ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME: Form 990, tax year 2016

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Organization
ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME (EIN 42-0733472)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-10
IRS object ID
201811309349300401
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-05-10T02:22:46-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line150 South Sixth Street Suite 2800AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN420733472EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1St Anthony Regional HospitalBusinessNameLine1Txt
Business Name Line2and Nursing HomeBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlSTANBusinessNameControlTxt
Phone7127945246PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1311 South Clark Street PO Box 628AddressLine1Txt
CityCarrollCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51401ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJohn MunsonPersonNm
Person TitleCFOPersonTitleTxt
Phone7127945246PhoneNum
Signature2018-04-30SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKristina RasmussenPreparerPersonNm
PTINP00143920PTIN
Phone6123974000PhoneNum
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerEdward H Smith JrPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1311 South Clark Street PO Box 628AddressLine1Txt
CityCarrollCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51401ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$112,159,791GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.stanthonyhospital.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1905FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionConsistently providing high quality healthcare services to met patient and community needs.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee827TotalEmployeeCnt
Total Volunteers542TotalVolunteersCnt
Total Gross UBI$1,519TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$170,296PYContributionsGrantsAmt
CY Contributions Grants$1,356,314CYContributionsGrantsAmt
PY Program Service Revenue$73,302,323PYProgramServiceRevenueAmt
CY Program Service Revenue$75,621,692CYProgramServiceRevenueAmt
PY Investment Income$1,074,479PYInvestmentIncomeAmt
CY Investment Income$5,654,894CYInvestmentIncomeAmt
PY Other Revenue-$489,405PYOtherRevenueAmt
CY Other Revenue-$487,317CYOtherRevenueAmt
PY Total Revenue$74,057,693PYTotalRevenueAmt
CY Total Revenue$82,145,583CYTotalRevenueAmt
PY Grants And Similar Paid$6,500PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$6,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$36,193,177PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$39,674,142CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$34,959,121PYOtherExpensesAmt
CY Other Expenses$36,686,520CYOtherExpensesAmt
PY Total Expenses$71,158,798PYTotalExpensesAmt
CY Total Expenses$76,366,662CYTotalExpensesAmt
PY Revenues Less Expenses$2,898,895PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,778,921CYRevenuesLessExpensesAmt
Total Assets BOY$145,239,794TotalAssetsBOYAmt
Total Assets EOY$155,354,796TotalAssetsEOYAmt
Total Liabilities BOY$21,354,065TotalLiabilitiesBOYAmt
Total Liabilities EOY$23,604,911TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$123,885,729NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$131,749,885NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSt. Anthony Regional Hospital is inspired by faith and committed to excellence. We are dedicated to improving the health of the people we serve. We will lead in providing high quality, high value healthcare services responsive to the needs of our patients and the region. We are committed to the health ministry of our sponsors, the Franciscan Sisters of Perpetual Adoration.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$69,036,475ExpenseAmt
Grant$6,000GrantAmt
Revenue$75,621,692RevenueAmt
DescSt. Anthony Regional Hospital is a 99 bed acute care facility and St. Anthony Nursing Home has 79 beds in Carroll, IA. In the year ended June 30, 2017, St. Anthony Regional Hospital and Nursing Home provided health care services to approximately 2,732 inpatients, 77,822 outpatients, and 41,239 clinic visits. St. Anthony Regional Hospital provided services for 1,667 acute care inpatients, and provided psychiatric, swing bed, and nursing home services for the remainder of inpatients. Outpatient services were provided to patients through ancillary departments, emergency room, and clinics.See Schedule O.St. Anthony Hospital provides services of cardiac rehabilitation, dialysis, hospice care, laboratory, observation, chemotherapy, pathology, radiology, respiratory therapy, physical therapy, occupational therapy, speech therapy, diabetes, medcial oncology, radiation therapy, and surgical services. St. Anthony's largest patient service area is laboratory. In the year ended June 30, 2017, St. Anthony serviced 17,884 patients in laboratory, 7,375 in emergency room, 6,925 in radiology. The activities pursued by St. Anthony Regional Hospital and Nursing Home in the provision of health care services are consistent with its exempt purpose.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,098,752ExpenseAmt
DescAs part of its mission, St. Anthony Regional Hospital provides medical care to individuals who are unable to pay for services, incurs costs in excess of reimbursement for services to medicaid beneficiaries, and carries out other activities and programs free of charge to support the community in which it operates. Community benefit projects include community health education, health care support services, behavioral health services, community health improvement advocacy, and other traditional charity care.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$72,135,227TotalProgramServiceExpensesAmt
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 EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
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 Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document133IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee827EmployeeCnt
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 Members10GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
