FOUNDATION HEALTH LLC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- FOUNDATION HEALTH LLC (EIN 81-3021580)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-15
- IRS object ID
- 201813199349318186
- 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 | 2018-11-15T17:59:33-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 911194016 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARK NUBER PS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10900 NE 4TH STREET SUITE 1400 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 813021580 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FOUNDATION HEALTH LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FOUN | BusinessNameControlTxt |
| Phone | 9074585550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71396 | AddressLine1Txt |
| City | FAIRBANKS | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99707 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHEN P LESLIE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9074585550 | PhoneNum |
| Signature | 2018-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SARA ELIZABETH J HYRE | PreparerPersonNm |
| PTIN | P00235495 | PTIN |
| Phone | 4254544919 | PhoneNum |
| Preparation | 2018-11-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 65.158.230.194 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-15 | IPDt |
| IP Tm | 14:14:13 | IPTm |
| IP Timezone | PS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 2DE068ACBFA10A31F139242116409E8904B6E6F4 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 00A7300E43E73FAEAEBEB9E0895558C2993B7DE4 | 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) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Principal Officer | STEPHEN P LESLIE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71396 | AddressLine1Txt |
| City | FAIRBANKS | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99707 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $285,727,395 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FOUNDATIONHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Other Organization Dsc | LLC | OtherOrganizationDsc |
| Formation | 2016 | FormationYr |
| Legal Domicile State | AK | LegalDomicileStateCd |
| Activity Or Mission | COMPASSIONATE HEALTH CARE FOR EVERY CHAPTER IN YOUR LIFE STORY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 2085 | TotalEmployeeCnt |
| Total Volunteers | 126 | TotalVolunteersCnt |
| Total Gross UBI | $1,709,895 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $597,754 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $246,726 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $275,244,830 | CYProgramServiceRevenueAmt |
| CY Investment Income | $6,491,823 | CYInvestmentIncomeAmt |
| CY Other Revenue | $3,744,016 | CYOtherRevenueAmt |
| CY Total Revenue | $285,727,395 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $148,779,423 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $132,877,487 | CYOtherExpensesAmt |
| CY Total Expenses | $281,656,910 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | $4,070,485 | CYRevenuesLessExpensesAmt |
| Total Assets EOY | $91,369,723 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $21,726,714 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $69,643,009 | NetAssetsOrFundBalancesEOYAmt |
| Mission | COMPASSIONATE HEALTH CARE FOR EVERY CHAPTER IN YOUR LIFE STORY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $231,538,784 | ExpenseAmt |
| Revenue | $273,551,005 | RevenueAmt |
| Desc | FOUNDATION HEALTH LLC OWNS AND OPERATES FAIRBANKS MEMORIAL HOSPITAL (HOSPITAL), DENALI CENTER (HOME), AND TANANA VALLEY CLINIC (CLINIC). THE HOSPITAL IS A GENERAL ACUTE, SOLE COMMUNITY, 152 BED FACILITY. THE HOSPITAL SERVES PATIENTS FROM FAIRBANKS AND THROUGHOUT THE INTERIOR OF ALASKA PROVIDING INPATIENT CARE, EMERGENCY CARE AND A BROAD ARRAY OF OUTPATIENT MEDICAL SERVICES. THE HOME IS A 90 BED SKILLED NURSING CARE HOME THAT PROVIDES POST ACUTE CARE FOR SHORT TERM PATIENTS, AS WELL AS LONG TERM CARE FOR OTHER PATIENTS. THE CLINIC IS A MULTI-SPECIALTY CLINIC THAT OFFERS 15 MEDICAL SPECIALITIES AND OPERATES A WALK-IN CLINIC WITH AFTER HOURS SERVICES. THE HOSPITAL SERVED 47,338 PATIENTS IN 2017 , INCLUDING 1,111 BABIES DELIVERED. THE HOME SERVED 203 INDIVIDUALS AND THE CLINIC PROVIDED ACCESS TO CARE FOR 40,838 PEOPLE. | Desc |
| Total Program Service Expenses | $231,538,784 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| 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 | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln 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 | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 144 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 2085 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | AK | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHEN LESLIE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9074583310 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1650 COWLES STREET | AddressLine1Txt |
| City | FAIRBANKS | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99701 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JEFF COOK | |||||||||
