Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 73,413 | 78,758 | 834,042 | 2,869,264 | 15,863 | 3,871,340 |
| 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 | 17,199,823 | 18,324,153 | 18,548,341 | 20,518,962 | 21,456,621 | 96,047,900 |
| 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 | 17,273,236 | 18,402,911 | 19,382,383 | 23,388,226 | 21,472,484 | 99,919,240 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 99,919,240 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 17,273,236 | 18,402,911 | 19,382,383 | 23,388,226 | 21,472,484 | 99,919,240 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 163,449 | 234,821 | 241,725 | 300,131 | 309,447 | 1,249,573 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 163,449 | 234,821 | 241,725 | 300,131 | 309,447 | 1,249,573 |
| 11 | Net income from unrelated business activities not included on 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 VI.) .. | 46,275 | 67,364 | 63,372 | 286,080 | 463,091 | |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 17,482,960 | 18,705,096 | 19,624,108 | 23,751,729 | 22,068,011 | 101,631,904 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2022 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2023. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | OTHER INCOME |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE BOARD IS COMPOSED OF TWO VOTING MEMBERS (REPRESENTING THE PARENT HOSPITALS) AND SEVEN AT-LARGE MEMBERS. WHILE THE AT-LARGE MEMBERS ARE ABLE TO MAKE MOTIONS TO APPROVE INFORMATIONAL ITEMS THAT COME BEFORE THE BOARD, ONLY THE TWO VOTING MEMBERS ARE ABLE TO VOTE ON PROPOSALS THAT HAVE OPERATIONAL SIGNIFICANCE. |
| FORM 990, PART VI, SECTION A, LINE 3 | DURING THE FISCAL YEAR, THE ORGANIZATION'S MEDICAL DIRECTOR POSITION WAS PROVIDED THROUGH SERVICE AGREEMENT WITH CARLA DAVIS. CARLA'S 2022 COMPENSATION FROM PARTNERS IN HOME CARE FOR THESE WAS $254,254. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE CORPORATION SHALL HAVE ONE CLASS OF MEMBERSHIP COMPOSED OF ONE MEMBER. THE NAME OF THE MEMBER, EQUALLY REPRESENTED BY ST. PATRICK HOSPITAL AND HEALTH SCIENCES CENTER AND COMMUNITY MEDICAL CENTER, IS THE MISSOULA HOSPITAL ALLIANCE, INC. THE RIGHTS OF THE MEMBER SHALL BE EXERCISED BY THE BOARD OF DIRECTORS OF THE MISSOULA HOSPITAL ALLIANCE, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | ST. PATRICK HOSPITAL AND HEALTH SCIENCES CENTER AND COMMUNITY MEDICAL CENTER SHALL EACH HAVE THE RIGHT TO APPOINT ONE (1) DIRECTOR. THESE DIRECTORS SHALL NOT BE LIMITED IN THE NUMBER OF TERMS SERVED. THE BALANCE OF THE DIRECTORS SHALL BE AT-LARGE DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE MEMBER HAS THE RIGHT TO ELECT AND REMOVE MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBER HAS THE RIGHT OF APPROVAL OF: 1. THE MISSION STATEMENT OF PARTNERS IN HOME CARE (PIHC). 2. THE SELECTION AND REMOVAL OF THE CHIEF EXECUTIVE OFFICER. 3. THE ANNUAL OPERATING AND CAPITAL BUDGET FOR THE CORPORATION. THE BOARD OF DIRECTORS WILL SUBMIT ALL BUDGETS TO THE MEMBER AT THE ANNUAL MEETING. UNTIL APPROVAL BY THE MEMBER, NEITHER THE DIRECTORS NOR OFFICERS OF THE CORPORATION HAVE THE AUTHORITY TO EXPEND MONEY FOR ITEMS CONTAINED IN THE BUDGETS. 4. MAJOR NEW SERVICES APPROVED BY THE BOARD OF DIRECTORS. 5. CHANGES TO THE ARTICLES OF INCORPORATION AND BY-LAWS. |
