PETERSBURG MEDICAL CENTER: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- PETERSBURG MEDICAL CENTER (EIN 92-6001607)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-03-27
- IRS object ID
- 201920869349300022
- Schema version
- 2017v2.3
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-03-27T11:50:16-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3601 C STREET STE 600 | AddressLine1Txt |
| City | ANCHORAGE | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99503 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 926001607 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Petersburg Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % DORAN HAMMETT | InCareOfNm |
| Business Name Control | PETE | BusinessNameControlTxt |
| Phone | 9077724291 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 589 | AddressLine1Txt |
| City | PETERSBURG | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99833 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PHILIP HOFSTETTER | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Signature | 2019-03-25 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Nayyir Rawhani CPA | PreparerPersonNm |
| PTIN | P01772194 | PTIN |
| Phone | 9072788878 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 69.161.24.166 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 92085320190865000001 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-03-27 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 472FA6308740A6A330A20EEE82F3FBC431A8F875 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 79CA4C5E9B951742828FA09982B6E1CED73F8C27 | AtSubmissionFilingDeviceId |
| 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 | PHILIP HOFSTETTER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 589 | AddressLine1Txt |
| City | PETERSBURG | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99833 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,328,487 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.pmcak.org | WebsiteAddressTxt |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Other Organization Dsc | COMP | OtherOrganizationDsc |
| Formation | 1993 | FormationYr |
| Legal Domicile State | AK | LegalDomicileStateCd |
| Activity Or Mission | OUR MISSION IS TO PROVIDE EXCELLENT HEALTHCARE AND TO PROMOTE WELLNESS IN OUR COMMUNITY | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 161 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $542,012 | PYContributionsGrantsAmt |
| CY Contributions Grants | $707,866 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $14,964,626 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,448,752 | CYProgramServiceRevenueAmt |
| PY Investment Income | $72,036 | PYInvestmentIncomeAmt |
| CY Investment Income | $77,367 | CYInvestmentIncomeAmt |
| PY Other Revenue | $63,353 | PYOtherRevenueAmt |
| CY Other Revenue | $94,502 | CYOtherRevenueAmt |
| PY Total Revenue | $15,642,027 | PYTotalRevenueAmt |
| CY Total Revenue | $16,328,487 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,914,813 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,295,431 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,731,232 | PYOtherExpensesAmt |
| CY Other Expenses | $4,990,151 | CYOtherExpensesAmt |
| PY Total Expenses | $17,646,045 | PYTotalExpensesAmt |
| CY Total Expenses | $15,285,582 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,004,018 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,042,905 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,817,478 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,275,982 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,860,362 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,443,315 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,957,116 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,832,667 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | OUR MISSION IS TO PROVIDE EXCELLENT HEALTHCARE AND TO PROMOTE WELLNESS IN OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $2,848,355 | ExpenseAmt |
| Revenue | $4,424,676 | RevenueAmt |
| Desc | NURSING SERVICES PROVIDED IN ACUTE CARE, INTENSIVE CARE, SWINGBED, EMERGENCY ROOM, OPERATING ROOM AND HOME HEALTH SAVINGS. THESE SERVICES ARE PROVIDED IN A SEMI-REMOTE RURAL AREA OF ALASKA. ACCESS TO THE AREA IS BY AIR OR WATER ONLY. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,686,706 | ExpenseAmt |
| Revenue | $5,156,398 | RevenueAmt |
