BILLINGS CLINIC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: BILLINGS CLINIC (EIN 81-0231784)
Tax period: 2010-07-01 to 2011-06-30
Filed: 2012-05-10
IRS object ID: 201231329349302078
Schema version: 2010v3.4
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 J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-05-10T11:19:23-07:00	Timestamp
Tax Period End Date	2011-06-30	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2010-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	810231784	EIN

Name Name

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

Field	Value	IRS element (for citing)
Name Control	BILL	NameControl
Phone	4062382500	Phone

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

Officer Officer

Field	Value	IRS element (for citing)
Name	Connie F Prewitt	Name
Title	CFO	Title
Phone	4062382134	Phone
Date Signed	2012-05-15	DateSigned

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Nicholas Wolter MD	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

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

Field	Value	IRS element (for citing)
Gross Receipts	1091195196	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	billingsclinic.com	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1907	YearFormation
State Legal Domicile	MT	StateLegalDomicile
Activity Or Mission Description	Billings Clinic will be a national leader in providing the best clinical quality, patient safety, service and value.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	12	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	3893	TotalNbrEmployees
Total Nbr Volunteers	248	TotalNbrVolunteers
Total Gross UBI	5393358	TotalGrossUBI
Net Unrelated Business Txbl Income	118877	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	5252157	ContributionsGrantsPriorYear
Contributions Grants Current Year	3799079	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	486738291	ProgramServiceRevenuePriorYear
Program Service Revenue CY	501834997	ProgramServiceRevenueCY
Investment Income Prior Year	4176066	InvestmentIncomePriorYear
Investment Income Current Year	11022251	InvestmentIncomeCurrentYear
Other Revenue Prior Year	13867154	OtherRevenuePriorYear
Other Revenue Current Year	16685027	OtherRevenueCurrentYear
Total Revenue Prior Year	510033668	TotalRevenuePriorYear
Total Revenue Current Year	533341354	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	262345592	SalariesEtcPriorYear
Salaries Etc Current Year	269671198	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	224834233	OtherExpensePriorYear
Other Expenses Current Year	235125312	OtherExpensesCurrentYear
Total Expenses Prior Year	487179825	TotalExpensesPriorYear
Total Expenses Current Year	504796510	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	22853843	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	28544844	RevenuesLessExpensesCY
Total Assets BOY	497625440	TotalAssetsBOY
Total Assets EOY	534176825	TotalAssetsEOY
Total Liabilities BOY	231421885	TotalLiabilitiesBOY
Total Liabilities EOY	227968706	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	266203555	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	306208119	NetAssetsOrFundBalancesEOY
Mission Description	Billings Clinic is a not for profit healthcare organization serving the nearly 600,000 residents of eastern and south-central Montana, northern Wyoming and the western Dakotas. Billings Clinic operates a multi-specilty group practice in Billings and in six regional locations, an acute care hospital and long term care facility. Their mission is healthcare, education and research.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	180207783	Expense
Grants	0	Grants
Revenue	282694101	Revenue
Description	Hospital patient care	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	180804402	Expense
Grants	0	Grants
Revenue	192785005	Revenue
Description	Clinic patient care	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	11157663	Expense
Grants	0	Grants
Revenue	7677754	Revenue
Description	Nursing home patient care	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Expense	7454296	Expense
Grants	0	Grants
Revenue	17529502	Revenue
Description	See Schedule O, statement 1	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	7454296	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	0	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	17529502	TotalOfOtherProgramServiceRev
Total Program Service Expense	379624144	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	1	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	230	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	3893	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	12	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	Connie F Prewitt	NamePerson
Telephone Number	4062382134	TelephoneNumber

