SUMMIT HEALTHCARE ASSOCIATION: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- SUMMIT HEALTHCARE ASSOCIATION (EIN 86-0320447)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202223199349327022
- Schema version
- 2021v4.2
- 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 D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-15T18:04:19-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 440160260 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 77 WEST UNIVERSITY DRIVE | AddressLine1Txt |
| City | MESA | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 852015830 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860320447 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUMMIT HEALTHCARE ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SUMM | BusinessNameControlTxt |
| Phone | 9285374375 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2200 E SHOW LOW LAKE ROAD | AddressLine1Txt |
| City | SHOW LOW | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85901 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID ROTHENBERGER | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9285374375 | PhoneNum |
| Signature | 2022-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DAVID | PersonFirstNm |
| Person Last | ROTHENBERGER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KELLY M WHITE | PreparerPersonNm |
| PTIN | P00622256 | PTIN |
| Phone | 4808346030 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUMMIT HEALTHCARE REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID ROTHENBERGER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2200 E SHOW LOW LAKE ROAD | AddressLine1Txt |
| City | SHOW LOW | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $266,080,790 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | SUMMITHEALTHCARE.NET | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1976 | FormationYr |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Activity Or Mission | TRUSTED TO DELIVER EXCEPTIONAL, COMPASSIONATE CARE CLOSE TO HOME. SUMMIT HEALTHCARE CONTINUES TO PROMOTE HEALTH AND WELLNESS TO THE COMMUNITIES WE SERVE. WE INVEST IN STATE-OF-THE-ART EQUIPMENT TO HELP OUR PATIENTS REACH THEIR HEALTH CARE GOALS AND RETURN TO A HEALTHY, ACTIVE LIFESTYLE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 1531 | TotalEmployeeCnt |
| Total Volunteers | 45 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $16,266,491 | PYContributionsGrantsAmt |
| CY Contributions Grants | $11,237,908 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $196,560,890 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $243,298,763 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$500,551 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,031,317 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,470,838 | PYOtherRevenueAmt |
| CY Other Revenue | $2,738,151 | CYOtherRevenueAmt |
| PY Total Revenue | $214,797,668 | PYTotalRevenueAmt |
| CY Total Revenue | $258,306,139 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $108,162,472 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $115,505,601 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $107,568,577 | PYOtherExpensesAmt |
| CY Other Expenses | $137,625,962 | CYOtherExpensesAmt |
| PY Total Expenses | $215,731,049 | PYTotalExpensesAmt |
| CY Total Expenses | $253,131,563 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$933,381 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,174,576 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $295,477,019 | TotalAssetsBOYAmt |
| Total Assets EOY | $298,424,920 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $145,472,082 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $136,125,672 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $150,004,937 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $162,299,248 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TRUSTED TO DELIVER EXCEPTIONAL, COMPASSIONATE CARE CLOSE TO HOME. SUMMIT HEALTHCARE CONTINUES TO PROMOTE HEALTH AND WELLNESS TO THE COMMUNITIES WE SERVE. WE INVEST IN STATE-OF-THE-ART EQUIPMENT TO HELP OUR PATIENTS REACH THEIR HEALTH CARE GOALS AND RETURN TO A HEALTHY, ACTIVE LIFESTYLE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $196,043,189 | ExpenseAmt |
| Revenue | $244,569,108 | RevenueAmt |
| Desc | SUMMIT HEALTHCARE IS A LICENSED 89-BED NOT-FOR-PROFIT RURAL HOSPITAL. SUMMIT HEALTHCARE IS COMMITTED TO PROVIDE EXCEPTIONAL COMPASSIONATE CARE TO THE COMMUNITIES WE SERVE. SUMMIT HEALTHCARE'S ARRAY OF SERVICES INCLUDE A 24-EMERGENCY DEPARTMENT WHICH IS PEDIATRIC CERTIFIED, CARDIAC AND VASCULAR CATH LAB, DIAGNOSTIC IMAGING, WOMEN'S IMAGING, HOME HEALTH SERVICES, IV THERAPY, CANCER CENTER WITH MEDICAL AND RADIATION ONCOLOGY, WOMEN & INFANT SERVICES, LEVEL II NURSERY, THERAPY SERVICES WITH CHILDREN'S THERAPY - OCCUPATIONAL HEALTH- PHYSICAL THERAPY - SPEECH THERAPY, PAIN MEDICINE, SURGICAL SERVICES, TELEMEDICINE, WOUND CARE AND HYPERBARICS AND MUCH MORE. WE ARE PROUD TO OFFER TECHNOLOGY USUALLY FOUND IN LARGER CITIES - RIGHT HERE IN THE WHITE MOUNTAINS. FOR A COMPLETE LIST OF SERVICES VISIT