FOUNDATION HEALTH LLC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- FOUNDATION HEALTH LLC (EIN 81-3021580)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2021-12-06
- IRS object ID
- 202123409349300127
- Schema version
- 2019v5.2
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-12-06T13:03:43-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 911194016 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARK NUBER PS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10900 NE 4TH STREET SUITE 1400 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 813021580 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FOUNDATION HEALTH LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FOUN | BusinessNameControlTxt |
| Phone | 9074585550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1650 COWLES STREET | AddressLine1Txt |
| City | FAIRBANKS | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99701 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GARY RODERICK | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9074585550 | PhoneNum |
| Signature | 2021-11-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MEGAN R RYAN | PreparerPersonNm |
| PTIN | P00737884 | PTIN |
| Phone | 4254544919 | PhoneNum |
| Preparation | 2021-11-22 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amended Return | Yes (X) | AmendedReturnInd |
| Principal Officer | GARY RODERICK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1650 COWLES STREET | AddressLine1Txt |
| City | FAIRBANKS | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $312,916,877 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FOUNDATIONHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Other Organization Dsc | LLC | OtherOrganizationDsc |
| Formation | 2016 | FormationYr |
| Legal Domicile State | AK | LegalDomicileStateCd |
| Activity Or Mission | COMPASSIONATE HEALTH CARE FOR EVERY CHAPTER IN YOUR LIFE STORY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 2321 | TotalEmployeeCnt |
| Total Volunteers | 164 | TotalVolunteersCnt |
| Total Gross UBI | $1,312,441 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $485,321 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $238,116 | PYContributionsGrantsAmt |
| CY Contributions Grants | $252,387 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $298,741,470 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $308,333,601 | CYProgramServiceRevenueAmt |
| PY Investment Income | $64,613 | PYInvestmentIncomeAmt |
| CY Investment Income | $92,937 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,266,826 | PYOtherRevenueAmt |
| CY Other Revenue | $4,237,952 | CYOtherRevenueAmt |
| PY Total Revenue | $303,311,025 | PYTotalRevenueAmt |
| CY Total Revenue | $312,916,877 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $200,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $100,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $161,760,929 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $174,487,378 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $133,943,479 | PYOtherExpensesAmt |
| CY Other Expenses | $142,863,508 | CYOtherExpensesAmt |
| PY Total Expenses | $295,904,408 | PYTotalExpensesAmt |
| CY Total Expenses | $317,450,886 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,406,617 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,534,009 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $104,873,353 | TotalAssetsBOYAmt |
| Total Assets EOY | $99,415,943 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $27,185,657 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $26,262,256 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $77,687,696 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $73,153,687 | NetAssetsOrFundBalancesEOYAmt |
| Mission | COMPASSIONATE HEALTH CARE FOR EVERY CHAPTER IN YOUR LIFE STORY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $256,003,532 | ExpenseAmt |
| Grant | $100,000 | GrantAmt |
| Revenue | $308,364,845 | RevenueAmt |
| Desc | FOUNDATION HEALTH LLC OWNS AND OPERATES FAIRBANKS MEMORIAL HOSPITAL (HOSPITAL), DENALI CENTER (HOME), AND TANANA VALLEY CLINIC (CLINIC). THE HOSPITAL IS A GENERAL ACUTE, SOLE COMMUNITY, 152 BED FACILITY. THE HOSPITAL SERVES PATIENTS FROM FAIRBANKS AND THROUGHOUT THE INTERIOR OF ALASKA PROVIDING INPATIENT CARE, EMERGENCY CARE AND A BROAD ARRAY OF OUTPATIENT MEDICAL SERVICES. THE HOME IS A 90 BED SKILLED NURSING CARE HOME THAT PROVIDES POST ACUTE CARE FOR SHORT TERM PATIENTS, AS WELL AS LONG TERM CARE FOR OTHER PATIENTS. THE CLINIC IS A MULTI-SPECIALTY CLINIC THAT OFFERS 15 MEDICAL SPECIALITIES AND OPERATES A WALK-IN CLINIC WITH AFTER HOURS SERVICES. THE HOSPITAL SERVED 48,541 PATIENTS IN 2019, INCLUDING 986 BABIES DELIVERED. THE HOME SERVED 216 INDIVIDUALS AND THE CLINIC PROVIDED ACCESS TO CARE FOR 49,948 PEOPLE. | Desc |
| Total Program Service Expenses | $256,003,532 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 74 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 2321 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | AK | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GARY RODERICK CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9074583310 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1650 COWLES STREET | AddressLine1Txt |
| City | FAIRBANKS | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99701 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|---|
| ROMEL C WRENN | |||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $1,070,830 | $0 | $39,878 | |||
| CARY S KELLER | |||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $878,360 | $0 | $42,082 | |||
