anderson
Board Member	3.0	Yes (X)	$6,000
Darrell Ehrlick
Board Member	3.0	Yes (X)	$6,000
Elizabeth Fulton
Secretary	5.0	Yes (X)	$6,000	Yes (X)
David Brown
Vice Chair	5.0	Yes (X)	$6,000	Yes (X)
Robert N Hurd MD
Board Member, Physician	73.0	Yes (X)	$36,653		3.0	$402,041
Clayton H McCracken MD
Board Member, Physician	73.0	Yes (X)	$46,577			$365,937
J Scott Millikan MD
Chair, Physician	78.0	Yes (X)	$51,064	Yes (X)		$624,362
Penni Nance
Board Member	30.0	Yes (X)	$6,000
Joy Ott
Treasurer	5.0	Yes (X)	$6,000	Yes (X)	1.0
Aaron Sparboe
Board Member	3.0	Yes (X)	$6,000		1.0
Maria Valandra
Board Member	3.0	Yes (X)	$6,000
Nicholas Wolter MD
CEO	73.0	Yes (X)	$36,243	Yes (X)	3.0	$1,121,335	$0
Connie F Prewitt
CFO	70.0		$106,901	Yes (X)	1.0	$527,218
Randall K Gibb MD
Physician	70.0		$44,730			$1,057,594		Yes (X)
Scott A Sample MD
Physician	70.0		$46,724			$1,023,533		Yes (X)
Roger G Santala MD
Physician	70.0		$41,613			$824,839		Yes (X)
Micheal A Morone MD
Physician	70.0		$48,399			$792,603		Yes (X)
Jared J Lund MD
Physician	70.0		$52,257			$791,347		Yes (X)
Lyle Knight
former board member	0.0		$0			$13,441			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$7,544,250	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$559,161	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	332	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1	CityContractorAddress/USAddress/City	StateContractorAddress/USAddress/State	ZIP CodeContractorAddress/USAddress/ZIPCode	ServicesServicesDesc	CompensationCompensationAmt
SODEXO INC
BOX 37000	BILLINGS	MT	59107	FOOD SERVICE	$5,748,661
HEALTHCARE OUTSOURCING NETWORK
621 17TH STREET STE 1800	DENVER	CO	80293	EARLY OUT VENDOR	$2,496,864
HAYES LOCUMS LLC
6700 N ANDREWS AVE STE 600	FORT LAUDERDALE	FL	33309	Physician services	$2,418,352
COMMAND HEALTH
PO BOX 844797	DALLAS	TX	75284	TRANSCRIPTION	$1,794,655
OPTUMINSIGHT
2771 MOMENTUM PLACE	CHICAGO	IL	60689	DENIAL RECOVERY	$1,543,796

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	33	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Related Organizations	$2,223,188	RelatedOrganizationsAmt
Noncash Contributions	$279,300	NoncashContributionsAmt
Total Contributions	$2,223,188	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE	621110	$550,329,645	$550,329,645
REFERENCE LAB	621500	$3,829,629		$3,829,629
INCOME ON EQUITY INVESTEES	900099	$6,709,280	$6,709,280
CLINICAL TRIAL REVENUE	541900	$1,042,250	$1,042,250
MEANINGFUL USE PAYMENTS	621110	$2,693,019	$2,693,019

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$250,977	TotalRevenueColumnAmt
Exclusion	$250,977	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$564,854,800	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,264,502	TotalRevenueColumnAmt
Unrelated Business Revenue	$305,852	UnrelatedBusinessRevenueAmt
Exclusion	$5,958,650	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$92,849	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$76,667	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$16,182	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$16,182	TotalRevenueColumnAmt
Exclusion	$16,182	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$715,002,399	SecuritiesAmt
Other	$279,000	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$705,803,119	SecuritiesAmt
Other	$457,976	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$9,199,280	SecuritiesAmt
Other	-$178,976	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$9,020,304	TotalRevenueColumnAmt
Exclusion	$9,020,304	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$269,162	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$49,396	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$219,766	TotalRevenueColumnAmt
Exclusion	$219,766	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
IT SERVICES TO OTHER HOSPITALS	541519	$3,681,817	$3,681,817
OPTICAL SHOP/COSMETICS	446199	$759,933	$759,933
INSURANCE PREMIUMS	524298	$839,060		$839,060

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,723,936	TotalRevenueColumnAmt
Related Or Exempt Func Income	$5,723,936	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$11,004,746	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$593,603,488	TotalRevenueColumnAmt
Related Or Exempt Func Income	$567,337,190	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$8,577,231	UnrelatedBusinessRevenueAmt
Exclusion	$15,465,879	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$747,332	TotalAmt
Program Services	$747,332	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$12,422	TotalAmt
Program Services	$12,422	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$3,453,717	TotalAmt
Program Services	$3,103,698	ProgramServicesAmt
Management And General	$233,743	ManagementAndGeneralAmt
Fundraising	$116,276	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$249,128,710	TotalAmt
Program Services	$196,428,457	ProgramServicesAmt
Management And General	$52,686,956	ManagementAndGeneralAmt
Fundraising	$13,297	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$11,813,872	TotalAmt
Program Services	$9,351,611	ProgramServicesAmt
Management And General	$2,458,656	ManagementAndGeneralAmt
Fundraising	$3,605	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$22,091,453	TotalAmt
Program Services	$17,441,558	ProgramServicesAmt
Management And General	$4,639,829	ManagementAndGeneralAmt
Fundraising	$10,066	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$15,754,925	TotalAmt
Program Services	$12,446,390	ProgramServicesAmt
Management And General	$3,300,657	ManagementAndGeneralAmt
Fundraising	$7,878	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$35,000	TotalAmt
Management And General	$35,000	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$1,283,948	TotalAmt
Management And General	$1,283,948	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$200,248	TotalAmt
Management And General	$200,248	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$159,612	TotalAmt
Management And General	$159,612	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$1,005,611	TotalAmt
Management And General	$1,005,611	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$43,489,966	TotalAmt
Program Services	$14,671,015	ProgramServicesAmt
Management And General	$28,818,951	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,483,169	TotalAmt
Program Services	$96,104	ProgramServicesAmt
Management And General	$1,356,798	ManagementAndGeneralAmt
Fundraising	$30,267	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$7,249,074	TotalAmt
Program Services	$5,043,705	ProgramServicesAmt
Management And General	$2,169,342	ManagementAndGeneralAmt
Fundraising	$36,027	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$12,126,577	TotalAmt
Program Services	$1,066,624	ProgramServicesAmt
Management And General	$11,059,953	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$7,800,571	TotalAmt
Program Services	$5,460,400	ProgramServicesAmt
Management And General	$2,340,171	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$2,337,080	TotalAmt
Program Services	$1,631,455	ProgramServicesAmt
Management And General	$705,625	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$66,000	TotalAmt
Management And General	$66,000	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$6,544,705	TotalAmt
Program Services	$4,581,294	ProgramServicesAmt
Management And General	$1,963,411	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$19,634,995	TotalAmt
Program Services	$13,744,497	ProgramServicesAmt
Management And General	$5,890,498	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$3,137,218	TotalAmt
Program Services	$1,350,550	ProgramServicesAmt
Management And General	$1,786,668	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$84,818,027	$84,818,027
BAD DEBT	$34,640,002	$34,640,002
REPAIRS & MAINTENANCE	$6,403,339	$4,482,337	$1,921,002
UBI TAXES	$658,458		$658,458