| CHAIR | 1.00 | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| GARY RODERICK | |||||||||
| VICE CHAIR | 1.00 | 1.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ROGER FLOERCHINGER | |||||||||
| TREASURER | 0.30 | 1.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOE FAULHABER | |||||||||
| SECRETARY | 1.30 | 1.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SCOTT BELL | |||||||||
| BOARD MEMBER | 0.60 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KAREN PERDUE | |||||||||
| BOARD MEMBER | 1.20 | 0.70 | Yes (X) | $0 | $0 | $0 | |||
| BILL VIVLAMORE | |||||||||
| BOARD MEMBER | 0.40 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RICHARD HATTAN | |||||||||
| BOARD MEMBER | 0.60 | 0.40 | Yes (X) | $0 | $0 | $0 | |||
| STEVE FRANK | |||||||||
| BOARD MEMBER | 0.20 | 0.40 | Yes (X) | $0 | $0 | $0 | |||
| MARK KOWAL MD | |||||||||
| BOARD MEMBER | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| LAURA BRUNNER MD | |||||||||
| BOARD MEMBER | 40.00 | 0.00 | Yes (X) | $298,484 | $0 | $6,956 | |||
| TERI KISS RN | |||||||||
| BOARD MEMBER | 40.00 | 0.00 | Yes (X) | $149,895 | $0 | $6,248 | |||
| CLAY TRIPLEHORN MD | |||||||||
| BOARD MEMBER | 40.00 | 0.20 | Yes (X) | $347,762 | $0 | $40,533 | |||
| GREGORY L JOHNSON | |||||||||
| CEO THRU 12/17 | 40.00 | 0.00 | Yes (X) | Yes (X) | $428,862 | $0 | $21,714 | ||
| JIM L LYNCH | |||||||||
| COO/CEO BEG. 12/17 | 40.00 | 0.00 | Yes (X) | $288,288 | $0 | $14,552 | |||
| STEPHEN P LESLIE | |||||||||
| CFO | 40.00 | 0.00 | Yes (X) | $203,105 | $0 | $9,621 | |||
| JOHN E COTTER | |||||||||
| ANCILLARY SERVICES DIRECTOR | 40.00 | 0.00 | $186,693 | $0 | $10,577 | Yes (X) | |||
| DANNY R ROBINETTE | |||||||||
| CMO | 40.00 | 0.00 | $367,040 | $0 | $9,018 | Yes (X) | |||
| KARL H SANFORD | |||||||||
| ASSOC. ADMIN. | 40.00 | 0.00 | $208,747 | $0 | $11,788 | Yes (X) | |||
| CLINT BROOKS | |||||||||
| ASSOC. ADMIN. | 40.00 | 0.00 | $189,747 | $0 | $6,523 | Yes (X) | |||
| KAREN M JUSTIN-TANNER | |||||||||
| CNO | 40.00 | 0.00 | $173,529 | $0 | $2,936 | Yes (X) | |||
| JOSHUA L BURRILL | |||||||||
| COMPLIANCE OFFICER | 40.00 | 0.00 | $182,040 | $0 | $543 | Yes (X) | |||
| SHELLEY D EBENAL | |||||||||
| EXECUTIVE DIRECTOR GFCHF | 0.00 | 40.00 | $233,202 | $0 | $44,310 | Yes (X) | |||
| ROMEL C WRENN | |||||||||
| PHYSICIAN MANAGER | 40.00 | 0.00 | $1,034,656 | $0 | $15,864 | Yes (X) | |||
| CARSON S WEBB | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,252,081 | $0 | $17,276 | Yes (X) | |||
| MICHAEL D SWENSON | |||||||||
| PHYSICIAN MANAGER | 40.00 | 0.00 | $443,833 | $0 | $17,664 | Yes (X) | |||
| VANESSA A VENEZIA | |||||||||
| PHYSICIAN MANAGER | 40.00 | 0.00 | $425,650 | $0 | $21,596 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $6,413,614 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $257,719 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 125 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CROSS COUNTRY STAFFING INC | |||||
| LA LOCKBOX FILE 50941 | LOS ANGELES | CA | 90074 | MEDICAL STAFFING | $10,326,284 |
| INFOR US INC | |||||
| NW 7418 PO BOX 1450 | MINNEAPOLIS | MN | 55485 | PROGRAM SERVICES AND FEES | $1,138,577 |
| MAYO COLLABORATIVE SVCS INC | |||||
| PO BOX 9146 | MINNEAPOLIS | MN | 55480 | PHYICIANS REFERENCE SERVICES | $1,104,204 |
| MED DATA INC | |||||
| PO BOX 639190 | CINCINNATI | OH | 45263 | MEDICAL BILLING AGENCY | $1,015,588 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 75397 | PHYSICIAN FEES | $862,629 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 45 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $127,930 | GovernmentGrantsAmt |
| All Other Contributions | $118,796 | AllOtherContributionsAmt |
| Total Contributions | $246,726 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| OUTPATIENT REVENUE | 622110 | $124,418,332 | $122,750,624 | $1,667,708 |
| INPATIENT REVENUE | 621110 | $82,037,812 | $82,037,812 | |
| CLINIC | 621111 | $39,960,866 | $39,960,866 | |
| NURSING HOME | 623110 | $20,086,355 | $20,086,355 | |
| PHARMACY | 446110 | $4,169,368 | $4,131,068 | $38,300 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,572,097 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,572,097 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $275,244,830 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,482,765 | TotalRevenueColumnAmt |
| Exclusion | $6,482,765 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $368,249 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $368,249 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $368,249 | TotalRevenueColumnAmt |
| Exclusion | $368,249 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $9,058 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $9,058 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,058 | TotalRevenueColumnAmt |
| Exclusion | $9,058 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA/MEALS | 722514 | $2,421,736 | $2,421,736 |
| DAY CARE CENTER | 624410 | $776,983 | $776,983 |
