GIBSON GENERAL HOSPITAL INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- GIBSON GENERAL HOSPITAL INC (EIN 35-0877575)
- Tax period
- 2022-10-01 to 2023-09-30
- Filed
- 2024-08-15
- IRS object ID
- 202442289349301869
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-08-15T13:58:43-05:00 | ReturnTs |
| Tax Period End | 2023-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 N MERIDIAN ST SUITE 200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350877575 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GIBS | BusinessNameControlTxt |
| Phone | 8123853401 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47670 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LOIS MORGAN | PersonNm |
| Person Title | CAO | PersonTitleTxt |
| Phone | 8123853401 | PhoneNum |
| Signature | 2024-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EMILIE M KNIERIEM CPA | PreparerPersonNm |
| PTIN | P01330194 | PTIN |
| Phone | 3176334705 | PhoneNum |
| Preparation | 2024-08-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2024-08-08 14:25:15Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEACONESS GIBSON HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LOIS MORGAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47670 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $53,568,949 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.DEACONESS.COM/DEACONESS-GIBSON-HOSPITAL | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1941 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY, PATIENT-CENTERED, COST-EFFECTIVE CARE FOR PEOPLE IN THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 252 | TotalEmployeeCnt |
| Total Volunteers | 26 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $111,755 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,076,382 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $47,396,653 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $50,726,450 | CYProgramServiceRevenueAmt |
| PY Investment Income | $310,453 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,401,790 | CYInvestmentIncomeAmt |
| PY Other Revenue | $331,351 | PYOtherRevenueAmt |
| CY Other Revenue | $364,327 | CYOtherRevenueAmt |
| PY Total Revenue | $48,150,212 | PYTotalRevenueAmt |
| CY Total Revenue | $53,568,949 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,606 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,963,110 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,004,171 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $26,067,231 | PYOtherExpensesAmt |
| CY Other Expenses | $25,711,143 | CYOtherExpensesAmt |
| PY Total Expenses | $42,030,341 | PYTotalExpensesAmt |
| CY Total Expenses | $42,719,920 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,119,871 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $10,849,029 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $49,017,736 | TotalAssetsBOYAmt |
| Total Assets EOY | $59,188,001 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $18,878,673 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $18,199,909 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $30,139,063 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $40,988,092 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF GIBSON GENERAL HOSPITAL AND THE SKILLED NURSING FACILITY IS TO PROVIDE HIGH QUALITY, PATIENT-CENTERED, COST-EFFECTIVE CARE FOR PEOPLE IN OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $33,825,617 | ExpenseAmt |
| Grant | $4,606 | GrantAmt |
| Revenue | $50,814,726 | RevenueAmt |
| Desc | THE HOSPITAL'S MISSION IS TO PROVIDE HIGH QUALITY AND COST-EFFECTIVE HEALTHCARE, WHICH INCLUDES PATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO THE RESIDENTS OF THE SURROUNDING TRI-STATE AREA. ALL EXPENSES RELATE TO COSTS ASSOCIATED WITH PROVIDING THESE SERVICES, AND MAINLY INCLUDE SALARIES AND WAGES TO STAFF AND SUPPLIES COST. THERE WERE 333 ADMISSIONS AND 38,735 VISITS DURING THE YEAR. | Desc |
| Total Program Service Expenses | $33,825,617 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 57 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 252 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHERYL A WATHEN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8124503296 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 MARY STREET | AddressLine1Txt |
| City | EVANSVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47747 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MARION JOCHIM | ||||||||
| CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SUSAN STRAUB | ||||||||
| VICE CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| STEPHEN LANKFORD | ||||||||
| TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GEORGE A BALLARD | ||||||||
| SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR DAVID PURDOM | ||||||||
| CHIEF OF STAFF TERM | 40.00 | 0.00 | Yes (X) | $293,323 | $0 | $46,384 | ||
| JENNIFER BARTLEY | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| HENRY BREWSTER | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MARC JARED FLORENCE | ||||||||