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$18,582,615	TotalAmt
Program Services	$11,363,460	ProgramServicesAmt
Management And General	$7,098,498	ManagementAndGeneralAmt
Fundraising	$120,657	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$554,658,646	TotalAmt
Program Services	$422,480,938	ProgramServicesAmt
Management And General	$131,839,635	ManagementAndGeneralAmt
Fundraising	$338,073	FundraisingAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part X	Yes (X)	InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$8,918,608	BOYAmt
EOY	$20,873,647	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$29,927,976	BOYAmt
EOY	$22,712,397	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$86,828,955	BOYAmt
EOY	$87,737,588	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$197,649	BOYAmt
EOY	$242,088	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$7,647,986	BOYAmt
EOY	$7,547,825	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$4,739,759	BOYAmt
EOY	$5,467,785	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$473,780,535	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$236,496,403	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$209,229,067	BOYAmt
EOY	$237,284,132	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$231,540,602	BOYAmt
EOY	$227,085,235	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$2,334,596	BOYAmt
EOY	$6,356,131	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$42,449,651	BOYAmt
EOY	$49,677,468	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$623,814,849	BOYAmt
EOY	$664,984,296	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$53,447,272	BOYAmt
EOY	$53,078,163	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$197,758	BOYAmt
EOY	$393,670	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$165,690,000	BOYAmt
EOY	$161,900,000	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$3,221,006	BOYAmt
EOY	$2,436,275	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$44,019,247	BOYAmt
EOY	$44,493,417	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$266,575,283	BOYAmt
EOY	$262,301,525	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$325,789,057	BOYAmt
EOY	$366,749,658	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$10,858,059	BOYAmt
EOY	$13,980,496	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$20,592,450	BOYAmt
EOY	$21,952,617	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$357,239,566	BOYAmt
EOY	$402,682,771	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$623,814,849	BOYAmt
EOY	$664,984,296	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$38,944,842	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$15,525,334	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$9,026,971	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consol And Sep Basis Fincl Stmt	Yes (X)	ConsolAndSepBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Total Grassroots Lobbying TotalGrassrootsLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$0	FilingOrganizationsTotalAmt

Total Direct Lobbying TotalDirectLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$159,612	FilingOrganizationsTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$159,612	FilingOrganizationsTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$554,499,034	FilingOrganizationsTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$554,658,646	FilingOrganizationsTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,000,000	FilingOrganizationsTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$250,000	FilingOrganizationsTotalAmt

Field	Value	IRS element (for citing)
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$1,000,000	CurrentYearMinus3Amt
Current Year Minus2	$1,000,000	CurrentYearMinus2Amt
Current Year Minus1	$1,000,000	CurrentYearMinus1Amt
Current Year	$1,000,000	CurrentYearAmt
Total	$4,000,000	TotalAmt

Field	Value	IRS element (for citing)
Lobbying Ceiling	$6,000,000	LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$37,524	CurrentYearMinus3Amt
Current Year Minus2	$82,631	CurrentYearMinus2Amt
Current Year Minus1	$219,228	CurrentYearMinus1Amt
Current Year	$159,612	CurrentYearAmt
Total	$498,995	TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$250,000	CurrentYearMinus3Amt
Current Year Minus2	$250,000	CurrentYearMinus2Amt
Current Year Minus1	$250,000	CurrentYearMinus1Amt
Current Year	$250,000	CurrentYearAmt
Total	$1,000,000	TotalAmt

Field	Value	IRS element (for citing)
Grassroots Ceiling	$1,500,000	GrassrootsCeilingAmt

Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year	$0	CurrentYearAmt
Total	$0	TotalAmt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$23,259,946	BeginningYearBalanceAmt
Contributions	$551,706	ContributionsAmt
Investment Earnings Or Losses	$2,064,279	InvestmentEarningsOrLossesAmt
Other Expenditures	$19,994	OtherExpendituresAmt
End Year Balance	$25,855,937	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$21,981,852	BeginningYearBalanceAmt
Contributions	$415,028	ContributionsAmt
Investment Earnings Or Losses	$1,054,443	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$204,010	GrantsOrScholarshipsAmt
Administrative Expenses	-$12,633	AdministrativeExpensesAmt
End Year Balance	$23,259,946	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$21,026,911	BeginningYearBalanceAmt
Contributions	$246,728	ContributionsAmt
Investment Earnings Or Losses	$724,344	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$44,349	GrantsOrScholarshipsAmt
Administrative Expenses	-$28,218	AdministrativeExpensesAmt
End Year Balance	$21,981,852	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$19,640,069	BeginningYearBalanceAmt
Contributions	$605,720	ContributionsAmt
Investment Earnings Or Losses	$781,122	InvestmentEarningsOrLossesAmt
End Year Balance	$21,026,911	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$18,575,246	BeginningYearBalanceAmt
Contributions	$665,198	ContributionsAmt
Investment Earnings Or Losses	$399,625	InvestmentEarningsOrLossesAmt
End Year Balance	$19,640,069	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$5,841,497	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$22,516,411	OtherCostOrOtherBasisAmt
Book Value	$28,357,908	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$177,110,018	OtherCostOrOtherBasisAmt
Depreciation	$71,229,702	DepreciationAmt
Book Value	$105,880,316	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,726,152	OtherCostOrOtherBasisAmt
Depreciation	$1,367,355	DepreciationAmt
Book Value	$358,797	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$239,269,405	OtherCostOrOtherBasisAmt
Depreciation	$155,564,314	DepreciationAmt
Book Value	$83,705,091	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$27,317,051	OtherCostOrOtherBasisAmt
Depreciation	$8,335,031	DepreciationAmt
Book Value	$18,982,020	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$237,284,132	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (11 entries)

