2020-05-26T07:30:46-05:00 2019-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2018-07-01 350811197 FAIRBANKS HOSPITAL INC FAIR 3178498222 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 JANINE R SHOPP VICE PRESIDENT AND CFO 3175729387 2020-05-25 1 NATHAN A RODGERS CPA P01568275 3176334705 2020-05-25 47.227.233.166 2020-05-25 16:47:04 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 CF253C16AA79457DBB141110F0942FA5491417DB 2018 2020-09-23 17:36:50Z BARBARA ELLIOTT 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 23511033 0 X WWW.FAIRBANKSCD.ORG X 1946 IN NONPROFIT ORGANIZATION FOCUSED ON RECOVERY FROM ALCOHOL AND OTHER DRUG PROBLEMS. 16 15 420 243 0 0 829343 741481 22693792 21206545 188893 84874 1211069 1218034 24923097 23250934 233000 140000 0 0 15843310 17036980 35700 1400 700175 8400218 8982669 24512228 26161049 410869 -2910115 27619664 25241548 2076778 2436021 25542886 22805527 X FAIRBANKS IS A NONPROFIT ORGANIZATION FOCUSED ON RECOVERY FROM ALCOHOL AND OTHER DRUG PROBLEMS, SERVING AS A RESOURCE TO IMPROVE THE WELL-BEING OF INDIVIDUALS, FAMILIES AND COMMUNITIES BY OFFERING HOPE AND SUPPORT THROUGH ITS PROGRAMS AND SERVICES. 0 0 8455335 8996062 ADULT INPATIENT SERVICES CONSISTING OF DETOXIFICATION, REHABILITATION AND RESIDENTIAL SERVICES. THE DETOXIFICATION PHASE IS A MEDICALLY MANAGED LEVEL OF CARE WHERE THE EXTENT OF THE PATIENT'S ADDICTION IS DETERMINED AND THE PHYSICAL AND PSYCHOLOGICAL IMPACT OF THAT ADDICTION IS ASSESSED AND THE APPROPRIATE TREATMENT COURSE IS INITIATED. FOR THE CURRENT FISCAL YEAR, FAIRBANKS HOSPITAL HAD 8,270 ADULT DETOX PATIENT DAYS.THE REHABILITATION PHASE OCCURS WHEN FURTHER INPATIENT STABILIZATION/TREATMENT IS NEEDED AND REQUIRED CONTINUED MEDICAL SUPERVISION. THE TREATMENT PROCESS IS MULTI-DISCIPLINARY AND GROUP ORIENTED. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 1,124 ADULT REHAB PATIENT DAYS. THE RESIDENTIAL PROGRAM IS FOR THE PATIENT WHO REQUIRES A RESTRICTIVE ENVIRONMENT TO ABSTAIN FROM USING BUT WHO IS MEDICALLY STABLE. THE PATIENT PARTICIPATES IN NO LESS THAN FOUR HOURS OF THERAPY DAILY AND NURSING CARE IS PROVIDED, IF NEEDED. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 1,184 ADULT RESIDENTIAL PATIENT DAYS. 4025498 4282932 ADULT OUTPATIENT SERVICES PROGRAM CONSISTING OF PARTIAL HOSPITALIZATION (PHP) AND INTENSIVE OUTPATIENT PROGRAM (IOP). THE PHP PROGRAM IS SIX TO SEVEN HOURS PER DAY MONDAY THROUGH FRIDAY AND IS A MULTI-DISCIPLINARY AND GROUP ORIENTED TREATMENT PROGRAM. IT WILL CONTAIN EVALUATION AND EDUCATION. IT ALLOWS THE PATIENT TO EXPERIENCE LIFE ON THE "OUTSIDE" WHILE BEING INVOLVED IN A VERY INTENSE LEVEL OF TREATMENT. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 7,903 PHP VISITS.IOP IS AVAILABLE TO THOSE WHOSE ADDICTION IS NOT SO SEVERE AS TO REQUIRE INPATIENT OR PHP SERVICES. THE PATIENTS MUST DEMONSTRATE THE ABILITY TO REMAIN DRUG-FREE DURING THE ENTIRE TREATMENT COURSE AND INDICATE A WILLINGNESS TO BECOME INVOLVED IN A 12-STEP PROGRAM. IOP PATIENTS GENERALLY MEET FOR THREE HOURS, THREE TIMES PER WEEK. IOP OFFERS EDUCATION AND GROUP THERAPY. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 11,633 VISITS.LEVEL 1 OUTPATIENT - IN ALIGNMENT WITH THE AMERICAN SOCIETY FOR ADDICTION MEDICINE (ASAM), FAIRBANKS CONSIDERS PATIENTS WHOSE SEVERITY OF SUBSTANCE USE IS MILD AND CAUSES MINIMAL INTERRUPTION IN THEIR FUNCTIONING AS BEING BEST SUITED FOR LEVEL 1 OP SERVICES. THESE INDIVIDUALS MAY PRESENT WITH MILD, CO-OCCURRING SUBSTANCE ABUSE AND MENTAL HEALTH AND/OR PHYSICAL HEALTH CONDITIONS. THEY MAY ALREADY BE RECEIVING SERVICES FOR THESE OTHER CO-OCCURRING CONDITIONS, BUT NEED MORE EDUCATION, SUPPORT AND TREATMENT FOR ISSUES RELATED TO THEIR SUBSTANCE USE. ADDITIONALLY, LEVEL 1 MAY BE APPROPRIATE FOR INDIVIDUALS