| Desc | OTHER HEALTHCARE SERVICES. THESE SERVICES ARE PROVIDED IN A SEMI-REMOTE AREA OF RURAL ALASKA. ACCESS TO THE AREA IS BY AIR OR WATER ONLY. THE SERVICES INCLUDE LABORATORY, IMAGING, AND PHYSICAL THERAPY. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,133,394 | ExpenseAmt |
| Revenue | $2,393,815 | RevenueAmt |
| Desc | CLINIC. WE PROVIDE CLINIC SERVICES TO SEMI-REMOTE AREAS OF ALASKA ACCESSIBLE BY AIR OR WATER ONLY. NURSING HOME. WE PROVIDE NURSING HOME SERVICES IN A SEMI-REMOTE AREA OF RURAL ALASKA. ACCESSIBLE BY AIR OR WATER ONLY. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,910,472 | ExpenseAmt |
| Revenue | $3,473,863 | RevenueAmt |
| Desc | LONG TERM CARE | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,910,472 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $3,473,863 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $9,578,927 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 41 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 161 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DORAN HAMMETT | PersonNm |
| Phone | 9077724291 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 589 | AddressLine1Txt |
| City | PETERSBURG | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99833 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JEROD COOK | ||||||||
| President | 2.0 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GEORGE DOYLE | ||||||||
| Vice President | 2.0 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARLENE CUSHING | ||||||||
| MEMBER | 2.0 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JIM ROBERTS | ||||||||
| Member | 2.0 | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| DARLENE WHITETHORN | ||||||||
| Member | 2.0 | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| TIM KOENEMAN | ||||||||
| Member | 2.0 | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| KATHI RIEMER | ||||||||
| Member | 2.0 | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| CINDI LAGOUDAKIS | ||||||||
| Member | 2.0 | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| PHILIP HOFSTETTER | ||||||||
| CEO - as of June 2018 | 40.0 | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| Elizabeth Woodyard | ||||||||
| CEO - Thru June 2018 | 40.0 | 0.25 | Yes (X) | $174,262 | $0 | $38,338 | ||
| Doran Hammett | ||||||||
| CFO | 40.0 | 0.25 | Yes (X) | $158,460 | $0 | $42,746 | ||
| Mark Tuccillo | ||||||||
| Physician | 40.0 | 0.0 | $234,244 | $0 | $65,580 | Yes (X) | ||
| JENNIFER HYER | ||||||||
| Physician | 40.0 | 0.0 | $206,987 | $0 | $63,867 | Yes (X) | ||
| COURTNEY HESS | ||||||||
| Physician | 40.0 | 0.0 | $202,896 | $0 | $52,522 | Yes (X) | ||
| KRISTOFOR SARGENT | ||||||||
| Physician | 40.0 | 0.0 | $201,417 | $0 | $58,358 | Yes (X) | ||
| Jennifer Bryner | ||||||||
| CNO | 40.0 | 0.0 | $139,635 | $0 | $49,050 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,317,901 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $370,461 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CPSI | |||||
| PO BOX 850309 | MOBILE | AL | 36685 | INFO. TECHNOLOGY | $289,811 |
| INNOVATIVE EMPLOYEE SOLUTIONS | |||||
| 9665 GRANITE RIDGE 420 | SAN DIEGO | CA | 92123 | AGENCY STAFFING | $170,942 |
| LONG BUILDING TECHNOLOGIES | |||||
| PO BOX 5501 | DENVER | CO | 80217 | HVAC UPGRADE | $153,550 |
| INTEGRITY MEDICAL STAFFING LLC | |||||
| PO BOX 104 | CHESHIRE | MA | 01225 | AGENCY STAFFING | $128,343 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 740709 | ATLANTA | GA | 30374 | REFERENCE LAB | $100,189 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $707,866 | GovernmentGrantsAmt |
| Total Contributions | $707,866 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICES | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $15,448,752 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,448,752 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,448,752 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $74,954 | TotalRevenueColumnAmt |
| Exclusion | $74,954 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $19,900 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $19,900 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,900 | TotalRevenueColumnAmt |
| Exclusion | $19,900 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,413 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,413 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,413 | TotalRevenueColumnAmt |
| Exclusion | $2,413 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER OPERATING REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $74,602 | TotalRevenueColumnAmt |
