Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
BENEFIS HOSPITALS INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1101 26TH STREET SOUTH
 
Room/suite
City or town, state or country, and ZIP + 4
GREAT FALLS, MT59405
D Employer identification number

81-0232122
E Telephone number

G Gross receipts $ 501,801,061
F Name and address of principal officer:
LAURA GOLDHAHN
1101 26TH STREET SOUTH
GREAT FALLS,MT59405
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.BENEFIS.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1897
M State of legal domicile: MT
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: BENEFIS HOSPITALS, INC. IS A 513 BED HOSPITAL, PROVIDING INPATIENT AND OUTPATIENT SERVICES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 11
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 7
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 2,389
6 Total number of volunteers (estimate if necessary) .... 6 545
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,053,770 0
9 Program service revenue (Part VIII, line 2g) ......... 242,223,015 498,946,250
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -350,692 790,935
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,038,521 1,541,270
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 245,964,614 501,278,455
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 98,128,700 95,693,909
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 130,163,330 383,491,409
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 228,292,030 479,185,318
19 Revenue less expenses. Subtract line 18 from line 12...... 17,672,584 22,093,137
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 401,952,006 132,767,947
21 Total liabilities (Part X, line 26)............ 162,857,953 151,999,870
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 239,094,053 -19,231,923
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: BENEFIS HOSPITALS, INC. IS DEDICATED TO OUR CHRISTIAN TRADITION AS A HEALING MINISTRY TO PROVIDE EXCELLENT PHYSICAL, EMOTIONAL, AND SPIRITUAL CARE TO ALL IN NEED.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 235,843,754 including grants of $   ) (Revenue $ 293,080,291 )
BENEFIS HOSPITALS, INC. OPERATES A 513 BED, TWO-CAMPUS FACILITY PROVIDING ACUTE CARE, REHABILITATION SERVICES, AND PSYCHIATRIC HEALTH SERVICES TO THE PUBLIC REGARDLESS OF ABILITY TO PAY.
4b (Code:   ) (Expenses $ 133,679,115 including grants of $   ) (Revenue $ 166,121,483 )
BENEFIS HOSPITALS, INC. PROVIDES OUTPATIENT MEDICAL AND SURGICAL SERVICES TO THE PUBLIC REGARDLESS OF ABILITY TO PAY.
4c (Code:   ) (Expenses $ 31,982,659 including grants of $   ) (Revenue $ 39,744,476 )
BENEFIS HOSPITALS, INC. PROVIDES HOSPICE, DIALYSIS, AND SKILLED NURSING SERVICES TO THE PUBLIC REGARDLESS OF ABILITY TO PAY.
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 401,505,528
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? ........
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
Yes
 
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
No
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II....................... Click to see attachment
32
Yes
 
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
198
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
2,389
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
11
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
7
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
 
No
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
DALE BIMLER
1101 26TH STREET SOUTH
GREAT FALLS,MT59405
(406) 455-2565
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) DOMINIC CASELNOVA III
PHARMACY DIRECTOR
 60.00         X   175,699 0 15,039
(2) COLONEL LESLIE L DIXON
DIRECTOR
 3.00 X           0 0 0
(3) PAUL DOLAN MD
CMQO
 59.00     X       655,373 0 75,181
(4) CHRIS EBELING
CHAIR
 6.00 X   X       0 0 0
(5) BILL FERRIN
DIRECTOR
 3.00 X           0 0 0
(6) LAURA GOLDHAHN
PRESIDENT
 39.00     X       0 707,446 89,549
(7) PETER GRAY
EXECUTIVE DIRECTOR
 60.00         X   148,780 0 6,787
(8) JULIE HICKETHIER
COO
 60.00     X       580,616 0 66,112
(9) KATHY HILL
CAO
 60.00         X   149,294 0 14,372
(10) JEFF JARACZESKI
DIRECTOR
 3.00 X           0 0 0
(11) JOE LODUCA
CAO
 60.00         X   150,850 0 13,378
(12) KEVIN A MCCAFFERTY MD
DIRECTOR
 3.00 X           0 0 0
(13) LYLE J ONSTAD MD
DIRECTOR
 3.00 X           0 0 0
(14) SUSAN WALLACE RAPH MN
DIRECTOR
 3.00 X           0 0 0
(15) DAVID A ROHRER MD
DIRECTOR
 3.00 X           0 0 0
(16) MAYILYN K ROSE
DIRECTOR
 3.00 X           0 0 0
(17) JERRY W SPEER MD
DIRECTOR
 3.00 X           0 302,167 6,252
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) FRANK SOLTYS
EXECUTIVE DIRECTOR
 60.00         X   141,811 0 6,787
(19) GREGORY S TIERNEY MD
DIRECTOR
 3.00 X           0 0 0
(20) BILL WEBER
DIRECTOR
 3.00 X           0 0 0
(21) DAVID WILSEY
DIRECTOR
 3.00 X           0 0 0


















1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 2,002,423 1,009,613 293,457
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet36
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
ARAMARK HEALTHCARE FOOD
25271 NETWORK PLACE
CHICAGO,IL60673 		CAFETERIA 1,997,801
ANESTHESIA ASSOCIATES
401 15TH AVENUE SOUTH 109
GREAT FALLS,MT59405 		MEDICAL 1,877,132
METRO AVIATION INC
PO BOX 7008
SHREVEPORT,LA71137 		AMBULANCE 1,512,523
COGENT HEALTHCARE
PO BOX 645037
CINCINNATI,OH45264 		HOSPITALISTS 1,066,483
CITY OF GREAT FALLS
PO BOX 5021
GREAT FALLS,MT59403 		UTILITIES 960,774
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet113
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet  
Program Service Revenue Business Code
2a PATIENT SERVICES 621,990 494,118,472 494,118,472    
b OTHER OPERATIONS 621,990 4,827,778 4,827,778    
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 498,946,250
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 589,958     589,958
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   200,977
b Less: cost or other basis and sales expenses    
c Gain or (loss)   200,977
d Net gain or (loss)..........MediumBullet 200,977     200,977
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a 513,511
b Less: cost of goods sold ..b 522,606
c Net income or (loss) from sales of inventory..MediumBullet -9,095     -9,095
Miscellaneous Revenue Business Code
11a CAFETERIA 722,210 1,550,365     1,550,365
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 1,550,365
12 Total revenue. See Instructions....MediumBullet 501,278,455 498,946,250 0 2,332,205
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21    
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 1,377,282 1,186,558 190,724  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 79,451,050 68,448,758 11,002,292  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....        
9 Other employee benefits ....... 9,043,010 158,615 8,884,395  
10 Payroll taxes ........... 5,822,567   5,822,567  
11 Fees for services (non-employees):        
a Management ...... 31,006,602   31,006,602  
b Legal .........        
c Accounting ...........        
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other ..........        
12 Advertising and promotion ....        
13 Office expenses ....... 47,663,422 46,246,185 1,417,237  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 12,967,062 6,434,933 6,532,129  
17 Travel ............ 537,775 389,282 148,493  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 5,922,439   5,922,439  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 7,936,071 6,435,185 1,500,886  
23 Insurance .............. 18,437 18,437    
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a CONTRACTUAL ADJ/CHARITY 241,174,476 241,174,476    
b OTHER EXPENSES 21,908,200 16,656,174 5,252,026  
c BAD DEBT EXPENSE 14,356,925 14,356,925    
d
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 479,185,318 401,505,528 77,679,790 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 13,447,360 1 23,198,521
2 Savings and temporary cash investments .......   2  
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 42,557,563 4 41,563,391
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 7,392,737 8 7,642,738
9 Prepaid expenses and deferred charges ............ 2,294,774 9 822,048
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 117,804,947
b Less: accumulated depreciation. ..... 10b 75,728,713 233,279,295 10c 42,076,234
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ...... 76,838,291 12 14,550,138
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 26,141,986 15 2,914,877
16 Total assets. Add lines 1 through 15 (must equal line 34)... 401,952,006 16 132,767,947
Liabilities 17 Accounts payable and accrued expenses . 22,937,658 17 26,653,080
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities .......... 131,518,076 20 123,059,068
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 8,402,219 25 2,287,722
26 Total liabilities. Add lines 17 through 25..... 162,857,953 26 151,999,870
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 230,445,277 27 -19,231,923
28 Temporarily restricted net assets ..... 2,422,346 28 0
29 Permanently restricted net assets ..... 6,226,430 29 0
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 239,094,053 33 -19,231,923
34 Total liabilities and net assets/fund balances ..... 401,952,006 34 132,767,947
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
501,278,455
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
479,185,318
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
22,093,137
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
239,094,053
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-280,419,113
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
-19,231,923
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number

