SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
ST PETER'S HEALTH
 
Employer identification number

81-0233121
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance 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 discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
 
No
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance 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 Financial Assistance at cost
(from Worksheet 1) . . . 		  1,774 9,283,995 19,744,930   0 %
b Medicaid (from Worksheet 3, column a) . . . . .     26,299,042 15,899,683 10,399,359 4.100 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .   1,774 35,583,037 35,644,613 10,399,359 4.100 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     388,447   388,447 0.150 %
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     42,000   42,000 0.020 %
j Total. Other Benefits . .     430,447   430,447 0.170 %
k Total. Add lines 7d and 7j .   1,774 36,013,484 35,644,613 10,829,806 4.270 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(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            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
2,997,317
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
202,001
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
56,374,649
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
56,811,439
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-436,790
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
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(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 %
1HELENA SURGICENTER
  		SURGERY CENTER 50 % 6.6 % 43.4 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 ST PETER'S HEALTH
2475 BROADWAY
HELENA,MT59601
WWW.SPHEALTH.ORG
13346 		X X         X   PHYSICIAN CLINICS URGENT CARE SERVICES 1
Schedule H (Form 990) 2019
Page 4
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
ST PETER'S HEALTH
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V SECTION C FOR URL
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Page 5
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
ST PETER'S HEALTH
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V SECTION C FOR URL
b
SEE PART V SECTION C FOR URL
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Page 6
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
ST PETER'S HEALTH
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Page 7
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
ST PETER'S HEALTH
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Page 8
Schedule H (Form 990) 2019
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
SCHEDULE H, PART V, SECTION B, LINE 5 A CONSULTANT WAS ENGAGED TO FACILITATE THE COMMUNITY NEEDS ASSESSMENT THROUGH USE OF AN ONLINE KEY INFORMANT SURVEY. THE KEY INFORMANTS REPRESENTED PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. THESE KEY INFORMANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. THROUGH THIS PROCESS, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY POPULATIONS (INCLUDING AFRICAN AMERICAN, HISPANIC AND NATIVE AMERICANS, ASIANS, CHINESE, AND KOREAN, THE DISABLED, DUAL-LANGUAGE