GOSHEN HOSPITAL ASSOCIATION INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
GOSHEN HOSPITAL ASSOCIATION INC (EIN 35-6001540)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-15
IRS object ID
201843199349311149
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

FieldValueIRS element (for citing)
Return2018-11-15T14:41:54-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN420714325PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RSM US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11 S WACKER DRIVE STE 800AddressLine1Txt
CityCHICAGOCityNm
State AbbreviationILStateAbbreviationCd
ZIP60606ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN356001540EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GOSHEN HOSPITAL ASSOCIATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlGOSHBusinessNameControlTxt
Phone5743642665PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 HIGH PARK AVENUEAddressLine1Txt
CityGOSHENCityNm
State AbbreviationINStateAbbreviationCd
ZIP46526ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBEN BONTRAGERPersonNm
Person TitleCFOPersonTitleTxt
Phone5743642665PhoneNum
Signature2018-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonZACK FORTSCHPreparerPersonNm
PTINP00052725PTIN
Phone3126343400PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address108.171.131.188IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-13IPDt
IP Tm18:49:11IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id7C605E2F418ECD3347EC446B51AB1B1A7CC4F3F2AtSubmissionCreationDeviceId
At Submission Filing Device Id354853D176645FF21C21F7ED33B55DFC3B3529D0AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1GOSHEN HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerRANDAL CHRISTOPHELPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 HIGH PARK AVENUEAddressLine1Txt
CityGOSHENCityNm
State AbbreviationINStateAbbreviationCd
ZIP46526ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$396,327,477GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressHTTPS://GOSHENHEALTH.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1946FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionTO IMPROVE THE HEALTH OF OUR COMMUNITIES BY PROVIDING INNOVATIVE, OUTSTANDING CARE AND SERVICES.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee1736TotalEmployeeCnt
Total Volunteers439TotalVolunteersCnt
Total Gross UBI-$55,634TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$55,634NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$95,964PYContributionsGrantsAmt
CY Contributions Grants$206,635CYContributionsGrantsAmt
PY Program Service Revenue$227,910,843PYProgramServiceRevenueAmt
CY Program Service Revenue$240,916,847CYProgramServiceRevenueAmt
PY Investment Income$947,118PYInvestmentIncomeAmt
CY Investment Income$10,989,229CYInvestmentIncomeAmt
PY Other Revenue$6,285,762PYOtherRevenueAmt
CY Other Revenue$9,176,451CYOtherRevenueAmt
PY Total Revenue$235,239,687PYTotalRevenueAmt
CY Total Revenue$261,289,162CYTotalRevenueAmt
PY Grants And Similar Paid$337,848PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$612,176CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$93,482,641PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$101,902,953CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$124,423,883PYOtherExpensesAmt
CY Other Expenses$136,563,582CYOtherExpensesAmt
PY Total Expenses$218,244,372PYTotalExpensesAmt
CY Total Expenses$239,078,711CYTotalExpensesAmt
PY Revenues Less Expenses$16,995,315PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$22,210,451CYRevenuesLessExpensesAmt
Total Assets BOY$355,806,978TotalAssetsBOYAmt
Total Assets EOY$392,614,896TotalAssetsEOYAmt
Total Liabilities BOY$60,182,655TotalLiabilitiesBOYAmt
Total Liabilities EOY$60,723,012TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$295,624,323NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$331,891,884NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MISSION OF GOSHEN HOSPITAL IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES BY PROVIDING INNOVATIVE, OUTSTANDING CARE AND SERVICE, THROUGH EXCEPTIONAL PEOPLE DOING EXCEPTIONAL WORK.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$200,582,085ExpenseAmt
Grant$612,176GrantAmt
Revenue$249,420,366RevenueAmt
DescGOSHEN HOSPITAL IS A NON-DENOMINATIONAL NOT-FOR-PROFIT ORGANIZATION PROVIDING HEALTH CARE SERVICES FOR THE GENERAL PUBLIC AS WELL AS CHARITY WITHIN THE COMMUNITY. SEE SCHEDULE O FOR ADDITIONAL DETAIL.Desc
Total Program Service Expenses$200,582,085TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan OutstandingYes (1)LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document162IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1736EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BEN BONTRAGERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5743642665PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 HIGH PARK AVEAddressLine1Txt
CityGOSHENCityNm
State AbbreviationINStateAbbreviationCd
ZIP46526ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
MARTHA SUZIE YEAGER
DIRECTOR1.00Yes (X)$0$0$0
RANDY CRIPE
CHAIR1.00Yes (X)$0$0$0Yes (X)
BRENDA SROF
SECRETARY/TREASURER1.00Yes (X)$0$0$0Yes (X)
KAREN SMITH
DIRECTOR1.00Yes (X)$0$0$0
SUSAN STIFFNEY RN
DIRECTOR1.00Yes (X)$0$0$0
JODY NEER MD
VICE CHAIR1.00Yes (X)$0$437,929$69,877Yes (X)40.00
KAREN PLETCHER
DIRECTOR1.00Yes (X)$0$0$0
LILIANE QUINTERO
DIRECTOR1.00Yes (X)$0$0$0
DANIEL NAFZIGER MD
DIRECTOR1.00Yes (X)$0$166,482$14,79740.00
BONITA SCHROCK
DIRECTOR1.00Yes (X)$0$0$0
LANE REED MD
DIRECTOR(AS OF 1/1/17)1.00Yes (X)$0$0$0
RANDAL CHRISTOPHEL
PRESIDENT AND CEO40.00Yes (X)$855,730$0$171,841Yes (X)2.00
AMY FLORIA
CHIEF FINANCIAL OFFICER40.00$485,964$0$54,976Yes (X)1.00
ALAN WELDY
VP OF HR AND COMPLIANCE40.00$503,544$0$101,266Yes (X)1.00
ROB MYERS
CHIEF OPERATING OFFICER40.00$459,726$0$104,422Yes (X)1.00
MARGARET S FRANGER
VP OF CANCER SERVICES40.00$388,886$0$89,491Yes (X)
STEVE GARBODEN
VP PLANNING AND MANAGED CARE40.00$322,505$0$60,679Yes (X)
VLADIMIR RADIVOJEVIC
VP OF SURGICAL SERVICES40.00$227,442$0$41,126Yes (X)
JULIE CROSSLEY
CHIEF NURSING OFFICER40.00$243,498$0$73,209Yes (X)
MARK PODGORSKI
VP OF HOSPITAL OPERATIONS40.00$317,733$0$79,513Yes (X)
LARRY ALLEN MD
CHIEF MEDICAL EXECUTIVE40.00$473,606$0$97,661Yes (X)
HUBERT FORNALIK MD
PHYSICIAN40.00$615,339$0$31,745Yes (X)
RODERICH SCHWARZ MD
PHYSICIAN40.00$598,898$0$54,968Yes (X)
DANIEL BRUETMAN MD
PHYSICIAN40.00$577,879$0$61,198Yes (X)
HOUMAN VAGHEFI MD
PHYSICIAN40.00$563,622$0$66,874Yes (X)
EBENEZER KIO MD
PHYSICIAN40.00$551,337$0$61,117Yes (X)
PAM KARSEN
VP OF NURSING0.00$153,734$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$7,339,443TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$604,411TotReportableCompRltdOrgAmt
Total Other Compensation$1,234,760TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K73IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
DJ CONSTRUCTION CO INC
3414 ELKHART RDGOSHENIN46526CONSTRUCTION COMPANY$3,215,829
APOGEE MEDICAL MANAGEMENT
15059 N SCOTTSDALE RD SUITE 600SCOTTSDALEAZ852542685CONTRACTED STAFFING$1,488,125
MICHIANA ANESTHESIA CARE PC
416 E MONROE SUITE 200SOUTH BENDIN46601CONTRACTED STAFFING$1,440,507
DIVERSIFIED CLINICAL SERVICES
4500 SALISBURY ROAD SUITE 300JACKSONVILLEFL32216CONTRACTED STAFFING$1,219,879
BONA VITA ARCHITECTURE
6832 TREE TOP TRAILFORT WAYNEIN46845ARCHITECTURE$1,218,364
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K49CntrctRcvdGreaterThan100KCnt
Related Organizations$206,635RelatedOrganizationsAmt
Total Contributions$206,635TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT CAREDesc
Business622110BusinessCd
Total Revenue Column$240,916,847TotalRevenueColumnAmt
Related Or Exempt Func Income$240,916,847RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$240,916,847TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,968,116TotalRevenueColumnAmt
Unrelated Business Revenue-$55,634UnrelatedBusinessRevenueAmt
Exclusion$5,023,750ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,316,381RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$1,316,381RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,316,381TotalRevenueColumnAmt
Exclusion$1,316,381ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$141,059,428SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$133,357,858SecuritiesAmt
Other$1,680,457OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$7,701,570SecuritiesAmt
Other-$1,680,457OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,021,113TotalRevenueColumnAmt
Exclusion$6,021,113ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
FOOD SERVICE REVENUE722514$356,551$356,551
FINANCE CHARGES561000$289,474$289,474
OTHER ONCOLOGY REV MIS621500$233,090$233,090

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,980,955TotalRevenueColumnAmt
Related Or Exempt Func Income$6,980,955RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$7,860,070OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$261,289,162TotalRevenueColumnAmt
Related Or Exempt Func Income$248,420,366RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue-$55,634UnrelatedBusinessRevenueAmt
Exclusion$12,717,795ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$612,176TotalAmt
Program Services$612,176ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$4,278,634TotalAmt
Program Services$944,546ProgramServicesAmt
Management And General$3,334,088ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$70,807,246TotalAmt
Program Services$48,805,822ProgramServicesAmt
Management And General$22,001,424ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$4,758,246TotalAmt
Program Services$3,092,860ProgramServicesAmt
Management And General$1,665,386ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$17,105,321TotalAmt
Program Services$11,118,459ProgramServicesAmt
Management And General$5,986,862ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,953,506TotalAmt
Program Services$3,219,779ProgramServicesAmt
Management And General$1,733,727ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,599,469TotalAmt
Management And General$1,599,469ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$128,535TotalAmt
Management And General$128,535ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$174,000TotalAmt
Management And General$174,000ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$716,804TotalAmt
Management And General$716,804ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$18,639,390TotalAmt
Program Services$18,639,390ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,126,843TotalAmt
Program Services$3,126,843ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,557,626TotalAmt
Program Services$4,557,626ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$2,463,625TotalAmt
Program Services$2,463,625ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,225,306TotalAmt
Program Services$2,225,306ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$690,372TotalAmt
