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        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>3000</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Preston Simmons</PersonNm>
        <TitleTxt>Director</TitleTxt>
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        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>3000</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jared Baker</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>2</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>2500</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>6915628</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>72600</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>146</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Hudson Staffing</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PLLC 4409 Ivan Creek DR</AddressLine1Txt>
            <CityNm>Franklin</CityNm>
            <StateAbbreviationCd>TN</StateAbbreviationCd>
            <ZIPCd>37064</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Temporary Contract Staffing</ServicesDesc>
        <CompensationAmt>698104</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>The Good Life Medstaff</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 3544</AddressLine1Txt>
            <CityNm>Omaha</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68103</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Temporary Contract Staffing</ServicesDesc>
        <CompensationAmt>461035</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>J Ross Tanner</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3841 PIPER ST</AddressLine1Txt>
            <AddressLine2Txt>DO 35555 Kenai Spur HWY PMB345</AddressLine2Txt>
            <CityNm>Soldotna</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99669</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Physician Services</ServicesDesc>
        <CompensationAmt>396350</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>Kurt Mentzer</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>12000 Lilac DR</AddressLine1Txt>
            <CityNm>Anchorage</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99516</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Physician Services</ServicesDesc>
        <CompensationAmt>376223</CompensationAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Peak Imaging</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>9339 NE 5th ST</AddressLine1Txt>
            <CityNm>Terrebonne</CityNm>
            <StateAbbreviationCd>OR</StateAbbreviationCd>
            <ZIPCd>97760</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Physician Services Imaging</ServicesDesc>
        <CompensationAmt>370376</CompensationAmt>
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      <CntrctRcvdGreaterThan100KCnt>16</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>0</FundraisingAmt>
      <RelatedOrganizationsAmt>5160918</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>1760364</GovernmentGrantsAmt>
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      <NoncashContributionsAmt>93172</NoncashContributionsAmt>
      <TotalContributionsAmt>6921282</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Hosspital</Desc>
        <BusinessCd>622000</BusinessCd>
        <TotalRevenueColumnAmt>93667980</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>93667980</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Physician Offices</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>16085481</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>16085481</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>Long Term Care</Desc>
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        <RelatedOrExemptFuncIncomeAmt>12903381</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>Home Health Care</Desc>
        <BusinessCd>621610</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>1317748</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>123974590</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
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        <RelatedOrExemptFuncIncomeAmt>1558025</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
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        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
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        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
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      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>9275</OtherAmt>
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        <OtherAmt>0</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
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        <OtherAmt>9275</OtherAmt>
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      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>9275</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9275</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
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      <ContriRptFundraisingEventAmt>0</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>0</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
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      <GamingGrossIncomeAmt>0</GamingGrossIncomeAmt>
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      <NetIncomeFromGamingGrp>
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        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
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        <Desc>Cafeteria and Other Revenues</Desc>
        <BusinessCd>900099</BusinessCd>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
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      <OtherRevenueMiscGrp>
        <Desc>Other Operating Revenues</Desc>
        <BusinessCd>900099</BusinessCd>
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        <RelatedOrExemptFuncIncomeAmt>39988</RelatedOrExemptFuncIncomeAmt>
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      <MiscellaneousRevenueGrp>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
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      <GrantsToDomesticOrgsGrp>
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        <ProgramServicesAmt>152223</ProgramServicesAmt>
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      <GrantsToDomesticIndividualsGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