LEARNERS, THE ELDERLY, ESL, ETHNIC/RACIAL, EUROPEAN, FOSTER CHILDREN, THE HOMELESS, THE INDIGENT, THOSE WITH INSURANCE BARRIERS, LATIN AMERICANS, LGBT, LOW-INCOME, MEDICARE/MEDICAID RECIPIENTS, MENTALLY ILL/DISABLED, MINORITIES, NIGERIANS, PACIFIC ISLANDERS, RURAL POPULATIONS, SINGLE MOTHERS, UNINSURED/UNDERINSURED, WOMEN, YOUTH), OR OTHER MEDICALLY UNDERSERVED POPULATIONS (INCLUDING ADOLESCENTS RESIDING IN LOCAL GROUP HOMES, ADULTS, THOSE WITH AUTISM, CHILDREN WITH SPECIAL EDUCATION SERVICES, THOSE WITH CHRONIC HEALTH CONDITIONS, THOSE IN CRISIS, DISABLED, ELDERLY, ETHNIC/RACIAL, FOSTER CHILDREN, HIGH-RISK MOTHERS AND INFANTS, THE HOMELESS, THOSE IN JAIL, LGBT, LOW-INCOME/POVERTY, MEDICARE/MEDICAID, MENTALLY ILL/DISABLED, MINORITIES, NATIVE AMERICANS, NEGLECTED CHILDREN, PARENTS WITH YOUNG CHILDREN, PEOPLE VISITING COMMUNITY HEALTH CENTERS, PRE-RELEASE CITIZENS, THOSE RECOVERING FROM ADDICTION, TEEN MOTHERS, THOSE WITH TRAUMA, UNDERINSURED/UNINSURED, UNDOCUMENTED, VETERANS, WOMEN, YOUTH). IN THE ONLINE SURVEY, KEY INFORMANTS WERE ASKED TO RATE THE DEGREE TO WHICH VARIOUS HEALTH ISSUES ARE A PROBLEM IN THEIR OWN COMMUNITY. FOLLOW-UP QUESTIONS ASKED THEM TO DESCRIBE WHY THEY IDENTIFY PROBLEM AREAS AS SUCH, AND HOW THESE MIGHT BE BETTER ADDRESSED. FINAL PARTICIPATION INCLUDED REPRESENTATIVES OF THE ORGANIZATION OUTLINED BELOW. 5TH AVENUE ADVERTISING AREA IV AGENCY ON AGING AWARE, INC. BIKE WALK HELENA BIKE WALK MONTANA CARROLL COLLEGE (AND WELLNESS CENTER) CHILD CARE PARTNERSHIPS CITY OF EAST HELENA/CITY OF HELENA CITY OF HELENA COMMUNITY DEVELOPMENT DEPARTMENT CITY OF HELENA PUBLIC WORKS COOPERATIVE HEALTH-HEALTHCARE FOR THE HOMELESS DEPARTMENT OF COMMUNITY DEVELOPMENT AND PLANNING DEPARTMENT OF ENVIRONMENTAL QUALITY-REMEDIATION DIVISION DISABILITY RIGHTS MONTANA EXPLORATIONWORKS SCIENCE CENTER FAMILY PROMISE OF GREATER HELENA FLORENCE CRITTENTON HOME AND SERVICES HEALTHY MOTHERS HEALTHY BABIES, THE MONTANA COALITION HELENA AREA CHAMBER OF COMMERCE HELENA BUSINESS IMPROVEMENT DISTRICT HELENA CITIZENS COUNCIL HELENA FAMILY YMCA HELENA FOOD SHARE HELENA HOUSING AUTHORITY HELENA POLICE DEPARTMENT HELENA PUBLIC SCHOOLS HELENA UNITED METHODIST MINISTRIES HOUSE OF REPRESENTATIVES HPC KALMORE DENTAL LEWIS AND CLARK CONSERVATION DISTRICT MONTANA INDEPENDENT LIVING PROJECT MONTANA MENTAL HEALTH OMBUDSMAN OFFICE MONTANA NO KID HUNGRY MONTANA PUBLIC HEALTH LABORATORY MONTANA SCHOOL SERVICES FOUNDATION MONTANA STATE LEGISLATURE MONTANA UNITED INDIAN ASSOCIATION MORRISON MAIERLE, INC. MOUNTAIN VIEW FAMILY HEALTH CARE MT HEAD START ASSOCIATION PUREVIEW HEALTH CENTER ROCKY MOUNTAIN DEVELOPMENT COUNCIL SENIOR COMPANION PROGRAM SAFE ROUTES TO SCHOOL COMMITTEE ODEXO SCHOOL SERVICES K-12 SOUTH HILLS INTERNAL MEDICINE SPH BOARD MEMBER ST. PETER'S HOSPITAL ST. PETER'S MEDICAL GROUP STATE OF MONTANA, DEPARTMENT OF ENVIRONMENTAL QUALITY THE FRIENDSHIP CENTER THE NATIONAL ALLIANCE ON MENTAL ILLNESS-HELENA UNITED WAY OF THE LEWIS AND CLARK AREA YOUTH CONNECTIONS COALITION YWCA OF HELENA
SCHEDULE H, PART V, SECTION B, LINE 6B ST. PETER'S HOSPITAL COLLABORATED WITH LEWIS AND CLARK PUBLIC HEALTH TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT.