| GREGORY J WOOD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $852,432 | $0 | $24,968 | |||
| KENNETH STARKS | |||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $832,666 | $0 | $34,165 | |||
| MILAN BAJMOCZI | |||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $753,572 | $0 | $30,023 | |||
| DANNY ROBINETTE | |||||||||
| CHIEF MEDICAL OFFICER NON-MGMT. | 40.00 | 0.00 | $519,873 | $0 | $37,610 | Yes (X) | |||
| ZACH WERLE | |||||||||
| BOARD MEMBER | 40.40 | 0.40 | $418,253 | $0 | $40,792 | Yes (X) | |||
| VANESSA VENEZIA | |||||||||
| PHYSICIAN (THRU 11/19) | 40.00 | 0.00 | $378,987 | $0 | $33,009 | Yes (X) | |||
| STEPHEN LESLIE | |||||||||
| CFO (THRU 06/19) | 40.00 | 0.00 | $394,235 | $0 | $12,966 | Yes (X) | |||
| CLINT BROOKS | |||||||||
| CHIEF OPERT OFFICER SHARED SERV. | 40.00 | 0.00 | $394,613 | $0 | $11,429 | Yes (X) | |||
| LAURA BRUNNER | |||||||||
| BOARD MEMBER | 40.80 | 0.40 | $386,414 | $0 | $11,132 | Yes (X) | |||
| SHELLEY EBENAL | |||||||||
| FHP CEO | 40.00 | 0.00 | $299,947 | $0 | $39,174 | Yes (X) | |||
| JIM LYNCH | |||||||||
| FHP CEO | 40.00 | 0.00 | $311,654 | $0 | $6,400 | Yes (X) | |||
| JENNIFER N WELCH | |||||||||
| CHIEF HR OFFICER | 40.00 | 0.00 | $215,226 | $0 | $35,779 | Yes (X) | |||
| ELIZABETH WOODYARD | |||||||||
| CHIEF CLINICAL SERVICES | 40.00 | 0.00 | $213,215 | $0 | $24,278 | Yes (X) | |||
| TERI KISS | |||||||||
| CHIEF QUALITY OFFICER | 40.00 | 0.00 | $228,853 | $0 | $8,319 | Yes (X) | |||
| CAROL F BARNETT | |||||||||
| COMPLIANCE OFFICER | 40.00 | 0.00 | $195,897 | $0 | $24,735 | Yes (X) | |||
| KARL SANFORD | |||||||||
| ASSOC ADMIN (THRU 04/19) | 40.00 | 0.00 | $185,170 | $0 | $16,393 | Yes (X) | |||
| MICHAEL POWERS | |||||||||
| TVC CEO | 40.00 | 0.00 | $154,331 | $0 | $12,993 | Yes (X) | |||
| GARY RODERICK | |||||||||
| BOARD MEMBER/CFO (THRU 7/19) | 40.00 | 0.40 | $113,546 | $0 | $7,915 | Yes (X) | Yes (X) | ||
| MARK SIMON | |||||||||
| BOARD MEMBER | 0.20 | 0.40 | $23,313 | $0 | $0 | Yes (X) | |||
| JEFF COOK | |||||||||
| PRESIDENT | 2.30 | 0.70 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| JOE FAULHABER | |||||||||
| VICE PRESIDENT | 2.40 | 0.70 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| SCOTT BELL | |||||||||
| TREASURER | 0.60 | 0.60 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| WILLIAM VIVLAMORE | |||||||||
| SECRETARY | 0.40 | 1.30 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| STEVE FRANK | |||||||||
| BOARD MEMBER | 0.70 | 0.60 | $0 | $0 | $0 | Yes (X) | |||
| RICHARD HATTAN | |||||||||
| BOARD MEMBER | 0.50 | 0.40 | $0 | $0 | $0 | Yes (X) | |||
| GALEN JOHNSON | |||||||||
| BOARD MEMBER | 0.10 | 0.70 | $0 | $0 | $0 | Yes (X) | |||
| CHERYL KILGORE | |||||||||
| BOARD MEMBER | 0.20 | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| KAREN PEDUE | |||||||||
| BOARD MEMBER | 1.30 | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| MARGARET SODEN | |||||||||
| BOARD MEMBER | 0.80 | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $8,821,387 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $494,040 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 221 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CROSS COUNTRY STAF | |||||
| LA LOCKBOX FILE 50941 | LOS ANGELES | CA | 90074 | MEDICAL STAFFING | $7,413,912 |
| MAYO COLLABORATIVE | |||||
| DBA MAYO MEDICAL LABORATORIES PO 91 | MINNEAPOLIS | MN | 55480 | REFERENCE LAB SERVICES & CONSULTING SERV | $1,264,925 |
| LOCUMTENENS COM | |||||
| PO BOX 405547 | ATLANTA | GA | 30384 | PHYSICIAN FEES | $887,752 |
| MISSION SEARCH CON | |||||
| 2203 N LOIS AVE STE 1225 | TAMPA | FL | 33607 | MEDICAL STAFFING | $751,764 |
| AM ESCROW & CLOSIN | |||||
| 1699 WALL ST SUITE 700 | MOUNT PROSPECT | IL | 60056 | MEDICAL STAFFING | $715,004 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 30 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $243,519 | GovernmentGrantsAmt |
| All Other Contributions | $8,868 | AllOtherContributionsAmt |
| Total Contributions | $252,387 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| OUTPATIENT REVENUE | 622110 | $140,030,525 | $138,752,593 | $1,277,932 |
| INPATIENT REVENUE | 621110 | $87,701,999 | $87,701,999 | |
| CLINIC | 621111 | $50,505,032 | $50,505,032 | |
| NURSING HOME | 623110 | $21,884,473 | $21,884,473 | |
| PHARMACY | 446110 | $4,050,523 | $4,018,273 | $32,250 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,161,049 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,161,049 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $308,333,601 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $88,435 | TotalRevenueColumnAmt |
| Exclusion | $88,435 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $231,692 | 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 | $231,692 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $231,692 | TotalRevenueColumnAmt |
| Exclusion | $231,692 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,502 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,502 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,502 | TotalRevenueColumnAmt |
| Exclusion | $4,502 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA/MEALS | 722514 | $2,669,938 | $2,669,938 |
| DAY CARE CENTER | 624410 | $942,869 | $942,869 |
| MDA MGMT FEES | 900099 | $84,000 | $84,000 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $309,453 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $31,244 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,259 | UnrelatedBusinessRevenueAmt |
