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BOZEMAN DEACONESS HEALTH SERVICES: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
BOZEMAN DEACONESS HEALTH SERVICES (EIN 81-0232121)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-11
IRS object ID
201103159349303630
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-11T16:55:45-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1401N 31ST ST SUITE 1120 PO BOX 7112AddressLine1
CityBILLINGSCity
StateMTState
ZIP Code591037112ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN810232121EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BOZEMAN DEACONESS HEALTH SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBOZENameControl
Phone4065855000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1915 HIGHLAND BOULEVARDAddressLine1
CityBOZEMANCity
StateMTState
ZIP Code59715ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGORDON DAVIDSONName
TitleCFO/VP OF FINANCETitle
Phone4065855000Phone
Date Signed2011-11-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSTEVE MARKOVICHName
Phone4068962400Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN NORDWICKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1915 HIGHLAND BOULEVARDAddressLine1
CityBOZEMANCity
StateMTState
ZIP Code59715ZIPCode
FieldValueIRS element (for citing)
Gross Receipts203429339GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BOZEMANDEACONESS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1911YearFormation
State Legal DomicileMTStateLegalDomicile
Activity Or Mission DescriptionTO IMPROVE COMMUNITY HEALTH AND QUALITY OF LIFE FOR RESIDENTS AND VISITORS OF THE BOZEMAN, MT AREA.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees1577TotalNbrEmployees
Total Nbr Volunteers214TotalNbrVolunteers
Total Gross UBI2974273TotalGrossUBI
Net Unrelated Business Txbl Income-328956NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4169523ContributionsGrantsPriorYear
Contributions Grants Current Year589263ContributionsGrantsCurrentYear
Program Service Revenue Prior Year156533927ProgramServiceRevenuePriorYear
Program Service Revenue CY167836517ProgramServiceRevenueCY
Investment Income Prior Year380856InvestmentIncomePriorYear
Investment Income Current Year4150938InvestmentIncomeCurrentYear
Other Revenue Prior Year-1001700OtherRevenuePriorYear
Other Revenue Current Year-328130OtherRevenueCurrentYear
Total Revenue Prior Year160082606TotalRevenuePriorYear
Total Revenue Current Year172248588TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year122598GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY628328GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year66897050SalariesEtcPriorYear
Salaries Etc Current Year71680409SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year81877844OtherExpensePriorYear
Other Expenses Current Year85825379OtherExpensesCurrentYear
Total Expenses Prior Year148897492TotalExpensesPriorYear
Total Expenses Current Year158134116TotalExpensesCurrentYear
Revenues Less Expenses Prior Year11185114RevenuesLessExpensesPriorYear
Revenues Less Expenses CY14114472RevenuesLessExpensesCY
Total Assets BOY277866382TotalAssetsBOY
Total Assets EOY276617016TotalAssetsEOY
Total Liabilities BOY85491758TotalLiabilitiesBOY
Total Liabilities EOY68712966TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY192374624NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY207904050NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO IMPROVE COMMUNITY HEALTH AND QUALITY OF LIFE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change1SignificantChange
Expense32976166Expense
Revenue29778518Revenue
DescriptionBOZEMAN DEACONESS HEALTH GROUP IS OUR DEPARTMENT THAT PROVIDES PHYSICIAN SERVICES TO OUTPATIENTS. THE NUMBER OF MEDICARE AND MEDICAID PATIENTS SEEN IN 2010 INCREASED FROM 2009 BY 12%. REVENUE FOR THESE PATIENTS AND UNINSURED PATIENTS TOTALED 53% OF ALL CLINIC REVENUE. TOTAL OPERATING REVENUES WERE $29,778,518 WITH ASSOCIATED OPERATING EXPENSES OF $32,976,166. THE LOSS OF $3,197,647 IS REFLECTIVE OF OUR COMMITMENT TO PROVIDE ACCESS TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense17863844Expense
Revenue29509218Revenue
DescriptionBOZEMAN DEACONESS SURGICAL SERVICES STRIVES TO OFFER A WIDE ARRAY OF SURGICAL OPTIONS USING STATE OF THE ART TECHNOLOGY. OF THE 5,086 INPATIENT AND OUTPATIENT SURGERIES, ABOUT ONE THIRD WERE MEDICARE AND MEDICAID PATIENTS, WHICH COMPRISED 39% ($17,063,817) OF TOTAL REVENUE FROM THESE SERVICES ($44,185,983). OVER HALF OF THE MEDICARE/MEDICAID REVENUES ($9,593,173) WERE UNREIMBURSED AND WRITTEN OFF, ALONG WITH ANOTHER $5,083,592 FROM OTHER PAYORS. OUR OPERATING ROOOM ALSO RECORDED $12,696,074 IN OPERATING EXPENSES PLUS ANOTHER $5,167,770 OF INDIRECT OVERHEAD.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense6919373Expense
Revenue7986743Revenue
DescriptionTHE EMERGENCY ROOM AT BOZEMAN DEACONESS HOSPITAL IS ONE OF THE BUSIEST DEPARTMENTS IN OUR ORGANIZATION, WITH JUST UNDER 23,000 VISITS IN 2010. APPROXIMATELY 32% OF THESE VISITS WERE FROM MEDICARE AND MEDICAID PATIENTS, COMPRISING $4,081,537 OF THE $14,306,472 OF THE GROSS REVENUE. OVER HALF OF THE MEDICARE/MEDICAID REVENUE IS UNREIMBURSED (56%) AND WRITTEN OFF, ALONG WITH ALMOST 40% OF THE REMAINING REVENUE (TOTAL WRITE-OFFS OF $6,319,729). DIRECT AND INDIRECT EXPENSES INCURRED IN SUPPORTING THESE EMERGENCY OPERATIONS ACCUMULATED TO $6,919,373.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense74178713Expense
Grants628328Grants
Revenue97586997Revenue
DescriptionBOZEMAN DEACONESS HEALTH SERVICES OPERATES AN 86 BED HOSPITAL FACILITY (HOSPITAL), ALONG WITH A 43 UNIT ASSISTED LIVING HOME AND A 115 UNIT INDEPENDENT LIVING HOME (HILLCREST SENIOR LIVING OR HSL). ALL PATIENT AND RESIDENT SERVICE REVENUE IS USED TO PROVIDE HEALTH CARE SERVICES, HEALTH CARE PROMOTION, AND HEALTH CARE EDUCATION TO BOZEMAN AND THE SURROUNDING COMMUNITIES.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp74178713TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt628328TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev97586997TotalOfOtherProgramServiceRev
Total Program Service Expense131938096TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached0FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096145NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1577NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1GORDON DAVIDSONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4065851036TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1915 HIGHLAND BLVDAddressLine1
CityBOZEMANCity
StateMTState
ZIP Code59715ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
MARY POHL
CHAIR1.00XX000
TERRY CUNNINGHAM
1ST VICE CHAIR1.00XX000
JULIE JACKSON
2ND VICE CHAIR1.00XX000
JOHN MURDOCH
SECRETARY1.00XX000
DAVID DICKENSHEETS
SECRETARY (7/09-6/10)1.00XX000
JANET COLOMBO
TREASURER1.00XX000
KIRK MILLER
TRUSTEE1.00X000
TOM MILLESON
TRUSTEE1.00X000
DR JOHN ROBBINS
TRUSTEE, DOCTOR50.00X140916024157
REV DAVE MCCONNELL
TRUSTEE1.00X000
BRIAN BROWN
TRUSTEE1.00X000
JAYNEE GROSETH
TRUSTEE1.00X000
JOHN NORDWICK
CEO/PRESIDENT50.00X390301036574
STAN MOSER
CAO50.00X333980933
GORDON DAVIDSON
CFO/VP FINANCE50.00X263213035309
ELIZABETH LEWIS
SENIOR VP OPERATIONS/LEGAL50.00245715040890X
CHERYL RIDGELY
VP BUSINESS DEVELOPMENT/MA50.00182171032341X
ANNE CASTILLO MD
DOCTOR50.00676992015789X
JACK HENSOLD MD
DOCTOR50.00545041030252X
J BRUCE ROBERTSON MD
DOCTOR50.00407608033037X
TIM JOHNSON MD
DOCTOR50.00359121034420X
PEPPER HENYON MD