Program Services$690,372ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,156,331TotalAmt
Management And General$1,156,331ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$24,326,426TotalAmt
Program Services$24,326,426ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$11,310,145TotalAmt
Program Services$11,310,145ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,822,190TotalAmt
Program Services$1,822,190ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
DRUGS & MEDICAL SUPPLIE$48,615,487$48,615,487
HOSPITAL ASSESSMENT FEE$6,576,497$6,576,497
REPAIRS & MAINTENANCE$5,177,826$5,177,826
SHARED SAVINGS$1,328,602$1,328,602

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,928,108TotalAmt
Program Services$1,928,108ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$239,078,711TotalAmt
Program Services$200,582,085ProgramServicesAmt
Management And General$38,496,626ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,379,098BOYAmt
EOY$13,210,110EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$2,106,519EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$29,794,781BOYAmt
EOY$33,374,015EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$5,107,001BOYAmt
EOY$6,131,522EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$6,307,843BOYAmt
EOY$5,516,023EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$230,326,203LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$117,189,432LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$111,370,850BOYAmt
EOY$113,136,771EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$201,069,527BOYAmt
EOY$217,542,917EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$777,878BOYAmt
EOY$1,597,019EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$355,806,978BOYAmt
EOY$392,614,896EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$14,669,119BOYAmt
EOY$16,793,277EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$45,348,215BOYAmt
EOY$43,565,292EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$165,321BOYAmt
EOY$364,443EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$60,182,655BOYAmt
EOY$60,723,012EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$294,875,832BOYAmt
EOY$331,213,036EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$748,491BOYAmt
EOY$678,848EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$295,624,323BOYAmt
EOY$331,891,884EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$355,806,978BOYAmt
EOY$392,614,896EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$22,210,451ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$15,762,395NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments-$576,042PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$1,240,511OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$11,573OtherActivitiesAmt
Total Lobbying Expenditures$11,573TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationLOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$2,736,366InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$4,027,467OtherCostOrOtherBasisAmt
Book Value$6,763,833BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$104,838,283OtherCostOrOtherBasisAmt
Depreciation$40,469,548DepreciationAmt
Book Value$64,368,735BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$377,004InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$36,948OtherCostOrOtherBasisAmt
Depreciation$180,210DepreciationAmt
Book Value$233,742BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$110,782,847OtherCostOrOtherBasisAmt
Depreciation$76,539,674DepreciationAmt
Book Value$34,243,173BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,527,288OtherCostOrOtherBasisAmt
Book Value$7,527,288BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$113,136,771TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
ASSET RETIREMENT OBLIGATION$113,138
DEFERRED MALPRACTICE$109,000
INTEREST RATE SWAP$2,758
CLAIMS LIABILITY$139,547
FieldValueIRS element (for citing)
Total Liability$364,443TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE INTERNAL REVENUE SERVICE HAS DETERMINED THAT GOSHEN HEALTH AND CERTAIN AFFILIATED ENTITIES ARE TAX-EXEMPT ORGANIZATIONS AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CERTAIN SUBSIDIARIES OF GOSHEN HEALTH ARE TAXABLE ENTITIES, THE TAX EXPENSE AND LIABILITIES OF WHICH ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. GOSHEN HEALTH AND ITS TAX-EXEMPT AFFILIATED ENTITIES EACH FILE A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THESE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE SUCH MATTERS AS THE TAX-EXEMPT STATUS OF EACH ENTITY, THE CONTINUED TAX-EXEMPT STATUS OF BONDS, THE NATURE, CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME, AND VARIOUS POSITIONS RELATING TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (REPORTED ON FORM 990T). AS OF DECEMBER 31, 2017 AND 2016, THERE ARE NO UNRECOGNIZED TAX BENEFITS RESULTING FROM UNCERTAIN TAX POSITIONS. FORMS 990 AND 990T FILED BY GOSHEN HEALTH AND ITS TAX-EXEMPT AFFILIATED ENTITIES ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. FORMS 990 AND 990T FILED BY GOSHEN HEALTH AND ITS TAX-EXEMPT AFFILIATED ENTITIES ARE NO LONGER SUBJECT TO EXAMINATION FOR TAX YEAR 2014 AND PRIOR.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served6567PersonsServedCnt
Total Community Benefit Expns$4,361,603TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,361,603NetCommunityBenefitExpnsAmt
Total Expense0.02000TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served8563PersonsServedCnt
Total Community Benefit Expns$33,760,840TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,813,617DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,947,223NetCommunityBenefitExpnsAmt
Total Expense0.05950TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served15130PersonsServedCnt
Total Community Benefit Expns$38,122,443TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,813,617DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,308,826NetCommunityBenefitExpnsAmt
Total Expense0.07950TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served39984PersonsServedCnt
Total Community Benefit Expns$2,382,900TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$49,674DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,333,226NetCommunityBenefitExpnsAmt
Total Expense0.01070TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Persons Served2084PersonsServedCnt
Total Community Benefit Expns$765,555TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$67,929DirectOffsettingRevenueAmt
Net Community Benefit Expns$697,626NetCommunityBenefitExpnsAmt
Total Expense0.00320TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,754,808TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$23,754,808NetCommunityBenefitExpnsAmt
Total Expense0.10920TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Persons Served61PersonsServedCnt
Total Community Benefit Expns$852,575TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$852,575NetCommunityBenefitExpnsAmt
Total Expense0.00390TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Persons Served42129PersonsServedCnt
Total Community Benefit Expns$27,755,838TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$117,603DirectOffsettingRevenueAmt
Net Community Benefit Expns$27,638,235NetCommunityBenefitExpnsAmt
Total Expense0.12700TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served57259PersonsServedCnt
Total Community Benefit Expns$65,878,281TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,931,220DirectOffsettingRevenueAmt
Net Community Benefit Expns$44,947,061NetCommunityBenefitExpnsAmt
Total Expense0.20650TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$162,601TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$162,601NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$162,601TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$162,601NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$7,789,822BadDebtExpenseAmt
Reimbursed By Medicare$43,847,620ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$57,132,834CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$13,285,214MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GOSHEN HOSPITAL ASSOCIATION INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 HIGH PARK AVENUEAddressLine1Txt
CityGOSHENCityNm
State AbbreviationINStateAbbreviationCd
ZIP46526ZIPCd
FieldValueIRS element (for citing)
Website AddressHTTPS://GOSHENHEALTH.COMWebsiteAddressTxt
State License100270430StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1GOSHEN HOSPITAL ASSOCIATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTPS://GOSHENHEALTH.COM/PROMO-PAGES/COMMUNITY-NEEDSOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTPS://GOSHENHEALTH.COM/PROMO-PAGES/COMMUNITY-NEEDSStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://GOSHENHEALTH.COM/PATIENT-TOOLS/PAY-ONLINEFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://GOSHENHEALTH.COM/PATIENT-TOOLS/PAY-ONLINEFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://GOSHENHEALTH.COM/PATIENT-TOOLS/PAY-ONLINEFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back MedicareYes (X)LookBackMedicareInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
GOSHEN HOSPITAL ASSOCIATION, INC.PART V, SECTION B, LINE 5: THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. THE HEALTH NEEDS OF ELKHART COUNTY WERE IDENTIFIED AND PRIORITIZED THROUGH A SYSTEMATIC DATA INFORMED PROCESS AND WITH THE INPUT OF INDIVIDUALS THROUGHOUT ELKHART COUNTY AND IN THE ELKHART COUNTY HEALTH DEPARTMENT.MORE THAN 23,000 SURVEYS, AVAILABLE IN BOTH ENGLISH AND SPANISH, WERE SENT TO COMMUNITY MEMBERS, INCLUDING THE MINORITY POPULATIONS OF AMISH, HISPANIC AND AFRICAN-AMERICAN. PERSONS RECEIVING THE COMMUNITY SURVEY COULD RESPOND VIA A WEB LINK, THROUGH THE POST, OR BY PHONE (AVAILABLE 24/7)FROM THE LAST WEEK OF MAY 2015 THROUGH THE SECOND WEEK OF JUNE 2015. OVER 600 SURVEYS WERE RETURNED, 599 (93.2%) OF THESE FROM ELKHART COUNTY. BESIDES PROVIDING RESIDENTIAL AND DEMOGRAPHIC INFORMATION, RECIPIENTS WERE ALSO ASKED TO RATE THEIR OWN HEALTH, THE COMMUNITY'S HEALTH, THE TOP HEALTH NEEDS IN THE COMMUNITY, WHETHER OR NOT THERE WERE ENOUGH PROGRAMS TO MEET THESE NEEDS, AND HOW GOSHEN HOSPITAL ASSOCIATION, INC. COULD IMPROVE. ELKHART COUNTY HEALTH DEPARTMENT OFFICIALS WERE ALSO CONSULTED. NO COMMENTS WERE RECEIVED FROM THE PUBLIC REGARDING THE LAST CHNA REPORT AND IMPLEMENTATION PLAN.GOSHEN HOSPITAL ASSOCIATION, INC. CONTRACTED WITH THE BOWEN RESEARCH CENTER, DEPARTMENT OF FAMILY MEDICINE, INDIANA UNIVERSITY SCHOOL OF MEDICINE, TO ANALYZE PRIMARY DATA COLLECTED FROM THE SURVEYS. THE BOWEN CENTER ALSO ANALYZED VARIOUS EXISTING HEALTH, SOCIAL, AND ECONOMIC SECONDARY DATA SETS. FOR CONTEXTUAL COMPARISONS, ELKHART COUNTY DATA WERE COMPARED WITH KOSCIUSKO, LAGRANGE, MARSHALL, NOBLE AND ST. JOSEPH COUNTIES, AS WELL AS THE STATE OF INDIANA.