Address US AddressUS

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 Form990PartVIISectionA (21 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
W Ballard
Board member	2	X	7500	0	0
D Brown
Board member	2	X	0	0	6725
E Fulton
Board member	2	X	0	0	3016
T Hathaway
Board member	2	X	0	0	7961
L Knight
Board member	2	X	12000	0	0
P Nance
Board member	2	X	7500	0	0
J Ott
Board member	2	X	0	0	6451
L Overstreet
Board member	2	X	0	0	7961
M Schaer
Board member	2	X	12000	0	0
J Shepard Lovell
Board member	2	X	0	0	4613
Dr J Millikan
Baord member/physician	95	X	552827	0	37557
Dr C McCracken
Board member/physician	75.00	X	290421	0	32836
Dr N Wolter
CEO	60		660565	0	181021	X
C Prewitt
CFO	68		307503	0	52964	X
D Ebel
CFO	1		20555	0	0	X
Dr Wentzell
Dermatologic surgeon	50		1124787	0	34369		X
Dr Morone
Neurologic surgeon	75.00		985119	0	32047		X
Dr Purcell
Oncologist/hemotologist	70.00		927888	0	32949		X
Dr Sample
Interventional cardiologist	100.00		826025	0	32214		X
Dr Lindenbaum
Radiologist	50.00		796772	0	32003		X
Dr Knostman
Former board member	0		11714	0	835			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	6543176	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	505522	TotalOtherCompensation
Number Individuals GT100 K	319	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation	Address Line2AddressOfContractor/AddressUS/AddressLine2
Sodexo
C/O Billings Clinic	Billings	MT	59101	Patient food service	5025851
MD Network
Box 731	Cody	WY	82414	Transcription services	2095433
Healthcare Resource Group
12610 E Mirabeau Parkway	Spokane Valley	WA	99216	Temporary staffing	1921533	Suite 800
Weatherby Locums Inc
PO Box 972633	Dallas	TX	75397	Professional staffing	1716543
Bauer Construction
148 Hallowell Lane	Billings	MT	59101	Building contractor	1363753

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	38	NumberOfContractorsGT100K
Federated Campaigns	0	FederatedCampaigns
Membership Dues	0	MembershipDues
Fundraising Events	0	FundraisingEvents
Related Organizations	3799079	RelatedOrganizations
Government Grants	0	GovernmentGrants
All Other Contributions	0	AllOtherContributions
Noncash Contributions	0	NoncashContributions
Total Contributions	3799079	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
Patient service revenue	622000	496441639	496441639	0	$0
Reference lab	621500	3614459	0	3614459	$0
IT services to other hospitals	541519	1148047	0	1148047	$0
Optical shop	446130	630264	0	630264	$0
Partnership income related to program service	541900	588	0	588	$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	501834997	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	5777894	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$5,777,894	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	68849	Real
Personal	0	Personal

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	101211	Real
Personal	0	Personal

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-32362	Real
Personal	0	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-32362	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	-$32,362	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	562139723	Securities
Other	537166	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	556830883	Securities
Other	601649	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	5308840	Securities
Other	-64483	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	5244357	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$5,244,357	ExclusionAmount

Field	Value	IRS element (for citing)
Cntrbtns Rprtd Fundraising Events	0	CntrbtnsRprtdFundraisingEvents
Gross Sales Of Inventory	458024	GrossSalesOfInventory
Cost Of Goods Sold	320099	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	137925	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$137,925	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
Insurance premiums	524298	6819037	6819037	0	$0
Share of JV	621300	945708	945708	0	$0

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	8814719	TotalRevenueColumn
Related Or Exempt Function Income	8814719	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	16579464	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	533341354	TotalRevenueColumn
Related Or Exempt Function Income	513021103	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	5393358	UnrelatedBusinessRevenue
Exclusion	$11,127,814	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	2242033	Total
Program Services	0	ProgramServices
Management And General	2242033	ManagementAndGeneral
Fundraising	0	Fundraising

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	222925838	Total
Program Services	181367104	ProgramServices
Management And General	41558734	ManagementAndGeneral
Fundraising	0	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	10619638	Total
Program Services	8633793	ProgramServices
Management And General	1985845	ManagementAndGeneral
Fundraising	0	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	19995413	Total
Program Services	14286553	ProgramServices
Management And General	5708860	ManagementAndGeneral
Fundraising	0	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	13888276	Total
Program Services	10837236	ProgramServices
Management And General	3051040	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	1350911	Total
Program Services	2375	ProgramServices
Management And General	1348536	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	182158	Total
Program Services	0	ProgramServices
Management And General	182158	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	37524	Total
Program Services	0	ProgramServices
Management And General	37524	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	846809	Total
Program Services	0	ProgramServices
Management And General	846809	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	31835921	Total
Program Services	10505061	ProgramServices
Management And General	21330860	ManagementAndGeneral
Fundraising	0	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	994706	Total
Program Services	139339	ProgramServices
Management And General	855367	ManagementAndGeneral
Fundraising	0	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	92227877	Total
Program Services	88164821	ProgramServices
Management And General	4063056	ManagementAndGeneral
Fundraising	0	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	5494653	Total
Program Services	463233	ProgramServices
Management And General	5031420	ManagementAndGeneral
Fundraising	0	Fundraising

