Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
BILLINGS CLINIC FOUNDATION
 
Employer identification number
81-0407289
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) Billings Clinic
2800 Tenth Avenue North
Billings,MT59107
81-0231784 501 c 3 4,455,989       To support medical services & capital ne
(2) Glendive Medical Center
202 Prospect Drive
Glendive,MT59330
81-6016016 501 c 3 20,000       To support operational excellence initia
(3) Livingston Healthcare
320 Alpenglow Lane
Livingston,MT59047
81-0378200 501 c 3 16,000       To support operational excellence initia
(4) Sheridan Memorial Hospital
440 West Lurel Ave
Plentywood,MT59254
81-0243720 501 c 3 13,000       To support operational excellence initia
(5) North Big Horn Hospital
1115 Lane 12
Lovell,WY82431
83-6000891 501 c 3 11,500       To support operational excellence initia
(6) Pioneer Medical Center
301 West 7th
Big Timber,MT59011
47-5437700 501 c 3 11,500       To support operational excellence initia
(7) Roundup Memorial Healthcare
1202 3rd Street West
Roundup,MT59072
81-0245848 501 c 3 11,500       To support operational excellence initia
(8) Yellowstone CityCo Health dba Rive
123 S 27th St
Billings,MT59101
81-0513538 501 c 3 9,265       To support Super Utilization Alliance pr
(9) Wheatland Memorial Hospital
530 3rd St NW
Harlowton,MT59036
81-0392231 501 c 3 8,000       To support operational excellence initat
(10) Beartooth Billings Clinic
2525 N Broadway
Red Lodge,MT59068
81-0224734 501 c 3 8,000       To support operational excellence initia
(11) Daniels Memorial Hospital
105 5th Ave E
Scobey,MT59263
81-6016920 501 c 3 5,750       To support operational excellence initia
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
11
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015
Page 2

Schedule I (Form 990) 2015
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
non-cash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of non-cash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Monitoring procedures (Part I, line 2) Monthly financial reports are reviewed and signed by the project manager, and then submitted to the Foundation for approval prior to drawing of funds.
Schedule I (Form 990) 2015



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