GIBSON GENERAL HOSPITAL INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- GIBSON GENERAL HOSPITAL INC (EIN 35-0877575)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-08-09
- IRS object ID
- 201702219349300010
- Schema version
- 2015v3.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-09T08:16:43-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 273858252 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEAN DORTON ALLEN FORD PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 106 W VINE STREET SUITE 600 | AddressLine1Txt |
| City | LEXINGTON | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40507 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350877575 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GIBS | BusinessNameControlTxt |
| Phone | 8123853401 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47670 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EMMETT C SCHUSTER | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8123853401 | PhoneNum |
| Signature | 2017-08-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LEIGH MCKEE | PreparerPersonNm |
| PTIN | P00169845 | PTIN |
| Phone | 8592552341 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | EMMETT C SCHUSTER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47670 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $33,917,144 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GIBSONGENERAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1941 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY, PATIENT-CENTERED, COST-EFFECTIVE CARE FOR PEOPLE IN THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 430 | TotalEmployeeCnt |
| Total Volunteers | 54 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $87,755 | PYContributionsGrantsAmt |
| CY Contributions Grants | $111,233 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $34,349,394 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $33,111,853 | CYProgramServiceRevenueAmt |
| PY Investment Income | $226,562 | PYInvestmentIncomeAmt |
| CY Investment Income | $351,120 | CYInvestmentIncomeAmt |
| PY Other Revenue | $457,321 | PYOtherRevenueAmt |
| CY Other Revenue | $342,938 | CYOtherRevenueAmt |
| PY Total Revenue | $35,121,032 | PYTotalRevenueAmt |
| CY Total Revenue | $33,917,144 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,014,317 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,255,806 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $17,486,310 | PYOtherExpensesAmt |
| CY Other Expenses | $15,836,238 | CYOtherExpensesAmt |
| PY Total Expenses | $35,500,627 | PYTotalExpensesAmt |
| CY Total Expenses | $34,092,044 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$379,595 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$174,900 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $21,739,217 | TotalAssetsBOYAmt |
| Total Assets EOY | $20,555,925 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,818,988 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,599,013 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,920,229 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,956,912 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF GIBSON GENERAL HOSPITAL AND THE SKILLED NURSING FACILITY IS TO PROVIDE HIGH QUALITY, PATIENT-CENTERED, COST-EFFECTIVE CARE FOR PEOPLE IN OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $29,576,099 | ExpenseAmt |
| Revenue | $33,128,496 | RevenueAmt |
| Desc | THE HOSPITAL'S MISSION IS TO PROVIDE HIGH QUALITY AND COST-EFFECTIVE HEALTHCARE, WHICH INCLUDES PATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO THE RESIDENTS OF THE SURROUNDING TRI-STATE AREA. ALL EXPENSES RELATE TO COSTS ASSOCIATED WITH PROVIDING THESE SERVICES, AND MAINLY INCLUDE SALARIES AND WAGES TO STAFF AND SUPPLIES COST. THERE WERE 365 ADMISSIONS AND 32,046 VISITS DURING THE YEAR. | Desc |