| BOARD MEMBER | 1.00 | 62.00 | Yes (X) | $0 | $590,416 | $135,997 | ||
| BOB GIBSON | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DEREK MCGRAW | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $7,097 | $0 | $0 | ||
| DUSTIN PRIESTLY | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM ALLEN WHITE MD | ||||||||
| BOARD MEMBER | 1.00 | 57.00 | Yes (X) | $0 | $241,994 | $51,245 | ||
| GREG WRIGHT | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| LYNN LINGAFELTER | ||||||||
| BOARD MEMBER | 1.00 | 55.00 | Yes (X) | $0 | $882,665 | $182,889 | ||
| MARY KEY | ||||||||
| BOARD MEMBER PARTIAL TERM | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SHAWN MCCOY | ||||||||
| BOARD MEMBER PARTIAL TERM | 1.00 | 55.00 | Yes (X) | $0 | $1,560,717 | $317,182 | ||
| CLAUDIA EISENMANN | ||||||||
| VP DHS CRITICAL ACCESS HOS | 25.00 | 35.00 | Yes (X) | $0 | $399,486 | $27,027 | ||
| LOIS MORGAN | ||||||||
| CAO | 50.00 | 0.00 | Yes (X) | $0 | $214,822 | $32,263 | ||
| SHANE C HAYES | ||||||||
| CNO | 50.00 | 0.00 | Yes (X) | $104,139 | $0 | $31,905 | ||
| COREY POTTS | ||||||||
| CRNA | 40.00 | 0.00 | $264,680 | $0 | $42,684 | Yes (X) | ||
| BETH N MCGRAW | ||||||||
| LEAD MULTI-MODALITY TECH | 40.00 | 0.00 | $119,968 | $0 | $10,625 | Yes (X) | ||
| SARAH A JENNE | ||||||||
| STAFF NURSE RN CAH | 40.00 | 0.00 | $110,429 | $0 | $14,736 | Yes (X) | ||
| TAMMY R WARMACK | ||||||||
| DIRECTOR NURSING DEPT CAH | 40.00 | 0.00 | $104,546 | $0 | $23,746 | Yes (X) | ||
| SARAH A PADILLA | ||||||||
| TEAM LEADER RN CAH | 40.00 | 0.00 | $103,635 | $0 | $11,226 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,107,817 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,890,100 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $927,909 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PROGRESSIVE HEALTH OF INDIANA | |||||
| 150 N ROSENBERGER | EVANSVILLE | IN | 47710 | THERAPY SERVICES | $2,444,878 |
| TOTAL MSP LLC | |||||
| 221 W COLLEGE AVE FLOOR 2 | APPLETON | WI | 54911 | STAFFING | $2,135,917 |
| GREAT LAKES EMERGENCY PHYSICIANS | |||||
| 1602 AVENUE Q | LUBBOCK | TX | 79401 | MEDICAL PRO FEES | $1,188,491 |
| TRI-STATE GASTROENTEROLOGY | |||||
| PO BOX 5068 | EVANSVILLE | IN | 47716 | MEDICAL PRO FEES | $572,675 |
| MID WEST HOSPITAL PHYSICIANS | |||||
| 1602 AVENUE Q | LUBBOCK | TX | 79401 | MEDICAL PRO FEES | $362,654 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $16,420 | RelatedOrganizationsAmt |
| Government Grants | $1,059,962 | GovernmentGrantsAmt |
| Total Contributions | $1,076,382 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $50,726,450 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $50,726,450 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $50,726,450 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,401,790 | TotalRevenueColumnAmt |
| Exclusion | $1,401,790 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $130,631 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $130,631 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $130,631 | TotalRevenueColumnAmt |
| Exclusion | $130,631 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $145,420 | TotalRevenueColumnAmt |
| Exclusion | $145,420 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $88,276 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $88,276 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $233,696 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $53,568,949 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $50,814,726 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,677,841 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,606 | TotalAmt |
| Program Services | $4,606 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $779,643 | TotalAmt |
| Management And General | $779,643 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,270,509 | TotalAmt |
| Program Services | $11,213,058 | ProgramServicesAmt |
| Management And General | $2,057,451 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $479,595 | TotalAmt |
| Program Services | $390,431 | ProgramServicesAmt |
| Management And General | $89,164 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,475,902 | TotalAmt |
| Program Services | $814,368 | ProgramServicesAmt |
| Management And General | $661,534 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $998,522 | TotalAmt |
| Program Services | $825,383 | ProgramServicesAmt |
| Management And General | $173,139 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,723 | TotalAmt |
| Management And General | $45,723 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,285,139 | TotalAmt |
| Program Services | $8,884,376 | ProgramServicesAmt |
| Management And General | $2,400,763 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,598 | TotalAmt |
| Program Services | $22 | ProgramServicesAmt |
| Management And General | $5,576 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $428,938 | TotalAmt |