81-0232122
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number

81-0232122
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c 11,091
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e 3,273
f Ending balance ................................... 1f 7,818
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 8,650,429 6,708,274 7,442,737
b Contributions ........   1,547,349 1,828,005
c Investment earnings or losses ...   772,024 -963,297
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		8,650,429 377,218 1,599,171
f Administrative expenses ....      
g End of year balance ......   8,650,429 6,708,274
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet0 %
b
Permanent endowment: SchDMd Bullet0 %
c
Term endowment: SchDMd Bullet0 %
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............        
d Equipment ................   117,804,947 75,728,713 42,076,234
e Other .................        
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 42,076,234
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) 2007 BONDS D/S RESERVE FUND 		8,830,620 F

(B) 2007 BONDS INTEREST RESERVE 		2,914,458 F

(C) 2007 BONDS PRINCIPAL RESERVE 		2,805,060 F






Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 14,550,138
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
THIRD-PARTY SETTLEMENTS 2,287,722








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 2,287,722
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
  PART IV, LINE 1B: THE ORGANIZATION MAINTAINS TRUST ACCOUNTS FOR PATIENTS LIVING IN THE ONSITE NURSING HOME.
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT FUNDS ARE RELATED TO BENEFIS HEALTHCARE FOUNDATION. THESE ACCOUNTS WERE TRANSFERRED TO BENEFIS HEALTH SYSTEM, INC., A RELATED EXEMPT ORGANIZATION, DURING 2010.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. EFFECTIVE JANUARY 1, 2009, THE ORGANIZATION ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2010 OR 2009.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number