| Total Program Service Expenses | $29,576,099 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 64 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 430 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8123853401 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47670 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| MICHAEL GREEN | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT GIBSON JR | |||||||
| BOARD CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARION JOCHIM | |||||||
| BOARD VICE-CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DONALD J HAUKE | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MIKE WOOD | |||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DR KRISHNA MURTHY | |||||||
| CHIEF OF STAFF | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| GEORGE ANKENBRAND | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| GEORGE A BALLARD | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DR HM BREWSTER | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BRAD SCHMITT | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LARRY JOHNSON | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| J ROBERT KINKLE | |||||||
| SECOND VICE-CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DR MS KRISHNA | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN LANKFORD | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SHERRI SMITH | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SUSAN STRAUB | |||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RON HARRINGTON | |||||||
| CHIEF FINANCIAL OFFICER | 42.31 | $128,854 | $0 | $3,097 | Yes (X) | ||
| EMMETT C SCHUSTER | |||||||
| CHIEF EXECUTIVE OFFICER | 42.31 | $219,575 | $0 | $13,440 | Yes (X) | ||
| LORI PHILLIPS | |||||||
| CHIEF NURSING OFFICER | 40.00 | $145,523 | $0 | $4,145 | Yes (X) | ||
| JIM CHILDERS | |||||||
| CHIEF FINANCIAL OFFICER | 42.31 | $0 | $0 | $0 | Yes (X) | ||
| DORIS A BEST | |||||||
| PHYSICIAN | 40.00 | $208,352 | $0 | $8,455 | Yes (X) | ||
| RICHARD M CLARK | |||||||
| PHYSICIAN | 41.54 | $205,007 | $0 | $17,783 | Yes (X) | ||
| KWABENA OWUSU-DEKYI | |||||||
| PHYSICIAN | 40.77 | $175,292 | $0 | $13,898 | Yes (X) | ||
| COREY A POTTS | |||||||
| CRNA | 40.00 | $232,041 | $0 | $12,987 | Yes (X) | ||
| STEPHEN R SHOEMAKER | |||||||
| PHYSICIAN | 43.10 | $226,176 | $0 | $10,617 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,540,820 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $84,422 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| THOMAS JOSEPH MD | |||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | MEDICAL PRO FEES | $585,640 |
| BLAKE TITZER | |||||
| 12011 PROSPECT COURT | EVANSVILLE | IN | 47720 | MEDICAL PRO FEES | $374,542 |
| PHILOMINA THURUTHUMALY MD | |||||
| 1707 BRENTWOOD DRIVE | PRINCETON | IN | 47670 | MEDICAL PRO FEES | $243,750 |
| ALLIANT MANAGEMENT SERVICES | |||||
| 12800 B MERIDIAN ST SUITE 400 | CARMEL | IN | 46032 | HOSPITAL MANAGEMENT | $144,661 |
| MEDICAL STAFFING SOLUTIONS LLC | |||||
| 9700 HWY 57 NORTH SUITE A | EVANSVILLE | IN | 47725 | HOSPITAL STAFFING | $142,358 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $75,583 | RelatedOrganizationsAmt |
| All Other Contributions | $35,650 | AllOtherContributionsAmt |
| Total Contributions | $111,233 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $33,111,853 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,111,853 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $33,111,853 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $137,253 | TotalRevenueColumnAmt |
| Exclusion | $137,253 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $169,614 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $169,614 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $169,614 | TotalRevenueColumnAmt |
| Exclusion | $169,614 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $213,867 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $213,867 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $213,867 | TotalRevenueColumnAmt |
| Exclusion | $213,867 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA SALES | 722210 | $156,681 | $156,681 | |