| Program Services | $314,663 | ProgramServicesAmt |
| Management And General | $114,275 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,400,136 | TotalAmt |
| Program Services | $1,163,154 | ProgramServicesAmt |
| Management And General | $1,236,982 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,763 | TotalAmt |
| Program Services | $27,897 | ProgramServicesAmt |
| Management And General | $3,866 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,840 | TotalAmt |
| Program Services | $28,840 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $402,195 | TotalAmt |
| Program Services | $302,040 | ProgramServicesAmt |
| Management And General | $100,155 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,011,349 | TotalAmt |
| Program Services | $1,510,483 | ProgramServicesAmt |
| Management And General | $500,866 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $340,716 | TotalAmt |
| Program Services | $45,291 | ProgramServicesAmt |
| Management And General | $295,425 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL & DRUG SUPPLIES | $6,050,327 | $5,995,211 | $55,116 |
| MEDICAID ASSESSMENT FEE | $1,269,639 | $1,269,639 | |
| DUES & SUB. | $119,043 | $78,878 | $40,165 |
| LICENSE AND FEES | $23,963 | $15,878 | $8,085 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,267,774 | TotalAmt |
| Program Services | $941,399 | ProgramServicesAmt |
| Management And General | $326,375 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,719,920 | TotalAmt |
| Program Services | $33,825,617 | ProgramServicesAmt |
| Management And General | $8,894,303 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,883,569 | BOYAmt |
| EOY | $34,228,417 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,528,378 | BOYAmt |
| EOY | $1,572,783 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,905,332 | BOYAmt |
| EOY | $5,062,518 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,000 | BOYAmt |
| EOY | $81,782 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $772,762 | BOYAmt |
| EOY | $398,563 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $676,581 | BOYAmt |
| EOY | $601,953 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $20,079,122 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,125,610 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,549,949 | BOYAmt |
| EOY | $13,953,512 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,581,165 | BOYAmt |
| EOY | $3,288,473 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,017,736 | BOYAmt |
| EOY | $59,188,001 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,409,584 | BOYAmt |
| EOY | $6,239,985 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,183,058 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,688,283 | BOYAmt |
| EOY | $9,756,195 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,597,748 | BOYAmt |
| EOY | $2,203,729 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,878,673 | BOYAmt |
| EOY | $18,199,909 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,139,063 | BOYAmt |
| EOY | $40,988,092 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,139,063 | BOYAmt |
| EOY | $40,988,092 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,017,736 | BOYAmt |
| EOY | $59,188,001 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $10,849,029 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $5,919 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,919 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL PAID MEMBERSHIP DUES TO INDIANA HOSPITAL ASSOCATION "IHA AND THE AMERICAN HOSPITAL ASSOCIATION "AHA". IHA ATTRIBUTED 10.78% OF THE $13,301 IN DUES TO LOBBYING EXPENSES. AHA ATTRIBUTED 32% OF THE $14,015 IN DUES TO LOBBYING EXPENSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $421,244 | OtherCostOrOtherBasisAmt |
| Book Value | $421,244 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,035,666 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,647,191 | DepreciationAmt |
| Book Value | $6,388,475 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,893,380 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,478,419 | DepreciationAmt |
| Book Value | $5,414,961 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,728,832 | OtherCostOrOtherBasisAmt |
| Book Value | $1,728,832 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,953,512 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER RECEIVABLES | $147,169 |
| RIGHT OF USE ASSET | $574,734 |
| FUNDS HELD BY TRUSTEE | $174,477 |
| INVESTMENTS IN JOINT VENTURES | $2,362,656 |
| PHYSICIAN 457F | $29,437 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,288,473 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| THIRD PARTY PAYABLE | $607,379 |
| RIGHT OF USE LIABILITIES | $1,211,878 |
| PHYSICIAN 457F | $29,437 |