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      <BenefitsToMembersGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
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      <CompCurrentOfcrDirectorsGrp>
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        <ProgramServicesAmt>1745964</ProgramServicesAmt>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
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        <ProgramServicesAmt>2996084</ProgramServicesAmt>
        <ManagementAndGeneralAmt>749021</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>4569724</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>3165947</ProgramServicesAmt>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
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        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28089</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>142571</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
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        <ManagementAndGeneralAmt>10496</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <FeesForServicesProfFundraising>
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        <FundraisingAmt>0</FundraisingAmt>
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      <FeesForSrvcInvstMgmntFeesGrp>
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        <FundraisingAmt>0</FundraisingAmt>
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      <AdvertisingGrp>
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        <ProgramServicesAmt>28242</ProgramServicesAmt>
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      <InformationTechnologyGrp>
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        <ProgramServicesAmt>853479</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1205222</ManagementAndGeneralAmt>
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      <RoyaltiesGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
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        <FundraisingAmt>0</FundraisingAmt>
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        <ProgramServicesAmt>348479</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1993632</ManagementAndGeneralAmt>
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      <TravelGrp>
        <TotalAmt>260385</TotalAmt>
        <ProgramServicesAmt>178772</ProgramServicesAmt>
        <ManagementAndGeneralAmt>81613</ManagementAndGeneralAmt>
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      <PymtTravelEntrtnmntPubOfclGrp>
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        <FundraisingAmt>0</FundraisingAmt>
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      <ConferencesMeetingsGrp>
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        <ManagementAndGeneralAmt>540922</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <PaymentsToAffiliatesGrp>
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        <FundraisingAmt>0</FundraisingAmt>
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      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>4551835</ProgramServicesAmt>
        <ManagementAndGeneralAmt>505760</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>492398</ProgramServicesAmt>
        <ManagementAndGeneralAmt>844704</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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        <Desc>Repairs and Maintenance</Desc>
        <TotalAmt>2321242</TotalAmt>
        <ProgramServicesAmt>983237</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1338005</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <OtherExpensesGrp>
        <Desc>Dues and Subscriptions</Desc>
        <TotalAmt>278000</TotalAmt>
        <ProgramServicesAmt>67838</ProgramServicesAmt>
        <ManagementAndGeneralAmt>210162</ManagementAndGeneralAmt>
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      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Recruitment</Desc>
        <TotalAmt>1923311</TotalAmt>
        <ProgramServicesAmt>1388070</ProgramServicesAmt>
        <ManagementAndGeneralAmt>535241</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>Miscellaneous</Desc>
        <TotalAmt>310632</TotalAmt>
        <ProgramServicesAmt>181229</ProgramServicesAmt>
        <ManagementAndGeneralAmt>129403</ManagementAndGeneralAmt>
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      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>129405244</TotalAmt>
        <ProgramServicesAmt>100603236</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28802008</ManagementAndGeneralAmt>
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      <CashNonInterestBearingGrp>
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        <EOYAmt>2876</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>42940215</BOYAmt>
        <EOYAmt>42730141</EOYAmt>
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      <PledgesAndGrantsReceivableGrp>
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        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>15489824</BOYAmt>
        <EOYAmt>20440376</EOYAmt>
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      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
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        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>2130034</BOYAmt>
        <EOYAmt>2340672</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>737230</BOYAmt>
        <EOYAmt>885529</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>111575270</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>64784321</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>43376835</BOYAmt>
        <EOYAmt>46790949</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
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        <EOYAmt>0</EOYAmt>
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      <InvestmentsOtherSecuritiesGrp>
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        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
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        <EOYAmt>0</EOYAmt>
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        <FPGFamilyIncmLmtFreeCarePct>100</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>300</FPGFamilyIncmLmtDscntCarePct>