SCHEDULE H, PART V, SECTION B, LINE 7a https://www.sphealth.org/community-health/community-needs-and-improvements
SCHEDULE H, PART V, SECTION B, LINE 10a https://www.sphealth.org/community-health/community-needs-and-improvements
SCHEDULE H, PART V, SECTION B, LINE 11 St. Peter's Health is committed to making a positive impact on the health of the community it serves. One of the many strategies we use to do this is by providing for the unique health needs of area residents utilizing the Community Health Improvement Plan (CHIP) process. Community Health Improvement Plan process The goals of these process are to: To improve residents' health status, increase their life spans, and elevate their overall quality of life. A healthy community is not only one where its residents suffer little from physical and mental illness, but also one where its residents enjoy a high quality of life. To reduce the health disparities among residents. By gathering demographic information along with health status and behavior data, it will be possible to identify population segments that are most at-risk for various diseases and injuries. Intervention plans aimed at targeting these individuals may then be developed to combat some of the socio-economic factors which have historically had a negative impact on residents' health. To increase accessibility to preventive services for all community residents. More accessible preventive services will prove beneficial in accomplishing the first goal (improving health status, increasing life spans, and elevating the quality of life), as well as lowering the costs associated with caring for late-stage diseases resulting from a lack of preventive care. This is a two-part process: . First, identify the health needs facing our community (conduct a Community Health Needs Assessment, or CHNA); Every three years, partner with a third party vendor, Professional Research Consultants, Inc., of Omaha, Nebraska, to complete a Community Health Needs Assessment (CHNA). This CHNA included a random-sample telephone survey of community residents on their health conditions, behaviors, preferences; it also included an online "key informant" survey targeted to individuals with a broad interest in the health of the community. St. Peter's partnered with the Lewis & Clark Public Health to plan and develop the survey instruments. . Second, St. Peter's Health Population Health Team reviews the CHNA to understand the identified community needs to develop a measurable plan (a Community Health Improvement Plan, or CHIP) that focuses on the areas of greatest needs, taking into account the total available resources to effectively address those issues. The CHIP creates a common agenda and strategic plan to focus energy, resources, policies, projects, and programs that will be most effective in improving the health of our community. After a series of strategic planning meetings, the draft CHIP is presented to the St. Peter's Health (SPH) Outcomes Committee, a sub-committee of the St. Peter's Health Board, where a multidisciplinary group of key stakeholders review the plan to address the identified needs within the St Peter's Health Service Area. Once the CHIP is approved through the SPH Outcomes Committee, it is presented, discussed, and approved at the St. Peter's Health System Board and published on the SPH Website. In 2018 the following health needs were identified as a priority areas and during 2020 the following actions steps were taken to address the need: 1) Access to healthcare services: a) Barriers to Access: Our interventions focused on decreasing the barriers to accessing health care services were two fold. i) Appointment Availability: One are of focus was increasing appointment availability. The pandemic provided a prime opportunity to rapidly expand appointment availability via telehealth. (1) Telehealth in the outpatient setting: As a result of the Montana's Shelter in Place during 2020 COVID-19 Pandemic, St. Peter's Health had to rapidly implement Telehealth options that were not previously in place within the medical group setting. Over the course of the year we were able to connect 91 of our employed providers to the telehealth platform and completed over 14,000 virtual clinic visits. Additionally, St. Peter's Health partnered with the local assisted and skilled nursing facilities and provided a virtual device that captured vital signs and components of a digital physical assessment so that the patient were able to be assessed by an SPH employed provider, but within the safety of the facility to decrease the risk of COVID-19 exposure. (2) University of Utah Health Telehealth Collaboration: Telestroke is a program that we have in place with the University of Utah Health. It was launched in 2019. This program provides technology that connects an emergency provider to a stroke specialist from University of Utah Health with one click of a button. They can see the patient, get access to CT scans, etc. This allows us to elevate the level of care we're able to provide locally, resulting in improved clinical outcomes and keeping patients closer to home for care. In 2020, we used tele-stroke 100 times in our emergency department, a little under half of all patients presenting with stroke symptoms. (3) Increased Rural Health Access with