GOSHEN HOSPITAL ASSOCIATION, INC.PART V, SECTION B, LINE 11: THE HEALTH NEEDS LISTED BELOW ACCOUNT FOR 96.6% OF THE HEALTH NEEDS IDENTIFIED BY COMMUNITY RESIDENTS AND SUPORTED BY SECONDARY DATA FROM ELKHART COUNTY.-OBESITY/EXERCISE/HEALTHY EATING-ACCESS TO HEALTH SERVICES-TREATMENT OF CHRONIC DISEASES-MENTAL HEALTH/ADDICTION/DEPRESSION-POVERTY-HEALTH LITERACY-TOBACCO USE/SMOKINGGOSHEN HOSPITAL ASSOCIATION, INC. CONSIDERED THE FOLLOWING SOURCES OF INFORMATION IN PRIORITIZING THE HEALTH NEEDS THAT IT WOULD ADDRESS:-COMMUNITY PRECEPTIONS - THESE WERE OBTAINED THROUGH THE COMMUNITY SURVEY-STATISTICAL HEALTH INFORMATION - SECONDARY DATA FOR ELKHART COUNTY WAS COMPARED TO ITS BENCHMARKS-EXPERTISE OF HEALTH LEADERS - THE ELKHART COUNTY HEALTH DEPARTMENT ON THE MOST SIGNIFICANT HEALTH NEEDSAFTER CAREFUL CONSIDERATION, GOSHEN HOSPITAL ASSOCIATION, INC. HAS IDENTIFIED THE FOLLOWING HEALTH NEEDS IN RANK ODER THAT IT IS BEST EQUIPPED TO ADDRESS:-OBESITY-ACCESS TO HEALTH SERVICES-MENTAL HEALTH ISSUES-TREATMENT OF CHRONIC DISEASES - FOCUSING SPECIFICALLY ON DIABETES ANDHYPERTENSION, POTENTIALLY CANCER RELATED HEALTH ISSUES-TOBACCO USE/SMOKINGIN ADDITION, GOSHEN HOSPITAL ASSOCIATION, INC. WILL INDIRECTLY ADDRESS POVERTY. GOSHEN HOSPITAL ASSOCATION, INC. IS ALSO AWARE OF AND SENSITIVE TO THE HEALTH-RELATED NEEDS OF ALL MEMBERS OF THE COMMUNITY, AND CONTINUALLY SEEKS INNOVATIVE WAYS FOR PROVIDING IMPROVED ACCESS TO HEALTH SERVICES FOR THOSE IN POVERTY. THROUGH ONGOING PROGRAM DEVELOPMENT AND MONITORING, GOSHEN HOSPITAL ASSOCIATION, INC. WILL CONTINUE EXISTINGPROGRAMS FOR ADDRESSING HEALTH LITERACY. HOWEVER, THE EXPERTISE OF GOSHEN HEALTH IS BEST SUITED TO FORMALLY ADDRESS THE FIVE PRIORITY NEEDS NOTED.GOSHEN HOSPITAL ASSOCIATION, INC. DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2017 WITH RESPECT TO ITS PREVIOUSLY CONDUCTED CHNA:HEALTH NEED IDENTIFIED: OBESITYSERVICES WERE PROVIDED BY CENTER FOR WEIGHT REDUCTION WHICH IS A MULTI-DISCIPLINARY PROGRAM FOR WEIGHT REDUCTION. IT PROVIDES BOTH SURGICAL AND NON-SURGICAL WEIGHT LOSS OPTIONS. PROGRAMS ARE DESIGNED FOR THE PATIENT THROUGH A TEAM APPROACH AND INCLUDES AN ON-SITE FITNESS CENTER, SUPPORT GROUPS, AND COMMUNITY EDUCATION. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 699 AND 425 RESPECTIVELY. GOSHEN HOSPITAL ASSOCIATION, INC. OFFERED COMMUNITY PROGRAMS FOCUSING ON OBESITY PREVENTION, NUTRITION, WEIGHT MANAGEMENT, RUN THE HALLS AND HEALTHY STEPS TO HEALTHY WEIGHT. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 480 AND 713 RESPECTIVELY. FITNESS CENTER CLASSES, SEMINARS, SUPPORT GROUPS, TEEN HEALTH CLUB AS WELL AS AN ANNUAL GET UP AND GOSHEN EVENT WAS OFFERED TO THE COMMUNITY. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 13,116 AND 1,219 RESPECTIVELY.HEALTH NEED IDENTIFIED: ACCESS TO HEALTH SERVICESA TOTAL OF 17 NEW PROVIDERS IN 2016 AND 7 IN 2017, PCPS AND SPECIALTY PHYSICIANS WERE UTILIZED BY GOSHEN HOSPITAL ASSOCIATION, INC. TO HELP INCREASE THE ACCESS TO HEALTH SERVICES. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 3,357 AND 2,157 RESPECTULLY. GOSHEN HOSPITAL ASSOCIATION, INC. PARTIPATED IN NURSING CLINICALS AS WELL AS PROVIDED VARIOUS TYPES OF EDUCATION TO MEDICAL STUDENTS AND OTHER HEALTH PROFESSIONS. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 733 AND 2,084 RESPECTIVELY. LOW OR NO-COST COMMUNITY SCREENING EVENTS WERE HOSTED IN THE COMMUNITY. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 2,465 AND 1,912 RESPECTIVELY. COMMUNITY FLU SHOT CLINICS WERE OFFERED TO THE COMMUNITY. THE NUMBER OF PERSON SERVED IN 2016 AND 2017 IS 146 AND 69 RESPECTIVELY. GOSHEN HOSPITAL ASSOCIATION, INC. PROVIDES FREE ASSISTANCE TO COMMUNITY MEMBERS WHO HAVE A NON-EMERGENCY, HEALTH RELATED QUESTION THROUGH NURSE ON CALL SERVICES. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 11,952 AND 8,327 RESPECTIVELY.HEALTH NEED IDENTIFIED: MENTAL HEALTH ACCESS AND COORDINATIONGOSHEN HOSPITAL ASSOCIATION, INC. COORDINATED A TELEMENTAL HEALTH PROJECT IN WHICH PATIENTS COULD INTERACT WITH A MENTAL HEALTH PROFESSIONAL THROUGH VIDEO CONFERENCING. THE NUMBER OF PERSONS SERVED IN 2016 IS 40. SCREENINGS WERE CONDUCTED FOR DEPRESSION, DISTRESS, DEPRESSION AND MENTAL HEALTH. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 66,691 AND 28,308 RESPECTIVELY.GROUP THERAPY WAS OFFERED BY THE CENTER FOR CANCER CARE. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 31 AND 46 RESPECTIVELY. HEALTH NEED IDENTIFIED: TREATMENT OF CHRONIC CONDITIONSQUALITY MEASURES REGARDING DIABETES, HEART FAILURE, DEPRESSION AND OTHER AREAS DETERMINED BY PAYORS ARE MONITORED AND USED TO EVALUATE PROCESSES AND WORKFLOWS TO IMPROVE THE QUALITY OF CARE PROVIDED TO PATIENTS. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 36,634 AND 39,368 RESPECTIVELY. DIABETES EDUCATION, SUPPORT GROUPS, ACTION PLANS AND SEMINARS WERE PROVIDED BY GOSHEN HOSPITAL ASSOCIATION, INC. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 2,069 AND 1,177 RESPECTIVELY.SERVICES LIKE COPD ACTION PLANNING AND OUTREACH TELEPHONE CALLS WERE ALSO CONDUCTED. THE NUMBER OF PERSONS SERVED 2016 AND 2017 IS 61 AND 72 RESPECTIVELY.AMBULATORY NURSE CARE COORDINATION WAS GIVEN TO HIGH RISK ACO PATIENTS. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 1,390 AND 1,230 RESPECTIVELY.GOSHEN HOSPITAL ASSOCIATION, INC. COORDINATED SERVICES WITH HEALTH COACHES, HOME HEALTH CARE AND HOSPICE. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 232 AND 149 RESPECTIVELY.A CHRONIC-DISEASE SUPPORT GROUP AS WELL AS CANCER SUPPORT AND COORDINATED WAS PROVIDED. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 878 AND 2,617. RESPECTIVELY.GOSHEN HEALTH CREATED A COLORECTAL SCREEN KIT INITIATIVE IN 2017 THAT SERVED 135.GOSHEN HOSPITAL HELD A MEGABODY HEALTH FAIR AND FREE SCREENING EVENT IN 2017 THAT SERVED 2,913.HEALTH NEED IDENTIFIED: TOBACCO USE/SMOKING CESSATIONGOSHEN HOSPITAL ASSOCIATION, INC. PROVIDED TOBACCO EDUCATION AND SUPPORT GROUPS. THE NUMBER OF PERSONS SERVED IN 2016 AND 2017 IS 9,690 AND 9,215 RSPECTIVELY.