81-0232122
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    8,136,269   8,136,269 1.750 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		           
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs ..... 		    8,136,269   8,136,269 1.750 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    318,093   318,093 0.070 %
f Health professions education
(from Worksheet 5) .. 		    289,290   289,290 0.060 %
g Subsidized health services
(from Worksheet 6) .. 		    5,988,921   5,988,921 1.290 %
h Research (from Worksheet 7)     199,302   199,302 0.040 %
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    1,418,903   1,418,903 0.310 %
jTotal Other Benefits ...     8,214,509   8,214,509 1.770 %
kTotal. Add lines 7d and 7j. ..     16,350,778   16,350,778 3.520 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     16,800   16,800 0 %
2 Economic development            
3 Community support     15,940   15,940 0 %
4 Environmental improvements            
5 Leadership development and training for community members     11,543   11,543 0 %
6 Coalition building     2,432   2,432 0 %
7 Community health improvement advocacy     27,528   27,528 0.010 %
8 Workforce development            
9 Other     681   681 0 %
10 Total     74,924   74,924 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
6,940,138
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
337,985
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
85,421,261
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
106,425,033
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-21,003,772
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
11 TREASURE STATE
  		PREFERRED PROVIDER      
22 HEALTHCARE NETWORK
  		ORGANIZATION SERVING 50.000 % 0 % 50.000 %
33
  		GREAT FALLS AND      
44
  		SURROUNDING AREAS      
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?2
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 BENEFIS HOSPITALS INC EAST CAMPUS
1101 26TH STREET SOUTH
GREAT FALLS,MT59405 		X X         X    
2 BENEFIS HOSPITALS INC WEST CAMPUS
500 15TH AVENUE SOUTH
GREAT FALLS,MT59405 		X X              
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:NOT REQUIRED FOR 2010
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?1
Name and address Type of Facility (Describe)
1 BENEFIS SLETTEN HI-LINE CANCER CENTER
40 13TH STREET WEST
HAVRE,MT59501 		CANCER TREATMENT CENTER
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 14357000.
    PART I, LINE 6A: AS REQUIRED BY MONTANA LAW, THE ORGANIZATION ANNUALLY SUBMITS A COMMUNITY BENEFIT REPORT TO THE MONTANA ATTORNEY GENERAL'S OFFICE, WHICH OVERSEES NONPROFIT CORPORATIONS IN THE STATE. IN 2011, THE ATTORNEY GENERAL'S OFFICE RELEASED TO THE PUBLIC ITS FOURTH ANNUAL REPORT ON THE CHARITABLE ACTIVITIES OF MONTANA HOSPITALS, INCLUDING THE TEN LARGEST HOSPITALS IN THE STATE (WITH THE ORGANIZATION AMONG THEM). THE ORGANIZATION ITSELF ALSO ANNUALLY PREPARES A SUMMARY COMMUNITY BENEFIT REPORT FOR PURPOSES OF EXPLANATION TO THE LOCAL PUBLIC, WHICH IS PUBLISHED IN THE FORM OF A POSTING IN THE LOCAL NEWSPAPER.PART I, LINE 7G: THE ORGANIZATION AS PART OF ITS COMMUNITY BENEFIT INCLUDES THE COST OF SUBSIDIZED HEALTH SERVICES ATTRIBUTABLE TO SERVICES IT OFFERS THAT ARE SOLE COMMUNITY RESOURCES AND IF ABSENT WOULD NOT BE OFFERED IN THE SERVICE AREA. THE ORGANIZATION ONLY REPORTS THE SERVICES IF THEY ARE SUBSIDIZED.PART III, LINE 3: THE ORGANIZATION ESTIMATES THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ITS CHARITY CARE POLICY BY ANALYZING PAST ACTIVITY FOR ACCOUNTS CLASSIFIED AS BAD DEBT THAT SUBSEQUENTLY QUALIFIED FOR CHARITY CARE WHEN ADDITIONAL ELIGIBILITY INFORMATION WAS OBTAINED.PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS INCLUDE THE FOLLOWING NOTE REGARDING BAD DEBT EXPENSE: "THE CARRYING AMOUNT OF PATIENT AND RESIDENT RECEIVABLES IS REDUCED BY A VALUATION ALLOWANCE THAT REFLECTS MANAGEMENT'S 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 OR RESIDENTS DUE TO BAD DEBTS AND CHARITY CARE. MANAGEMENT CONSIDERS HISTORICAL WRITE-OFF AND RECOVERY INFORMATION IN DETERMINING THE ESTIMATED BAD DEBT PROVISION." THE COSTING METHODOLOGY UTILIZED TO CALCULATE THE COST OF THE ORGANIZATION'S BAD DEBT EXPENSE IS A COST TO CHARGE RATIO.PART III, LINE 8: THE ORGANIZATION DOES NOT BELIEVE THAT ANY SHORTFALL REPORTED IN LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT. THE ORGANIZATION USED ITS COST TO CHARGE RATIO TO OBTAIN THE MEDICARE ALLOWABLE COST REPORTED IN PART III, SECTION B. THE ORGANIZATION HAS A CONSIDERABLE POPULATION OF MEDICARE PATIENTS, AND IS PAID SUBSTANTIALLY LESS THAN ITS COSTS DUE TO THE REIMBURSEMENT METHODOLOGY USED BY MEDICARE.
    PART VI, LINE 2: BENEFIS HOSPITALS, INC. HISTORICALLY HAS ASSESSED THE HEALTH NEEDS OF THE COMMUNITIES WITHIN ITS SERVICE AREA THROUGH DIRECT OBSERVATION AND EXPERIENCE, AS WELL AS THROUGH THE USE OF CERTAIN SECONDARY DATA COMPILED BY INDEPENDENT SOURCES. THE HOSPITAL IS CURRENTLY ASSEMBLING A TEAM OF HEALTH CARE PROVIDERS, COMMUNITY AGENCIES, CLINICS, LOCAL HEALTH DEPARTMENTS, AND OTHER PUBLIC HEALTH PROFESSIONALS WHO WILL CONDUCT A COMMUNITY NEEDS ASSESSMENT IN THE FUTURE, AS CONTEMPLATED BY NEWLY ENACTED IRC SECTION 501(R).PART VI, LINE 3: THE ORGANIZATION HAS POSTED IN REGISTRATION AREAS, EMERGENCY ROOMS, AND FINANCIAL ASSISTANCE AREAS A SUMMARY OF ITS FINANCIAL ASSISTANCE POLICY ALONG WITH BROCHURES THAT DEFINE THE POLICY. THE POLICY AND APPLICATION IS AVAILABLE ONLINE AND IS MAILED TO EACH PATIENT ALONG WITH THEIR BILLING STATEMENT.PART VI, LINE 4: THE ORGANIZATION'S SERVICE AREA IS APPROXIMATELY 45,000 SQUARE MILES AND HAS A POPULATION OF APPROXIMATELY 225,000 PEOPLE. THE SERVICE AREA IS APPROXIMATELY 49.5% FEMALE AND 50.5% MALE. APPROXIMATELY 6.6% OF THE POPULATION IS UNDER 5 YEARS OF AGE, APPROXIMATELY 74% BETWEEN THE AGE OF 18 AND 65 YEARS OF AGE, AND APPROXIMATELY 14% OF THE POPULATION IS OVER THE AGE OF 65.THE SERVICE AREA IS 90.7% WHITE WITH THE NEXT LARGEST COMBINED POPULATION APPROXIMATELY 5.8% NATIVE AMERICAN AND THE REMAINDER AFRICAN-AMERICAN OR MULTIPLE RACES.
    THE AVERAGE HOUSHOLD SIZE IS 2.4 PEOPLE, WITH APPROXIMATELY 92.4% OF ALL HOUSING UNITS BEING OWNER OCCUPIED.THE AVERAGE PER CAPITA INCOME IS $17,566 WITH THE MEDIAN HOUSEHOLD INCOME BEING $32,971.(US CENSUS BUREAU, 2000 DEMOGRAPHIC PROFILE)PART VI, LINE 5: THE ORGANIZATION HELPS DEVELOP THE COMMUNITY THROUGH PARTICIPATION IN COMMUNITY LEADERSHIP ACTIVITIES, IMPROVED HEALTH ADVOCACY WITH COMMUNITY CLINICS, HEALTH FAIRS AND SUPPORT OF GENERAL HEALTH CLINICS. THE ORGANIZATION PROVIDES SUPPORT TO INDIAN HEALTH FACILITY CLINICS AND PROVIDES ECONOMIC FUNDING FOR COMMUNITY HEALTH CLINICS TO PROVIDE LOCUM DOCTORS TO COME DURING PLANNED AND UNPLANNED ABSENCES.BENEFIS HOSPITALS, INC. PROMOTES THE HEALTH OF PERSONS RESIDING THROUGHOUT ITS SERVICE AREA. THE HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS, WITHOUT REGARD TO ABILITY TO PAY, AND PARTICIPATES IN GOVERNMENT SPONSORED HEALTHCARE PAYMENT PROGRAMS. THE HOSPITAL USES ANY SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND OR IMPROVE ITS FACILITIES, AND ADVANCE ITS MEDICAL TRAINING, EDUCATION, AND RESEARCH PROGRAMS, THE HOSPITAL'S BOARD OF DIRECTORS (AND THAT OF BENEFIS HEALTH SYSTEM, ITS SOLE CORPORATE MEMBER) CONSISTS PRIMARILY OF INDIVIDUALS REPRESENTING THE COMMUNITY. THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF, WITH MEMBERSHIP AND PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS AND HEALTHCARE PROFESSIONALS, AS SET FORTH IN THE MEDICAL STAFF BYLAWS, RULES, AND REGULATIONS. IN THESE AND OTHER RESPECTS, THE HOSPITAL IS ORGANIZED AND OPERATED IN A MANNER THAT PROMOTES THE HEALTH OF THE COMMUNITY AND THEREFORE FULFILLS CHARITABLE PRUPOSES WITHIN THE MEANING OF INTERNAL REVENUE CODE SECTION 501(C)(3).
    PART VI, LINE 6: THE ORGANIZATION IS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM AND AS SUCH COORDINATES EFFORTS BETWEEN ALL SYSTEM ENTITIES TO REDUCE DUPLICATION AND PROMOTE THE BROADEST OFFERING OF SERVICES.
REPORTS FILED WITH STATES PART VI, LINE 7 MT
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number

81-0232122
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
No
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) DOMINIC CASELNOVA III (i)
(ii)		 160,493
0 		14,966
0 		240
0 		8,223
0 		6,816
0 		190,738
0 		0
0
(2) PAUL DOLAN MD (i)
(ii)		 255,750
0 		75,207
0 		324,416
0 		68,199
0 		6,982
0 		730,554
0 		318,056
0
(3) LAURA GOLDHAHN (i)
(ii)		 0
290,506 		0
86,086 		0
330,854 		0
83,767 		0
5,782 		0
796,995 		0
328,611
(4) PETER GRAY (i)
(ii)		 148,780
0 		0
0 		0
0 		0
0 		6,787
0 		155,567
0 		0
0
(5) JULIE HICKETHIER (i)
(ii)		 223,197
0 		63,724
0 		293,695
0 		65,670
0 		442
0 		646,728
0 		290,214
0
(6) KATHY HILL (i)
(ii)		 149,294
0 		0
0 		0
0 		7,585
0 		6,787
0 		163,666
0 		0
0
(7) JOE LODUCA (i)
(ii)		 134,798
0 		15,812
0 		240
0 		6,591
0 		6,787
0 		164,228
0 		0
0
(8) JERRY W SPEER MD (i)
(ii)		 0
292,679 		0
9,488 		0
0 		0
0 		0
6,252 		0
308,419 		0
0








Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  PART I, LINE 1A THE HEALTH CLUB WHERE OFFICERS ARE MEMBERS IS A SUBSIDIARY OF BENEFIS HEALTH SYSTEM, INC. (BHS). THE HEALTH CLUB DUES THAT BHS PAYS FOR ITS OFFICERS ARE TREATED AS TAXABLE INCOME TO THE INDIVIDUAL ACCORDINGLY. OFFICERS AND DEPARTMENT HEADS ARE ELIGIBLE FOR HEALTH CLUB DUES. SUBSTANTIATION IS REQUIRED BEFORE ANY REIMBURSEMENTS ARE PAID.
  PART I, LINE 4B BENEFIS HEALTH SYSTEM, INC. HISTORICALLY PERMITTED EXECUTIVES OF ITS AFFILIATED ENTITIES (INCLUDING THE ORGANIZATION) TO PARTICIPATE IN A NONQUALIFIED 457(F) RETIREMENT PLAN, WITH ANNUAL CONTRIBUTIONS BASED ON A PERCENT OF SALARY. IN 2010, THE SYSTEM SOUGHT THE ASSISTANCE OF AN INDEPENDENT COMPENSATION CONSULTING FIRM TO CONDUCT A COMPREHENSIVE REVIEW OF THE SYSTEM'S EXECUTIVE BENEFITS. BASED ON THE CONSULTANT'S RECOMMENDATIONS, BENEFIS HEALTH SYSTEM, INC. ADOPTED A MODIFIED VESTING SCHEDULE PURSUANT TO WHICH (I) ALL PARTICIPANTS IN THE PLANS WOULD BECOME FULLY VESTED IN SUPPLEMENTAL CONTRIBUTIONS MADE PRIOR TO 2010, WITH ALL PROCEEDS DISTRIBUTED CURRENTLY, AND (II) A NEW VESTING SCHEDULE WOULD APPLY TO FUTURE ACCRUALS UNDER CERTAIN OF THE PLANS. AS A RESULT OF THESE CHANGES, CERTAIN EXECUTIVES PARTICIPATING IN THE PLANS INCURRED SUBSTANTIAL ADDITIONAL TAXABLE INCOME IN 2010, AS SHOWN IN PART II, COLUMN B(III).
  PART I, LINE 7 BENEFIS HEALTH SYSTEM, INC. AND ITS AFFILIATES (INCLUDING THE ORGANIZATION) MAINTAIN AN INCENTIVE COMPENSATION PLAN THAT INCORPORATES BOTH SHARED AND INDIVIDUAL GOALS FOR MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM (INCLUDING MS. GOLDHAHN, MS. HICKETHIER, AND DR. DOLAN), AND IS SUBJECT TO A PRECONDITION THAT THE SYSTEM MUST ACHIEVE BUDGETED OPERATING PERFORMANCE. IN 2010, THE SYSTEM ADOPTED SHARED PERFORMANCE OBJECTIVES INCLUDING SYSTEM GROWTH AS WELL AS MEASURES TIED TO WORKFORCE, PATIENT EXPERIENCE, PATIENT SAFETY, CLINICAL QUALITY, FINANCE/OPERATIONS, AND COMMUNITY BENEFIT. THE INDIVIDUAL PERFORMANCE OBJECTIVES ADOPTED IN 2010 ARE BASED ON AN ARRAY OF QUALITY, FINANCIAL, OPERATIONAL AND STRATEGIC INITIATIVES. INCENTIVE OPPORTUNITY LEVELS ARE CALCULATED BASED ON PREDETERMINED PERCENTAGES OF EACH EXECUTIVE'S BASE SALARY, AND VARY BASED ON THE ACHIEVEMENT OF THRESHOLD, TARGET OR STRETCH LEVELS AS TO EACH PERFORMANCE OBJECTIVE. THE SYSTEM ALSO MAINTAINS A LONG-TERM INCENTIVE PLAN DIRECTED AT RECRUITING AND RETAINING EXECUTIVE LEADERSHIP. PAYMENTS UNDER THE LONG-TERM PLAN ARE CONDITIONED ON AN EXECUTIVE REMAINING EMPLOYED BY THE SYSTEM AND MAINTAINING SATISFACTORY INDIVIDUAL PERFORMANCE. IN ADDITION, THE SYSTEM MUST HAVE MAINTAINED SATISFACTORY OVERALL PERFORMANCE, BASED ON BOTH FINANCIAL CRITERIA AND SATISFACTION OF EMPLOYEES, PATIENTS AND PHYSICIANS. INCENTIVE OPPORTUNITIES UNDER THE LONG-TERM PLAN ARE APPROVED IN ADVANCE BY THE BENEFIS HEALTH SYSTEM, INC. COMPENSATION COMMITTEE, WITH LATER PAYOUTS APPROVED BY THE COMMITTEE BASED ON ACTUAL PERFORMANCE RESULTS.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number
81-0232122
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A BENEFIS HOSPITALS INC
  		81-0232122 61204KGH8 04-01-2007 2,455,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
B BENEFIS HOSPITALS INC
  		81-0232122 61204KGJ4 04-01-2007 350,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
C BENEFIS HOSPITALS INC
  		81-0232122 61204KGK1 04-01-2007 1,035,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
D BENEFIS HOSPITALS INC
  		81-0232122 61204KGL9 04-01-2007 1,880,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGM7 04-01-2007 415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGN5 04-01-2007 2,635,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGP0 04-01-2007 155,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGQ8 04-01-2007 3,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGR6 04-01-2007 940,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGS4 04-01-2007 2,415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGT2 04-01-2007 1,100,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGU9 04-01-2007 2,420,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGV7 04-01-2007 1,365,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGW5 04-01-2007 2,320,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGX3 04-01-2007 3,850,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGY1 04-01-2007 4,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGZ8 04-01-2007 4,245,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHA2 04-01-2007 4,460,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHB0 04-01-2007 4,680,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHC8 04-01-2007 4,920,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHD6 04-01-2007 5,160,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHE4 04-01-2007 5,410,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHF1 04-01-2007 7,985,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHG9 04-01-2007 43,310,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHH7 04-01-2007 10,000,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 2,516,108 358,712 1,060,763 1,926,796
4 Gross proceeds in reserve funds . . 169,567 24,175 71,488 129,852
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . . 372,123 53,052 156,883 284,966
7 Issuance costs from proceeds . . . 77,737 11,083 32,773 59,530
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . . 619,428 88,310 261,144 474,348
10 Capital expenditures from proceeds . . 1,896,680 270,402 799,619 1,452,448
11 Other spent proceeds . .        
12 Other unspent proceeds. . .        
13 Year of substantial completion . . . 2009 2009 2009 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X   X X   X  
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . .   X   X   X   X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .   X   X   X   X
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X   X   X   X
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X   X   X   X  
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 . . .. . . . . . 0 % 0 % 0 % 0 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue?   X   X   X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? . X   X   X   X  
b Name of provider . BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK
c Term of GIC . . 2.500000000000 2.500000000000 2.500000000000 2.500000000000
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . X   X   X   X  
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number
81-0232122
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A BENEFIS HOSPITALS INC
  		81-0232122 61204KGH8 04-01-2007 2,455,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
B BENEFIS HOSPITALS INC
  		81-0232122 61204KGJ4 04-01-2007 350,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
C BENEFIS HOSPITALS INC
  		81-0232122 61204KGK1 04-01-2007 1,035,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
D BENEFIS HOSPITALS INC
  		81-0232122 61204KGL9 04-01-2007 1,880,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGM7 04-01-2007 415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGN5 04-01-2007 2,635,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGP0 04-01-2007 155,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGQ8 04-01-2007 3,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGR6 04-01-2007 940,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGS4 04-01-2007 2,415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGT2 04-01-2007 1,100,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGU9 04-01-2007 2,420,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGV7 04-01-2007 1,365,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGW5 04-01-2007 2,320,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGX3 04-01-2007 3,850,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGY1 04-01-2007 4,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGZ8 04-01-2007 4,245,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHA2 04-01-2007 4,460,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHB0 04-01-2007 4,680,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHC8 04-01-2007 4,920,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHD6 04-01-2007 5,160,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHE4 04-01-2007 5,410,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHF1 04-01-2007 7,985,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHG9 04-01-2007 43,310,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHH7 04-01-2007 10,000,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 2,516,108 358,712 1,060,763 1,926,796
4 Gross proceeds in reserve funds . . 169,567 24,175 71,488 129,852
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . . 372,123 53,052 156,883 284,966
7 Issuance costs from proceeds . . . 77,737 11,083 32,773 59,530
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . . 619,428 88,310 261,144 474,348
10 Capital expenditures from proceeds . . 1,896,680 270,402 799,619 1,452,448
11 Other spent proceeds . .        
12 Other unspent proceeds. . .        
13 Year of substantial completion . . . 2009 2009 2009 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X   X X   X  
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . .   X   X   X   X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .   X   X   X   X
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X   X   X   X
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X   X   X   X  
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 . . .. . . . . . 0 % 0 % 0 % 0 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue?   X   X   X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? . X   X   X   X  
b Name of provider . BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK
c Term of GIC . . 2.500000000000 2.500000000000 2.500000000000 2.500000000000
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . X   X   X   X  
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number
81-0232122
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A BENEFIS HOSPITALS INC
  		81-0232122 61204KGH8 04-01-2007 2,455,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
B BENEFIS HOSPITALS INC
  		81-0232122 61204KGJ4 04-01-2007 350,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
C BENEFIS HOSPITALS INC
  		81-0232122 61204KGK1 04-01-2007 1,035,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
D BENEFIS HOSPITALS INC
  		81-0232122 61204KGL9 04-01-2007 1,880,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGM7 04-01-2007 415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGN5 04-01-2007 2,635,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGP0 04-01-2007 155,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGQ8 04-01-2007 3,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGR6 04-01-2007 940,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGS4 04-01-2007 2,415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGT2 04-01-2007 1,100,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGU9 04-01-2007 2,420,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGV7 04-01-2007 1,365,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGW5 04-01-2007 2,320,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGX3 04-01-2007 3,850,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGY1 04-01-2007 4,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGZ8 04-01-2007 4,245,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHA2 04-01-2007 4,460,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHB0 04-01-2007 4,680,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHC8 04-01-2007 4,920,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHD6 04-01-2007 5,160,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHE4 04-01-2007 5,410,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHF1 04-01-2007 7,985,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHG9 04-01-2007 43,310,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHH7 04-01-2007 10,000,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 2,516,108 358,712 1,060,763 1,926,796
4 Gross proceeds in reserve funds . . 169,567 24,175 71,488 129,852
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . . 372,123 53,052 156,883 284,966
7 Issuance costs from proceeds . . . 77,737 11,083 32,773 59,530
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . . 619,428 88,310 261,144 474,348
10 Capital expenditures from proceeds . . 1,896,680 270,402 799,619 1,452,448
11 Other spent proceeds . .        
12 Other unspent proceeds. . .        
13 Year of substantial completion . . . 2009 2009 2009 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X   X X   X  
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . .   X   X   X   X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .   X   X   X   X
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X   X   X   X
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X   X   X   X  
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 . . .. . . . . . 0 % 0 % 0 % 0 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue?   X   X   X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? . X   X   X   X  
b Name of provider . BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK
c Term of GIC . . 2.500000000000 2.500000000000 2.500000000000 2.500000000000
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . X   X   X   X  
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number
81-0232122
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A BENEFIS HOSPITALS INC
  		81-0232122 61204KGH8 04-01-2007 2,455,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
B BENEFIS HOSPITALS INC
  		81-0232122 61204KGJ4 04-01-2007 350,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