| Exclusion | $74,602 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $74,602 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,328,487 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,448,752 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $171,869 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $436,540 | TotalAmt |
| Program Services | $313,974 | ProgramServicesAmt |
| Management And General | $122,566 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,858,891 | TotalAmt |
| Program Services | $7,090,849 | ProgramServicesAmt |
| Management And General | $2,768,042 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,329 | TotalAmt |
| Management And General | $22,329 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $658,751 | TotalAmt |
| Management And General | $658,751 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,524 | TotalAmt |
| Management And General | $87,524 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| ADMIN & FISCAL SERVICES | $1,418,555 | $1,418,555 | |
| NURSING SERVICES | $965,087 | $184,014 | $781,073 |
| PHYSICIANS | $960,719 | $960,719 | |
| MAINTENANCE | $284,750 | $284,750 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $592,436 | TotalAmt |
| Program Services | $432,312 | ProgramServicesAmt |
| Management And General | $160,124 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,285,582 | TotalAmt |
| Program Services | $9,578,927 | ProgramServicesAmt |
| Management And General | $5,706,655 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,202,130 | BOYAmt |
| EOY | $4,103,803 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,600 | BOYAmt |
| EOY | $1,395 | 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 | $4,518,970 | BOYAmt |
| EOY | $4,475,206 | 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 | $176,974 | BOYAmt |
| EOY | $210,499 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,613 | BOYAmt |
| EOY | $118,539 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $21,265,616 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $16,907,266 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,791,789 | BOYAmt |
| EOY | $4,358,350 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,029,537 | BOYAmt |
| EOY | $2,886,868 | 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 | $3,018,865 | BOYAmt |
| EOY | $1,121,322 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,817,478 | BOYAmt |
| EOY | $17,275,982 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,169,226 | BOYAmt |
| EOY | $1,232,743 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | 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 | $0 | BOYAmt |
| EOY | $0 | 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 | $13,691,136 | BOYAmt |
| EOY | $14,210,572 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,860,362 | BOYAmt |
| EOY | $15,443,315 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$360,993 | BOYAmt |
| EOY | -$2,125,437 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,318,109 | BOYAmt |
| EOY | $3,958,104 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,957,116 | BOYAmt |
| EOY | $1,832,667 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,817,478 | BOYAmt |
| EOY | $17,275,982 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,042,905 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $113,085 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$2,280,439 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $347,944 | OtherCostOrOtherBasisAmt |
| Book Value | $347,944 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,364,462 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,706,824 | DepreciationAmt |
| Book Value | $2,657,638 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,427,883 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,075,115 | DepreciationAmt |
| Book Value | $1,352,768 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $125,327 | OtherCostOrOtherBasisAmt |
| Depreciation | $125,327 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,358,350 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEF OUTFLOW EMPLOYER CONTRIB. | $1,121,322 |
| CONSTRUCTION IN PROGRESS | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,121,322 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| PAYABLE TO FOUNDATION | $29,204 |
| CAPITAL LEASE | $400,246 |
| NET PENSION LIABILITY | $11,926,974 |
| DEFERRED INFLOW-PENSION INVEST | $1,854,148 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $14,210,572 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $16,419,243 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $113,085 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $113,085 | RevenueNotReportedAmt |