| MISCELLANEOUS INCOME | 900099 | $16,643 | $16,643 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $173,324 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,917,144 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,128,496 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $677,415 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,472 | TotalAmt |
| Program Services | $451,325 | ProgramServicesAmt |
| Management And General | $50,147 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,615,767 | TotalAmt |
| Program Services | $12,254,190 | ProgramServicesAmt |
| Management And General | $1,361,577 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,825 | TotalAmt |
| Program Services | $110,433 | ProgramServicesAmt |
| Management And General | $54,392 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,990,095 | TotalAmt |
| Program Services | $2,332,274 | ProgramServicesAmt |
| Management And General | $657,821 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $983,647 | TotalAmt |
| Program Services | $885,282 | ProgramServicesAmt |
| Management And General | $98,365 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,347 | TotalAmt |
| Management And General | $112,347 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,399 | TotalAmt |
| Management And General | $8,399 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,872,101 | TotalAmt |
| Program Services | $4,246,752 | ProgramServicesAmt |
| Management And General | $625,349 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203,540 | TotalAmt |
| Management And General | $203,540 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,586 | TotalAmt |
| Program Services | $86,814 | ProgramServicesAmt |
| Management And General | $1,772 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $666,412 | TotalAmt |
| Program Services | $546,458 | ProgramServicesAmt |
| Management And General | $119,954 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,809 | TotalAmt |
| Program Services | $81,066 | ProgramServicesAmt |
| Management And General | $34,743 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,291 | TotalAmt |
| Program Services | $232,076 | ProgramServicesAmt |
| Management And General | $12,215 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,253,796 | TotalAmt |
| Program Services | $1,191,106 | ProgramServicesAmt |
| Management And General | $62,690 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $331,586 | TotalAmt |
| Program Services | $189,004 | ProgramServicesAmt |
| Management And General | $142,582 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $2,889,599 | $2,889,599 | |
| SUPPLIES | $2,382,840 | $2,118,624 | $264,216 |
| REPAIRS & MAINTENANCE | $903,314 | $632,320 | $270,994 |
| DUES & SUBSCRIPTIONS | $710,133 | $497,093 | $213,040 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,053,485 | TotalAmt |
| Program Services | $831,683 | ProgramServicesAmt |
| Management And General | $221,802 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,092,044 | TotalAmt |
| Program Services | $29,576,099 | ProgramServicesAmt |
| Management And General | $4,515,945 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $277,238 | BOYAmt |
| EOY | $1,112,783 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,000,000 | BOYAmt |
| EOY | $1,003,961 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,679,146 | BOYAmt |
| EOY | $3,399,288 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $439,566 | BOYAmt |
| EOY | $453,251 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $816,213 | BOYAmt |
| EOY | $756,580 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $174,946 | BOYAmt |
| EOY | $273,611 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $34,873,224 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $23,507,731 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,078,250 | BOYAmt |
| EOY | $11,365,493 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,221,927 | BOYAmt |
| EOY | $2,144,017 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,931 | BOYAmt |
| EOY | $46,941 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,739,217 | BOYAmt |