C BENEFIS HOSPITALS INC
  		81-0232122 61204KGK1 04-01-2007 1,035,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
D BENEFIS HOSPITALS INC
  		81-0232122 61204KGL9 04-01-2007 1,880,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGM7 04-01-2007 415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGN5 04-01-2007 2,635,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGP0 04-01-2007 155,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGQ8 04-01-2007 3,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGR6 04-01-2007 940,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGS4 04-01-2007 2,415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGT2 04-01-2007 1,100,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGU9 04-01-2007 2,420,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGV7 04-01-2007 1,365,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGW5 04-01-2007 2,320,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGX3 04-01-2007 3,850,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGY1 04-01-2007 4,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGZ8 04-01-2007 4,245,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHA2 04-01-2007 4,460,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHB0 04-01-2007 4,680,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHC8 04-01-2007 4,920,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHD6 04-01-2007 5,160,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHE4 04-01-2007 5,410,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHF1 04-01-2007 7,985,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHG9 04-01-2007 43,310,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHH7 04-01-2007 10,000,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 2,516,108 358,712 1,060,763 1,926,796
4 Gross proceeds in reserve funds . . 169,567 24,175 71,488 129,852
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . . 372,123 53,052 156,883 284,966
7 Issuance costs from proceeds . . . 77,737 11,083 32,773 59,530
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . . 619,428 88,310 261,144 474,348
10 Capital expenditures from proceeds . . 1,896,680 270,402 799,619 1,452,448
11 Other spent proceeds . .        
12 Other unspent proceeds. . .        
13 Year of substantial completion . . . 2009 2009 2009 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X   X X   X  
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . .   X   X   X   X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .   X   X   X   X
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X   X   X   X
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X   X   X   X  
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 . . .. . . . . . 0 % 0 % 0 % 0 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue?   X   X   X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? . X   X   X   X  
b Name of provider . BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK
c Term of GIC . . 2.500000000000 2.500000000000 2.500000000000 2.500000000000
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . X   X   X   X  
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number
81-0232122
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A BENEFIS HOSPITALS INC
  		81-0232122 61204KGH8 04-01-2007 2,455,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
B BENEFIS HOSPITALS INC
  		81-0232122 61204KGJ4 04-01-2007 350,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
C BENEFIS HOSPITALS INC
  		81-0232122 61204KGK1 04-01-2007 1,035,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
D BENEFIS HOSPITALS INC
  		81-0232122 61204KGL9 04-01-2007 1,880,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGM7 04-01-2007 415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGN5 04-01-2007 2,635,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGP0 04-01-2007 155,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGQ8 04-01-2007 3,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGR6 04-01-2007 940,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGS4 04-01-2007 2,415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGT2 04-01-2007 1,100,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGU9 04-01-2007 2,420,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGV7 04-01-2007 1,365,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGW5 04-01-2007 2,320,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGX3 04-01-2007 3,850,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGY1 04-01-2007 4,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGZ8 04-01-2007 4,245,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHA2 04-01-2007 4,460,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHB0 04-01-2007 4,680,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHC8 04-01-2007 4,920,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHD6 04-01-2007 5,160,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHE4 04-01-2007 5,410,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHF1 04-01-2007 7,985,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHG9 04-01-2007 43,310,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHH7 04-01-2007 10,000,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 2,516,108 358,712 1,060,763 1,926,796
4 Gross proceeds in reserve funds . . 169,567 24,175 71,488 129,852
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . . 372,123 53,052 156,883 284,966
7 Issuance costs from proceeds . . . 77,737 11,083 32,773 59,530
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . . 619,428 88,310 261,144 474,348
10 Capital expenditures from proceeds . . 1,896,680 270,402 799,619 1,452,448
11 Other spent proceeds . .        
12 Other unspent proceeds. . .        
13 Year of substantial completion . . . 2009 2009 2009 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X   X X   X  
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . .   X   X   X   X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .   X   X   X   X
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X   X   X   X
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X   X   X   X  
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 . . .. . . . . . 0 % 0 % 0 % 0 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue?   X   X   X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? . X   X   X   X  
b Name of provider . BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK
c Term of GIC . . 2.500000000000 2.500000000000 2.500000000000 2.500000000000
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . X   X   X   X  
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number
81-0232122
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A BENEFIS HOSPITALS INC
  		81-0232122 61204KGH8 04-01-2007 2,455,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
B BENEFIS HOSPITALS INC
  		81-0232122 61204KGJ4 04-01-2007 350,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
C BENEFIS HOSPITALS INC
  		81-0232122 61204KGK1 04-01-2007 1,035,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
D BENEFIS HOSPITALS INC
  		81-0232122 61204KGL9 04-01-2007 1,880,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGM7 04-01-2007 415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGN5 04-01-2007 2,635,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGP0 04-01-2007 155,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGQ8 04-01-2007 3,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGR6 04-01-2007 940,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGS4 04-01-2007 2,415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGT2 04-01-2007 1,100,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGU9 04-01-2007 2,420,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGV7 04-01-2007 1,365,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGW5 04-01-2007 2,320,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGX3 04-01-2007 3,850,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGY1 04-01-2007 4,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGZ8 04-01-2007 4,245,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHA2 04-01-2007 4,460,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHB0 04-01-2007 4,680,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHC8 04-01-2007 4,920,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHD6 04-01-2007 5,160,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHE4 04-01-2007 5,410,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHF1 04-01-2007 7,985,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHG9 04-01-2007 43,310,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHH7 04-01-2007 10,000,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 2,516,108 358,712 1,060,763 1,926,796
4 Gross proceeds in reserve funds . . 169,567 24,175 71,488 129,852
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . . 372,123 53,052 156,883 284,966
7 Issuance costs from proceeds . . . 77,737 11,083 32,773 59,530
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . . 619,428 88,310 261,144 474,348
10 Capital expenditures from proceeds . . 1,896,680 270,402 799,619 1,452,448
11 Other spent proceeds . .        
12 Other unspent proceeds. . .        
13 Year of substantial completion . . . 2009 2009 2009 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X   X X   X  
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . .   X   X   X   X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .   X   X   X   X
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X   X   X   X
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X   X   X   X  
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 . . .. . . . . . 0 % 0 % 0 % 0 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue?   X   X   X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? . X   X   X   X  
b Name of provider . BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK
c Term of GIC . . 2.500000000000 2.500000000000 2.500000000000 2.500000000000
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . X   X   X   X  
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number
81-0232122
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A BENEFIS HOSPITALS INC
  		81-0232122 61204KGH8 04-01-2007 2,455,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
B BENEFIS HOSPITALS INC
  		81-0232122 61204KGJ4 04-01-2007 350,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
C BENEFIS HOSPITALS INC
  		81-0232122 61204KGK1 04-01-2007 1,035,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
D BENEFIS HOSPITALS INC
  		81-0232122 61204KGL9 04-01-2007 1,880,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGM7 04-01-2007 415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGN5 04-01-2007 2,635,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGP0 04-01-2007 155,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGQ8 04-01-2007 3,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGR6 04-01-2007 940,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGS4 04-01-2007 2,415,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGT2 04-01-2007 1,100,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGU9 04-01-2007 2,420,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGV7 04-01-2007 1,365,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGW5 04-01-2007 2,320,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGX3 04-01-2007 3,850,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGY1 04-01-2007 4,045,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KGZ8 04-01-2007 4,245,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHA2 04-01-2007 4,460,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHB0 04-01-2007 4,680,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHC8 04-01-2007 4,920,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHD6 04-01-2007 5,160,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHE4 04-01-2007 5,410,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHF1 04-01-2007 7,985,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHG9 04-01-2007 43,310,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
BENEFIS HOSPITALS INC
  		81-0232122 61204KHH7 04-01-2007 10,000,000 CONSTRUCTION OF NEW MEDICAL FACILITIES   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 2,516,108 358,712 1,060,763 1,926,796
4 Gross proceeds in reserve funds . . 169,567 24,175 71,488 129,852
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . . 372,123 53,052 156,883 284,966
7 Issuance costs from proceeds . . . 77,737 11,083 32,773 59,530
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . . 619,428 88,310 261,144 474,348
10 Capital expenditures from proceeds . . 1,896,680 270,402 799,619 1,452,448
11 Other spent proceeds . .        
12 Other unspent proceeds. . .        
13 Year of substantial completion . . . 2009 2009 2009 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X   X X   X  
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . .   X   X   X   X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .   X   X   X   X
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X   X   X   X
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X   X   X   X  
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 . . .. . . . . . 0 % 0 % 0 % 0 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue?   X   X   X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? . X   X   X   X  
b Name of provider . BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK 		BAYERISCHE
LANDESBANK
c Term of GIC . . 2.500000000000 2.500000000000 2.500000000000 2.500000000000
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . X   X   X   X  
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number