| Revenue Subtotal | $16,306,158 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $22,329 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $22,329 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $16,328,487 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $15,263,253 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $15,263,253 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $22,329 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $22,329 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $15,285,582 | TotalExpensesPerForm990Amt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 175. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 500. | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $60,115 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $60,115 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $60,115 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $60,115 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $60,115 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $60,115 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $373,247 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $4,174,720 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,514,238 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$339,518 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NONE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | PETERSBURG MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 103 FRAM ST PO BOX 589 | AddressLine1Txt |
| City | PETERSBURG | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99833 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https://www.pmcak.org/ | WebsiteAddressTxt |
| State License | GACH-006 | StateLicenseNum |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Other | NURSING HOME AND OUTPATIENT CLINIC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PETERSBURG MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.pmcak.org | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.pmcak.org | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 175. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 500. | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.pmcak.org | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.pmcak.org | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.pmcak.org | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | 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 (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B, LINE 5: | THE HOSPITAL PARTNERED WITH OTHER ENTITIES IN THE COMMUNITY WITH PARTICULAR EXPERTISE IN PUBLIC HEALTH THROUGH REGULAR CONSULTATION, EDUCATIONAL OPPORTUNITIES AND JOINT TRAINING. THESE ENTITIES CONSISTED OF THE ALASKA PUBLIC HEALTH NURSE, PETERSBURG EMS, SOUTHEAST ALASKA REGIONAL HEALTH CONSORTIUM (SEARHC) AND PETERSBURG MENTAL HEALTH. |
| PART V, SECTION B, LINE 6B: | INPUT FROM STAKEHOLDERS IN THE COMMUNITY NEEDS ASSESSMENT WAS OBTAINED BY WRITTEN SURVEYS, GROUP AND PERSONAL INTERVIEWS. PERSON/GROUPS SURVEYED: -PETERSBURG INDIAN ASSOCIATION (PIA) -WORKING AGAINST VIOLENCE FOR EVERYONE (W.A.V.E.) -PETERSBURG PARKS AND RECREATION -PETERSBURG PUBLIC SCHOOLS -PETERSBURG MINISTERIAL ASSOCIATION -PETERSBURG VOLUNTEER FIRE DEPARTMENT -PETERSBURG CANCER SUPPORT GROUP -MOUNTAINVIEW MANOR ASSISTED LIVING -SUPPORTING HEALTH AWARENESS AND RESILIENCY EDUCATION (SHARE) PROGRAM AND COALITION -BOROUGH OF PETERSBURG |
| PART V, SECTION B, LINE 11: | AGING COMMUNITY POPULATION: EDUCATION ON FALLS TO IMPOVE OUTCOMES ON FALL INCIDENTS IN THE HOME. GROW OUR PHYSICAL THERAPY DEPARTMENT AS WELL AS PROVIDE PHYSICAL AND OCCUPATIONAL THERAPY IN AN OUTPATIENT SETTING. NURSING SHORTAGE: PARTNER WITH THE UNIVERITY OF ALASKA TO PROVIDE RN TRAINING PROGRAM IN PETERSBURG. ADULT OBESITY RATES: PROVIDE EDUCATION ON HEALTHY EATING TO THE PUBLIC AS WELL AS EMPLOYEES WITH THE USE OF STAFF DIETICIANS. PARTNER WITH OTHER AGENCIES TO PROMOTE PHYSICAL ACTIVITY. |
| PART V, SECTION B, LINE 13H: | FAMILY SIZE IS ANOTHER ELIGIBILITY CRITERIA THAT IS CONSIDERED. |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE % OF FINANCIAL ASSISTANCE IS THE AMOUNT OF FINANCIAL ASSISTANCE AT COST $60,115 DIVIDED BY TOTAL EXPENSES OF $15,263,253. |
| PART III, LINE 2: | THE AMOUNT OF BAD DEBT EXPENSE IS THE NET DOLLAR AMOUNT OF PATIENT CHARGES TURNED OVER TO COLLECTION AGENCIES DURING THE YEAR. |
| PART III, LINE 4: | THERE IS NO FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS DESCRIBING BAD DEBT EXPENSE. |