SUMMITHEALTHCARE.NET.ACROSS THE COUNTRY, HEALTHCARE FACILITIES IN RURAL AREAS ARE COLLABORATING WITH LARGE NETWORKS TO CONTINUE TO PROVIDE A CONTINUUM OF CARE TO THEIR PATIENTS.EVENTSDUE TO THE COVID 19 PANDEMIC SUMMIT HEALTHCARE WAS UNABLE TO HOLD EVENTS IN 2021.FACILITYFOR 2021 SUMMIT HEALTHCARE'S NEW BUILDINGS, ADMINISTRATIVE SERVICES, OUTPATIENT PAVILION, AND OUTPATIENT SURGERY CENTER WERE ALL FULLY OPERATIONAL.EACH BUILDING WILL HOUSE THE FOLLOWING SERVICES WITH MORE HEALTHCARE SERVICES TO BE ADDED:ADMINISTRATIVE SERVICES BUILDING INCLUDES:ADMINISTRATION HUMAN RESOURCES MEDICAL RECORDS MATERIALS MANAGEMENT ENVIRONMENTAL SERVICES BUSINESS OFFICE FOR HOSPITAL AND PHYSICIAN CLINICS QUALITY AND PROFESSIONAL DEVELOPMENT MEDICAL STAFF SERVICES ACCOUNTING SOME INFORMATION TECHNOLOGYMEDICAL OFFICE BUILDING PRIMARY CARE SERVICESTHE URGENT CARE CLINICS IN SHOW LOW AND PINETOP WILL REMAIN OPENSPECIALTY SERVICESSUMMIT HEALTHCARE PLASTIC & RECONSTRUCTIVE SURGERYSUMMIT HEALTHCARE INTERNAL MEDICINESUMMIT HEALTHCARE NATUROPATHIC MEDICINESUMMIT HEALTHCARE PEDIATRICSSUMMIT HEALTHCARE ORTHOPEDICSSUMMIT HEALTHCARE PAIN CLINICSUMMIT HEALTHCARE HEART, LUNG AND VASCULARSUMMIT HEALTHCARE OB/GYNSUMMIT HEALTHCARE UROLOGYSUMMIT HEALTHCARE GENERAL SURGERYSUMMIT HEALTHCARE OUTPATIENT DIAGNOSTIC IMAGINGSUMMIT HEALTHCARE WOUND CARE CENTERHEALTHY STEPSSUMMIT HEALTHCARE PHARMACYAMBULATORY SURGERY CENTER PHYSICIANSSUMMIT HAS PHYSICIAN SPECIALISTS IN ONCOLOGY, RADIATION ONCOLOGY, PLASTIC SURGERY, CARDIOLOGY, PULMONARY MEDICINE, INTERNAL MEDICINE, PEDIATRICS, OBSTETRICS, PAIN MANAGEMENT, GENERAL SURGERY, ORTHOPEDICS, PODIATRY, UROLOGY, GENERAL SURGERY, VASCULAR SURGERY. WE CONTINUE TO RECRUIT NEW PHYSICIANS TO THE COMMUNITY TO MEET THE HEALTHCARE NEEDS. | Desc |
| Total Program Service Expenses | $196,043,189 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 223 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1531 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RUSSEL KUPFER ASSISTANT CONTROLLER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9285376804 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2200 E SHOW LOW LAKE ROAD | AddressLine1Txt |
| City | SHOW LOW | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85901 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| PAUL WATSON | ||||||||
| CHAIRMAN BOARD MEMBER | 4.00 | Yes (X) | $14,400 | $0 | $0 | |||
| DOUG WRIGHT DO | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | Yes (X) | $725,757 | $0 | $32,353 | |||
| JOHN CORDER | ||||||||
| BOARD MEMBER | 4.00 | Yes (X) | $14,400 | $0 | $0 | |||
| BECKY THOMPSON MD | ||||||||
| SECRETARY BOARD MEMBER | 4.00 | Yes (X) | $14,400 | $0 | $0 | |||
| NEIL TRAVER | ||||||||
| BOARD MEMBER | 4.00 | Yes (X) | $14,400 | $0 | $0 | |||
| DAVID ROTHENBERGER | ||||||||
| CFO | 40.00 | $293,340 | $0 | $35,358 | Yes (X) | |||
| CONNIE KAKAVAS | ||||||||
| CHRO | 40.00 | $188,684 | $0 | $25,981 | Yes (X) | |||
| KENNETH ALLEN | ||||||||
| CHIEF PRACTICE ADMINISTRAT | 40.00 | $278,151 | $0 | $9,161 | Yes (X) | |||
| ALLEN DEWITT MD | ||||||||
| FORMER CHIEF MEDICAL OFFICER | 40.00 | $403,890 | $0 | $20,361 | Yes (X) | |||
| AARON YOUNG | ||||||||
| FORMER CIO | 40.00 | $218,698 | $0 | $34,266 | Yes (X) | |||
| CAROLYN JACOBS | ||||||||
| FORMER CQCO | 40.00 | $207,057 | $0 | $9,161 | Yes (X) | |||
| DAVID MURRAY | ||||||||
| CCO | 40.00 | $207,824 | $0 | $9,061 | Yes (X) | |||
| SHAWN MORROW | ||||||||
| CEO | 40.00 | $250,658 | $0 | $10,452 | Yes (X) | |||
| JOHN FELTON | ||||||||
| COO | 40.00 | $287,399 | $0 | $24,553 | Yes (X) | |||
| BURKE DELANGE | ||||||||
| PHYSICIAN | 40.00 | $1,192,921 | $0 | $35,266 | Yes (X) | |||
| SIMRANJIT GALHOTRA | ||||||||
| PHYSICIAN | 40.00 | $992,578 | $0 | $35,358 | Yes (X) | |||
| DAX TRUJILLO | ||||||||
| PHYSICIAN | 40.00 | $937,165 | $0 | $34,266 | Yes (X) | |||
| JAMES OLACK | ||||||||
| PHYSICIAN | 40.00 | $1,232,032 | $0 | $24,882 | Yes (X) | |||
| FARBOD KHAKI | ||||||||
| PHYSICIAN | 40.00 | $1,092,224 | $0 | $31,750 | Yes (X) | |||
| RON MCARTHUR | ||||||||
| FORMER CEO | 40.00 | $452,214 | $0 | $16,112 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $9,018,192 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $388,341 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 111 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | 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 |
|---|---|---|---|---|---|
| ENSEMBLE | |||||
| PO BOX 639076 | CINCINNATI | OH | 45263 | SERVICES | $8,214,206 |
| ALLSCRIPTS | |||||
| 24630 NETWORK PLC | CHICAGO | IL | 60673 | SERVICES | $5,028,296 |
| MEDICAL SOLUTIONS | |||||
| PO BOX 850737 | MINNEAPOLIS | MN | 55485 | SERVICES | $4,326,505 |
| INTEGRATED MEDICAL SERVICES | |||||
| 3815 E BELL RD | PHOENIX | AZ | 85032 | SERVICES/PHYSICIAN | $3,261,171 |
| HEALTHCARE WORKFORCE LOGISTICS | |||||
| PO BOX 860573 | MINNEAPOLIS | MN | 55486 | SERVICES | $2,029,736 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 159 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $11,116,861 | GovernmentGrantsAmt |
| All Other Contributions | $121,047 | AllOtherContributionsAmt |