        <ExplainedBasisInd>1</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>1</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>https://www.sphosp.org/for-patients/financial-assistance/</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>https://www.sphosp.org/wp-content/uploads/2021/02/2021-FAP-Application.pdf</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>https://www.sphosp.org/wp-content/uploads/2018/08/Financial-Assistance-Brochure.pdf</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <OtherPublicityInd>X</OtherPublicityInd>
        <FAPActionsOnNonpaymentInd>1</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>0</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>1</NondisEmergencyCarePolicyInd>
        <AmountsGenerallyBilledInd>0</AmountsGenerallyBilledInd>
        <GrossChargesInd>0</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 5-South Peninsula Hospital</FormAndLineReferenceDesc>
        <ExplanationTxt>South Peninsula Hospital conducted a community health needs assessment (CHNA) for the southern Kenai Peninsula in 2023, in cooperation with MAPP of SKP Health Coalition. This CHNA was conducted in compliance with IRS Section 501(r), and identified health needs of the residents of the South Kenai Peninsula Hospital Service Area of the Kenai Peninsula Borough. The final assessment was adopted by the SPH Board of Directors on June 28, 2023, and made available to the public on the organization's website www.sphosp.org free of charge. The complete CHNA report can be found in the separate document link titled CHNA on the South Peninsula Hospital website www.sphosp.org. Numerous presentations were made of the report findings from June through October, including at meetings of the hospital's Board of Directors, Homer City Council, SPH general hospital staff, SPH general medical staff, Rotary and MAPP of the Southern Kenai Peninsula local community health coalition made up of twelve partnering local agencies representing the eight dimensions of wellness. The findings were reviewed internally by management and input received during presentations was taken into account in order to prioritize the most significant health needs to address. Consideration was given to the magnitude of the issue, consequences if issue was not addressed, and feasibility to affect change. Impact of the pandemic was found to be wide spread. Complete assessment findings, details and breakdown of the data can be found in the complete assessment report.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 11-South Peninsula Hospital</FormAndLineReferenceDesc>
        <ExplanationTxt>To address mental health needs identified in the 2023 CHNA, SPH applied for a behavioral health grant to add behavioral health component to women's health, provided a community resource guide pamphlet and ensure updated version remains in circulation, both on paper and electronically and continued to support regular, free wellness programs in the community through various programs including Wellness Wednesday. SPH is working with South Peninsula Behavioral Health to consider co-location of some mental health providers. SPH offered trainings and certifications for SPH staff in teen mental health first aid and our Community Health and Wellness Educator Nurse was trained in Teen Mental Health First Aid program. Teen mental health first aid training was offered at parent nights and to the communities of Nanwalek and Port Graham. We continue to participate as a lead agency in the community Safe &amp; Healthy Kids Fair and offer activities and lunch and learns with a focused towards mental health. In FY 2024 the Spring Health employee assistance program was added in addition to the continuation of the wellness reimbursement program which includes coverage for a wide array of mental health supports. To address housing needs SPH solicited for proposals and selected a contractor for a 26 unit housing complex. SPH continues to participate in and facilitate community meetings regarding housing including involvement in Guiding Growth forum, MAPP taskforce on housing solutions as part of the community health improvement plan (CHIP) and the City of Homer Comprehensive Plan update. To address substance use we continue our partnership with local addiction prevention and harm reduction agencies to co-design solutions to advance community health. Staff participated and supported All Things Recovery Coalition. Free facility, advocacy assistance, and support was provided to Megan's Place Needle exchange. SPH provided a grant writer to Kachemak Bay Recovery Connection who successfully wrote an opioid settlement grant application to expand recovery efforts; SPH has a representative on the board and provides funding for administrative support for additional grant acquisition and management. Our MAT nurse staffed the community resource (homeless) connect, the food pantry, the rotary health fair and the Kenai Peninsula fair. A training on responding to overdoses was provided at the local theater in advance of the movie and we continued harm reduction trainings both planned as well as offered upon request. To address the childcare shortage SPH is in the process of opening a childcare facility for staff, to be open by summer of 2025, which will free up more than thirty spots in the community currently occupied by children of SPH staff. Quarterly safe sitter babysitting course for youth in grades 6th-8th, expanding outreach to rural parts of the service area. Three trainings were offered at SPH; and one in the village. SPH focused on marketing and outreach to increase the number of annual or wellness visits a year by hiring a full time in house marketing assistant with focus on marketing/outreach expansion efforts, increased announcements of available PCPs and evening clinic offerings, hosted Brake for Breakfast in October, giving out free breakfast with important health tips including breast health and cancer prevention and hired additional PCP to meet growing demand of clinic visits. Free vaccines were offered during health fair blood draws and clinics offered free kids flu shots during designated hours. SPH contracts with Kachemak Bay Family Planning to offer free STD testing at the clinic and at the needle exchange. This year Weekly Wellness Wednesday programming, free and open to all, included a health presentation, a meal, and movement activity. SPH