DOCTOR50.00319732033951X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3564208TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation317653TotalOtherCompensation
Number Individuals GT100 K321NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ABSAROKA EMERGENCY PHYSICIANS
1184 N 15TH STREET SUITE 1BOZEMANMT59715ER PHYSICIANS FEE3154200
ARBOR MEDIC
PO BOX 10305BOZEMANMT59715LANDSCAPING/LAWN/SNOW REMOVAL987887
MC BUILDERS JV
1203 S CHURCHBOZEMANMT59715CONSTRUCTION725935
PERSNICKETY DRY CLEANERS
2020 W BABCOCKBOZEMANMT59715LAUNDRY629343
MAYO COLLABORATIVE SERVICES
PO BOX 9146MINNEAPOLISMN554809146REFERENCE LAB614572
FieldValueIRS element (for citing)
Number Of Contractors GT100 K32NumberOfContractorsGT100K
Related Organizations589263RelatedOrganizations
Total Contributions589263TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT SERVICE RE622110149552345149552345
NET RESIDENT REVENUE62300056321915632191
INCOME FROM SUBSIDIARI90009942401614240161
PHARMACY REVENUE44611032966126127972683815
INTEREST IN FOUNDATION90009922442452244245

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column2870963TotalRevenueColumn
Related Or Exempt Function Income2579737RelatedOrExemptFunctionIncome
Unrelated Business Revenue291226UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue167836517TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2358125TotalRevenueColumn
Exclusion$2,358,125ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1491164Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real1819294Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-328130Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-328130TotalRevenueColumn
Exclusion-$328,130ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities24162681Securities
Other6991589Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities23070907Securities
Other6290550Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1091774Securities
Other701039Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1792813TotalRevenueColumn
Unrelated Business Revenue-768UnrelatedBusinessRevenue
Exclusion$1,793,581ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column172248588TotalRevenueColumn
Related Or Exempt Function Income164861476RelatedOrExemptFunctionIncome
Unrelated Business Revenue2974273UnrelatedBusinessRevenue
Exclusion$3,823,576ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total628328Total
Program Services628328ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1134634Total
Program Services165654ProgramServices
Management And General968980ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total57644086Total
Program Services48763714ProgramServices
Management And General8880372ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2651424Total
Program Services2251744ProgramServices
Management And General399680ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5884618Total
Program Services4922746ProgramServices
Management And General961872ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4365647Total
Program Services3621647ProgramServices
Management And General744000ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total170710Total
Management And General170710ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total64500Total
Management And General64500ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total28285Total
Management And General28285ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total296622Total
Management And General296622ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total12247665Total
Program Services6499485ProgramServices
Management And General5748180ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total818211Total
Program Services30235ProgramServices
Management And General787976ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3033366Total
Program Services2375513ProgramServices
Management And General657853ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1632567Total
Program Services497393ProgramServices
Management And General1135174ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total364953Total
Program Services190458ProgramServices
Management And General174495ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total247026Total
Program Services130696ProgramServices
Management And General116330ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2720715Total
Program Services2720715ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total13046672Total
Program Services13046672ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total2383182Total
Program Services786434ProgramServices
Management And General1596748ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES304409953039575045245
PROVISION FOR BAD DEBTS1076280610762806
EQUIPMENT RENT & MAINTE585240238241082028294
TAXES & LICENSES13259271631781162749
DUES & SUBSCRIPTIONS378709160820217889

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total10066Total
Management And General10066ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total158134116Total
Program Services131938096ProgramServices
Management And General26196020ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY17321904BOY
EOY32758275EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY22357943BOY
EOY19695581EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY393600EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4576504BOY
EOY4955740EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1329478BOY
EOY1555426EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis205298345LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec91885168LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY116700102BOY
EOY113413177EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY59110499BOY
EOY46045379EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY17530792BOY
EOY18168044EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY16161676BOY
EOY16338434EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY8813248BOY
EOY8721359EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY13964236BOY
EOY14572001EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY277866382BOY
EOY276617016EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY14571481BOY
EOY16032568EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY883657BOY
EOY795670EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY55419753BOY
EOY31766186EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3239409BOY
EOY8005388EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY11377458BOY
EOY12113154EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY85491758BOY
EOY68712966EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY184727649BOY
EOY197960821EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY6063573BOY
EOY8352216EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1583402BOY
EOY1591013EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY192374624BOY
EOY207904050EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY277866382BOY
EOY276617016EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses14114472ReconcilationRevenueExpenses
Reconcilation Other Changes1414954ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$2,225GrantsOtherOrganizationsAmount
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$0DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$26,000OtherActivitiesAmount
Total Lobbying Expenditures IIB28225TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF OTHER LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1I:ReturnReference