WHO ARE NOT INTERESTED IN RECOVERY, BUT ARE MANDATED INTO TREATMENT. THEY MAY OR MAY NOT HAVE COMPLETED AN EDUCATION COURSE, BUT APPEAR TO NEED MORE THAN JUST EDUCATION AS INDICATED BY THEIR USE OR SERVICE HISTORY. INDIVIDUALS WHO NEED MORE THAN JUST EDUCATION TO ENHANCE THEIR MOTIVATION OR TO CREATE AMBIVALENCE MAY ALSO BENEFIT FROM THIS LEVEL OF CARE. AT THE SAME TIME, INDIVIDUALS WHO ARE IN EARLY RECOVERY AND VIEW TREATMENT AS POTENTIALLY HELPFUL AND ARE ENTERING TREATMENT FOR THE FIRST TIME WILL BENEFIT FROM LEVEL 1. PATIENTS IN THIS LEVEL OF CARE MAY BE RECEIVING MEDICATION ASSISTED TREATMENT (MAT) SERVICES AND/OR OTHER THERAPIES DUE TO THEIR SUBSTANCE USE INCLUDING PATIENTS WHO NEED A STEP DOWN FROM IOP WHOM THE TREATMENT TEAM FINDS HAVE CONTINUED THERAPEUTIC NEEDS BEYOND THE SUPPORT OF AN AFTERCARE PROGRAM. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 2,615 ADULT LEVEL 1 VISITS. 1164808 1239298 YOUNG ADULT INPATIENT SERVICES CONSISTING OF DETOXIFICATION, REHABILITATION, AND RESIDENTIAL SERVICES FOR MALES BETWEEN THE AGES OF 19-23. THE DETOXIFICATION PHASE IS A MEDICALLY MANAGED LEVEL OF CARE WHERE THE EXTENT OF THE PATIENT'S ADDICTION IS DETERMINED AND THE PHYSICAL AND PSYCHOLOGICAL IMPACT OF THAT ADDICTION IS DETERMINED AND THE APPROPRIATE TREATMENT COURSE IS INITIATED. YOUNG ADULT GUIDANCE SPECIALISTS ARE MEMBERS OF THE TREATMENT TEAM. DURING THIS PHASE OF CARE, VARIOUS MULTI-DISCIPLINARY EVALUATIONS ARE COMPLETED. FAMILIES AND OTHER SUPPORT INDIVIDUALS (SCHOOL, PROBATION, CASEWORKERS, ETC.) ARE INVOLVED. FOR THE CURRENT FISCAL YEAR, FAIRBANKS HOSPITAL HAD 757 YOUNG ADULT DETOX PATIENT DAYS. 6286242 140000 6832853 ADOLESCENT INPATIENT SERVICES CONSISTING OF DETOXIFICATION, REHABILITATION, AND RESIDENTIAL SERVICES. THE DETOXIFICATION PHASE IS A MEDICALLY MANAGED LEVEL OF CARE WHERE THE EXTENT OF THE PATIENT'S ADDICTION IS DETERMINED AND THE PHYSICAL AND PSYCHOLOGICAL IMPACT OF THAT ADDICTION IS ASSESSED AND THE APPROPRIATE TREATMENT COURSE IS INITIATED. ADOLESCENT GUIDANCE SPECIALISTS ARE MEMBERS OF THE TREATMENT TEAM. DURING THIS PHASE OF CARE, VARIOUS MULTI-DISCIPLINARY EVALUATIONS ARE COMPLETED. FAMILIES AND OTHER SUPPORT INDIVIDUALS (SCHOOL, PROBATION, CASEWORKERS, ETC) ARE INVOLVED. FOR THE CURRENT FISCAL YEAR, FAIRBANKS HOSPITAL HAD 128 ADOLESCENT DETOX PATIENT DAYS.THE ADOLESCENT REHAB PHASE IS FOR PATIENTS NEEDING FURTHER INPATIENT STABILIZATION/TREATMENT AND REQUIRES MEDICAL SUPERVISION. THIS TREATMENT PROCESS IS MULTI-DISCIPLINARY AND GROUP-ORIENTED. ADOLESCENTS RECEIVE INFORMATION ON DEVELOPING SOCIAL SKILLS, COMMUNICATION, HOW TO GAIN INTERNAL CONTROL OVER FEELINGS, HOW TO DEAL WITH ANGER, HOW TO DEAL WITH PEER PRESSURE, AND OTHER DEVELOPMENT NEEDS. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 108 ADOLESCENT REHAB PATIENT DAYS AND 2,701 ADOLESCENT RESIDENTIAL PATIENT DAYS.THE YOUNG ADULT REHAB PHASE IS FOR PATIENTS NEEDING FURTHER INPATIENT STABILIZATION/TREATMENT AND REQUIRE MEDICAL SUPERVISION. THIS TREATMENT PROCESS IS MULTI-DISCIPLINARY AND GROUP ORIENTED. AN IMPORTANT PART OF THE PROGRAM INCLUDES FAMILY MEMBERS OF THE PATIENT. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 162 YOUNG ADULT REHAB PATIENT DAYS.THE RESIDENTIAL PHASE IS FOR YOUNG ADULTS IN NEED OF STABILIZATION AND TREATMENT. TREATMENT IS MULTI-DISCIPLINARY AND GROUP ORIENTED. YOUNG ADULTS RECEIVE INFORMATION ON DEVELOPING SOCIAL SKILLS, COMMUNICATION, HOW TO GAIN INTERNAL CONTROL OVER FEELING, HOW TO DEAL WITH ANGER, HOW TO DEAL WITH PEER PRESSURE, AND OTHER DEVELOPMENT NEEDS. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 1,079 YOUNG ADULT RESIDENTIAL PATIENT DAYS.ADOLESCENT OUTPATIENTS SERVICES PROGRAM SERVED 452 PHP VISITS AND 987 IOP VISITS DURING THE CURRENT FISCAL YEAR. YOUNG ADULT OUTPATIENT SERVICES PROGRAM SERVED 1,122 PHP VISITS AND 1,207 IOP VISITS DURING THE CURRENT FISCAL YEAR. ADULT HALFWAY HOUSE SERVED 459 PATIENT DAYS DURING THE CURRENT FISCAL YEAR. FAIRBANKS HOSPITAL PROVIDED 4,280 PATIENT DAYS AT LAVERNA LODGE FOR MEN, 1,805 DAYS AT LAVERNA LODGE FOR WOMEN, AND 23,002 PATIENT DAYS AT SUPPORTED LIVINGS FACILITIES DURING THE CURRENT FISCAL YEAR. 6286242 140000 6832853 19931883 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 53 0 1 420 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 16 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X JANINE R SHOPP 3175729387 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 X JOHN RYAN VICE CHAIR TO CHAIR APR'19 1.00 0.00 X X 0 0 0 ANN MERKEL BOARD MEMBER TO VICE CHAIR APR'19 1.00 0.00 X X 0 0 0 KEVIN MURPHY TREASURER 1.00 0.00 X X 0 0 0 ADRIENNE TAKACS BOARD MEMBER TO SECRETARY APR'19 1.00 0.00 X X 0 0 0 PATRICK CARR BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID CORBITT BOARD MEMBER 1.00 0.00 X 0 0 0 BILLIE FOUTS BOARD MEMBER-TERM BEGAN APR'19 1.00 0.00 X 0 0 0 GREG FULK BOARD MEMBER 1.00 0.00 X 0 0 0 SWATI GUNALE BOARD MEMBER-TERM BEGAN APR'19 1.00 0.00 X 0 0 0 MICHAEL HERTEL BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID HERZOG BOARD MEMBER 1.00 0.00 X 0 0 0 MARISSA MANLOVE BOARD MEMBER 1.00 0.00 X 0 0 0 WILLIAM MCKAY II BOARD MEMBER 1.00 0.00 X 0 0 0 MATTHEW NEFF BOARD MEMBER 1.00 0.00 X 0 0 0 ELIZABETH SMITH BOARD MEMBER 1.00 0.00 X 0 0 0 TOM FLOWERS CHAIRMAN-TERM ENDED APR'19 1.00 0.00 X X 0 0 0 CAROL BROWN LUKEMEYER SECRETARY-TERM ENDED APR'19 1.00 0.00 X X 0 0 0 BARBARA ELLIOT PRESIDENT/CEO 36.00 4.00 X X 244288 0 35658 JANINE SHOPP CFO 32.40 3.60 X 143096 0 25807 DR DARRIN MANGIACARNE MEDICAL DIRECTOR 40.00 0.00 X 311449 0 39419 DR ANDREW SONDERMAN PHYSICIAN 40.00 0.00 X 255486 0 18256 ELIZABET STAHL DIRECTOR PEOPLE 40.00 0.00 X 118254 0 8298 ROBIN PARSONS CCO 40.00 0.00 X 116641 0 14969 DR JENNIFER BELL PHYSICIAN 40.00 0.00 X 112729 0 2445 JUDY FELDMAN NURSE PRACTITIONER/CNO 40.00 0.00 X 106888 0 16463 1408831 0 161315 8 0 1 0 SODEXO INC & AFFILIATES 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 FOOD SERVICE MANAGEMENT & STAFF 1230581 CALDWELL VANRIPER INC 701 E NEW YORK STREET INDIANAPOLIS IN 46202 MARKETING 926076 ABBASPOUR INC 7320 E 82ND STREET INDIANAPOLIS IN 46256 PHARMACY SERVICES 366189 LAB CORPORATION OF AMERICA HOLDINGS PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 349834 NETSMART TECHNOLOGIES PO BOX 823519 PHILADELPHIA PA 19182 IT SERVICES 243268 9 47920 693561 741481 PATIENT SERVICE REVENUE 621300 21206545 21206545 21206545 230133 230133 144600 0 144600 144600 144600 145259 -145259 -145259 -145259 232710 47920 114840 117870 117870 ASSISTED LIVING PROGRAM 624229 652409 652409 GIFT SHOP & CAFETERIA REVENUE 624100 88522 88522 214633 214633 955564 23250934 21351145 0 1158308 X 140000 140000 799717 657249 124419 18049 12410722 10199791 1930827 280104 362539 297954 56403 8182 2468366 2028634 384022 55710 995636 818267 154898 22471 173080 40711 118200 14169 59440 13981 40593 4866 1400 1400 31182 7335 21294 2553 2786648 1804385 866713 115550 664049 23204 600814 40031 1745063 1597507 92250 55306 1448171 1148424 288600 11147 39269 9237 26817 3215 62783 14768 42875 5140 13203 13203 1231939 1014750 189319 27870 308592 3868 304634 90 419250 98615 286313 34322 26161049 19931883 5528991 700175 975633 1373237 4582461 4153920 4330541 5517387 642816 799807 25975527 14714941 11745767 11260586 5227488 1654959 114958 481652 27619664 25241548 1554909 1989003 271077 226077 250792 220941 2076778 2436021 X 25226612 22529811 316274 275716 25542886 22805527 27619664 25241548 X -2910115 413853 -241097 X X 0 1 X 1 0 X SCHEDULE A, PART 1, LINE 3: FAIRBANKS HOSPITAL, INC. HAS BEEN