DescDesc	Book ValueBookValueAmt
NOTE RECEIVABLE FROM NEW WEST	$33,782,799
INSURANCE RECEIVABLE	$315,957
DUE FROM RELATED PARTY	$1,524,069
RECEIVABLE FROM JOINT VENTURE	$122,680
DEPOSITS	$18,025
DEFERRED FINANCING COSTS	$2,025,955
BILLINGS CLINIC FOUNDATION	$48,274,260
NEW WEST HEALTH SERVICES	-$39,228,194
STILLWATER BILLINGS CLINC	$2,736,443
EXPRESSCARE	-$455,720
ACCRUED INTEREST	$561,194

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$49,677,468	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDesc	AmtAmt
DUE TO MDOR	$375,279
DEPOSITS	$15,800
INTEREST RATE SWAP AGREEMENT	$23,417,939
ESTIMATED CLAIMS LIABILITY	$7,441,641
ACCRUED BOND INTEREST & INTEREST SWAPS	$991,694
PROVISION FOR UNPAID CLAIMS	$12,251,064

Field	Value	IRS element (for citing)
Total Liability	$44,493,417	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$564,456,238	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$15,525,334	NetUnrealizedGainsInvstAmt
Other Revenue	$865,368	OtherRevenueAmt
Revenue Not Reported	$16,390,702	RevenueNotReportedAmt
Revenue Subtotal	$548,065,536	RevenueSubtotalAmt
Investment Expenses Not Incld	$1,005,611	InvestmentExpensesNotIncldAmt
Other Revenues Not Included	$44,532,341	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$45,537,952	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$593,603,488	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$519,013,033	TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal	$519,013,033	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$1,005,611	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$34,640,002	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$35,645,613	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$554,658,646	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
DESCRIBE THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS	SCHEDULE D, PART V, LINE 4 The Clinics endowment is held by the BILLINGS CLINIC Foundation. The endowment consists of approximately 70 individual funds established for a variety of purposes. The endowment includes both donor restricted endowment funds and funds designated by the governing body to function as endowments (board-designated endowment funds). Endowment funds are invested and held in perpetuity to provide a source of income for Billings Clinic programs and needs.
UNCERTAIN TAX POSITIONS	SCHEDULE D, PART X, LNE 2 The Clinic has been recognized as exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code and a similar provision of state law. Accordingly, no provision for income taxes for these entities has been made in the accompanying financial statements. However, the Clinic is subject to federal and state income tax on any unrelated business taxable income. The Clinic files tax returns in the U.S. federal jurisdiction. With a few exceptions, the Clinic is no longer subject to U.S. federal examinations by tax authorities for years before 2011.
REVENUE ON BOOKS, NOT ON RETURN	SCHEDULE D, PART XI, LINE 2D CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 865,368
REVENUE ON RETURN, NOT ON BOOKS	SCHEDULE D, PART XI, LINE 4B CHANGE IN INTEREST OF AFFILIATES 9,586,487 BAD DEBT EXPENSE RECLASSED TO EXPENSE 34,640,002 INTEREST IMPUTED ON INTERCOMPANY RECEIVABLES 305,852 TOTAL 44,532,341
EXPENSE ON RETURN, NOT ON BOOKS	SCHEDULE D, PART XII, LINE 4B BAD DEBT EXPENSE RECLASSED TO EXPENSE 34,640,002

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	120.	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,490,315	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$14,490,315	NetCommunityBenefitExpnsAmt
Total Expense	0.02780	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$47,319,732	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$43,939,406	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,380,326	NetCommunityBenefitExpnsAmt
Total Expense	0.00650	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$61,810,047	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$43,939,406	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,870,641	NetCommunityBenefitExpnsAmt
Total Expense	0.03430	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,160,042	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$561,217	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,598,825	NetCommunityBenefitExpnsAmt
Total Expense	0.00500	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,421,072	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,523,758	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,897,314	NetCommunityBenefitExpnsAmt
Total Expense	0.00750	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$49,537,533	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$38,301,313	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,236,220	NetCommunityBenefitExpnsAmt
Total Expense	0.02160	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,137,013	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$315,814	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$821,199	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$560,932	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$325	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$560,607	NetCommunityBenefitExpnsAmt
Total Expense	0.00110	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$59,816,592	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$40,702,427	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$19,114,165	NetCommunityBenefitExpnsAmt
Total Expense	0.03680	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$121,626,639	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$84,641,833	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$36,984,806	NetCommunityBenefitExpnsAmt
Total Expense	0.07110	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Persons Served	140	PersonsServedCnt
Total Community Benefit Expns	$21,211	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$21,211	NetCommunityBenefitExpnsAmt

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Persons Served	60	PersonsServedCnt
Total Community Benefit Expns	$27,657	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$27,657	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Persons Served	500	PersonsServedCnt
Total Community Benefit Expns	$48,407	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$25,979	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$22,428	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Persons Served	700	PersonsServedCnt
Total Community Benefit Expns	$97,275	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$25,979	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$71,296	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$34,640,002	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$166,499,307	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$183,433,038	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$16,933,731	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Billings Clinic	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 Tenth Avenue North	AddressLine1
City	Billings	City
State	MT	State
ZIP Code	59101	ZIPCode

Field	Value	IRS element (for citing)
Website Address	www.billingsclinic.com	WebsiteAddressTxt
State License	13345	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Research Facility	Yes (X)	ResearchFacilityInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Billings Clinic	BusinessNameLine1