GOSHEN HOSPITAL ASSOCIATION, INC.PART V, SECTION B, LINE 13H: FAMILY SIZE IS ANOTHER FACTOR IN DETERMINING DISCOUNTS GRANTED TO PATIENTS.
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - GOSHEN HOSPITAL
200 HIGH PARK AVEGOSHENIN46526CLINIC
2 - THE RETREAT WOMEN'S HEALTH CENTER
1135 PROFESSIONAL DRIVEGOSHENIN46526CLINIC
3 - INDIANA LAKES ACCOUNTABLE CARE
2018 SOUTH MAIN STREETGOSHENIN46526ACO: AMBULATORY CARE COORDINATION
4 - INDIANA LAKES MANAGED CARE
2018 SOUTH MAIN STREETGOSHENIN46526HEALTH CARE MANAGEMENT
5 - NEW PARIS MEDICAL CLINIC
200 HIGH PARK AVEGOSHENIN46526CLINIC

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 6A:GOSHEN HOSPITAL ASSOCIATION, INC. REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE GOSHEN HEALTH, INC. ANNUAL COMMUNITY BENEFIT REPORT (EIN: 35-1955872).
PART I, LINE 7:GOSHEN HOSPITAL ASSOCIATION, INC. CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 21,489,163.
PART II, COMMUNITY BUILDING ACTIVITIES:GOSHEN HOSPITAL ASSOCIATION, INC. PROMOTED THE HEALTH OF ITS COMMUNITY BY SUPPORTING VARIOUS LOCAL ORGANIZATIONS THAT ENGAGE IN COMMUNITY BUILDING ACTIVITIES.
PART III, LINE 2:GOSHEN HOSPITAL ASSOCATION, INC.'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS "LOOK-BACK" METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY.
PART III, LINE 3:GOSHEN HOSPITAL ASSOCIATION, INC. ESTIMATED THE POSSIBLE AMOUNT OF CHARITY CARE WITHIN BAD DEBT EXPENSE BY REVIEWING ACCOUNTS THAT WERE INTERNALLY CODED AS HAVING BEEN PROVIDED A FINANCIAL ASSISTANCE APPLICATION, BUT THAT WAS NOT COMPLETED BY THE PATIENT OR GUARANTOR, IN WHICH THE ACCOUNT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT.
PART III, LINE 4:THE FOLLOWING NARRATIVE ADDRESSES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHICH IS INCLUDED IN THE FOOTNOTES IN THE FINANCIAL STATEMENTS FOR GOSHEN HOSPITAL ASSOCIATION, INC.:THE PROVISION FOR UNCOLLECTED PATIENT ACCOUNTS, FOR ALL PAYORS, IS RECOGNIZED WHEN SERVICES ARE PROVIDED BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CHANGES AND TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND AGING, THE SIGNIFICANCE OF INDIVIDUAL PAYORS TO OUTSTANDING ACCOUNTS RECEIVABLE BALANCES, AND HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, AS ADJUSTED FOR COLLECTION INDICATORS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION OF UNCOLLECTED PATIENT ACCOUNTS AN THE ALLOWANCE FOR UNCOLLECTED ACCOUNTS. IN ADDITION, GOSHEN HOSPITAL FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES. PATIENT ACCOUNTS THAT ARE UNCOLLECTED, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTION POLICIES OF GOSHEN HOSPITAL AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CARE IF DEEMED TO OTHERWISE MEET FINANCIAL ASSISTANCE POLICIES OF GOSHEN HOSPITAL.
PART III, LINE 8:ACTUAL MONTH AND YEAR TO DATE REVENUE, CONTRACTUALS, ACCOUNTS RECEIVABLE BALANCES, RATIOS AND STATISTICS ARE COMPARED TO BUDGET AND PRIOR YEAR ON A MONTHLY BASIS. VARIANCES ARE REVIEWED AND ANALYZED BY FINANCE REPRESENTATIVES, HOSPITAL DIRECTORS AND CFO. ADDITIONALLY, ACTUAL CONTRACTUAL ALLOWANCE AS A PERCENTAGE OF GROSS ACCOUNTS RECEIVABLE AND CONTRACTUAL PROVISION AS A PERCENTAGE OF GROSS PATIENT CHARGES COMPARED TO BUDGETED AND PRIOR YEAR AMOUNTS ARE MONTIORED. THIS IS DONE AS PART OF THE HOSPITAL'S MONTHLY CLOSE PROCESS, EXPLANATIONS TO VARIANCES (OR NON-VARIANCES WHEN EXPECTED) ARE RESEARCHED AND PROVIDED BY THE APPROPRIATE PERSONNEL AND REVIEWED WITH MANAGEMENT OF THE HOSPITAL. THE FINANCE DEPARTMENT ALSO CONSIDERS THESE KEY PERFORMANCE INDICATORS WHEN DEVELOPING THEIR ESTIMATES OF CONTRACTUAL ALLOWANCES TO ENSURE RECORDED AMOUNTS APPEAR REASONABLE BASED ON ACTUAL DATA AVAILABLE.FINANCIAL REPRESENTATIVES PREPARE AND UPDATE THE CONTRACTUAL ALLOWANCE MODEL AS A BASIS FOR ALL THIRD PARTY PAYORS BASED ON ACTUAL STATISTICS (E.G. DISCHAGES, DAYS, ETC.) AND ON CURRENT REIMBURSEMENT RATES. THE MODEL ANALYZES PATIENT RECEIVABLES AND CONTRACTUAL ALLOWANCE BY PAYOR AND BY PATIENT STATUS. THE MODEL ESTIMATES THE COLLECTABILITY OF PATIENT ACCOUNTS BASED ON HISTORICAL COLLECTION RATES. FINANCE COLLEAGUES ALSO UPDATE THE MODEL TO ACCOUNT FOR CHANGES IN REIMBURSEMENT RULES. AFTER THE MODEL IS PREPARED, IT IS REVIEWED BY THE CHIEF FINANCIAL OFFICER FOR APPROPRIATENESS AND REASONABLENESS.CONTRACTUAL ALLOWANCE CALCULATIONS ARE RECONCILED TO THE GENERAL LEDGER ON A MONTHLY BASIS. ONCE THE CALCULATION IS PREPARED, THE FINANCE DEPARTMENT ADJUSTS THE GENERAL LEDGER ACCOUNTS.
PART III, LINE 9B:FINANCIAL ASSISTANCE IS GRANTED TO THOSE PATIENTS UNABLE TO PAY ALL OR A PORTION OF THEIR BILL AND WHO ARE UNABLE TO QUALIFY FOR ASSISTANCE THROUGH FEDERAL AND STATE GOVERNMENT ASSISTANCE PROGRAMS. IF AFTER INSURANCE REIMBURSEMENT ADDITIONAL ASSISTANCE IS NEEDED, ALL PATIENTS MAY OBTAIN FINANCIAL ASSISTANCE IF THE INCOME CRITERIA ARE MET. ALL FINANCIAL ASSISTANCE APPLICATIONS ARE BASED ON POLICY GUIDELINES. UNINSURED PATIENTS ARE REQUIRED TO PROVIDE DOCUMENTATION AND AN APPLICATION. WHEN APPROVED, THE ADJUSTMENT IS APPLIED TO THE PATIENT'S ACCOUNT. FOR PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, PAYMENT PLANS AND LUMP SUM SETTLEMENTS ARE AVAILABLE. GOSHEN HOSPITAL ASSOCIATION, INC. ALSO PARTNERS WITH A LOCAL FINANCING INSTITUTION TO PROVIDE A FLEXIBLE AND AFFORDING FINANCING SOLUTION.