DETERMINED BY THE IRS TO BE A PUBLIC CHARITY UNDER IRS CODE SECTION 170(B)(1)(A)(III). PER SCHEDULE H INSTRUCTIONS ONLY ORGANIZATIONS THAT OPERATE AT LEAST ONE FACILITY THAT IS, OR IS REQUIRED TO BE, LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED BY A STATE AS A HOSPITAL IS REQUIRED TO COMPLETE THIS SCHEDULE. FAIRBANK HOSPITAL, INC. IS A PRIVATE MENTAL HEALTH INSTITUTION AND CERTIFIED AS AN ADDICTIONS SERVICE PROVIDER. FAIRBANKS HOSPITAL IS NOT LICENSED BY THE INDIANA STATE DEPARTMENT OF HEALTH AS A HOSPITAL, BUT IS RECOGNIZED BY THE CENTERS FOR MEDICAID AND MEDICARE AS AN ACUTE CARE HOSPITAL. THE COMPLETION OF SCHEDULE H IS NOT REQUIRED; HOWEVER, FAIRBANKS' MANAGEMENT HAS DECIDED TO COMPLETE SCHEDULE H TO PROVIDE INFORMATION TO THE COMMUNITY REGARDING ITS FINANCIAL ASSISTANCE, COMMUNITY BENEFITS, AND FACILITY INFORMATION. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1085518 658550 668851 1075217 964196 736558 615236 1085518 1013434 268722 317960 964196 949663 324621 260850 1013434 861341 434001 345679 949663 0.74360 0.00000 0.25640 0 0 138876 138876 16628124 8359866 8268258 921 76 845 9207606 6354999 2852607 11260586 ESTIMATED THIRD PARTY SETTLEMENTS 220941 220941 X 23748445 413853 413853 23334592 31182 -114840 -83658 23250934 26244707 114840 114840 26129867 31182 31182 26161049 PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE THOSE ASSETS WHOSE USE HAS BEEN LIMITED BY DONORS FOR A SPECIFIC OPERATING OR CAPITAL PURPOSE. BOARD DESIGNATED FUNDS ARE SET ASIDE BY THE BOARD FOR SPECIFIC PURPOSES INCLUDING CHARITY CARE. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY FAIRBANKS AND HOPE ACADEMY AND RECOGNIZE A TAX LIABILITY IF FAIRBANKS AND HOPE ACADEMY HAVE TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY FAIRBANKS AND HOPE ACADEMY, AND HAS CONCLUDED THAT AS OF JUNE 30, 2019 AND 2018, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EVENT ACTIVITY -114,840. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT ACTIVITY 114,840. CIRCLE OF HOPE DINNER 280630 47920 232710 13904 42036 11902 46998 280630 47920 232710 13904 42036 11902 46998 114840 117870 1 1 X 0 1 X 0 1 0 1 0 866800 866800 0.03310 4628669 4663010 0 0.00000 5495469 4663010 866800 0.03310 655360 655360 0.02510 191966 191966 0.00730 847326 847326 0.03240 6342795 4663010 1714126 0.06550 1 2327613 1959501 1555984 403517 X 1 1 1 1 FAIRBANKS HOSPITAL INC 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 WWW.FAIRBANKSCD.ORG 83-5-1-PI-P X LICENSED PRIVATE MENTAL HEALTH INSTITUTION FAIRBANKS HOSPITAL INC 1 0 0 1 X X X X X X X X 18 1 0 0 1 X SEE PART V, PAGE 8 X X 1 18 1 SEE PART V, PAGE 8 0 1 X 0.000000000000 250.000000000000 X X X 1 1 X X X X 1 X SEE PART V, SECTION D X SEE PART V, SECTION D X HTTP://WWW.FAIRBANKSCD.ORG/PROGRAMS/CATEGORY/COST-AND-INSURANCE/ X X X X X X 1 X 0 X X X X 0 X X 0 0 FAIRBANKS HOSPITAL, INC PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA THE HOSPITAL USED BOTH PRIMARY AND SECONDARY RESEARCH AND DATA TO TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENTED THE COMMUNITY IT SERVED INCLUDING THOSE WITH SPECIAL KNOWLEDGE.PRIMARY RESEARCH WAS CONDUCTED THROUGH IN-DEPTH 30-45 MINUTES PHONE INTERVIEWS THROUGH CONDUCTED THROUGH A THIRD-PARTY RESEARCH FIRM, SMARI RESEARCH, WITH NINE C-SUITE, DIRECTORS, OR MANAGER-LEVEL HUMAN RESEARCH DECISION MAKERS RECRUITED FROM A TARGETED NATIONAL SAMPLE IN TRANSPORTATION, PRIVATE NURSING, FINANCE, HEALTHCARE, HIGHER EDUCATION, AND LAW. IN ADDITION, IN-PERSON PHONE INTERVIEWS WERE CONDUCTED WITH SIX KEY FAIRBANKS REFERRAL SOURCES IN THE INDIANA STATE DEPARTMENT OF CHILD SERVICES, PRIVATE THERAPISTS, PROBATION OFFICERS, AND A FAMILY PHYSICIAN. PRIMARY RESEARCH ALSO INCLUDED 400 COMPLETED ONLINE SURVEYS FROM HEADS OF HOUSEHOLDS IN THE INDIANAPOLIS