| DUE TO RELATED PARTIES | $355,035 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,203,729 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $469,335 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $469,335 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01100 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,966,314 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,261,983 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,704,331 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06330 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,435,649 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,261,983 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,173,666 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07430 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,435,649 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,261,983 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,173,666 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07430 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $578,022 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $25,604,500 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $19,402,228 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $6,202,272 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47670 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.DEACONESS.COM/DEACONESS-GIBSON-HOS | WebsiteAddressTxt |
| State License | 20-005019-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.DEACONESS.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.DEACONESS.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GIBSON GENERAL HOSPITAL INC | PART V, SECTION B, LINE 5: DEACONESS GIBSON HOSPITAL CONSULTED WITH THE FOLLOWING GROUPS TO GATHER INPUT AND DATA:- THE UNIVERSITY OF EVANSVILLE FACULTY, STAFF, AND STUDENTS IN PUBLIC HEALTH AREAS.- INDIANA UNIVERSITY SCHOOL OF PUBLIC HEALTH RESEARCH FACULTY AND STUDENTS.- INDIANA UNIVERSITY CENTER FOR SURVEY RESEARCH FACULTY AND STAFF. - MEASURES MATTER, LLC- GIBSON COUNTY HEALTH DEPARTMENT- TULIP TREE FAMILY HEALTH CARE- CARING COMMUNITIES OF GIBSON COUNTY/YOUTH FIRST- ALBION FELLOWS BACON CENTER- PURDUE EXTENSION- RIVEROAKS HEALTH CAMPUS- GIBSON GENERAL HEALTH FOUNDATION- SOUTH GIBSON SCHOOL CORPORATION- VINCENNES UNIVERSITY GIBSON CENTER- ARC OF SOUTHWEST INDIANA- YMCA CAMP CARSON- MULTIPLE STAFF AND PROVIDERS FROM DEACONESS GIBSON HOSPITALTO INCLUDE THE VOICES OF PEOPLE REPRESENTING THE COMMUNITY, SURVEYS WERE SENT TO ORGANIZATIONS SERVING GIBSON COUNTY WITH UNIQUE PERSPECTIVES ON ISSUES IMPACTING HEALTH AND SOCIAL DETERMINANTS OF HEALTH AMONG RESIDENTS. |
| GIBSON GENERAL HOSPITAL INC | PART V, SECTION B, LINE 6B: INDIANA RURAL HEALTH ASSOCIATION |
| GIBSON GENERAL HOSPITAL INC | PART V, SECTION B, LINE 7D: CHNA LOCATION:THE CHNA REPORTS CAN BE LOCATED AT THE HOSPITAL'S WEBSITE LOCATED ON THE "COMMUNITY HEALTH NEEDS ASSESSMENT" PAGE LOCATED UNDER "ABOUT US". HTTPS://WWW.DEACONESS.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| GIBSON GENERAL HOSPITAL INC | PART V, SECTION B, LINE 11: BY ANALYZING ALL THREE PRIORITIZED LISTS FROM THE THREE FOCUS GROUPS, IRHA IDENTIFIED THE ITEMS THAT APPEARED MOST FREQUENTLY INDICATING THE COMMUNITY'S PERCEPTION OF AREAS OF GREATEST NEED. THE LIST FOLLOWS: MENTAL/BEHAVIORAL HEALTH SUBSTANCE USE: ILLEGAL DRUGS, ALCOHOL, TOBACCO CHRONIC DISEASE OBESITY HEALTHY FOOD: ACCESS AND AFFORDABILITY PEDIATRIC CARE AWARENESS OF AVAILABLE SERVICES FOR HEALTHCARE RESOURCES FOR CHILDREN AND YOUNG ADULTS BASED ON THE INFORMATION GATHERED AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE INDIANA RURAL HEALTH ASSOCIATION HAS IDENTIFIED THE AREAS OF GREATEST NEED IN GIBSON COUNTY. THROUGH THE COLLECTION OF HEALTH DATA AND COMMUNITY INPUT ON THE COUNTY'S ASSETS, VALUES, AND WEAKNESSES WITHIN THE HOSPITAL'S SERVICE AREA, THE FOLLOWING NEEDS WERE IDENTIFIED AS BEING OF THE HIGHEST IMPORTANCE:IDENTIFIED NEEDS: MENTAL HEALTH SERVICES AVAILABILITY & COST SERVICES AND PROGRAMS FOR SUBSTANCE USE/DRUG MISUSE TOBACCO AND E-TOBACCO USE CHRONIC DISEASE PREVENTION, EDUCATION, TREATMENT |
| GIBSON GENERAL HOSPITAL INC | PART V, SECTION B, LINE 15E: WELL FUND IS AVAILABLE TO DEACONESS HEALTH SYSTEM PATIENTS TO ASSIST WITH APPLYING FOR MEDICAID OR EXCHANGE PRODUCTS. |
| GIBSON GENERAL HOSPITAL INC | PART V, SECTION B, LINE 16J: DEACONESS HOSPITAL SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS HOSPITAL SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTIBILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES. |
| GIBSON GENERAL HOSPITAL, INC.: | SCHEDULE H, PART V, LINE 7A:HTTPS://WWW.DEACONESS.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| GIBSON GENERAL HOSPITAL, INC.: | SCHEDULE H, PART V, LINE 10A:HTTPS://WWW.DEACONESS.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| GIBSON GENERAL HOSPITAL, INC.: | SCHEDULE H, PART V, LINE 16A:HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCESCHEDULE H, PART V, LINE 16A:HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCESCHEDULE H, PART V, LINE 16A:HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - STAR ONE REHAB | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY |
| 2 - PHYSICIAN OUTPATIENT CLINICS | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | SUBSIDIZED CARE PHYSICIAN PRACTICES |