PART VI, LINE 2:AS A COMMUNITY HOSPITAL, GOSHEN HOSPITAL ASSOCIATION, INC. IS DEDICATED TO MEETING THE SPECIFIC HEALTH CARE NEEDS OF OUR COMMUNITY. THE HOSPITAL HAS 123 PATIENT BEDS AND OVER 137 PHYSICIANS ON ITS MEDICAL STAFF IN NEARLY 25 SPECIALTIES. THESE PHYSICIANS, TOGETHER WITH OTHER DEDICATED PROFESSIONALS, PROVIDE A WIDE RANGE OF SERVICES INCLUDING THE FOLLOWING: ACUTE MEDICAL & SURGICAL, EMERGENCY, HOME HEALTH, RADIOLOGY, LABORATORY, CANCER CARE, BARIATRICS, WOMEN'S HEALTH, PAIN MANAGEMENT, SLEEP STUDIES, REHABILITATION, PATIENT AND COMMUNITY HEALTH EDUCATION, PROFESSIONAL EDUCATION, AND CARDIOVASCULAR SERVICES.THE CENTER FOR CANCER CARE IS A LEADER IN INNOVATIVE CANCER TREATMENT. WE WERE AMONG THE FIRST TO ADOPT A COMPREHENSIVE, MULTIDISCIPLINARY APPROACH TO CANCER TREATMENT. WE OFFER HOLISTIC PROGRAMS FOR STRENGTHENING MINDS AS WELL AS BODIES, PLACE A PREMIUM ON FAMILY INVOLVEMENT AND SPIRITUAL NEEDS, AND ENCOURAGE PATIENTS TO PLAY A DECISION-MAKING ROLE IN TREATMENT SELECTION. THE CENTER FOR CANCER CARE HAS SPECIALLY TRAINED SURGICAL ONCOLOGISTS, A BREAST SURGEON, MEDICAL ONCOLOGISTS, A RADIATION ONCOLOGIST, NATUROPATHIC PRACTITIONERS AND HIGHLY DISTINGUISHED MAGNET DESIGNATED NURSES.GOSHEN HOSPITAL ASSOCIATION, INC. IMPROVES THE HEALTH AND WELL-BEING OF ITS COMMUNITIES BY PROVIDING COMMUNITY WELLNESS AND EDUCATION PROGRAMS. THROUGH LOCAL PARTNERSHIPS, THE HOSPITAL IDENTIFIES HEALTH ISSUES AND CREATES PROGRAMS TO ENSURE OUR COMMUNITY IS THE HEALTHIEST PLACE TO LIVE, WORK AND RAISE A FAMILY. THE FIRST OF THESE PROGRAMS COVER CPR, EMS, DIABETES, CHILDBIRTH, FITNESS, NUTRITION, COMMUNITY EDUCATION AND HEALTH SCREENINGS AND ELKHART COUNTY CHILDHOOD OBESITY INITIATIVE. THE CPR CLASS IS FOR ANYONE - PROFESSIONALS OR PRIVATE CITIZENS - WHO WANT TO KNOW HOW TO PERFORM LIFE-SAVING CARDIOPULMONARY RESUSCITATION; FIRST AID CLASSES ARE ALSO OFFERED. EMS TRAINING IS AVAILABLE FOR PERSONS INTERESTED IN BECOMING EMERGENCY MEDICAL TECHNICIANS OR FIREFIGHTERS. THE DIABETES EDUCATION HELPS PEOPLE DELAY THE ONSET AND SLOW THE PROGRESSION OF COMPLICATIONS FROM THIS DISEASE. IT INCLUDES SEMINARS, SUPPORT GROUPS, CONSULTATIONS AND SCREENINGS. CHILDBIRTH EDUCATION PREPARES EXPECTANT MOTHERS AND THEIR FAMILIES DURING THIS SIGNIFICANT TIME IN THEIR LIFE. CLASSES REVIEW MANY ASPECTS OF CHILDBIRTH INCLUDING LABOR REHEARSAL, CESAREAN DELIVERIES, SINGLE-TEEN ISSUES, BREAST FEEDING AND A CLASS JUST FOR SIBLINGS.IN ADDITION TO VARIOUS COMMUNITY WELLNESS AND EDUCATION PROGRAMS, GOSHEN HOSPITAL ASSOCATION, INC. PROVIDES A FULL-SERVICES RESOURCE FOR COMPEHENSIVE HEALTH INFORMATION AND ASSISTANCE. NURSE ON CALL (NOC) IS FULL-SERVICE, MULTI-LINGUAL HEALTH INFORMATION, REFERRAL AND NURSE TRIAGE TELEPHONE SERVICE AVAILABLE 24 HOURS A DAY, 7 DAYS A WEEK. NOC IS STAFFED BY SPECIALLY TRAINED, KNOWLEDGEABLE AND EXPERIENCED REGISTERED NURSES. THIS FREE SERVICE PROVIDES MEDICAL GUIDANCE WHEN SICK OR INJURED, INFORMATION ON PHYSICIANS IN THE AREA, REFERRALS TO COMMUNITY RESOURCES AND REGISTRATION FOR CLASSES AND EVENTS.
PART VI, LINE 3:UNINSURED PATIENTS ARE SCREENED DURING THE PRE-REGISTRATION PROCESS FOR ELIGIBILITY IN THE HEALTHY INDIANA PLAN AND OFFER ANY OTHER KNOWN SOURCES OF FINANCIAL ASSISTANCE. ALL REGISTRATION LOCATIONS HAVE FINANCIAL ASISSTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE AND WILL HAVE INFORMATION ON THE CRITERIA AND PROCESS FOR APPLYING FOR FINANCIAL ASSISTANCE. APPLICATONS ARE ALSO PROVIDED TO ANY PATIENTS WITH A BALANCE DUE WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE. COUNSELORS ARE AVAILABLE TO PATIENTS TO AID IN THE APPLICATION PROCESS INCLUDING THE COLLECTION OF INFORMATION TO COMPLETE THE APPLICATION. PAYMENT OPTIONS AND INFORMATION ON FINANCIAL ASSISTANCE IS AVAILABLE ON THE HOSPITAL'S WEBSITE. PATIENTS MAY DOWNLOAD A PRELIMINARY APPLICATION, AND THE PATIENT AGREEMENT ASSOCIATED WITH FINANCIAL ASSISTANCE FORM THE WEBSITE, THIS INFORMATION IS AVAILABLE IN ENGLISH AND SPANISH.
PART VI, LINE 4:GOSHEN HOSPITAL SERVES THE NORTHERN INDIANA AREA IN ELKHART COUNTY. ACCORDING TO THE 2017 CENSUS, THE POPULATION OF ELKHART COUNTY IS 205,032. THE MEDIAN INCOME FOR A HOUSEHOLD IS ELKHART COUNTY BASED ON THE 2016 CENSUS IS $49,692. APPROXIMATELY 13.2% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 27.7% OF THOSE UNDER THE AGE 18 AND 14.4% OF THOSE AGE 65 AND OVER. THE RACIAL MAKEUP OF THE COUNTY WAS ABOUT 74.9% WHITE, 6.2% AFRICAN AMERICAN, AND 16.0% HISPANIC OR LATINO. THE REMAINING 2.9% OF THE POPULATION IS A MAKEUP OF ALL OTHER RACES.
PART VI, LINE 5:ALL OF THE HOPSITAL'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. A MAJORITY OF THE BOARD MEMBERS ARE INDEPENDENT OF THE ORGANIZATION. THE GOVERNING BODY APPROVES MEDICAL STAFF PRIVELEGES AS INDICATED IN THE ORGANIZATION'S CREDENTIALING AND PRIVELEGING POLICIES AND AS RECOMMENDED BY THE MEDICAL EXECUTIVE COMMITTEE OF THE HOSPITAL. THE HOSPITAL'S GOVERNING BODY APPROVES THE ANNUAL OPERATING BUDGET FOR THE HOSPITAL AND THE EXPENDITURE OF CAPITAL FUNDS ABOVE CERTAIN DOLLAR AMOUNTS. THE GOVERNING BODY ALSO PARTICIPATES IN STRATEGIC PLANNING INITIATIVES TO DETERMINE GOALS OBJECTIVES FOCUSED ON PATIENT CARE FOR THE COMMUNITY.