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 FldIAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1John R MunsonBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7127945115PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1311 South Clark StAddressLine1Txt
CityCarrollCityNm
State AbbreviationIAStateAbbreviationCd
ZIP514010628ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Fred Dolezal
Chairman0.300.00Yes (X)Yes (X)$0$0$0
Tom Gronstal
Vice-Chairman0.300.00Yes (X)Yes (X)$0$0$0
Sr Romana Klaubauf
Secretary0.300.00Yes (X)Yes (X)$0$0$0
Nick Badding
Treasurer0.300.00Yes (X)Yes (X)$0$0$0
Howard J Drees
Board Member0.300.00Yes (X)$0$0$0
Sr Theresa Keller
Board Member0.300.00Yes (X)$0$0$0
Sr Maris Kerwin
Board Member0.300.00Yes (X)$0$0$0
Wayne Seaman
Board Member0.300.00Yes (X)$0$0$0
Sr Donna Venticher
Board Member0.300.00Yes (X)$0$0$0
Peggy White
Board Member0.300.30Yes (X)$0$0$0
Edward H Smith Jr
CEO/President40.000.30Yes (X)$358,950$0$42,644
John Munson
CFO/Vice President40.000.30Yes (X)$171,197$0$21,096
Richard C Sazama MD
Physician40.000.00$428,340$0$15,150Yes (X)
Nelson H Lo MD
Physician40.000.00$370,872$0$29,670Yes (X)
Maria Hernandez-Zacharias
Physician40.000.00$351,976$0$15,780Yes (X)
Jwong H Ling
Physician40.000.00$309,628$0$0Yes (X)
Tina F Schechinger MD
Physician40.000.00$237,294$0$23,058Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,228,257TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$147,398TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K32IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
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
Medical Oncology
1221 Pleasant StDes MoinesIA50309Oncology Services$551,064
Deloitte and Touche LLP
PO Box 844708DallasTX752844708Accounting Services$148,500
Kimberly R Sevening DBA Hope Group LLC
24327 Douglas CirWaterlooNE68069Computer Services$146,300
Jeffery R Peterson DBA JP Flooring
1411 Amy AveCarollIA51401Carpet and Flooring Services$141,710
Dr Jed Hagen
2313 Skyline DrCarrollIA51401Pathology Services$128,000
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Related Organizations$1,356,314RelatedOrganizationsAmt
Noncash Contributions$400,042NoncashContributionsAmt
Total Contributions$1,356,314TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Patient Svc Revenue621400$41,240,402$41,240,402
Medicare/Medicaid Pmts621400$33,931,319$33,931,319
Cafeteria Sales621400$449,971$449,971
FieldValueIRS element (for citing)
Total Program Service Revenue$75,621,692TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,516,740TotalRevenueColumnAmt
Exclusion$1,516,740ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,047,327RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,536,163RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$488,836RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$488,836TotalRevenueColumnAmt
Exclusion-$488,836ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$32,577,597SecuritiesAmt
Other$38,602OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$28,437,257SecuritiesAmt
Other$40,788OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$4,140,340SecuritiesAmt
Other-$2,186OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,138,154TotalRevenueColumnAmt
Exclusion$4,138,154ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescInc. from PartnershipDesc
Business900004BusinessCd
Total Revenue Column$1,519TotalRevenueColumnAmt
Unrelated Business Revenue$1,519UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,519OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$82,145,583TotalRevenueColumnAmt
Related Or Exempt Func Income$75,171,721RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$1,519UnrelatedBusinessRevenueAmt
Exclusion$5,616,029ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$5,000TotalAmt
Program Services$5,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$1,000TotalAmt
Program Services$1,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$527,877TotalAmt
Management And General$527,877ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$31,672,542TotalAmt
Program Services$30,782,891ProgramServicesAmt
Management And General$889,651ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$679,330TotalAmt
Program Services$611,095ProgramServicesAmt
Management And General$68,235ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,555,329TotalAmt
Program Services$4,354,465ProgramServicesAmt
Management And General$200,864ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,239,064TotalAmt
Program Services$2,154,188ProgramServicesAmt
Management And General$84,876ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$151,464TotalAmt
Management And General$151,464ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$186,990TotalAmt
Management And General$186,990ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$287,746TotalAmt
Management And General$287,746ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,934,624TotalAmt
Program Services$6,730,685ProgramServicesAmt
Management And General$1,203,939ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$285,931TotalAmt
Program Services$33,667ProgramServicesAmt
Management And General$252,264ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,202,974TotalAmt
Program Services$2,012,184ProgramServicesAmt
Management And General$190,790ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$448,134TotalAmt
Program Services$448,134ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,961,254TotalAmt
Program Services$1,951,819ProgramServicesAmt
Management And General$9,435ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$349,015TotalAmt
Program Services$286,912ProgramServicesAmt
Management And General$62,103ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$590,875TotalAmt
Program Services$590,875ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,897,146TotalAmt
Program Services$5,897,146ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$312,837TotalAmt
Program Services$312,837ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$14,075,053$14,075,053
Repair and Maintenance$2,002,106$1,887,276$114,830
Community Event support$371$371

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$76,366,662TotalAmt
Program Services$72,135,227ProgramServicesAmt