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	6400757	Total
Program Services	3451592	ProgramServices
Management And General	2949165	ManagementAndGeneral
Fundraising	0	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	2474418	Total
Program Services	1589867	ProgramServices
Management And General	884551	ManagementAndGeneral
Fundraising	0	Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	321995	Total
Program Services	118837	ProgramServices
Management And General	203158	ManagementAndGeneral
Fundraising	0	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	11325346	Total
Program Services	99811	ProgramServices
Management And General	11225535	ManagementAndGeneral
Fundraising	0	Fundraising

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	17097750	Total
Program Services	13249267	ProgramServices
Management And General	3848483	ManagementAndGeneral
Fundraising	0	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	15165636	Total
Program Services	4572896	ProgramServices
Management And General	10592740	ManagementAndGeneral
Fundraising	0	Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
Recruitment	1661887	5805	1656082
Bad debt	36589311	36259311	330000
Bed tax	3453397	280947	3172450
Dues and fees	980483	163626	816857
Repairs	6102137	4946511	1155626

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	581636	Total
Program Services	486159	ProgramServices
Management And General	95477	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	504796510	Total
Program Services	379624144	ProgramServices
Management And General	125172366	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	17087854	BOY
EOY	10559381	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	21883719	BOY
EOY	21303735	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	68297133	BOY
EOY	67931288	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	8546299	BOY
EOY	8704883	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	6794151	BOY
EOY	6505363	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	5524333	BOY
EOY	5380977	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	408241254	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	212978957	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	186707728	BOY
EOY	195262297	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	139090983	BOY
EOY	171354595	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	12191155	BOY
EOY	11657517	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	3722305	BOY
EOY	3222544	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	27779780	BOY
EOY	32294245	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	497625440	BOY
EOY	534176825	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	47708467	BOY
EOY	48962844	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	144839706	BOY
EOY	137531015	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	2531045	BOY
EOY	6327042	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	36342667	BOY
EOY	35147805	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	231421885	BOY
EOY	227968706	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	240597129	BOY
EOY	279868321	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	7725992	BOY
EOY	7316156	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	17880434	BOY
EOY	19023642	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	266203555	BOY
EOY	306208119	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	497625440	BOY
EOY	534176825	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	28544844	ReconcilationRevenueExpenses
Reconcilation Other Changes	11459720	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Both	X	FinancialStatementBoth
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Total Grassroots Lobbying TotalGrassrootsLobbying

Field	Value	IRS element (for citing)
Filing Organizations Totals	0	FilingOrganizationsTotals

Total Direct Lobbying TotalDirectLobbying

Field	Value	IRS element (for citing)
Filing Organizations Totals	37524	FilingOrganizationsTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

Field	Value	IRS element (for citing)
Filing Organizations Totals	37524	FilingOrganizationsTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

Field	Value	IRS element (for citing)
Filing Organizations Totals	504758986	FilingOrganizationsTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

Field	Value	IRS element (for citing)
Filing Organizations Totals	504796510	FilingOrganizationsTotals

Lobbying Nontaxable LobbyingNontaxableAmount

Field	Value	IRS element (for citing)
Filing Organizations Totals	1000000	FilingOrganizationsTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

Field	Value	IRS element (for citing)
Filing Organizations Totals	250000	FilingOrganizationsTotals

Tot Lobbying Grassroot Minus Non Tx TotLobbyingGrassrootMinusNonTx

Field	Value	IRS element (for citing)
Filing Organizations Totals	0	FilingOrganizationsTotals

Tot Lobby Expend Mns Lobbying Nontx TotLobbyExpendMnsLobbyingNontx

Field	Value	IRS element (for citing)
Filing Organizations Totals	0	FilingOrganizationsTotals

