SOUTH PENINSULA HOSPITAL INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- SOUTH PENINSULA HOSPITAL INC (EIN 92-0037099)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-10
- IRS object ID
- 201911309349303966
- Schema version
- 2017v2.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule K
- Schedule L
- Schedule O
- Schedule R
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-10T12:23:41-07:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 920037099 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH PENINSULA HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 9072358101 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4300 Bartlett Street | AddressLine1Txt |
| City | Homer | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99603 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Lane Chesley | PersonNm |
| Person Title | Board Treasurer | PersonTitleTxt |
| Phone | 9072358101 | PhoneNum |
| Signature | 2019-05-10 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 216.67.102.194 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Joseph Woodin | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4300 Bartlett Street | AddressLine1Txt |
| City | Homer | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99603 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $79,749,587 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://www.sphosp.org/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1969 | FormationYr |
| Legal Domicile State | AK | LegalDomicileStateCd |
| Activity Or Mission | South Peninsula Hospital promotes community health and wellness by providing personalized, high-quality, locally coordinated healthcare. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 539 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,418,819 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,518,929 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $62,029,622 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $73,059,515 | CYProgramServiceRevenueAmt |
| PY Investment Income | $77,953 | PYInvestmentIncomeAmt |
| CY Investment Income | $105,172 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $2,065,971 | CYOtherRevenueAmt |
| PY Total Revenue | $66,526,394 | PYTotalRevenueAmt |
| CY Total Revenue | $79,749,587 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $45,550 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $39,610,657 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $47,361,002 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $26,012,760 | PYOtherExpensesAmt |
| CY Other Expenses | $28,334,081 | CYOtherExpensesAmt |
| PY Total Expenses | $65,623,417 | PYTotalExpensesAmt |
| CY Total Expenses | $75,740,633 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $902,977 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,008,954 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $79,565,579 | TotalAssetsBOYAmt |
| Total Assets EOY | $82,986,015 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $35,047,288 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $34,458,770 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $44,518,291 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $48,527,245 | NetAssetsOrFundBalancesEOYAmt |
| Mission | South Peninsula Hospital promotes community health and wellness by providing personalized, high-quality, locally coordinated healthcare. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $36,974,966 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $52,963,565 | RevenueAmt |
| Desc | Our 22 bed acute care hospital provided inpatient services to 804 patients for total patient days of 3539 during the 2017 tax year. Total outpatient visits for the year were 49544 which includes 5216 emergency rooms visits, 1286 ambulatory surgery visits, and other outpatient services such as imaging, laboratory, physical therapy, infusion, chemotherapy, and sleep lab. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $13,766,945 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $10,035,381 | RevenueAmt |
| Desc | The Hospital operates several provider based clinics which include family medicine, orthopaedics, general surgery, neurology, internal medicine, and urology. These various outpatient provider based clinics had 20537 patient visits during the 2017 tax year. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,677,792 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $9,044,385 | RevenueAmt |
| Desc | The Hospital operates a long-term care facility provides skilled nursing care to an average of 26 patients daily for a total of 9551 resident days during the 2017 tax year. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,585,503 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,016,184 | RevenueAmt |
| Desc | Our Home Health division caring for patients in the home performed 4,952 home visits during the tax year to an average of 60 patients per month. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,585,503 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $1,016,184 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $59,005,206 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 121 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 539 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | AK | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPH Finance Department | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9072350324 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4300 Bartlett Street | AddressLine1Txt |
| City | Homer | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99603 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Bernadette Wilson | |||||||||
| Secretary | 4 | 0 | Yes (X) | $1,100 | $0 | $0 | |||
| Julie Woodworth | |||||||||
| Director | 2 | 0 | Yes (X) | $1,200 | $0 | $0 | |||
| Vickey Hodnik | |||||||||