Field	Value	IRS element (for citing)
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	13	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	www.billingsclinic.com	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	www.healthybydesignyellowstone.org	OtherWebsiteURLTxt
Rpt Available Upon Request	Yes (X)	RptAvailableUponRequestInd
Adopt Implementation Strategy	Yes (X)	AdoptImplementationStrategyInd
Exec Implementation Strategy	Yes (X)	ExecImplementationStrategyInd
Develop Community Wide Plan	Yes (X)	DevelopCommunityWidePlanInd
Exec Community Wide Plan	Yes (X)	ExecCommunityWidePlanInd
Include Operational Plan	Yes (X)	IncludeOperationalPlanInd
Prioritize Health Needs	Yes (X)	PrioritizeHealthNeedsInd
Prioritize Services	Yes (X)	PrioritizeServicesInd
All Needs Addressed	false	AllNeedsAddressedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Used Deter Elig Free Care	Yes (true)	FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care	120.	FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt Care	Yes (true)	FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care	300.	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (true)	ExplainedBasisInd
Income Level	Yes (X)	IncomeLevelInd
Asset Level	Yes (X)	AssetLevelInd
Medical Indigency	Yes (X)	MedicalIndigencyInd
Insurance Status	Yes (X)	InsuranceStatusInd
Uninsured Discount	Yes (X)	UninsuredDiscountInd
Medicaid Medicare	Yes (X)	MedicaidMedicareInd
State Regulation	Yes (X)	StateRegulationInd
Residency	Yes (X)	ResidencyInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
Posted On Website	Yes (X)	PostedOnWebsiteInd
Attached To Invoice	Yes (X)	AttachedToInvoiceInd
Posted In Emergency Room	Yes (X)	PostedInEmergencyRoomInd
Posted In Admission Office	Yes (X)	PostedInAdmissionOfficeInd
Provided On Admission	Yes (X)	ProvidedOnAdmissionInd
Available On Request	Yes (X)	AvailableOnRequestInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Average Negotiated Rates	Yes (X)	AverageNegotiatedRatesInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, LINE 3	Describe how the hospital took into account input from persons who represent the community: Key Informant Focus Groups were held in the community, including five different groups with 8-12 participants in each. The groups represented local social services providers, legislators, physicians and other health professionals, employers, educators and low-income groups. Employers, Educators & public service were represented by the following organizations: Laurel Public schools, chamber of commerce, rocky mountain college, billings gazette, CTA architects engineers, MET transit & City County planning department & the Billings Police Department. Social Service providers were represented by: Center for children and families, family services, United Way of Yellowstone county, parents let's unite for kids, HRDC, Rimrock foundation, Easter seals Montana, and La Vie. Physicians and other Health professionals were represented by: Yellowstone naturopathic clinic, St. Vincent Healthcare, Billings Clinic, Rocky Mountain Health Network, Montana-Wyoming Tribal Leaders Council, Advanced Care Hospital, Riverstone Health, Mental Health Center, and Community Crisis Center. Legislators and Elected Officials were represented by: City Council Member, State Legislative Representative, Mayor, and City Administrator. The Billings Southside Community group was represented by 24 individual members of the community. The survey itself included a random sample of 400 individuals 18 and older living in Yellowstone County.
SCHEDULE H, PART V, LINE 4	Other hospitals included with the CHNA: The entire CHNA was conducted by Professional Research Consultants (PRC). Billings Clinic's Community Health Needs Assessment was conducted in a pre-existing community health partnership called "The Alliance" with St. Vincent Healthcare (hospital organization) and RiverStone Health (public health department for city and county). The Alliance had conducted a CHNA in 2006 & 2011 as well.
SCHEDULE H, PART V, LINE 7	Needs not addressed in the most recently conducted CHNA: Billings Clinic has started to address the needs that we have the assets and resources to address. The objective of Billings Clinic's community benefit plan for the next several years is to align, enhance and/or develop programs based on a set of criteria established by our Community Health Improvement Committee, including: * Billings Clinic's mission, vision and values, * Billings Clinic's strategic operating plan, * Data obtained through the 2005, 2011 and 2014 Community Health Needs Assessments, * The Alliance Plan to Improve the Community's Health, * IRS 990 Schedule H requirements, and * The Institute for Healthcare Improvement's Triple Aim (Improve the health of the population; enhance the patient experience of care (including quality, access and reliability); and reduce, or at least control, the per capita cost of care.) We will, as appropriate and possible, design methods to measure program effectiveness in the short and longer terms and at the organizational and population levels. If any community health needs do not meet the above criteria, we will not be able to address that particular need in the next few years. At this time, Billings Clinic does not have the resources necessary to address all needs, including: * lack of transportation (only available during weekdays on a limited basis); * Access to dental care (we don't have dental services) * Availability of substance abuse treatment (limited). In some areas we don't offer any services but do advocate on policy, such as: * Seat belt usage * Firearm safety, * Lack of healthcare coverage (Medicaid expansion efforts)

Field	Value	IRS element (for citing)
Facility	16	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (16 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	FacilityFacilityTxt
Billings Clinic (Billings Clinic)
2800 Tenth Avenue North	Billings	MT	59101	Multispeciality Physician Outpatient Clinics
Billings Clinic (Aspen Meadows)
3155 Avenue C	Billings	MT	59102	Long Term Care Facility
Livingston Imaging
504 S 13th St	Livingston	MT	59047	Medical Imaging
Billings Clinic Sheridan Dialysis
1401 West 5th St	Sheridan	WY	82801	Dialysis Unit
Beartooth Billings Clinic
2525 North Broadway	Red Lodge	MT	59068	Primary Care
Behavioral Health Center
1020 North 27th Street 4th Floor	Billings	MT	59101	Mental Health
Billings Clinic Anticoagulation Clinic
1020 North 27th Street 1st Floor	Billings	MT	59101	Anticoagulation Clinic
Billings Clinic Cancer Center
801 North 29th Street	Billings	MT	59101	Cancer Care, Gynecologic Care
Billings Clinic Cody
201 Yellowstone Avenue	Cody	WY	82414	Anticoagulation, Cancer, Pediatrics
Billings Clinic Heights
760 Wicks Lane	Billings	MT	59105	primary care
Billings Clinic Miles City
620 South Haynes Avenue	Miles City	MT	59301	primary care, pediatrics
Billings Clinic North 30th Building
1045 N 30th St	Billings	MT	59101	Diabetes, Endocrinology
Billings Clinic Surgery Center
2929 Tenth Ave North	Billings	MT	59101	general surgery, urology
Billings Clinic West
2675 Central Avenue	Billings	MT	59102	Obstetrics & Gynecology
Billings Sports Plex
5000 Southgate Dr	Billings	MT	59101	Sports medicine
Bozeman OBGYN
925 Highland Blvd	Bozeman	MT	59715	Obstetrics & Gynecology