| MDA MGMT FEES | 900099 | $84,000 | $84,000 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $93,048 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,183 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $3,887 | UnrelatedBusinessRevenueAmt |
| Exclusion | $76,978 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,375,767 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $285,727,395 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $273,551,005 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,709,895 | UnrelatedBusinessRevenueAmt |
| Exclusion | $10,219,769 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,658,436 | TotalAmt |
| Program Services | $963,104 | ProgramServicesAmt |
| Management And General | $1,695,332 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,796,517 | TotalAmt |
| Program Services | $95,671,572 | ProgramServicesAmt |
| Management And General | $22,124,945 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,799,870 | TotalAmt |
| Program Services | $2,261,362 | ProgramServicesAmt |
| Management And General | $538,508 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,089,337 | TotalAmt |
| Program Services | $16,625,562 | ProgramServicesAmt |
| Management And General | $463,775 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,435,263 | TotalAmt |
| Program Services | $6,676,574 | ProgramServicesAmt |
| Management And General | $1,758,689 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,355 | TotalAmt |
| Program Services | $22,093 | ProgramServicesAmt |
| Management And General | $222,262 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,162 | TotalAmt |
| Management And General | $29,162 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,149 | TotalAmt |
| Management And General | $67,149 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,908,501 | TotalAmt |
| Program Services | $25,641,942 | ProgramServicesAmt |
| Management And General | $5,266,559 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $772,346 | TotalAmt |
| Management And General | $772,346 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,164,025 | TotalAmt |
| Program Services | $1,656,957 | ProgramServicesAmt |
| Management And General | $1,507,068 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,156,078 | TotalAmt |
| Program Services | $4,352,945 | ProgramServicesAmt |
| Management And General | $1,803,133 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,797,301 | TotalAmt |
| Program Services | $34,392,915 | ProgramServicesAmt |
| Management And General | $9,404,386 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $417,108 | TotalAmt |
| Program Services | $246,522 | ProgramServicesAmt |
| Management And General | $170,586 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,616 | TotalAmt |
| Program Services | $44,261 | ProgramServicesAmt |
| Management And General | $70,355 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $254,216 | TotalAmt |
| Program Services | $189,858 | ProgramServicesAmt |
| Management And General | $64,358 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,178,132 | TotalAmt |
| Program Services | $902,522 | ProgramServicesAmt |
| Management And General | $275,610 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $20,039,927 | $20,035,870 | $4,057 |
| PHARMACEUTICAL SUPPLIES | $9,232,581 | $9,115,428 | $117,153 |
| REPAIR AND MAINTENANCE | $3,527,238 | $3,517,038 | $10,200 |
| SUBSIDY EXPENSE | $185,265 | $185,265 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,789,487 | TotalAmt |
| Program Services | $9,036,994 | ProgramServicesAmt |
| Management And General | $3,752,493 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $281,656,910 | TotalAmt |
| Program Services | $231,538,784 | ProgramServicesAmt |
| Management And General | $50,118,126 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $16,932,451 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $64,380,274 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,022,539 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,980,567 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $488,948 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $176,700 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $312,248 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $741,644 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $91,369,723 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $21,126,714 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $600,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $21,726,714 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $69,643,009 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $69,643,009 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $91,369,723 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,070,485 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $65,572,524 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $67,149 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $67,149 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | FOUNDATION HEALTH (FH) ENGAGED AN INDEPENDENT CONTRACTOR TO PROVIDE GOVERNMENT RELATIONS AND LOBBYING CONSULTING SERVICES. THE CONTRACTOR WORKED WITH THE ALASKA STATE LEGISLATURE AND GOVERNMENT ON COMPLEX ISSUES RELATED TO FH'S CHARITABLE MISSION IN 2017. | ExplanationTxt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $488,948 | OtherCostOrOtherBasisAmt |