| Director | 2 | 0 | Yes (X) | $1,200 | $0 | $0 | |||
| Matthew Hambrick | |||||||||
| Director | 2 | 0 | Yes (X) | $8,000 | $0 | $0 | |||
| Thomas Clark | |||||||||
| Vice President | 5 | 0 | Yes (X) | $1,200 | $0 | $0 | |||
| David Groesbeck | |||||||||
| President | 10 | 0 | Yes (X) | $1,200 | $0 | $0 | |||
| Lane Chesley | |||||||||
| Treasurer | 5 | 0 | Yes (X) | $1,200 | $0 | $0 | |||
| Keri-Ann Baker | |||||||||
| Director | 2 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Walter Partridge | |||||||||
| Director | 2 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Todd Boling | |||||||||
| Director and General Surgeon | 2 | 0 | Yes (X) | $266,164 | $0 | $0 | |||
| Matthew North | |||||||||
| Former Director | 2 | 0 | Yes (X) | $1,200 | $0 | $0 | Yes (X) | ||
| Susan Drathman | |||||||||
| Former Director | 2 | 0 | Yes (X) | $1,200 | $0 | $0 | |||
| Robert Letson | |||||||||
| Former CEO | 50 | $287,361 | $0 | $5,000 | Yes (X) | Yes (X) | |||
| Holly Torres | |||||||||
| Former CFO | 50 | 0 | $169,342 | $0 | $4,892 | Yes (X) | |||
| Lee Yale | |||||||||
| Chief Nursing Officer | 50 | 0 | $50,500 | $0 | $0 | Yes (X) | |||
| Joseph Woodin | |||||||||
| Chief Executive Officer | 50 | $0 | $0 | $0 | Yes (X) | ||||
| Melinda Von Kilpatrick | |||||||||
| Former CNO | 50 | 0 | $72,748 | $0 | $0 | Yes (X) | |||
| Brent Adcox | |||||||||
| Orthopaedic Surgeon | 40 | 0 | $1,216,397 | $0 | $5,000 | Yes (X) | |||
| Edson Knapp | |||||||||
| Radiologist | 40 | 0 | $783,265 | $0 | $7,600 | Yes (X) | |||
| Gregory Hough | |||||||||
| General Surgeon | 40 | 0 | $760,445 | $0 | $5,000 | Yes (X) | |||
| Brian Miller | |||||||||
| CRNA | 40 | 0 | $352,866 | $0 | $5,000 | Yes (X) | |||
| Kathryn Ostrom | |||||||||
| OB/GYN Physician | 40 | 0 | $344,656 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,321,244 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $32,492 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 62 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Peak Imaging | |||||
| 4438 Towne Heights Ln | Homer | AK | 99603 | Radiology Services | $684,623 |
| Raymond Fowler | |||||
| 40914 Crested Crane St | Homer | AK | 99603 | Anesthesia Services | $660,680 |
| Alaska Urology LLC | |||||
| PO Box 200754 | Anchorage | AK | 99801 | Urology Physician Services | $366,845 |
| Robert Lee Gear MD | |||||
| 6817 North 57th Place | Paradise Valley | AZ | 85253 | Emergency Room Physician | $327,790 |
| Paula Godfrey | |||||
| PO Box 3194 | Homer | AK | 99603 | Emergency Room Physician | $311,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $0 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $0 | RelatedOrganizationsAmt |
| Government Grants | $4,498,923 | GovernmentGrantsAmt |
| All Other Contributions | $20,006 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $4,518,929 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Hospital | 622000 | $52,963,565 | $52,963,565 | $0 | $0 |
| Physician Offices | 621110 | $10,035,381 | $10,035,381 | $0 | $0 |
| Long Term Care | 623110 | $9,044,385 | $9,044,385 | $0 | $0 |
| Home Health Care | 621610 | $1,016,184 | $1,016,184 | $0 | $0 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $73,059,515 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $117,623 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $117,623 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | -$12,451 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | -$12,451 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$12,451 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$12,451 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $0 | ContriRptFundraisingEventAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| USAC Internet Subsidies | 900099 | $1,604,520 | $1,604,520 | $0 | $0 |
| Cafeteria and other revenue | 900099 | $276,165 | $276,165 | $0 | $0 |
| Other operating revenue | 900099 | $185,286 | $185,286 | $0 | $0 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,065,971 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $79,749,587 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $75,125,486 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $105,172 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,550 | TotalAmt |
| Program Services | $45,550 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,519,604 | TotalAmt |
| Program Services | $759,802 | ProgramServicesAmt |
| Management And General | $759,802 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,368,392 | TotalAmt |
| Program Services | $24,781,030 | ProgramServicesAmt |
| Management And General | $6,587,362 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,118,153 | TotalAmt |
| Program Services | $1,673,341 | ProgramServicesAmt |
| Management And General | $444,812 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,212,280 | TotalAmt |
| Program Services | $7,230,466 | ProgramServicesAmt |
| Management And General | $2,981,814 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,142,573 | TotalAmt |
| Program Services | $1,600,706 | ProgramServicesAmt |
| Management And General | $541,867 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,916 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $170,916 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,647 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $85,647 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,526,694 | TotalAmt |
| Program Services | $5,988,685 | ProgramServicesAmt |
| Management And General | $1,538,009 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,182 | TotalAmt |
| Program Services | $37,091 | ProgramServicesAmt |
| Management And General | $37,091 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,512,172 | TotalAmt |
| Program Services | $5,977,130 | ProgramServicesAmt |
| Management And General | $1,535,042 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,320,404 | TotalAmt |