METRO AREA AND EIGHT SURROUNDING COUNTIES, MATCHING THE DEMOGRAPHIC AND SOCIOECONOMIC SEGMENTS OF THE MAJORITY OF OUR TREATMENT DECISION-MAKERS. ADDITIONAL SOURCES OF DATA INCLUDED FAIRBANKS PATIENT DEMOGRAPHICS, COUNTY HEALTH RANKINGS/PROFILES, AND TREATMENT EPISODE DATA-TEDS. FOCUS GROUP QUESTIONS INCLUDED AWARENESS OF FAIRBANKS AND SERVICES PROVIDED, IDENTIFICATION OF STRENGTHS AND WEAKNESSES IN THE ADDICTION TREATMENT SYSTEM, BARRIERS TO SERVICES, GAPS IN SERVICES, AND RECOMMENDATIONS FOR THE SYSTEM OF CARE. THE METHODOLOGY FOR COLLECTING SECONDARY DATA USED IN THE REPORT INCLUDED ONLINE QUESTIONNAIRES EMAILED TO GROUPS OF FAIRBANKS ALUMNI AND PARENT SUPPORT GROUP MEMBERS. PROPRIETARY RESEARCH FROM THE INDIANA WORKFORCE RECOVERY INDIANA WORKPLACE SUBSTANCE USE AND RECOVERY SURVEY 2019. ADDITIONAL SOURCES INCLUDED THE CONSUMPTION AND CONSEQUENCE OF ALCOHOL, TOBACCO, AND DRUGS IN INDIANA: A STATE EPIDEMIOLOGICAL PROFILES, WELLNESS COUNCIL OF INDIANA DATA FROM PRIMARY SERVICE AREA, STATE DEPARTMENT OF HEALTH DATA. FAIRBANKS HOSPITAL, INC PART V, SECTION B, LINE 7D: THE HOSPITAL FACILITY'S CHNA IS AVAILABLE TO THE PUBLIC ON THE HOSPITAL'S WEBSITE AT HTTP://WWW.FAIRBANKSCD.ORG/ UNDER "FOR PROFESSIONALS AND "ADDITIONAL RESOURCES FOR PROFESSIONALS". CLICK ON "COMMUNITY NEEDS ASSESSMENT OR ENTER THE FOLLOWING WEB ADDRESS INTO THE BROWSER: HTTPS://WWW.FAIRBANKSCD.ORG/PROFESSIONALS/RESOURCES/ FAIRBANKS HOSPITAL, INC PART V, SECTION B, LINE 11: THE HOSPITAL FACILITY COMPLETED ITS MOST RECENT CHNA AS OF 6/30/19, AND HAS IDENTIFIED SEVEN SIGNIFICANT NEEDS FOR ITS IMPLEMENTATION STRATEGY COVERING THE TAX YEARS 2019 - 2021 AND APPROVED IN TAX YEAR 2019.1. SUPPORT FOR ADOLESCENTS AND INFORMATION FOR THEIR FAMILIES ON PREVENTION AND TREATMENT PROGRAMS.2. AVAILABILITY OF LONG-TERM CARE THROUGHOUT RECOVERY.3. FAMILY COUNSELING CENTERS.4. TREATMENT FOR ADULT WOMEN.5. LONG-TERM RESIDENTIAL TREATMENT OPTIONS.6. MORE CO-OCCURRING/BEHAVIORAL HEALTH SERVICES.7. EDUCATION AND RECOVERY PROGRAMS TO SUPPORT INDIANA BUSINESSES IDENTIFY AND ASSIST EMPLOYEES AND FAMILIES WHO NEED SUBSTANCE-USE TREATMENT.THE HOSPITAL HAS THE FOLLOWING RECOMMENDATIONS/STRATEGIES TO ADDRESS EACH OF THE NEEDS IDENTIFIED IN THE ASSESSMENT.1. EXPAND AWARENESS OF EXISTING ADOLESCENT PREVENTION AND TREATMENT PROGRAMS.2. PROMOTE LONG-TERM RECOVERY THROUGH INCREASED ALUMNI ASSOCIATION MEMBERSHIP, SUPPORTIVE LIVING PROGRAM, AND FAIRBANKS RECOVERY CENTER.3. CREATE A FAMILY COUNSELING CENTER TO ENGAGE AND SUPPORT FAMILIES FOR THOSE IMPACTED BY ADDICTION.4. ENHANCE COMMUNICATION ABOUT INDIVIDUALIZED TREATMENT FOR SPECIAL POPULATIONS SUCH AS SPECIFIC TREATMENT PROGRAMS FOR WOMEN, ADOLESCENTS, CO-OCCURRING DISORDERS, AND OTHERS.5. EXPAND AWARENESS AND AVAILABILITY OF LONG-TERM RESIDENTIAL PROGRAMS.6. FURTHER DEVELOP CO-OCCURRING TREATMENT AVAILABLE AT FAIRBANKS.7. DEVELOP AN EDUCATIONAL TOOL KIT OF RESOURCES FOR BUSINESSES ON ADDRESSING SUBSTANCE USE IN THEIR COMPANIES. FAIRBANKS HOSPITAL, INC PART V, SECTION B, LINE 13B: FAIRBANKS HAS FUNDS AVAILABLE BASED ON THE PATIENT PARTICIPATION IN AND DISPLAYED COMMITMENT TO THE RECOVERY PROCESS,AND IF THE PATIENT HAS PROVEN A GENUINE FINANCIAL NEED. FAIRBANKS HOSPITAL, INC.: SCHEDULE H, PART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.FAIRBANKSCD.ORG/WP-CONTENT/UPLOADS/2019/04/FAIRBANKS-CHARITY-CARE-POLICY-4-2-19.PDFFAIRBANKS HOSPITAL, INC.:SCHEDULE H, PART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.FAIRBANKSCD.ORG/WP-CONTENT/UPLOADS/2019/10/FAIRBANKS-HOSPITAL-SELF-PAY-CHARITY-CARE-OR-PATIENT-ASSISTANCE-FORM-1.PDF FAIRBANKS HOSPITAL, INC.: SCHEDULE H, PART V, LINE 7A:HTTPS://WWW.FAIRBANKSCD.ORG/PROFESSIONALS/RESOURCES/ 4 1 - LAVERNA LODGE - MEN 1550 E 156TH ST CARMEL IN 46032 DRUG & ALCOHOL RESIDENTIAL