| Depreciation | $176,700 | DepreciationAmt |
| Book Value | $312,248 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $312,248 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | Desc |
| Amt | $600,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $600,000 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $285,643,395 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $285,643,395 | RevenueSubtotalAmt |
| Other Revenues Not Included | $84,000 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $84,000 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $285,727,395 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $281,572,910 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$84,000 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$84,000 | ExpensesNotReportedAmt |
| Expenses Subtotal | $281,656,910 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $281,656,910 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | MDA MGMT FEES NETTED WITH EXPENSE FOR FS PURPOSES 84,000. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | MDA MGMT FEE REVENUE REPORTED ON PART VIII -84,000. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 350.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,312,424 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,312,424 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00470 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $63,615,892 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $49,687,904 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,927,988 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04950 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $64,928,316 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $49,687,904 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,240,412 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05420 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $102,331 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $102,331 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $161,242 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $161,242 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $217,656 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $217,656 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $481,229 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $481,229 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $65,409,545 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $49,687,904 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,721,641 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05600 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,700 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,700 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,879 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,879 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,579 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $13,579 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $17,247,562 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $51,226,071 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $57,071,661 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$5,845,590 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIRBANKS MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1650 COWLES STREET | AddressLine1Txt |
| City | FAIRBANKS | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://WWW.FOUNDATIONHEALTH.ORG/FMH | WebsiteAddressTxt |
| State License | GACH-004 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room Other | Yes (X) | EmergencyRoomOtherInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIRBANKS MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (1) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 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 | HTTPS://WWW.FOUNDATIONHEALTH.ORG/FMH/ABOUT_FMH/COMMUNITY_HEALTH_DOCS/FAIRBA | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | 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 | 350.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.FOUNDATIONHEALTH.ORG/FMH/PATIENTS__VISITORS/FINANCIAL_SERVICES/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.FOUNDATIONHEALTH.ORG/FMH/PATIENTS__VISITORS/FINANCIAL_SERVICES/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.FOUNDATIONHEALTH.ORG/FMH/PATIENTS__VISITORS/FINANCIAL_SERVICES/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FAIRBANKS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: THE CHNA WAS CONDUCTED IN 2016. THE BANNER HEALTH CHNA STEERING COMMITTEE WAS FORMED, COMMISSIONED TO GUIDE THE CHNA PROCESS, AND WAS COMPRISED OF PROFESSIONALS FROM VARIOUS DISCIPLINES ACROSS THE ORGANIZATION. THE LIST OF STEERING COMMITTEE MEMBERS IS IN THE APPENDIX OF THE REPORT (URL INCLUDED IN 7.A.) BEGINNING IN 2016 THE COMMITTEE CONDUCTED AN ASSESSMENT OF THE HEALTH NEEDS OF RESIDENTS OF THE FAIRBANKS NORTH STAR BOROUGH, ALASKA AS WELL AS THOSE IN ITS