| Program Services | $2,641,911 | ProgramServicesAmt |
| Management And General | $678,493 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,655,445 | TotalAmt |
| Program Services | $1,317,170 | ProgramServicesAmt |
| Management And General | $338,275 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,613 | TotalAmt |
| Program Services | $120,276 | ProgramServicesAmt |
| Management And General | $3,337 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $231,018 | TotalAmt |
| Program Services | $183,812 | ProgramServicesAmt |
| Management And General | $47,206 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $546,529 | TotalAmt |
| Program Services | $527,838 | ProgramServicesAmt |
| Management And General | $18,691 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,072,224 | TotalAmt |
| Program Services | $2,765,002 | ProgramServicesAmt |
| Management And General | $307,222 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,044,346 | TotalAmt |
| Program Services | $991,578 | ProgramServicesAmt |
| Management And General | $52,768 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,970,891 | TotalAmt |
| Program Services | $2,363,818 | ProgramServicesAmt |
| Management And General | $607,073 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,740,633 | TotalAmt |
| Program Services | $59,005,206 | ProgramServicesAmt |
| Management And General | $16,735,427 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,179 | BOYAmt |
| EOY | $2,179 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,352,772 | BOYAmt |
| EOY | $19,601,347 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,449,174 | BOYAmt |
| EOY | $16,215,774 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,825,791 | BOYAmt |
| EOY | $1,700,305 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $604,764 | BOYAmt |
| EOY | $598,655 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $90,135,040 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $47,783,640 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,722,462 | BOYAmt |
| EOY | $42,351,400 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,608,437 | BOYAmt |
| EOY | $2,516,355 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,565,579 | BOYAmt |
| EOY | $82,986,015 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,190,063 | BOYAmt |
| EOY | $16,652,193 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,209,867 | BOYAmt |
| EOY | $943,503 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,537,061 | BOYAmt |
| EOY | $16,773,247 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,080 | BOYAmt |
| EOY | $89,827 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,954,217 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,047,288 | BOYAmt |
| EOY | $34,458,770 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,493,005 | BOYAmt |
| EOY | $48,501,959 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,286 | BOYAmt |
| EOY | $25,286 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,518,291 | BOYAmt |
| EOY | $48,527,245 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,565,579 | BOYAmt |
| EOY | $82,986,015 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,008,954 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $0 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $5,035 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,035 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1 | FormAndLineReferenceDesc |
| Explanation | The Hospital pays annual dues to entities that perform lobbying activities. Those entities are the Alaska State Hospital and Nursing Home Association, The American Hospital Association, and the American Healthcare Association. The amount reported on Schedule H Part IV is based on the estimated annual percentage of lobbying activities as reported by these entities for 2017. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $188,508 | OtherCostOrOtherBasisAmt |
| Book Value | $188,508 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $61,872,854 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,939,651 | DepreciationAmt |
| Book Value | $35,933,203 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $140,475 | OtherCostOrOtherBasisAmt |
| Depreciation | $71,325 | DepreciationAmt |
| Book Value | $69,150 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $24,270,201 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,733,725 | DepreciationAmt |
| Book Value | $4,536,476 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $3,663,002 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,038,939 | DepreciationAmt |
| Book Value | $1,624,063 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $42,351,400 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $79,749,587 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $0 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Recoveries Prior Year Grants | $0 | RecoveriesPriorYearGrantsAmt |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $79,749,587 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $0 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $79,749,587 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $75,740,633 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $0 | DonatedServicesUseFcltsAmt |
| Prior Year Adjustments | $0 | PriorYearAdjustmentsAmt |
| Losses Reported | $0 | LossesReportedAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $75,740,633 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $0 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $75,740,633 | TotalExpensesPerForm990Amt |