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7, column f	Bad debt expense included on Form 990, part IX, line 25 but excluded for purposes of calculating percentages in this column equal $34,640,002.
SCHEDULE H, PART I, LINE 7	THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A and 7B. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. The information for lines 7e through 7i was derived from information in the general ledger and other financial data related specifically to the various types of community benefits. Line 7g, subsidized health services includes various physican clinics in order to better serve the Montana areas. Total costs for the physician clinics were $24,162,214.
SCHEDULE H, PART III, LINE 2	Explain the organization's methodology to estimate the amount reported for bad debt expense: The Organization 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 bad debts.
SCHEDULE H, PART III, LINE 4	See page 11 of the attached audited financial statements for the footnote that describes bad debt expense.
SCHEDULE H, PART III, LINE 8	We believe that 46 percent of Billings Clinic's Medicare shortfalls should be counted as a community benefit. Our rationale is that 46 percent is the best estimate of the percentage of Montana's Medicare population (65 and older) who are at or below 300% of Federal Poverty Level, based on U.S. Census data. The upper limit of our financial assistance policy is 300%. For the calculation of the unreimbursed cost of Medicare a ratio of patient care cost to charges using worksheet 2 was utilized and applied to gross Medicare charges. We do not use the Cost Report for this number. The Cost Report only captures revenue related to the facility and does not capture revenue/losses related to clinical professional services, which are a substantial portion of Billings Clinic Medicare shortfalls.
SCHEDULE H, PART III, LINE 9b	Billings Clinic had a formal, written policy in tax year 2013, effective as of 10/5/11 (OHA-205 "Patient Financial Services"). We did have a collection process, which was used to screen patients for financial assistance prior to making payment arrangements for care. The policy applies equally to all patients - insured, under-insured or uninsured. Once a determination has been made and adjustments applied to the account balance, any remaining balance would fall into the regular guidelines of collection, giving patients financing options that will work within their monthly budget. Patients who cannot meet the requirements of a payment arrangement should be offered the loan program and/or financial assistance as options. If the patient agrees to financial assistance, the application should be requested. Agency will print and mail financial assistance applications and this will be completed by the end of each business day. After a patient completes the application, the patient will send it back to Billings Clinic for financial assistance determination.
NEEDS ASSESSMENT	The 2014 Community Health Needs Assessment (CHNA) was a systematic, data driven approach to determining the health status, behaviors and needs of residents in Yellowstone County. Billings Clinic partnered with the local health care Alliance, including another local hospital, St. Vincent Healthcare, and city/county health department, RiverStone Health, to coordinate and pay for the CHNA. It serves as a tool to improve the health status and improve the quality of life overall of Yellowstone County residents. In the winter of 2013-2014, the Yellowstone County Community Health Survey consisted of 400 randomized telephone (landline & mobile) contacts representing the diverse socioeconomic and geographic characteristics of Yellowstone County. Existing vital statistics and other health-related data are incorporated into the assessment as secondary sources. In addition, focus groups were conducted among physicians, legislators, social services, educators, employers and low-income groups. Results of the 2014 Community Health Assessment were reviewed by the Alliance, a community forum sponsored by the Alliance's community health coalition (called Healthy By Design), and the Billings Clinic Community Health Improvement Committee (a Board committee). Findings were compared between 2014, 2011 and 2006 assessment results. An Implementation Plan has been completed, both for the Alliance (community-wide) and for Billings Clinic (organization-wide). Implementation of many of the objectives has begun, with community workgroups, using measures and evaluation. The URL for the CHNA is located at http://www.billingsclinic.com/about-us/giving-back-to-the-community
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	* All patients may apply for financial assistance - informational brochures with a one-page summary, and application forms are available at registration desks in the clinic and hospital, the Emergency Department discharge desk, care management staff and on our website at billingsclinic.com. * Information about financial assistance is printed on the back of patient bills. * Patients hospitalized without identifying a third party payer source are screened for coverage/assistance - SSI (Social Security Supplemental income, if approved will qualify for Medicaid), SSDI (Social Security Disability Income), Veterans' Administration, Indian Health Services, Workers Compensation, Medicaid, Crime Victims, and health insurance coverage. * A Financial Assistance brochure is mailed to new patients (Clinic and Hospital) in their pre-admission packets. These packets are mailed to all patients, even if they cannot be reached by phone in advance. * An application is mailed to patients whose payment pattern indicates that they may need assistance. * Patient Financials Services staff is available to help any patient needing assistance to complete an application. * According to our existing Financial Application policy, a patient is not eligible for financial assistance if the account has been sent to bad debt. We do bring accounts back in-house for charity assistance on a case-by-case basis. * An account is sent to bad debt at least 158 days after they are considered "self-pay," including at least three statements, letter and phone call attempts to contact the patient.
COMMUNITY INFORMATION	Billings Clinic is based in Billings, Montana, the largest city in Montana, with more than 150,000 people in Yellowstone County. In Billings, there are two not-for-profit hospitals of similar size. Billings Clinic is an integrated, not for profit, community-governed health care organization providing services to a forty-three county area in eastern Montana and northern Wyoming. Billings Clinic defines its broad geographic service area as 43 counties in eastern Montana and northern Wyoming, encompassing nearly 128,000 square miles with a population of 595,000 people. Today, Billings Clinic employs more than 4,225 employees, including 259 physicians, and 90 mid-level practitioners, and operates a multi-specialty physician clinic; 285-bed acute care hospital; level II trauma center; a 90-bed long-term care facility; a clinical research center; and a variety of ambulatory, diagnostic and treatment services. Thirty-eight of those 43 counties are either wholly or partly designated as Health Professional Shortage Areas (HPSA) by the US Department of Health and Human Services, Health Resources and Services Administration under the Primary Medical Care discipline. The area includes five American Indian Reservations and an American Indian population of 38,882, or 6.9% of the service area's population. The US Census Bureau 2008 estimates show that 27.3% of Montana families are below 200% of the Federal Poverty level, compared to 26.6% for the nation and Montana is ranked 13th lowest of 50 states in Median Family Income. According to the 2010 US Census, Montana had 17.3% of the population without health insurance coverage in 2010, including all ages of the civilian, non-institutionalized population.
Promotion of community health	Billings Clinic is an integrated health care organization, combining a not-for-profit multi-specialty medical group practice with a hospital and long term care facility. Our organization promoted community health in many ways in Fiscal Year 2014, including: * Substantial financial assistance and charity care was provided to patients in need. Billings Clinic provides more charity care than another other hospital or health care organization in Montana. * Care was provided to Medicare and Medicaid patients, as well as SCHIP for children. * Our Board's governance and nominating committee reviewed the entire 990, including Schedule H, which was then discussed with the entire Board of Directors. The Community Benefit Report, including Schedule H data, is also reviewed by the Board committee for Community Health Improvement. * Billings Clinic is a teaching hospital and supports, along with Riverstone Health and St. Vincent Healthcare, the only post-graduate medical education in Montana - the Montana Family Medicine Residency Program. Nearly 90 percent of the graduates establish a practice in rural, medically underserved settings in Montana. In addition we provide ongoing preceptorships for medical, nursing and pharmacy students so that they can obtain real-life experience during college and graduate school. In 2013, we also created and were approved for a new Internal Medicine Residency program. Residents started the program in July of 2014. * Billings Clinic is a Medicaid disproportionate share hospital serving a significantly disproportionate number of low-income patients. * Our full-time emergency department is maintained where no one is denied care, within our capacity to provide care. * Our board of directors is composed of community members who reside in the primary service area. Only three out of 12 board members are employees - two are employed physicians and one is our CEO. * Medical staff privileges are open to all qualified physicians in our community. Operating surpluses are directed solely toward meeting our charitable purposes, including education, research, capital expenses, debt amortization, patient care improvements and medical education. * Billings Clinic has the only inpatient psychiatric services for youth and adults available in our region of central and eastern Montana and northern Wyoming, despite significant financial loss. We are committed to mental health care and continually work to find ways to reach those in need in the region, such as through telemedicine programs and education for primary care providers.
State filing of community benefit report	Billings Clinic files a community benefit report to the state of Montana's Attorney General's office, with different values than requested by Schedule H.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (10 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
BILLINGS CLINIC FOUNDATION
2917 Tenth Avenue North	Billings	MT	59101	810407289	501(C)(3)	$257,739	support operations
MONTANA HEALTH NETWORK
11 SOUTH 7TH STREET	MILES CITY	MT	59301	816073209	501(C)(3)	$23,600	RURAL HEALTH DEVELOPMENT
YELLOWSTONE CITY-COUNTY HLTH DBA RIVERSTONE HEALTH
123 SOUTH 27TH STREET	BILLINGS	MT	59101	810513538	GOVT	$20,000	SUPPORT OPERATIONS
Community Crisis Center
704 N 30TH ST	BILLINGS	MT	59101	203231164	501(c)(3)	$74,425	SUPPORT OPERATIONS
RIVERSTONE HEALTH FOUNDATION
PO BOX 1562	BILLINGS	MT	59103	352332179	501(c)(3)	$30,000	SUPPORT OPERATIONS
RONALD MCDONALD HOUSE CHARITIES OF MONTANA
1144 NORTH 30TH STREET	BILLINGS	MT	59101	810400667	501(C)(3)	$12,500	SUPPORT OPERATIONS
YES Kids
3814 PARKHILL DR	BILLINGS	MT	59102			$10,000	SUPPORT OPERATIONS
FAMILY MED RESIDENCY OF W MT
401 WEST RAILROAD	MISSOULA	MT	59802	816001713	501(c)(6)	$211,988	SUPPORT OPERATIONS
MACK PRODUCTIONS
3333 2ND AVENUE N 170	BILLINGS	MT	59101			$14,799	SPONSORSHIP
BIG SKY STATE GAMES
PO BOX 7139	BILLINGS	MT	59103	810431595	501(C)(3)	$6,000	SPONSORSHIP