| Total Contributions | $11,237,908 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 622000 | BusinessCd |
| Total Revenue Column | $243,298,763 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $243,298,763 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $243,298,763 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $434,786 | TotalRevenueColumnAmt |
| Exclusion | $434,786 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $29,002 | 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 | $29,002 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,002 | TotalRevenueColumnAmt |
| Exclusion | $29,002 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,313,182 | SecuritiesAmt |
| Other | $58,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,703,764 | SecuritiesAmt |
| Other | $70,887 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $609,418 | SecuritiesAmt |
| Other | -$12,887 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $596,531 | TotalRevenueColumnAmt |
| Exclusion | $596,531 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA & GIFT SHOP | 622000 | $994,101 | $994,101 | |
| OTHER PROFESSIONAL FEES | 622000 | $842,599 | $842,599 | |
| MEANINGFUL USE FUNDS | 622000 | $192,546 | $192,546 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $679,903 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $235,200 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $444,703 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,709,149 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $258,306,139 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $244,569,108 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,499,123 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,406,633 | TotalAmt |
| Program Services | $9,406,633 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,287,634 | TotalAmt |
| Program Services | $74,196,792 | ProgramServicesAmt |
| Management And General | $14,090,842 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,593 | TotalAmt |
| Program Services | $76,144 | ProgramServicesAmt |
| Management And General | $14,449 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,570,424 | TotalAmt |
| Program Services | $9,724,971 | ProgramServicesAmt |
| Management And General | $1,845,453 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,150,317 | TotalAmt |
| Program Services | $5,169,357 | ProgramServicesAmt |
| Management And General | $980,960 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,773 | TotalAmt |
| Program Services | $85,970 | ProgramServicesAmt |
| Management And General | $80,803 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,203 | TotalAmt |
| Program Services | $51,139 | ProgramServicesAmt |
| Management And General | $48,064 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $362,762 | TotalAmt |
| Management And General | $362,762 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,729,031 | TotalAmt |
| Program Services | $26,412,783 | ProgramServicesAmt |
| Management And General | $17,316,248 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,046,680 | TotalAmt |
| Program Services | $236,651 | ProgramServicesAmt |
| Management And General | $810,029 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,208,250 | TotalAmt |
| Program Services | $9,006,466 | ProgramServicesAmt |
| Management And General | $3,201,784 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,856 | TotalAmt |
| Program Services | $42,474 | ProgramServicesAmt |
| Management And General | $145,382 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,420 | TotalAmt |
| Program Services | $65,211 | ProgramServicesAmt |
| Management And General | $223,209 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,863,754 | TotalAmt |
| Program Services | $3,817,630 | ProgramServicesAmt |
| Management And General | $1,046,124 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,086,787 | TotalAmt |
| Program Services | $14,591,891 | ProgramServicesAmt |
| Management And General | $3,494,896 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,767,742 | TotalAmt |
| Program Services | $1,730,114 | ProgramServicesAmt |
| Management And General | $37,628 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $38,629,408 | $36,623,165 | $2,006,243 |
| EQUIPMENT RENTAL | $1,743,556 | $1,539,662 | $203,894 |
| DUES & SUBCRIPTIONS | $1,329,396 | $300,572 | $1,028,824 |
| PHYSICIAN RECRUITMENT | $925,709 | $209,300 | $716,409 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,190,635 | TotalAmt |
| Program Services | $2,756,264 | ProgramServicesAmt |
| Management And General | $9,434,371 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $253,131,563 | TotalAmt |
| Program Services | $196,043,189 | ProgramServicesAmt |
| Management And General | $57,088,374 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,937,880 | BOYAmt |
| EOY | $5,020,093 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,064,671 | BOYAmt |
| EOY | $58,146,595 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,743,999 | BOYAmt |