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 |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $665,758 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $665,758 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0089 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $22,347,337 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,032,902 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,314,435 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.031 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $23,013,095 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,032,902 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,980,193 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0399 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 49 | ActivitiesOrProgramsCnt |
| Persons Served | 525 | PersonsServedCnt |
| Total Community Benefit Expns | $327,396 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $327,396 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0044 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 53 | PersonsServedCnt |
| Total Community Benefit Expns | $1,596 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,596 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Persons Served | 48226 | PersonsServedCnt |
| Total Community Benefit Expns | $26,430,319 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,983,126 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,447,193 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0997 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 26 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $12,194 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,194 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0002 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 97 | ActivitiesOrProgramsCnt |
| Persons Served | 48804 | PersonsServedCnt |
| Total Community Benefit Expns | $26,771,505 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,983,126 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,788,379 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1043 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 99 | ActivitiesOrProgramsCnt |
| Persons Served | 48804 | PersonsServedCnt |
| Total Community Benefit Expns | $49,784,600 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $39,016,028 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,768,572 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1442 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $5,110 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,110 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $5,110 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,110 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $940,767 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $705,575 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $17,825,914 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $24,547,188 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$6,721,274 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 0 | WrittenDebtCollectionPolicyInd |
| 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 | South Peninsula Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4300 Bartlett St | AddressLine1Txt |
| City | Homer | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99603 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.sphosp.org | WebsiteAddressTxt |
| State License | GACH-010 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | South Peninsula 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 |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.sphosp.org/about-sph/health-needs-assessment/ | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | www.mappofskp.net | OtherWebsiteURLTxt |
| 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 | www.sphosp.org/about-sph/health-needs-assessment/ | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| 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 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 | www.sphosp.org/wp-content/uploads/2018/05/HW-074-Patient-Financial-Assistance.pdf | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.sphosp.org/wp-content/uploads/2018/02/Copy-of-2018-FAP-Application.pdf | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.sphosp.org/wp-content/uploads/2018/08/Finnacial-Assistance-brochure.pdf | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5-South Peninsula Hospital | The assessment was conducted using the MAPP model for assessments (mobilizing to action through planning and partnerships), a model designed by the centers for disease control in conjunction with the National Association of City and County Health Officials. This type of assessment is designed to include the eight dimensions of wellness, and incorporate both leadership and input from broad interest of the community we serve. Our assessment was the collaborative effort of South Peninsula Hospital, Ak Dept of Public Health, South Peninsula Behavioral Health, Sprout Family Services, Kachemak Bay UAA Campus, Haven House, Sustainable Homer, City of Homer, Seldovia Village Tribe FQHC, Kachemak Family Planning, and Cook Inlet Councel on Alcohol and drug abuse. The input for the assessment came from staff and clients of these organizations, key interviews in subject areas, focus groups, and the general population via surveys and specific outreach to the underserved. |