hosted Homer Steps Up free walking challenge, where over 700 individuals enrolled. Sunrise Medical Weight loss offered community education presentations and Homer Medical has a Certified Diabetes Educator nurse. To support our aging population SPH host a Senior Day at State fair and senior focused offerings through Health Fair and Wellness Wednesdays. To increase services for a rapidly growing senior population, a free standing wound care clinic to care for patients with referrals from any of the family practice providers in the service area is being formulated within the primary care clinic; set to relocate in 2025. SPH continues to seek funding and community support for an expanded Oncology/Infusion Clinic unit, and the addition of nuclear medicine. Audiology has joined the specialty clinic, an upper extremity expert joined orthopedics and a full time neurologist has started a practice. The Rehabilitation clinic has relocated to a downtown location for easier access and parking. To address barriers to care, training and planning was conducted for determining the social determinants of health (SDOH) at time of admission to ensure patients receive the appropriate support services when discharged. SPH will work with local, borough and statewide coalitions and resources to identify and help address significant gaps of services and resources in the hospital's service area. Starting 2025, SPH will fully implement SDOH screenings for food insecurity, housing instability, transportation needs, utility difficulties and interpersonal safety, work to connect patients to services upon discharge, and report measures and data to CMS. Training and planning was conducted for this project. Numerous financial navigators were hired to strengthen awareness of financial assistance options and brochures are at registration windows. The SPH foundation has developed a Patient Assistance fund for taxi vouchers and travel reimbursement for patients experiencing transportation or travel cost barriers to seeking much needed care. SPH continues to partner with the Kachemak Bay Rotary Club to offer deeply discounted blood draws on an annual basis with over 800 individuals taking advantage in 2023. To address social isolation SPH continues to offer free community seasonal offerings and event such as Wellness Wednesday and Homer Steps up. Hospital representatives continue to work on collective improved community health through participation in MAPP of the Southern Kenai Peninsula local health coalition and MAPP workgroups. SPH offers volunteer opportunities at the hospital such as gift shop, pet therapy, long term care visitors and event assistance. To address Staff Workforce Shortages SPH prioritizes retaining current staff through increased job and employee satisfaction. We have added an internal C.N.A. earn to learn program with around 6 students per semester. The SPH Foundation scholarship funds provided scholarships for allied health programs and C.N.A. training. SPH supports the Kachemak Bay Campus in their C.N.A., nursing and allied health curriculums and clinical rotations. We hosted three tours to high school students of all departments, with emphasis on career tracks. We partnered with UAA and HHS to be the site for an annual AHEC career boot camp. Seventeen students participated in a one day job shadow program.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16j-South Peninsula Hospital</FormAndLineReferenceDesc>
        <ExplanationTxt>Financial Assistance information is provided on patient statements and as financial navigators call patients to discuss bills, financial assistance program information is shared. SPH also offers free consults through the Financial Navigators for seniors accessing and signing up for Medicare. SPH's financial aid counselor office is located in the main entrance of the hospital for easy access and financial aid counselors are represented at community fairs.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>10</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SPH Long Term Care</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4300 Bartlett Street</AddressLine1Txt>
            <CityNm>Homer</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99603</ZIPCd>
          </USAddress>
          <FacilityTxt>Long term care skilled nursing facility</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SPH Home Health</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>203 W Pioneer</AddressLine1Txt>
            <CityNm>Homer</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99603</ZIPCd>
          </USAddress>
          <FacilityTxt>Home Health Services</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Homer Medical Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4136 Bartlett St</AddressLine1Txt>
            <CityNm>Homer</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99603</ZIPCd>
          </USAddress>
          <FacilityTxt>Family Practice Medical Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SPH Specialty Physician &amp; Family Care Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4201 Bartlett St</AddressLine1Txt>
            <CityNm>Homer</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99603</ZIPCd>
          </USAddress>
          <FacilityTxt>Orthopaedics, General Surgery, Urology, Primary Care, and other Specialty physicians</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SPH West Wing Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4117 Bartlett St</AddressLine1Txt>
            <CityNm>Homer</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99603</ZIPCd>
          </USAddress>
          <FacilityTxt>OBGYN and Women's health services</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SPH Infusion Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4251 Bartlett St</AddressLine1Txt>
            <CityNm>Homer</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99603</ZIPCd>
          </USAddress>
          <FacilityTxt>Infusion Treatments</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SPH-Peninsula Surgical Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4252 Hohe St Suite B</AddressLine1Txt>
            <CityNm>Homer</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99603</ZIPCd>
          </USAddress>
          <FacilityTxt>General Surgery Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SPH Neurology &amp; Sleep Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4300 Bartlett St</AddressLine1Txt>