| EOY | $20,555,925 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,479,739 | BOYAmt |
| EOY | $2,488,341 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,417 | BOYAmt |
| EOY | $69,297 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,469,980 | BOYAmt |
| EOY | $6,714,094 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,839,852 | BOYAmt |
| EOY | $1,327,281 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,818,988 | BOYAmt |
| EOY | $10,599,013 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,868,298 | BOYAmt |
| EOY | $9,909,971 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,931 | BOYAmt |
| EOY | $46,941 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,920,229 | BOYAmt |
| EOY | $9,956,912 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,739,217 | BOYAmt |
| EOY | $20,555,925 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$174,900 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $211,583 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $421,244 | OtherCostOrOtherBasisAmt |
| Book Value | $421,244 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,903,821 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,222,558 | DepreciationAmt |
| Book Value | $8,681,263 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,241,503 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,114,688 | DepreciationAmt |
| Book Value | $2,126,815 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $306,656 | OtherCostOrOtherBasisAmt |
| Depreciation | $170,485 | DepreciationAmt |
| Book Value | $136,171 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,365,493 | TotalBookValueLandBuildingsAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 280.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $381,723 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $381,723 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01120 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,914,843 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,063,675 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,851,168 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11300 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,296,566 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,063,675 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,232,891 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12420 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,707 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,610 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,097 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,763 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,763 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,970 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,610 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,360 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,305,536 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,065,285 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,240,251 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12440 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,880,350 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $7,855,876 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,023,889 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$168,013 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47670 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.GIBSONGENERAL.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 280.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GIBSON GENERAL HOSPITAL INC | PART V, SECTION B, LINE 5: INPUT WAS GATHERED AND ANALYZED FROM INDIVIDUALS THAT REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN THE HEALTHCARE INDUSTRY, DURING THE COURSE OF PREPARING THE COMMUNITY HEALTH NEEDS ASSESSMENT. |