| Exclusion | $275,950 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,006,260 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $312,916,877 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $307,054,663 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,312,441 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,297,386 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,000 | TotalAmt |
| Program Services | $100,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,756,451 | TotalAmt |
| Program Services | $2,694,481 | ProgramServicesAmt |
| Management And General | $2,061,970 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,861,617 | TotalAmt |
| Program Services | $115,513,667 | ProgramServicesAmt |
| Management And General | $22,347,950 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,229,320 | TotalAmt |
| Program Services | $2,714,728 | ProgramServicesAmt |
| Management And General | $514,592 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,097,004 | TotalAmt |
| Program Services | $15,247,462 | ProgramServicesAmt |
| Management And General | $3,849,542 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,542,986 | TotalAmt |
| Program Services | $7,951,671 | ProgramServicesAmt |
| Management And General | $1,591,315 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $300,434 | TotalAmt |
| Management And General | $300,434 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,845 | TotalAmt |
| Management And General | $163,845 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,353 | TotalAmt |
| Management And General | $83,353 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,089,841 | TotalAmt |
| Program Services | $19,589,677 | ProgramServicesAmt |
| Management And General | $8,500,164 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $607,677 | TotalAmt |
| Management And General | $607,677 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,281,433 | TotalAmt |
| Program Services | $417,516 | ProgramServicesAmt |
| Management And General | $1,863,917 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,028,083 | TotalAmt |
| Program Services | $7,653,761 | ProgramServicesAmt |
| Management And General | $1,374,322 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,244,202 | TotalAmt |
| Program Services | $38,118,191 | ProgramServicesAmt |
| Management And General | $10,126,011 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $463,989 | TotalAmt |
| Program Services | $303,588 | ProgramServicesAmt |
| Management And General | $160,401 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,369 | TotalAmt |
| Program Services | $58,580 | ProgramServicesAmt |
| Management And General | $57,789 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $375,280 | TotalAmt |
| Program Services | $207,051 | ProgramServicesAmt |
| Management And General | $168,229 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,420,198 | TotalAmt |
| Program Services | $1,041,311 | ProgramServicesAmt |
| Management And General | $378,887 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $22,762,959 | $22,737,434 | $25,525 |
| PHARMACEUTICAL SUPPLIES | $9,713,862 | $9,569,330 | $144,532 |
| NON MEDICAL SUPPLIES | $6,872,240 | $6,714,796 | $157,444 |
| UBI TAXES | $387,200 | $387,200 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,952,543 | TotalAmt |
| Program Services | $5,370,288 | ProgramServicesAmt |
| Management And General | $6,582,255 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $317,450,886 | TotalAmt |
| Program Services | $256,003,532 | ProgramServicesAmt |
| Management And General | $61,447,354 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,117,606 | BOYAmt |
| EOY | $23,884,392 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,028,002 | BOYAmt |
| EOY | $4,121,598 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,603,417 | BOYAmt |
| EOY | $58,602,318 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,290,999 | BOYAmt |
| EOY | $7,949,759 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,763,538 | BOYAmt |
| EOY | $3,339,210 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $796,439 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $185,990 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $463,516 | BOYAmt |
| EOY | $610,449 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,606,275 | BOYAmt |
| EOY | $908,217 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,873,353 | BOYAmt |
| EOY | $99,415,943 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,411,489 | BOYAmt |
| EOY | $24,250,042 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,137,722 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $774,168 | BOYAmt |
| EOY | $874,492 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,185,657 | BOYAmt |
| EOY | $26,262,256 | 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 | $77,687,696 | BOYAmt |
| EOY | $73,153,687 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,687,696 | BOYAmt |
| EOY | $73,153,687 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,873,353 | BOYAmt |
| EOY | $99,415,943 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$4,534,009 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $65,359 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $17,994 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $83,353 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | FOUNDATION HEALTH (FH) ENGAGED AN INDEPENDENT CONTRACTOR TO PROVIDE GOVERNMENT RELATIONS AND LOBBYING CONSULTING SERVICES. THE CONTRACTOR WORKED WITH THE ALASKA STATE LEGISLATURE AND GOVERNMENT ON COMPLEX ISSUES RELATED TO FH'S CHARITABLE MISSION IN 2019. IN 2019 FH PAID $65,359 FOR THESE SERVICES. ALASKA STATE HOSPITAL AND NURSING HOME ASSOCIATION USE 7% OF ALL DUES PAID TO THEM FOR SPECIFIC LOBBYING EXPENSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $796,439 | OtherCostOrOtherBasisAmt |