REHAB - SEPARATE LOCATION FOR MEN 2 - LAVERNA LODGE - WOMEN 785 N KNIGHTSTOWN RD SHELBYVILLE IN 46176 DRUG & ALCOHOL RESIDENTIAL REHAB - SEPARATE LOCATION FOR WOMEN 3 - SUPPORTED LIVING PROGRAM 6100 CLARKS CREEK RD STE 102 104 PLAINFIELD IN 46168 ADULT HALFWAY HOUSE & DRUG & ALCOHOL SUPPORTED LIVING 4 - PLAINFIELD ADDICTIONS TREATMENT FACILITY 6100 CLARKS CREEK RD STE 102 104 PLAINFIELD IN 46168 OUTPATIENT CENTER PART I, LINE 3C: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES MEDICAL INDIGENCY AND INSURANCE STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART I, LINE 7: FAIRBANKS USES THE IRS WORKSHEETS PROVIDED IN THE INSTRUCTIONS FOR FORM 990, SCHEDULE H TO CALCULATE A SINGLE COST TO CHARGE RATIO WHICH IS APPLIED TO THE CHARGES FOR FINANCIAL ASSISTANCE AND OTHER BENEFITS TO PROVIDE AMOUNTS AT COST. PART I, LN 7 COL(F): EFFECTIVE JULY 1, 2012, FAIRBANKS ADOPTED ACCOUNTING STANDARDS UPDATE (ASU)2011-07, HEALTHCARE ENTITIES (TOPIC 954), "PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTHCARE ENTITIES," WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO PRESENT THE PROVISION FOR BAD DEBTS RELATING TO PATIENT SERVICE REVENUE AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS RATHER THAN AS AN OPERATING EXPENSE. ADOPTION OF THIS STANDARD HAS NO IMPACT ON ITS FINANCIAL POSITION, RESULTS OF OPERATIONS, OR CASH FLOWS. PART III, LINE 2: OUTSTANDING ACCOUNTS RECEIVABLE BALANCES ARE WORKED BY OUR COLLECTIONS AND STATEMENT VENDOR STAFF FOR 120 DAYS. WRITE-OFFS MAY BE DETERMINED AND MADE TO SPECIFIC ACCOUNTS AT THAT TIME. AT THE END OF EACH MONTH, FAIRBANKS ACCRUES 100% OF THE BALANCES EQUAL TO/GREATER THAN 180 DAYS OLD.IF SUBSEQUENT RECOVERIES ARE MADE, FAIRBANKS REDUCES THE AMOUNT OF THE BAD DEBT ACCOUNT. PART III, LINE 3: FAIRBANKS DOES NOT ATTRIBUTE ANY BAD DEBT EXPENSE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP), THEREFORE NO PORTION OF BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE INDIVIDUALS IS CONSIDERED A COMMUNITY BENEFIT. PART III, LINE 4: BAD DEBT EXPENSE FOOTNOTE TO AUDITED FINANCIAL STATEMENTS IS LOCATED ON PAGES 7 AND 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER THE HEADING "ALLOWANCE FOR DOUBTFUL ACCOUNTS". PART III, LINE 8: MEDICARE ALLOWABLE COSTS ARE CALCULATED BY USING THE RATIO OF COST TO CHARGES. THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED JUNE 30, 2019: HOSPITAL STATEMENT OF REIMBURSABLE COST. PART III, LINE 9B: WHEN AN ACCOUNT IS IDENTIFIED AS UNCOLLECTIBLE, IT BECOMES BAD DEBT. IF THE FINANCIAL POSITION OF THE IDENTIFIED INDIVIDUAL'S ACCOUNT HAS BEEN VERIFIED AS BEING IN A FINANCIAL POSITION OF 250% FEDERAL POVERTY LEVEL, THE ACCOUNT WILL BE RECLASSED AS CHARITY CARE. PART VI, LINE 2: FAIRBANKS ENGAGED THE SERVICES OF THE INDIANA UNIVERSITY CENTER FOR HEALTH POLICY TO CONDUCT COMMUNITY FOCUS GROUPS. THE GROUPS WERE DETERMINED THROUGH DISCUSSION WITH ACADEMIC AND HEALTHCARE EXPERTS WHO HAVE KNOWLEDGE OF THE SUBSTANCE IMPACTED POPULATION IN THE INDIANAPOLIS METROPOLITAN AREA. FIVE SEPARATE FOCUS GROUPS WERE DEVELOPED. THE FIRST GROUP CONSISTED OF ADDICTION SERVICE PROVIDERS FOR LOW INCOME AND MINORITY POPULATIONS; THE SECOND GROUP WAS COMPOSED OF COMMUNITY STAKEHOLDERS FROM THE STATE CRIMINAL JUSTICE DEPARTMENT, TASK FORCE ON DRUG FREE MARION COUNTY, HALFWAY HOUSES, PRIMARY MEDICAL CARE COALITION, AND EMPLOYEE ASSISTANCE PROGRAMS. ADOLESCENTS ATTENDING THE RECOVERY HIGH SCHOOL COMPRISED THE THIRD GROUP; PARENTS OF ADOLESCENTS WHO HAD RECEIVED ADDICTION TREATMENT SERVICES WERE IN THE FOURTH, AND THE FIFTH GROUP CONSISTED OF ADULT PATIENTS WHO HAD SUCCESSFULLY COMPLETED INPATIENT TREATMENT. FOCUS GROUP QUESTIONS INCLUDED IDENTIFICATION OF STRENGTHS AND WEAKNESSES IN THE ADDICTION TREATMENT SYSTEM, BARRIERS TO