ExplanationHIRED CONSULTANT TO PROVIDE LOBBYING SERVICES IN CONNECTION WITH GOVERNMENTAL AFFAIRS REPRESENTATION TO ENSURE HOSPITAL, COMMUNITY, AND EMPLOYEE INTERESTS AND NEEDS ARE REPRESENTED.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis7104648InvestmentCostOrOtherBasis
Other Cost Or Other Basis2493939OtherCostOrOtherBasis
Book Value9598587BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis129562271OtherCostOrOtherBasis
Depreciation54325578Depreciation
Book Value75236693BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis66137487OtherCostOrOtherBasis
Depreciation37559590Depreciation
Book Value28577897BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings113413177TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
SHORT TERM INVESTMENTS - CDS15471193F
ALTERNATIVE INVESTMENTS2696851F
FieldValueIRS element (for citing)
Total Of Book Value Securities18168044TotalOfBookValueSecurities

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionINVESTMENT IN LIMITED LIABILITY COMPANIESDescription
Book Value16338434BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related16338434TotalOfBookValueProgramRelated

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
DEFERRED FINANCING COSTS, NET598461
ACCRUED INT RECEIVABLE & OTHER RECEIVABLES1725593
INTEREST IN NET ASSETS OF FOUNDATION11940446
DUE FROM AFFILIATES73654
OTHER ASSETS233847
FieldValueIRS element (for citing)
Total Book Value Other Assets14572001TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DEPOSITS$12,033,154
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$80,000
FieldValueIRS element (for citing)
Total Of Amounts12113154TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationTHE ORGANIZATION HAS ADOPTED THE PROVISIONS OF ACCOUNTING STANDARDS CODIFICATION TOPIC ASC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, AND AS OF DECEMBER 31, 2010 AND 2009, THE UNRECOGNIZED TAX BENEFIT ACCRUAL WAS ZERO. THE ORGANIZATION WILL RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS IN INCOME TAX EXPENSE, IF INCURRED. THE ORGANIZATION IS NO LONGER SUBJECT TO FEDERAL OR STATE TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2007.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense5309311TotalCommunityBenefitExpense
Direct Offsetting Revenue523960DirectOffsettingRevenue
Net Community Benefit Expense4785351NetCommunityBenefitExpense
Percent Of Total Expense0.03050PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense8572781TotalCommunityBenefitExpense
Direct Offsetting Revenue6135577DirectOffsettingRevenue
Net Community Benefit Expense2437204NetCommunityBenefitExpense
Percent Of Total Expense0.01560PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense288852TotalCommunityBenefitExpense
Direct Offsetting Revenue419275DirectOffsettingRevenue
Net Community Benefit Expense-130423NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense14170944TotalCommunityBenefitExpense
Direct Offsetting Revenue7078812DirectOffsettingRevenue
Net Community Benefit Expense7092132NetCommunityBenefitExpense
Percent Of Total Expense0.04610PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense638912TotalCommunityBenefitExpense
Direct Offsetting Revenue191886DirectOffsettingRevenue
Net Community Benefit Expense447026NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense189201TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense189201NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense26723644TotalCommunityBenefitExpense
Direct Offsetting Revenue19140026DirectOffsettingRevenue
Net Community Benefit Expense7583618NetCommunityBenefitExpense
Percent Of Total Expense0.04840PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense448178TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense448178NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense27999935TotalCommunityBenefitExpense
Direct Offsetting Revenue19331912DirectOffsettingRevenue
Net Community Benefit Expense8668023NetCommunityBenefitExpense
Percent Of Total Expense0.05540PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense42170879TotalCommunityBenefitExpense
Direct Offsetting Revenue26410724DirectOffsettingRevenue
Net Community Benefit Expense15760155NetCommunityBenefitExpense
Percent Of Total Expense0.10150PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense9253TotalCommunityBuildingExpense
Net Community Building Expense9253NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense101TotalCommunityBuildingExpense
Net Community Building Expense101NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense9354TotalCommunityBuildingExpense
Net Community Building Expense9354NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$6,033,583BadDebtExpenseAmount
Amount Attributable To622847AmountAttributableTo
Amount Reimbursed By Medicare29047855AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare31870366CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2822511MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1BOZEMAN DEACONESS HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1915 HIGHLAND BLVDAddressLine1
CityBOZEMANCity
StateMTState
ZIP Code59107ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NOT REQUIREDBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities6NumberOfOtherFacilities

Other Facilities OtherFacilities (6 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
DEACONESS INTERCITY IMAGING LLC
915 HIGHLAND BLVDBOZEMANMT59715OUTPATIENT IMAGING CENTER
ROCKY MOUNTAIN SURGERY CENTER LLC
1450 ELLIS ST SUITE 101BOZEMANMT59715OUTPATIENT SURGICAL CENTER
BOZEMAN DIALYSIS CENTER
931 HIGHLAND BLVD SUITE 3105BOZEMANMT59715OUTPATIENT DIALYSIS CENTER
HILLCREST SENIOR LIVING
1201 HIGHLAND BLVDBOZEMANMT59715INDEPENDENT AND ASSISTED LIVING FACILITY
HOSPICE OF SOUTHWEST MONTANA LLC
1600 ELLIS STREET SUITE 3ABOZEMANMT59715HOSPICE SERVICES
FAMILY DOCTORS URGENT CARE LLC
120 N 18TH AVENUEBOZEMANMT59715OUTPATIENT HEALTH CARE

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanation
PART I, LINE 3C: ANY INDIVIDUAL AND THEIR DEPENDENTS WHO ARE AT 150% OF THE FEDERAL POVERTY INCOME LEVEL OR BELOW WILL BE ELIGIBLE TO RECEIVE A 100% WRITE-OFF OF THE SELF-PAY PORTION OF INCURRED CHARGES, UPON COMPLETION OF AN APPLICATION. ANY UNINSURED INDIVIDUAL WITH INCOME UNDER 250% OF THE FEDERAL POVERTY GUIDELINES (FPG) WILL BE ELIGIBLE TO RECEIVE A DISCOUNT FROM CHARGES BASED ON CERTAIN GUIDELINES. COMPLETION OF THE FINANCIAL ASSISTANCE APPLICATION AND PROOF OF MEDICAID DENIAL WILL BE REQUIRED. IN SOME CASES, FULL OR PARTIAL ASSISTANCE MAY BE PROVIDED TO INSURED INDIVIDUALS WITH GROSS FAMILY INCOMES ABOVE 250% OF THE FPG ADJUSTED FOR FAMILY SIZE. CATASTROPHIC FINANCIAL ASSISTANCE IS AVAILABLE TO INDIVIDUALS WHO HAVE A LARGE BALANCE REMAINING AFTER ALL THIRD PARTY PAYMENTS HAVE BEEN TAKEN INTO ACCOUNT. THE BALANCE UNDER CONSIDERATION IS THAT AMOUNT WHICH IS DEEMED TO BE THE PATIENT'S FINANCIAL RESPONSIBILITY. IF SUCH RESPONSIBILITY IS GREATER THAN 50% OF THE FAMILY'S ANNUAL HOUSEHOLD INCOME, THE EXCESS AMOUNT WILL BE TREATED AS CATASTROPHIC FINANCIAL ASSISTANCE AND WRITTEN OFF OF THE PATIENT'S ACCOUNT. THIS ASSISTANCE IS AVAILABLE WITHOUT RESPECT TO THE FPG, BUT THEY MUST FOLLOW THE SAME PROCESS AS ALL OTHER PATIENTS SEEKING FINANCIAL ASSISTANCE BASED UPON FPG. ASSET TESTS ARE NOT USED FOR DETERMINING ANY LEVEL OF FINANCIAL ASSISTANCE. ALL DECISIONS REGARDING FINANCIAL ASSISTANCE ARE IN THE SOLE DISCRETION OF BDH. PRIOR TO RECEIVING SERVICES, BDH WILL MAKE AN EFFORT TO NOTIFY THE PATIENT REGARDING THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE.