| Depreciation | $185,990 | DepreciationAmt |
| Book Value | $610,449 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $610,449 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | Desc |
| Amt | $874,492 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $874,492 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $312,754,380 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $312,754,380 | RevenueSubtotalAmt |
| Other Revenues Not Included | $162,497 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $162,497 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $312,916,877 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $317,288,389 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$162,497 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$162,497 | ExpensesNotReportedAmt |
| Expenses Subtotal | $317,450,886 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $317,450,886 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | INTEREST INCOME 78,497. MDA MGMT FEES 84,000. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | INTEREST INCOME -78,497. MDA MGMT FEES -84,000. |
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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| 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 | $926,485 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $926,485 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $73,149,042 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $67,013,207 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,135,835 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01930 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $74,075,527 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $67,013,207 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,062,320 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02220 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $131,968 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $131,968 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $186,468 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $186,468 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $45,513,639 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $41,543,323 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,970,316 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01250 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $440,779 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $440,779 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $46,272,854 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $41,543,323 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,729,531 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01490 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $120,348,381 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $108,556,530 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,791,851 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03710 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,750 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,750 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,669 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,669 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,419 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,419 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $20,550,801 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $50,294,689 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $50,575,201 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$280,512 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIRBANKS MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1650 COWLES STREET | AddressLine1Txt |
| City | FAIRBANKS | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://WWW.FOUNDATIONHEALTH.ORG/FMH | WebsiteAddressTxt |
| State License | GACH-004 | 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 | FAIRBANKS MEMORIAL HOSPITAL | 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 | 19 | 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 | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| 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 | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.FOUNDATIONHEALTH.ORG/FMH/PATIENTS__VISITORS/FINANCIAL_SERVICES/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.FOUNDATIONHEALTH.ORG/FMH/PATIENTS__VISITORS/FINANCIAL_SERVICES/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.FOUNDATIONHEALTH.ORG/FMH/PATIENTS__VISITORS/FINANCIAL_SERVICES/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FAIRBANKS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: THE COMMUNITY BENEFIT STEERING COMMITTEE (CBSC) GUIDED ALL ASPECTS OF THE CHNA PROCESS INCLUDING OVERSIGHT OF THE ASSESSMENT DATA AND PROCESS, PRIORITIZING IDENTIFIED HEALTH NEEDS, AND DEVELOPMENT OF IMPLEMENTATION STRATEGIES AND REPORTING. THE CBSC SERVED AS OVERSIGHT TO A BROADER COMMUNITY ADVISORY COMMITTEE (CAC) COMPRISED OF KEY INFORMANTS AMONG COMMUNITY ENTITIES SUCH AS PUBLIC HEALTH, GOVERNMENT (SEVERAL STATE, LOCAL, TRIBAL, AND REGIONAL), EDUCATION, AND SOCIAL SERVICES INCLUDING REPRESENTATION OF THE UNDERSERVED, MARGINALIZED, UNINSURED, AND MINORITY POPULATIONS. THERE WERE NO PUBLIC COMMENTS RECEIVED (VIA THE ORGANIZATION WEBSITE LINK) FOR THE 2016 CHNA AND IMPLEMENTATION REPORTS. SUMMARY INPUT FROM THE COMMMUNITY: A PHASED PROCESS OVER A FOUR MONTH PERIOD IN FALL 2019 WITH OVERSIGHT FROM AN INTERNAL STEERING COMMITTEE AND INCLUDED THE COMMUNITY