SERVICES, GAPS IN SERVICES, AND RECOMMENDATIONS FOR THE SYSTEM OF CARE. PART VI, LINE 3: THOSE INDIVIDUALS SEEKING ADMISSION TO FAIRBANKS HAVE THE OPPORTUNITY TO MEET WITH A FINANCIAL COUNSELOR TO DETERMINE WHAT RESOURCES ARE AVAILABLE. IN ADDITION, AN INFORMATION BOOKLET IS GIVEN TO THE FAMILIES DURING THE ADMISSION PROCESS WHICH NOTES THAT CHARITY CARE IS AVAILABLE. LASTLY, SIGNS ARE VISIBLE TO PATIENTS IN THE ACCESS DEPARTMENT WHERE ADMISSIONS TAKE PLACE. FAIRBANKS USES THE LOCAL MEDIA TO ASSIST IN EDUCATING THE PUBLIC CONCERNING PREVENTION, INTERVENTION AND TREATMENT. ALSO, FAIRBANKS PARTICIPATES IN NATIONAL ALCOHOL AWARENESS MONTH, RECOVERY MONTH COMMUNITY ACTIVITIES, AND PROVIDES COMMUNITY EDUCATION THROUGH THE SUSAN LI CONFERENCE. PART VI, LINE 4: FOR THE FISCAL YEAR ENDED JUNE 30, 2019, 15,088 LIVES WERE TOUCHED; 71% FROM UNITED WAY OF CENTRAL INDIANA COUNTIES, 12% SURROUNDING COUNTIES, 14% REMAINING INDIANA COUNTIES, AND 3% OUT OF STATE.OTHER INFORMATION RELATED TO THE COMMUNITY AREA SERVED:GENDER: 65% MALE, 35% FEMALE; AGE: 14% AGES UNDER 20, 51% AGES 20-39, 29% AGES 40-59, AND 6% AGE 60 YEARS OR OLDER;MARITAL STATUS: 21% MARRIED, 47% SINGLE, 11% DIVORCED, 13% OTHER;ETHNICITY: 76% CAUCASIAN, 20% AFRICAN AMERICAN, AND 4% OTHER;EDUCATION: 28% HIGH SCHOOL GRADUATES, 19% COLLEGE GRADUATES, 3% POST GRADUATES, AND 50% OTHER. PART VI, LINE 5: THE ORGANIZATION FURTHERS ITS EXEMPT PURPOSE BY PROMOTING HEALTH OF THE COMMUNITY THROUGH THE FOLLOWING: THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF A MAJORITY OF INDEPENDENT PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. SURPLUS OF FUNDS WHEN AVAILABLE ARE USED TO IMPROVE THE PATIENT CARE AND MEDICAL EDUCATION OF THE STAFF; AND A PERCENTAGE OF OPERATING INCOME IS RESTRICTED FOR PATIENT SCHOLARSHIP FUNDS. FAIRBANKS USES THE LOCAL MEDIA TO ASSIST IN EDUCATING THE PUBLIC CONCERNING PREVENTION, INTERVENTION AND TREATMENT. THE ORGANIZATION ALSO PARTICIPATES IN NATIONAL ALCOHOL AWARENESS MONTH, RECOVERY MONTH COMMUNITY ACTIVITIES AND PROVIDES COMMUNITY EDUCATION THROUGH THE SUSAN LI CONFERENCE. PART VI, LINE 6: N/A - ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 1 HOPE ACADEMY 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 203094377 501C3 140000 GENERAL SUPPORT 1 PART I, LINE 2: THERE WERE NO CASH GRANT FUNDS GREATER THAN $5,000 AWARDED DURING THE YEAR. ASSISTANCE WAS PROVIDED ONLY TO A 501(C)(3) PUBLIC CHARITY FOR GENERAL SUPPORT. X X X X 1 0 0 0 0 0 0 0 0 BARBARA ELLIOT PRESIDENT/CEO 244288 0 0 0 0 0 13888 0 21770 0 279946 0 0 0 JANINE SHOPP CFO 143096 0 0 0 0 0 4224 0 21583 0 168903 0 0 0 DR DARRIN MANGIACARNE MEDICAL DIRECTOR 311449 0 0 0 0 0 17649 0 21770 0 350868 0 0 0 DR ANDREW SONDERMAN PHYSICIAN 255486 0 0 0 0 0 14490 0 3766 0 273742 0 0 0 PART I, LINE 4A UNDER A QUALIFYING TERMINATION AGREEMENT (DEFINED AS AN INVOLUNTARY SEPARATION FROM SERVICE OTHER THAN FOR CAUSE) DATED 2/5/2018, DR. BELL WAS ENTITLED TO SEVERANCE PAY BASED HER EMPLOYMENT AGREEMENT DATED 7/21/2017. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRED THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION FROM FAIRBANKS HOSPITAL. SEVERANCE PAYMENTS WERE MADE DURING CALENDAR YEAR 2018 TO THE FOLLOWING LISTED PERSON IN PART VII: DR. JENNIFER BELL $62,404. SCHEDULE J, PART II: MS. BARBARA ELLIOTT IS COMPENSATED BY FAIRBANKS HOSPITAL, INC. FOR HER DUTIES AS PRESIDENT/CEO OF THE HOSPITAL. A PORTION OF HER COMPENSATION RECEIVED FROM FAIRBANKS HOSPITAL, INC. IS ALLOCATED TO HOPE ACADEMY FOR DUTIES PROVIDED. FOR THE CALENDAR YEAR 2018, 4% OF MS. ELLIOTT'S SALARIES AND BENEFITS TOTALING $11,198 WERE ALLOCATED TO HOPE ACADEMY. MS. JANINE SHOPP IS COMPENSATED BY FAIRBANKS HOSPITAL, INC. FOR HER DUTIES AS VICE PRESIDENT AND CFO OF THE HOSPITAL. A PORTION OF HER COMPENSATION RECEIVED FROM FAIRBANKS HOSPITAL, INC. IS ALLOCATED TO HOPE ACADEMY FOR DUTIES PROVIDED. FOR CALENDAR YEAR 2018, 10% OF MS. SHOPP'S SALARIES AND BENEFITS TOTALING $16,890 WERE ALLOCATED TO HOPE ACADEMY. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEWING THE FORM 990 INCLUDES A DETAILED REVIEW OF THE FORM 990 AND REQUIRED SCHEDULES BY THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND BOARD FINANCE COMMITTEE. EACH VOTING MEMBER OF THE GOVERNING BODY REVIEWS AND APPROVES THE FORM 990 AT THE BOARD OF DIRECTOR MEETING PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS MUST COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY. BOARD MEMBERS WHO HAVE A POTENTIAL FOR CONFLICT MUST RECUSE THEMSELVES FROM VOTING ON SUBJECTS THAT MIGHT POSE A CONFLICT. THE CORPORATE COMPLIANCE OFFICER REVIEWS ANY POTENTIAL CONFLICTS THAT ARE REPORTED. FORM 990, PART VI, SECTION B, LINE 15 ALL CURRENT MEMBERS OF THE BOARD OF DIRECTORS ARE GIVEN A WRITTEN EVALUATION FORM TO RATE THE CEO. ALL INFORMATION IS THEN COMPILED IN A FINAL REPORT AND PRESENTED BY THE BOARD CHAIR TO THE CEO. FOR COMPENSATION, WE COMPILE DATA PROVIDED BY OUR INDEPENDENT AUDITORS FROM THE INDIANA HOSPITAL ASSOCIATION, OTHER MENTAL HEALTH PROVIDERS, AND NAATP (NATIONAL ASSOCIATION OF ADDICTION TREATMENT PROVIDERS) TO ENSURE THE SALARY IS COMPETITIVE AND REASONABLE. MEMBERS OF THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS MEET TO DISCUSS AND REVIEW THAT DATA AND MAKE A FINAL DECISION REGARDING COMPENSATION THAT IS THEN REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. A SIMILAR PROCESS IS CONDUCTED TO DETERMINE THE COMPENSATION OF OTHER OFFICERS & KEY EMPLOYEES. FAIRBANKS USES A THIRD PARTY VENDOR TO CONDUCT A PERIOD REVIEW OF MARKET DATA TO COMPARE COMPENSATION WITHIN THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND DETAILED FINANCIAL STATEMENT INFORMATION IS AVAILABLE TO THE PUBLIC UPON REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 PER REGULATION 1.6033-2(A)(2)(II)(L)(1). ADDITIONALLY, SUMMARY FINANCIAL STATEMENT INFORMATION IS AVAILABLE IN THE ANNUAL REPORTS ON THE ORGANIZATION'S WEBSITE. FORM 990, PART VII, SECTION A, LINE 1A: RELATED ORGANIZATION HOURS MS. BARBARA ELLIOTT IS COMPENSATED BY FAIRBANKS HOSPITAL, INC. FOR HER DUTIES AS PRESIDENT/CEO OF THE HOSPITAL. A PORTION OF HER COMPENSATION RECEIVED FROM FAIRBANKS HOSPITAL, INC. IS ALLOCATED TO HOPE ACADEMY FOR DUTIES PROVIDED. FOR THE CALENDAR YEAR 2018, 4% OF MS. ELLIOTT'S SALARIES AND BENEFITS TOTALING $11,198 WERE ALLOCATED TO HOPE ACADEMY. MS. JANINE SHOPP IS COMPENSATED BY FAIRBANKS HOSPITAL, INC. FOR HER DUTIES AS VICE PRESIDENT AND CFO OF THE HOSPITAL. A PORTION OF HER COMPENSATION RECEIVED FROM FAIRBANKS HOSPITAL, INC. IS ALLOCATED TO HOPE ACADEMY FOR DUTIES PROVIDED. FOR CALENDAR YEAR 2018, 10% OF MS. SHOPP'S SALARIES AND BENEFITS TOTALING $16,890 WERE ALLOCATED TO HOPE ACADEMY. FORM 990, PART IX, LINE 11G PURCHASE SERVICES: PROGRAM SERVICE EXPENSES 1,804,385. MANAGEMENT AND GENERAL EXPENSES 866,713. FUNDRAISING EXPENSES 115,550. TOTAL EXPENSES 2,786,648. FORM 990, PART XI, LINE 9: NET ASSETS TRANSFERRED TO HOPE ACADEMY -241,097. FORM 990, PART XI, LINE 2C: AUDIT OVERSIGHT THE ORGANIZATION UTILIZES THE AUDIT AND FINANCE COMMITTEE OF THE BOARD OF DIRECTORS TO OVERSEE THE AUDIT PROCEDURES AND SELECTION OF THE INDEPENDENT ACCOUNTING FIRM. THE RECOVERY HIGH SCHOOL AT FAIRBANKS INC DBA HOPE ACADEMY 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 203094377 CHARTER SCHOOL IN 501(C)(3) LINE 2 FAIRBANKS HOSPITAL INC 1 0 1 0 1 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 THE RECOVERY HIGH SCHOOL AT FAIRBANKS INC DBA HOPE ACADEMY B 381097 COST THE RECOVERY HIGH SCHOOL AT FAIRBANKS INC DBA HOPE ACADEMY J 144600 COST