| EOY | $4,540,896 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,036,959 | BOYAmt |
| EOY | $2,804,056 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $318,784,769 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $139,266,650 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $187,851,691 | BOYAmt |
| EOY | $179,518,119 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,582,914 | BOYAmt |
| EOY | $47,271,877 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $258,905 | BOYAmt |
| EOY | $1,123,284 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $295,477,019 | BOYAmt |
| EOY | $298,424,920 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,464,610 | BOYAmt |
| EOY | $27,656,180 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,049,368 | BOYAmt |
| EOY | $1,614,807 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,562,617 | BOYAmt |
| EOY | $52,850,403 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,657,423 | BOYAmt |
| EOY | $53,663,062 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $738,064 | BOYAmt |
| EOY | $341,220 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,472,082 | BOYAmt |
| EOY | $136,125,672 | 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 | $149,356,314 | BOYAmt |
| EOY | $161,665,224 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $648,623 | BOYAmt |
| EOY | $634,024 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,004,937 | BOYAmt |
| EOY | $162,299,248 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $295,477,019 | BOYAmt |
| EOY | $298,424,920 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,174,576 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $8,080,507 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$960,772 | 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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,340,953 | OtherCostOrOtherBasisAmt |
| Book Value | $5,340,953 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $175,248,588 | OtherCostOrOtherBasisAmt |
| Depreciation | $58,473,605 | DepreciationAmt |
| Book Value | $116,774,983 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,211,715 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,434,027 | DepreciationAmt |
| Book Value | $14,777,688 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $107,411,685 | OtherCostOrOtherBasisAmt |
| Depreciation | $69,359,018 | DepreciationAmt |
| Book Value | $38,052,667 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,571,828 | OtherCostOrOtherBasisAmt |
| Book Value | $4,571,828 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $179,518,119 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVENTORY CLEARING ACCOUNT | Desc |
| Amt | $341,220 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $341,220 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $266,023,884 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $8,080,507 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $8,080,507 | RevenueNotReportedAmt |
| Revenue Subtotal | $257,943,377 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $362,762 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $362,762 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $258,306,139 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $252,768,801 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $252,768,801 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $362,762 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $362,762 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $253,131,563 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "IRC") AND SIMILAR STATE PROVISIONS. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE HOSPITAL'S TAX-EXEMPT PURPOSE MAY BE SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. IN ADDITION, THE HOSPITAL QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A)(III) OF THE IRC AND HAS BEEN CLASSIFIED AS AN ORGANIZATION OTHER THAN A PRIVATE FOUNDATION UNDER SECTION 509(A)(1) OF THE IRC. THE HOSPITAL HAS PROVIDED FOR INCOME TAXES ON ITS UNRELATED BUSINESS INCOME, WHICH HAVE NOT BEEN SIGNIFICANT, AS REQUIRED BY SECTION 512 OF THE CODE. WMSP HAS ELECTED TO BE TREATED AS A PARTNERSHIP FOR FEDERAL AND STATE INCOME TAX PURPOSES. MEMBERS ARE REQUIRED TO INCLUDE IN THEIR INDIVIDUAL INCOME TAX RETURNS THEIR SHARE OF INCOME OR LOSS, AS ADJUSTED TO REFLECT THE EFFECTS OF CERTAIN TRANSACTIONS WHICH ARE AFFORDED DIFFERENT ACCOUNTING TREATMENTS. WMSP INCOME DOES NOT QUALIFY AS UNRELATED BUSINESS INCOME TAXES FOR THE HOSPITAL AND IS NOT TAXABLE. THE HOSPITAL FOLLOWS THE GUIDANCE ISSUED BY ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA ("US GAAP"). UNDER THIS GUIDANCE, THE HOSPITAL ACCOUNTS FOR THE EFFECT OF ANY UNCERTAIN TAX POSITIONS BASED ON WHETHER IT IS "MORE-LIKELY-THAN-NOT" THAT THE POSITION WILL BE SUSTAINED BY THE TAXING AUTHORITY UPON EXAMINATION. THE HOSPITAL ROUTINELY EVALUATES POTENTIAL UNCERTAIN TAX POSITIONS. THE HOSPITAL HAS IDENTIFIED ITS STATUS AS AN EXEMPT ORGANIZATION AS A TAX POSITION; HOWEVER, THE ORGANIZATION HAS DETERMINED THAT SUCH TAX POSITION DOES NOT RESULT IN AN UNCERTAINTY THAT REQUIRES RECOGNITION. THE HOSPITAL