Management And General$4,231,435ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,938,636BOYAmt
EOY$569,137EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$12,048,209BOYAmt
EOY$15,441,457EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$17BOYAmt
EOY$31EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,977,648BOYAmt
EOY$1,984,980EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$429,459BOYAmt
EOY$570,479EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$139,433,379LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$74,304,400LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$63,061,990BOYAmt
EOY$65,128,979EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$51,580,897BOYAmt
EOY$58,084,112EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,729,743BOYAmt
EOY$452,709EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$12,473,195BOYAmt
EOY$13,122,912EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$145,239,794BOYAmt
EOY$155,354,796EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,986,067BOYAmt
EOY$8,281,162EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,881,000BOYAmt
EOY$13,034,768EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,418,800BOYAmt
EOY$1,044,082EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,068,198BOYAmt
EOY$1,244,899EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,354,065BOYAmt
EOY$23,604,911EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$119,178,876BOYAmt
EOY$126,371,872EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,606,853BOYAmt
EOY$5,278,013EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$100,000BOYAmt
EOY$100,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$123,885,729BOYAmt
EOY$131,749,885EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$145,239,794BOYAmt
EOY$155,354,796EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,778,921ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,657,900NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$427,335OtherChangesInNetAssetsAmt
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

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

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$8,732OtherActivitiesAmt
Total Lobbying Expenditures$8,732TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationSt. Anthony Hospital is a member of the Iowa Hospital Association, A percentage of the membership dues paid to IHA is related to lobbing activities.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,173,907BeginningYearBalanceAmt
Contributions$143,951ContributionsAmt
Investment Earnings Or Losses$1,764,112InvestmentEarningsOrLossesAmt
Grants Or Scholarships$9,750GrantsOrScholarshipsAmt
Other Expenditures$679,220OtherExpendituresAmt
End Year Balance$13,393,000EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$11,720,664BeginningYearBalanceAmt
Contributions$357,317ContributionsAmt
Investment Earnings Or Losses$138,893InvestmentEarningsOrLossesAmt
Grants Or Scholarships$9,500GrantsOrScholarshipsAmt
Other Expenditures$33,467OtherExpendituresAmt
End Year Balance$12,173,907EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,950,534BeginningYearBalanceAmt
Contributions$1,706,686ContributionsAmt
Investment Earnings Or Losses$510,919InvestmentEarningsOrLossesAmt
Grants Or Scholarships$3,500GrantsOrScholarshipsAmt
Other Expenditures$443,975OtherExpendituresAmt
End Year Balance$11,720,664EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,852,058BeginningYearBalanceAmt
Contributions$1,626,938ContributionsAmt
Investment Earnings Or Losses$1,547,970InvestmentEarningsOrLossesAmt
Grants Or Scholarships$4,000GrantsOrScholarshipsAmt
Other Expenditures$1,072,432OtherExpendituresAmt
End Year Balance$9,950,534EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,622,373BeginningYearBalanceAmt
Contributions$3,018,705ContributionsAmt
Investment Earnings Or Losses$739,105InvestmentEarningsOrLossesAmt
Grants Or Scholarships$2,500GrantsOrScholarshipsAmt
Other Expenditures$525,625OtherExpendituresAmt
End Year Balance$7,852,058EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.49000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.51000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$693,934OtherCostOrOtherBasisAmt
Book Value$693,934BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$91,423,691OtherCostOrOtherBasisAmt
Depreciation$42,824,858DepreciationAmt
Book Value$48,598,833BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$38,350,956OtherCostOrOtherBasisAmt
Depreciation$29,281,578DepreciationAmt
Book Value$9,069,378BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,964,798OtherCostOrOtherBasisAmt
Depreciation$2,197,964DepreciationAmt
Book Value$6,766,834BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$65,128,979TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
Deferred Compensation Investments$1,244,899
Beneficial Interest in Net Assets of the Foundation$11,878,013
FieldValueIRS element (for citing)
Total Book Value Other Assets$13,122,912TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDeferred compensationDesc
Amt$1,244,899Amt
FieldValueIRS element (for citing)
Total Liability$1,244,899TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$85,723,727TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$1,657,900NetUnrealizedGainsInvstAmt
Other Revenue$671,160OtherRevenueAmt
Revenue Not Reported$2,329,060RevenueNotReportedAmt
Revenue Subtotal$83,394,667RevenueSubtotalAmt
Investment Expenses Not Incld$287,746InvestmentExpensesNotIncldAmt
Other Revenues Not Included-$1,536,830OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$1,249,084RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$82,145,583TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$77,859,571TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$1,780,655OtherExpensesIncludedAmt
Expenses Not Reported$1,780,655ExpensesNotReportedAmt
Expenses Subtotal$76,078,916ExpensesSubtotalAmt
Investment Expenses Not Incld2$287,746InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$287,746ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$76,366,662TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:All restricted endowed funds held at St. Anthony Foundation are used for the benefit of St. Anthony Regional Hospital for pastoral care and scholarships.