| PART III, LINE 9B: | PETERSBURG MEDICAL CENTER HAS FINANCIAL ASSISTANCE GUIDELINES FOR GUARANTORS WITH LIMITED MEANS TO PAY. FINANCIAL SERVICE REPRESENTATIVES WILL SPECIFICALLY NOTIFY SELF PAY GUARANTORS OF THE EXISTENCE OF THE FINANCIAL ASSISTANCE GUIDELINES IN ANY INSTANCE WHERE THE GUARANTOR STATES OR IMPLIES A LIMITED MEANS TO PAY ACCOUNT BALANCES. |
| PART VI, LINE 2: NEEDS ASSESSMENT | The organization's board maintains an awareness of the health care needs of the community and attempts to provide for those needs while remaining financially viable. |
| PART VI, LINE 3: PATIENT EDUCATION OF ELIBIBILITY FOR ASSITANCE | THE ORGANIZATION'S STAFF INFORMS ANY PATIENT FOR WHOM THEY BECOME AWARE OF POSSIBLE ELGIBILITY FOR FINANCIAL ASSISTANCE OF THE EXISTANCE OF SUCH ASSISTANCE. THE SAME APPLIES TO POSSIBLE FEDERAL AND STATE ASSISTANCE. |
| PART VI, LINE 4: COMMUNITY INFORMATION | The organization operates on an island off the southeast coast of Alaska. The island is accessed only by air or water. The core population is 3,000. The primary industry is fishing. A once thriving timber industry has now ceased to exist. |
| PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH | The organization operates under the direction of a board of locally elected citizens. The board is not compensated. They serve because they want to have the best possible health services within the community given the limited resources. The hospital conducts regular health fairs and distributes relevant health information to the community to keep its residents informed of the services available. Surplus funds are used to continually upgrade hospital equipment and facilities. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt |
|---|---|---|---|---|
| Elizabeth Woodyard | ||||
| CEO - Thru June 2018 | $174,262 | $38,338 | $212,600 | |
| Doran Hammett | ||||
| CFO | $158,460 | $34,861 | $201,206 | $7,885 |
| Mark Tuccillo | ||||
| Physician | $234,244 | $51,534 | $299,824 | $14,046 |
| JENNIFER HYER | ||||
| Physician | $206,987 | $45,537 | $270,854 | $18,330 |
| COURTNEY HESS | ||||
| Physician | $202,896 | $44,637 | $255,418 | $7,885 |
| KRISTOFOR SARGENT | ||||
| Physician | $201,417 | $44,312 | $259,775 | $14,046 |
| Jennifer Bryner | ||||
| CNO | $139,635 | $30,720 | $188,685 | $18,330 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, ITEM K, OTHER ORGANIZATION TYPE: | COMPONENT UNIT OF PETERSBURG BOROUGH, AK |
| FORM 990, PART III, LINE 4D, OTHER PROGRAM SERVICES | NURSING HOME. WE PROVIDE NURSING HOME SERVICES IN A SEMI-REMOTE AREA OF RURAL ALASKA. ACCESS TO THE AREA IS BY AIR OR WATER ONLY. |
| FORM 990, PART VI, SECTION B, LINE 11: | THE CHIEF FINANCIAL OFFICER AND THE CHIEF EXECUTIVE OFFICER WILL EACH REVIEW THE COMPLETED RETURN SEPARATELY AND THEN RESOLVE ANY ISSUES WHICH ARISE PRIOR TO FILING THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 15: | THE CHIEF EXECUTIVE OFFICERS SALARY IS DETERMINED BY THE BOARD OF DIRECTORS AFTER REVIEWING SALARIES FOR SIMILAR POSITIONS IN COMPARABLE ORGANIZATIONS OF THE HEALTHCARE INDUSTRY. A SALARY HISTORY OF THE POSITION IS PART OF THE REVIEW. THE COMPENSATION REVIEW IS MADE IN CONJUNCTION WITH THE CEOS ANNUAL EVALUATION. |
| FORM 990, PART VI, SECTION C, LINE 19: | PETERSBURG MEDICAL CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 19: | In 2018, the Borough adopted the provisions of GASB Statement No. 75 Accounting and Financial Reporting for Postemployment Benefits Other Than Pensions, which, among other accounting and reporting criteria, requires the Borough to recognize its proportional share of the Net OPEB Liability (and related deferred inflows of resources and deferred outflows of resources), as of the beginning of the Boroughs fiscal year. As a result of the implementation of this statement, the Borough has recorded an opening balance adjustment to reflect opening balance OPEB liabilities and related accounts and to decrease opening net position BY $2,280,439. |
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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PETERSBURG MEDICAL CENTER FND | ||||||||||
| PO BOX 589 | PETERSBURG | AK | 99833 | 920134279 | SEE PAGE 5 | AK | 501(C)(3) | 509(A)(3) | PETERSBURG | Yes (true) |
| Petersburg Borough | ||||||||||
| PO BOX 329 | PETERSBURG | AK | 99833 | 926000142 | LOCAL GOV | AK | SEC 115 | N/A | NA | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART II, LINE 1: | FormAndLineReferenceDesc |
| Explanation | B: CARRY OUT FUNDRAISING & CHARITABLE ACTIVITIES FOR PETERSBURG MEDICAL CENTER. | ExplanationTxt |