2019-05-10T12:23:41-07:00 2018-06-30 990 2017-07-01 920037099 SOUTH PENINSULA HOSPITAL INC SOUT 9072358101 4300 Bartlett Street Homer AK 99603 Lane Chesley Board Treasurer 9072358101 2019-05-10 216.67.102.194 2017 2019-02-21 02:37:17Z Joseph Woodin 4300 Bartlett Street Homer AK 99603 79749587 0 X https://www.sphosp.org/ X 1969 AK South Peninsula Hospital promotes community health and wellness by providing personalized, high-quality, locally coordinated healthcare. 10 7 539 25 0 0 4418819 4518929 62029622 73059515 77953 105172 0 2065971 66526394 79749587 0 45550 0 0 39610657 47361002 0 0 0 26012760 28334081 65623417 75740633 902977 4008954 79565579 82986015 35047288 34458770 44518291 48527245 South Peninsula Hospital promotes community health and wellness by providing personalized, high-quality, locally coordinated healthcare. 0 0 36974966 0 52963565 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. 13766945 0 10035381 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. 6677792 0 9044385 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. 1585503 0 1016184 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. 1585503 0 1016184 59005206 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 121 0 1 539 1 0 0 0 0 0 0 0 0 0 0 X 10 7 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 0 0 0 AK X X SPH Finance Department 9072350324 4300 Bartlett Street Homer AK 99603 Bernadette Wilson Secretary 4 0 X 1100 0 0 Julie Woodworth Director 2 0 X 1200 0 0 Vickey Hodnik Director 2 0 X 1200 0 0 Matthew Hambrick Director 2 0 X 8000 0 0 Thomas Clark Vice President 5 0 X 1200 0 0 David Groesbeck President 10 0 X 1200 0 0 Lane Chesley Treasurer 5 0 X 1200 0 0 Keri-Ann Baker Director 2 0 X 0 0 0 Walter Partridge Director 2 0 X 0 0 0 Todd Boling Director and General Surgeon 2 0 X 266164 0 0 Matthew North Former Director 2 0 X X 1200 0 0 Susan Drathman Former Director 2 0 X 1200 0 0 Robert Letson Former CEO 50 X X 287361 0 5000 Holly Torres Former CFO 50 0 X 169342 0 4892 Lee Yale Chief Nursing Officer 50 0 X 50500 0 0 Joseph Woodin Chief Executive Officer 50 X 0 0 0 Melinda Von Kilpatrick Former CNO 50 0 X 72748 0 0 Brent Adcox Orthopaedic Surgeon 40 0 X 1216397 0 5000 Edson Knapp Radiologist 40 0 X 783265 0 7600 Gregory Hough General Surgeon 40 0 X 760445 0 5000 Brian Miller CRNA 40 0 X 352866 0 5000 Kathryn Ostrom OB/GYN Physician 40 0 X 344656 0 0 4321244 0 32492 62 1 1 1 Peak Imaging 4438 Towne Heights Ln Homer AK 99603 Radiology Services 684623 Raymond Fowler 40914 Crested Crane St Homer AK 99603 Anesthesia Services 660680 Alaska Urology LLC PO Box 200754 Anchorage AK 99801 Urology Physician Services 366845 Robert Lee Gear MD 6817 North 57th Place Paradise Valley AZ 85253 Emergency Room Physician 327790 Paula Godfrey PO Box 3194 Homer AK 99603 Emergency Room Physician 311000 15 0 0 0 0 4498923 20006 0 4518929 Hospital 622000 52963565 52963565 0 0 Physician Offices 621110 10035381 10035381 0 0 Long Term Care 623110 9044385 9044385 0 0 Home Health Care 621610 1016184 1016184 0 0 0 0 0 0 73059515 117623 0 0 117623 0 0 0 0 0 0 0 0 0 0 0 -12451 0 0 0 -12451 -12451 0 0 -12451 0 USAC Internet Subsidies 900099 1604520 1604520 0 0 Cafeteria and other revenue 900099 276165 276165 0 0 Other operating revenue 900099 185286 185286 0 0 0 0 0 0 2065971 79749587 75125486 0 105172 X 45550 45550 0 0 0 0 0 0 1519604 759802 759802 0 0 0 0 0 31368392 24781030 6587362 0 2118153 1673341 444812 0 10212280 7230466 2981814 0 2142573 1600706 541867 0 0 0 0 0 170916 0 170916 0 85647 0 85647 0 0 0 0 0 0 0 0 0 0 0 7526694 5988685 1538009 0 74182 37091 37091 0 7512172 5977130 1535042 0 3320404 2641911 678493 0 0 0 0 0 1655445 1317170 338275 0 123613 120276 3337 0 0 0 0 0 231018 183812 47206 0 546529 527838 18691 0 0 0 0 0 3072224 2765002 307222 0 1044346 991578 52768 0 2970891 2363818 607073 0 75740633 59005206 16735427 0 2179 2179 18352772 19601347 0 0 14449174 16215774 0 0 0 0 0 0 1825791 1700305 604764 598655 90135040 47783640 41722462 42351400 0 0 0 0 0 0 0 0 2608437 2516355 79565579 82986015 13190063 16652193 0 0 1209867 943503 18537061 16773247 0 0 0 0 156080 89827 0 0 1954217 35047288 34458770 X 44493005 48501959 25286 25286 0 0 44518291 48527245 79565579 82986015 4008954 0 0 0 0 0 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 5035 5035 0 Schedule C, Part II-B, Line 1 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. 