| 3 - LIFESTYLES DIABETES CENTER | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | DIABETES EDUCATION COUNSELING |
| 4 - GGH-FAMILY PRACTICE | ||||
| 510 N MAIN ST | PRINCETON | IN | 47670 | FAMILY MEDICINE |
| 5 - BRINK'S FAMILY PRACTICE | ||||
| 410 N MAIN ST | PRINCETON | IN | 47670 | FAMILY MEDICINE/ HOSPITALIST |
| 6 - FORT BRANCH WELLNESS CLINIC | ||||
| 7851 S PROFESSIONAL DR | FORT BRANCH | IN | 47648 | FAMILY PRACTICE |
| 7 - GGH-SKILLED NURSING FACILITY | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | SKILLED NURSING REHAB CENTER |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | GIBSON GENERAL HOSPITAL USES THE FOLLOWING FACTORS, IN ADDITION TO THE FPG, TO DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY: MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS. ADDITIONALLY, IF AN INDIVIDUAL IS HOMELESS, DECEASED, RECENTLY FILED FOR OR COMPLETED BANKRUPTCY, OR MEETS SPECIAL CIRCUMSTANCES RELATED TO ABILITY TO PAY, THE INDIVIDUAL MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. |
| PART I, LINE 7: | GIBSON GENERAL HOSPITAL CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. |
| PART III, LINE 2: | METHODOLOGY USED TO ESTIMATE BAD DEBT: MANAGEMENT ANALYZES THIRD-PARTY PAYOR SOURCES AND MAKES AN ESTIMATE BASED ON AGING OF ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO ITS SERVICE AREA. ADDITIONALLY, A SIGNIFICANT PROVISION IS ESTIMATED AND RECORDED FOR SELF-PAY PAYMENTS BASED ON PAST EXPERIENCE. |
| PART III, LINE 3: | THE HOSPITAL DOES NOT PURSUE COLLECTION AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. THESE AMOUNTS ARE NOT REPORTED AS NET PATIENT REVENUE BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. GIBSON GENERAL HOSPITAL DOES NOT ATTRIBUTE ANY BAD DEBT EXPENSE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP), THEREFORE NO PORTION OF BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE INDIVIDUALS IS CONSIDERED A COMMUNITY BENEFIT. |
| PART III, LINE 4: | THE FOOTNOTE DESCRIBING BAD DEBT EXPENSES IS INCLUDED IN THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER FOOTNOTE "CHARITY CARE, COMMUNITY BENEFIT AND ASSISTANCE TO THE UNINSURED" STARTING ON PAGE 13 AND "PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE" STARTING ON PAGE 11. |
| PART III, LINE 8: | MEDICARE SHORTFALL:THE HOSPITAL IS A CRITICAL ACCESS HOSPITAL AND IS REIMBURSED 101%, LESS 2% SEQUESTRATION, OF MEDICARE ALLOWANCE COSTS FOR INPATIENT SERVICES, SWING BED, AND OUTPATIENT PART B SERVICES. THE REVENUE SHORTFALL IS THE DIFFERENCE BETWEEN THE ALLOWABLE COST FOR THE SKILLED NURSING FACILITY AND THE PPS REIMBURSEMENT ALLOWED FOR THAT SKILLED NURSING FACILITY. THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED SEPTEMBER 30, 2023: HOSPITAL STATEMENT OF REIMBURSABLE COST. |
| PART III, LINE 9B: | COLLECTION PRACTICES:COLLECTION PRACTICES ARE APPLIED TO ALL PATIENTS AT GIBSON GENERAL HOSPITAL. ONCE PATIENTS RECEIVE SERVICES, THE PATIENTS' ACCOUNTS ARE BILLED TO THE APPROPRIATE INSURANCE COMPANY. ONCE PAYMENT IS RECEIVED FROM THE INSURANCE COMPANY, THE REMAINING BALANCE, IF ANY, BECOMES THE PATIENT'S RESPONSIBILITY. NOTIFICATION OF THE BALANCE DUE IS SENT VIA WRITTEN CORRESPONDENCE. IF THE BALANCE IS NOT PAID AND THE ACCOUNT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE ACCOUNT IS SENT TO A COLLECTION AGENCY TO CONTINUE EFFORTS TO COLLECT THE REMAINING BALANCE DUE. IF THE BALANCE DUE IS NOT PAID WITHIN A CERTAIN NUMBER OF MONTHS, THE ACCOUNT IS RETURNED TO THE HOSPITAL AND THE ACCOUNT IS WRITTEN OFF AS UNCOLLECTIBLE. |
| PART VI, LINE 2: | ASSESSING COMMUNITY NEEDS:IN ADDITION TO COMPLETING A CHNA EVERY THREE YEARS, THE HOSPITAL'S LEADERSHIP IS COMPRISED OF COMMUNITY MEMBERS WHO ENGAGE IN DAILY CONVERSATIONS WITH OTHER COMMUNITY MEMBERS AND LEADERS REGARDING THE COMMUNITY THEY LIVE IN AND ITS NEEDS. THESE CONVERSATIONS SUPPLEMENT THE UNDERSTANDING OF THE COMMUNITY'S HEALTH NEEDS IDENTIFIED IN THE CHNA. HOSPITAL LEADERSHIP ALSO USES STRATEGIC PLANNING TO SPONSOR AND ENGAGE IN COMMUNITY ACTIVITIES THAT HELPS LEADERSHIP ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY THE HOSPITAL SERVES. |
| PART VI, LINE 3: | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL DISPLAYS POSTERS IN THE CENTRAL REGISTRATION AND EMERGENCY ROOM WAITING-AREA NOTIFYING PATIENTS THAT THEY WILL BE SEEN REGARDLESS OF THEIR ABILITY TO PAY AND FINANCIAL ASSISTANCE IS AVAILABLE TO UNINSURED AND UNDERINSURED IN COMPLIANCE WITH EMTALA. THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE ON THE HOSPITAL'S WEBSITE AT WWW.DEACONESS.COM/DEACONESS-GIBSON-HOSPITAL; AVAILABLE UPON REQUEST, WITHOUT CHARGE, AT THE BUSINESS OFFICE, ADMISSIONS, AND VIA MAIL; PLAIN LANGUAGE SUMMARY IS CONSPICUOUSLY DISPLAYED IN THE HOSPITAL AND CLINIC WAITING-AREAS; AND, THE PLAIN LANGUAGE SUMMARY IS PROVIDED TO EACH PERSON UPON ADMISSION TO THE HOSPITAL. ANY PATIENTS WITHOUT INSURANCE OR WITH A BALANCE DUE AFTER INSURANCE IS BILLED ARE PROVIDED A PLAIN LANGUAGE SUMMARY, FAP APPLICATION, AND CONTACT INFORMATION FOR THE HOSPITAL'S PATIENT FINANCIAL COUNSELOR BY MAIL. |