PRIMARY SERVICE AREA. THE CHNA PROCESS UNDERTAKEN WAS CONDUCTED IN COMPLIANCE WITH FEDERAL REQUIREMENTS. FMH LEADERSHIP TEAM CREATED A COMMUNITY ADVISORY COUNCIL (CAC) OF COMMUNITY LEADERS THAT REPRESENTED THE UNDERSERVED, UNINSURED, AND MINORITY POPULATIONS. PARTICIPANTS WERE IDENTIFIED BASED ON THEIR ROLE IN PUBLIC HEALTH REALM OF THE HOSPITAL'S SURROUNDING COMMUNITY. EMPHASIS WAS PLACED ON IDENTIFYING POPULATIONS WITHIN THE SERVICE AREA THAT ARE CONSIDERED MINORITY AND/OR UNDERSERVED. EACH PARTICIPANT IS VESTED IN THE OVERALL HEALTH OF THE COMMUNITY AND BROUGHT PERSPECTIVE WITH REGARDS TO POPULATION'S HEALTH NEEDS. THE CAC MET OVER A PERIOD OF SEVERAL WEEKS TO REVIEW THE CURRENT HEALTH OUTCOMES DATA AND HEALTH FACTORS FOR THE AREA AND TO STUDY WRITTEN AND FOCUS GROUPS AS WELL AS INPUT SINCE THE PREVIOUS CHNA. RECOMMENDATIONS FOR PRIORITIZATION OF NEEDS CAME FROM THIS CAC AS A RESULT OF ALIGNING ANY DEMONSTRATED WORSENING TRENDS IN PRIMARY AND SECONDARY DATA FOR HEALTH OUTCOMES FOR THE AREA, IDENTIFICATION OF APPARENT HEALTH DISPARITIES, AND OTHER FACTORS OF CONCERN TO THE MEMBERS OF FOCUS GROUPS. THE CAC MEMBERSHIP IS LISTED IN THE REPORT (URL IN 7.A.) AND THEY REPRESENTED ORGANIZATIONS INCLUDING: FAIRBANKS NATIVE ASSOCIATION, TANANA CHIEFS CONFERENCE, FAIRBANKS NORTH STAR BOROUGH SCHOOL DISTRICT, BOROUGH ASSEMBLY, RAVEN LANDING (RETIREMENT COMMUNITY), FAIRBANKS RESCUE MISSION, FAIRBANKS RESOURCE AGENCY (DISABLED), CITY COUNCIL, INTERIOR COMMUNITY HEALTH (LOW INCOME), FAIRBANKS SENIOR CENTER, ALASKA STATE TROOPERS, FIRE AND RESCUE, AND REGIONAL COMMUNITY HEALTH. |
| FAIRBANKS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 2: THE HOSPITAL, FAIRBANKS MEMORIAL HOSPITAL (FMH), WAS PREVIOUSLY OPERATED BY BANNER HEALTH THROUGH AN OPERATING LEASE WITH THE GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION (GFCHF) UP UNTIL 12/31/16 WHEN THE LEASE WAS TERMINATED. EFFECTIVE 1/1/17, FMH IS OPERATED BY FOUNDATION HEALTH, A NEWLY FORMED ENTITY OWNED BY THE GFCHF. FOUNDATION HEALTH APPLIED FOR AND RECEIVED TAX EXEMPT STATUS AS OF 1/1/17. IN CONUNCTION WITH THE REORGANIZATION, THE FACILITY RECEIVED A NEW STATE LICENSE NUMBER. |
| FAIRBANKS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: PRIORITY 1) BEHAVIORAL HEALTH AND SUBSTANCE ABUSE - ADDRESSED INTERNALLY WITH ADDITIONAL PSYCHIATRIC AND SOCIAL WORK STAFF RESOURCES TO THE EMERGENCY DEPARTMENT. WITHIN THE COMMUNITY, FMH PROVIDED SUPPORT TO HELP ESTABLISH A COMMUNITY SOBERING CENTER, CONTINUES TO SUPPORT THE COMMUNITY SERVICE PATROL, AND CONTRIBUTES TO LEADERSHIP WITHIN A COMMUNITY COALITION FOR IMPROVEMENT IN BEHAVIORAL HEALTH ACCESS TO CARE. CONTRIBUTES LEADERSHIP TO THE OPIOID COLLABORATIVE LOCALLY AND STATEWIDE AND HAS INITIATED CHANGES TO LOCAL PRESCRIBING PROTOCOLS. PRIORITY 2) CHRONIC DISEASE - FOCUS ON HEALTHLY LIFESTYLE EDUCATION. INTERNALLY DEVELOPED COMMUNITY EDUCATION MODULES AND EVENTS FOR HEALTHY EATING OPTIONS, DIABETES EDUCATION AND SUPPORT, OBESITY EDUCATION, AND INDOOR AIR QUALITY. CONTRIBUTED TO PLANNING AND OPERATION OF A MEN'S HEALTH FAIR WITH WIDE RANGE OF SCREENING AND EDUCATION RESOURCES. PROVIDES SUPPORT TO YOUTH AND OTHER COMMUNITY ATHLETIC ACTIVITIES AND SPORT EVENTS. IN COLLABORATION WITH COMMUNITY ORGANIZATIONS ADVOCATE FOR STATEWIDE CAMPAIGN FOR "GET OUT AND PLAY EVERY DAY". 3) ACCESS TO CARE - FOCUS ON IMPROVING PERCENTAGE OF POPULATION WITH PRIMARY CARE PROVIDER. COLLABORATE WITH MEDICAL STAFF OF PRIMARY CARE CLINICS TO RECRUIT PROVIDERS, MANAGE PRIMARY CARE PRACTICES TO IMPROVE ACCESS, SCHEDULING, CALL ABANDONMENT RATE, AND ON-LINE PORTAL ACCESS, AND TO PROMOTE ACCESS BY PATIENTS WITHIN ALL SOCIOECONOMIC DEMOGRAPHICS. NEEDS IDENTIFIED BUT NOT PRIORITIZED DURING 2017 WERE 1) SENIOR CARE/ALZHEIMERS - WHICH WAS DEFERRED TO LOCAL ORGANIZATIONS FOR ALZHEIMERS AND 2) SEXUALLY TRANSMITTED INFECTIONS - WHICH WAS DEFERRED TO PUBLIC HEALTH AND WATCHFUL EVALUATION OF REPORTING DATA WHICH WAS BELIEVED TO BE SKEWED DUE TO REPORTING INCIDENT IMPROVEMENTS. |
| FAIRBANKS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 13B: DISCOUNTED CARE IS PROVIDED TO PATIENTS WITH ANNUAL HOUSEHOLD INCOME LESS THAN $125,000. |
| FAIRBANKS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 13H: COVERAGE THROUGH OTHER PROGRAMS OR INSURANCE MUST BE EXHAUSTED OR DENIED. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - TANANA VALLEY CLINIC LLC | ||||
| 1001 NOBLE STREET | FAIRBANKS | AK | 99701 | MULTI SPECIALTY CLINIC |
| 2 - DENALI CENTER | ||||
| 1510 19TH AVENUE | FAIRBANKS | AK | 99701 | SKILLED NURSING FACILITY |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE ORGANIZATION USES A FIXED DOLLAR HOUSEHOLD INCOME AMOUNT TO IDENTIFY PATIENTS ELIGIBLE FOR DISCOUNTED CARE. |
| PART I, LINE 7: | THE ORGANIZATION USED THE COST TO CHARGE RATIO FROM WORKSHEET 2 TO CALCULATE THE AMOUNTS REPORTED ON PART I, LINE 7 |