| Schedule H, Part V, Section B, Line 11-South Peninsula Hospital | 1. ACES (Adverse Childhood Experiences) - SPH is one of five local agencies working to implement Trauma Informed Care practices throughout it's facility, and support our goal of becoming Alaska's first Trauma-informed community. The Hospital's Health and Wellness RN serves on the MAPP resilience coalition leadership team, while the Hospital helps to implement resilience coalition work group strategies. SPH provides administration for the Local MAPP Health coalition. Our Clinic screen for ACE (Adverse childhood experience) upon patient intake. 2. Childcare/Daycare - SPH has an active task force working to address the severe shortage in affordable day care in the Service area. The Hospital is the lead agency in programs such as Safe Sitter and Safe Kids, and also sponsors the annual Health Kids Fair. SPH offers spiritual care for patients and staff, and attends annual kindergarten roundup to connect parents and guardians with necessary care for newly enrolled students. SPH Offers quarterly baby sitting classes to youth in grades 6-8. Free sports physicals are offered to high school students during the sports physical clinic. 3. Access to Care: SPH works with local agencies to support a wheel chair accessible tax. SPH also has a representative on the Kenai Peninsula Borough Transportation planning committee to advocate for affordable local transportation. The Hospital offers tax vouchers to patients who do not have transportation, and coordinates with Medicaid for patient travel. The Hospital adheres to Patient Centered Medical Homer Level II standards which supports evening and weekend appointments as well as 24/7 online access. The electronic health patient portal offers immediate messaging to providers, health information, data tracking, bill pay and more. The Homer Medical Center was expanded by more than 5,200 square feet during the tax year which allowed for 7 additional exam rooms as well as onsite ancillary services such as lab and xray. An additional family medicine provider was added, and the hospital has contracted with a mid level to assist in our orthopaedic clinic. The Hospital offers certified enrollment and financial counselors 7 days a week to help patients qualify for programs, enroll in the insurance marketplace, or other qualified assistance programs. Financial assistance information is readily available both at our registration desk and also on our public website. We offer a self-pay discount for high cost advanced imaging procedures. We also offer promotion screenings and labs at annual community Health fairs. 4. Substance Abuse and misuse, mental health, Domestic Violence - SPH cosponsors two community forums on addiction and supports the development of a community wide task force for the opioid crisis. Three hospital employees serve on that task force and several other on subcommittees. The Hospital continued to provide SART/SANE nursing services through the emergency department. SPH continues to monitor the need for an inpatient addiction/detox facility due to a clear lack in the community due to lack of reimbursements, facilities, and certified staffing. Further a lack of sober living options exists in the community forcing detoxed patients back into sometimes unstable living conditions. The Hospital continues to work with the opioid tax force and local officials to research this dilemma. The Hospital provides training for medical and nursing staff related to the science of addiction to reduce stigma and increase empathy, and ensure that Emergency room staff are up to date on available mental health and addiction resources in the community. The Hospital hosts a community needle exchange program bi-weekly in the training center. The Hospital is the lead agency for At-risk maternal and newborn working group which address addiction related concerns in this population. SPH also offers a CDC approved pain management program at Homer Medical Center seeking to empower patient to manage their pain with alternate therapies. The Hospital sponsors community training to first responders to overdoses and distributes drug disposal bags with narcotics prescriptions in both the clinic and ER setting. 5. Aging population/physical health - The Hospital offers specialty clinics which encompass cardiology, urology, oncology, pulmonology, dementia, geriatric psychiatry and depression, gastrointestinal, wound care, ophthalmology, podiatry, medication management, and other age-related health concerns. The majority of our community health and wellness offerings focus on chronic disease prevention and management, including a 6 session disease management program. Our diabetes education program is now certified with the American diabetes association and appointment are offered onsite at the specialty clinic and evenings at Homer medical center, as well as regular office visits or accompanying inpatient stays. The Hospital also offers cancer care with a full time infusion clinic and visits from area oncologists. The Hospital sponsors a Senior Day at the peninsula fair to encourage multi-generational socializing, and also provides home health services to enable seniors to receive care in their own surroundings. 6. Chronic Illness - This community need is being managed in multiple ways beginning with healthy lifestyle training to cover nutrition and exercise as obesity and poor nutrition is one of the root causes of chronic illness. The Hospital employs a full time functional medicine physician who teaches patients how to target the root cause of many chronic illness through nutrition, supplements, healthy eating, exercise, and reduction of stress. The Hospital sponsored two visiting Chefs at the Market promoting nutrition and the importance of eating local organic produce. The Hospital has been unable to provide specialized care for alzheimers and dementia patients but continues to seek out local resources to fill this gap. 7. Healthcare professional recruitment and retention - The Hospital consistently works with recruiters and advertising resources to attract talented providers. The hospital also supports a nurse residency program to promote the education and advancement of local nursing students. 8. Poor local economy / jobs - The Hospital is one of the largest employers in the service area and works hard to pay competitive wages/benefits to area residents. The Hospital provide scholarships and support residents who wish to receive a healthcare related education and training. CNA course scholarships are offered, and the Hospital supports the UAA Kachemak Bay campus by providing clinical rotation opportunities. 