| FORM 990, PART VI, SECTION A, LINE 8B | THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE DRAFT FORM WAS REVIEWED BY THE DIRECTOR OF FINANCE AND CEO. ONCE ANY NEEDED CORRECTIONS WERE MADE, THE DRAFT WAS PROVIDED TO THE BOARD OF DIRECTORS. THE BOARD WILL APPROVE THE DRAFT AT ITS NEXT SCHEDULED MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | POLICY: ALL STAFF, VOLUNTEERS, AND MEMBERS OF THE BOARD OF DIRECTORS AND PROFESSIONAL ADVISORY COMMITTEE OF THE AGENCY WILL DISCLOSE ANY DUALITY OF INTEREST OR POTENTIAL CONFLICT OF INTEREST. DEFINITION: A CONFLICT OF INTEREST MAY EXIST WHEN AN INDIVIDUAL WILL DERIVE ANY PROFIT OR GAIN DIRECTLY OR INDIRECTLY BY REASON OF HIS/HER ROLE IN THE AGENCY, AND THE OBJECTIVITY OR LOYALTY OF THAT INDIVIDUAL COULD BE QUESTIONED. PROCEDURE - BOARD OF DIRECTORS: 1. IF A MATTER ARISES IN WHICH A MEMBER OF THE BOARD HAS A CONFLICT OF INTEREST, THIS SHALL BE PROMPTLY DISCLOSED BY THE BOARD MEMBER TO THE BOARD OF DIRECTORS. 2. IN MATTERS INVOLVING A CONFLICT OF INTEREST, A BOARD OF DIRECTORS MEMBER MUST DISCLOSE ANY KNOWN SIGNIFICANT REASONS WHY A TRANSACTION MIGHT NOT BE IN THE BEST INTEREST OF THE AGENCY AND A BOARD MEMBER SHALL NOT PARTICIPATE IN DISCUSSION NOR VOTE ON THE RELATED TRANSACTIONS. 3. ALL BOARD MEMBERS OF AGENCY WILL DISCLOSE ANY DUALITY OF INTEREST OR POTENTIAL CONFLICT OF INTEREST. PROCEDURE: STAFF AND VOLUNTEERS: 1. ANY EMPLOYEE, CONTRACTED STAFF MEMBER, OR VOLUNTEER (INCLUDING A NON-EMPLOYEE MEMBER OF THE PROFESSIONAL ADVISORY COMMITTEE) THAT COULD, OR WOULD, DERIVE ANY PROFIT OR GAIN DIRECTLY OR INDIRECTLY BY A RELATIONSHIP WITH ANOTHER AGENCY, MUST MAKE THE CONFLICT KNOWN TO THE SUPERVISOR OR COMPLIANCE OFFICER. IF A STAFF MEMBER HAS TIES TO OR OWNERSHIP IN AN UNRELATED COMPANY, HE/SHE WILL NOTIFY THE SUPERVISOR, SO AS NOT TO BE PLACED IN A COMPROMISING POSITION. FOR EXAMPLE, A STAFF MEMBER WHO IS ALSO AN EMPLOYEE OF A HOSPITAL THAT GIVES REFERRALS TO THE AGENCY OR A STAFF MEMBER WHO HAS OWNERSHIP IN A MEDICAL SUPPLY COMPANY THAT PROVIDES MEDICAL SUPPLIES TO THE AGENCY. THE SUPERVISOR, IN CONJUNCTION WITH THE LEADERS OF THE AGENCY, WILL DETERMINE APPROPRIATE ACTIONS. 2. THE NATURE OF OUTSIDE INTERESTS MAY BE DETERMINED AS OWNERSHIP, ENTERTAINMENT, GIFTS, LOANS, EMPLOYMENT STATUS, OR RELATED STAFF MEMBERS OR VOLUNTEERS. 3. IT IS THE RESPONSIBILITY OF ALL STAFF MEMBERS AND VOLUNTEERS TO INFORM HIS/HER IMMEDIATE SUPERVISOR IF HE/SHE CONCURRENTLY WORKS FOR A COMPETITOR OF THE AGENCY. IT IS THE EMPLOYEE'S RESPONSIBILITY TO NOTIFY HIS/HER SUPERVISOR OF ANY CHANGES IN EMPLOYMENT STATUS. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE CEO'S COMPENSATION IS COMPARED TO MARKET STUDIES ANNUALLY. COMP WAS REVIEWED Q2 2022 AND WENT TO THE BOD FOR REVIEW AND LEVEL-SETTING. ALL OTHER EMPLOYEES' WAGES ARE BASED ON A REGIONAL SALARY MARKET SURVEY AND APPROVED BY THE CEO. THE LAST SUVEY WAS PERFORMED IN 2022 (ONE IS PERFORMED EVERY YEAR). |
| FORM 990, PART VI, SECTION C, LINE 19 | PARTNERS IN HOME CARE MAKE THEIR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THE AUTHORITY AND PROCESS FOR SELECTING THE FINANCIAL STATEMENT AUDITOR AND FOR OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT DID NOT CHANGE DURING THE FISCAL YEAR. |
| Software ID: | |
| Software Version: |