| PART III, LINE 2: | CONTRACTUAL (CT) AND BAD DEBT (BD) ALLOWANCES FOR HOSPITAL ACCOUNTS RECEIVABLE (A/R) BALANCES ARE CALCULATED EACH MONTH BY COMPARING TARGET ADJUSTMENTS TO OBSERVED ADJUSTMENTS; THE DIFFERENCE BETWEEN TARGET ADJUSTMENTS AND OBSERVED ADJUSTMENTS IS BOOKED AS AN ALLOWANCE. TARGET ADJUSTMENTS ARE FOUND BY APPLYING TARGET PERCENTAGES TO THE GROSS CHARGES THAT RESULTED IN CURRENT A/R BALANCES. TARGET PERCENTAGES ARE DERIVED FROM HISTORICAL ADJUSTMENT DATA, ON CLOSED ACCOUNTS, IN A LOOKBACK PERIOD CONTAINING 12 MONTHS. THE CT LOOKBACK PERIOD IS THE 12 MONTH PERIOD ENDING 3 MONTHS PRIOR TO THE CURRENT PERIOD. THE BD LOOKBACK PERIOD IS THE 12 MONTH PERIOD ENDING 15 MONTHS PRIOR TO THE CURRENT PERIOD. TARGET ADJUSTMENT PERCENTAGES ARE UPDATED EACH MONTH AND CALCULATED FOR ACCOUNT PORTFOLIOS BASED ON INPATIENT/OUTPATIENT DESIGNATION AND FINANCIAL CLASS. ACTUAL COLLECTIONS ON PRIOR PERIOD A/R BALANCES ARE REVIEWED TO ENSURE THE ALLOWANCE METHODOLOGY IS APPROPRIATE AND RELIABLY ESTIMATES A/R COLLECTABILITY. |
| PART III, LINE 4: | SEE AUDITED FINANCIAL STATEMENTS, PAGE 7 FOR DISCUSSION REGARDING THE ORGANIZATION'S ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| PART III, LINE 8: | MEDICARE REIMBURSEMENT DID NOT COVER THE FULL COST OF TREATING MEDICARE PATIENTS IN 2017. THE SHORTFALL IS APPROXIMATELY $5.8M . FOUNDATION HEALTH PROVIDES MEDICALLY NECESSARY HEALTH CARE SERVICES TO ALL PATIENTS REGARDLESS OF PAYER. MANY OTHER PROVIDERS MAY LIMIT OR NOT ACCEPT MEDICARE PATIENTS DUE TO THE INADEQUATE REIMBURSEMENT. THEREFORE, FOUNDATION HEALTH MAY OFTEN BE THE ONLY OPTION FOR MEDICARE PATIENTS IN OUR COMMUNITY. BY ACCEPTING INADEQUATE MEDICARE REIMBURSEMENT, WE REDUCE THE AMOUNT OF FINANCIAL ASSISTANCE AND BURDEN ON OTHER GOVERNMENTAL PROGRAMS, SUCH AS MEDICAID. |
| PART III, LINE 9B: | PATIENTS THAT WE BELIEVE MAY QUALIFY FOR FINANCIAL ASSISTANCE ARE TOLD ABOUT OUR FINANCIAL ASSISTANCE PROGRAM AND GIVEN AN APPLICATION (IF WANTED) DURING THE ADMISSIONS PROCESS. IF THE PATIENT APPLIES AND QUALIFIES, THE BALANCE IS WRITTEN OFF IN PART OR IN FULL. IF THE ACCOUNT IN NOT WRITTEN OFF ENTIRELY, THE REDUCED BALANCE IS TREATED IN THE SAME MANNER AS ACCOUNTS FOR PATIENTS WITHOUT INSURANCE, WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE. THE COLLECTION POLICY INCLUDES 8 PATIENT STATEMENTS AND 2 REMINDER LETTERS SENT TO THE PATIENT. PAYMENT PLANS ARE MADE AVAILABLE ; ATTEMPTS ARE MADE TO VERIFY PHYSICAL ADDRESSES OF PATIENTS; AND EFFORTS USED TO DETERMINE IF THE PATIENT MAY BE MEDICAID ELIGIBLE. OUR BILLING STAFF ATTEMPTS TO CONTACT AS MANY PATIENTS AS POSSIBLE. |
| PART VI, LINE 2: | COMMUNITY TOWN HALL MEETINGS OPEN TO THE PUBLIC DURING TRANSITION FROM BANNER HEALTH - LED BY ADMINISTRATIVE TEAM AND GOVERNING BOARD OF ORGANIZATION. THE LINK FOR COMMUNITY FEEDBACK IS ON THE ORGANIZATION WEBSITE AND INITIATES AN EMAIL DIRECTLY TO COMMUNICATIONS DIRECTOR. THE CANCER TREATMENT PROGRAM CONDUCTS A FORMAL ANNUAL COMMUNITY NEEDS ASSESSMENT ACCORDING TO ACCREDITATION STANDARDS. |
| PART VI, LINE 3: | REGISTRATION STAFF OFFERS FINANCIAL ASSISTANCE INFORMATION AT THE TIME OF REGISTRATION FOR PATIENTS LACKING INSURANCE COVERAGE. MONTHLY BILLING STATEMENTS INCLUDE A PHONE NUMBER TO CALL FOR INFORMATION ON FINANCIAL ASSISTANCE AND POSSIBLE ELIGIBILITY FOR OTHER PROGRAMS. INPATIENTS WITH NO INSURANCE ARE CONTACT BY OUR INPATIENT FINANCIAL SERVICES REPRESENTATIVE FOR MEDICAID SCREENING. WE ALSO CONTRACT WITH A THIRD PARTY VENDOR TO CONDUCT OUTREACH TO DISCHARGED PATIENTS WITH SELF PAY BILLS TO ASSIST THEM TO APPLY TO OTHER PROGRAMS SUCH AS MEDICAID. MEDICARE FINANCIAL ASSISTANCE BROCHURES ARE AVAILABLE IN THE EMERGENCY DEPARTMENT AND OTHER REGISTRATION AREAS. INFORMATION REGARDING OUR FINANCIAL ASSISTANCE PROGRAM IS PUBLISHED ON OUR WEBSITE. |
| PART VI, LINE 4: | FAIRBANKS MEMORIAL HOSPITAL IS THE SOLE COMMUNITY PROVIDER AND ONLY STATE LICENSED HOSPITAL IN ITS PRIMARY AND SECONDARY SERVICE AREAS. - THE PRIMARY AREA INCLUDES THE 7,400 SQUARE MILE FAIRBANKS NORTH STAR BOROUGH (FNSB). - THE SECONDARY AREA IS APPROXIMATELY 127,000 SQUARE MILES OF WHAT IS REFERRED TO AS INTERIOR OR NORTHERN ALASKA - WITH VERY FEW OF THE COMMUNITIES IN THIS AREA ACCESSIBLE BY ROAD. - THE POPULATION WITHIN THE PRIMARY SERVICE AREA IS ESTIMATED AT 106,470 AND 32,818 IN THE SECONDARY AREA. - OVERALL, THE HOSPITAL'S SERVICE POPULATION IS ESTIMATED TO BE A POPULATION OF 139,288. - THE NEXT CLOSEST HOSPITAL IS 350 MILES SOUTH OF FAIRBANKS. THOSE WHO ARE NOT SERVED BY THIS HOSPITAL ARE POTENTIALLY RECEIVING SERVICES FROM TANANA CHIEFS CONFERENCE - CHIEF ANDREW ISAAC HEALTH CENTER (AN INDIAN HEALTH SERVICE), BASSETT ARMY COMMUNITY HOSPITAL (FOR MILITARY BENEFICIARIES), AND AN AMBULATORY SURGERY CENTER. THE POPULATION OF THE FNSB IS 54% MALE 46% FEMALE, CAUCASIANS REPRESENT 69% OF THE POPULATION AND HISPANIC 9%, BLACK 6%, ASIAN/PACIFIC ISLANDER 3%, AMERICAN INDIAN/ALASKA NATIVE 7%, OTHER 6%. MEDIAN HOUSEHOLD INCOME IS $70,304, COST OF LIVING 132.4, MEDIAN AGE 31.8, MEDIAN HOUSE VALUE $234,000. OF ALL FAMILIES, 6% PSA BELOW THE POVERTY LEVEL, WITH CHILDREN 9%, AND SINGLE FEMALES WITH CHILDREN 30%. THE POPULATION IS REPRESENTED BY COMMERCIAL INSURANCE AT 68%, MEDICAID 17%, MEDICARE 8%, AND UNINSURED 7%. NO FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS OR POPULATIONS ARE PRESENT IN THE FNSB. |