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

Field	Value	IRS element (for citing)
Current Year Minus3	1000000	CurrentYearMinus3
Current Year Minus2	1000000	CurrentYearMinus2
Current Year Minus1	1000000	CurrentYearMinus1
Current Year	1000000	CurrentYear
Total	4000000	Total

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

Total Lobbying Expenditures2 TotalLobbyingExpenditures2

Field	Value	IRS element (for citing)
Current Year Minus3	136064	CurrentYearMinus3
Current Year Minus2	105276	CurrentYearMinus2
Current Year Minus1	21245	CurrentYearMinus1
Current Year	37524	CurrentYear
Total	300109	Total

Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2

Field	Value	IRS element (for citing)
Current Year Minus3	250000	CurrentYearMinus3
Current Year Minus2	250000	CurrentYearMinus2
Current Year Minus1	250000	CurrentYearMinus1
Current Year	250000	CurrentYear
Total	1000000	Total

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

Grassroots Lobbying Expenditures GrassrootsLobbyingExpenditures

Field	Value	IRS element (for citing)
Current Year Minus3	0	CurrentYearMinus3
Current Year Minus2	0	CurrentYearMinus2
Current Year Minus1	0	CurrentYearMinus1
Current Year	0	CurrentYear
Total	0	Total

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	19640069	BeginningOfYearBalance
Contributions	605720	Contributions
Investment Earnings Or Losses	781122	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	0	OtherExpenditures
Administrative Expenses	0	AdministrativeExpenses
End Of Year Balance	21026911	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	18575246	BeginningOfYearBalance
Contributions	665198	Contributions
Investment Earnings Or Losses	399625	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	0	OtherExpenditures
Administrative Expenses	0	AdministrativeExpenses
End Of Year Balance	19640069	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1781249	BeginningOfYearBalance
Contributions	1048699	Contributions
Investment Earnings Or Losses	-197238	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	0	OtherExpenditures
Administrative Expenses	0	AdministrativeExpenses
End Of Year Balance	2632710	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.1	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.9	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	1	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	1	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	17998001	OtherCostOrOtherBasis
Book Value	17998001	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	150196046	OtherCostOrOtherBasis
Depreciation	59104941	Depreciation
Book Value	91091105	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	1374959	OtherCostOrOtherBasis
Depreciation	1131838	Depreciation
Book Value	243121	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	205217322	OtherCostOrOtherBasis
Depreciation	145114848	Depreciation
Book Value	60102474	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	33454926	OtherCostOrOtherBasis
Depreciation	7627330	Depreciation
Book Value	25827596	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	195262297	TotalOfBookValueLandBuildings

Other Assets OtherAssets

Field	Value	IRS element (for citing)
Description	Beneficial interest in Billings Clinic Foundation	Description
Book Value	32294245	BookValue

Field	Value	IRS element (for citing)
Total Book Value Other Assets	32294245	TotalBookValueOtherAssets
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
Swap valuation	$19,210,571
Provision for unpaid claims	$9,294,689
Estimated claims	$6,642,545