| PART VI, LINE 4: | COMMUNITY INFORMATION/ COMMUNITY SERVED:THE HOSPITAL'S PRIMARY SERVICE AREA INCLUDES GIBSON COUNTY, INDIANA. GIBSON COUNTY IS LOCATED IN SOUTHWESTERN, INDIANA, AND IS LARGELY RURAL WITH AGRICULTURE AND COAL MINING AS PRIMARY INDUSTRIES. GIBSON COUNTY, INDIANA, IS APPROXIMATELY 155 MILES SOUTHWEST OF INDIANAPOLIS AND 25 MILES NORTH OF EVANSVILLE, INDIANA, WITH AN ESTIMATED POPULATION OF 33,145. IN 2019 THE POPULATION MEDIAN AGE WAS 41.4 YEARS WITH FORTY-FIVE PERCENT (45%) OF THE POPULATION AGE 45 AND OLDER. THE POVERTY RATE WAS 9.31% AND THE MEDIAN HOUSEHOLD ANNUAL INCOME WAS $55,462. APPROXIMATELY 75-80% OF THE HOSPITAL'S PATIENT POPULATION UTILIZES MEDICARE, MEDICAID, AND/OR OTHER GOVERNMENT-SUBSIDIZED PROGRAMS. TRADITIONALLY, THE HOSPITAL HAS BEEN RELIED UPON AS A SAFETY NET HOSPITAL FOR OLDER PATIENTS, LOW-INCOME PATIENTS, AND PATIENTS WITH LIMITED MEANS TO TRAVEL TO THE LARGER CITY OF EVANSVILLE, INDIANA. |
| PART VI, LINE 5: | COMMUNITY HEALTH PROMOTION:THE HOSPITAL PARTICIPATES IN MANY ORGANIZATIONS AND ACTIVITIES DESIGNED TO IMPROVE THE HEALTH AND WELFARE OF THE SURROUNDING COMMUNITY. IN ADDITION TO PARTICIPATION ON VARIOUS BOARDS AND CIVIC ORGANIZATIONS FOCUSED ON ECONOMIC DEVELOPMENT, THE HOSPITAL'S LEADERSHIP PARTICIPATES IN THE INDIANA PATIENT SAFETY COALITION, THE DEPARTMENT OF HOMELAND SECURITY, DISTRICT 10 EMERGENCY PREPAREDNESS AND NATIONAL INCIDENT MANAGEMENT SAFETY PROGRAMS. AS MEMBERS OF THE INDIANA RURAL HEATH ASSOCIATION AND THE INDIANA STATE RURAL HEALTH NETWORK, THE HOSPITAL PARTICIPATES IN PROGRAMS DESIGNED TO ASSIST RURAL HEALTHCARE ORGANIZATIONS STATEWIDE AND HAS ASSISTED IN OBTAINING AND IMPLEMENTING COMMUNICATION, INFORMATION SHARING, AND OTHER ACTIVITIES TO IMPROVE THE ACCESS TO HEALTHCARE IN GIBSON COUNTY AND THE SURROUNIDNG AREAS. |
| PART VI, LINE 6: | AFFILIATED HEALTH CARE SYSTEM:GIBSON GENERAL HOSPITAL BECAME AFFILIATED WITH DEACONESS HEALTH SYSTEM IN DECEMBER 2016 COOPERATING TO PROVIDE HEALTH CARE SERVICES TO THEIR COMMUNITIES. ADDITIONALLY, THE HOSPITAL DOES PARTICIPATE IN SEVERAL COALITIONS AND COOPERATIVES WITH OTHER PROVIDERS AND OFTEN COLLABORATES WITH THE LARGER SYSTEM IN THE EVANSVILLE AREA TO PROVIDE ACCESS TO SERVICES THE HOSPITAL CANNOT PROVIDE SUCH AS CARDIAC AND NEUROLOGICAL SURGERY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SHAWN MCCOY | ||||||||||||||
| BOARD MEMBER PARTIAL TERM | $0 | $1,004,638 | $0 | $322,989 | $0 | $233,090 | $0 | $273,802 | $0 | $43,380 | $0 | $1,877,899 | $0 | $216,756 |
| LYNN LINGAFELTER | ||||||||||||||
| BOARD MEMBER | $0 | $608,584 | $0 | $168,260 | $0 | $105,821 | $0 | $151,033 | $0 | $31,856 | $0 | $1,065,554 | $0 | $97,784 |
| MARC JARED FLORENCE | ||||||||||||||
| BOARD MEMBER | $0 | $418,131 | $0 | $95,606 | $0 | $76,679 | $0 | $98,824 | $0 | $37,173 | $0 | $726,413 | $0 | $72,580 |
| CLAUDIA EISENMANN | ||||||||||||||
| VP DHS CRITICAL ACCESS HOS | $0 | $343,460 | $0 | $52,803 | $0 | $3,223 | $0 | $16,580 | $0 | $10,447 | $0 | $426,513 | $0 | $0 |
| DR DAVID PURDOM | ||||||||||||||
| CHIEF OF STAFF TERM | $291,751 | $0 | $0 | $0 | $1,572 | $0 | $16,316 | $0 | $30,068 | $0 | $339,707 | $0 | $0 | $0 |
| COREY POTTS | ||||||||||||||
| CRNA | $263,133 | $0 | $0 | $0 | $1,547 | $0 | $14,322 | $0 | $28,362 | $0 | $307,364 | $0 | $0 | $0 |
| WILLIAM ALLEN WHITE MD | ||||||||||||||
| BOARD MEMBER | $0 | $151,976 | $0 | $44,609 | $0 | $45,409 | $0 | $26,812 | $0 | $24,433 | $0 | $293,239 | $0 | $0 |
| LOIS MORGAN | ||||||||||||||
| CAO | $0 | $180,392 | $0 | $31,178 | $0 | $3,252 | $0 | $11,003 | $0 | $21,260 | $0 | $247,085 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | SOCIAL CLUB DUES ARE PAID FOR SHAWN MCCOY FOR ORGANIZATION BUSINESS ONLY. ANY PERSONAL USE OF THE CLUB MUST BE PAID BY THE EMPLOYEE. |
| PART I, LINE 4B | SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS: SEVERANCE NONQUALIFIED EQUITY-BASED SHAWN MCCOY $ -0- $ 20,500 $ -0- WILLIAM ALLEN WHITE, MD 0 15,209 0 MARC J. FLORENCE 0 20,500 0 DAVID PURDOM 0 20,500 0 LYNN LINGAFELTER 0 20,500 0 PART I, 4B: SHAWN MCCOY: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $247,426. SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $216,756. WILLIAM ALLEN WHITE, MD: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $21,523. SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $21,523. MARC J. FLORENCE: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $77,614. SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $72,580. LYNN LINGAFELTER: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $126,485. SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $97,784. |