ADVISORY COUNCIL. THE PHASED PROCESS INCLUDED ANALYSIS OF DETERMINANTS OF HEALTH DATA AND COMMUNITY HEALTH ASSESSMENT SURVEYS, PRIORITIZATION, HEALTH IMPROVEMENT PLANNING, AND IMPLEMENTATION PLANNING. THE RESULTING CHNA AND CHIP REPORTS WERE REVIEWED AND APPROVED BY THE ORGANIZATIONS GOVERNING BOARD. THE COMMUNITY ADVISORY COUNCIL INCLUDED KEY INFORMANTS FROM THE FOLLOWING ORGANIZATIONS WITH (*) INDICATING ORGANIZATIONS WHOSE FOCUS IS LARGELY MEDICALLY UNDERSERVED, LOW INCOME, MINORITY POPULATIONS - *FAIRBANKS NATIVE ASSOCIATION, *FAIRBANKS COMMUNITY MENTAL HEALTH, *ALASKA DIVISION OF PUBLIC HEALTH, US ARMY MEDICAL DEPARTMENT, *LOVE INC OF THE TANANA VALLEY, *INTERIOR COMMUNITY HEALTH CENTER, *LITERACY COUNCIL OF ALASKA, *ALASKA HEALTH FAIR, *UNITED WAY OF THE TANANA VALLEY, CITY OF FAIRBANKS, FAIRBANKS NORTH STAR BOROUGH SCHOOL DISTRICT, *INTERIOR CENTER FOR NON-VIOLENT LIVING, *NORTH STAR COUNCIL ON AGING, *FAIRBANKS NORTH STAR BOROUGH. |
| FAIRBANKS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: 1) MENTAL HEALTH -(RECOGNIZING THE COMORBIDITY OF SUBSTANCE USE) FOCUS ON REDUCTION OF WAIT TIME FOR OUTPATIENT ACCESS, PARTNER TO SUPPORT YOUTH AND ADOLESCENT LOCAL PLACEMENT, ADJUST TO MEDICAID 1115 WAIVER CHANGING GAPS, PARTNER FOR HOUSING AND WORKFORCE SHORTAGES, COORDINATE LOCAL PLANNING AND SERVICES.2) SENIOR CARE - IMPROVE PUBLIC AND LEADER UNDERSTANDING OF ISSUES, INCREASE ACCESSBILITY FOR MENTAL AND PHYSICAL FITNESS, AID NAVIGATION, ADDRESS MEDICAID ELIGIBILITY WAIT TIME, PARTNER FOR HOUSING SOLUTIONS, ASESS WORKFORCE DEVELOPMENT, COORDINATE PLANNING. 3) ACES/TRAUMA - IMPROVE COMMUNITY UNDERSTANDING AND IMPACTS, EXPAND PREVENTION AND RESILIENCY PROGRAMS, CREATE COLLABORATIVE GROUP.4) HEALTHY BEHAVIORS - IMPROVE UNDERSTANDING OF RECOMMENDATIONS FOR WELLNESS CHECKS, MOVEMENT, NUTRITION, IMMUNIZATION. INCREASE SCREENING FOR 2030 HEALTHY ALASKAN INDICATORS, IMPROVE VACCINATION RATES, DEVELOP RESOURCE GUIDE, JOINT PLANNING AMONG SERVICES. EACH OF THESE FOUR GROUPS HAS AN ONGOING COMMUNITY WORK GROUP TEAM ESTABLISHED AND THE ORGANIZATION WILL SUPPORT THE FACILITATION OF ONGOING COLLABORATIONS. NEEDS ASSESSED BUT NOT ADDRESSED (OR ADDRESSED AS SUBSETS OF THE MAJOR FOUR): POVERTY, AIR/WATER QUALITY, PRENATAL CARE RATES, PREVENTABLE INJURIES, DENTAL, TRANSPORTATION, MOBILITY, BURNOUT, SUBSPECIALTY ACCESS, REMOTE LOCATIONS, VISITING NURSES, AND INTELLECTUAL DEVELOPMENTAL DISABILITIES. THE IDENTIFIED NEEDS WHICH ARE NOT SPECIFICALLY ADDRESSED WERE NOT ENTIRELY EXCLUDED, MANY ARE WITHIN THE CONTEXT OF THE FOCUS AREAS; THEY DID NOT HOWEVER RISE TO THE PRIORITIZATION LEVELS DESCRIBED IN 3.E. |
| FAIRBANKS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 13B: THE ORGANIZATION USES A FIXED DOLLAR HOUSEHOLD INCOME AMOUNT TO IDENTIFY PATIENTS ELIGIBLE FOR DISCOUNTED CARE. |
| FAIRBANKS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 13H: COVERAGE THROUGH OTHER PROGRAMS OR INSURANCE MUST BE EXHAUSTED OR DENIED. FAMILY SIZE. |
| PART V, SECTION B, LINE 7A: | HTTPS://WWW.FOUNDATIONHEALTH.ORG/COMMUNITY_COMMITMENT/COMMUNITY_HEALTH_NEEDS_ASSESSMENT/COMMUNITY_NEEDS/CHNA/2019_FHP_COMMUNITY_HEALTH_NEEDS_ASSESSMENT |
| PART V, SECTION B, LINE 10A: | HTTPS://WWW.FOUNDATIONHEALTH.ORG/COMMUNITY_COMMITMENT/COMMUNITY_HEALTH_NEEDS_ASSESSMENT/COMMUNITY_NEEDS/CHIP |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - TANANA VALLEY CLINIC LLC | ||||
| 1001 NOBLE STREET | FAIRBANKS | AK | 99701 | MULTI SPECIALTY CLINIC |
| 2 - DENALI CENTER | ||||
| 1510 19TH AVENUE | FAIRBANKS | AK | 99701 | SKILLED NURSING FACILITY |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE ORGANIZATION USES A FIXED DOLLAR HOUSEHOLD INCOME AMOUNT TO IDENTIFY PATIENTS ELIGIBLE FOR DISCOUNTED CARE. |
| PART I, LINE 7: | THE ORGANIZATION USED THE COST TO CHARGE RATIO FROM WORKSHEET 2 TO CALCULATE THE AMOUNTS REPORTED ON PART I, LINE 7. |
| PART I, LINE 7G: | FOUNDATION HEALTH OPERATES TANANA VALLEY CLINIC WHICH IS A MULTI-SPECIALTY CLINIC OFFERING FAMILY PRACTICE, PEDIATRIC, OB-GYN SERVICES AMONG OTHERS. THE CLINIC ACCEPTS ALL GOVERNMENT PAYERS INCLUDING MEDICARE AND MEDICAID WITH NO LIMITATIONS. THE CLINIC ALSO PROVIDES FINANCIAL ASSISTANCE TO PATIENTS WHO QUALIFY. |
| PART II: COMMUNITY BUILDING ACTIVITIES | COALITION LEADERSHIP AND PARTICIPATION IN ESTABLISHED COMMUNITY COALITIONS FOR HOMELESSNESS, SUBSTANCE USE, ACCESSIBLE BEHAVIORAL HEALTH CARE, AND PUBLIC HEALTH SERVICES THROUGHOUT THE INTERIOR OF ALASKA. PROVIDE SPACE AND SUPPORT SERVICES FOR WORKFORCE DEVELOPMENT AMONG PEOPLE WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES (SEARCH PROGRAM). |
| PART III, LINE 2: | CONTRACTUAL (CT) AND BAD DEBT (BD) ALLOWANCES FOR HOSPITAL ACCOUNTS RECEIVABLE (A/R) BALANCES ARE CALCULATED EACH MONTH BY COMPARING TARGET ADJUSTMENTS TO OBSERVED ADJUSTMENTS; THE DIFFERENCE BETWEEN TARGET ADJUSTMENTS AND OBSERVED ADJUSTMENTS IS BOOKED AS AN ALLOWANCE. TARGET ADJUSTMENTS ARE FOUND BY APPLYING TARGET PERCENTAGES TO THE GROSS CHARGES THAT RESULTED IN CURRENT A/R BALANCES. TARGET PERCENTAGES ARE DERIVED FROM HISTORICAL ADJUSTMENT DATA, ON CLOSED ACCOUNTS, IN A LOOKBACK PERIOD CONTAINING 12 MONTHS. THE CT LOOKBACK PERIOD IS THE 12 MONTH PERIOD ENDING 3 MONTHS PRIOR TO THE CURRENT PERIOD. THE BD LOOKBACK PERIOD IS THE 12 MONTH PERIOD ENDING 15 MONTHS PRIOR TO THE CURRENT PERIOD. TARGET ADJUSTMENT PERCENTAGES ARE UPDATED EACH MONTH AND CALCULATED FOR ACCOUNT PORTFOLIOS BASED ON INPATIENT/OUTPATIENT DESIGNATION AND FINANCIAL CLASS. ACTUAL COLLECTIONS ON PRIOR PERIOD A/R BALANCES ARE REVIEWED TO ENSURE THE ALLOWANCE METHODOLOGY IS APPROPRIATE AND RELIABLY ESTIMATES A/R COLLECTABILITY. |