Part X, Line 2:The Internal Revenue Service has determined that the Hospital is an organization exempt from income tax under the Internal Revenue Code; and accordingly, no provision for income taxes is recorded in the consolidated statement of activities. Accounting for income taxes provides that a tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. The Hospital recorded no liabilities for unrecognized tax benefits as of June 30, 2017 and 2016. The Hospital is engaged in certain activities that result in unrelated business income recorded within other revenue in the consolidated statements of activities.
Part XI, Line 2d - Other Adjustments:Change in beneficial interest of Net Assets of Foundation 671,160.
Part XI, Line 4b - Other Adjustments:Rental Expenses -1,536,163. Realized Loss on Sale of Assets -2,186. Income from Partnerships 1,519.
Part XII, Line 2d - Other Adjustments:Rental Expenses 1,536,163. Realized Loss on Sale of Assets 2,186. Transfer to Foundation - Reimbursed Expenses 242,306.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other399.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$479,926TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$479,926NetCommunityBenefitExpnsAmt
Total Expense0.00630TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,429,310TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,609,661DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,819,649NetCommunityBenefitExpnsAmt
Total Expense0.03690TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Expense0.00000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,909,236TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,609,661DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,299,575NetCommunityBenefitExpnsAmt
Total Expense0.04320TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$197,844TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$23,520DirectOffsettingRevenueAmt
Net Community Benefit Expns$174,324NetCommunityBenefitExpnsAmt
Total Expense0.00230TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$179,139TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,000DirectOffsettingRevenueAmt
Net Community Benefit Expns$174,139NetCommunityBenefitExpnsAmt
Total Expense0.00230TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,102,762TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,122,947DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,979,815NetCommunityBenefitExpnsAmt
Total Expense0.05210TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Expense0.00000TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$204,300TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$62,607DirectOffsettingRevenueAmt
Net Community Benefit Expns$141,693NetCommunityBenefitExpnsAmt
Total Expense0.00190TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,684,045TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,214,074DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,469,971NetCommunityBenefitExpnsAmt
Total Expense0.05860TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,593,281TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,823,735DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,769,546NetCommunityBenefitExpnsAmt
Total Expense0.10180TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,565TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,565NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,565TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$12,565NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,103,486BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$22,383,909ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$26,978,801CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,594,892MedicareSurplusOrShortfallAmt

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 Line1St Anthony Regional HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1311 South Clark St PO Box 628AddressLine1Txt
CityCarrollCityNm
State AbbreviationIAStateAbbreviationCd
ZIP514010628ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.stanthonyhospital.orgWebsiteAddressTxt
State License14009OHStateLicenseNum
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 Line1St Anthony Regional HospitalBusinessNameLine1Txt
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 FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part V, Section COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttps://www.stanthonyhospital.org/images/sarpdf/CHNA.13/CHNA16Final.pdfStrategyWebsiteURLTxt
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 Care399.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
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
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLwww.stanthonyhospital.org/images/sarpdf/Financial_Assistance_Policy.pdfFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Part V, Section CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.stanthonyhospital.org/images/sarpdf/Plain_Language_Summary.pdfFAPSummaryOnWebsiteURLTxt
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
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
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 Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
St. Anthony Regional HospitalPart V, Section B, Line 5: In the year ended 6/30/16, St. Anthony Regional Hospital conducted a CHNA assessment. A total of 20 individuals were interviewed, including internal stakeholders - those affiliated or employed by St. Anthony Regional Hospital and Nursing Home - and external stakeholders from across the area. The interviews were conducted using a structured questionnaire with key stakeholders being asked to discuss community health needs and availability of services and recommendations for improving community health. All interviews were reviewed and comments analyzed to identify the most frequently mentioned community health issues. The interviews were conducted during the months of May and June 2016.
St. Anthony Regional HospitalPart V, Section B, Line 6b: St. Anthony Regional Hospital and Nursing Home contracted with Community Health Advisors, LLC for assistance with the Community Health Needs Assessment.