Implementation of satellite clinic in Townsend: This new clinic opened in 2020 in Townsend, MT located in Broadwater County which is located 30 miles away from our main SPH Campus. The St. Peter's Health - Townsend Clinic provides comprehensive primary care services five days per week as well as rotating specialties including urology, general surgery and orthopedics to Townsend and the greater Broadwater County area. The clinic also houses laboratory services and diagnostic imaging services, like x-ray and ultrasound. ii) Transportation: The other area of focus was addressing limited transportation as a barrier to accessing care. To alleviate this we implemented a community paramedicine program aimed at treating individuals in their environment. This care delivery model allows paramedics to access services in their home with referral from their primary care team and connection via assisted telemedicine back to their PCP. The goal of the community paramedicine program is to provide public health and preventative care in the field to improve health outcomes and access to care. This program can provide many different types of care-blood draws, immunizations, chronic health condition education, facilitation of tele-health visits for those who have access challenges, vital signs monitoring, etc. Patients served through this program have verbalized some aspects of a social determinant of health barriers that prevents them from accessing care in a traditional environment - transportation challenges, COVID-19 diagnosis, and other socio-economic barriers. b) Routine medical care (children): This specific need was not actively addressed in 2020 as the need was not as pressing as other problems and there were insufficient resources, both financial and personnel, to address the need as a result of shifts in organizational priorities to address the global COVID-19 pandemic. c) Ratings of Local Healthcare: In January of 2020, SPH hired a Patient Experience Partner to focus on improving the experience of our community members receiving care within SPH to in turn improve the ratings of the local healthcare provided. The patient experience partner collaborates with leaders across our organization to pinpoint specific patient experience measures we need to improve on. This position helps leaders create improvement plans and actionable steps they can track, to improve the patient experience. Some of these measures for 2020 and 2021 include: . Explanation of the test and treatment (Outpatient Services) . Did my nurse explain things in a way you can understand (Inpatient) . Care Provider Concern for my questions and worries (Medical Practice) . Did the team work together to care for me (Medical Practice) . Information about at home care (Emergency Department) . Communication about delays (Urgent Care) d) Other Access Improvements: St. Peter's Health also continued to address the barriers to accessing mental and other health and social care services outside of our walls by participation in the CONNECT advisory board, working to advocate for and increase the number of services and organizations in the community represented and utilizing the system. The CONNECT electronic referral system is a community and state wide closed-loop referral system which streamlines referrals of patients for needed services. 2) Cancer: a) Cancer is a leading cause of death: i) Improve Community Awareness on Breast Cancer: During 2020 SPH Sponsored Carroll College athletic programming to bring cancer awareness to local students and community members with a focus on breast cancer awareness. SPH also collaborated with key stakeholders to publish three Health Matters Columns within the local newspaper, Helena Independent Record. Topics included: . Health Matters: Breast Cancer in Our Community . Health Matters: Screening, early detection important tools in detecting breast cancer b) Prostate Cancer Deaths: This spec
SCHEDULE H, PART V, SECTION B, LINE 16A-16C THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP IS MADE AVAILABLE ON THE HOSPITAL'S WEBSITE: https://www.sphealth.org/patients-visitors/billing/financial-assistance
SCHEDULE H, PART V, SECTION B, LINE 16J PATIENTS RECEIVE NOTIFICATION OF THE FINANCIAL ASSISTANCE POLICY UPON DISCHARGE AS WELL AS IN THEIR PATIENT STATEMENTS.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2019
Page 9
Schedule H (Form 990) 2019
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?5
Name and address Type of Facility (describe)
1 HOSPICE AND HOMELINK OF ST PETERS HOSPIT
201 SOUTH CALIFORNIA
HELENA,MT59601 		HOSPICE AND HOME HEALTH
2 APEX OF ST PETERS HOSPITAL
201 SOUTH CALIFORNIA
HELENA,MT59601 		HOME OXYGEN SERVICES
3 ST PETER'S MEDICAL GROUP BROADWAY
2550 BROADWAY
HELENA,MT59601 		PHYSICIAN CLINIC
4 ST PETER'S MEDICAL GROUP NORTH
3330 PTARMIGAN LANE
HELENA,MT59602 		PHYSICIAN CLINIC
5 ST PETER'S HEALTH - TOWNSEND CLINIC
515 S FRONT ST
TOWNSEND,MT59644 		PHYSICIAN CLINIC
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Schedule H (Form 990) 2019
Page 10
Schedule H (Form 990) 2019
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Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
SCHEDULE H, PART I, LINE 3C ST PETER'S HEALTH USES ASSET LEVELS AND MEDICAL INDIGENCY IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE.