Field	Value	IRS element (for citing)
Total501c3 Org	7	Total501c3OrgCnt
Total Other Org	3	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	scholarships	GrantTypeTxt
Recipient	51	RecipientCnt
Cash Grant	$12,422	CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	ORGANIZATION'S PROCEDURES FOR MONITORING USE OF GRANT FUNDS IN THE U.S.	FormAndLineReferenceDesc
Explanation	SCHEDULE I, PART I, LINE 2 The organization awards scholarships to individuals who exhibit a strong desire and potential to excel in the health care field. Students must complete an application form which includes their most recent official high school transcript or G.E.D. and current college transcript. The application must include three individual references on using the organization's recommendation questionnaire. The organization also provides grants to other health related organizations.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	Yes (X)	FirstClassOrCharterTravelInd
Travel For Companions	Yes (X)	TravelForCompanionsInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Robert N Hurd MD
Board Member, Physician	$398,770	$0	$3,271	$21,726	$14,927	$438,694	$0
Clayton H McCracken MD
Board Member, Physician	$365,638	$0	$299	$26,617	$19,960	$412,514	$0
J Scott Millikan MD
Chair, Physician	$623,852	$0	$510	$31,525	$19,539	$675,426	$0
Nicholas Wolter MD
CEO	$940,678	$175,998	$4,659	$22,525	$13,718	$1,157,578	$0	$0	$0	$0	$0	$0	$0	$0
Connie F Prewitt
CFO	$439,214	$87,574	$430	$82,225	$24,676	$634,119	$0
Lyle Knight
former board member	$13,441	$0	$0	$0	$0	$13,441	$12,000
Randall K Gibb MD
Physician	$1,052,987	$0	$4,607	$22,525	$22,205	$1,102,324	$0
Scott A Sample MD
Physician	$1,018,954	$0	$4,579	$22,525	$24,199	$1,070,257	$0
Roger G Santala MD
Physician	$824,166	$0	$673	$25,525	$19,088	$869,452	$0
Micheal A Morone MD
Physician	$791,956	$0	$647	$21,013	$27,386	$841,002	$0
Jared J Lund MD
Physician	$790,701	$0	$646	$22,525	$29,732	$843,604	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
INFORMATION REGARDING BENEFITS PROVIDED	SCHEDULE J, PART I, LINE 1A Billings Clinic periodically arranges and pays for charter travel for management and/or Board members attending governance education, State legislative hearings and association meetings. Billings Clinic also pays for the travel expense of spouses of Board members attending organizationally approved/arranged governance education. This reimbursement is reported as income consistent with the Board travel reimbursement policy. there was no taxable travel utilized in FY14.
NON-QUALIFIED BENEFIT PLANS	SCHEDULE J, PART I, LINE 4B The Billings Clinic Board Deferred Compensation Plan provides that all amounts earned are deferred until age 65 when payments are made over 5 years. Interest is accrued and credited each quarter and account balances are always 100% vested. During the year, former board member Lyle Knight received payment on previously reported deferrals in the amount of $13,441. 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. The following individuals are participants in the plan and received a deferral during the 2013 calendar year which is included in deferred compensation on Schedule J, Part II, column C. Connie F. Prewitt - $59,700
NON-FIXED PAYMENTS	The Board of Directors annually determines the incentive plan amount for the CEO and the Senior Executive Team based on an external compensation study. The availability of the incentive is triggered by the organizational operating margin performance targets. The incentive is awarded based on financial performance as well as organizational performance measurements in quality, service satisfaction, both patient and employee satisfaction and then individual goals set each year if the target is triggered. The incentive is paid only if triggered following the financial audit presentation.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
MONTANA FACILITY FINANCE AUTHORITY
A	364615155	612043FL8	2008-05-30	$60,000,000	capital projects	Yes (true)	false	false
MONTANA FACILITY FINANCE AUTHORITY
B	364615155	61204MAA5	2011-08-24	$140,000,000	capital projects, refund 2008 bond	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$31,315,000	$0	$60,000,000	$5,535,735	$0	$0	$1,200,000	$0	$0	$49,976,092	$0	$0	2009	false	false	Yes (true)	Yes (true)
B	$6,785,000	$0	$140,124,100	$0	$0	$0	$858,750	$0	$0	$42,097,226	$84,553,156	$12,614,968		false	Yes (true)	false	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Private Bus Concerning UBIPrivateBusConcerningUBIPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropPct	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	false	false	0.00000	0.00000	0.00000	false	false	0.00000	false	Yes (true)
B	false	false	false	false	0.00000	0.00000	0.00000	false	false	0.00000	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
A	false	false	false	Yes (true)	false	false	false	0	false	Yes (true)
0
B	false	Yes (true)	false	false	Yes (true)	false	false	0	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	schedule k, part iv, line 2c	FormAndLineReferenceDesc
Explanation	the 2008 bond issue rebate calculation was completed on 02/25/13.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
AARON SPARBOE
SEE PART v	$811,693	RENT	false
NEW WEST HEALTH SERVICES
SEE PART V	$13,931,015	CLAIMS PAID	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	RELATIONSHIP BETWEEN INTERESTED PERSON & THE ORGANIZATION	FormAndLineReferenceDesc
Explanation	PART IV, LINE 1 COLUMN B AARON SPARBOE, BOARD MEMBER OF BILLINGS CLINIC, RENTS TWO CLINICS TO THE ORGANIZATION. PART IV, LINE 2 COLUMN B NICHOLAS WOLTER, CONNIE PREWITT, AND JOY OTT ARE OFFICERS OR DIRECTORS OF BOTH BILLINGS CLINIC AND OF NEW WEST HEALTH SERVICES, A WHOLLY-OWNED SUBSIDIARY OF BILLINGS CLINIC. DURING THE YEAR, NEW WEST HEALTH SERVICES PAID CLAIMS FOR BILLINGS CLINIC IN THE AMOUNT OF $13,931,015. THIS TRANSACTION IS ALSO DISCLOSED ON SCHEDULE R, PART V, LINE 2, CODE M.	ExplanationTxt