| GIBSON GENERAL HOSPITAL INC | PART V, SECTION B, LINE 11: NEEDS WERE IDENTIFIED AFTER REVIEW OF THE SURVEY GIVEN. THE HOSPITAL IS PRIORITIZING THE ITEMS FROM THE COMMUNITY INPUT AND EVALUATING THE RESOURCES NEEDED TO ADDRESS THE TOP COMMUNITY NEEDS. OBESITY AND ASSISTED LIVING ARE TWO AREAS THAT THE HOSPITAL DOES NOT HAVE THE RESOURCES CURRENTLY TO MEET THE COMMUNITY CONCERNS AND NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA.PLEASE SEE THE ATTACHED IMPLEMENTATION POLICY TO SEE HOW THE HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - STAR ONE REHAB | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY |
| 2 - PHYSICIAN OUTPATIENT CLINICS | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | SUBSIDIZED CARE PHYSICIAN PRACTICES |
| 3 - HOPE HOUSE | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | GERIATRIC CONSULTING MEDICATION MANAGEMENT |
| 4 - LIFESTYLES DIABETES CENTER | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | DIABETES EDUCATION COUNSELING |
| 5 - GGH - SKILLED NURSING FACILITY | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | SKILLED NURSING REHAB CENTER |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H | GIBSON GENERAL HOSPITAL, INC. (GGH) IS A NOT-FOR-PROFIT 501(C)(3) CORPORATION OPERATING A 25-BED CRITICAL ACCESS HOSPITAL WITH AN ATTACHED 45-BED SKILLED NURSING FACILITY LOCATED IN PRINCETON, INDIANA. THE HOSPITAL HAS BEEN IN THE COMMUNITY SINCE 1907, AND MOVED TO ITS CURRENT LOCATION IN 1962.THE ACUTE-CARE FACILITY HOUSES PHYSICIAN PRACTICES, INCLUDING FAMILY MEDICINE, GENERAL SURGERY AND ORTHOPEDIC SURGERY; OUTPATIENT CLINICS, SUCH AS A OCCUPATIONAL MEDICINE CLINIC, PAIN MANAGEMENT CENTER, SLEEP DIAGNOSTICS CENTER, AND A SPECIALTY CLINIC THAT HOUSES ROTATING SPECIALISTS, INCLUDING ALLERGY/IMMUNOLOGY, CARDIOLOGY, GASTROENTEROLOGY, GYNECOLOGY, OPHTHALMOLOGY, OTOLARYNGOLOGY, PSYCHOLOGY AND UROLOGY; A HOME HEALTH AGENCY; AND A 45-BED SKILLED NURSING FACILITY.OFF-SITE FACILITIES INCLUDE ONE FAMILY MEDICINE CLINIC, LOCATED 1.5 MILES AWAY IN DOWNTOWN PRINCETON, AND ONE FAMILY MEDICINE CLINIC AND AN OUTPATIENT REHABILITATION OFFICE LOCATED 10 MILES FROM THE HOSPITAL OFF HWY. 41 IN FORT BRANCH, INDIANA. IN ADDITION TO THE FAMILY MEDICINE CLINIC IN FORT BRANCH, THE HOSPITAL ALSO OPERATES A BRANCH OF ITS REHABILITATION AND SPORTS THERAPY SERVICES IN THE SAME OFFICE COMPLEX.IN ADDITION TO THE SERVICES MENTIONED ABOVE, GGH OFFERS A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES, INCLUDING: ACUTE HOSPITAL CAREBEHAVIORAL HEALTH SERVICES OUTPATIENT MENTAL HEALTH SERVICES EMPLOYEE ASSISTANCE PROGRAM BUSINESS HEALTH SERVICES IME MEDICAL SURVEILLANCE CONTRACTED ON-SITE STAFFING PHYSICAL EXAMS: DEPT. OF TRANSPORTATION, PRE-PLACEMENT, RETURN-TO-WORK, FIT-FOR-DUTY AND EXECUTIVE DRUG & ALCOHOL TESTING SCREENINGS: HEARING, VISION AND SPIROMETRY WORK-RELATED DISABILITY EVALUATIONS CPR/AED/FIRST AID HEPATITIS B AND FLU IMMUNIZATIONS DIAGNOSTIC TESTING: LAB AND X-RAY, RESPIRATOR CLEARANCE & FIT TESTING CARE EMPLOYEE ASSISTANCE PROGRAM WORK CONDITIONING/WORK HARDENING ERGONOMIC ASSESSMENTS: WORKSTATION ANALYSIS, FUNCTIONAL JOB ANALYSIS AND PRE WORK SCREEN DEVELOPMENTCARDIOPULMONARY SERVICES CARDIAC EVENT MONITORING CARDIAC REHABILITATION - PHASES I TO III ECHOCARDIOGRAPHY STRESS TESTING PULMONARY REHABILITATION RESPIRATORY THERAPYDIABETES PROGRAM (LIFESTYLES DIABETES CENTER) DIABETES EDUCATION & MANAGEMENTEMERGENCY ROOMGIBSON HOME HEALTH SERVICES SKILLED NURSING CARE PHYSICAL THERAPY HOME CARE AID OCCUPATIONAL THERAPY SPEECH THERAPY MEDICAL SOCIAL SERVICES GUARDIAN MEDICAL MONITORINGINFUSION THERAPY SERVICES BLOOD PRODUCTS CHEMOTHERAPY IV MEDICATION AND HYDRATIONLABORATORY SERVICESMEDICAL/SURGICAL OUTPATIENT SERVICESMULTI-SPECIALTY HEALTH CENTERNUTRITION COUNSELINGONCOLOGY/HEMATOLOGY SERVICESORTHOPEDIC SERVICESPAIN MANAGEMENT CENTERRADIOLOGY SERVICES DIGITAL MAMMOGRAPHY CT SCAN DXA SCAN BONE DENSITY SCREENING FLUOROSCOPY MRI NUCLEAR MEDICINE ULTRASOUND X-RAYREHABILITATION & THERAPY SERVICES (STAR ONE) ATHLETIC TRAINING BALANCE ASSESSMENT BURN THERAPY ERGONOMIC ASSESSMENT HAND THERAPY OCCUPATIONAL THERAPY PEDIATRIC THERAPY PHYSICAL THERAPY SPEECH THERAPY WOUND CARESKILLED NURSING FACILITY SLEEP DIAGNOSTIC CENTER (OVERNIGHT AND OUTPATIENT TAKE-HOME STUDIES)SURGICAL SERVICES - INPATIENT & OUTPATIENTSWING BED PROGRAMTRI-STATE LAPAROSCOPIC HERNIA CENTERWELLNESS CLINIC |