PART VI, LINE 6:HOSPITAL MANAGEMENT PROVIDES GOSHEN HEALTH WITH THE HOSPITAL'S ANNUAL OPERATING BUDGET AND KEY STRATEGIC OBJECTIVES. IN ADDITION, THE HOSPITAL MANAGEMENT PROVIDES GOSHEN HOSPITAL ASSOCIATION, INC. WITH VARIOUS KEY METRICS INVOLVING PATIENT SATISFACTION, PATIENT QUALITY AND COLLEAGUE SATISFACTION. GOSHEN HOSPITAL ASSOCIATION, INC. REVIEWS THE DATA TO ENSURE KEY INITIATIVES ARE FOCUSED TOWARDS THE PROMOTING AND MEETING THE HEALTHCARE NEEDS OF THE COMMUNITIES. IN ADDITION, THE HOSPITAL COLLABORATES WITH GOSHEN HEALTH TO PROVIDE NECESSARY NURSING EDUCATION AND PHYSICIAN RECRUITMENT TO ASSIST IN MEETING THE HEALTH NEEDS OF THE COMMUNITY.
PART VI, LINE 7, REPORTS FILED WITH STATESIN

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
MAPLE CITY HEALTH CARE CENTER
213 MIDDLEBURY STREETGOSHENIN46528351749398501(C)(3)$200,000OPERATING SUPPORT
BOYS & GIRLS CLUBS ELKHART COUNTY
102 WEST LINCOLN SUITE 240GOSHENIN46526351033735501(C)(3)$125,200OPERATING SUPPORT
NORTHERN INDIANA HISPANIC HEALTH
444 NAPPANEE STREETELKHARTIN46514320039221501(C)(3)$60,000OPERATING SUPPORT
THE HORIZON EDUCATIONAL ALLIANCE
124 E WASHINGTON STREETGOSHENIN46528460803293501(C)(3)$30,000OPERATING SUPPORT
CENTER FOR HEALING AND HOPE
423 E JEFFERSON STREETGOSHENIN46528020560511501(C)(3)$21,383OPERATING SUPPORT
UNITED CANCER SERVICES ELKHART COUNTY
23971 US HIGHWAY 33ELKHARTIN46530351091429501(C)(3)$20,000OPERATING SUPPORT
COUNCIL ON AGING OF ELKHART COUNTY INC
230 E JACKSON BLVDELKHARTIN46516510178910501(C)(3)$20,000OPERATING SUPPORT
CARE FOUNDATION INC
64468 MEADOW RIDGE DRIVEGOSHENIN46526352111562501(C)(3)$15,000OPERATING SUPPORT
ELKHART COUNTY CLUBHOUSE
PO BOX 173GOSHENIN46527271151738501(C)(3)$10,800OPERATING SUPPORT
OAKLAWN
PO BOX 809GOSHENIN46527351070041501(C)(3)$10,000OPERATING SUPPORT
BOYS & GIRLS CLUBS BAK PAK A KID
PO BOX 614GOSHENIN465270614351033735501(C)(3)$10,000OPERATING SUPPORT
BASHOR HOME OF THE UMC INC
62226 COUNTY ROAD 15GOSHENIN46526350933555501(C)(3)$7,800OPERATING SUPPORT
FAMILY CHRISTIAN DEVELOPMENT CENTER
151 S LOCKE STREETNAPPANEEIN46550351979463501(C)(3)$7,550OPERATING SUPPORT
CHILD AND PARENT SERVICES
100 W HIVELY AVENUEELKHARTIN46517350888765501(C)(3)$6,000OPERATING SUPPORT
GOSHEN COMMUNITY SCHOOLS
613 PURL STREETGOSHENIN46526351099157501(C)(3)$6,000OPERATING SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org15Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S. CONSISTS OF REQUIRING THE COMPLETION OF A FOLLOW-UP REPORT FORM WITH SUBSEQUENT GRANT FUND APPLICATIONS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E Expnss0WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JODY NEER MD
VICE CHAIR$0$391,569$0$28,875$0$17,485$0$28,727$0$41,150$0$507,806$0$0
DANIEL NAFZIGER MD
DIRECTOR$0$61,491$0$104,841$0$150$0$14,445$0$352$0$181,279$0$0
RANDAL CHRISTOPHEL
PRESIDENT AND CEO$591,722$0$242,362$0$21,646$0$131,413$0$40,428$0$1,027,571$0$0$0
AMY FLORIA
CHIEF FINANCIAL OFFICER$371,147$0$99,927$0$14,890$0$23,285$0$31,691$0$540,940$0$0$0
ALAN WELDY
VP OF HR AND COMPLIANCE$389,972$0$103,196$0$10,376$0$64,668$0$36,598$0$604,810$0$0$0
ROB MYERS
CHIEF OPERATING OFFICER$383,619$0$71,415$0$4,692$0$65,539$0$38,883$0$564,148$0$0$0
MARGARET S FRANGER
VP OF CANCER SERVICES$308,096$0$79,394$0$1,396$0$57,945$0$31,546$0$478,377$0$0$0
STEVE GARBODEN
VP PLANNING AND MANAGED CARE$251,636$0$60,201$0$10,668$0$28,816$0$31,863$0$383,184$0$0$0
VLADIMIR RADIVOJEVIC
VP OF SURGICAL SERVICES$168,505$0$43,576$0$15,361$0$6,354$0$34,772$0$268,568$0$0$0
JULIE CROSSLEY
CHIEF NURSING OFFICER$208,116$0$33,397$0$1,985$0$45,396$0$27,813$0$316,707$0$0$0
MARK PODGORSKI
VP OF HOSPITAL OPERATIONS$253,163$0$59,157$0$5,413$0$51,756$0$27,757$0$397,246$0$0$0
LARRY ALLEN MD
CHIEF MEDICAL EXECUTIVE$371,912$0$89,971$0$11,723$0$61,987$0$35,674$0$571,267$0$0$0
HUBERT FORNALIK MD
PHYSICIAN$569,839$0$45,500$0$0$0$28,896$0$2,849$0$647,084$0$0$0
RODERICH SCHWARZ MD
PHYSICIAN$515,678$0$83,220$0$0$0$26,210$0$28,758$0$653,866$0$0$0
DANIEL BRUETMAN MD
PHYSICIAN$508,512$0$69,367$0$0$0$28,446$0$32,752$0$639,077$0$0$0
HOUMAN VAGHEFI MD
PHYSICIAN$482,889$0$80,733$0$0$0$22,690$0$44,184$0$630,496$0$0$0
EBENEZER KIO MD
PHYSICIAN$510,837$0$40,500$0$0$0$28,896$0$32,221$0$612,454$0$0$0
PAM KARSEN
VP OF NURSING$0$0$0$0$153,734$0$0$0$0$0$153,734$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AGOSHEN HOSPITAL REIMBURSED 2 DIRECTORS AND 1 OFFICER REPORTED ON PART VII, SECTION A FOR TRAVEL EXPENSES OF COMPANIONS. GOSHEN HOSPITAL PAID FOR COUNTRY CLUB DUES FOR 1 OFFICER LISTED IN FORM 990, PART VII. ALL REIMBURSEMENTS ARE CONSIDERED TAXABLE INCOME TO EMPLOYEES. GOSHEN HOSPITAL GROSSED UP THE TAXABLE VALUE OF AUTOMOBILES FOR 3 OF THE OFFICERS LISTED IN FORM 990, PART VII AND INCLUDED THE AMOUNT IN THE EMPLOYEES' W-2 AS ADDITIONAL COMPENSATION.
PART I, LINE 1BGOSHEN HOSPITAL DOES NOT HAVE A SPECIFIC WRITTEN POLICY FOR THE REIMBURSEMENT OF EXPENSE FOR TRAVEL FOR COMPANIONS, BUT DOES REQUIRE ALL EXPENSES TO BE SUBSTANTIATED IN ACCORDANCE WITH AN ACCOUNTABLE PLAN. THESE REIMBURSEMENTS OF EXPENSES WERE REGARDED AS A BONA FIDE BUSINESS EXPENSE AND WERE NOT TREATED AS TAXABLE TO THE INDIVIDUALS.