St. Anthony Regional HospitalPart V, Section B, Line 7d: www.stanthonyhospital.org/images/sarpdf/CHNA.13/CHNA13Final.pdf
St. Anthony Regional HospitalPart V, Section B, Line 11: The following significant health needs were identified in the St. Anthony Regional Hospital and Nursing Home service area.- Access to Care Related to Cost and Use of Insurance- Cancer - Treatment and Prevention- Chronic Disease Management- Health Education- Mental Health Services- Nutrition and Exercise- Obesity and Diabetes- Substance Abuse - Tobacco and Alcohol- Transportation- VaccinationsSt. Anthony Regional Hospital and Nursing Home has worked to meet these identified heath needs this year in the following ways:Access to Care Related to Cost and Use of Insurance:- Distributed copies of outreach and education materials on the St. Anthony Cares financial assistance program.- The certified financial counselors helped people in the community sign up in health exchanges. - We distributed Spanish materials to help non-English speaking population.Cancer - Treatment and Prevention:- We continued public awareness campaigns aimed at cancer screening.- We provided 1,437 mammograms.- The expanded and remodeled radiation oncology department procedures increased.- We started doing CT lung scanning during the past year.Chronic Disease Management:- The Health Coach helped patients access information and treat chronic diseases.- The St. Anthony Care Clinic offered diabetes education, wound care and health coaching.- The Healthy Bodies exercise program continued to help at risk patients.Health Education:- We have provided community education by local physicians and professional staff to address community health education with the following programs:Managing Diabetes, Women's Heart Health, No Symptoms Required, Pain Management Anatomy of a Bicycle, Girls Night Out, Advanced Care Planning Conversations, My Heart is Fluttering is it Love or Should I See a Doctor, Making the Most of a Health Heart, Cancer the Emperor of All Maladies, Change for Life, Eat Well, Move More, Live Longer, Feeding Your Young Child, Healthy Active Children, Talking about Men's Health, Menopause Education, and Women's Incontinence. Mental Health:- We have contracted with mental health providers to provide coverage and continue to provide adult and adolescent care on and inpatient and outpatient basis. Inpatients days have increased 34.7% and outpatient visits have increased 9.5% from 2016 to 2017.- We have continued to support Carroll County Supervisors and area schools' efforts to increase access to mental health in area.Nutrition, Exercise, Obesity and Diabetes:- The Health Coach and Chronic Care Clinic provide services to manage diet, diabetes and weight loss.- The Chronic Care Clinic provides diabetes education and healthy bodies exercise program and St. Anthony partnered with Elderbridge Agency to host stepping classes and active body classes.- We continued to promote support groups for anyone affected by diabetes, along with family and any others in a supporting role.- We continued to work with local employers to promote wellness programs and work with community partners and health providers to try to decrease BMI and increase activity levels of Carroll County residents.- We increased Carroll County Health Rankings in the state of Iowa from 21st to 15th; and Health Factor improved from 13th to 11th out of 99 counties.Substance Abuse - Tobacco and Alcohol:- We maintained routine screening for tobacco use for outpatient and clinic patients.- Referrals, as appropriated, made for assistance with tobacco cessation.- We maintained routine screening for alcohol use for all patients admitted to the hospital.Vaccinations:- Collaborated with Public Health departments to promote and administer vaccines.- Designed a public education message on the importance of flu vaccine.Transportation:The objective was to address challenges related to public transportation for medical care in the service area. The Public Health Department is addressing the transportation needs by maintaining a list of available taxi services and raising funds to support taxi vouchers for elderly patients. However, given the challenge of enduring adequate transportation in a rural area, this need was not addressed by St. Anthony due to lack of infrastructure and expertise.
St. Anthony Regional HospitalPart V, Section B, Line 13h: Additional eligibility criteria for financial assistance include Medicaid/Medicare coverage, and State regulations.
Part V, line 16b, FAP Application website:www.stanthonyhospital.org/images/sarpdf/St_Anthony_CARES_Financial_Application.pdf
FieldValueIRS element (for citing)
Facility6FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - St Anthony Regional Hospice
311 South Clark StCarrollIA51401Hospice Services
2 - St Anthony Regional Hospital
311 South Clark StCarrollIA51401Dialysis Services
3 - St Anthony Regional Home Hlth Agency
311 South Clark StCarrollIA51401Home Health Services
4 - St Anthony Regional Hospital
311 South Clark StCarrollIA51401Psychiatric Services
5 - Wall Lake Medical Clinic
311 West First StWall LakeIA51466Rural Health Clinic
6 - St Anthony Nursing Home
311 South Clark StCarrollIA51401Nursing Home

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:In addition to FPG, the Hospital will consider the extent to which the patient's household has assets that could be used to meet his or her financial obligation. Assets may include, but are not limited to, cash, savings and checking account, certificates of deposit, stocks and bonds, individual retirement accounts (IRAs), trust funds, real estate (excluding the patient's home) and motor vehicles. The hospital will take into account any liabilities that are the responsibility of the patient's household. To releave stress related to financial burdens, families with a medical catastrophe with self-pay balances greater than 20 percent of their annual household income in one calender year may be eligible for substantial discounts.