Field	Value	IRS element (for citing)
Total Of Amounts	35147805	TotalOfAmounts
Total Revenue	533341354	TotalRevenue
Total Expenses	504796510	TotalExpenses
Excess Or Deficit For Year	28544844	ExcessOrDeficitForYear
Net Unrealized GL On Investments	11458970	NetUnrealizedGLOnInvestments
Donated Services And Facilities	0	DonatedServicesAndFacilities
Investment Expenses	0	InvestmentExpenses
Prior Period Adjustments	0	PriorPeriodAdjustments
Other	$750	OtherAmount
Total Adjustments	11459720	TotalAdjustments
Excess Or Deficit Per FS	40004564	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	535472699	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	11458970	NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities	750	DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants	0	RecoveriesOfPriorYearGrants
Other Revenues	91	OtherRevenues
Revenue Not Rptd F990	11459811	RevenueNotRptdF990
Revenue Subtotal	524012888	RevenueSubtotal
Investment Expenses Not Included	846809	InvestmentExpensesNotIncluded
Other Revenues Not Included	8481657	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	9328466	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	533341354	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	495470747	TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities	0	DonatedServicesUseOfFacilities
Prior Year Adjustments	0	PriorYearAdjustments
Losses Reported	0	LossesReported
Other Expenses Included	98	OtherExpensesIncluded
Expenses Not Rptd F990	98	ExpensesNotRptdF990
Expenses Subtotal	495470649	ExpensesSubtotal
Investment Expenses Not Included2	846809	InvestmentExpensesNotIncluded2
Other Expenses Not Included	8479052	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	9325861	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	504796510	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (7 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchD_P05_S00_L04	Schedule D, Part V, Line 4	Schedule D, Part V, Line 4 - Endowment funds are to be invested and held in perpetuity to provide a source of income for Billings Clinic programs and needs.
SchD_P10_S00_L02	Schedule D, Part X, Line 2	There is no footnote.
SchD_P11_S00_L08	Schedule D, Part XI, Line 8	Transfer of donated equipment from Billings Clinic Foundation
SchD_P12_S00_L02d	Schedule D, Part XII, Line 2d	Rounding
SchD_P12_S00_L04b	Schedule D, Part XII, Line 4b	Reclass 1,110,614 MHI income 7,245,376 Auxiliary income 125,667
SchD_P13_S00_L02d	Schedule D, Part XIII, Line 2d	Rounding
SchD_P13_S00_L04b	Schedule D, Part XIII, Line 4b	Reclass 1,110,614 MHI expenses 7,242,771 Auxiliary expense 125,667

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent100	X	Pcent100
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	0	ExpensesExceededBudget
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Persons Served	36860	PersonsServed
Total Community Benefit Expense	13980388	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	13980388	NetCommunityBenefitExpense
Percent Of Total Expense	0.0299	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Persons Served	101446	PersonsServed
Total Community Benefit Expense	41029483	TotalCommunityBenefitExpense
Direct Offsetting Revenue	44491568	DirectOffsettingRevenue
Net Community Benefit Expense	-3462085	NetCommunityBenefitExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	138306	PersonsServed
Total Community Benefit Expense	55009871	TotalCommunityBenefitExpense
Direct Offsetting Revenue	44491568	DirectOffsettingRevenue
Net Community Benefit Expense	10518303	NetCommunityBenefitExpense
Percent Of Total Expense	0.0299	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	36	NumberOfActivitiesOrPrograms
Persons Served	103561	PersonsServed
Total Community Benefit Expense	3555877	TotalCommunityBenefitExpense
Direct Offsetting Revenue	347552	DirectOffsettingRevenue
Net Community Benefit Expense	3208325	NetCommunityBenefitExpense
Percent Of Total Expense	0.0069	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	7	NumberOfActivitiesOrPrograms
Persons Served	553	PersonsServed
Total Community Benefit Expense	2577748	TotalCommunityBenefitExpense
Direct Offsetting Revenue	518588	DirectOffsettingRevenue
Net Community Benefit Expense	2059160	NetCommunityBenefitExpense
Percent Of Total Expense	0.0044	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	12	NumberOfActivitiesOrPrograms
Persons Served	185239	PersonsServed
Total Community Benefit Expense	45466560	TotalCommunityBenefitExpense
Direct Offsetting Revenue	38058116	DirectOffsettingRevenue
Net Community Benefit Expense	7408444	NetCommunityBenefitExpense
Percent Of Total Expense	0.0158	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	12561	PersonsServed
Total Community Benefit Expense	3640581	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2965	DirectOffsettingRevenue
Net Community Benefit Expense	3637616	NetCommunityBenefitExpense
Percent Of Total Expense	0.0078	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	6	NumberOfActivitiesOrPrograms
Persons Served	3296	PersonsServed
Total Community Benefit Expense	196323	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	196323	NetCommunityBenefitExpense
Percent Of Total Expense	0.0004	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	62	NumberOfActivitiesOrPrograms
Persons Served	305210	PersonsServed
Total Community Benefit Expense	55437089	TotalCommunityBenefitExpense
Direct Offsetting Revenue	38927221	DirectOffsettingRevenue
Net Community Benefit Expense	16509868	NetCommunityBenefitExpense
Percent Of Total Expense	0.0353	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	62	NumberOfActivitiesOrPrograms
Persons Served	443516	PersonsServed
Total Community Benefit Expense	110446960	TotalCommunityBenefitExpense
Direct Offsetting Revenue	83418789	DirectOffsettingRevenue
Net Community Benefit Expense	27028171	NetCommunityBenefitExpense
Percent Of Total Expense	0.0652	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	4	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	173808	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	173808	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	3	NumberOfActivitiesOrPrograms
Persons Served	388	PersonsServed
Total Community Building Expense	76977	TotalCommunityBuildingExpense
Direct Offsetting Revenue	36294	DirectOffsettingRevenue
Net Community Building Expense	40683	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	7	NumberOfActivitiesOrPrograms
Persons Served	388	PersonsServed
Total Community Building Expense	250785	TotalCommunityBuildingExpense
Direct Offsetting Revenue	36294	DirectOffsettingRevenue
Net Community Building Expense	214491	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$16,410,297	BadDebtExpenseAmount
Amount Attributable To	5161647	AmountAttributableTo
Amount Reimbursed By Medicare	158775249	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	167364107	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-8588858	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