            <CityNm>Homer</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99603</ZIPCd>
          </USAddress>
          <FacilityTxt>Neurology &amp; Sleep Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Serene Waters Mental Health Services</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4135 Hohe St</AddressLine1Txt>
            <CityNm>Homer</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99603</ZIPCd>
          </USAddress>
          <FacilityTxt>Mental Health Outpatient Services</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>SPH OBGYN Medical Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>263 W Fairview Ave</AddressLine1Txt>
            <CityNm>Homer</CityNm>
            <StateAbbreviationCd>AK</StateAbbreviationCd>
            <ZIPCd>99603</ZIPCd>
          </USAddress>
          <FacilityTxt>OBGYN Medical Clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Costs associated with financial assistance were based on the Medicare Cost Report cost to charge ratio for tax year 2023. Costs associated with other benefits are based on actual reported costs per activity or department.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part II</FormAndLineReferenceDesc>
        <ExplanationTxt>Community building activities included activities in the community such as working with project homeless connect, the Southern Kenai Peninsula Resiliency Coalition, sponsoring support services for mothers and babies at the farmers market, and working to promote community wellness.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Section A, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Percentage of self pay writeoffs that are charity care times the cost to charge ratio to get the true cost.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Section B, Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>This data was obtained from the CMS website on our Provider Statistical &amp; Reimbursement Report for the tax year. We believe the shortfall in line 8 should be considered community benefit due to the provision of care to Medicare patients regardless of their ability to pay. Further the hospital is not allowed to collect from the contractual writeoffs from patients despite the deficit in the cost to provide the services to this population.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Section C, Line 9b</FormAndLineReferenceDesc>
        <ExplanationTxt>The facility has a debt collection policy. The policy allows for any funds sent to bad debt that are eligible for financial assistance to be pulled back from a collection agency.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>South Peninsula Hospital uses a collaborative effort within state and local agencies and also community members and focus groups to identify the community health needs.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The hospital employs 2 financial counselors and 3 financial navigators that are available to meet with patients to discuss bills, payment plans, and financial assistance options. The counselors can also assist patients with completing the charity care application. Additionally, a copy of the FAP is available at all registration areas, displayed prominently in the emergency rooms and waiting rooms, and published on our website.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The hospital serves the Southern Kenai Peninsula Service Area located in the Kenai Peninsula Borough. That service area encompasses several communities in South Central Alaska to include Anchor Point, Diamond Ridge, Fox River, Fritz Creek, Happy Valley, Homer, Kachemack City, Nanwalek, Nikolaevsk, Ninilchick, Port Graham, and Seldovia for an estimated population of 20,000.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
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      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Elemental Consulting</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO Box 547</AddressLine1Txt>
          <CityNm>Homer</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99603</ZIPCd>
        </USAddress>
        <RecipientEIN>933149508</RecipientEIN>
        <CashGrantAmt>80577</CashGrantAmt>
        <PurposeOfGrantTxt>Support for community MAPP program, mobilizing action through planning and partnerships, a coalition for health improvement on the peninsula. This program supports All Things Recovery.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Hospice of Homer</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO Box 4174</AddressLine1Txt>
          <CityNm>Homer</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99603</ZIPCd>
        </USAddress>
        <RecipientEIN>920015943</RecipientEIN>
        <CashGrantAmt>51540</CashGrantAmt>
        <PurposeOfGrantTxt>Support for the hospice program and community resource for DME and end of life care.</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Kachemak Bay Family Planning</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3959 Ben Walters Ln</AddressLine1Txt>
          <CityNm>Homer</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99603</ZIPCd>
        </USAddress>
        <RecipientEIN>920106486</RecipientEIN>
        <CashGrantAmt>20106</CashGrantAmt>
        <PurposeOfGrantTxt>Support for private community STD testing.</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>3</Total501c3OrgCnt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule I, Part I, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Assistance was provided to healthcare non-profits which support the community health needs. Records are kept in the Hospital's accounting system.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
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      <HousingAllowanceOrResidenceInd>X</HousingAllowanceOrResidenceInd>
      <PaymentsForUseOfResidenceInd>X</PaymentsForUseOfResidenceInd>
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>0</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
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      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
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        <PersonNm>Brent Adcox</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Edson Knapp</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Ryan Smith</PersonNm>