0 188508 188508 0 61872854 25939651 35933203 0 140475 71325 69150 0 24270201 19733725 4536476 0 3663002 2038939 1624063 42351400 79749587 0 0 0 0 0 79749587 0 0 0 79749587 75740633 0 0 0 0 0 75740633 0 0 0 75740633 1 1 X 1 X 1 X 1 1 1 0 0 1 0 665758 0 665758 0.0089 1 0 22347337 20032902 2314435 0.031 0 0 0 0 0 0 2 0 23013095 20032902 2980193 0.0399 49 525 327396 0 327396 0.0044 4 53 1596 0 1596 0 18 48226 26430319 18983126 7447193 0.0997 0 0 0 0 0 0 26 0 12194 0 12194 0.0002 97 48804 26771505 18983126 7788379 0.1043 99 48804 49784600 39016028 10768572 0.1442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 5110 0 5110 0.0001 0 0 0 0 0 0 0 0 0 0 0 0 8 0 5110 0 5110 0.0001 0 940767 705575 17825914 24547188 -6721274 X 0 1 1 South Peninsula Hospital 4300 Bartlett St Homer AK 99603 www.sphosp.org GACH-010 X X X X South Peninsula Hospital 1 0 0 1 X X X X X X X X 16 1 0 0 1 X www.sphosp.org/about-sph/health-needs-assessment/ X www.mappofskp.net X 1 17 1 www.sphosp.org/about-sph/health-needs-assessment/ 0 0 1 X 100 300 X X X X X 1 1 X X X 1 X www.sphosp.org/wp-content/uploads/2018/05/HW-074-Patient-Financial-Assistance.pdf X www.sphosp.org/wp-content/uploads/2018/02/Copy-of-2018-FAP-Application.pdf X www.sphosp.org/wp-content/uploads/2018/08/Finnacial-Assistance-brochure.pdf X X X X X 1 X 0 X X X X 1 0 0 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 7 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 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. 1 Hospice of Homer PO BOX 4174 HOMER AK 99603 920115943 501c3 26300 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 19250 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. 2 0 Schedule I, Part I, Line 2 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. X X X 0 1 X X X 1 1 0 0 0 0 0 0 0 Robert Letson Former CEO 156577 0 0 0 474387 0 5080 0 0 0 636044 0 0 0 Holly Torres Former CFO 248362 0 10000 0 0 0 7125 0 0 0 265487 0 0 0 Lee Yale Chief Nursing Officer 143321 0 10000 0 0 0 0 0 0 0 153321 0 0 0 Joseph Woodin Chief Executive Officer 124152 0 0 0 1321 0 1077 0 0 0 126550 0 0 0 Melinda Von Kilpatrick Former CNO 103378 0 -2415 0 9104 0 0 0 0 0 110067 0 0 0 Brent Adcox Orthopaedic Surgeon 947744 0 325000 0 18500 0 5000 0 0 0 1296244 0 0 0 Edson Knapp Radiologist 789278 0 0 0 19625 0 5000 0 1300 0 815203 0 0 0 Gregory Hough General Surgeon 713168 0 83122 0 17825 0 14039 0 0 0 828154 0 0 0 Brian Miller CRNA 413448 0 0 0 17475 0 5000 0 0 0 435923 0 0 0 Kathryn Ostrom OB/GYN Physician 397678 0 0 0 0 0 0 0 0 0 397678 0 0 0 Todd Boling Director and General Surgeon 278612 0 0 0 0 0 0 0 0 0 278612 0 0 0 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. A Kenai Peninsula Borough 2011 Refunding Bonds 920030894 2011-09-15 3285000 Refunding bonds 0 0 0 B Kenai Peninsula Borough 2015 Refunding Bonds 920030894 2015-06-04 8655000 Refunding Bonds 0 0 0 C Kenai Peninsula Borough 2016 Refunding Bonds 920030894 2016-11-03 2660000 Refunding Bonds 0 0 0 D Kenai Peninsula Borough Revenue Bonds 920030894 2017-04-27 4500000 Hospital Expansion and Maintenance 0 0 0 A 2110000 0 3802589 0 0 0 0 0 0 0 0 0 2009 0 1 1 1 B 110000 0 9884491 0 0 0 0 0 0 0 0 0 2009 0 1 1 1 C 20000 0 3050412 0 0 0 0 0 0 0 0 0 2009 0 1 1 1 D 215000 0 4795700 0 62086 0 23647 0 0 4724721 0 109418 2018 0 0 0 1 A 0 0 0 0 0 0 0 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 1 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 1 0 0 0 0 C 0 0 0 0 0 0 0 0 0 D 0 0 0 0 1 0 0 0 0 A 1 B 1 C 1 D 1 Matthew Hambrick Board member 15550 Rental of real property at FMV 0 Katie Ostrom Medical Staff member 24660 Rental of medical equipment at FMV 0 Peninsula Surgical Clinic Inc Todd Boling Owned by Board member 197012 Locums General Surgery fees 0 Woodworth Electric Owned by Spouse of Board member 118056 Contract electrical services 0 Jonas Ridge Owned by Board member 81600 Rental of medical office space at FMV 0 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. 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 0 0 1 0 1 0 0 0 0 0 1 0 0 0 1 0 1 0 1 Kenai Peninsula Borough c 6215000 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 16645000 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 29574 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 6215000 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 6215000 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. 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. 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.