| PART III, LINE 2: | PERCENT OF TOTAL EXPENSE $2,880,350 OF BAD DEBT EXPENSE IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN A (TOTAL FUNCTIONAL EXPENSES), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN, SCHEDULE H, PART III, SECTION A, LINE 2. METHODOLOGY USED TO ESTIMATE BAD DEBT ACCOUNTS ARE BILLED TO THE APPROPRIATE INSURANCE AND ONCE PAYMENT IS RECEIVED AND THE BALANCE AMOUNT IS THE PATIENT'S RESPONSIBILITY, THE ACCOUNTS ARE SENT LETTERS FOR THE BALANCE DUE. IF NOT PAID WITHIN 30 DAYS, ACCOUNTS ARE SENT TO COLLECTIONS TO WORK BASED ON LAST NAME ON THE ACCOUNT. IF THE ACCOUNT IS NOT PAID WITHIN 150 DAYS, THE ACCOUNT IS SENT BACK TO THE HOSPITAL AND THEN THE ACCOUNT IS WRITTEN OFF AS UNCOLLECTIBLE. |
| PART III, LINE 8: | THE HOSPITAL IS A CRITICAL ACCESS HOSPITAL AND IS REIMBURSED 101%, LESS 2% SEQUESTRATION, OF MEDICARE ALLOWANCE COSTS FOR INPATIENT SERVICES, SWING BED, AND OUTPATIENT PART B SERVICES. THE SEQUESTRATION IS THE REASON FOR THE SHORTFALL. |
| PART III, LINE 9B: | COLLECTION PRACTICES ARE APPLIED TO ALL PATIENTS AT GIBSON GENERAL HOSPITAL PRIORITIZING THE ITEMS FROM THE COMMUNITY INPUT AND EVALUATING THE RESOURCES NEEDED TO ADDRESS THE TOP COMMUNITY NEEDS. |
| PART VI, LINE 2: | GIBSON COUNTY, INDIANA, IS LOCATED IN SOUTHWESTERN INDIANA, APPROXIMATELY 146 MILES SOUTHWEST OF INDIANAPOLIS AND 25 MILES NORTH OF EVANSVILLE, INDIANA. WITH A POPULATION OF 33,503, GIBSON COUNTY IS THE PRIMARY SERVICE AREA FOR THE HOSPITAL. IN ADDITION, THE HOSPITAL SERVES PATIENTS FROM NEIGHBORING COUNTIES.BETWEEN APRIL AND JULY 2015, THE HOSPITAL PARTNERED WITH THE INDIANA RURAL HEALTH ASSOCIATION (IRHA) TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT TO IDENTIFY AREAS OF GREATEST NEED IN GIBSON COUNTY. THROUGH THE COLLECTION OF HEALTH DATA AND COMMUNITY INPUT ON THE COUNTY'S ASSETS, VALUES, AND WEAKNESSES WITHIN THE HOSPITAL'S SERVICE AREA, THE FOLLOWING NEEDS WERE IDENTIFIED AS BEING OF THE HIGHEST IMPORTANCE: IDENTIFIED NEEDS: - FITNESS/ACTIVITY - CHRONIC DISEASE PREVENTION/TREATMENT - MENTAL HEALTH SERVICES AVAILABILITY - HEALTHCARE ACCESS AND QUALITY - LIVING CONDITIONS - DRUG AND TOBACCO MISUSE ADDITIONALLY, TO AID GIBSON GENERAL HOSPITAL IN THE CREATION OF AN ACTION PLAN, THE IRHA MADE PRELIMINARY RECOMMENDATIONS FOR DEALING WITH THE DEFINED AREAS OF NEED.RECOMMENDATIONS: FITNESS/ACTIVITY: - EVALUATE OPPORTUNITY TO CREATE WALKING/BIKING PATHS IN COMMUNITY - EXERCISE PROGRAMS INDOORS AND OUTDOORS - WELLNESS PROGRAMS - SCREENINGS FOR BLOOD PRESSURE/HEART RATE AND BMI - COMMUNITY ACTIVITIES - EVENTS IN THE PARK - FAMILY NIGHTS OUT - FAMILY ADVENTURE NIGHTS - MONTHLY FITNESS NEWSLETTER - COUNTY BIGGEST LOSER WITH INCENTIVES CHRONIC DISEASE: - FOCUS EDUCATION ON THE BENEFITS OF SCREENING AND EARLY DETECTION - FOCUS ON EVIDENCE-INFORMED SKILL-BASED PROGRAMS IMPLEMENT SELF-MANAGEMENT INITIATIVES ACCORDING TO IOM RECOMMENDATIONS - HEALTHY EATING AND WEIGHT REGULATION - EXERCISE PROGRAMS MENTAL HEALTH SERVICES AVAILABILITY: - IDENTIFY SERVICES AND PROVIDERS IN GIBSON COUNTY - REFER PATIENTS TO MENTAL HEALTH SERVICES HEALTHCARE ACCESS AND QUALITY: - MARKET AVAILABILITY OF SERVICES AND COST COMPARISONS VS. OTHER COMMUNITIES -IDENTIFY AREAS FOR IMPROVED POLICIES AND PROCEDURES TO ENSURE BEST PRACTICES ARE ACHIEVED AND DOCUMENTED-COLLABORATE WITH PHYSICIANS TO IMPROVE QUALITY AND ACCESS -COMPLETE A MARKET ANALYSIS FOR URGENT CARE FACILITY LIVING CONDITIONS: - FOCUS ON IMPROVING WHAT IS ALREADY IN PLACE - EVALUATE MARKET FOR HEALTH LIVING FACILITY, SUCH AS THE YMCA - EVALUATE OPPORTUNITY OF OUTPATIENT REHAB THROUGH GGH INTO COMMUNITY LIVING DYNAMICDRUGS: - FOCUS ON EDUCATION REGARDING THE EFFECTS OF DRUGS ON HEALTH - PARTNER WITH LOCAL AND STATE AGENCIES TO LEVERAGE DRUG EDUCATION SUPPORT - CREATE A CULTURE OF HEALTH - CREATE PARENT GROUPS - INVOLVE SOCIAL SERVICE AGENCIES - INCREASE SERVICES FOR MENTAL HEALTH NEEDS SEE ATTACHMENT FOR THE HOSPITAL'S IMPLEMENTATION PLAN BASED OFF THESE RECOMMENDATIONS. |