Part I, Line 7:The cost to charge ratio was used when calculating the amounts reported in Part 1, line 7, with the exception of line 7g, subsidized heath services. Subsidized heath services are reported using departmental cost from the 2017 cost report.
Part I, Line 7g:St. Anthony Regional Hospital has eight physician clinics that are included in subsidized health services where cost exceeds the reimbursements.
Part II, Community Building Activities:The Hospital CEO participates in the Carroll Area Development board that is active in workforce development. The hospital emergency room director attended regional meetings on disaster readiness. The CEO is a board member of the Iowa Hospital Association Board of Directors. There are managers of the Hospital that serve on local health advisory boards.
Part III, Line 2:St. Anthony Regional Hospital reports bad debt in accordance with generally accepted accounting principles (GAAP). Bad debt at cost is calculated with the same cost to charge ratio used for the charity care at cost multiplied by the estimated debt charges.Part III, Line 3:St. Anthony Regional Hospital works with those qualifying for charity care along every step of the process including accepting applications for financial assistance after previous attempts to work with the patient fail. Every effort is made to work with the patient to provide financial assistance when appropriate. While there are people who do not cooperate with the Hospital regarding payment plans, financial assistance or with those trying to help them get on government programs. For individuals not providing necessary information it is impossible to know the reason for not cooperating and therefore know whether they will qualify for charity care. St. Anthony Regional Hospital is unable to reasonably determine whether any amount of bad debt could have been classified as charity care if individuals do not provide the necessary information to evaluate their situation to determine qualification with the charity care policy.Part III, Line 4: The financial statements for St. Anthony Regional Hospital do not include a footnote regarding bad debts; however, the bad debt expense from the financial statement is a percent of revenue that is an estimate of the historical bad debt written off.
Part III, Line 8:The amount of Medicare short fall on line 7 should be included in the community benefit because Medicare pays less than the cost for rendering services. The Medicare allowable costs are taken from the Medicare cost report and determined based on the cost to charge ratio from the Medicare report.
Part III, Line 9b:The policy states that St. Anthony Regional Hospital offers charity care to all patients who meet the criteria for financial aid and want assistance. Patients who do not have insurance may qualify for St. Anthony Cares based on annual income and family size. Patients with insurance may also qualify for St. Anthony Cares for bills not covered by insurance. Charity information is available upon admission and disclosed in monthly billing statements. An application is completed by the patient and based on the income and family size the amount of charity is determined based on the federal poverty guidelines. Patients receive statements and make payment arrangements with Preferred Medical Deposits (PMD). Accounts at PMD with no activity after 60 days are then turned over to our collection agency Avadyne Health.Reasonable efforts will be extended to patients to make them aware of the Care. It includes the following action: - Providing written notice on their billing statement form the payment processor that financial assistant is available. - Making a determination regarding Financial Assistance eligibility if the patient submits a complete CARES application during the application period. - Nofify the patient who submits an incomplete CARES application about how to complete it properly, and giving the patient a reasonable opportunity to do so. The Hospital must provide this notification in writing and must provide contact information for resources in assisting the patient with completing the CARES application. Providing a Plain Language Summary identifying the ECAs that the Hospital may take if needed, and stating a deadline after which ECAs may be initiated that is no earlier than 30 days after the date when the written notice is provided.
Part VI, Line 2:The Hospital and county performs a community needs assessment every three years to identify specific health concerns of the county. Meetings are held with community partners to identify needs from the daily work and with clients, students, educators, health care, volunteer services, case management, behavior medicine, and others in the county. A survey was developed to gather county residents identified needs. The primary data collection included a web based community survey. The survey was posted on the hospital website. Similar versions of the survey were distributed by the Carroll County Public Health Department and Manning Regional Health Care Center. There were over 250 people who participated in the survey.The needs assessment was completed and adopted by the St. Anthony Hospital Board of Directors. The implementation strategy was developed and implemented based on the assessment of the survey. The hospital coordinated efforts with the Carroll County Public Health Department to ensure that community benefit resources address needs to improve the health of residents of the service area. The Carroll County Public Health Department provides emergency preparedness, blood pressure clinics, care for your self program, disease management, health opportunities for parents, immunizations, senior health, assistant to obstetrics patients, and TB testing to the community.
Part VI, Line 3:The financial counselor from the organization informs and educates patients about eligibility of federal, state, and local government programs and charity care policies. The charity care policy is made available to patients in the admissions office and provided in the admission packets. If patients have questions they can stop in the business office and discuss them with a financial counselor.