        <TitleTxt>CEO</TitleTxt>
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        <PersonNm>Nathan Kincaid</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>677949</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Michael Boling</PersonNm>
        <TitleTxt>Director and General Surgeon</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>198</BonusFilingOrganizationAmount>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Christopher Landess</PersonNm>
        <TitleTxt>ER Physician</TitleTxt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Paula Godfrey</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>196</BonusFilingOrganizationAmount>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22205</NontaxableBenefitsFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Lucy Fisher</PersonNm>
        <TitleTxt>Physician</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>12494</BonusFilingOrganizationAmount>
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        <PersonNm>Christina Tuomi</PersonNm>
        <TitleTxt>CMO</TitleTxt>
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        <PersonNm>Angela Hinnegan</PersonNm>
        <TitleTxt>COO</TitleTxt>
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        <TitleTxt>CNO</TitleTxt>
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        <PersonNm>Anna Hermanson</PersonNm>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>The hospital provides gift cards for special events. The taxes on those gift cards are grossed up and covered by the employer. The hospital also provides a wellness benefit, the use of local health facilities, and pays up to half of gym memberships through the wellness program not to exceed $500 per year. The hospital provides housing as part of recruiting contracts and a stipend for business use of a personal residence. These allowances are included on the employees W-2.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1b</FormAndLineReferenceDesc>
        <ExplanationTxt>Although the hospital does not have a written policy governing all fringe benefits, it does closely follow IRS guidelines for the treatment of those benefits and includes all applicable fringe benefits as taxable earnings and reports them on form W-2.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board determine the CEO's compensation based on a comparative review of other facility's 990's and wage and compensation surveys done by various agencies including the Alaska Hospital and Healthcare Association.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>4a Paula Godfrey severance payment of 76,140. 4b Employees contribute to and participate in a nonqualified 457 compensation plan.</ExplanationTxt>
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      <ProceduresCorrectiveActionGrp>
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      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <ProceduresCorrectiveActionInd>0</ProceduresCorrectiveActionInd>
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        <NameOfInterested>
          <PersonNm>Renda Knapp MD</PersonNm>
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        <TransactionAmt>410744</TransactionAmt>
        <TransactionDesc>Employment</TransactionDesc>
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      <BusTrInvolveInterestedPrsnGrp>
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        <TransactionDesc>Employment</TransactionDesc>
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      <BusTrInvolveInterestedPrsnGrp>
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          <PersonNm>Emily Knapp</PersonNm>
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        <TransactionDesc>Employment</TransactionDesc>
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      <BusTrInvolveInterestedPrsnGrp>
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          <PersonNm>Katelyn Wythe</PersonNm>
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        <TransactionDesc>Employment</TransactionDesc>
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          <PersonNm>Hannah Knapp</PersonNm>
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        <TransactionDesc>Employment</TransactionDesc>
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      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>Equipment and construction</Desc>
        <ContributionCnt>1</ContributionCnt>
        <NoncashContributionsRptF990Amt>93172</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>FMV</MethodOfDeterminingRevenuesTxt>
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      <AnyPropertyThatMustBeHeldInd>0</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>0</ReviewProcessUnusualNCGiftsInd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>South Peninsula Hospital is operated by South Peninsula Hospital Inc. through an operating agreement with the Kenai Peninsula Borough. In accordance with that agreement certain key decisions must be approved by the Kenai Peninsula Borough Assembly. Signing of any leases in excess of one year or $100,000 also requires Borough approval. The issuance of tax exempt bonds backed by the revenues of the hospital requires voter approval.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is prepared by Hospital Finance, reviewed first by the Executive Team which includes the CFO, COO, and CEO, and then distributed to the Board of Directors for review and approval. The Board of Directors then approved the CFO to sign and submit the return electronically.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Directors signs an annual conflict of interest attestation indicating whether any conflicts of interest exist. In matters where Board action is required, any members with an identified conflict of interest state their conflict and refrain from voting.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>South Peninsula Hospital does have independent compensation review studies performed periodically to ensure that the wages are reasonable and customary for key positions. Comparative industry compensation data is utilized determining compensation levels for key staff. The Board of Directors discusses and sets the wage for the CEO based on market and other available data.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The hospital makes its governing documents, 990, form 1023, and financial statements available upon request. It also provides a financial overview to the public during its monthly board meetings, as well as quarterly financial overview presentations at the quarterly Borough Assembly meetings.</ExplanationTxt>