| PART VI, LINE 3: | THE HOSPITAL HAS POSTERS IN THE CENTRAL REGISTRATION AND EMERGENCY ROOM WAITING AREA INFORMING PATIENTS THAT WE SEE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND ALSO PROVIDE FINANCIAL ASSISTANCE TO UNINSURED AND UNDERINSURED IN COMPLIANCE WITH EMTALA. ALL EMERGENCY ROOM PATIENTS ARE SEEN BY A PRACTITIONER PRIOR TO SOLICITATION OF FINANCIAL ASSISTANCE OR INSURANCE INFORMATION. ALL PATIENTS WHO DO NOT HAVE INSURANCE AND PATIENTS WHO HAVE BALANCES AFTER INSURANCE ARE CONTACTED BY OUR PATIENT FINANCIAL COUNSELOR BY MAIL WITH A FINANCIAL ASSISTANCE APPLICATION. |
| PART VI, LINE 4: | THE HOSPITAL'S PRIMARY SERVICE AREA ENCOMPASSES GIBSON COUNTY, INDIANA, SW PIKE COUNTY, AND POSEY COUNTY, INDIANA. GIBSON COUNTY HAS A POPULATION DENSITY OF 66/SQ MILE. SW PIKE COUNTY HAS A POPULATION DENSITY OF 38/SQ MILE. GIBSON GENERAL HOSPITAL HAS TWO LARGE COMPETING HEALTHCARE SYSTEMS 35 MILES TO THE SOUTH. TRADITIONALLY, THE HOSPITAL HAS BEEN RELIED UPON AS A SAFETY NET HOSPITAL FOR OLDER PATIENTS, LOW-INCOME PATIENTS, AND PATIENTS WITH LIMITED MEANS TO TRAVEL TO THE LARGER CITY OF EVANSVILLE, INDIANA. MUCH OF GIBSON COUNTY IS RURAL WITH AGRICULTURE AND COAL MINING AS PRIMARY INDUSTRIES. GIBSON COUNTY DOES ENJOY SOME ECONOMIC BENEFIT FROM TOYOTA MANUFACTURING OF INDIANA. IN ADDITION, APPROXIMATELY 75-80% OF THE HOSPITAL'S PATIENT POPULATION IS FUNDED BY MEDICARE, MEDICAID AND OR OTHER GOVERNMENT SUBSIDIZED PLANS. |
| PART VI, LINE 5: | THE HOSPITAL IS INVOLVED IN NUMEROUS COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES. NUMEROUS COMMUNITY CONCERNS ARE ADDRESSED, INCLUDING HEALTH IMPROVEMENT, EDUCATION, SAFETY, AND ACCESS TO CARE. THE HOSPITAL ENCOURAGES ITS EMPLOYEES TO SERVE ON COMMUNITY BOARDS AND PARTICIPATE IN HEALTH PROGRAMS THAT PROMOTE BETTER HEALTH AND COMMUNITIES. THE HOSPITAL PARTNERS WITH STATE AND COUNTY-WIDE AGENCIES, INCLUDING SCHOOL CORPORATIONS, EMPLOYERS AND AREA HEALTH PROVIDERS TO PROMOTE HEALTH AND WELLNESS AND PREVENT DISEASE. THESE ACTIVITIES INCLUDE, BUT ARE NOT LIMITED TO:1. OFFERING DISCOUNTED HEART-HEALTH AND BREAST CANCER SCREENINGS FOR WOMEN.2. WORKING WITH SCHOOLS TO PROVIDE EDUCATION ABOUT HEALTH CAREERS, AND HOW EDUCATION IMPACTS FUTURES.3. WORKING WITH SCHOOLS TO OFFER FREE ATHLETIC PHYSICALS.4. WORKING WITH AREA EMPLOYERS ON HEALTH PROMOTION, SCREENING AND WELLNESS OPPORTUNITIES FOR THEIR EMPLOYEES.5. OFFERING A SAFE, CONVENIENT TRICK-OR-TREAT LOCATION FOR AREA CHILDREN.6. SPONSORING VARIOUS EDUCATIONAL GUIDES TO ENSURE HEALTH, SAFETY AND DRUG AWARENESS EDUCATION TAKES PLACE IN AREA SCHOOLS. |
| PART VI, LINE 6: | GIBSON GENERAL HOSPITAL IS NOT PART OF AN AFFILIATED HEALTHCARE SYSTEM. THE HOSPITAL DOES PARTICIPATE IN SEVERAL COALITIONS AND COOPERATIVES WITH OTHER PROVIDERS AND OFTEN COLLABORATES WITH THE LARGER SYSTEM IN THE EVANSVILLE AREA TO PROVIDE ACCESS TO SERVICES THE HOSPITAL CANNOT PROVIDE SUCH AS CARDIAC AND NEUROLOGICAL SURGERY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EMMETT C SCHUSTER | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $219,575 | $0 | $0 | $0 | $0 | $0 | $3,624 | $0 | $9,816 | $0 | $233,015 | $0 | $0 | $0 |
| DORIS A BEST | ||||||||||||||
| PHYSICIAN | $208,352 | $0 | $0 | $0 | $0 | $0 | $4,044 | $0 | $4,411 | $0 | $216,807 | $0 | $0 | $0 |
| RICHARD M CLARK | ||||||||||||||
| PHYSICIAN | $205,007 | $0 | $0 | $0 | $0 | $0 | $4,206 | $0 | $13,577 | $0 | $222,790 | $0 | $0 | $0 |
| KWABENA OWUSU-DEKYI | ||||||||||||||
| PHYSICIAN | $175,292 | $0 | $0 | $0 | $0 | $0 | $3,580 | $0 | $10,318 | $0 | $189,190 | $0 | $0 | $0 |
| COREY A POTTS | ||||||||||||||
| CRNA | $232,041 | $0 | $0 | $0 | $0 | $0 | $4,704 | $0 | $8,283 | $0 | $245,028 | $0 | $0 | $0 |
| STEPHEN R SHOEMAKER | ||||||||||||||
| PHYSICIAN | $226,176 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $10,617 | $0 | $236,793 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| CITY OF PRINCETON | |||||||
| A | 356001169 | 2005-06-01 | $7,100,000 | CAPITAL IMPROVEMENTS | 0 | 0 | 0 |
| CITY OF PRINCETON | |||||||