Part VI, Line 4:The Hospital is located in the city of Carroll in West Central Iowa, Carroll County with a population of 20,562. St. Anthony Hospital also serves portions of 6 surrounding counties with a radius of 50 miles. St. Anthony Hospital operates 5 satellite physician clinics in the service area, in addition to 3 physician clinics in the hospital. The six counties of Audubon, Carroll, Calhoun, Crawford, Green, and Sac comprise the hospital's primary service area. The estimated population of St. Anthony's six county area was 72,685 in 2014. The estimated 2014 median house hold income for all counties in the service area is less than the median Iowa household income of $52,716, as well as the national median income of $53,482. The majority of the population in the St. Anthony, six county service area is White/ Caucasian. Crawford County has a significant Hispanic population, with more than one-quarter of the population being Hispanic. The majority of the service area is comprised of English speaking residents. The exception is Crawford County were nearly one-quarter of the population speaks a language other than English in the home, nearly all of them being Spanish speaking.
Part VI, Line 5:St. Anthony Regional Hospital has demonstrated a commitment to promoting health care to further its exempt purpose providing quality health care in the community and surrounding counties for one hundred and eleven years. The majority of the Hospital's board members are from local businesses and reside in the community. The Hospital's medical staff consists of 38 active staff, 2 associate staff in the community, and 77 courtesy staff from outside the community. St. Anthony Regional Hospital is a regional provider and is committed to providing quality care to the community.
Part VI, Line 7, Reports Filed With StatesIA

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
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 (7 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
Edward H Smith Jr
CEO/President$286,977$0$49,609$0$22,364$0$25,268$0$17,376$0$401,594$0$0$0
John Munson
CFO/Vice President$157,668$0$12,141$0$1,388$0$5,220$0$15,876$0$192,293$0$0$0
Richard C Sazama MD
Physician$417,444$0$0$0$10,896$0$12,600$0$2,550$0$443,490$0$0$0
Nelson H Lo MD
Physician$368,042$0$0$0$2,830$0$11,244$0$18,426$0$400,542$0$0$0
Maria Hernandez-Zacharias
Physician$343,951$0$0$0$8,025$0$0$0$15,780$0$367,756$0$0$0
Jwong H Ling
Physician$299,343$0$10,285$0$0$0$0$0$0$0$309,628$0$0$0
Tina F Schechinger MD
Physician$217,046$0$18,152$0$2,096$0$7,182$0$15,876$0$260,352$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 4bSt. Anthony Regional Hospital and Nursing Home has a non-qualified deferred compensation plan that complies with Section 457(f) of the Internal Revenue Code and the short-term deferral provisions of section 409A of the Code. The plan is to be an unfunded plan maintained primarily for the purpose of providing deferred compensation benefits for a select group of management or highly compensated employees. No payments were made from the non-qualified deferred compensation plan during the year.
Part I, Line 7In their roles as executives employed by St. Anthony Regional Hospital, the executives are eligible for incentive payouts. The incentive award will be a percentage of the base pay compensation for the CEO, CFO, and other executives. The ultimate payout includes a reduction/increase multiplier depending on whether the organization reached specified performance metrics identified by the Board of Directors.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
Carroll County IA
A426004323144813AB82006-11-22$6,672,573Construction of Hospital Addition000
City of Carroll IA
B426004322145181CK72006-11-22$5,402,508Construction of Hospital Addition000
City of Carroll IA
C4260043220000000002012-11-26$4,820,000Refund Bonds Issued 12/20/2001000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndRetiredRetiredAmtOther Spent ProceedsOtherSpentProceedsAmt
A$6,969,080$133,451$6,835,629200900Yes (1)Yes (1)
B$5,637,070$107,254$5,529,816200900Yes (1)Yes (1)$3,220,000
C$4,820,000$50,0002009Yes (1)0Yes (1)Yes (1)$1,928,000$4,770,000

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00000.000000.000000.00000000
B00000.000000.000000.00000000
C00000.000000.000000.00000000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndTerm Of GICTermOfGICPctRegulatory Safe Harbor StsfdRegulatorySafeHarborStsfdIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
Citi Group
A000Yes (1)00Yes (1)1.900000000000Yes (1)00
Citi Group
B000Yes (1)00Yes (1)1.900000000000Yes (1)00
(no name)
C00Yes (1)000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0
C0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule K, Supplemental Information:FormAndLineReferenceDesc
ExplanationThe two 2006 issues actually comprise a single issue for tax purposes, but are reported separately herein because the two series were issued by two different issuers (each of which files a form 8038) and were accounted for separately. Differences between the issue price (Part1) and the total proceeds (Part II , line 3) are due to investment earnings and ( for column B) to a small excess amount (less than $1,000) that was used to pay principal on bonds. Part IV, Line 2c. The rebate computation was performed on 11/19/2012 for the 2006 bonds outstanding.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Drees Co
Entity more than 35% controlled by H. Drees (Board Member) and family.$158,689Plumbing/Heating Services0
Badding Construction
Entity more than 35% controlled by N. Badding (Officer) and family.$103,266Construction Services0

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescBuildingDesc
Contribution1ContributionCnt
Noncash Contributions Rpt F990$400,042NoncashContributionsRptF990Amt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Column (b):FormAndLineReferenceDesc
ExplanationNumber in column (b) reflects the number of contributions.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2Sister Romana Klaubauf, Sister Theresa Keller, Sister Maris Kerwin, and Sister Donna Venticher have a business relationship through their membership in The Franciscan Sisters of Perpetual Adoration.