| PART I, LINE 6 | COMPENSATION CONTINGENT UPON NET EARNINGS: INCENTIVE COMPENSATION PAYMENTS MADE BY THE ORGANIZATION ARE BASED UPON SUCCESSFUL ACHIEVEMENT OF ESTABLISHED INPATIENT SATISFACTION MEASURES, OUTPATIENT SATISFACTION MEASURES, COMPLIANCE WITH PUBLICLY REPORTED QUALITY INDICATORS, OPERATING MARGIN AS WELL AS OTHER TECHNICAL AND PERSONAL FUNCTIONAL GOALS OF BOTH THE ORGANIZATION AND RELATED ORGANIZATIONS. DEACONESS HOSPITAL'S INCENTIVE COMPENSATION PROGRAMS ARE FORMULATED TO REWARD BEHAVIOR THAT BALANCES PATIENT NEEDS AND EFFICIENT DELIVERY OF PATIENT CARE TO ENSURE THE BEST OUTCOMES ARE ACHIEVED. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | CLASSES OF MEMBERS OR STOCKHOLDERS: DEACONESS HEALTH SYSTEM, INC., A TAX EXEMPT 501(C)(3) ORGANIZATION, IS THE SOLE CORPORATE MEMBER OF GIBSON GENERAL HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | POWER TO ELECT OR APPOINT: DEACONESS HEALTH SYSTEM, THE SOLE MEMBER OF THE ORGANIZATION, HAS THE POWER TO APPOINT AND REMOVE EACH MEMBER. THE ORGANIZATION GOVERNING DOCUMENTS ALLOWS FOR THE COUNTY COMMISSIONERS OF GIBSON COUNTY, INDIANA TO SELECT ONE (1) MEMBER OF THE BOARD OF TRUSTEES; THREE (3) REPRESENTATIVES FROM THE ORGANIZATION'S SOLE MEMBER; THE MAYOR OF PRINCETON, INDIANA; THE PRESIDENT OF GIBSON GENERAL HOSPITAL FOUNDATION; THE CHIEF OF STAFF OF GIBSON GENERAL HOSPITAL TO SERVE AS EX-OFFICIO MEMBER; AND TWO MEMBERS OF THE MEDICAL COMMUNITY. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING GOVERNANCE DECISIONS ARE RESERVED TO THE SOLE MEMBER OF THE ORGANIZATION, DEACONESS HEALTH SYSTEM. - APPROVAL OF ANNUAL OR LONG-TERM CAPITAL BUDGETS, OPERATING BUDGETS AND STRATEGIC PLANS, OR ANY EXPENDITURE IN EXCESS OF $150,000 NOT INCLUDED IN AN APPROVED BUDGET. - THE SALE OR TRANSFER OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY KEY OPERATIONAL ASSETS. - THE FILING OF BANKRUPTCY OR SIMILAR INSOLVENCY PROCESS WITH RESPECT TO THE CORPORATION. - ANY TRANSFER OF SUBSTANTIAL MANAGEMENT RESPONSIBILITY WITH RESPECT TO THE CORPORATION. - ANY AMENDMENT TO THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS. - ANY BORROWING EQUAL TO OR GREATER THAN $150,000, OR ANY AMENDMENT TO FINANCING OR LOAN DOCUMENTS TO WHICH THE CORPORATION IS A PARTY. - ANY DECISION TO CHANGE THE NAME OF THE HOSPITAL, CHANGE THE HOSPITAL CAMPUS FROM A CRITICAL ACCESS HOSPITAL STATUS, RELOCATE OR SUBSTANTIALLY REDUCE OR TERMINATE SERVICES TO THE COMMUNITY. - ANY DECISION TO REDUCE THE LEVEL OF CHARITABLE SERVICES TO THE COMMUNITY. - ANY DECISION RELATING TO THE TERMINATION OF THE CORPORATION'S EMPLOYEE RETIREMENT PLAN. - ADOPTION OF ANY POLICIES RELATING TO THE OPERATION OF THE BOARD, THE CORPORATION, OR THE HOSPITAL THAT ARE INCONSISTENT WITH POLICIES OF DEACONESS. - ANY OF THE FOREGOING ACTIONS BY THE CORPORATION AS THE OWNER, MEMBER OF ANY OF THE CORPORATION'S SUBSIDIARIES OR AFFILIATES, INCLUDING THE HOSPITAL. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS: THE PROCESS OF REVIEWING THE FORM 990 INCLUDES A DETAILED REVIEW OF THE FORM AND REQUIRED SCHEDULES BY THE CHIEF FINANCIAL OFFICER AND MANAGEMENT. AFTER THIS REVIEW IS PERFORMED AND ALL QUESTIONS ARE ANSWERED, THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS OF DEACONESS HEALTH SYSTEM AT THE BOARD MEETING PRIOR TO THE FILING DATE OF THE FORM 990. ANY ADDITIONAL QUESTIONS ARE ANSWERED AND THE FINAL FILING IS THEN COMPLETED. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: THE CONFLICT OF INTEREST POLICY IS INCLUDED WITHIN THE BYLAW OF THE ORGANIZATION AND COVERS ALL BOARD OF TRUSTEES. THE POLICY PROVIDES PROCEDURES TO PREVENT THOSE WITH DUALITY OF INTEREST OR POSSIBLE CONFLICTS OF INTEREST FROM PARTICIPATING IN ANY ACTION THAT COULD PERSONALLY BENEFIT THE INDIVIDUAL TRUSTEE. THE CEO AND/OR BOARD COMPLIANCE OFFICER REVIEW ANNUAL WRITTEN AND SIGNED CONFLICT OF INTEREST STATEMENTS THAT PROVIDE ANY DUALITY OF INTEREST OR POSSIBLE CONFLICTS OF INTEREST DISCLOSED BY ALL BOARD OF TRUSTEES. THE INDIVIDUAL TRUSTEE WILL AGAIN DISCLOSE TO THE BOARD WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION AND RECUES HIMSELF OR HERSELF FROM VOTING ON THE RELATED ISSUE. THE BOARD MEETING MINUTES DOCUMENT THE DISCLOSURE MADE, WHO ABSTAINED FROM VOTING, AND THE QUORUM SITUATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION PROCESS: CEO: THE CEO EVALUATION COMMITTEE, CONSISTING OF FOUR INDEPENDENT AND BOARD CHAIR APPOINTMENT TRUSTEE MEMBERS, EVALUTATES THE PERFORMANCE OF THE CEO ON AN ANNUAL BASIS AND MAKES COMPENSATION-RELATED RECOMMENDATIONS TO THE BOARD PRIOR TO THE CEO'S ANNUAL REVIEW DATE FOR APPROVAL. THE EVALUATION COMMITTEE USES A COMPENSATION CONSULTANT, COMPENSATION SURVEY, AND COMPARATIVE DATA FROM SIMLIAR ORGANIZATION TO DETERMINE THE CEO'S COMPENSATION PACKAGE. ALL DELIBERATION AND DECISIONS ARE DOCUMENTED IN THE EVALUATION COMMITTEE'S MINUTES. OFFICERS AND/OR KEY EMPLOYEES: ANNUAL REVIEWS FOR TOP MANAGEMENT OFFICIALS ARE CONDUCTED BY THE CEO. THE COMPENSATION IS ANNUALLY REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST AND BOARD OF TRUSTEES APPROVAL. WRITTEN REQUESTS SHOULD BE SENT TO ATTN: JAMES CHILDERS, AT THE ADDRESS LISTED ON PAGE 1 OF THE FORM 990. |