9. Partnerships and Collaborations - part of the Hospital's strategic plan is to continue building collaborative relationships with local healthcare providers and agencies in order to improve community health. The MAPP program is the largest example of this multi-agency collaborative effort. The Hospital continues to take the lead on training and education for local agencies including Basic Life saver courses, CPR, body mechanics, lifting and patient transfer techniques, and the importance of ergonomics. The Hospital collaborates with Local schools, colleges, mental health agencies, and law enforcement. 10. Environmental concerns - The Hospital proactively changed all of its lighting to LED bulbs decreasing its consumption of electrical resources in the facility and parking lots. Additionally, lighting in areas not staff 24 hours were placed on motion sensors to decrease the amount of energy consumption. |
| Schedule H, Part V, Section B, Line 13h-South Peninsula Hospital | In addition to other FAP eligible patients, deceased patients without an estate are also eligible for Financial Assistance. |
| Schedule H, Part V, Section B, Line 16j-South Peninsula Hospital | The Financial Assistance Policy is displayed throughout our facility, at registration desks, on bulletin boards, in waiting rooms, at the annual health fair, on our public website, and in our financial counselling offices |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| SPH Long Term Care | ||||
| 4300 Bartlett Street | Homer | AK | 99603 | Long term care skilled nursing facility |
| SPH Community Health Services | ||||
| 203 W Pioneer | Homer | AK | 99603 | Home Health Services |
| Homer Medical Center | ||||
| 4136 Bartlett St | Homer | AK | 99603 | Family Practice Medical Clinic |
| SPH Specialty Physician Clinic | ||||
| 4201 Bartlett St | Homer | AK | 99603 | Orthopaedics, General Surgery, Neurology, Urology, and other Specialty physicians |
| SPH West Wing Clinic | ||||
| 4117 Bartlett St | Homer | AK | 99603 | OBGYN and Women's health services |
| SPH Behavioral Health | ||||
| 4251 Bartlett St | Homer | AK | 99603 | Behavioral health services |
| SPH Functional Medicine Clinic | ||||
| 203 W Pioneer Ave Suite 2 | Homer | AK | 99603 | Functional Medicine clinic |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 7 | Costs associated with financial assistance were based on the Medicare Cost Report's cost to charge ratio for tax year 2017. Costs associated with Other Benefits e-j are based on actual reported cost per activity or department for the tax year 2017. |
| Schedule H, Part I, Line 7g | The Hospital included in subsidized health services costs associated with Physician clinics for family medicine ($2,934,260), Diabetes and Internal Medicine ($339,467), Functional Medicine ($272,451), Orthopaedics ($19,861), and other Specialty Physicians ($375,668). |
| Schedule H, Part II | The Hospital is a leader in the community when it comes to health improvement advocacy through collaborations such as the MAPP program, support of local non-profits such as Hospice and South Peninsula Behavioral Health, and provision of community education and programming for health improvement, active lifestyles, and nutrition. |
| Schedule H, Part III, Section A, Line 4 | Bad debts and charity care are subtracted from patient service revenue to arrive at net patient revenue. The following information relates to uncompensated care for the years ended June 30, 2018 and 2017. Bad debts 2018 $1,699,188 2017 $1,678,691. Charges forgone based on established rates 2018 $1,476,663 2017 $1,841,409. |
| Schedule H, Part III, Section B, Line 8 | This data was obtained from the CMS website on our Provider Statistical & Reimbursement Report (PS&R) for the tax year. We believe that the shortfall in line 8 should be considered community benefit due to the provision of care to Medicare patients regardless of their ability to pay. Further the Hospital is not allowed to collect the contractual write-offs from patients despite the deficit in the cost to provide services to this population. |
| Schedule H, Part VI, Line 2 | Hospital uses a collaborative effort with state and local agencies and also community members and focus groups to identify the community health needs. This effort is spearheaded by an entity called MAPP. |
| Schedule H, Part VI, Line 3 | The Hospital employs 3 financial counselors that are available to meet with patients to discuss bills, payment plans, and financial assistance options. The counselors can also assist patient with completing the charity application. Additionally, a copy of the FAP is available at all registration areas, displayed prominently in the Emergency rooms and waiting rooms, and published on our website. |
| Schedule H, Part VI, Line 4 | The Hospital serves the South Peninsula Hospital Service Area located in the Kenai Peninsula Borough. That service area encompasses several communities in South Central Alaska to include Anchor Point, Diamond Ridge, Fox River, Fritz Creek, Happy Valley, Homer, Kachemak City, Nanwalek, Nikolaevsk, Ninilchik, Port Graham, and Seldovia for an estimated population of 13,969 as of the 2014 Census. |
| Schedule H, Part VI, Line 5 | South Peninsula Hospital is the leader in the community for healthcare provision and education. The Hospital uses its staff and resources to deploy flu shots, provide annual lab and health screenings to over 1,000 residents, provides training and health advocacy, sponsors local health care initiatives and businesses, and invests resources back into the community. The Board of directors is comprised of community members who work to span the differences between health care services and community health need. The Hospital uses all surplus monies to reinvest back into the Hospital plant, operations, and community through programs, services, and facilities. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| Hospice of Homer | ||||||||