Form 990, Part VI, Section A, line 6The members of the St. Anthony Regional Hospital are the sisters of the religious community known as the Congregation of the Sisters of the Third Order of St. Francis of Perpetual Adoration (FSPA). The members have the power to elect the board of directors, amend the articles of incorporation and bylaws of the organizations, and dissolve the organization.
Form 990, Part VI, Section A, line 7aThe Franciscan Sisters of Perpetual Adoration, as members of the St. Anthony Regional Hospital, elect and approve the board of directors for St. Anthony Regional Hospital.
Form 990, Part VI, Section A, line 7bAll decisions, including dissolution of the organization, made by the Board of Directors of St. Anthony Regional Hospital are subject to the approval of the Franciscan Sisters of Perpetual Adoration.
Form 990, Part VI, Section B, line 11bSt. Anthony Regional Hospital gathers the necessary information for the completion of the Form 990 within the finance department and with assistance from the human resources and operation departments. The form was prepared by an independent accounting firm. Drafts of the form were reviewed by the CFO and the Audit committee. After the internal reviews were complete, the final version of the form 990 was given to each member of the Board of Directors prior to filing the return.
Form 990, Part VI, Section B, line 12cThe Officers and Board Members annually disclose in writing, "any interest which would be inconsistent with the expeditious, proper, and impartial performance of duties." Defining disclosable conflict or duality of interest as any matter in which the corporations are "interested which affects the financial interest or employment of such member, a member of his/her family by blood or marriage, or any business enterprise in which he/she or such family member is employed or has a financial interest." Officers and Board Members are required to disclose the facts surrounding any possible conflict of interest throughout the year. If a conflict of interest is disclosed by an Officer or Board Member, during a board meeting the Officer or Board Member will not participate in any discussions or deliberations regarding the matter and would abstain from any voting decisions on this matter during the meeting. All conflict of interests that are disclosed will be reported in the minutes of the board meetings.
Form 990, Part VI, Section B, line 15At the direction of the Board of Directors the CEO gathers compensation information (salary and benefits) from various sources including Iowa Hospital Association and benefit consultants for like-sized organizations. The Executive Committee then determines the annual compensation for the CEO, other officers, and any key employees for the total board approval. The compensation process for the CEO is completed in August annually. The other officers compensation is completed in March annually.
Form 990, Part VI, Section C, line 19St. Anthony Regional Hospital mails its consolidated audited financial statements to financial institutions, governmental institutions, board members, and the Iowa Hospital Association. The Form 990 is available at guidestar.org. St. Anthony Regional Hospital discloses financial statements to bondholders, the IHA, and the Iowa Attorney General's office. St. Anthony Regional Hospital's governing documents, conflict of interest policy, and financial statements are available to the public upon request.
Form 990, Part IX, line 11gPhysician Fees: Program service expenses 1,950,921. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,950,921. Patient Service Fees: Program service expenses 986,274. Management and general expenses 0. Fundraising expenses 0. Total expenses 986,274. Contract Labor: Program service expenses 2,501,710. Management and general expenses 485. Fundraising expenses 0. Total expenses 2,502,195. Laundry Fees: Program service expenses 323,285. Management and general expenses 0. Fundraising expenses 0. Total expenses 323,285. Consulting Fees: Program service expenses 34,009. Management and general expenses 36,385. Fundraising expenses 0. Total expenses 70,394. Professional Fees: Program service expenses 597,199. Management and general expenses 957,215. Fundraising expenses 0. Total expenses 1,554,414. Recruiting Fees: Program service expenses 337,287. Management and general expenses 209,854. Fundraising expenses 0. Total expenses 547,141.
Form 990, Part XI, line 9:Transfer to Foundation - Reimbursed Expenses -242,306. Change in beneficial interest of Net Assets of Foundation 671,160. Income From Partnership -1,519.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
St Anthony Foundation
311 South Clark PO Box 628CarrollIA51401421419695FundraisingIA501(c)(3)12aSt Anthony Regional Hospital and Nursing HomeYes (1)
Franciscan Sisters of Perpetual Adoration
912 Market StreetLa crosseWI546014782390806386Religious OrderWI501(c)(3)10N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
St Anthony Foundation
C$1,356,314FMV
St Anthony Foundation
P$242,306FMV

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