SCHEDULE H, PART I, LIne 7 THE ORGANIZATION USED AN INTERNAL COST ALLOCATION SYSTEM FOR LINES 7A, 7B AND 7G. THE COST ALLOCATION SYSTEM ADDRESSES ALL PATIENT SEGMENTS. THE COSTS ARE ESTIMATED BY ALLOCATING DEPARTMENTAL COSTS BASed ON DIRECT COSTS LESS ANY OTHER OPERATING REVENUE, THEN BY DOING AN ALLOCATION OF BENEFITS, DEPRECIATION AND OTHER OVERHEAD COSTS. THE INFORMATION FOR LINES 7E AND 7I WAS DERIVED FROM INFORMATION IN THE GENERAL LEDGER AND OTHER FINANCIAL DATA RELATED SPECIFICALLY TO THE VARIOUS TYPES OF COMMUNITY BENEFITS.
SCHEDULE H, PART III, SECTION A, LINE 2 THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. BAD DEBT EXPENSE IS REPORTED AT CHARGES AS RECORDED BY THE ORGANIZATION. BAD DEBT EXPENSE IS REPORTED NET OF DISCOUNTS AND CONTRACTUAL ALLOWANCES. A PAYMENT ON AN ACCOUNT PREVIOUSLY WRITTEN OFF REDUCES BAD DEBT EXPENSE IN THE CURRENT YEAR.
SCHEDULE H, PART III, SECTION A, LINE 3 TO DETERMINE THE PORTION OF BAD DEBT THAT SHOULD BE CONSIDERED A COMMUNITY A HISTORICAL PERCENTAGE WAS USED. THIS WAS DONE TO RECLASSIFY THE PORTION OF BAD DEBT EXPENSE THAT WOULD HAVE BEEN CONSIDERED CHARITY CARE IF THE INDIVIDUAL WOULD HAVE COMPLETED THE FINANCIAL ASSISTANCE APPLICATION.
SCHEDULE H, PART III, SECTION B, LINE 8 NO ALLOCATION OF THE MEDICARE SHORTFALL WAS TREATED AS A COMMUNITY BENEFIT. THE ORGANIZATION UTILIZES AN INTERNAL COST ALLOCATION SYSTEM. THE COSTS ARE ESTIMATED BY ALLOCATING DEPARTMENTAL COSTS BASED ON DIRECT COSTS LESS ANY OTHER OPERATING REVENUE, THEN BY COMPLETING AN ALLOCATION OF BENEFITS, DEPRECIATION AND OTHER OVERHEAD COSTS.
SCHEDULE H, PART III, SECTION C, LINE 9B ST. PETER'S HOSPITAL RECOGNIZES ITS RESPONSIBILITY TO RENDER NECESSARY HEALTH CARE SERVICES TO ALL PERSONS IN NEED OF SUCH CARE, REGARDLESS OF RACE, CREED, COLOR OR ECONOMIC CIRCUMSTANCES. ST. PETER'S HOSPITAL RECOGNIZES THAT PAYMENT FOR SERVICES RENDERED IS DUE AND PAYABLE AT THE TIME OF SERVICE. THE HOSPITAL ACCEPTS INSURANCE ASSIGNMENTS AND SOME OTHER APPROVED ARRANGEMENTS FOR DELAYED PAYMENT. FINANCIAL ASSISTANCE IS AVAILABLE FOR ALL QUALIFIED PATIENTS. PATIENTS NOT COVERED BY INSURANCE OR UNABLE TO PAY IN FULL FOR SERVICES RENDERED MUST CONTACT THE APPROPRIATE PATIENT ACCOUNT REPRESENTATIVE WHO WILL ASSIST THE PATIENT AND/OR FAMILY IN DETERMINING IF HE/SHE QUALIFIES FOR PATIENT ASSISTANCE. COLLECTION ACTIVITY WILL BE SUSPENDED WHILE A FINANCIAL ASSISTANCE APPLICATION IS UNDER REVIEW.