PART I, LINE 7: THE COST TO CHARGE RATIO FROM WORKSHEET 2 WAS USED TO OBTAIN THE COSTS RELATED TO CHARITY CARE, MEDICAID, AND OTHER MEANS-TESTED PROGRAMS. ALL OTHER BENEFITS WERE CALCULATED USING OUR INTERNAL COSTING SYSTEM. THIS SYSTEM ASSIGNS ALL DIRECT EXPENSES TO SEPARATE COST CENTERS (DEPARTMENTS) AND ACCOUNTS. INDIRECT COSTS ARE THEN ALLOCATED TO APPLICABLE DEPARTMENTS BASED ON APPROPRIATE STATISTICS. FOR EXAMPLE, ENGINEERING AND ENVIRONMENTAL SERVICES WOULD BE ALLOCATED BASED ON SQUARE FOOTAGE WHEREAS INFORMATION SYSTEMS AND BENEFITS ARE ALLOCATED BASED ON AN ACCUMULATED COST PERCENTAGE AS DETERMINED BY THE MEDICARE COST REPORT. OUR INTERNAL SYSTEM DOES RECORD PATIENT REVENUES BASED ON TYPE (INPATIENT VS. OUTPATIENT VS. EMERGENCY) AND PAYOR (MEDICID, MEDICARE, COMMERCIAL, SELF-PAY, ETC.). RELATED COSTS ARE THEN DETERMINED BASED ON THE PRO-RATED SHARE AS A PERCENTAGE OF THE TOTAL. FOR EXAMPLE, IF MEDICAID COMPRISES 7% OF A DEPARTMENTS REVENUE, MEDICAID EXPENSES ARE CALCULATED AT 7% OF THE TOTAL AS WELL.
PART I, LINE 7G: AMOUNT OF COST ATTRIBUTABLE TO A PHYSICIAN CLINIC IS $24,544,748. ALL COSTS ASSOCIATED WITH A PROVIDER-BASED CLINIC OPERATIONAL DEPARTMENT WERE CONSIDERED PART OF THIS TOTAL.
PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR IS $11,249,782.
PART II: BOZEMAN DEACONESS HEALTH SERVICES PROVIDED LEADERSHIP DEVELOPMENT TO ASPIRING HEALTHCARE PROFESSIONALS THROUGH THE JUNIOR ACHIEVEMENT PROGRAM. BDHS EMPLOYEES SPOKE WITH HIGH SCHOOL STUDENTS ABOUT A CAREER AS A NURSE AND PROVIDED THEM WITH REAL LIFE EXAMPLES OF WHAT THE PROFESSION ENTAILS. THESE ACTIVITIES PROMOTE HEALTHCARE BECAUSE THE INDIVIDUALS ARE DIRECTED TOWARD LEARNING ABOUT HEALTH CARE PROFESSIONS AND WILL HOPEFULLY ENCOURAGE FUTURE INTEREST IN THESE TYPES OF POSITIONS THAT PROMOTE HEALTHCARE.ONE OF OUR ADMINISTRATORS PARTICIPATED IN ECONOMIC AND BUSINESS DEVELOPMENT THROUGH INVOLVEMENT IN SEVERAL ADVISORY BOARDS AND TASK FORCE PROJECTS AND INITIATIVES. THE INVOLVEMENT IN THESE COMMUNITY INITIATIVES PROVIDES AWARENESS OF HEALTH ISSUES AND EDUCATION ON HOW TO ACCESS HEALTH SERVICES.