| PART III, LINE 4: | SEE AUDITED FINANCIAL STATEMENTS, PAGE 10 FOR DISCUSSION REGARDING THE ORGANIZATION'S ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| PART III, LINE 8: | MEDICARE REIMBURSEMENT DID NOT COVER THE FULL COST OF TREATING MEDICARE PATIENTS IN 2019. THE SHORTFALL IS $280,512. FOUNDATION HEALTH PROVIDES MEDICALLY NECESSARY HEALTH CARE SERVICES TO ALL PATIENTS REGARDLESS OF PAYER. MANY OTHER PROVIDERS MAY LIMIT OR NOT ACCEPT MEDICARE PATIENTS DUE TO THE INADEQUATE REIMBURSEMENT. THEREFORE, FOUNDATION HEALTH MAY OFTEN BE THE ONLY OPTION FOR MEDICARE PATIENTS IN OUR COMMUNITY. BY ACCEPTING INADEQUATE MEDICARE REIMBURSEMENT, WE REDUCE THE AMOUNT OF FINANCIAL ASSISTANCE AND BURDEN ON OTHER GOVERNMENTAL PROGRAMS, SUCH AS MEDICAID. |
| PART III, LINE 9B: | PATIENTS THAT WE BELIEVE MAY QUALIFY FOR FINANCIAL ASSISTANCE ARE TOLD ABOUT OUR FINANCIAL ASSISTANCE PROGRAM AND GIVEN AN APPLICATION (IF WANTED) DURING THE ADMISSIONS PROCESS. IF THE PATIENT APPLIES AND QUALIFIES, THE BALANCE IS WRITTEN OFF IN PART OR IN FULL. IF THE ACCOUNT IN NOT WRITTEN OFF ENTIRELY, THE REDUCED BALANCE IS TREATED IN THE SAME MANNER AS ACCOUNTS FOR PATIENTS WITHOUT INSURANCE, WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE. THE COLLECTION POLICY INCLUDES 8 PATIENT STATEMENTS AND 2 REMINDER LETTERS SENT TO THE PATIENT. PAYMENT PLANS ARE MADE AVAILABLE; ATTEMPTS ARE MADE TO VERIFY PHYSICAL ADDRESSES OF PATIENTS; AND EFFORTS USED TO DETERMINE IF THE PATIENT MAY BE MEDICAID ELIGIBLE. OUR BILLING STAFF ATTEMPTS TO CONTACT AS MANY PATIENTS AS POSSIBLE. |
| PART VI, LINE 2: | A LINK FOR COMMUNITY FEEDBACK IS ON THE ORGANIZATION WEBSITE AND INITIATES AN EMAIL DIRECTLY TO COMMUNICATIONS DIRECTOR. THE COMMUNICATIONS DIRECTOR IS ACCOUNTABLE FOR ADDRESSING THE FEEDBACK THROUGHLY. THE ADMINISTRATIVE TEAM COLLABORATED WITH THE TANANA CHIEFS CONFERENCE ORGANIZATION TO VISIT AND HOST VILLAGE INPUT MEETINGS IN SIX RURAL SERVICE AREAS. FEEDBACK WAS INCORPORATED INTO OPERATIONAL AND CLINICAL IMPROVEMENTS. THE CANCER TREATMENT PROGRAM CONDUCTS A FORMAL ANNUAL COMMUNITY NEEDS ASSESSMENT ACCORDING TO ACCREDITATION STANDARDS. THE ADMINISTRATIVE TEAM OF THE HOSPITAL MAINTAINS FORMAL AND INFORMAL RELATIONSHIPS WITH GOVERNMENT, BUSINESS, PROVIDER, AND HEALTH SYSTEM CONSUMER GROUPS AND ROUTINELY ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY AS REPRESENTED BY INPUT FROM THESE ENTITIES. |
| PART VI, LINE 3: | REGISTRATION STAFF OFFERS FINANCIAL ASSISTANCE INFORMATION AT THE TIME OF REGISTRATION FOR PATIENTS LACKING INSURANCE COVERAGE. MONTHLY BILLING STATEMENTS INCLUDE A PHONE NUMBER TO CALL FOR INFORMATION ON FINANCIAL ASSISTANCE AND POSSIBLE ELIGIBILITY FOR OTHER PROGRAMS. INPATIENTS WITH NO INSURANCE ARE CONTACT BY OUR INPATIENT FINANCIAL SERVICES REPRESENTATIVE FOR MEDICAID SCREENING. WE ALSO CONTRACT WITH A THIRD PARTY VENDOR TO CONDUCT OUTREACH TO DISCHARGED PATIENTS WITH SELF PAY BILLS TO ASSIST THEM TO APPLY TO OTHER PROGRAMS SUCH AS MEDICAID. MEDICARE FINANCIAL ASSISTANCE BROCHURES ARE AVAILABLE IN THE EMERGENCY DEPARTMENT AND OTHER REGISTRATION AREAS. INFORMATION REGARDING OUR FINANCIAL ASSISTANCE PROGRAM IS PUBLISHED ON OUR WEBSITE. |
| PART VI, LINE 4: | FAIRBANKS MEMORIAL HOSPITAL IS THE SOLE COMMUNITY PROVIDER AND ONLY STATE LICENSED HOSPITAL IN ITS PRIMARY AND SECONDARY SERVICE AREAS.- THE PRIMARY AREA INCLUDES THE 7,400 SQUARE MILE FAIRBANKS NORTH STAR BOROUGH (FNSB) POPULATION 100,031 - THE SECONDARY AREA IS APPROXIMATELY 127,000 SQUARE MILES OF WHAT IS REFERRED TO AS INTERIOR OR NORTHERN ALASKA - WITH VERY FEW OF THE COMMUNITIES IN THIS AREA ACCESSIBLE BY ROAD.- OVERALL, THE HOSPITAL'S SERVICE POPULATION IS ESTIMATED TO BE A POPULATION OF 139,288 WITH 89 PERCENT OF THE HOSPITAL BUSINESS SERVING THE PRIMARY AREA; FAIRBANKS NORTH STAR BOROUGH.- THE NEXT CLOSEST HOSPITAL IS 350 MILES SOUTH OF FAIRBANKS.THOSE WHO ARE NOT SERVED BY THIS HOSPITAL ARE POTENTIALLY RECEIVING SERVICES FROM TANANA CHIEFS CONFERENCE - CHIEF ANDREW ISAAC HEALTH CENTER (AN INDIAN HEALTH SERVICE), BASSETT ARMY COMMUNITY HOSPITAL (FOR MILITARY BENEFICIARIES), AND AN AMBULATORY SURGERY CENTER.PER U.S. CENSUS BUREAU, THE FAIRBANKS NORTH STAR BOROUGH POPULATION IS 71% WHITE, 6% ALASKA NATIVE/AMERICAN INDIAN, 4% BLACK, AND SMALLER PERCENTAGES ARE ASIAN, HISPANIC, AND TWO OR MORE RACIAL DESCENTS. THE MEDIAN AGE IS 31.7 YEARS WITH LARGEST AGE GROUP BEING 20-29 YEARS OLD (21%) AND ALL AGE GROUPS UNDER 40 EXCEED U.S. AVERAGE AND 13% ARE 60 AND OLDER.MEDIAN HOUSEHOLD INCOME IS $75,488, PER CAPITA INCOME $35,328. MEDIAN HOUSE VALUE $259,500 AND 59% OF HOUSING IS OWNER OCCUPIED. OF ALL PERSONS, 7.7% BELOW THE POVERTY LINE, CHILDREN 10%. PERSONS WITHOUT HEALTH INSURANCE, UNDER AGE 65 AT 13%. VETERANS COMPRISE 16% OF THE POPULATION. NO FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS OR POPULATIONS ARE PRESENT IN THE FNSB. |
| PART VI, LINE 5: | FAIRBANKS MEMORIAL HOSPITAL IS GOVERNED BY A COMMUNITY BOARD COMPRISED OF VOLUNTEER COMMUNITY REPRESENTATIVES. THE BOARD ESTABLISHES THE ORGANIZATIONS PRIORITIES, ENSURES OPERATIONS ARE CONSISTENT WITH THE NON-PROFIT PURPOSE AND MISSION, AND REINVESTS IN NEW EQUIPMENT AND TECHNOLOGY, NEW OR EXPANDED PATIENT SERVICES, AND MAINTAINS EXISTING ASSETS TO MEET COMMUNITY NEED AND LONG TERM HEALTH. FMH UTILIZES AN OPEN MEDICAL STAFF MODEL; THE HOSPITAL AND CLINIC ALSO EMPLOY AND CONTRACT WITH PROVIDERS TO ENSURE EFFICIENT, EVIDENCE-BASED, AND HIGH QUALITY CLINICAL CARE WITHIN AN INTEGRATED SYSTEM ALONG THE FULL CONTINUUM OF CARE. THE HOSPITAL FUNCTIONS IN A BOROUGH AND CITY GOVERNMENT STRUCTURE THAT DOES NOT INCLUDE A PUBLIC HEALTH INFRASTRUCTURE OUTSIDE THE STATE SYSTEM RESOURCES; THEREFOR, FOR ALL PUBLIC HEALTH INITIATIVES AND EMERGENCIES, THE HOSPITAL FUNCTIONS AS CRITICAL PUBLIC HEALTH FACILIATOR, PLANNER, AND PROVIDER. THE HOSPITAL ALSO FUNCTIONS IN COLLABORATION WITH ALASKA TRIBAL HEALTH PROVIDERS AND ARMY-AIRFORCE HEALTH PROVIDERS, ALL OF WHICH PARTNER FOR EMERGENCY PREPAREDNESS. |