| PART VI, LINE 5: | FAIRBANKS MEMORIAL HOSPITAL IS GOVERNED BY A COMMUNITY BOARD COMPRISED OF VOLUNTEER COMMUNITY REPRESENTATIVES. THE BOARD ESTABLISHES THE ORGANIZATIONS PRIORITIES, ENSURES OPERATIONS ARE CONSISTENT WITH THE NON-PROFIT PURPOSE AND MISSION, AND REINVESTS IN NEW EQUIPMENT AND TECHNOLOGY, NEW OR EXPANDED PATIENT SERVICES, AND MAINTAINS EXISTING ASSETS TO MEET COMMUNITY NEED AND LONG TERM HEALTH. FMH UTILIZES AN OPEN MEDICAL STAFF MODEL; MAKING FACILITIES AVAILABLE TO CREDENTIALED COMMUNITY PROVIDERS; THE HOSPITAL AND CLINIC ALSO EMPLOY AND CONTRACT WITH PROVIDERS TO ENSURE EFFICIENT, EVIDENCE-BASED, AND HIGH QUALITY CLINICAL CARE WITHIN AN INTEGRATED SYSTEM ALONG THE FULL CONTINUUM OF CARE. |
| PART VI, LINE 6: | FOUNDATION HEALTH LLC IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. |
| LINE 7, STATE FILING OF COMMUNITY BENEFIT REPORT: | ALASKA DOES NOT REQUIRE FILING OF A COMMUNITY BENEFIT REPORT. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | Yes (1) | 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 | 0 | 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAURA BRUNNER MD | ||||||||||||||
| BOARD MEMBER | $186,926 | $0 | $110,456 | $0 | $1,102 | $0 | $6,177 | $0 | $779 | $0 | $305,440 | $0 | $0 | $0 |
| TERI KISS RN | ||||||||||||||
| BOARD MEMBER | $149,182 | $0 | $0 | $0 | $713 | $0 | $4,835 | $0 | $1,413 | $0 | $156,143 | $0 | $0 | $0 |
| CLAY TRIPLEHORN MD | ||||||||||||||
| BOARD MEMBER | $220,438 | $0 | $124,358 | $0 | $2,966 | $0 | $10,789 | $0 | $29,744 | $0 | $388,295 | $0 | $0 | $0 |
| GREGORY L JOHNSON | ||||||||||||||
| CEO THRU 12/17 | $345,881 | $0 | $81,001 | $0 | $1,980 | $0 | $10,800 | $0 | $10,914 | $0 | $450,576 | $0 | $0 | $0 |
| JIM L LYNCH | ||||||||||||||
| COO/CEO BEG. 12/17 | $222,101 | $0 | $65,529 | $0 | $658 | $0 | $8,884 | $0 | $5,668 | $0 | $302,840 | $0 | $0 | $0 |
| STEPHEN P LESLIE | ||||||||||||||
| CFO | $175,517 | $0 | $27,268 | $0 | $320 | $0 | $7,021 | $0 | $2,600 | $0 | $212,726 | $0 | $0 | $0 |
| JOHN E COTTER | ||||||||||||||
| ANCILLARY SERVICES DIRECTOR | $167,531 | $0 | $17,952 | $0 | $1,210 | $0 | $6,701 | $0 | $3,876 | $0 | $197,270 | $0 | $0 | $0 |
| DANNY R ROBINETTE | ||||||||||||||
| CMO | $365,060 | $0 | $0 | $0 | $1,980 | $0 | $0 | $0 | $9,018 | $0 | $376,058 | $0 | $0 | $0 |
| KARL H SANFORD | ||||||||||||||
| ASSOC. ADMIN. | $177,999 | $0 | $29,750 | $0 | $998 | $0 | $7,120 | $0 | $4,668 | $0 | $220,535 | $0 | $0 | $0 |
| CLINT BROOKS | ||||||||||||||
| ASSOC. ADMIN. | $163,069 | $0 | $26,141 | $0 | $537 | $0 | $6,523 | $0 | $0 | $0 | $196,270 | $0 | $0 | $0 |
| KAREN M JUSTIN-TANNER | ||||||||||||||
| CNO | $173,338 | $0 | $0 | $0 | $191 | $0 | $0 | $0 | $2,936 | $0 | $176,465 | $0 | $0 | $0 |
| JOSHUA L BURRILL | ||||||||||||||
| COMPLIANCE OFFICER | $50,913 | $0 | $40,000 | $0 | $91,127 | $0 | $0 | $0 | $543 | $0 | $182,583 | $0 | $0 | $0 |
| SHELLEY D EBENAL | ||||||||||||||
| EXECUTIVE DIRECTOR GFCHF | $182,926 | $0 | $50,000 | $0 | $276 | $0 | $7,746 | $0 | $36,564 | $0 | $277,512 | $0 | $0 | $0 |
| ROMEL C WRENN | ||||||||||||||
| PHYSICIAN MANAGER | $801,092 | $0 | $231,486 | $0 | $2,078 | $0 | $10,800 | $0 | $5,064 | $0 | $1,050,520 | $0 | $0 | $0 |
| CARSON S WEBB | ||||||||||||||
| PHYSICIAN | $701,148 | $0 | $550,501 | $0 | $432 | $0 | $10,800 | $0 | $6,476 | $0 | $1,269,357 | $0 | $0 | $0 |
| MICHAEL D SWENSON | ||||||||||||||
| PHYSICIAN MANAGER | $155,891 | $0 | $287,189 | $0 | $753 | $0 | $10,800 | $0 | $6,864 | $0 | $461,497 | $0 | $0 | $0 |
| VANESSA A VENEZIA | ||||||||||||||
| PHYSICIAN MANAGER | $392,118 | $0 | $33,245 | $0 | $287 | $0 | $10,800 | $0 | $10,796 | $0 | $447,246 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | FOUNDATION HEALTH LLC PROVIDED ONE MONTH OF HOUSING TO JOSHUA BURRILL. THIS WAS TREATED AS TAXABLE COMPENSATION AND INCLUDED IN FORM W-2 WAGES. |
| PART I, LINE 4A | JOSHUA BURRILL RECEIVED SEVERANCE OF $83,007 DURING 2017. |
| PART I, LINE 7 | BONUS PAYMENT TO SHELLEY EBENAL IS DISCRETIONARY. THE BONUS WAS APPROVED BY GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION, FOUNDATION HEALTH'S SOLE MEMBER. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 6: | VOLUNTEER HOURS ARE CALCULATED BY INDIVIDUALS LOGGING THEIR HOURS ON OUR VOLGISTICS KIOSK AND THEIR TIME IS DIVIDED INTO CLERICAL AND PATIENT/RESIDENT CARE. THE TOTAL HOURS VOLUNTEERS SERVED WAS 9244 HOURS IN 26 DEPARTMENTS. SOME EXAMPLES OF THEIR SERVICE INCLUDE OFFERING SPIRITUAL CARE BY DENOMINATION FOR THOSE WHO REQUEST IT AND PET THERAPY BY APPOINTMENT AS WELL AS BEDSIDE VISITS AND HELPING IN OUR CAF, GIFT SHOP AND VARIOUS OFFICES WHICH REQUEST THEIR ASSISTANCE. |