FILES INFORMATIONAL AND INCOME TAX RETURNS IN THE U.S. FEDERAL JURISDICTION AND THE STATE OF ARIZONA. AS OF DECEMBER 31, 2021, U.S. FEDERAL INFORMATIONAL AND INCOME TAX RETURNS FOR YEARS ENDED PRIOR TO DECEMBER 31, 2018 AND STATE RETURNS FOR YEARS ENDED PRIOR TO DECEMBER 31, 2017 ARE CLOSED TO ASSESSMENT. INTEREST AND PENALTIES, IF ANY, ARE ACCRUED AS A COMPONENT OF MANAGEMENT AND GENERAL EXPENSES WHEN ASSESSED. | 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 |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| 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 | $636,214 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $636,214 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $213,584,367 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $143,826,868 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $69,757,499 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.27560 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $214,220,581 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $143,826,868 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $70,393,713 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.27810 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $641,223,847 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $468,318,797 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $172,905,050 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.68310 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $641,223,847 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $468,318,797 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $172,905,050 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.68310 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $855,444,428 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $612,145,665 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $243,298,763 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.96120 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $11,091,906 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $153,408,097 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $41,787,891 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $111,620,206 | 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 | 0 | 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 | SUMMIT HEALTHCARE ASSOCIATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2200 E SHOW LOW LAKE RD | AddressLine1Txt |
| City | SHOW LOW | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SUMMITHEALTHCARE.NET | WebsiteAddressTxt |
| State License | H0132 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUMMIT HEALTHCARE ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.SUMMITHEALTHCARE.NET | 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 | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.SUMMITHEALTHCARE.NET | 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 | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| 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 |
| Includes Publicity Measures | 0 | IncludesPublicityMeasuresInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Engaged Legal Judicial Process | Yes (X) | EngagedLegalJudicialProcessInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| 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 (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SUMMIT HEALTHCARE ASSOCIATION | PART V, SECTION B, LINE 5: THE HOSPITAL CREATED A COMMITTEE CALLED "COMMUNITY HEALTH NEEDS COMMITTEE AND IT CONSISTS OF: NAVAJO COUNTY PUBLIC HEALTH, COMMUNITY COUNSELING CENTERS, COMMUNITY BRIDGES AND VARIOUS RELIGIOUS GROUPS; NAVAJO COUNTY COURTS; AND NAVAJO COUNTY PUBLIC ATTORNEY. |
| SUMMIT HEALTHCARE ASSOCIATION | PART V, SECTION B, LINE 7D: OFFERED AT COMMUNITY TOWN HALL MEETINGS. |
| SUMMIT HEALTHCARE ASSOCIATION | PART V, SECTION B, LINE 13H: NUMBER OF DEPENDENTS, FAMILY SIZE. |
| SUMMIT HEALTHCARE ASSOCIATION | PART V, SECTION B, LINE 20E: PATIENTS ARE NOTIFIED WHEN NEED IS IDENTIFIED. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 18 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|
| 1 - SUMMIT HEALTHCARE INTERNAL MEDICINE | |||||
| 2450 E SHOW LOW LAKE ROAD BLDG 1 | SHOW LOW | AZ | 85901 | INTERNAL MEDICINE | |
| 2 - SUMMIT HEALTHCARE FAMILY MEDICINE | |||||
| 2963 W WHITE MOUNTAIN BLVD | LAKESIDE | AZ | 85929 | FAMILY MEDICINE | |
| 3 - SUMMIT HEALTHCARE PRACTICE MANAGEMENT | |||||
| 3401 S WHITE MOUNTAIN RD SUITE D | SHOW LOW | AZ | 85901 | FAMILY MEDICINE | |
| 4 - SUMMIT HEALTHCARE HEBER-OVERGAARD COMMUN | |||||
| 2931 S HWY 260 PO BOX 1013 | OVERGAARD | AZ | 85933 | FAMILY MEDICINE | |
| 5 - SUMMIT HEALTHCARE FAMILY MEDICINE SNOWFL | |||||
| 1121 S MAIN STREET | SNOWFLAKE | AZ | 85937 | FAMILY MEDICINE | |
| 6 - SUMMIT HEALTHCARE SNOWFLAKE MEDICAL CENT | |||||
| 590 S MAIN STREET | SNOWFLAKE | AZ | 85937 | FAMILY MEDICINE | |
| 7 - SUMMIT HEALTHCARE FAMILY MEDICINE SHOWLO | |||||
| 5171 CUB LAKE ROAD SUITE B270 | SHOW LOW | AZ | 85901 | FAMILY MEDICINE, OBSTETRICS/GYNECOLOGY | |
| 8 - SUMMIT HEALTHCARE HIGH DESERT CLINIC | |||||