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          <BusinessNameLine1Txt>Kenai Peninsula Borough</BusinessNameLine1Txt>
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          <AddressLine1Txt>144 N Binkley St</AddressLine1Txt>
          <CityNm>Soldotna</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99669</ZIPCd>
        </USAddress>
        <EIN>920030894</EIN>
        <PrimaryActivitiesTxt>Local area government</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>AK</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>115</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>N/A</PublicCharityStatusTxt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>South Peninsula Hospital Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>4300 Bartlett St</AddressLine1Txt>
          <CityNm>Homer</CityNm>
          <StateAbbreviationCd>AK</StateAbbreviationCd>
          <ZIPCd>99603</ZIPCd>
        </USAddress>
        <EIN>830354063</EIN>
        <PrimaryActivitiesTxt>Fundraising and Community Health Support</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>AK</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)3</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Public Charity</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>1</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
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          <BusinessNameLine1Txt>Kenai Peninsula Borough</BusinessNameLine1Txt>
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        <MethodOfAmountDeterminationTxt>The Hospital receives property taxes and bond proceeds from the Kenai Peninsula Borough service area to assist with its capital repairs and replacement as well as debt service. This amount represents the total received in the current year for these purposes.</MethodOfAmountDeterminationTxt>
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      <TransactionsRelatedOrgGrp>
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          <BusinessNameLine1Txt>Kenai Peninsula Borough</BusinessNameLine1Txt>
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        <MethodOfAmountDeterminationTxt>The Kenai Peninsula Borough acts as the loan guarantor on certain bond issuances in the event that South Peninsula Hospital Inc. ceased to exist prior to the retirement of the debt. This amount represents the total outstanding principal on the bonds as of the end of the tax year.</MethodOfAmountDeterminationTxt>
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      <TransactionsRelatedOrgGrp>
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          <BusinessNameLine1Txt>Kenai Peninsula Borough</BusinessNameLine1Txt>
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        <TransactionTypeTxt>e</TransactionTypeTxt>
        <InvolvedAmt>45450</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>The Hospital received a $7,000,000 loan from the Kenai Peninsula Borough to finance the replacement of the Hospital's EMR software. This amount represents the total outstanding principal on the note as of the end of the tax year.</MethodOfAmountDeterminationTxt>
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      <TransactionsRelatedOrgGrp>
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          <BusinessNameLine1Txt>Kenai Peninsula Borough</BusinessNameLine1Txt>
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        <MethodOfAmountDeterminationTxt>South Peninsula Hospital operates the hospital on behalf of the Kenai Peninsula Borough through a sublease and operating agreement for a cost of $1 per annum.</MethodOfAmountDeterminationTxt>
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          <BusinessNameLine1Txt>Kenai Peninsula Borough</BusinessNameLine1Txt>
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        <TransactionTypeTxt>q</TransactionTypeTxt>
        <InvolvedAmt>5160918</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>The Kenai Peninsula Borough reimbursed South Peninsula Hospital for certain organizational expenses such as the annual audit, property insurance, professional fees for the community health needs assessment, capital expenses, and the debt service on behalf of the hospital. The amount represents the total of these payments during the tax year.</MethodOfAmountDeterminationTxt>
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          <BusinessNameLine1Txt>South Peninsula Hospital Foundation</BusinessNameLine1Txt>
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        <InvolvedAmt>15517</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>South Peninsula Hospital received $15,517 in grants from the South Peninsula Hospital Foundation to support the Hospitals mission.</MethodOfAmountDeterminationTxt>
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          <BusinessNameLine1Txt>South Peninsula Hospital Foundation</BusinessNameLine1Txt>
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        <MethodOfAmountDeterminationTxt>South Peninsula Hospital supplied a office, equipment, and supplies to the South Peninsula Hospital Foundation's Executive Director. This amount presented the estimated cost of those items for the current fiscal year.</MethodOfAmountDeterminationTxt>
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          <BusinessNameLine1Txt>South Peninsula Hospital Foundation</BusinessNameLine1Txt>
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        <TransactionTypeTxt>o</TransactionTypeTxt>
        <InvolvedAmt>95118</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>South Peninsula Hospital supplied paid employees to the South Peninsula Hospital Foundation's which included an Executive Director and accounting staff. This amount presented the estimated payroll and related cost of those employees.</MethodOfAmountDeterminationTxt>
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      <ExplanationTxt>An extension was needed to file the 990 as the financial audit was not complete and delayed the preparation of the Hospital's 990.</ExplanationTxt>
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