| PO BOX 4174 | HOMER | AK | 99603 | 920115943 | 501c3 | $26,300 | Actual payments | The hospital provides other cash assistance to Hospice of Homer in the amount of $2,000 a month to help sustain operations and provide palliative care to area residents which is does not provide itself. |
| Kachemak Bay Family Planning | ||||||||
| 3959 Ben Walters Ln | Homer | AK | 99603 | 920106486 | 501c3 | $19,250 | Actual cash paid | The Hospital supports the efforts of Kachemak Bay Family Planning which provides a number of free community health services such as STD testing and other diagnostics labs for the underserved population. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule I, Part I, Line 2 | FormAndLineReferenceDesc |
| Explanation | Other assistance was provided to local healthcare non-profits which support the community health needs such as Hospice of Homer, Kachemak Bay Family Planning, and MAPP. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| 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 | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | 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 (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Robert Letson | ||||||||||||||
| Former CEO | $156,577 | $0 | $0 | $0 | $474,387 | $0 | $5,080 | $0 | $0 | $0 | $636,044 | $0 | $0 | $0 |
| Holly Torres | ||||||||||||||
| Former CFO | $248,362 | $0 | $10,000 | $0 | $0 | $0 | $7,125 | $0 | $0 | $0 | $265,487 | $0 | $0 | $0 |
| Lee Yale | ||||||||||||||
| Chief Nursing Officer | $143,321 | $0 | $10,000 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $153,321 | $0 | $0 | $0 |
| Joseph Woodin | ||||||||||||||
| Chief Executive Officer | $124,152 | $0 | $0 | $0 | $1,321 | $0 | $1,077 | $0 | $0 | $0 | $126,550 | $0 | $0 | $0 |
| Melinda Von Kilpatrick | ||||||||||||||
| Former CNO | $103,378 | $0 | -$2,415 | $0 | $9,104 | $0 | $0 | $0 | $0 | $0 | $110,067 | $0 | $0 | $0 |
| Brent Adcox | ||||||||||||||
| Orthopaedic Surgeon | $947,744 | $0 | $325,000 | $0 | $18,500 | $0 | $5,000 | $0 | $0 | $0 | $1,296,244 | $0 | $0 | $0 |
| Edson Knapp | ||||||||||||||
| Radiologist | $789,278 | $0 | $0 | $0 | $19,625 | $0 | $5,000 | $0 | $1,300 | $0 | $815,203 | $0 | $0 | $0 |
| Gregory Hough | ||||||||||||||
| General Surgeon | $713,168 | $0 | $83,122 | $0 | $17,825 | $0 | $14,039 | $0 | $0 | $0 | $828,154 | $0 | $0 | $0 |
| Brian Miller | ||||||||||||||
| CRNA | $413,448 | $0 | $0 | $0 | $17,475 | $0 | $5,000 | $0 | $0 | $0 | $435,923 | $0 | $0 | $0 |
| Kathryn Ostrom | ||||||||||||||
| OB/GYN Physician | $397,678 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $397,678 | $0 | $0 | $0 |
| Todd Boling | ||||||||||||||
| Director and General Surgeon | $278,612 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $278,612 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 1a | The Hospital provided corporate housing to its CEO and other professional employees as a recruiting incentive due to the rural nature of the facility and related housing shortage. That housing subsidy was grossed-up when it was included as taxable earnings. The Hospital also provides as a 'wellness benefit' the use of local health facilities and pays up to 1/2 of gym membership fees through the wellness program, not to exceed $400/year. |
| Schedule J, Part I, Line 1b | Although the Hospital does not have a written policy governing all fringe benefits, it does closely follow IRS guidelines for the treatment of those benefits and includes all applicable fringe as taxable earnings and reports them on Form W-2. |
| Schedule J, Part I, Line 4 | A severance payment of $380,810 was paid to the former CEO, Robert Letson in January 2018. Several key employees participated in a nonqualified 457 compensation plan, they are Robert Letson $36500, Joseph Woodin $1321.43, Brent Adcox $18500, Edson Knapp $19625, and Brian Miller $17475. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Business Name Line2IssuerName/BusinessNameLine2Txt | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| Kenai Peninsula Borough | ||||||||
| A | 2011 Refunding Bonds | 920030894 | 2011-09-15 | $3,285,000 | Refunding bonds | 0 | 0 | 0 |
| Kenai Peninsula Borough | ||||||||
| B | 2015 Refunding Bonds | 920030894 | 2015-06-04 | $8,655,000 | Refunding Bonds | 0 | 0 | 0 |
| Kenai Peninsula Borough | ||||||||
| C | 2016 Refunding Bonds | 920030894 | 2016-11-03 | $2,660,000 | Refunding Bonds | 0 | 0 | 0 |
| Kenai Peninsula Borough | ||||||||
| D | Revenue Bonds | 920030894 | 2017-04-27 | $4,500,000 | Hospital Expansion and Maintenance | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $2,110,000 | $0 | $3,802,589 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | 2009 | 0 | Yes (1) | Yes (1) | Yes (1) |
| B | $110,000 | $0 | $9,884,491 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | 2009 | 0 | Yes (1) | Yes (1) | Yes (1) |
| C | $20,000 | $0 | $3,050,412 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | 2009 | 0 | Yes (1) | Yes (1) | Yes (1) |
| D | $215,000 | $0 | $4,795,700 | $0 | $62,086 | $0 | $23,647 | $0 | $0 | $4,724,721 | $0 | $109,418 | 2018 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| C | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| D | 0 | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| C | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| D | 0 | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
| D | Yes (1) |
Schedule K IRS990ScheduleK
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd | Business Name Line2NameOfInterested/BusinessName/BusinessNameLine2Txt |
|---|---|---|---|---|
| Matthew Hambrick | ||||
| Board member | $15,550 | Rental of real property at FMV | 0 | |
| Katie Ostrom | ||||
| Medical Staff member | $24,660 | Rental of medical equipment at FMV | 0 | |
| Peninsula Surgical Clinic Inc | ||||
| Owned by Board member | $197,012 | Locums General Surgery fees | 0 | Todd Boling |
| Woodworth Electric | ||||
| Owned by Spouse of Board member | $118,056 | Contract electrical services | 0 | |
| Jonas Ridge | ||||
| Owned by Board member | $81,600 | Rental of medical office space at FMV | 0 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, Line 7b | The Hospital is operated by South Peninsula Hospital Inc. through a Sublease and Operating Agreement with the Kenai Peninsula Borough. In accordance with that agreement, certain key decisions must be approved by the Kenai Peninsula Borough Assembly, and the Mayor. For example, the purchase of property plant and equipment in excess of $250,000 requires Borough Assembly approval. Signing of any leases in excess of 1 year or $100,000 also requires borough approval. The issuance of tax exempt bonds backed by the revenues of the hospital require voter approval. |
| Form 990, Part VI, Section A, Line 8a | The organization attempts to document each meeting of the governing board, however due to personnel vacancies, there were a small number of meetings for which no minutes were generated. |
| Form 990, Part VI, Section A, Line 8b | the organization attempts to document each subcommittee meeting of the governing body, however due to personnel vacancies a small number of meetings occurred without minutes. |
| Form 990, Part VI, Section B, Line 11b | The 990 was prepared by the Hospital Finance Department and submitted to Administration for review. After approval of the 990 by the board of directors, it is filed. |
| Form 990, Part VI, Section B, Line 12c | Compliance with the policy was regularly monitored. |
| Form 990, Part VI, Section C, Line 19 | The Hospital makes is governing documents, 990, Form 1023, and financial statements available upon request. It also provides a financial overview to the public during it's monthly board meetings, as well as a quarterly financial overview at quarterly Borough assembly meetings. |
| Form 990, Part IX, Line 11g | Professional fees for consulting, contract staffing, locums physician, and other medical and non-medical professionals. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Kenai Peninsula Borough | ||||||||||
| 144 N Binkley St | Soldotna | AK | 99669 | 920030894 | Local area government | AK | 115 | N/A | N/A | 0 |
| South Peninsula Hospital Foundation | ||||||||||
| PO Box 2548 | Homer | AK | 99603 | 830354063 | Fundraising and Community Health Support | AK | 501c3 | public charity | N/A | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Kenai Peninsula Borough | ||
| c | $6,215,000 | Value of property tax revenues provided for the benefit of the hospital, capital reimbursements, and reimbursements for property insurance, audit fees, and professional fees. |
| Kenai Peninsula Borough | ||
| e | $16,645,000 | The Kenai Peninsula has issued certain tax exempt bonds on behalf of the Hospital for capital improvements. This amount represents the current outstanding balance on those bonds as of June 30 2018 |
| Kenai Peninsula Borough | ||
| o | $29,574 | The Hospital shared an occupational therapist with the Kenai Peninsula Borough school district. This amount represents the salaries billed to the Borough for that OT. |
| Kenai Peninsula Borough | ||
| q | $6,215,000 | The Kenai peninsula borough reimburses the hospital for certain expenses. This amount represents the total property tax revenue, capital reimbursements, and operating reimbursements for FY18. |
| Kenai Peninsula Borough | ||
| s | $6,215,000 | This is the amount of cash transferred from the Kenai Peninsula Borough to the South Peninsula Hospital service area for the use of capital improvements, and operations. |
| Kenai Peninsula Borough | ||
| k | $1 | South Peninsula Hospital Inc operates the Hospital through a sublease and operating agreement with the Kenai Peninsula Borough. Per the lease the Hospital must pay $1 per annum to the borough. |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule R, Part V, Line 1c | The Hospital receives property taxes and bond proceeds from the Kenai Peninsula Borough Service Area to assist with it's capital repairs and replacement as well as debt service. This amount represents the total received in 2018 for these purposes. |
| Schedule R, Part V, Line 1e | The Kenai Peninsula Borough acts as the loan guarantor on certain bond issuances in the event that South Peninsula Hospital Inc ceased to exist prior to retirement of that date. This amount represents the total outstanding principal on bonds as of the end of the tax year. |
| Schedule R, Part V, Line 1k | South Peninsula Hospital Inc operates the Hospital on behalf of the Kenai Peninsula Borough through a sublease and operating agreement for a cost of $1 per annum. |
| Schedule R, Part V, Line 1o | During the tax year, the Hospital shared an Occupational Therapist with the Kenai Peninsula Borough school district to serve the needs of local area residents. This amount represents the amount of payroll and travel expenses billed to the Borough during the tax year. |
| Schedule R, Part V, Line 1q | The Kenai Peninsula Borough reimbursed South Peninsula Hospital for certain organizational expenses such the annual audit, property insurance, professional fees for the community health needs assessment, capital expenses, and debt service on behalf of the hospital. This amount represents the total of those payments during the tax year. |
| Schedule R, Part V, Line 1s | The Kenai Peninsula Borough transfers to South Peninsula Hospital, or its debtors, cash from property tax revenues for use in operations, capital reimbursement, and debt service. |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | An automatic extension was filed and accepted by the IRS to allow time for completion of the audited financial report and preparation of the 990. | ExplanationTxt |