PART I, LINES 4A-BTHE FOLLOWING INDIVIDUALS RECIEVED SEVERANCE PAYMENTS IN 2017 THAT WERE TREATED AS TAXABLE AND INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III): VLADIMIR RADIVOJEVIC $13,916 ELIGIBLE EXECUTIVES PARTICIPATE IN VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. THE FOLLWING INDIVIDUALS PARTICIPATE IN THE PLAN: RANDAL CHRISTOPHEL LARRY ALLEN MARK PODGORSKI ALAN WELDY ROB MYERS JULIE CROSSLEY MARGARET FRANGER THE FOLLOWING INDIVIDUALS RECIEVED NONQUALIFIED PLAN PAYMENTS IN 2017 THAT ARE INCLUDED AS TAXABLE INCOME IN SCHEDULE J, PART II, COLUMN (B)(III): PAMELA KARSEN $153,734

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

FieldValueIRS element (for citing)
PersonJODY NEER MDPersonNm
Relationship With OrgTRUSTEERelationshipWithOrgTxt
Loan PurposeMISCELLANEOUSLoanPurposeTxt
Loan From OrganizationYes (X)LoanFromOrganizationInd
Original Principal$75,000OriginalPrincipalAmt
Balance Due$40,000BalanceDueAmt
Default0DefaultInd
Board Or Committee ApprovalYes (1)BoardOrCommitteeApprovalInd
Written AgreementYes (1)WrittenAgreementInd
FieldValueIRS element (for citing)
Total Balance Due$40,000TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, LINE 4ATHE MISSION OF GOSHEN HOSPITAL IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES BY PROVIDING INNOVATIVE, OUTSTANDING CARE AND SERVICE, THROUGH EXCEPTIONAL PEOPLE DOING EXCEPTIONAL WORK. THE HOSPITAL'S VALUES INCLUDE: -COMPASSION - AND COMMITMENT TO SERVICE WITH EMPATHY. -ACCOUNTABILITY - WITH INTEGRITY AND ACTION. -RESPECT - THROUGH TREATING OTHERS AS YOU WISH TO BE TREATED. -EXCELLENCE - IN ALL WE DO. BUILDING UPON OUR MISSION AND VALUES, GOSHEN HOSPITAL WILL DELIVER EXCEPTIONAL HEALTHCARE TO THE COMMUNITIES WE SERVE USING AN INTEGRATED MODEL OF CARE AND ACHIEVING EXCELLENCE THROUGH A COMMITMENT TO QUALITY, LEADERSHIP, AND INNOVATION. BY 2020, WE WILL ACHIEVE THIS VISION BY FOCUSING ON THE FOLLOWING STRATEGIC PRIORITIES: -LEAD THE REGION IN CLINICAL INTEGRATION AND MANAGEMENT OF POPULATION HEALTH. -DELIVER HIGH VALUE TO OUR PATIENTS, PROVIDERS, PAYERS AND COLLEAGUES. -GOSHEN'S ONCOLOGY AND HEART & VASCULAR SERVICE LINES BECOME THE DESTINATION OF CHOICE IN OUR BROADER REGION. -CULTIVATE A CULTURE FOR COLLEAGUES WHERE PERSONAL AND PROFESSIONAL MISSIONS ARE ALIGNED. -INSPIRE A SPIRIT OF PARTNERSHIP AND GENEROSITY BY ENGAGING OUR COMMUNITY WITH OPPORTUNITIES THAT MEET REGIONAL HEALTH NEEDS. AS A COMMUNITY HOSPITAL, GOSHEN HOSPITAL IS DEDICATED TO MEETING THE SPECIFIC HEALTH CARE NEEDS OF OUR COMMUNITIES. AS A COMMUNITY LEADER, THE HOSPITAL IS COMMITTED TO PROVIDING CARE IN AN INNOVATING AND DYNAMIC ENVIRONMENT. THE HOSPITAL HAS 123 PATIENT BEDS AND OVER 137 PHYSICIANS ON ITS MEDICAL STAFF IN NEARLY 25 SPECIALTIES. THESE PHYSICIANS, TOGETHER WITH OTHER DEDICATED PROFESSIONALS, PROVIDE A WIDE RANGE OF SERVICES INCLUDING THE FOLLOWING: ACUTE MEDICAL & SURGICAL, EMERGENCY, HOME HEALTH, RADIOLOGY, LABORATORY, CANCER CARE, BARIATRICS, WOMEN'S HEALTH, PAIN MANAGEMENT, SLEEP STUDIES, REHABILITATION, PATIENT AND COMMUNITY HEALTH EDUCATION AND PROFESSIONAL EDUCATION. GOSHEN HOSPITAL HAS CONSISTENTLY MET NATIONAL QUALITY STANDARDS. THE HOSPITAL COMPOSITE SCORES FOR PUBLICLY REPORTED QUALITY MEASURES IN THE AREAS OF ACUTE MYOCARDIAL INFARTCTION, PNEUMONIA, HEART FAILURE, SURGICAL CARE IMPROVEMENT PROJECT, AND HOSPITAL OUTPATIENT EXCEEDED 95% IN 2013. IN ADDITION, HEALTHCARE EXCEL (QUALITY IMPROVEMENT ORGANIZATION FOR INDIANA) REPORTED THAT THE HOSPITAL WAS ABOVE OUR PEER GROUP AND OVERALL STATE PERFORMANCE IN 17 OUT OF 19 AREAS OF OUR PUBLICLY REPORTED MEASURES FOR CY 2013. THE AMERICAN NURSES CREDENTIALING CENTER'S (ANCC) MAGNET RECOGNITION PROGRAM FOR EXCELLENCE IN NURSING SERVICES HAS DESIGNATED GOSHEN HOSPITAL AS A MAGNET HOSPITAL. DESIGNATED HOSPITALS HAVE SUCCESSFULLY CREATED A WORK ENVIRONMENT THAT NURSES FIND BOTH PERSONALLY AND PROFESSIONALLY REWARDING, ADVANCING THE PRACTICE OF NURSING AND IMPROVING PATIENT OUTCOMES. RESEARCH SHOWS THAT MAGNET HOSPITALS ARE MORE EFFECTIVE AT ATTRACTING AND KEEPING QUALITY NURSES. GOSHEN HOSPITAL IS AMONG AN ELITE GROUP OF ONLY 7% OF HOSPITALS IN THE NATION TO BE RE-DESIGNATED AS A MAGNET FACILITY AND THE ONLY FACILITY IN THE REGION. THE GOSHEN CENTER FOR CANCER CARE IS ACCREDITED BY THE COMMISSION ON CANCER OF THE AMERICAN COLLEGE OF SURGEONS (COC). RECEIVING CARE AT A COC-APPROVED CENTER FOR CANCER CARE ASSURES THAT PATIENTS WILL HAVE ACCESS TO: -QUALITY CARE CLOSE TO HOME. -COMPREHENSIVE CARE OFFERING A RANGE OF STATE-OF-THE ART SERVICES AND EQUIPMENT. -A MULTIDISCIPLINARY TEAM APPROACH TO COORDINATE THE BEST TREATMENT OPTIONS AVAILABLE TO CANCER PATIENTS. -PARTICIPATION IN CANCER CLINICAL TRIALS, EDUCATION AND SUPPORT. -LIFELONG PATIENT FOLLOW-UP THROUGH A CANCER REGISTRY THAT COLLECTS DATA ON TYPE AND STAGE OF CANCERS AND TREATMENT RESULTS. -ONGOING MONITORING AND IMPROVEMENT IN CARE. THE CENTER FOR CANCER CARE IS A LEADER IN INNOVATIVE CANCER TREATMENT. WE WERE AMONG THE FIRST TO ADOPT A COMPREHENSIVE, MULTIDISCIPLINARY APPROACH TO CANCER TREATMENT. WE OFFER HOLISTIC PROGRAMS FOR STRENGTHENING MINDS AS WELL AS BODIES, PLACE A PREMIUM ON FAMILY INVOLVEMENT AND SPIRITUAL NEEDS, AND ENCOURAGE PATIENTS TO PLAY A DECISION-MAKING ROLE IN TREATMENT SELECTION. THE CENTER FOR CANCER CARE HAS SPECIFICALLY TRAINED SURGICAL ONCOLOGISTS, A BREAST SURGEON, MEDICAL ONCOLOGIST, RADIATION ONCOLOGIST, NATUROPATHIC PRACTITIONERS AND HIGHLY DISTINGUISHED MAGNET DESIGNATED NURSES. GOSHEN HOSPITAL IMPROVES THE HEALTH AND WELL-BEING OF ITS COMMUNITIES BY PROVIDING COMMUNITY WELLNESS AND EDUCATION PROGRAMS. THROUGH LOCAL PARTNERSHIPS, THE HOSPITAL IDENTIFIES HEALTH ISSUES AND CREATES PROGRAMS TO ENSURE OUR COMMUNITY IS THE HEALTHIEST PLACE TO LIVE, WORK AND RAISE A FAMILY. THE FIRST OF THESE PROGRAMS COVER CPR, EMS, DIABETES, CHILDBIRTH, FITNESS, NUTRITION, COMMUNITY EDUCATION AND HEALTH SCREENINGS THE ELKHART COUNTY CHILDHOOD OBESITY INITIATIVE. THE CPR CLASS IS FOR ANYONE - PROFESSIONALS OR PRIVATE CITIZENS - WHO WANT TO KNOW HOW TO PERFORM LIFE-SAVING CARDIOPULMONARY RESUSCITATION; FIRST AID CLASSES ARE ALSO OFFERED. EMS TRAINING IS AVAILABLE FOR PERSONS INTERESTED IN BECOMING EMERGENCY MEDICAL TECHNICIANS OR FIREFIGHTERS. THE DIABETES EDUCATION HELPS PEOPLE DELAY THE ONSET AND SLOW THE PROGRESSION OF COMPLICATIONS FROM THIS DISEASE. IT INCLUDES SEMINARS, SUPPORT GROUPS, CONSULTATIONS AND SCREENINGS. CHILDBIRTH EDUCATION PREPARES EXPECTANT MOTHERS AND THEIR FAMILIES DURING THIS SIGNIFICANT TIME IN THEIR LIFE. CLASSES REVIEW MANY ASPECTS OF CHILDBIRTH INCLUDING LABOR REHEARSAL, CESAREAN DELIVERIES, SINGLE-TEEN ISSUES, BREAST FEEDING AND A CLASS JUST FOR SIBLINGS. IN ADDITION TO VARIOUS COMMUNITY WELLNESS AND EDUCATION PROGRAMS, GOSHEN HOSPITAL PROVIDES A FULL-SERVICE RESOURCE FOR COMPREHENSIVE HEALTH INFORMATION AND ASSISTANCE. NURSE ON CALL (NOC) IS A FULL-SERVICE, MULTI-LINGUAL HEALTH INFORMATION, REFERRAL AND NURSE TRIAGE TELEPHONE SERVICE AVAILABLE 24 HOURS A DAY, 7 DAYS A WEEK. NOC IS STAFFED BY SPECIALLY TRAINED, KNOWLEDGEABLE AND EXPERIENCED REGISTRED NURSES. THIS FREE SERVICE PROVIDES MEDICAL GUIDANCE WHEN SICK OR INJURED, INFORMATION FOR PHYSICIANS IN THE AREA, REFERRALS TO COMMUNITY RESOURCES AND REGISTRATION FOR CLASSES AND EVENTS. THE GOSHEN HEALTH COMMUNITY BENEFIT FUND IS ONE EXAMPLE OF HOW GOSHEN HEALTH RE-INVESTS MONEY INTO THE COMMUNITIES WE SERVE. 