PART III, LINE 4: THE ORGANIZATION USES WORKSHEET 2 TO CALCULATE BAD DEBT EXPENSE AT COST. BAD DEBT IS REPORTED BASED UPON ACTUAL BAD DEBT EXPENSE NET OF DISCOUNTS AND CONTRACTUAL ADJUSTMENTS, LESS RECOVERIES.IN DETERMINING THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR CHARITY CARE POLICY, WE OBTAINED STATISTICAL INFORMATION DIRECTLY FROM OUR CREDIT AGENCIES. FROM THIS INFORMATION WE WERE ABLE TO CALCULATE AN AVERAGE PERCENTAGE (10.5%) OF ACCOUNTS TURNED OVER FOR COLLECTIONS THAT WOULD HAVE BEEN SUBSEQUENTLY DEEMED UNCOLLECTIBLE OR RETURNED FOR CHARITY. THE ORGANIZATION USES WORKSHEET 2 TO CALCULATE BAD DEBT EXPENSE AT COST. THIS PERCENTAGE WAS APPLIED TO BAD DEBT EXPENSE AT COST TO DETERMINE THE ESTIMATE. NONE OF THE BAD DEBT IS INCLUDED AS COMMUNITY BENEFIT.NOTE IN AUDITED FINANCIAL STATEMENTS:THE CARRYING AMOUNT OF PATIENT AND RESIDENT RECEIVABLES IS REDUCED BY A VALUATION ALLOWANCE THAT REFLECTS MANAGEMENTS BEST ESTIMATE OF AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS, RESIDENTS AND THIRD-PARTY PAYORS. MANAGEMENT REVIEWS PATIENT AND RESIDENT RECEIVABLES BY PAYOR CLASS AND APPLIES PERCENTAGES TO DETERMINE ESTIMATED AMOUNTS THAT WILL NOT BE COLLECTED FROM THIRD PARTIES UNDER CONTRACTUAL AGREEMENTS AND AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS AND RESIDENTS DUE TO BAD DEBTS. MANAGEMENT CONSIDERS HISTORICAL WRITE OFF AND RECOVERY INFORMATION IN DETERMINING THE ESTIMATED BAD DEBT PROVISION.
PART III, LINE 8: THE ENTIRE AMOUNT OF SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT.THE MEDICARE SHORTFALL REPRESENTS A COST ABSORBED BY THE HOSPITAL AS A RESULT OF PROVIDING CARE TO MEDICARE PATIENTS. THE CONTRACT DRIVING THIS LOSS IS A NONDISCRETIONARY CONTRACT, AS IS PROVIDING THE SERVICES TO THIS POPULATION OF INDIVIDUALS. THE COST OF PROVIDING THIS BENEFIT TO THE COMMUNITY SHOULD BE REPORTABLE AS SUCH. MEDICARE ALLOWABLE COSTS OF CARE ARE BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CMS.FOR THE JOINT VENTURES, NET MEDICARE REVENUE WAS USED AS THE REVENUE RECEIVED, AND THAT % OF TOTAL REVENUES WAS APPLIED AGAINST OPERATING EXPENSES TO DETERMINE RELATED COSTS. THE JOINT VENTURE PORTION OF THE SHORTFALL IS $972,737.
PART III, LINE 9B: THE COLLECTION POLICY DOES NOT SPECIFICALLY ADDRESS THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE.
PART VI, LINE 6B: THE ORGANIZATION'S COMMUNITY BENEFIT REPORTED CAN BE FOUND ON ITS WEBSITE AT WWW.BOZEMANDEACONESS.ORG.
PART VI, LINE 2: BOZEMAN DEACONESS CONDUCTS A HEALTH CARE NEEDS ASSESSMENT ONCE EVERY TWO YEARS, WITH THE MOST RECENT BEING COMPLETED IN 2009. THE PRELIMINARY STEPS TO PERFORMING THIS ASSESSMENT INVOLVE GATHERING INFORMATION ABOUT THE CONSUMER AND THE COMMUNITY ASSETS. THIS INCLUDES ECONOMIC AND DEMOGRAPHIC PROFILES, BIRTH AND DEATH CHARACTERISTICS, DISEASE INCIDENCE AND PREVALENCE, HEALTH STATUS AND BEHAVIORS, HEALTH CARE UTILIZATION, SOCIAL AND COMMUNITY ISSUES, AND SCHOOL AND STUDENT POPULATION CHARACTERISTICS. WE ALSO REVIEW LOCAL ASSOCIATIONS, LOCAL INSTITUTIONS AND THEIR RESOURCES, COMMUNITY HEALTH RESOURCES, AND PHYSICAL ASSETS OF THE COMMUNITY. USING THIS DATA, WE DETERMINE THE SCOPE OF THE ASSESSMENT AND ISSUES TO BE ADDRESSED. SURVEY QUESTIONS ARE THEN DEVELOPED AND THE SURVEY IS ADMINISTERED TO TWO POPULATIONS: A GENERAL HOUSEHOLD MAIL SURVEY (RANDOM SAMPLE OF 2,550 GALLATIN COUNTY HOUSEHOLDS) AND A SELF-SELECTED 'CONVENIENCE' SURVEY (SURVEYS LEFT AND COLLECTED AT SELECTED LOCATIONS.) UPON RECEIVING THE RESULTS, SENIOR ADMINISTRATION AND THE BOARD DEVELOP PRIORITIES AND SET FORTH A COURSE OF ACTION.
PART VI, LINE 3: BOZEMAN DEACONESS HOSPITAL IS DEEPLY COMMITTED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS NEEDING, BUT UNABLE TO AFFORD, MEDICALLY NECESSARY HEALTH CARE SERVICES. BDH POSTS NOTICE OF ITS FINANCIAL ASSISTANCE POLICY IN ALL ADMITTING AREAS, AS WELL AS ON THE WEBSITE. AT THE EARLIEST FEASIBLE TIME, BDH WILL ATTEMPT TO DETERMINE WHETHER A PATIENT HAS THIRD PARTY COVERAGE FOR ANY PART OF THE HOSPITAL SERVICES PROVIDED. IF A PATIENT DOES NOT HAVE THIRD PARTY COVERAGE, A PATIENT ADVOCATE FROM THE MASH PROGRAM WILL SCREEN ALL INPATIENT CASES AND ANY OUTPATIENT CASES EXCEEDING $1,000 IN TOTAL CHARGES TO DETERMINE IF THE PATIENT QUALIFIES FOR THIRD PARTY FUNDING. IF NOT, THE PATIENT ADVOCATE WILL EXPLAIN THE FINANCIAL ASSISTANCE POLICY AND GIVE THE PATIENT AN APPLICATION IF DESIRED. IN CIRCUMSTANCES WHERE PAYMENT IN FULL WILL CAUSE FINANCIAL HARDSHIP THAT WILL SIGNIFICANTLY HARM THE PATIENT OR PATIENT'S FAMILY, THE APPLICANT MAY BE ASKED TO VISIT WITH CONSUMER CREDIT COUNSELING SERVICES TO FURTHER REVIEW THEIR FINANCIAL SITUATIONS. UPON REQUEST, PATIENTS MAY BE ASKED TO COMPLETE AN APPLICATION FOR MEDICAID PARTICIPATION OR FOR COVERAGE BY OTHER GOVERNMENTAL PAYMENT PROGRAMS. PATIENT BILLS ALSO CONTAIN BILLING INFORMATION EXPLAINING FINANCIAL OPTIONS AND PROVIDE CONTACT INFORMATION TO THE APPROPRIATE RESOURCES.