SCHEDULE H, PART VI, LINE 2 NEED ASSESSMENT: ST. PETER'S HOSPITAL CONDUCTS A COMMUNITY SURVEY EVERY THREE YEARS. THE COMMUNITY SURVEY IS PERFORMED BY AN INDEPENDENT CONTRACTOR THAT SELECTS AN ADEQUATE SAMPLE SIZE FOR THE AREA. THE HOMES OF ST. PETER'S HOSPITAL EMPLOYEES ARE EXCLUDED FROM THE SURVEY. THE SURVEY INCLUDES QUESTIONS RELATED TO EVALUATING THE COMMUNITY'S EXPERIENCE AND ABILITY TO ACCESS HEALTHCARE. THE SURVEY HELPS TO IDENTIFY SPECIALTY AREAS OF CONCERN. THE RESULTS OF THE SURVEYS ARE REVIEWED BY THE SENIOR MANAGEMENT TEAM AS WELL AS THE BOARD TO IDENTIFY THE AREAS OF FOCUS. IN 2019, THE ST. PETER'S BOARD OF DIRECTORS, MADE UP OF COMMUNITY MEMBERS, PHYSICIANS, AND SENIOR MANAGEMENT, AND WORKED WITH A CONSULTANT TO DEVELOP ST. PETER'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). BASED ON THE FINDINGS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE BOARD AND ITS COMMUNITY RELATIONS COMMITTEE PRIORITIZED COMMUNITY HEALTH NEEDS FOR THE ORGANIZATION. THE COMMUNITY RELATIONS COMMITTEE REPRESENTS A BROAD RANGE OF COMMUNITY INTERESTS AND GIVES FINAL APPROVAL OF THE CHNA AND CHIP. THE PUBLIC RELATIONS AND MARKETING DEPARTMENT IS RESPONSIBLE FOR THE FACILITATION AND IMPLEMENTATION OF THE CHNA AND CHIP.
SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION ELIGIBILITY FOR ASSISTANCE: ST. PETER'S HOSPITAL (1) POSTS ITS CHARITY CARE POLICY ON ITS WEBSITE AS WELL AS AT THE ADMITTING DESK, EMERGENCY ROOM, ON THE MONTHLY STATEMENTS AND CASHIER AREAS IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT, (2) OFFERS A SUMMARY OF OUR POLICY AND APPLICATION TO SELF-PAY PATIENTS WITH CONTACT INFORMATION TO PATIENTS AS PART OF THE INTAKE PROCESS, (3) PROVIDES A COPY OF FINANCIAL ASSISTANCE CONTACT INFORMATION TO PATIENTS WITH DISCHARGE MATERIALS, (4) FINANCIAL COUNSELORS DISCUSS WITH PATIENTS EXPECTING TO OWE MORE THAN $500, THE AVAILABILITY OF PATIENT ASSISTANCE AND VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSISTS THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE.
SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: ST. PETER'S HOSPITAL IS A 123-BED ACUTE CARE HOSPITAL FACILITY SERVING RESIDENTS OF LEWIS AND CLARK COUNTY AND PORTIONS OF JEFFERSON, BROADWATER, MEAGHER, AND POWELL COUNTIES. ST. PETER'S IS THE SOLE FACILITY IN THE PRIMARY SERVICES AREA. THE HOSPITAL FINANCIAL PAYOR MIX CONSISTED OF 1.8% SELF-PAY PATIENTS, 14.1% OF MEDICAID PATIENTS AND 49.1% MEDICARE PATIENTS. APPROXIMATELY 17% OF THE POPULATION IS AGE 65 AND OLDER. APPROXIMATELY 11.4% OF THE POPULATION IS BELOW THE FEDERAL POVERTY LEVEL. THE NEAREST HOSPITAL IN THE AREA IS APPROXIMATELY 35 MILES FROM THE ST. PETER'S CAMPUS.
SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: THE ORGANIZATION'S GOVERNING BODY MEMBERS RESIDE IN THE COMMUNITY. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SURPLUS FUNDS ARE USED TO MAKE CAPITAL PURCHASES AND UPGRADES TO THE FACILITIES. ST. PETER'S HOSPITAL IS THE SOLE ACUTE CARE PROVIDER IN THE PRIMARY SERVICE AREA, AND OPERATES AN EMERGENCY ROOM AND TWO URGENT CARE CLINICS. THE PRIMARY SERVICE AREA IS MADE UP OF LEWIS AND CLARK COUNTY AND THE NORTHERN PORTION OF JEFFERSON COUNTY. THERE IS A POPULATION OF APPROXIMATELY 92,170. OUT-MIGRATION IS GENERALLY LIMITED TO TERTIARY SERVICES NOT AVAILABLE AT ST. PETER'S HOSPITAL INCLUDING, CARDIAC SURGERY AND NEO-NATAL CARE. ST. PETER'S HOSPITAL PROVIDES CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. ST. PETER'S HOSPITAL MAINTAINS CHARGES AS ONE OF THE LOWEST HOSPITALS WITHIN THE STATE DEPENDING ON THE SERVICES BEING PROVIDED. ST. PETER'S HOSPITAL SPONSORS SEVERAL WELLNESS SCREENINGS, HEALTH FAIRS, AND EDUCATIONAL LECTURES, CLASSES, AND EVENTS THROUGHOUT THE YEAR TO PROMOTE BETTER LIVING, NUTRITION AND GOOD HEALTH. ST. PETER'S (SPH) ENSURES THAT ITS PATIENTS, THEIR FAMILIES AND PERSONNEL HAVE SPIRITUAL CARE AVAILABLE TO THEM. SPH RESPECTS NATIVE-AMERICAN CULTURE AND THE CEREMONIES THAT ARE IMPORTANT TO MEET THE SPIRITUAL AND CULTURAL NEEDS AND PROMOTE OPTIMAL HEALING OF NATIVE- AMERICAN PATIENTS. IN ORDER TO ENSURE A PATIENT'S RIGHT TO ACCESS THESE CEREMONIES, A PROCEDURE HAS BEEN PUT IN PLACE. CONTINUING EDUCATION IS ALSO PROVIDED TO MEMBERS OF THE MEDICAL COMMUNITY ON AN ON-GOING BASIS. IN ADDITION, ST. PETER'S HOSPITAL HAD 12,000 VOLUNTEER HOURS FROM THE COMMUNITY ASSISTING IN A VARIETY OF ROLES WITHIN THE ORGANIZATION. ST. PETER'S HOSPITAL MADE $88,000 OF CASH AND IN-KIND DONATIONS TO A VARIETY OF ORGANIZATIONS WITHIN THE COMMUNITY. THIS INCLUDES, BUT IS NOT LIMITED TO, SMALL FRY FOOTBALL, CARROLL COLLEGE, FAMILY FUN FEST, BREAST CANCER AWARENESS, HEALTHY MOTHERS HEALTHY BABIES, HELENA FOOD SHARE, NAMI, GIRLS THRIVE INC, HELENA SCHOOLS,HELENA POLICE DEPARTMENT TRAINING, CARROLL COLLEGE ATHLETICS WITH EMERGENCY SERVICES AT EVENTS, UNITED WAY TO ASSIST LOW-INCOME AND HOMELESS RESIDENTS WITH BASIC NEEDS, SPIRIT OF SERVICE CAMPAIGN BY PROVIDING SUPPLIES AND VOLUNTEERS TO HELP ELDERLY RESIDENTS AND OTHERS WITH SPECIAL NEEDS IMPROVE THEIR HOMES AND YARDS AND YOUTH FOUNDATION, THE PRICKLY PEAR LAND TRUST, WHICH HELPS PRESERVE AND MAINTAIN ACCESS TO TRAILS AND OPEN LAND FOR THE COMMUNITY. THE DONATIONS WERE MADE TO ASSIST THESE COMMUNITY SPONSORS IN THEIR VARIOUS PROGRAMS.
Schedule H (Form 990) 2019
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