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

Address Address

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)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Teaching Hospital	X	TeachingHospital
Research Facility	X	ResearchFacility
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	6	NumberOfOtherFacilities

Other Facilities OtherFacilities (6 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
Billings Clinic (Billings Clinic)
2800 Tenth Avenue North	Billings	MT	59101	Multispecialty physician outpatient clinics
Billings MRI Center
1041 N 29th St	Billings	MT	59101	Medical imaging
Billings Clinic (Aspen Meadows)
3155 Avenue C	Billings	MT	59102	Long term care facility
Bozeman Dialysis Center
931 Highland Blvd	Bozeman	MT	59715	Dialysis unit
Livingston Imaging
504 S 13th St	Livingston	MT	59047	Medical imaging
Billings Clinic Sheridan Dialysis
1401 West 5th St	Sheridan	WY	82801	Dialysis unit

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchH_P01_S00_L03c	Schedule H, Part I, Line 3c	The Federal Poverty Guidelines (FPG) are utilized to determine eligibility. In addition, Billings Clinic utilizes a calculator that has built into the formulas the FPG and the cost of living within our area to help determine the patient's ability to pay. Our application requires submitting bank statement and investment account information to consider assets as part of the process. The application includes: o Completed and signed application and financial assistance checklist completed. o Letter of need completed. o Complete copies of previous years federal and state tax returns, all pages, all schedules, all W-2's. o Debt to income ratio o Type of employment (part/time, seasonal, etc.) o Copies of earnings for last three months for each person in the household, i.e., paystubs, social security, pensions, unemployment benefits, etc. Profit and Loss statement for self employed applicants. o Copies of last three months bank statements, savings statements, investment account statements. o Letters of support from assisting party if household is receiving assistance from family and/or friends. o Award letters from SNAP, LIEAP, TANF, college loans, general assistance, etc. o If currently unemployed, when was last day of work? o How they spend their income (Information from bank statements).
SchH_P01_S00_L07	Schedule H, Part I, Line 7	For the calculation of the unreimbursed cost of charity care and Medicaid, a ratio of patient care cost to charges using worksheet 2 was utilized. For the calculation of the cost of subsidized services, individual department cost to charge ratios were used, rather than facility wide.
SchH_P01_S00_L072f	Schedule H, Part I, Line 7, Column f	Bad debt expense included on Form 990, Part IX, line 25, Column A, but subtracted for purposes of calculating the percentage column is $36,589,311.
SchH_P01_S00_L07g	Schedule H, Part I, Line 7g	Included as subsidized health services are the unreimbursed costs attributable to our rural primary care physician clinics and regional physician outreach clinics (minus bad debt, charity care, Medicaid and Medicare) at a total net benefit of $2,637,190. The specialty outreach clinics offer biweekly or monthly specialty care in rural areas without that care available. Outreach clinics provided 15,053 specialty appointments. Primary care branch clinics had 114,806 encounters in FY11. Both outreach and primary care branch clinics offer financial asistance to eligible patients, and they see patients with Medicare, Medicaid and Health Montana Kids (SCHIP).
SchH_P02_S00_L00	Schedule H, Part II	Billings Clinic's community building activities include support for the Alliance, a partnership between city-county public health department, St. Vincent Healthcare and Billings Clinic for community health improvement efforts, community influenza vaccinations and disaster response planning. This includes advocacy for community health at the local and regional level. Under Workforce Development, Billings Clinic coordinates and sponsors a regional Science Expo to encourage young scientists to become future nurses, physicians or health care professionals.