| PART VI, LINE 6: | FOUNDATION HEALTH LLC IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. |
| PART VI, LINE 7: | ALASKA DOES NOT REQUIRE FILING OF A COMMUNITY BENEFIT REPORT. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY OF ALASKA | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3211 PROVIDENCE DRIVE | AddressLine1Txt |
| City | ANCHORAGE | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 995088030 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 926000147 | RecipientEIN |
| IRC Section | GOVERNMENT | IRCSectionDesc |
| Cash Grant | $100,000 | CashGrantAmt |
| Purpose Of Grant | SCHOOL OF NURSING EXPANSION | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FOUNDATION HEALTH MAINTAIN RECORDS SHOWING GRANT REGRANT RECEIPTS AND GRANT EXPENDITURES. THE GRANT MANAGERS MAINTAIN INFORMATION REGARDING HOW EXPENSES WERE SPENT. THE GRANT ACCOUNTANT CONFIRMS WITH GRANT MANAGERS WHETHER OR NOT THEY HAVE PROOF OF ELIGIBILITY AND SELECTION CRITERIA. GRANT FUNDS ARE OVERSEEN BY THE GRANT MANAGERS. EXPENSES ARE PROCESSED THROUGH ACCOUNTS PAYABLE AND CODED TO EACH GRANT ACTIVITY CODE. ACCOUNTING COMPLETES INVOICES TO GRANT ADMINISTRATORS AND RECONCILES MONEY SPENT TO MONEY INVOICED. WHEN ACCOUNTING CREATES THE INVOICE, THE GRANT MANAGERS REVIEW AND APPROVE THE INVOICES PRIOR TO SENDING THE INVOICE TO THE GRANT ADMINISTRATOR. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROMEL C WRENN | ||||||||||||||
| PHYSICIAN | $821,831 | $0 | $242,724 | $0 | $6,275 | $0 | $11,200 | $0 | $28,678 | $0 | $1,110,708 | $0 | $0 | $0 |
| CARY S KELLER | ||||||||||||||
| PHYSICIAN | $824,787 | $0 | $203 | $0 | $53,370 | $0 | $11,200 | $0 | $30,882 | $0 | $920,442 | $0 | $0 | $0 |
| GREGORY J WOOD | ||||||||||||||
| PHYSICIAN | $691,058 | $0 | $157,128 | $0 | $4,246 | $0 | $11,200 | $0 | $13,768 | $0 | $877,400 | $0 | $0 | $0 |
| KENNETH STARKS | ||||||||||||||
| PHYSICIAN | $541,891 | $0 | $264,282 | $0 | $26,493 | $0 | $0 | $0 | $34,165 | $0 | $866,831 | $0 | $0 | $0 |
| MILAN BAJMOCZI | ||||||||||||||
| PHYSICIAN | $739,029 | $0 | $9,000 | $0 | $5,543 | $0 | $0 | $0 | $30,023 | $0 | $783,595 | $0 | $0 | $0 |
| DANNY ROBINETTE | ||||||||||||||
| CHIEF MEDICAL OFFICER NON-MGMT. | $364,887 | $0 | $134,256 | $0 | $20,730 | $0 | $11,200 | $0 | $26,410 | $0 | $557,483 | $0 | $0 | $0 |
| ZACH WERLE | ||||||||||||||
| BOARD MEMBER | $188,534 | $0 | $226,963 | $0 | $2,756 | $0 | $11,200 | $0 | $29,592 | $0 | $459,045 | $0 | $0 | $0 |
| VANESSA VENEZIA | ||||||||||||||
| PHYSICIAN (THRU 11/19) | $339,704 | $0 | $18,754 | $0 | $20,529 | $0 | $11,200 | $0 | $21,809 | $0 | $411,996 | $0 | $0 | $0 |
| STEPHEN LESLIE | ||||||||||||||
| CFO (THRU 06/19) | $277,026 | $0 | $114,437 | $0 | $2,772 | $0 | $11,200 | $0 | $1,766 | $0 | $407,201 | $0 | $0 | $0 |
| CLINT BROOKS | ||||||||||||||
| CHIEF OPERT OFFICER SHARED SERV. | $278,546 | $0 | $113,372 | $0 | $2,695 | $0 | $11,200 | $0 | $229 | $0 | $406,042 | $0 | $0 | $0 |
| LAURA BRUNNER | ||||||||||||||
| BOARD MEMBER | $215,543 | $0 | $156,441 | $0 | $14,430 | $0 | $10,004 | $0 | $1,128 | $0 | $397,546 | $0 | $0 | $0 |
| SHELLEY EBENAL | ||||||||||||||
| FHP CEO | $289,516 | $0 | $0 | $0 | $10,431 | $0 | $9,739 | $0 | $29,435 | $0 | $339,121 | $0 | $0 | $0 |
| JIM LYNCH | ||||||||||||||
| FHP CEO | $54,960 | $0 | $82,208 | $0 | $174,486 | $0 | $6,400 | $0 | $0 | $0 | $318,054 | $0 | $0 | $0 |
| JENNIFER N WELCH | ||||||||||||||
| CHIEF HR OFFICER | $152,441 | $0 | $62,361 | $0 | $424 | $0 | $6,396 | $0 | $29,383 | $0 | $251,005 | $0 | $0 | $0 |
| ELIZABETH WOODYARD | ||||||||||||||
| CHIEF CLINICAL SERVICES | $179,083 | $0 | $33,160 | $0 | $972 | $0 | $3,062 | $0 | $21,216 | $0 | $237,493 | $0 | $0 | $0 |
| TERI KISS | ||||||||||||||
| CHIEF QUALITY OFFICER | $175,572 | $0 | $30,268 | $0 | $23,013 | $0 | $6,088 | $0 | $2,231 | $0 | $237,172 | $0 | $0 | $0 |
| CAROL F BARNETT | ||||||||||||||
| COMPLIANCE OFFICER | $175,805 | $0 | $19,574 | $0 | $518 | $0 | $7,265 | $0 | $17,470 | $0 | $220,632 | $0 | $0 | $0 |
| KARL SANFORD | ||||||||||||||
| ASSOC ADMIN (THRU 04/19) | $129,628 | $0 | $54,172 | $0 | $1,370 | $0 | $5,312 | $0 | $11,081 | $0 | $201,563 | $0 | $0 | $0 |
| MICHAEL POWERS | ||||||||||||||
| TVC CEO | $86,882 | $0 | $66,216 | $0 | $1,233 | $0 | $3,601 | $0 | $9,392 | $0 | $167,324 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4A | JIM LYNCH RECEIVED A SEVERANCE PAYMENT OF $155,746 DURING 2019. |
| PART I, LINE 5 | PHYSICIANS RECEIVE PRODUCTION PAY IN ADDITION TO THEIR BASE COMPENSATION. A SET SPECIFIC RATE OF PAY IS PAID PER WORK RELATIVE VALUE UNIT PERFORMED OVER AN AGGREGATE THRESHOLD. |
| PART I, LINE 6 | THE MANAGEMENT INCENTIVE PROGRAM PROVIDES AN INCENTIVE PAYMENT BASED ON ACHIEVEMENT OF TARGET MEASURES IN THE CATEGORIES OF PATIENT SATISFACTION (25%), CULTURE (15%), QUALITY/SAFETY (30%), AND FINANCIAL PERFORMANCE (30%). THE FINANCIAL TARGET IS OPERATING INCOME. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 6: | VOLUNTEER HOURS ARE CALCULATED BY INDIVIDUALS LOGGING THEIR HOURS ON OUR VOLGISTICS KIOSK AND THEIR TIME IS DIVIDED INTO CLERICAL AND PATIENT/RESIDENT CARE. THE TOTAL HOURS VOLUNTEERS SERVED WAS 10,584 HOURS IN 26 DEPARTMENTS. SOME EXAMPLES OF THEIR SERVICE INCLUDE OFFERING SPIRITUAL CARE BY DENOMINATION FOR THOSE WHO REQUEST IT AND PET THERAPY BY APPOINTMENT AS WELL AS BEDSIDE VISITS AND HELPING IN OUR CAFETERIA, GIFT SHOP AND VARIOUS OFFICES WHICH REQUEST THEIR ASSISTANCE. |