Schedule M IRS990ScheduleM

Field	Value	IRS element (for citing)
Works Of Art		WorksOfArtGrp
Art Historical Treasures		ArtHistoricalTreasuresGrp
Art Fractional Interest		ArtFractionalInterestGrp
Books And Publications		BooksAndPublicationsGrp
Clothing And Household Goods		ClothingAndHouseholdGoodsGrp
Cars And Other Vehicles		CarsAndOtherVehiclesGrp
Boats And Planes		BoatsAndPlanesGrp
Intellectual Property		IntellectualPropertyGrp
Securities Publicly Traded		SecuritiesPubliclyTradedGrp
Securities Closely Held Stock		SecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust Intrsts		SecurPrtnrshpTrustIntrstsGrp
Securities Miscellaneous		SecuritiesMiscellaneousGrp
Qualified Contrib Hist Struct		QualifiedContribHistStructGrp
Qualified Contrib Other		QualifiedContribOtherGrp
Real Estate Residential		RealEstateResidentialGrp

Real Estate Commercial RealEstateCommercialGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	1	ContributionCnt
Noncash Contributions Rpt F990	$250,000	NoncashContributionsRptF990Amt
Method Of Determining Revenues	fair market value	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Real Estate Other		RealEstateOtherGrp
Collectibles		CollectiblesGrp
Food Inventory		FoodInventoryGrp
Drugs And Medical Supplies		DrugsAndMedicalSuppliesGrp
Taxidermy		TaxidermyGrp
Historical Artifacts		HistoricalArtifactsGrp
Scientific Specimens		ScientificSpecimensGrp
Archaeological Artifacts		ArchaeologicalArtifactsGrp