| 100 E CODE TALKERS DRIVE | HOLBROOK | AZ | 85025 | FAMILY MEDICINE | |
| 9 - SUMMIT HEALTHCARE FAMILY MEDICINE LAKESI | |||||
| 218 W WHITE MOUNTAIN BLVD | LAKESIDE | AZ | 85929 | FAMILY MEDICINE | |
| 10 - MOUNTAIN FAMILY CARE & WALK-IN | |||||
| 320 E DEUCE OF CLUBS | SHOW LOW | AZ | 85901 | FAMILY MEDICINE | |
| 11 - SUMMIT HEALTHCARE HEART LUNG & VASCULAR | |||||
| 5300 S SUTTER DRIVE SUITE 1 | SHOW LOW | AZ | 85901 | CARDIOLOGY, PULMONOLOGY, NATUROPATHIC MEDICINE | |
| 12 - SUMMIT HEALTHCARE UROLOGY | |||||
| 2051 E EVERGREEN LANE SUITE 8 | SHOW LOW | AZ | 85901 | UROLOGY | |
| 13 - SUMMIT HEALTHCARE ORTHOPEDIC SURGERY | |||||
| 2051 E EVERGREEN LANE SUITE A | SHOW LOW | AZ | 85901 | ORTHOPEDIC | |
| 14 - SUMMIT HEALTHCARE GENERAL & VASCULAR SUR | |||||
| 5171 CUB LAKE ROAD SUITE C350 | SHOW LOW | AZ | 85901 | GENERAL/VASCULAR SURGERY | |
| 15 - SUMMIT HEALTHCARE CANCER CENTER | |||||
| 2500 E HUNT STREET SUITE H | SHOW LOW | AZ | 85901 | ONCOLOGY | |
| 16 - SUMMIT HEALTHCARE PAIN CLINIC | |||||
| 1500 S WHITE MOUNTAIN BLVD SUITE | SHOW LOW | AZ | 85901 | PAIN MANAGEMENT | 300 |
| 17 - SUMMIT HEALTHCARE ANESTHESIOLOGY | |||||
| 2200 E SHOW LOW LAKE RD | SHOW LOW | AZ | 85901 | ANESTHESIOLOGY | |
| 18 - SUMMIT HEALTHCARE PLASTIC SURGERY & DERM | |||||
| 2450 E SHOW LOW LAKE RD SUITE 2A | SHOW LOW | AZ | 85901 | DERMATOLOGY, PLASTIC SURGERY | |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | COST TO CHARGE RATIO |
| PART I, LINE 7G: | SUBSIDIZED HEALTH SERVICES ARE CLINICAL SERVICES PROVIDED TO PATIENTS DESPITE A FINANCIAL LOSS TO THE ORGANIZATION. THE DIFFERENCE BETWEEN THE COSTS THE HOSPITAL INCURS TO PROVIDE A SPECIFIC SERVICE AND THE AMOUNT THE HOSPITAL RECEIVES AS PAYMENT FOR THAT SERVICE, DEFINE SUBSIDIZED HEALTH SERVICES. FURTHERMORE, THEY ARE THOSE CLINICAL SERVICES THAT: IF THE HOSPITAL WERE UNABLE TO PROVIDE, WOULD RESULT IN NOT MEETING COMMUNITY NEEDS. THIS WOULD MEAN THAT PATIENTS WOULD BE REQUIRED TO GO ELSEWHERE FOR SERVICES WHICH WOULD THEN BECOME THE RESPONSIBILITY OF GOVERNMENT OR OF OTHER TAX-EXEMPT ORGANIZATIONS. |
| PART I, LN 7 COL(F): | PLEASE REFER TO THE EXPLANATION OF BAD DEBT EXPENSE PROVIDED FOR PART III, LINE 4. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | N/A |
| PART III, LINE 2: | COST TO CHARGE RATIO |
| PART III, LINE 4: | CHARGES TO THE FINANCIAL ASSISTANCE PROGRAM ARE NOT APPLIED TO BAD DEBT. THEREFORE, NONE OF THE ORGANIZATION'S BAD DEBT EXPENSE IS ATTRIBUTABLE TO THE CHARITY CARE POLICY.FINANCIAL STATEMENT FOOTNOTE:THE HOSPITAL DOES NOT HAVE A FINANCIAL STATEMENT FOOTNOTE SPECIFIC TO BAD DEBT EXPENSE, BUT DOES INCLUDE A FINANCIAL FOOTNOTE RELATED TO CHARITY CARE. THE FINANCIAL STATEMENTS COMPUTE CHARITY CARE BY AGGREGATING GROSS CHARGES AND ALL DEDUCTIONS FROM REVENUE, WHILE THE SCHEDULE H COMPUTATIONS IN PARTS I AND III ARE CALCULATED USING A COST TO CHARGE APPROACH. THE FINANCIAL STATEMENT FOOTNOTE FOLLOWS:CHARITY CARE AND COMMUNITY BENEFITIN THE FURTHERANCE OF ITS CHARITABLE PURPOSES, THE HOSPITAL PROVIDES CHARITY CARE AND OTHER BENEFITS TO THE COMMUNITY IT SERVES. THE HOSPITAL'S CHARITY CARE POLICY IS DESIGNED TO PROVIDE A DISCOUNT OR WAIVER OF THE COST OF SERVICES FOR UNINSURED OR UNDERINSURED PATIENTS WITHOUT THE ABILITY TO PAY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS PATIENT SERVICE REVENUE. IN ADDITION TO PROVIDING CHARITY CARE, THE HOSPITAL PAYS FOR THE COSTS OF MANY PUBLIC PROGRAMS, INCLUDING UNPAID MEDICARE AND AHCCCS COSTS AND DELIVERY OF COMMUNITY OUTREACH PROGRAMS THAT INCLUDE HEALTH EDUCATION, DIAGNOSTIC SCREENINGS, COMMUNITY HEALTH ASSESSMENT SURVEYS AND MOBILE SERVICES. THE HOSPITAL ESTIMATES CHARITY CARE COSTS BASED ON THE HOSPITAL'S COST TO CHARGE RATIO, WHICH INCLUDES BOTH DIRECT AND INDIRECT COSTS. TRADITIONALLY CHARITY CARE IS ESTIMATED BASED ON THE AVERAGE COST OF SERVICES PROVIDED FOR WHICH CHARGES ARE WRITTEN OFF IN ACCORDANCE WITH THE HOSPITAL'S CHARITY CARE POLICY. A SUMMARY OF THE GROSS CHARGES AND COSTS INCURRED FOR PROVIDING CHARITY CARE AND OTHER COMMUNITY BENEFITS FOR THE YEARS ENDED DECEMBER 31 ARE AS FOLLOWS: UNPAID COSTS RELATING TO THE AHCCCS PROGRAM $129,127,624TRADITIONAL CHARITIY, AT COST $618,125TOTAL CHARITY CARE $129,745,749 UNPAID COSTS RELATING TO THE MEDICARE PROGRAM $216,404,119TOTAL CHARITY CARE AND COMMUNITY BENEFIT COSTS $346,149,868 |
| PART III, LINE 8: | THE ENTIRE SHORTFALL IS ATTRIBUTED TO COMMUNITY BENEFIT. |
| PART III, LINE 9B: | PROCEDURE: CHARITY CARE IS DEFINED AS AN INABILITY TO PAY.THE PATIENT'S INDIGENCE MUST BE DETERMINED BY THE FACILITY, NOT BY THE PATIENT. THIS DETERMINATION MAY OCCUR AT ANY TIME PRIOR TO THE PATIENT'S ACCOUNT ACHIEVING ZERO BALANCE; PRIOR TO ADMISSION, AT ADMISSION, AFTER DISCHARGE OR DURING THE BILLING AND COLLECTION PROCESS.THE CHARITY DETERMINATION IS TO BE MADE BASED ON THE PATIENT/RESPONSIBLE PARTY'S NET WORTH, NET INCOME AND THE NUMBER OF MEMBERS IN THE HOUSEHOLD. SUMMIT HEALTHCARE ASSOCIATION BASES THEIR CHARITY CARE ON THE FEDERAL POVERTY INCOME GUIDELINES.THE FACILITY MUST DETERMINE THAT NO SOURCE OTHER THAN THE PATIENT/RESPONSIBLE PARTY WOULD BE LEGALLY RESPONSIBLE FOR THE PATIENT'S MEDICAL BILL. THIS INCLUDES FEDERAL, STATE OR LOCAL FINANCIAL PROGRAMS AND/OR LEGAL GUARDIANS.THE PATIENT'S BUSINESS OFFICE FILE WILL CONTAIN DOCUMENTATION OF THE METHOD BY WHICH INDIGENCE WAS DETERMINED ALONG WITH ALL SUPPORTING DOCUMENTATION TO SUBSTANTIATE THE DECISION. THE FINAL DETERMINATION WILL BE MADE BY THE CFO, WITH THE RECOMMENDATION OF THE PATIENT ACCOUNT SUPERVISOR. |