| FORM 990, PART VI, SECTION A, LINE 6 | FOUNDATION HEALTH'S SOLE MEMBER IS GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | FOUNDATION HEALTH'S SOLE MEMBER, GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION, APPOINTS 5 OF FOUNDATION HEALTH'S BOARD MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING ACTIONS REQUIRE APPROVAL BY THE ORGANIZATION'S SOLE MEMBER: 1) SALE OF ALL OR SUBSTANTIALLY ALL ASSETS OF THE COMPANY; 2) SUBSTANTIALLY CHANGING THE NATURE OR SCOPE OF THE BUSINESS OF THE COMPANY; 3) THE PARTICIPATION IN PARTNERSHIP AGREEMENTS, JOINT VENTURES, OR OTHER ASSOCIATIONS OF ANY KIND WITH ANY PERSON OR PERSONS; 4) EQUIPMENT PURCHASES EXCEEDING $5,000 AND EXCEEDING THE APPROVED OPERATING BUDGET; 5) ENTERING INTO GUARANTIES; INCURRING LIABILITIES; BORROWING MONEY, ISSUING NOTES, BONDS, AND OTHER OBLIGATIONS; OR SECURING ANY COMPANY OBLIGATION BY MORTGAGE OR PLEDGE OR ANY COMPANY PROPERTY OR INCOME; AND 6) LENDING MONEY, INVESTMENT OR REINVESTMENT OF THE COMPANY'S FUNDS, OR RECEIPT AND HOLDING OF PROPERTY AS SECURITY FOR REPAYMENT, INCLUDING, WITHOUT LIMITATION, LOANING MONEY TO, AND OTHERWISE HELPING THE MEMBER, ANY OFFICERS, EMPLOYEES, OR AGENTS. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 WILL BE EMAILED TO THE FINANCE COMMITTEE MEMBERS FOR THEIR REVIEW PRIOR TO SUBMISSION. ANY QUESTIONS WILL BE RESOLVED PRIOR TO OBTAINING THE SIGNATURE OF THE CFO. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS, OFFICERS AND THE QUALITY AND COMPLIANCE COMMITTEE MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST THAT MAY GIVE RISE TO A CONFLICT OF INTEREST PROMPTLY TO THE QUALITY AND COMPLIANCE COMMITTEE BOARD. THE COMMITTEE MUST THEN CONSIDER THE DISCLOSED INTEREST AND EITHER AUTHORIZE THE CONTINUATION OF THE POTENTIAL FINANCIAL INTEREST AND ANY RELATED TRANSACTION WITH APPROPRIATE PROTECTIONS, OR DISAPPROVE OF IT. OTHER FH EMPLOYEES MUST GO THROUGH A SIMILAR PROCESS OF DISCLOSURE TO THEIR RESPECTIVE SUPERVISOR AND TO THE QUALITY AND COMPLIANCE COMMITTEE. ALL BOARD MEMBERS, MEMBERS OF LOCAL BOARDS OF OWNED FACILITIES, OFFICERS OF FHP, ADMINISTRATORS, EMPLOYED PHYSICIANS, AND OTHER EMPLOYEES AND INDIVIDUALS DESIGNATED BY THEIR SUPERVISORS OR BY THE CHIEF COMPLIANCE OFFICER MUST COMPLETE AN ANNUAL SURVEY THAT IS DISTRIBUTED UNDER THE SUPERVISION OF THE CHIEF COMPLIANCE BOARD. THE SURVEY INCLUDES A QUESTIONNAIRE THAT IS DESIGNED TO IDENTIFY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST, AS WELL AS OTHER TRANSACTION AND RELATIONSHIPS REQUIRED TO BE DISCLOSED IN THE FORM 990 AND SCHEDULE L. |
| FORM 990, PART VI, SECTION B, LINE 15 | FOUNDATION HEALTH PARTNERS USES A PAY RATE CALCULATOR IN ORDER TO DETERMINE COMPENSATION. THE FHP COMPENSATION BOARD APPROVES THE FHP PAY RATE CALCULATOR (PRC) GUIDELINES WHICH IS USED EVERY TIME AN OFFER OR PAY CHANGE IS MADE FOR AN EMPLOYEE. ANY OFFER OUTSIDE OF THE RECOMMENDED RANGE WILL REQUIRE AN APPROVAL. OFFER APPROVALS GO TO THE COMPENSATION AND BENEFITS TEAM, WHICH WILL THEN DECIDE WHAT TYPE OF APPROVAL IS ULTIMATELY REQUIRED. UNDER THE FHP PHILOSOPHY, AN EXCEPTION COMMITTEE WILL BE CREATED TO REVIEW REQUESTED EXCEPTIONS THAT ARE OTHERWISE CONTRARY TO FHP'S COMPENSATION PHILOSOPHY. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CASUAL LABOR : PROGRAM SERVICE EXPENSES 10,957,575. MANAGEMENT AND GENERAL EXPENSES 711,661. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,669,236. PHYSICIAN FEES : PROGRAM SERVICE EXPENSES 4,642,050. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,642,050. SERVICE CONTRACTS MAINT : PROGRAM SERVICE EXPENSES 2,539,571. MANAGEMENT AND GENERAL EXPENSES 1,018,973. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,558,544. OTHER: PROGRAM SERVICE EXPENSES 7,502,746. MANAGEMENT AND GENERAL EXPENSES 3,535,925. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,038,671. |
| FORM 990, PART XI, LINE 9: | ASSET TRANSFER FROM RELATED PARTY 65,572,524. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| DENALI CENTERLLC | |||||||||
| 1510 19TH AVENUE | FAIRBANKS | AK | 99701 | 300945293 | COMPREHENSIVE SHORT AND LONG TERM CARE CENTER | AK | $21,132,800 | $2,994,760 | FOUNDATION HEALTH LLC |
| FAIRBANKS MEMORIAL HOSPITAL LLC | |||||||||
| 1650 COWLES STREET | FAIRBANKS | AK | 99701 | 320499956 | HOSPITAL/HEALTHCARE SERVICES | AK | $214,517,314 | $90,064,123 | FOUNDATION HEALTH LLC |
| TANANA VALLEY CLINIC LLC | |||||||||
| 1001 NOBLE STREET | FAIRBANKS | AK | 99701 | 611797882 | PRIMARY CARE SERVICES | AK | $33,821,228 | $6,277,643 | FOUNDATION HEALTH LLC |
| FAIRBANKS MEMORIAL CARDIOLOGY CENTER LLC | |||||||||
| 1650 COWLES ST | FAIRBANKS | AK | 99701 | 364841105 | CARDIOLOGY CLINIC | AK | $14,373,609 | $756,253 | FOUNDATION HEALTH LLC |
| FAIRBANKS MEMORIAL HOME MEDICAL EQUIPMENT LLC | |||||||||
| 19 COLLEGE RD STE D | FAIRBANKS | AK | 99701 | 371830937 | HOME MEDICAL EQUIPMENT RENTALS AND SALES | AK | $1,798,444 | $671,373 | FOUNDATION HEALTH LLC |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71396 | AddressLine1Txt |
| City | FAIRBANKS | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 71396 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 920035784 | EIN |
| Primary Activities | OWN/LEASE HOSPITAL RELATED MEDICAL FACILITIES | PrimaryActivitiesTxt |
| Legal Domicile State | AK | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 509(A)(1) | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 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 | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION | ||
| C | $65,572,524 | CASH |
| GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION | ||
| K | $36,176,972 | CASH |
| GREATER FAIRBANKS COMMUNITY HOSPITAL FOUNDATION | ||
| O | $702,167 | CASH |