Other Non Cash Contri Table OtherNonCashContriTableGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Desc	other miscellaneous	Desc
Contribution	3	ContributionCnt
Noncash Contributions Rpt F990	$29,307	NoncashContributionsRptF990Amt
Method Of Determining Revenues	fair market value	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	false	ReviewProcessUnusualNCGiftsInd
Third Parties Used	false	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	NONCASH CONTRIBUTIONS	FormAndLineReferenceDesc
Explanation	SCHEDULE M, PART I, COLUMN B THE NUMBER IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Buisiness & Family Relationships	FORM 990, Part VI, LINE 2 NICHOLAS WOLTER, CONNIE PREWITT, AND JOY OTT have a business relationship because they are directors or officers of the WHOLLY-owned subsidiary disclosed on Schedule R, Part IV. DESCRIBE THE PROCESS TO REVIEW THE FORM 990 FORM 990, PART VI, LINE 11B The 990 review is completed before the return is filed. It is reviewed by the CFO, the executive group, the governance and nominating committee of the board and finally the board of directors.
DESCRIBE HOW CONFLICT OF INTEREST POLICY IS MONITORED & ENFORCED	FORM 990, PART VI, LINE 12C The Governance and Nominating Committee of the Board of Directors, according to their charter, review annually the disclosure statements of the Board of Directors and senior executives and take action to resolve conflicts. A Conflict of Interest Review Panel, chaired by the Compliance Officer, as outlined in organizational policy, is responsible for reviewing disclosed conflicts and approving necessary conflict management plans of all other interested persons at Billings Clinic.
DESCRIBE PROCESS FOR DETERMINING COMPENSATION	FORM 990, PART VI, LINE 15A & 15B Billings Clinic has as executive compensation program administered by independent trustees following best practices and the highest regulatory standards expected of a not-for-profit organization. They follow a board approved charter and overall executive compensation philosophy which defines the market as a comparable set of not-for-profit health care delivery systems. They look at relevant market data of similar roles in similar organizations. Annual disclosure of the committee's actions and decisions to the full Board is required.
DESCRIBE HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC	FORM 990, PART VI, LINE 19 Billings Clinic makes it governing documents, conflict of interest policy and financial statements available to the public on an as needed basis.
OTHER CHANGES IN NET ASSETS	FORM 990, PART XI, LINE 9 CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 865,368 CHANGE IN INTEREST OF AFFILIATES (9,586,487) INTEREST IMPUTED ON INTERCOMPANY RECEIVABLES 305,852 TOTAL (9,026,971)
PRIOR YEAR BALANCE SHEET	PART X, COLUMN A DURING 06/30/14, THE ORGANIZATION MADE RECLASSIFICATIONS TO THE 06/30/13 CONSOLIDATED FINANCIAL STATEMENTS TO CONFORM TO THE 06/30/14 FINANCIAL STATEMENT PRESENTATION. THESE RECLASSIFICATIONS DID NOT HAVE A NET EFFECT ON THE CONSOLIDATED FINANCIALS, HOWEVER FOR 990 PURPOSES, THE RECLASSIFICATION RESULTED IN A CHANGE TO THE 06/30/13 NET ASSETS. 06/30/13 PRIOR YEAR NET ASSETS - 354,302,789 06/30/13 RESTATED PRIOR YEAR NET ASSETS - 357,239,566 INCREASE IN NET ASSETS - 2,936,777* * THE INCREASE IN NET ASSETS IS ATTRIBUTABLE TO THE PRESENTATION OF HOW BILLINGS CLINIC SHOWS THEIR INVESTMENT IN AN AFFILIATE. THE AFFILIATE IS ELIMINATED ON THE CONSOLIDATED FINANCIALS BUT IS TREATED AS A SEPERATE ENTITY FOR TAX PURPOSES AND IS NOT ELIMINATED ON THE BILLINGS CLINIC 990.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	Montana Healthcare Indemnity LLC	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2800 Tenth Avenue North	AddressLine1
City	Billings	City
State	MT	State
ZIP Code	59101	ZIPCode

Field	Value	IRS element (for citing)
EIN	810231784	EIN
Primary Activities	Ins. Captive	PrimaryActivitiesTxt
Legal Domicile State	MT	LegalDomicileStateCd
Total Income	$990,342	TotalIncomeAmt
End Of Year Assets	$13,266,236	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	Billings	BusinessNameLine1

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrganizationControlledOrganizationInd
Billings Clinic Foundation
2917 Tenth Avenue North	Billings	MT	59101	810407289	fundraising	MT	501(c)(3)	line 7	billings	Yes (true)
Stillwater Hospital Association
710 N 11th St	Columbus	MT	59019	810286525	hospital	MT	501(c)(3)	line 3	billings	Yes (true)
STILLWATER COMMUNITY HEALTHCARE FDN
710 11TH ST	COLUMBUS	MT	59019	200748325	fundraising	MT	501(c)(3)	line 7	billings	Yes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd
New West Health Services
130 Neill Avenue	Helena	MT	59601	841418136	Insurance sales	MT	Billings Clinic	C-Corporation	$157,806,229	$29,175,582	1.00000	Yes (true)
Billings Clinic Express Care LLC
2800 10th Avenue north	Bilings	MT	59101	463355499	Outpatient Clinic	MT	Billings Clinic	C-Corporation	$168,416	$510,601	1.00000	Yes (true)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (10 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
NEW WEST HEALTH SERVICES
A	$644,530	interco amount
BILLINGS CLINIC FOUNDATION
B	$580,305	interco amount
BILLINGS CLINIC FOUNDATION
B	$257,739	interco amount
BILLINGS CLINIC FOUNDATION
C	$2,223,188	interco amount
NEW WEST HEALTH SERVICES
D & Q	$33,782,799	interco amount
BILLINGS CLINIC FOUNDATION
D	$72,447	interco amount
STILLWATER HOSPITAL ASSOCIATION
D	$494,752	interco amount
BILLINGS CLINIC EXPRESS CARE LLC
D	$956,870	interco amount
STILLWATER HOSPITAL ASSOCIATION
L	$559,780	interco amount
NEW WEST HEALTH SERVICES
M	$13,931,015	interco amount