| FORM 990, PART VI, SECTION A, LINE 6 | FOUNDATION HEALTH'S SOLE MEMBER IS GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | FOUNDATION HEALTH'S SOLE MEMBER, GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION, APPOINTS 5 OF FOUNDATION HEALTH'S BOARD MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING ACTIONS REQUIRE APPROVAL BY THE ORGANIZATION'S SOLE MEMBER: 1) SALE OF ALL OR SUBSTANTIALLY ALL ASSETS OF THE COMPANY; 2) SUBSTANTIALLY CHANGING THE NATURE OR SCOPE OF THE BUSINESS OF THE COMPANY; 3) THE PARTICIPATION IN PARTNERSHIP AGREEMENTS, JOINT VENTURES, OR OTHER ASSOCIATIONS OF ANY KIND WITH ANY PERSON OR PERSONS; 4) EQUIPMENT PURCHASES EXCEEDING $5,000 AND EXCEEDING THE APPROVED OPERATING BUDGET; 5) ENTERING INTO GUARANTIES; INCURRING LIABILITIES; BORROWING MONEY, ISSUING NOTES, BONDS, AND OTHER OBLIGATIONS; OR SECURING ANY COMPANY OBLIGATION BY MORTGAGE OR PLEDGE OR ANY COMPANY PROPERTY OR INCOME; AND 6) LENDING MONEY, INVESTMENT OR REINVESTMENT OF THE COMPANY'S FUNDS, OR RECEIPT AND HOLDING OF PROPERTY AS SECURITY FOR REPAYMENT, INCLUDING, WITHOUT LIMITATION, LOANING MONEY TO, AND OTHERWISE HELPING THE MEMBER, ANY OFFICERS, EMPLOYEES, OR AGENTS. |
| FORM 990, PART VI, SECTION B, LINE 11B | A FULL COPY OF THE FORM 990 WILL BE EMAILED TO THE BOARD FOR THEIR REVIEW PRIOR TO SUBMISSION. ANY QUESTIONS WILL BE RESOLVED PRIOR TO OBTAINING THE SIGNATURE OF THE CFO. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS, OFFICERS AND THE QUALITY AND COMPLIANCE COMMITTEE MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST THAT MAY GIVE RISE TO A CONFLICT OF INTEREST PROMPTLY TO THE QUALITY AND COMPLIANCE COMMITTEE BOARD. THE COMMITTEE MUST THEN CONSIDER THE DISCLOSED INTEREST AND EITHER AUTHORIZE THE CONTINUATION OF THE POTENTIAL FINANCIAL INTEREST AND ANY RELATED TRANSACTION WITH APPROPRIATE PROTECTIONS, OR DISAPPROVE OF IT. OTHER FH EMPLOYEES MUST GO THROUGH A SIMILAR PROCESS OF DISCLOSURE TO THEIR RESPECTIVE SUPERVISOR AND TO THE QUALITY AND COMPLIANCE COMMITTEE. ALL BOARD MEMBERS, MEMBERS OF LOCAL BOARDS OF OWNED FACILITIES, OFFICERS OF FHP, ADMINISTRATORS, EMPLOYED PHYSICIANS, AND OTHER EMPLOYEES AND INDIVIDUALS DESIGNATED BY THEIR SUPERVISORS OR BY THE CHIEF COMPLIANCE OFFICER MUST COMPLETE AN ANNUAL SURVEY THAT IS DISTRIBUTED UNDER THE SUPERVISION OF THE CHIEF COMPLIANCE BOARD. THE SURVEY INCLUDES A QUESTIONNAIRE THAT IS DESIGNED TO IDENTIFY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST, AS WELL AS OTHER TRANSACTION AND RELATIONSHIPS REQUIRED TO BE DISCLOSED IN THE FORM 990 AND SCHEDULE L. |
| FORM 990, PART VI, SECTION B, LINE 15 | FOUNDATION HEALTH PARTNERS USES A PAY RATE CALCULATOR IN ORDER TO DETERMINE COMPENSATION. THE FHP COMPENSATION BOARD APPROVES THE FHP PAY RATE CALCULATOR (PRC) GUIDELINES WHICH IS USED EVERY TIME AN OFFER OR PAY CHANGE IS MADE FOR AN EMPLOYEE. ANY OFFER OUTSIDE OF THE RECOMMENDED RANGE WILL REQUIRE AN APPROVAL. OFFER APPROVALS GO TO THE COMPENSATION AND BENEFITS TEAM, WHICH WILL THEN DECIDE WHAT TYPE OF APPROVAL IS ULTIMATELY REQUIRED. UNDER THE FHP PHILOSOPHY, AN EXCEPTION COMMITTEE WILL BE CREATED TO REVIEW REQUESTED EXCEPTIONS THAT ARE OTHERWISE CONTRARY TO FHP'S COMPENSATION PHILOSOPHY. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| AMENDED RETURN EXPLANATION | FOUNDATION HEALTH LLC AMENDS IT 2019 FORM 990 TO CORRECT COMPENSATION REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II. FORM 990, PART VII IS AMENDED TO REMOVE AMOUNTS REPORTED IN COLUMN (E). SCHEDULE J, PART II IS AMENDED TO REMOVE AMOUNTS REPROTED ON LINE (II) FOR EACH LISTED INDIVIDUAL. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| DENALI CENTERLLC | |||||||||
| 1510 19TH AVENUE | FAIRBANKS | AK | 99701 | 300945293 | COMPREHENSIVE SHORT AND LONG TERM CARE CENTER | AK | $21,083,418 | $3,813,720 | FOUNDATION HEALTH LLC |
| FAIRBANKS MEMORIAL HOSPITAL LLC | |||||||||
| 1650 COWLES STREET | FAIRBANKS | AK | 99701 | 320499956 | HOSPITAL/HEALTHCARE SERVICES | AK | $228,274,637 | $94,603,415 | FOUNDATION HEALTH LLC |
| TANANA VALLEY CLINIC LLC | |||||||||
| 1001 NOBLE STREET | FAIRBANKS | AK | 99701 | 611797882 | PRIMARY CARE SERVICES | AK | $41,598,170 | $9,862,486 | FOUNDATION HEALTH LLC |
| FAIRBANKS MEMORIAL CARDIOLOGY CENTER LLC | |||||||||
| 1650 COWLES ST | FAIRBANKS | AK | 99701 | 364841105 | CARDIOLOGY CLINIC | AK | $16,847,185 | $433,400 | FOUNDATION HEALTH LLC |
| FAIRBANKS MEMORIAL HOME MEDICAL EQUIPMENT LLC | |||||||||
| 19 COLLEGE RD STE D | FAIRBANKS | AK | 99701 | 371830937 | HOME MEDICAL EQUIPMENT RENTALS AND SALES | AK | $1,382,795 | $565,408 | FOUNDATION HEALTH LLC |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71396 | AddressLine1Txt |
| City | FAIRBANKS | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 71396 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 920035784 | EIN |
| Primary Activities | OWN/LEASE HOSPITAL RELATED MEDICAL FACILITIES | PrimaryActivitiesTxt |
| Legal Domicile State | AK | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 509(A)(1) | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (1) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 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 (3 entries)
| Transaction TypeTransactionTypeTxt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|
| GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION | |
| C | CASH |
| GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION | |
| K | CASH |
| GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION | |
| O | CASH |
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