81-0232122
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) KEVIN A MCCAFFERTY MD DIRECTOR 180,599 KEVIN MCCAFFERTY IS A PARTNER IN EMERGENCY PHYSICIANS PC, AN ENTITY THAT HAS AN AGREEMENT TO PROVIDE MEDICAL SERVICES TO THE ORGANIZATION.   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE N
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Liquidation, Termination, Dissolution or Significant Disposition of Assets
bullet Complete if the organization answered "Yes" to Form 990, Part IV, lines 31 or 32 or Form 990-EZ, line 36.
bullet Attach certified copies of any articles of dissolution, resolutions or plans.
bullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number
81-0232122
Part I
Liquidation, Termination or Dissolution. Complete if the organization answered "Yes" to Form 990, Part IV, line 31, or Form 990-EZ, line
36. Use Part III if additional space is needed.
1(a)Description of asset(s)
distributed or transaction
expenses paid		 (b)Date of
distribution		 (c)Fair market value of
asset(s) distributed or
amount of transaction
expenses		 (d)Method of
determining FMV for
asset(s) distributed or
transaction expenses		 (e)EIN of recipient (f)Name and address of recipient (g)IRC section
of recipient(s) (if
tax-exempt) or type
of entity
























Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2a
 
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .
2b
 
 
c
Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . .
2c
 
 
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution? . . . . .
2d
 
 
e
If the organization answered "Yes" to any of the questions in this line, provide the name of the person involved and explain in Part III. bullet
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.
Cat. No. 50087Z
Schedule N (Form 990 or 990-EZ) 2010