| PART VI, LINE 2: | SUMMIT HEALTHCARE ASSOCIATION DELIVERS COMMUNITY BENEFITS BASED ON THE UNIQUE HEALTH NEEDS OF THEIR RESPECTIVE SERVICE AREAS, REGARDLESS OF SOURCE OR AVAILABILITY OF PAYMENT. THESE PROGRAMS AND SERVICES ARE INTENDED TO IMPROVE ACCESS TO HEALTHCARE, HEALTH STATUS AND THE USE OF HEALTHCARE RESOURCES. SUMMIT HEALTHCARE PROVIDED CHARITY CARE AND COMMUNITY BENEFITS TO MEMBERS OF OUR COMMUNITY AS PART OF ITS VISION; "...TO BE A MODEL OF SUCCESS AS A RURAL HEALTHCARE PROVIDER BY DELIVERING EXCEPTIONAL HEALTH CARE AND PROMOTING WELLNESS FOR THE INDIVIDUAL, THE FAMILY, AND THE COMMUNITY"... |
| PART VI, LINE 3: | HOSPITAL ADMITTING STAFF MEMBERS ADVISE AND ASSIST ALL SELF-PAY PATIENTS OF THE OPTIONS FOR AVAILABLE ASSISTANCE. |
| PART VI, LINE 4: | SUMMIT HEALTHCARE ASSOCIATION (THE HOSPITAL) OPERATES SUMMIT HEALTHCARE, AN 89-BED ACUTE CARE HOSPITAL FACILITY. THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT, HOME HEALTH, IMAGING AND OTHER HEALTH CARE RELATED SERVICES TO THE RESIDENTS OF SHOW LOW, ARIZONA AND THE SURROUNDING WHITE MOUNTAIN COMMUNITIES. |
| PART VI, LINE 5: | PLEASE REFER TO INFORMATION CONTAINED IN FORM 990, PART III, LINE 4A. |
| PART VI, LINE 6: | N/A |
| PART VI, LINE 7, REPORTS FILED WITH STATES | AZ |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 | Yes (1) | InitialContractExceptionInd |
| Rebuttable Presumption Proc | Yes (1) | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES OLACK | ||||||||||||||
| PHYSICIAN | $1,232,032 | $0 | $0 | $0 | $0 | $0 | $7,108 | $0 | $17,774 | $0 | $1,256,914 | $0 | $0 | $0 |
| BURKE DELANGE | ||||||||||||||
| PHYSICIAN | $1,192,921 | $0 | $0 | $0 | $0 | $0 | $8,108 | $0 | $27,158 | $0 | $1,228,187 | $0 | $0 | $0 |
| FARBOD KHAKI | ||||||||||||||
| PHYSICIAN | $1,092,224 | $0 | $0 | $0 | $0 | $0 | $7,015 | $0 | $24,735 | $0 | $1,123,974 | $0 | $0 | $0 |
| SIMRANJIT GALHOTRA | ||||||||||||||
| PHYSICIAN | $992,578 | $0 | $0 | $0 | $0 | $0 | $8,200 | $0 | $27,158 | $0 | $1,027,936 | $0 | $0 | $0 |
| DAX TRUJILLO | ||||||||||||||
| PHYSICIAN | $937,165 | $0 | $0 | $0 | $0 | $0 | $7,108 | $0 | $27,158 | $0 | $971,431 | $0 | $0 | $0 |
| DOUG WRIGHT DO | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $725,757 | $0 | $0 | $0 | $0 | $0 | $8,200 | $0 | $24,153 | $0 | $758,110 | $0 | $0 | $0 |
| RON MCARTHUR | ||||||||||||||
| FORMER CEO | $452,214 | $0 | $0 | $0 | $0 | $0 | $5,000 | $0 | $11,112 | $0 | $468,326 | $0 | $0 | $0 |
| ALLEN DEWITT MD | ||||||||||||||
| FORMER CHIEF MEDICAL OFFICER | $403,890 | $0 | $0 | $0 | $0 | $0 | $2,588 | $0 | $17,773 | $0 | $424,251 | $0 | $0 | $0 |
| DAVID ROTHENBERGER | ||||||||||||||
| CFO | $293,340 | $0 | $0 | $0 | $0 | $0 | $8,200 | $0 | $27,158 | $0 | $328,698 | $0 | $0 | $0 |
| JOHN FELTON | ||||||||||||||
| COO | $287,399 | $0 | $0 | $0 | $0 | $0 | $2,508 | $0 | $22,045 | $0 | $311,952 | $0 | $0 | $0 |
| KENNETH ALLEN | ||||||||||||||
| CHIEF PRACTICE ADMINISTRAT | $278,151 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $9,161 | $0 | $287,312 | $0 | $0 | $0 |
| SHAWN MORROW | ||||||||||||||
| CEO | $250,658 | $0 | $0 | $0 | $0 | $0 | $1,986 | $0 | $8,466 | $0 | $261,110 | $0 | $0 | $0 |
| AARON YOUNG | ||||||||||||||
| FORMER CIO | $218,698 | $0 | $0 | $0 | $0 | $0 | $7,108 | $0 | $27,158 | $0 | $252,964 | $0 | $0 | $0 |
| DAVID MURRAY | ||||||||||||||
| CCO | $207,824 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $9,061 | $0 | $216,885 | $0 | $0 | $0 |
| CAROLYN JACOBS | ||||||||||||||
| FORMER CQCO | $207,057 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $9,161 | $0 | $216,218 | $0 | $0 | $0 |
| CONNIE KAKAVAS | ||||||||||||||
| CHRO | $188,684 | $0 | $0 | $0 | $0 | $0 | $8,108 | $0 | $17,873 | $0 | $214,665 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6 | THE PHYSICIAN'S RECEIVED INCENTIVE COMPENSATION BONUSES BASED ON RELATIVE VALUE UNITS WRUVS, AND OFFICERS RECEIVED BONUSES BASED ON BUDGET GOALS |
| PART I, LINE 8 | PHYSICIANS HAVE EMPLOYMENT AGREEMENTS. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF SHOW LOW ARIZONA | |||||||
| A | 860912110 | 2015-08-04 | $23,549,000 | REFUND 2005 BOND AND PAYING COSTS OF ISSUANCE | 0 | 0 | 0 |
| THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF SHOW LOW ARIZONA | |||||||
| B | 860912110 | 2017-10-31 | $39,046,000 | 2017A - CONSTRUCTION OF NEW FACILITIES AND LEASEHOLD IMPROVEMENTS | 0 | 0 | 0 |
| THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF SHOW LOW ARIZONA | |||||||
| C | 860912110 | 2017-10-31 | $5,460,000 | 2017B - CONSTRUCTION OF NEW FACILITIES AND LEASEHOLD IMPROVEMENTS | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|
| A | $23,549,000 | $23,287,023 | $261,977 | 2015 | 0 | Yes (1) | Yes (1) | Yes (1) |
| B | $39,046,000 | $550,000 | 2017 | 0 | 0 | 0 | Yes (1) | |