| B | 356001169 | 2007-10-01 | $2,096,000 | ENERGY CONSERVATION PROJECT | 0 | 0 | 0 |
| CITY OF PRINCETON | |||||||
| C | 356001169 | 2008-12-01 | $2,500,000 | RENOVATIONS - EMERGENCY DEPARTMENT | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|
| A | $7,100,000 | $55,566 | $7,044,434 | 2009 | 0 | Yes (1) | Yes (1) | Yes (1) |
| B | $2,096,000 | $2,096,000 | 2008 | 0 | 0 | Yes (1) | Yes (1) | |
| C | $2,500,000 | $31,500 | $2,468,500 | 2009 | 0 | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| C | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
| C | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LEANN COOPER | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SEE PART V | RelationshipDescriptionTxt |
| Transaction | $51,751 | TransactionAmt |
| Transaction | COMPENSATION PAID BY GGH | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART IV, LINE 1B | FormAndLineReferenceDesc |
| Explanation | LEANN COOPER IS THE EXECUTIVE DIRECTOR OF GIBSON GENERAL HEALTH FOUNDATION AND IS THE DAUGHTER OF BOARD MEMBER, DR. MICHAEL GREEN. THE HOSPITAL COMPENSATES FOR THE SALARY OF THE EXECUTIVE DIRECTOR OF THE GIBSON GENERAL HEALTH FOUNDATION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE HOSPITAL OBTAINS MANAGEMENT SUPPORT THROUGH ALLIANT MANAGEMENT SERVICES. |
| FORM 990, PART VI, SECTION B, LINE 11 | AN OFFICER OF THE BOARD REVIEWS THE 990 ON BEHALF OF THE BOARD OF DIRECTORS BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF TRUSTEES SIGNS A CONFLICT OF INTEREST STATEMENT ANNUALLY AND THE CEO OR A COMPLIANCE OFFICER REVIEWS THE SIGNED STATEMENTS. ANY BOARD MEMBER WHO HAS A CONFLICT OF INTEREST RECUSES HIMSELF OR HERSELF FROM VOTING ON THE RELATED ISSUE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO OR TOP MANAGEMENT OFFICIAL'S COMPENSATION IS REVIEWED ANNUALLY AND APPROVED BY THE BOARD OF TRUSTEES COMPENSATION COMMITTEE. THE COMMITTEE USES A COMPENSATION CONSULTANT, COMPENSATION SURVEY, AND COMPARATIVE DATA FROM SIMILAR ORGANIZATIONS TO DETERMINE THE CEO'S COMPENSATION. OFFICER COMPENSATION IS REVIEWED ANNUALLY BY THE CEO. COMPENSATION SURVEYS ARE USED IN DETERMINING OFFICER COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST, AT THE DISCRETION OF THE BOARD OF DIRECTORS AND MANAGEMENT. |
| FORM 990, PART IX, LINE 11G | CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 159,133. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 159,133. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,979,172. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,979,172. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 2,108,447. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,108,447. CONSULTING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 625,349. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 625,349. |
| FORM 990, PART XI, LINE 9: | PAIN MANAGEMENT MINORITY INTEREST -111,907. CHANGE IN BENEFICIAL INTEREST IN ASSETS AT COMMUNITY -4,990. JOINT VENTURE EQUITY - PAIN MANAGEMENT 328,480. |
| FORM 990, PART XII, LINE 2C | THE HOSPITAL'S BOARD AND SENIOR MANAGEMENT ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HEALTH FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47670 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350950175 | EIN |
| Primary Activities | PHILANTHROPIC SUPPORT OF THE HOSPITAL | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 11D, III-O | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL PAIN MANAGEMENT LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47670 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 472156126 | EIN |
| Primary Activities | PAIN MANAGEMENT SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $58,073 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $353,730 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.51000 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HEALTH FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $75,583 | InvolvedAmt |
| Method Of Amount Determination | COST | MethodOfAmountDeterminationTxt |
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