SchH_P03_S0A_L04	Schedule H, Part III, Section A, Line 4	The Organization reports patient accounts receivable for services rendered at net realizable amounts from third-party payors, patients and others. The Organization provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient, the Organization bills third-party payers directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. For the calculation of the unreimbursed cost of bad debt, a ratio of patient care cost to charges using worksheet 2 was utilized and applied to charges written off to bad debt. The facility does not routinely discount patient charges and any payments received would reduce the bad debt expense. At this time, the provider does not have a methodology in place to determine amounts applicable to patients who would qualify for charity care, but did not provide sufficient information. Many of these accounts are written off to charity care under the organization's current policies, based upon known factors, such as homelessness. Others are written off to bad debt, but cannot be identified. We do have a number that would cover possible patients who would have qualified for charity care in the hospital only, but did not provide enough information to qualify. That amount is a cost of $5,161,647.
SchH_P03_S0B_L08	Schedule H, Part III, Section B, Line 8	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. Billings Clinic provided care for 382,186 Medicare patient encounters, at an unreimbursed cost of $8,588,858. 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.
SchH_P03_S0C_L09b	Schedule H, Part III, Section C, Line 9b	There was not a formal, written policy in tax year 2010. We do now have one which is effective as of 10/5/11 (OHA-205 "Patient Financial Services"). However, during tax year 2010 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 a 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. 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.
SchH_P06_S00_L02	Schedule H, Part VI, Line 2	The 2010 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 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. The 2010 Community Health Survey consisted of 400 randomized telephone 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 and employers. Results of the 2010 Community Health Assessment were reviewed by the Alliance, a Healthy By Design sponsored community forum, and the Billings Clinic Community Health Improvement Committee. Findings were compared between 2010 and the 2006 assessment results. And Implementation Plan has been completed, both for the Alliance (community-wide) and for Billings Clinic (organization-wide).
SchH_P06_S00_L03	Schedule H, Part VI, Line 3	* All patients may apply for financial assistance - informational brochures and applications 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. * 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 charity assistance if the account is 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 120 days after they are considered just "self-pay", at least three statements, and/or multiple attempts to contact the patient.
SchH_P06_S00_L04	Schedule H, Part VI, Line 4	Billings Clinic is based in Billings, Montana, the largest city in Montana, with more than 148,000 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 3,400 employees, including 238 physicians, and 81 mid-level practitioners, and operates a multi-specialty physician clinic; 272-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 40 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.
SchH_P06_S00_L05	Schedule H, Part VI, Line 5	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 2011, 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, used for Schedule H, 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. * Billings Clinic is a Medicaid disproportionate share hospital serving a significantly disproportionate number of low-income patients. * Billings Clinic has the only inpatient psychiatric services 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. * 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.
SchH_P06_S00_L06	Schedule H, Part VI, Line 6	Not applicable.
SchH_P06_S00_L07	Schedule H, Part VI, Line 7	Billings Clinic files a community benefit report to the state of Montana's Attorney General's office.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	X	FirstClassOrCharterTravel
Travel For Companions	X	TravelForCompanions
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	1	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Dr J Millikan
549976	0	0	0	2851	0	29088	0	8271	0	590186	0	0	0
Dr C McCracken
290421	0	0	0	0	0	26259	0	6379	0	323059	0	0	0
Dr N Wolter
583023	0	77438	0	104	0	171775	0	9048	0	841388	0	0	0
C Prewitt
256940	0	50563	0	0	0	46264	0	6502	0	360269	0	0	0
Dr Wentzell
1124687	0	0	0	100	0	21775	0	12396	0	1158958	0	0	0
Dr Morone
790367	0	0	0	194751	0	20461	0	11389	0	1016968	0	194751	0
Dr Purcell
699177	0	31500	0	197211	0	21775	0	10061	0	959724	0	197211	0
Dr Sample
825026	0	0	0	0	0	21775	0	10241	0	857042	0	0	0
Dr Lindenbaum
776772	0	20000	0	0	0	21775	0	10030	0	828577	0	0	0
Dr Knostman
0	0	0	0	11714	0	835	0	0	0	12549	0	11714	0