PART VI, LINE 4: OUR 'COMMUNITY' IS DEFINED AS GALLATIN, PARK AND MADISON COUNTIES. CONSIDERED A RURAL AREA, POPULATIONS FROM THE 2010 US CENSUS WERE 89,513, 15,636, AND 7,691, RESPECTIVELY. THE ESTIMATED MEDIAN HOUSEHOLD INCOMES (BASED ON 2009) WERE $47,065, $39,525, AND $41,345, RESPECTIVELY. THE AVERAGE HOUSEHOLD SIZE IS: GALLATIN: 2.6, PARK 2.2, AND MADISON 2.11. THE ESTIMATED % OF PERSONS BELOW POVERTY LEVEL ARE: GALLATIN 13.4%, PARK 13.3%, AND MADISON 11.6%. THE 2010 FEDERAL POVERTY GUIDELINE FOR A FAMILY OF 2 IS $14,750. THE ESTIMATED % OF HOURSEHOLDS (BASED ON 2009) WITH INCOME LESS THAN $15,000 WERE: GALLATIN 9.44%, PARK 14.31%, AND MADISON 12.79. THE % OF POPULATION WITH HEALTHCARE COSTS COVERED BY A GOVERNMENT PAYOR WERE: GALLATIN - MEDICARE 10%, MEDICAID 5%, AND CHIP 1%; PARK - MEDICARE 17%, MEDICAID 8%, AND CHIP 2%; AND MADISON - MEDICARE 19%, MEDICAID 5%, AND CHIP 2%. THE % OF POPULATION UNDER 65 YEARS OLD WITHOUT HEALTH INSURANCE BY COUNTY IS: GALLATIN 24%, PARK 21%, AND MADISON 29%. BOZEMAN DEACONESS HOSPITAL IS THE ONLY LOCAL HOSPITAL IN THESE 3 COUNTIES, WHILE THERE IS 1 CRITICAL ACCESS HOSPITAL IN PARK COUNTY AND 2 IN MADISON COUNTY. FOR GALLATIN COUNTY, THE TOWNS OF MANHATTAN, THREE FORKS AND WEST YELLOWSTONE ARE DESIGNATED AS HAVING A SHORTAGE OF PRIMARY MEDICAL CARE. THE LOW INCOME POPULATION CENSUS TRACTS 6 AND 11 ARE DESIGNATED AS MEDICALLY UNDERSERVED AREA/POPULATION (MUA/P) FOR PARK COUNTY, PARK CLINIC AND COMMUNITY HEALTH PARTNERS HAVE A SHORTAGE IN PRIMARY MEDICAL CARE. ALL OF PARK COUNTY IS CONSIDERED A MEDICALLY UNDERSERVED AREA. IN MADISON COUNTY, THE TOWNS OF HARRISON, MADISON VALLEY, AND VIGINIA CITY AS WELL AS MADISON VALLEY CLINIC, TWIN BRIDGES AND LOW INCOME POPULATION HAVE A SHORTAGE IN PRIMARY MEDICAL CARE PROFESSIONALS. THE TOWN OF SHERIDAN IS DESIGNATED AS MUA/P.
PART VI, LINE 6: AS A SOLE COMMUNITY HOSPITAL, BOZEMAN DEACONESS HEALTH SERVICES IS COMMITTED TO PROVIDING QUALITY CARE AND PROMOTING HEALTH TO THE VERY COMMUNITY THAT SUPPORTS US. OUR GOVERNING BODY IS REPRESENTED BY INDIVIDUALS OF OUR COMMUNITY, WITH ALL BUT ONE BEING INDEPENDENT TO OUR ORGANIZATION. TO ENSURE IMMEDIATE ACCESS TO CARE, BDHS HAS AN OPEN MEDICAL STAFF AND REQUIRES EACH MEDICAL STAFF MEMBER TO CARE FOR ANYONE PRESENTING A NEED FOR CARE IN THE EMERGENCY DEPARTMENT. WE ALSO DEVOTE A SIGNIFICANT AMOUNT OF SURPLUS FUNDS TO MAINTAINING A HIGH LEVEL OF PATIENT CARE THROUGH QUALITY INITIATIVES AND TECHNOLOGY INVESTMENTS. BDHS GIVES BACK TO ITS COMMUNITY THROUGH COMMUNITY BENEFIT OPPORTUNITIES, WHICH AT OVER $15.7 MILLION COMPRISED 10.15% OF OUR TOTAL OPERATING EXPENSES (EXCLUDING BAD DEBT) IN 2010.VARIOUS EMPLOYEES, PHYSICIANS, ADMINISTRATORS, AND BOARD MEMBERS OF THE HOSPITAL ARE ACTIVELY INVOLVED IN VOLUNTEER ROLES INCLUDING COMMUNITY BOARD POSITIONS IN NUMEROUS OTHER ACTIVITIES, GROUPS, AND ORGANIZATIONS THAT ACTIVELY PROMOTE THE HEALTH OF THE COMMUNITY.