2017 MARKS THE 19TH ANNIVERSARY OF THE HEALTH SYSTEM'S COMMITMENT. ANY NONPROFIT ORGANIZATION WITH A MISSION CONSISTENT WITH THAT OF GOSHEN HEALTH AND WORKS TOWARD MEETING THE NEEDS OF THE COMMUNITY ARE ENCOURAGED TO APPLY. SINCE ITS INCEPTION IN 1998, THE COMMUNITY BENEFIT GRANT COMMITTEE OF GOSHEN HEALTH'S BOARD OF DIRECTORS HAS AWARDED MORE THAN $5.7 MILLION IN GRANTS TO COMMUNITY ORGANIZATIONS AND PROJECTS THAT MEET THE HEALTH NEEDS OF OUR COMMUNITY. IN 2017, THE COMMUNITY BENEFIT FUND GRANT COMMITTEE AWARDED $349,500 TO 29 DIFFERENT ORGANIZATIONS IN GOSHEN AND SURROUNDING COMMUNITIES. ALSO, $13,442 IN MATCHING GIFTS WERE DISTRIBUTED TO THE 2016 GRANT RECIPIENTS. ADDITIONALLY, FUNDS WERE DESIGNATED TO HELP CREATE THE NEW SITE FOR MAPLE CITY HEALTH CARE CENTER AS WELL AS TO FUND PILOT PROGRAMS LOCALLY IN TELEHEALTH. EVERY YEAR THE BOARD OF DIRECTORS OF GOSHEN HEALTH DESIGNATES A PERCENTAGE OF THE PREVIOUS YEAR'S OPERATIONAL BUDGET FOR THE HOSPITAL'S COMMUNITY BENEFIT FUND, THROUGH WHICH GRANTS ARE AWARDED EACH SPRING. IN 2017, AN ADDITONAL $200,000 WAS DONATED TO HELP MAPLE CITY EXPAND THE NUMBER OF PATIENTS SERVED. GOSHEN HOSPITAL PROVIDES HEALTH CARE SERVICES TO ALL MEMBERS OF THE COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFERS FINANCIAL ASSISTANCE TO THOSE PATIENTS UNABLE TO PAY ALL OR A PORTION OF THEIR BILL AND WHO ARE UNABLE TO QUALIFY FOR ASSISTANCE THROUGH FEDERAL AND STAT GOVERNMENT ASSISTANCE PROGRAMS. PATIENTS ARE ASKED TO COMPLETE A FINANCIAL AID APPLICATION TO DETERMINE THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. THE HOSPITAL PROVIDES THE ASSISTANCE OF A FINANCIAL ADVOCATE TO HELP PATIENTS COMPLETE THIS APPLICATION AND TO INVESTIGATE OTHER FORMS OF AVAILABLE ASSISTANCE INCLUDING ENROLLMENT IN MARKETPLACE PLANS. IN 2017, THE HOSPITAL EXTENDED CHARITY CARE TO 6,567 ACCOUNTS TOTALING $9.8 MILLION. GOSHEN HOSPITAL ALSO PARTNERS WITH A FINANCIAL INSTITUTION TO PROVIDE FLEXIBLE AND AFFORDABLE FINANCING SOLUTIONS FOR A PATIENT'S MEDICAL CARE. GOSHEN HEALTH RECEIVED THE BEACON AWARD FOR EXCELLENCE FROM THE AMERICAN ASSOCIATION OF CRITICAL CARE NURSES. THIS IS THE SECOND TIME GOSHEN HEALTH HAS WON THE AWARD AND IS ONLY ONE OF TWO IN THE STATE TO BE A RECIPIENT. GOSHEN IS THE ONLY HOSPITAL IN THE REGION TO HAVE RECEIVED THIS, AND SECOND IN INDIANA TO HAVE ACHIEVED THE HIGHEST STATUS, GOLD. GOSHEN HOSPITAL HAS BEEN NAMED AN ACCREDITED HEART FAILURE INSTITUTE BY THE NATIONAL HEALTHCARE ADDREDITATION COLLOQUIUM. THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS (NAPBC) HAS AWARDED THREE-YEAR, FULL ACCREDITATION TO GOSHEN HEALTH RETREAT WOMEN'S HEALTH CENTER. PRESS GANEY HAS AWARDED GOSHEN HEALTH WITH 7 SUMMIT AWARDS.
PART III, LINE 4A CONTINUEDTHE FOLLOWING ACHIEVEMENTS WERE AWARDED IN 2014: NCDR ACTION REGISTRY GWTG PLATINUM PERFORMANCE ACHIEVEMENT AWARD; THE CENTER OF DISTINCTION AWARD AND THE ROBERT A. WARRINER III, M.D., CENTER OF EXCELLENCE AWARD WAS GIVEN TO GOSHEN HEALTH WOUND CENTER BY HEALOGICS, INC.; GOSHEN HOSPITAL RECEIVED ACCREDITATION FROM THE INTERSOCIETAL ACCREDITATION COMMISSION (IAC) FOR FOUR TESTING AREAS; 2014 PRESS GANEY GUARDIAN OF EXCELLENCE AWARD WINNER FOR GOSHEN HEALTH BY REACHNG THE 95TH PERCENTILE FOR EACH REPORTING PERIOD FOR THE AWARD YEAR FOR EMPLOYEE ENGAGEMENT; OUTSTANDING ACHIEVEMENT AWARD FROM THE COMMION ON CANCER (COC) OF THE AMERCIAN COLLEGE OF SURGEONS (ACOS). IN ADDITION, GOSHEN HEALTH HAS RECEIVED THE H&V PLATINUM PERFORMANCE ACHIEVEMENT AWARD (NCDR) IN 2017, MAKING IT THE FIFTH YEAR IN A ROW TO RECEIVE THIS ACHIEVEMENT. IN 2017, THE ORGANIZATION ALSO RECEIVED THE WHO BABY-FRIENDLY DESIGNATION FOR THE THIRD CONSECUTIVE YEAR.
FORM 990, PART VI, SECTION A, LINE 2THE FOLLOWING OFFICERS, BOARD MEMBERS, AND KEY EMPLOYEES ARE EMPLOYEES OF GOSHEN HOSPITAL OR ITS RELATED ORGANIZATIONS, AND SERVE ON OTHER RELATED TAXABLE BOARDS: RANDAL CHRISTOPHEL, AMY FLORIA, ALAN WELDY, ROB MYERS, AND LARRY ALLEN, MD.
FORM 990, PART VI, SECTION B, LINE 11BA FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AND THE AUDIT COMMITTEE IN NOVEMBER FOR REVIEW AND QUESTIONS BEFORE THE RETURN IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CEACH BOARD MEMBER COMPLETES AN ANNUAL DISCLOSURE OF KNOWN OR POTENTIAL CONFLICTS. EACH DISCLOSURE IS REVIEWED BY THE VP-LEGAL. ADDITIONALLY WHEN AGENDA ITEMS ARE DISCUSSED AT MEETINGS IT IS ASKED IF THERE ARE ANY KNOWN OR POTENTIAL CONFLICTS OF INTEREST, AND CONFLICTED PARTIES MUST RECUSE THEMSELVES.
FORM 990, PART VI, SECTION B, LINE 15AN INDEPENDENT COMMITTEE APPROVES THE COMPENSATION WHICH IS DETERMINED TO BE REASONABLE BASED UPON INDEPENDENT COMPARABILITY DATA PROVIDED BY AN INDEPENDENT CONSULTANT. APPROVAL OF AMOUNTS ARE DOCUMENTED IN THE MINUTES.
FORM 990, PART VI, SECTION C, LINE 19GOSHEN HOSPITAL WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART XI, LINE 9:INTEREST RATE SWAP 4,425. EQUITY TRANSFER -1,244,936.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

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INDIANA LAKES ACCOUNTABLE CARE ORG LLC
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PARKMOR DRUG INC
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FieldValueIRS element (for citing)
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Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
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Div Related Organization0DivRelatedOrganizationInd
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Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
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