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchJ_P01_S00_L01a	Schedule J, Part I, Line 1a	Billings Clinic perioldically arranges and pays for charter travel for management and/or Board members attending governance education conferences, State legislative hearings and association meetings. There were 17 of these flights in FY11. Billings Clinic also pays for the travel expenses of spouses of Board members attending organizationally approved/arranged goverance education. This reimbursement is reported as income consistent with the Board travel reimbursement policy.
SchJ_P01_S00_L04	Schedule J, Part I, Line 4	Schedule J, Part I, Line 4 - Supplemental Retirement Agreement (CEO) - nonelective 457(f) agreement provides for fixed annual deferrals in amounts ranging from $115,000 to $165,000, which become vested and payable after continued employement on June 30, 2013 or earlier death, disability, involuntary termination without cause, or involuntary termination for good reason following a change in control of the corporation. Physician 457(f) Plan - Nonelective 457(f) agreement provides for one-time deferral of $200,000 in August 2006 to become vested and payable on July 1, 2010 or in a prorated amount on earlier death, disability or involuntary termination of employment without cause.
SchJ_P01_S00_L06	Schedule J, Part I, Line 6	Scheduel J, Part I, Line 6 - 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 target. 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

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEIN	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
Montana Facility Finance Authority
810302402	2008-05-30	60000000	Property, plant and equipment	0	0	0
Montana Facility Finance Authority
810302402	2009-06-24	12720000	Property, plant and equipment	0	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Amount RetiredAmountRetired	Amount Bond DefeasedAmountBondDefeased	Total ProceedsTotalProceeds	Amount In Reserve FundAmountInReserveFund	Capitalized InterestCapitalizedInterest	Refunding EscrowRefundingEscrow	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Credit EnhancementCreditEnhancement	Working Capital ExpendituresWorkingCapitalExpenditures	Capital ExpendituresCapitalExpenditures	Other Spent ProceedsOtherSpentProceeds	Amount UnspentAmountUnspent	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
0	0	60000000	5535735	0	0	1200000	0	0	53264265	0	0	2009	0	0	1	1
0	0	12720000	0	0	0	58000	0	0	12662000	0	0	2009	0	0	1	1

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged	Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
0	0	0	0	1	0	0	0	1
0	0	0	0	1	0	0	0	1

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiled	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Exception To RebateExceptionToRebate
0	0	0	0	0	0
0	0	0	0	0	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
F990_P06_S0B_L11b	Form 990, Part VI, Section B, Line 11b	The 990 review is completed before the return is filed is as follows: 1)CFO, 2)Executive group, 3)Governance and Nominating Committee of the Board, and 4)Board of Directors.
F990_P06_S0B_L12c	Form 990, Part VI, Section B, Line 12c	The Governance and Nominating Committee of the Board of Directors, according to their charter, reviews annually the disclosure statements of the Board of Directors and senior exectives and takes 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.
F990_P06_S0B_L15	Form 990, Part VI, Section B, Line 15	Billings Clinic has an 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.
F990_P06_S0C_L19	Form 990, Part VI, Section C, Line 19	Billings Clinic makes its tax forms available for public inspection through individual request.
F990_P11_S00_L05	Form 990, Part XI, Line 5	Part XI, line 5 unrealized gains and transfer of equipment from Billings Clinic Foundation

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

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

Address US AddressUS

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	Insurance captive	PrimaryActivities
Legal Domicile State	MT	LegalDomicileState
Total Income	7245376	TotalIncome
EOY Assets	9666532	EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

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

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

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

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2917 Tenth Avenue North	AddressLine1
City	Billings	City
State	MT	State
ZIP Code	59101	ZIPCode

Field	Value	IRS element (for citing)
EIN	810407289	EIN
Primary Activities	Fund raising	PrimaryActivities
Legal Domicile State	MT	LegalDomicileState
Exempt Code Section	501(c)(3)	ExemptCodeSection
Public Charity Status	7	PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

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

Field	Value	IRS element (for citing)
Controlled Org	0	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

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

Field	Value	IRS element (for citing)
Transaction Type	c	TransactionType
Amount Involved	3799079	AmountInvolved