PART VI, LINE 7: BOZEMAN DEACONESS HEALTH SERVICES OWNS A MAJORITY INTEREST IN ADVANCED MEDICAL IMAGING, ROCKY MOUNTAIN SURGERY CENTER, AND BOZEMAN DIALYSIS CENTER. ALL THREE OF THESE ORGANIZATIONS HOLD SIMILAR POLICIES REGARDING PROVIDING CARE TO ALL MEMBERS OF THE COMMUNITY AND OFFERING FINANCIAL ASSISTANCE AS DETERMINED BY ABILITY TO PAY.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
GREATER GALLATIN UNITED WAY
945 TECHNOLOGY BLVD 101FBOZEMANMT59718810384820501(C)(3)50000SUPPORT COMMUNITY HEALTH PROGRAMS WITHIN OUR SERVICE AREA
THE WELLNESS COMMUNITY
102 S 11TH AVEBOZEMANMT59715810542266501(C)(3)45348SUPPORT COMMUNITY HEALTH PROGRAMS WITHIN OUR SERVICE AREA
WESTERN MONTANA MENTAL HEALTH CENTER
BLDG T-9 FORT MISSOULA RDMISSOULAMT59804810307814501(C)(3)200000SUPPORT COMMUNITY HEALTH CRISIS PROGRAMS WITHIN OUR SERVICE AREA
BOZEMAN DEACONESS FOUNDATION
931 HIGHLAND BLVD SUITE 3200BOZEMANMT59715811407943501(C)(3)325000FUND ENDOWMENTS
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants4TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: RECIPIENTS OF GRANTS AND ASSISTANCE PREPARE INFORMATIONAL REPORTS SUBSTANTIATING THE USE OF THE FUNDS THAT WERE EARMARKED TO SUPPORT COMMUNITY HEALTH PROGRAMS. INVOLVEMENT OF BOZEMAN DEACONESS HEALTH SERVICES STAFF AND/OR ADMINISTRATION AS VOLUNTEERS IN THE ACTIVITIES BEING SUPPORTED ALSO ENSURES PROPER USAGE OF FUNDS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DR JOHN ROBBINS
12585700015059098830148540165653000
JOHN NORDWICK
319845060552099040225800162940429175000
GORDON DAVIDSON
2046020311580274530226550150010300869000
ELIZABETH LEWIS
1977260303340176550225520206850288952000
CHERYL RIDGELY
14980803167306900197980144660216435000
ANNE CASTILLO MD
63101800045974014700010890692781000
JACK HENSOLD MD
517399000276420147000166410576382000
J BRUCE ROBERTSON MD
3652830137120286130147000194260441734000
TIM JOHNSON MD
3294680137660158870147000207860394607000
PEPPER HENYON MD
295425000243070102480246230354603000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1APER JOHN NORDWICK'S CONTRACT, HE IS REIMBURSED FOR TWO BUSINESS TRIPS PER YEAR WHERE HIS WIFE ACCOMPANIES HIM. THESE ARE REPORTED AS TAXABLE COMPENSATION.
PART I, LINE 6A PHYSICIAN LISTED IN PART VII, SECTION A, RECEIVES INCENTIVE COMPENSATION BASED ON ACTUAL RELATIVE VALUE UNIT'S (RVU'S) PRODUCED IN EXCESS OF TARGETS. THE TOTAL OF THE INCENTIVE IS CALCULATED BY TAKING THE EXCESS RVU'S TIMES A RVU CONVERTER. THE RVU CONVERTER IS BASED UPON NET EARNINGS FROM SERVICES PROVIDED BY THE PHYSICIAN.
PART I, LINE 7THE BOARD ESTABLISHES GOALS EACH YEAR AND IF MET, THERE IS COMPENSATION TIED TO THEM. ALL SUCH COMPENSATION IS REVIEWED BY THE INDEPENDENT COMPENSATION SPECIALISTS. INCENTIVE COMPENSATION IS DETERMINED BY ACHIEVING FINANCIAL PERFORMANCE IN EXCESS OF BUDGETED PERFORMANCE, AND ACHIEVING PRE-DETERMINDED GOALS DEALING WITH PATIENT QUALITY, PATIENT SATISFACTION AND EMPLOYEE SATISFACTION. THIS APPLIES TO ALL SENIOR ADMINISTRATION AND ALL PHYSICIANS (WITH ONE EXCEPTION DESCRIBED IN SCHEDULE J, PART I LINE 6A) THAT RECEIVE COMPENSATION AND INCLUDES INCENTIVE COMPENSATION REFLECTED IN PART II, COLUMN B(II).

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MONTANA FACILITY FINANCE AUTHORITY
81030240261204JAA22004-03-0112695000TO FUND NEW MEDICAL OFFICE BUILDING IV ADDITION TO BOZEMAN DEACONESS CAMPUS.000
MONTANA FACILITY FINANCE AUTHORITY
810302402612043CE72005-09-0128545000TO FUND WING ADDITION OF HILLCREST AND DEFEASE HILLCREST CONSTRUCTION BONDS.000
MONTANA FACILITY FINANCE AUTHORITY
36461515561204EAH82010-04-226645000REFINANCING OF 1998 BOND DEBT000

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
125915588357764518540251831698541120051011
2800137140811418606636459960852666120060111
6645000651210013290020101011

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00000.000000.000000.000001
00000.000000.000000.000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
000000
000000
000000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CHANGES IN PROGRAM SERVICESFORM 990, PART III, LINE 3BOZEMAN DEACONESS HEALTH SERVICES (BDHS) SOLD ITS HOSPICE LINE OF BUSINESS IN APRIL 2010. SUBSEQUENTLY, BDHS INVESTED IN A JOINT VENTURE BECOMING A 50% MEMBER IN HOSPICE OF SOUTHWEST MONTANA, LLC.
FORM 990, PART VI, SECTION A, LINE 7BCHANGING THE ARTICLES OF INCORPORATION IN RELATIONSHIP TO THE PROCESS OF SELECTING BOARD MEMBERSHIP MUST BE APPROVED BY THE YELLOWSTONE CONFERENCE OF THE UNITED METHODIST CHURCH.
FORM 990, PART VI, SECTION B, LINE 11THE FINANCE COMMITTEE WILL REVIEW FORM 990 IN DETAIL AND WILL MAKE A RECOMMENDATION TO THE FULL BOARD FOR APPROVAL BEFORE FILING OF THE FORM 990. THE CFO REVIEWS THE FORM 990 AT A HIGHER LEVEL WITH THE BOARD BEFORE APPROVAL IS GRANTED.
FORM 990, PART VI, SECTION B, LINE 12CIN-HOUSE COUNSEL IDENTIFIES POTENTIAL CONFLICTS FROM ANNUAL DISCLOSURES AND INFORMS THE BOARD CHAIR. THE BOARD CHAIR DISCUSSES THE CONFLICT AND DECIDES WHETHER THE CONFLICT IS OF SUCH A NATURE TO EXCLUDE THE CONFLICTED PARTY FROM DISCUSSION AND/OR VOTE. THIS POLICY COVERS ALL BOARD MEMBERS, OFFICERS, SENIOR ADMINISTRATION, AND KEY EMPLOYEES.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE COMMITTEE RECEIVES A FORMAL PRESENTATION BY AN INDEPENDENT COMPENSATION CONSULTANT (AS SELECTED BY THE BOARD) QUALIFIED TO PERFORM COMPENSATION REVIEWS INCLUDING USAGE OF COMPARABILITY DATA. THIS PERSON PRESENTS RECOMMENDATIONS TO THE COMPENSATION COMMITTEE OF THE BOARD. THE COMPENSATION COMMITTEE MAKES RECOMMENDATIONS TO THE FULL BOARD ON AN ANNUAL BASIS FOR OFFICERS AND SENIOR ADMINISTRATION. THIS ANNUAL PROCESS WAS PERFORMED DURING 2010.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND ALL TAX RELATED INFORMATION REQUIRED TO BE AVAILABLE FOR PUBLIC INSPECTION ARE AVAILABLE VIA WALK-IN, TELEPHONE CALL, E-MAIL, AND/OR MAIL-IN REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE REQUIRED TO BE PROVIDED TO THE MUNICIPAL SECURITIES RULEMAKING BOARD, WHICH IS OUR TAX-EXEMPT BONDS TRUSTEE, VIA AN ON-LINE, CENTRAL FILING LOCATION CALLED ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA). THE FINANCIAL STATEMENTS CAN BE OBTAINED BY THE GENERAL PUBLIC AT THE EMMA WEBSITE. PER BOARD POLICY, THE FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC UPON SPECIFIC REQUEST TO BOZEMAN DEACONESS HEALTH SERVICES.