Schedule N (Form 990 or 990-EZ) 2010
Page 2
Part I
Liquidation, Termination or Dissolution (continued)
Note. If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B) should equal -0-.
Yes
No
3
Did the organization distribute its assets in accordance with its governing instrument(s)? If “No,” describe in Part III . . . . . . . . . . .
3
 
 
4a
Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate? . . . . . .
4a
 
 
b
If “Yes,” did the organization provide such notice? . . . . . . . . . . . . . . . . . . . . . . . . . .
4b
 
 
5
Did the organization discharge or pay all liabilities in accordance with state laws? . . . . . . . . . . . . . . . . . . .
5
 
 
6a
Did the organization have any tax-exempt bonds outstanding during the year? . . . . . . . . . . . . . . . . . . . .
6a
 
 
b
Did the organization discharge or defease tax-exempt bond liabilities in accordance with the Internal Revenue Code and state laws? . . . . . . . .
6b
 
 
c
If “Yes,” describe in Part III how the organization defeased or otherwise settled these liabilities. If “No,” explain in Part III.

Part II
Sale, Exchange, Disposition or Other Transfer of More Than 25% of the Organization's Assets. Complete if the organization answered "Yes" to Form 990, Part IV, line 32, or Form 990-EZ, line 36. Use Part III if additional space is needed.
1(a)Description of asset(s)
distributed or transaction
expenses paid		 (b)Date of
distribution		 (c)Fair market value of
asset(s) distributed or
amount of transaction
expenses		 (d)Method of
determining FMV for
asset(s) distributed or
transaction expenses		 (e)EIN of recipient (f)Name and address of recipient (g)IRC section
of recipient(s) (if
tax-exempt) or type
of entity
LAND AND BUILDING OWNED BY BENEFIS HOSPITALS TRANSFERRED TO BENEFIS HEALTH SYSTEM, INC., THE PARENT EXEMPT ORGANIZATION. 04-30-2010 272,007,831 ASSETS TRANSFERRED AT NET BOOK VALUE, APPROXIMATING FMV 26-3538104 BENEFIS HEALTH SYSTEM INC
 
1101 26TH STREET SOUTH
GREAT FALLS,MT59405 		501(C)(3)


















Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2a
 
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .
2b
 
 
c
Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2c
 
 
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization’s significant disposition of assets? . . . . . . .
2d
 
 
e
If the organization answered "Yes" to any of the questions in this line, provide the name of the person involved and explain in Part III.
Schedule N(Form 990 or 990-EZ) 2010

Schedule N (Form 990 or 990-EZ) 2010
Page 3
Part III
Supplemental Information. Complete to provide the information required by Parts I and II,
and any additional information.
Identifier Return Reference Explanation
    PART II, LINE 2E: CHRIS EBELING
    PART II, LINE 2E: CHRIS EBELING IS A DIRECTOR IN BENEFIS HOSPITALS, INC. AND BENEFIS HEALTH SYSTEM, INC.
Schedule N (Form 990 or 990-EZ) 2010


Additional Data


Software ID:  
Software Version:  


SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number

81-0232122
Identifier Return Reference Explanation
CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 IN EARLY 2010, AS PART OF A ONE-TIME REORGANIZATION, THE ORGANIZATION TRANSFERRED TO ITS TAX-EXEMPT PARENT ENTITY, BENEFIS HEALTH SYSTEM, INC., TITLE TO THE REAL ESTATE PREVIOUSLY OWNED BY THE ORGANIZATION. ON A GOING-FORWARD BASIS, BENEFIS HEALTH SYSTEM, INC. WILL OWN AND OVERSEE SUCH REAL ESTATE ASSETS FOR THE BENEFIT OF THE SYSTEM AS A WHOLE, LEASING THEM TO THE ORGANIZATION AND ITS AFFILIATES AS APPROPRIATE FOR THEIR RESPECTIVE OPERATIONS.
FORM 990, PART VI, SECTION A, LINE 2   CERTAIN OF THE OFFICERS AND DIRECTORS LISTED IN PART VII ALSO HOLD OFFICER AND/OR DIRECTOR POSITIONS IN RELATION TO THE ORGANIZATION'S AFFILIATES (AS IDENTIFIED IN SCHEDULE R) AND, IN THAT REGARD, MAY BE CONSIDERED TO HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER.
FORM 990, PART VI, SECTION A, LINE 3   PURSUANT TO A CONTRACTUAL ARRANGEMENT, THE ORGANIZATION OBTAINS CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES FROM ITS PARENT ENTITY, BENEFIS HEALTH SYSTEM, INC. (BHS). BHS PROVIDES THESE SERVICES TO ITS SUBSIDARY TAX EXEMPT OPERATING ENTITIES ON A CENTRALIZED BASIS.
FORM 990, PART VI, SECTION A, LINE 6   THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS BENEFIS HEALTH SYSTEM, INC., A MONTANA NON-PROFIT PUBLIC BENEFIT CORPORATION THAT HAS BEEN RECOGNIZED BY THE IRS AS DESCRIBED IN IRC SECTION 501(C)(3).
FORM 990, PART VI, SECTION A, LINE 7A   THE BOARD OF DIRECTORS OF THE ORGANIZATION IS ELECTED BY BENEFIS HEALTH SYSTEM, INC. AS THE ORGANIZATION'S SOLE CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7B   AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, BENEFIS HEALTH SYSTEM, INC. RETAINS CERTAIN RESERVED POWERS WITH RESPECT TO THE ORGANIZATION, INCLUDING AUTHORITY OVER MATTERS SUCH AS (WITHOUT LIMITATION) THE ORGANIZATION'S MISSION AND VISION STATEMENTS, STRATEGIC AND LONG-TERM PLANS, ELECTION OF ITS DIRECTORS AND OFFICERS, ANNUAL CAPITAL AND OPERATING BUDGETS, CHARITY CARE AND COMMUNITY BENEFIT POLICIES, AND ANY AMENDMENTS TO ITS ARTICLES OF INCORPORATION AND BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11   THIS FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT PERSONNEL OF BENEFIS HEALTH SYSTEM, INC. IN COLLABORATION WITH ITS OUTSTANDING ACCOUNTING FIRM. PRIOR TO FILING, A COPY OF THIS FORM 990 WAS DISTRIBUTED TO ALL MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS, WITH A PRESENTATION TO SUCH BOARD BY THE CHIEF FINANCIAL OFFICER OF BENEFIS HEALTH SYSTEM, INC.
  FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ANNUALLY COMPLETE A FORM TO DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. IN ADDITION, AT THE START OF EACH BOARD MEETING, MEMBERS ARE ASKED TO INDICATE WHETHER THEY HAVE A CONFLICT OF INTEREST WITH RESPECT TO ANY ITEMS ON THE AGENDA FOR THE MEETING. CONSISTENT WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY, BOARD MEMBERS ARE PROHIBITED FROM PARTICIPATING ON ANY MATTERS AS TO WHICH THEY HAVE A CONFLICT.
  FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE PRESIDENT, THE COO, AND THE CMQO WAS SET BY THE INDEPENDENT COMPENSATION COMMITTEE OF BENEFIS HEALTH SYSTEM, INC., WHICH IS CHARGED WITH ADMINISTERING THE SYSTEM'S EXECUTIVE COMPENSATION PHILOSOPHY, POLICIES AND PROGRAMS IN THE MANNER SET FORTH IN THE COMMITTEE'S WRITTEN CHARTER. THE COMMITTEE'S RESPONSIBILITIES INCLUDE (I) DETERMINING APPROPRIATE COMPENSATION FOR ALL EXECUTIVES AND OTHER DISQUALIFIED PERSONS, (II) EVALUATING AND ADOPTING EXECUTIVE COMPENSATION PLANS, POLICIES AND PROGRAMS, (III) REVIEWING AND APPROVING EXECUTIVE BENEFIT PLANS, AND (IV) VERIFYING THAT COMPENSATION IS APPROPRIATELY AND FULLY DISCLOSED AND REPORTED. THE COMMITTEE HAS ENGAGED AN INDEPENDENT COMPENSATION CONSULTING FIRM TO ASSIST IN ENSURING THAT AMOUNTS PAID TO THE SYSTEM'S EXECUTIVES ARE CONSISTENT WITH REASONABLE, FAIR MARKET LEVELS. THE PROCESS FOLLOWED BY THE COMMITTEE, INCLUDING THE DATA RELIED UPON AND THE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND TIMELY DOCUMENTED. THE COMPENSATION OF THE ORGANIZATION'S KEY EMPLOYEES WAS SET BY THEIR RESPECTIVE SUPERVISORY EXECUTIVES IN CONSULTATION WITH BENEFIS HEALTH SYSTEM'S HUMAN RESOURCES DEPARTMENT AND EXECUTIVE LEADERSHIP, BASED ON A REVIEW OF INDEPENDENT DATA AS TO AMOUNTS PAID BY SIMILARLY-SITUATED ORGANIZATIONS FOR PERSONS PERFORMING COMPARABLE SERVICES.
  FORM 990, PART VI, SECTION C, LINE 19 BENEFIS HOSPITALS, INC. PROVIDES COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST DURING NORMAL BUSINESS HOURS.
AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: FORM 990, PART VII, SECTION A, COLUMN B PAUL DOLAN - 1 HOUR LAURA GOLDHAHN - 21 HOURS JERRY SPEER - 57 HOURS
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 237,494. INTERAFFILIATE TRANSFERS -280,656,607. TOTAL TO FORM 990, PART XI, LINE 5: -280,419,113.
  FORM 990, PART XII, LINE 2C THE ORGANIZATION'S FINANCIAL RESULTS ARE REPORTED AS PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF BENEFIS HEALTH SYSTEM, INC. AND AFFILIATES. THE AUDIT COMMITTEE OF BENEFIS HEALTH SYSTEM, INC. IS RESPONSIBLE FOR SELECTION OF THE INDEPENDENT AUDIT FIRM AND OVERSEEING THE AUDIT.
  FORM 990, PART XI, LINE 5: IN EARLY 2010, AS PART OF A ONE-TIME REORGANIZATION, THE ORGANIZATION TRANSFERRED TO ITS SOLE MEMBER, BENEFIS HEALTH SYSTEM, INC., TITLE TO ITS REAL ESTATE, RESULTING IN A SIGNIFICANT CHANGE IN THE ORGANIZATION'S NET ASSETS. ON A GOING-FORWARD BASIS, BENEFIS HEALTH SYSTEM, INC. WILL OWN AND OVERSEE SUCH REAL ESTATE ASSETS, LEASING THEM TO THE ORGANIZATION AND ITS AFFILIATES AS APPROPRIATE IN LIGHT OF THEIR RESPECTIVE OPERATIONS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BENEFIS HOSPITALS INC
 
Employer identification number

81-0232122
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity







(1) BENEFIS SLETTEN HI-LINE CANCER CENTER LLC
1101 26TH STREET SOUTH
GREAT FALLS,MT59405
26-3144419 		MEDICAL CARE MT -291,584 1,840,955 BENEFIS HEALTH SYSTEM INC
 










Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) BENEFIS MEDICAL GROUP INC

1101 26TH STREET SOUTH

GREAT FALLS,MT59405
26-3538192 		PHYSICIAN SERVICES MT 501(C)(3) SCHEDULE A, LINE 3 BENEFIS HEALTH SYSTEM INC
 
 
No
(2) BENEFIS SPECTRUM MEDICAL INC

1101 26TH STREET SOUTH

GREAT FALLS,MT59405
81-0431871 		HOME HEALTH AND RELATED PRODUCTS MT 501(C)(3) SCHEDULE A, LINE 9 BENEFIS HEALTH SYSTEM INC
 
 
No
(3) BENEFIS HEALTH SYSTEM INC

1101 26TH STREET SOUTH

GREAT FALLS,MT59405
26-3538104 		MANAGEMENT AND SUPPORT SERVICES MT 501(C)(3) SCHEDULE A, LINE 11 BENEFIS HEALTH SYSTEM INC
 
 
No
(4) BENEFIS HEALTHCARE EES HEALTH PLAN AND TRUST

1101 26TH STREET SOUTH

GREAT FALLS,MT59405
36-3386166 		BENEFIT PLAN MT 501(C)(9)   BENEFIS HEALTH SYSTEM INC
 
 
No






For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) SPECTRUM HOME SOLUTIONS

2509 7TH AVE SOUTH
GREAT FALLS,MT59405
81-0431871 		IV THERAPY MT BENEFIS SPECTRUM MEDICAL INC
  		RELATED 337,068 257,484   No   Yes   50.670 %
(2) BBB LLC

1101 26TH STREET SOUTH
GREAT FALLS,MT59405
26-3652926 		MEDICAL BUILDING MT BENEFIS HEALTH SYSTEM INC
  		RELATED 93,505 9,686,166   No   Yes   60.000 %
(3) GREAT FALLS ATHLETIC CLUB LLC

1800 BENEFIS COURT
GREAT FALLS,MT59405
91-2081505 		FITNESS CLUB MT BENEFIS HEALTH SYSTEM INC
  		UNRELATED 217,538 2,478,270   No   Yes   51.000 %








Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) BENEFIS HEALTHCARE PRACTITIONERS PC
1101 26TH STREET SOUTH
GREAT FALLS,MT59405
20-1383362 		HEALTHCARE SERVICES MT BENEFIS HEALTH SYSTEM INC
  		C     100.000 %












Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
Yes
 
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
Yes
 
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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