| C | $5,460,000 | 2017 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| C | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|
| A | Yes (1) | 0 | 0 | 0 | 0 | 0 |
| B | Yes (1) | 0 | 0 | 0 | 0 | 0 |
| C | Yes (1) | 0 | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
| C | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | ALL OF THE HOSPITAL'S GOVERNING BOARD MEMBERS RECEIVED STIPEND PAYMENTS FOR BOARD OF DIRECTOR SERVICES. THE FOLLOWING BUSINESS TRANSACTIONS/RELATIONSHIPS ARE REPORTED FOR 2021. DOUG WRIGHT, D.O. MEDICAL DIRECTOR / PHYSICIAN WOUND CARE $755,757 BOARD MEMBER STIPEND $14,400 PINETOP FIRE BOARD MEMBER. PINETOP FIRE PROVIDES EMS SERVICES IN THE AREA AND DELIVERS PATIENTS TO SUMMIT'S EMERGENCY DEPARTMENT. BECKY THOMPSON, M.D. ON CALL PHYSICIAN GROUP LEADERSHIP COMPENSATION PERSONAL PHYSICIAN TO SEVERAL OFFICERS CHAIRMAN OF NORTHEASTERN ARIZONA REGIONAL CARE TEAM, A CLINICALLY INTEGRATED NETWORK ESTABLISHED BY SUMMIT HEALTHCARE IN PARTNERSHIP WITH NORTHEASTERN ARIZONA REGIONAL CARE TEAM. JOHN CORDER TIMBER MESA FIRE DISTRICT RETIREMENT BOARD MEMBER PAUL WATSON ASSISTANT NAVAJO COUNTY MANAGER . SUMMIT CONTRACTS WITH NAVAJO COUNTY FOR VARIOUS SERVICES. SERVES ON SEVERAL COMMITTEES FOR NAVAJO COUNTY REAL ESTATE $0 RON MCARTHUR RETIRED, FORMER CEO $452,214 TRUSTEE FOR ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION ALAN DEWITT, M.D. CHIEF MEDICAL OFFICER $403,890 PRESIDENT OF SUMMIT PHYSICIAN GROUP, SHMA HOSPICE COMPASSUS MEDICAL DIRECTOR >10% OWNER OF SNOWFLAKE MEDICAL CENTER BUILDING RENTED BY SUMMIT CONNIE KAKAVAS CHIEF HUMAN RESOURCES OFFICER $188,684 SHOW LOW CITY COUNCILWOMAN DAVID MURRAY CHIEF RISK AND COMPLIANCE OFFICER $207,824 WIFE EMPLOYED BY BLUE RIDGE SCHOOL DISTRICT WHITE MOUNTAIN BUSINESS ROUND TABLE COMMITTEE MEMBER AARON YOUNG CHIEF INFORMATION OFFICER $218,698 SHOW LOW CHAMBER OF COMMERCE BOARD MEMBER AARON YOUNG CHIEF INFORMATION OFFICER SHOW LOW CHAMBER OF COMMERCE BOARD MEMBER |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS REVIEWED IN THE SCHEDULED GOVERNING BOARD MEETING FOLLOWING ITS COMPLETION. |
| FORM 990, PART VI, SECTION B, LINE 12C | DIRECTOR OF MEDICAL STAFF/BOARD SERVICES IS RESPONSIBLE FOR MONITORING AND ENSURING RECORDS ARE UPDATED IN A TIMELY MANNER. |
| FORM 990, PART VI, SECTION B, LINE 15 | INDEPENDENT CONSULTING FIRMS ARE HIRED TO REVIEW THE COMPENSATION OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES. FINAL APPROVAL OF TOP MANAGEMENT COMPENSATION IS THE RESPONSIBILITY OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THESE DOCUMENTS ARE MADE AVAILABLE UP REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR: PROGRAM SERVICE EXPENSES 8,341,111. MANAGEMENT AND GENERAL EXPENSES 330,891. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,672,002. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 13,815,993. MANAGEMENT AND GENERAL EXPENSES 12,985,493. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,801,486. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 4,255,679. MANAGEMENT AND GENERAL EXPENSES 3,999,864. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,255,543. |
| FORM 990, PART XI, LINE 9: | CAPITAL DISTRIBUTIONS FOR WMSP, LLC REPORTED CONSOLIDATED BASIS -960,772. |
| PART XII, LINE 2C | THE ORGANIZATION DID NOT CHANGE EITHER ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|
| SUMMIT HEALTHCARE MEDICAL ASSOCIATES LLC | ||||||
| 2200 E SHOW LOW LAKE ROAD | SHOW LOW | AZ | 85901 | ACQUIRE, OPERATE AND MANAGE PHYSICIAN PRACTICES | AZ | SUMMIT HEALTHCARE ASSOCIATION |
| NORTHEASTERN ARIZONA REGIONAL CARE TEAM LLC | ||||||
| 2200 E SHOW LOW LAKE ROAD | SHOW LOW | AZ | 85901 | ESTABLISH CLINICALLY INTEGRATED NETWORK | AZ | SUMMIT HEALTHCARE ASSOCIATION |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WHITE MOUNTAIN SURGICAL PARTNERS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2200 E SHOW LOW LAKE ROAD | AddressLine1Txt |
| City | SHOW LOW | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 834109264 | EIN |
| Primary Activities | MANAGE OUTPATIENT SURGICAL DEPARTMENT | PrimaryActivitiesTxt |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $2,066,942 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $2,783,763 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (1) | GeneralOrManagingPartnerInd |
| Ownership | 0.68500 | OwnershipPct |
| 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 | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | 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 | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WHITE MOUNTAIN SURGICAL PARTNERS LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionTypeTxt |
| Involved | $6,704,796 | InvolvedAmt |
| Method Of Amount Determination | ACTUAL | MethodOfAmountDeterminationTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMNS D AND E: | FormAndLineReferenceDesc |
| Explanation | THE TOTAL INCOME AND END-OF-YEAR ASSETS CANNOT BE SEPARATELY IDENTIFIED AS THEY ARE CONSOLIDATED AND INTRINSIC TO THE EXEMPT PURPOSES AND REPORTED ACTIVITIES, CONTAINED HERE-IN, OF THE HOSPITAL. | ExplanationTxt |