CHANGES IN NET ASSETS OR FUND BALANCES:FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 2,252,454. TRANSFERS TO RELATED PARTIES -837,500. TOTAL TO FORM 990, PART XI, LINE 5: 1,414,954.
LISTING OF ALL CUSIP#'S ASSOCIATED WITH BOND ISSUANCESCHEDULE K, PART I, BOND A, CUSIP#'S FOR SERIES 2004 BOND$ 1,255,000 61204J AA 2 1,275,000 61204J AB 0 1,300,000 61204J AC 8 1,335,000 61204J AD 6 240,000 61204J AE 4 245,000 61204J AF 1 255,000 61204J AG 9 260,000 61204J AH 7 270,000 61204J AJ 3 280,000 61204J AK 0 290,000 61204J AL 8 305,000 61204J AM 6 315,000 61204J AN 4 330,000 61204J AP 9 340,000 61204J AQ 7 1,955,000 61204J AV 6 2,445,000 61204J AW 4
LISTING OF ALL CUSIP#'S ASSOCIATED WITH BOND ISSUANCESCHEDULE K, PART I, BOND B, CUSIP#'S FOR SERIES 2005 BOND$ 455,000 612043 CE7 655,000 612043 CF4 675,000 612043 CG2 700,000 612043 CH0 730,000 612043 CJ6 755,000 612043 CK3 785,000 612043 CL1 820,000 612043 CM9 845,000 612043 CN7 885,000 612043 CP2 920,000 612043 CQ0 960,000 612043 CR8 1,000,000 612043 CS6 1,040,000 612043 CT4 1,085,000 612043 CU1 1,125,000 612043 CV9 1,175,000 612043 CW7 1,220,000 612043 CX5 1,270,000 612043 CY3 1,325,000 612043 CZ0 7,555,000 612043 DA4 2,565,000 612043 DB2

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1HILLCREST SENIOR LIVING LIMITED LIABILITY COMPANYBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11201 HIGHLAND BLVDAddressLine1
CityBOZEMANCity
StateMTState
ZIP Code59715ZIPCode
FieldValueIRS element (for citing)
EIN810232121EIN
Primary ActivitiesASSISTED LIVING HOMEPrimaryActivities
Legal Domicile StateMTLegalDomicileState
Total Income6554531TotalIncome
EOY Assets38528538EOYAssets
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1BOZEMAN DEACONESS FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1931 HIGHLAND BLVD SUITE 3200AddressLine1
CityBOZEMANCity
StateMTState
ZIP Code59715ZIPCode
FieldValueIRS element (for citing)
EIN841407943EIN
Primary ActivitiesRAISE FUNDS TO SUPPORT BOZEMAN DEACONESS HEALTH SERVICESPrimaryActivities
Legal Domicile StateMTLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status7PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org1ControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
DEACONESS INTERCITY IMAGING LLC
915 HIGHLAND BLVDBOZEMANMT59715810666871HEALTHCARE - IMAGING SERVICESMTN/ARELATED17753242925078010.77500
ROCKY MOUNTAIN SURGICAL CENTER LLC
1450 ELLIS ST STE 101BOZEMANMT59715364462300HEALTHCARE - SURGICAL SERVICESMTN/ARELATED26329992828614100.56960
BOZEMAN DIALYSIS CENTER
PO BOX 37000BILLINGSMT59107810519879HEALTHCARE - DIALYSIS SERVICESMTN/ARELATED-28541-108385010.60000

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1BOZEMAN DEACONESS REAL ESTATE DEVELOPMENT CORPBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 10490AddressLine1
CityBOZEMANCity
StateMTState
ZIP Code59719ZIPCode
FieldValueIRS element (for citing)
EIN205496567EIN
Primary ActivitySALE OF REAL ESTATE PROPERTY AND RESIDENCES TO SENIORSPrimaryActivity
Legal Domicile StateMTLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Share Of Total Income70614ShareOfTotalIncome
Share Of EOY Assets9168200ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org1PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (11 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
DEACONESS INTERCITY IMAGING LLC
I290664GENERAL LEDGER AND CORP. RECORDS
DEACONESS INTERCITY IMAGING LLC
K131988GENERAL LEDGER AND CORP. RECORDS
DEACONESS INTERCITY IMAGING LLC
P1992509GENERAL LEDGER AND CORP. RECORDS
DEACONESS INTERCITY IMAGING LLC
R2016550GENERAL LEDGER AND CORP. RECORDS
BOZEMAN DEACONESS REAL ESTATE DEVELOPMENT CORP
J55725GENERAL LEDGER AND CORP. RECORDS
BOZEMAN DEACONESS REAL ESTATE DEVELOPMENT CORP
P65347GENERAL LEDGER AND CORP. RECORDS
BOZEMAN DEACONESS FOUNDATION
B325000GENERAL LEDGER AND CORP. RECORDS
BOZEMAN DEACONESS FOUNDATION
C589263GENERAL LEDGER AND CORP. RECORDS
BOZEMAN DEACONESS FOUNDATION
K54936GENERAL LEDGER AND CORP. RECORDS
BOZEMAN DEACONESS FOUNDATION
Q837500GENERAL LEDGER AND CORP. RECORDS
ROCKY MOUNTAIN SURGICAL CENTER LLC
R2322040GENERAL LEDGER AND CORP. RECORDS