| FORM 990, PART VI, LINE 16B, JOINT VENTURE POLICY: | THE ORGANIZATION DOES NOT HAVE A FORMAL WRITTEN POLICY ON EVALUATING PARTICIPATION IN A JOINT VENTURE, HOWEVER, THE ORGANIZATION PERFORMS DUE DILIGENCE AND INVOLVES LEGAL COUNSEL TO REVIEW ANY PARTNERSHIPS ENSURING THAT THE JOINT VENTURE WOULD BE ORGANIZED AND OPERATED IN A MANNER CONSISTENT WITH THE HOSPITAL'S EXEMPT PURPOSE AND STATUS. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,814,215. MANAGEMENT AND GENERAL EXPENSES 1,841,358. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,655,573. PROFESSIONAL FEES - MEDICAL: PROGRAM SERVICE EXPENSES 2,070,161. MANAGEMENT AND GENERAL EXPENSES 559,405. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,629,566. |
| FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT: | THE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT; AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| DEACONESS CLINIC INC | |||||||||||
| 421 CHESNUT STREET | PRINCETON | IN | 47713 | 263083364 | HEALTHCARE | IN | 501(C)(3) | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS HEALTH KENTUCKY INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 830966826 | HEALTHCARE | IN | 501(C)(3) | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS HEALTH SYSTEM INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 351532889 | HEALTHCARE | IN | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| DEACONESS HOSPITAL INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 350593390 | HEALTHCARE | IN | 501(C)(3) | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS SPECIALTY PHYSICIANS INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 824503095 | HEALTHCARE | IN | 501(C)(3) | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS UNION COUNTY HOSPITAL INC | |||||||||||
| 4604 US HWY 60 WEST | MORGANFIELD | KY | 42437 | 862614124 | HEALTHCARE | KY | 501(C)(3) | LINE 3 | DEACONESS HEALTH KENTUCKY | 0 | |
| DEACONESS VNA PLUS LLC | |||||||||||
| 610 E WALNUT ST | EVANSVILLE | IN | 47713 | 465223267 | HEALTHCARE | IN | 501(C)(3) | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| GIBSON GENERAL HEALTH FOUNDATION INC | |||||||||||
| 1808 SHERMAN DR | PRINCETON | IN | 47670 | 350950175 | SUPPORT GIBSON HOSPITAL | IN | 501(C)(3) | LINE 12A, I | DEACONESS GIBSON HOSPITAL | 0 | |
| METHODIST HEALTH INC | |||||||||||
| 1305 N ELM STREET | HENDERSON | KY | 42420 | 610461753 | HEALTHCARE | KY | 501(C)(3) | LINE 3 | DEACONESS HEALTH KENTUCKY | 0 | |
| UNION COUNTY METHODIST HOSPITAL FOUNDATION | |||||||||||
| 4604 US HWY 60 WEST | MORGANFIELD | KY | 42437 | 611230297 | SUPPORT METHODIST HOSPITAL | KY | 501(C)(3) | LINE 12A, I | DEACONESS HEALTH KENTUCKY | 0 | |
| DEACONESS ILLINOIS SPECIALTY CLINIC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 920904755 | HEALTHCARE | IL | 501(C)(3) | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS ILLINOIS CLINIC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 920574205 | HEALTHCARE | IL | 501(C)(3) | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS WOMEN'S HOSPITAL OF SOUTHERN INDIANA LLC | |||||||||||
| 4199 GATEWAY BLVD | NEWBURGH | IN | 47630 | 352062016 | HEALTHCARE | IN | 501(C)(3) | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| DEACONESS HEALTH PLANS LLC | |||||||||
| 7100 EAGLE CREST BLVD | EVANSVILLE | IN | 47715 | 383492529 | PREFERRED PROVIDER NETWORK | IN | N/A | 0 | 0 |
| ENCOMPASS HEALTH DEACONESS REHABILIATION | |||||||||
| 9001 LIBERTY PARKWAY | BIRMINGHAM | AL | 35242 | 721375246 | OUTPATIENT | AL | N/A | 0 | 0 |
| MAINSPRING MANAGERS LLC | |||||||||
| 4011 GATEWAY BLVD | NEWBURGH | IN | 47630 | 464601001 | NEUROLOGY SERVICES | IN | N/A | 0 | 0 |
| ORTHOALIGN LLC | |||||||||
| 4011 GATEWAY BLVD | NEWBURGH | IN | 47630 | 812816013 | HEALTHCARE | IN | N/A | 0 | 0 |
| PROGRESSIVE HEALTH OF IN LLC | |||||||||
| 150 N ROSENBERGER | EVANSVILLE | IN | 47712 | 208480988 | OUTPATIENT | IN | N/A | 0 | 0 |
| TRI - STATE HEALTHCARE CONSULTING LLC | |||||||||
| 4199 GATEWAY BLVD | NEWBURGH | IN | 47630 | 922120911 | HEALTHCARE | IN | N/A | 0 | 0 |
| TRI-STATE RADIATION ONCOLOGY | |||||||||
| PO BOX 819067 TAX DEPT | DALLAS | TX | 75381 | 263706834 | OUTPATIENT | DE | N/A | 0 | 0 |
| VASCMED LLC | |||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 472578168 | VASCULAR SERVICES | IN | N/A | 0 | 0 |
| BURKHARDT CANCER CENTER | |||||||||
| 4972 LINCOLN AVENUE STE 100 | EVANSVILLE | IN | 47715 | 300256432 | HEALTHCARE | IN | N/A | 0 | 0 |
| BOSTON IVF FERTILITY SERVICES AT THE WOMEN'S HOSPITAL | |||||||||
| 4199 GATEWAY BLVD | NEWBURGH | IN | 47630 | 455549778 | HEALTHCARE | IN | N/A | 0 | 0 |
| INNOVATIVE HEALTHCARE COLLABORATIVE OF INDIANA LLC | |||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 833592473 | HEALTHCARE | IN | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRI-STATE MEDICAL MANAGEMENT INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 MARY STREET | AddressLine1Txt |
| City | EVANSVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47747 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351875888 | EIN |
| Primary Activities | PHYSICIAN MANAGEMENT | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |