GRANDE RONDE HOSPITAL INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- GRANDE RONDE HOSPITAL INC (EIN 93-0505325)
- Tax period
- 2015-05-01 to 2016-04-30
- Filed
- 2016-12-15
- IRS object ID
- 201623509349301012
- Schema version
- 2015v2.1
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-12-15T10:40:16-08:00 | ReturnTs |
| Tax Period End | 2016-04-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 200079326 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DINGUS ZARECOR & ASSOCIATES PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12015 E MAIN AVE | AddressLine1Txt |
| City | SPOKANE VALLEY | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 992066130 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-05-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930505325 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRANDE RONDE HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GRAN | BusinessNameControlTxt |
| Phone | 5419638421 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3290 | AddressLine1Txt |
| City | LA GRANDE | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97850 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES MATTES | PersonNm |
| Person Title | TRUSTEE/CEO | PersonTitleTxt |
| Phone | 5419638421 | PhoneNum |
| Signature | 2016-12-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THOMAS DINGUS | PreparerPersonNm |
| PTIN | P00951009 | PTIN |
| Phone | 5092420874 | PhoneNum |
| Preparation | 2016-12-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAMES MATTES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3290 | AddressLine1Txt |
| City | LA GRANDE | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97850 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $87,710,306 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GRH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1962 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | TO ENSURE ACCESS TO HIGH-QUALITY, COST EFFECTIVE HEALTHCARE IN A SAFE, CUSTOMER-FRIENDLY ENVIRONMENT FOR ALL THOSE IN NEED OF OUR SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 742 | TotalEmployeeCnt |
| Total Volunteers | 97 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $900,410 | PYContributionsGrantsAmt |
| CY Contributions Grants | $646,942 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $73,144,830 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $84,117,192 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,744,342 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,662,227 | CYInvestmentIncomeAmt |
| PY Other Revenue | $487,827 | PYOtherRevenueAmt |
| CY Other Revenue | $783,369 | CYOtherRevenueAmt |
| PY Total Revenue | $76,277,409 | PYTotalRevenueAmt |
| CY Total Revenue | $87,209,730 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $50,512,027 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $55,334,723 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $97,993 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $21,010,658 | PYOtherExpensesAmt |
| CY Other Expenses | $24,496,402 | CYOtherExpensesAmt |
| PY Total Expenses | $71,522,685 | PYTotalExpensesAmt |
| CY Total Expenses | $79,831,125 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,754,724 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,378,605 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $90,603,339 | TotalAssetsBOYAmt |
| Total Assets EOY | $98,095,247 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,693,513 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,815,382 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $81,909,826 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $88,279,865 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO ENSURE ACCESS TO HIGH-QUALITY, COST EFFECTIVE HEALTHCARE IN A SAFE, CUSTOMER-FRIENDLY ENVIRONMENT FOR ALL THOSE IN NEED OF OUR SERVICES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $71,158,204 | ExpenseAmt |
| Revenue | $84,117,192 | RevenueAmt |
| Desc | GRANDE RONDE HOSPITAL, INC. (GRH) IS DEDICATED TO PROVIDING HIGH-QUALITY, COST-EFFECTIVE HEALTHCARE TO THE LOCAL COMMUNITY THROUGH THE OPERATION OF A 25-BED CRITICAL ACCESS HOSPITAL, 24-HOUR EMERGENCY DEPARTMENT, FAMILY BIRTHING CENTER, HOME HEALTH AND HOSPICE PROGRAMS, AND 10 OUTPATIENT PRIMARY AND SPECIALTY CARE CLINICS. GRH ALSO OPERATES A TELEMEDICINE PROGRAM WHICH ENABLES PATIENTS TO OBTAIN THE SERVICES OF SPECIALISTS SUCH AS ICU INTENSIVISTS, CARDIOLOGISTS, NEONATOLOGISTS, AND DERMATOLOGISTS AND HELPS REDUCE PATIENT TRAVEL FOR THESE SERVICES. DURING THE TAX YEAR, GRH SERVED 1,598 INPATIENTS, 48,984 OUTPATIENTS, 13,351 EMERGENCY PATIENTS, AND REGISTERED 253 BIRTHS. ADDITIONALLY, GRH PROVIDED SERVICES TO 228 PATIENTS IN THE HOME HEALTH PROGRAM, 78 PATIENTS IN THE HOSPICE PROGRAM AS WELL AS RECORDING 69,912 VISITS TO ITS PROVIDER-BASED CLINICS. DURING THE TAX YEAR, GRH WAS ABLE TO PROVIDE CHARITY CARE SERVICES TO THOSE WHO COULD NOT OTHERWISE AFFORD NECESSARY MEDICAL CARE. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 2,053,106 FOR CHARITY CARE, 22,467,695 FOR MEDICARE, 12,060,550 FOR MEDICAID, AND 7,735,696 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR ENDED APRIL 30, 2016. ADDITIONALLY, GRH PUBLISHES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS AVAILABLE ON THE HOSPITAL'S WEB SITE AND UPON REQUEST. THE REPORT PROVIDES ADDITIONAL DETAILS REGARDING ITS SERVICES AND ACTIVITIES. | Desc |
| Total Program Service Expenses | $71,158,204 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (true) | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 114 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 742 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GRANDE RONDE HOSPITAL INC | PersonNm |
| Phone | 5419638421 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 900 SUNSET DRIVE | AddressLine1Txt |
| City | LA GRANDE | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97850 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 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 |
|---|---|---|---|---|---|---|---|
| AARON SPRACKLEN | |||||||
| TRUSTEE/MEDI | 40.00 | Yes (X) | $325,400 | $0 | $49,451 | ||
| JAMES MATTES | |||||||
| TRUSTEE/CEO | 40.00 | Yes (X) | $306,325 | $0 | $49,269 | Yes (X) | |
| MICHAEL HETRICK | |||||||
| TRUSTEE/PHYS | 40.00 | Yes (X) | $182,449 | $0 | $42,444 | ||
| SUZANNE HOPPER | |||||||
| TRUSTEE | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVE LYON | |||||||
| CHAIR | 10.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| BRAD TRISLER | |||||||
| VICE CHAIR | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| BOB MESSINGER | |||||||
| TRUSTEE | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| BOB SEYMOUR | |||||||
| SECRETARY | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| TERI CHAMPLIN | |||||||
| TRUSTEE | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| LIBBY GOBEN | |||||||
| TRUSTEE | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN GARLITZ | |||||||
| TRUSTEE | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVE MCLEAN | |||||||
| TRUSTEE | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| WADE WEIS | |||||||
| FINANCE SENI | 40.00 | $150,461 | $0 | $37,731 | Yes (X) | ||
| BENJAMIN OLSON | |||||||
| PHYSICIAN | 40.00 | $699,705 | $0 | $49,462 | Yes (X) | ||
| SEYMOUR BRONSTEIN | |||||||
| PHYSICIAN | 40.00 | $474,929 | $0 | $30,191 | Yes (X) | ||
| ANDREW PEARSON | |||||||
| PHYSICIAN | 40.00 | $449,414 | $0 | $42,812 | Yes (X) | ||
| GERRY FUNK | |||||||
| PHYSICIAN | 40.00 | $407,676 | $0 | $49,660 | Yes (X) | ||
| CHRISTOPHER WOODWORTH | |||||||
| PHYSICIAN | 40.00 | $352,699 | $0 | $41,615 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,349,058 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $392,635 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 105 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| JOHNSON SID & CO | |||||
| 3150 10TH STREET | BAKER CITY | OR | 97814 | CONSTRUCTION | $4,767,636 |
| MCKESSON INFORMATION SOLUTIONS | |||||
| PO BOX 98347 | CHICAGO | IL | 60693 | HIS CONSULTING | $1,496,916 |
| PHILIPS HEALTHCARE | |||||
| PO BOX 100355 | ATLANTA | GA | 30384 | TECHNOLOGY | $461,061 |
| CAM CREDITS | |||||
| PO BOX E | LA GRANDE | OR | 97850 | COLLECTION SERV | $246,848 |
| HAMPTON PAVING LLC | |||||
| 1109 V AVE | LA GRANDE | OR | 97850 | CONSTRUCTION | $182,257 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $59,068 | RelatedOrganizationsAmt |
| Government Grants | $587,874 | GovernmentGrantsAmt |
| Total Contributions | $646,942 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 624100 | $84,102,598 | $84,102,598 |
| EDUCATION AND OTHER PATIENT | 624100 | $14,594 | $14,594 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $84,117,192 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,290,630 | TotalRevenueColumnAmt |
| Exclusion | $1,290,630 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $54,508 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $19,540 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $34,968 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,968 | TotalRevenueColumnAmt |
| Exclusion | $34,968 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $832,975 | SecuritiesAmt |
| Other | $4,500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $427,659 | SecuritiesAmt |
| Other | $38,219 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $405,316 | SecuritiesAmt |
| Other | -$33,719 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $371,597 | TotalRevenueColumnAmt |
| Exclusion | $371,597 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $35,242 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $15,158 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,084 | TotalRevenueColumnAmt |
| Exclusion | $20,084 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 900099 | $243,357 | $243,357 |
| OTHER REVENUE | 900099 | $193,547 | $193,547 |
| PHARMACY | 900099 | $163,717 | $163,717 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $127,696 | TotalRevenueColumnAmt |
| Exclusion | $127,696 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $728,317 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $87,209,730 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $84,117,192 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $2,445,596 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,144,451 | TotalAmt |
| Program Services | $587,568 | ProgramServicesAmt |
| Management And General | $556,883 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,249,169 | TotalAmt |
| Program Services | $37,398,953 | ProgramServicesAmt |
| Management And General | $5,801,790 | ManagementAndGeneralAmt |
| Fundraising | $48,426 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,138,409 | TotalAmt |
| Program Services | $1,836,817 | ProgramServicesAmt |
| Management And General | $300,202 | ManagementAndGeneralAmt |
| Fundraising | $1,390 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,684,783 | TotalAmt |
| Program Services | $4,431,117 | ProgramServicesAmt |
| Management And General | $1,245,641 | ManagementAndGeneralAmt |
| Fundraising | $8,025 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,117,911 | TotalAmt |
| Program Services | $2,629,706 | ProgramServicesAmt |
| Management And General | $484,587 | ManagementAndGeneralAmt |
| Fundraising | $3,618 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,036 | TotalAmt |
| Management And General | $179,036 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,349 | TotalAmt |
| Management And General | $114,349 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,210 | TotalAmt |
| Management And General | $93,210 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,642,218 | TotalAmt |
| Program Services | $4,153,618 | ProgramServicesAmt |
| Management And General | $485,590 | ManagementAndGeneralAmt |
| Fundraising | $3,010 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $225,730 | TotalAmt |
| Program Services | $6 | ProgramServicesAmt |
| Management And General | $225,724 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,077,054 | TotalAmt |
| Program Services | $1,558,713 | ProgramServicesAmt |
| Management And General | $513,574 | ManagementAndGeneralAmt |
| Fundraising | $4,767 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,007,796 | TotalAmt |
| Program Services | $874,300 | ProgramServicesAmt |
| Management And General | $132,017 | ManagementAndGeneralAmt |
| Fundraising | $1,479 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $396,649 | TotalAmt |
| Program Services | $293,175 | ProgramServicesAmt |
| Management And General | $99,291 | ManagementAndGeneralAmt |
| Fundraising | $4,183 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $239,899 | TotalAmt |
| Program Services | $150,145 | ProgramServicesAmt |
| Management And General | $89,754 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,230,390 | TotalAmt |
| Program Services | $4,859,846 | ProgramServicesAmt |
| Management And General | $367,023 | ManagementAndGeneralAmt |
| Fundraising | $3,521 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $565,242 | TotalAmt |
| Program Services | $355,470 | ProgramServicesAmt |
| Management And General | $209,772 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $7,623,885 | $7,623,885 | ||
| OTHER EXPENSES | $1,279,346 | $841,725 | $422,741 | $14,880 |
| REPAIRS & MAINTENANCE | $821,598 | $789,219 | $32,379 | |
| INDIRECT ALLOCATION | $2,773,941 | -$2,778,635 | $4,694 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,831,125 | TotalAmt |
| Program Services | $71,158,204 | ProgramServicesAmt |
| Management And General | $8,574,928 | ManagementAndGeneralAmt |
| Fundraising | $97,993 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,263,850 | BOYAmt |
| EOY | $7,830,352 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,058,098 | BOYAmt |
| EOY | $5,071,688 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,694,671 | BOYAmt |
| EOY | $14,448,563 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,566 | BOYAmt |
| EOY | $170,623 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $398,976 | BOYAmt |
| EOY | $807,902 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,232,134 | BOYAmt |
| EOY | $1,262,223 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $978,798 | BOYAmt |
| EOY | $1,272,690 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $97,402,599 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $56,740,418 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,811,997 | BOYAmt |
| EOY | $40,662,181 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,407,066 | BOYAmt |
| EOY | $24,395,665 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,663,183 | BOYAmt |
| EOY | $2,173,360 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,603,339 | BOYAmt |
| EOY | $98,095,247 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,364,629 | BOYAmt |
| EOY | $9,036,447 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $839,753 | BOYAmt |
| EOY | $492,931 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $489,131 | BOYAmt |
| EOY | $286,004 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,693,513 | BOYAmt |
| EOY | $9,815,382 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,676,463 | BOYAmt |
| EOY | $87,041,148 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,233,363 | BOYAmt |
| EOY | $1,238,717 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,909,826 | BOYAmt |
| EOY | $88,279,865 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,603,339 | BOYAmt |
| EOY | $98,095,247 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $7,378,605 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$954,852 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$53,714 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $10,677 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $10,677 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,189,674 | OtherCostOrOtherBasisAmt |
| Book Value | $1,189,674 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $48,417,781 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,762,469 | DepreciationAmt |
| Book Value | $22,655,312 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,267,387 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,910,835 | DepreciationAmt |
| Book Value | $1,356,552 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,271,132 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,067,114 | DepreciationAmt |
| Book Value | $14,204,018 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,256,625 | OtherCostOrOtherBasisAmt |
| Book Value | $1,256,625 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $40,662,181 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD-PARTY PAYOR SETTLEMENTS | Desc |
| Amt | $286,004 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $286,004 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE HOSPITAL HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX. THE HOSPITAL BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE HOSPITAL WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 2.500000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 4.500000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,190,801 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,762 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,186,039 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01490 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,463,982 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,463,982 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,654,783 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,468,744 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,186,039 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01490 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,442,977 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,333 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,439,644 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01800 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $246,762 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $234,762 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $804,561 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $351,658 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $452,903 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00570 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,919 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,919 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,501,219 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $366,991 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,134,228 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02670 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,156,002 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,835,735 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,320,267 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04160 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $845,783 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $720,945 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $24,557,583 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $25,443,304 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$885,721 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | false | 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 | GRANDE RONDE HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 900 SUNSET DRIVE | AddressLine1Txt |
| City | LA GRANDE | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97850 | 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 | GRANDE RONDE HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.GRH.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.GRH.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 500.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWWGRHORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWWGRHORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWWGRHORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | Yes (true) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, GRANDE RONDE HOSPITAL, INC. - PART V, LINE 5 | IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL BY UTILIZING A COMMITTEE BENEFIT SUBCOMMITTEE (CBSC) WHICH IS A GROUP COMPOSED OF COMMUNITY STAKEHOLDERS REPRESENTING BOTH HOSPITAL AND COMMUNITY INTERESTS IN THE CHNA PROCESS. THE GROUP INCLUDES INDIVIDUALS WITH BACKGROUNDS IN PUBLIC HEALTH, GOVERNMENT, THE NON-PROFIT SECTOR, BUSINESS, CHURCHES, HOSPITAL ADMINISTRATION MEMBERS, AND LONG-STANDING MEMBERS OF THE COMMUNITY. THE CBSC PROVIDED INPUT INTO THE CHNA PROCESS FROM START TO FINISH. THE CBSC PUT TOGETHER A COMMUNITY BENEFIT HEALTH NEEDS ASSESSMENT TASK FORCE TO PROVIDE INPUT FOR THE CONTENT OF THE ASSESSMENT TOOL (SURVEYS). THIS TASK FORCE WAS COMPRISED OF 35 COMMUNITY MEMBERS FROM THROUGHOUT UNION COUNTY, WITH REPRESENTATION FROM 16 PUBLIC, PRIVATE, GOVERNMENT AND FAITH- BASED ENTITIES INCLUDING, BUT NOT LIMITED TO, THE CENTER FOR HUMAN DEVELOPMENT (UNION COUNTY PUBLIC HEALTH DEPARTMENT), NE ORGEGON AREA HEALTH EDUCATION CENTER, OREGON HEALTH AND SCIENCES UNIVERSITY, AND UNION COUNTY CARE PROGRAM. IN ORDER TO MAINTAIN COMPLETE OBJECTIVITY THROUGHOUT THE SURVEY DEVELOPMENT AND IMPLEMENTATION PROCESS, THE CBSC ENGAGED THE SERVICES OF THE HOSPITAL COUNCIL OF NORTHWEST OHIO (HCNO) TO GUIDE THE ASSESSMENT PROCESS, ADMINISTER THE SURVEY AND COMPILE THE RESULTS. THE HCNO ALSO INTEGRATED SOURCES OF PRIMARY AND SECONDARY DATA IN THE FINAL RESULTS. |
| FACILITY 1, GRANDE RONDE HOSPITAL, INC. - PART V, LINE 11 | THERE WERE FOUR HEALTH CARE NEEDS IDENTIFIED BY THE CHNA. THE HOSPITAL HAS AN IMPLEMENTATION STRATEGY AND ASSOCIATED COMMUNITY BENEFIT PLAN WITH OBJECTIVES TO ADDRESS THESE NEEDS. ONE OF THE IDENTIFIED NEEDS - PRENATAL CARE IS NOT DIRECTLY BEING ADDRESSED THROUGH SPECIFIC OBJECTIVES OR NEW INITIATIVES DUE TO CURRENT CARE BEING GREATER THAN THE OVERALL STATE COMPARSION HOWEVER, THE HOSPITAL IS INDIRECTLY ADDRESSING THESE NEEDS THROUGH IT'S STRATEGIC GOALS. |
| FACILITY 1, GRANDE RONDE HOSPITAL, INC. - PART V, LINE 22D | THE HOSPITAL HAS A POLICY THAT GRANTS PATIENTS WITHOUT HEALTH INSURANCE A 10% DISCOUNT. THE DISCOUNT IS GREATER THAN THE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. IN ADDITION, ACCOUNTS WITH APPROVED FINANCIAL ASSISTANCE, CHARGES ARE REDUCED BY AN APPROVED DISCOUNT PERCENTAGE WHICH IS GREATER THAN THE ALLOWED DISCOUNT ON ANY COMMERCIAL CONTRACTS. |
| FACILITY 1, GRANDE RONDE HOSPITAL, INC. - PART V, LINE 24 | PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE RECEIVE DISCOUNTED CARE FOR MEDICALLY NECESSARY TREATMENT. SERVICES PROVIDED THAT ARE DETERMINED AS ELECTIVE OR MEDICALLY UNNECESSARY MAY BE CHARGED AT FULL PRICE. MEDICAL NECESSITY IS DETERMINED THROUGH AN INTERNAL COMMITTEE WHICH USES MEDICAID SERVICES AS THE BASIS FOR ALLOWABLE SERVICES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| GRANDE RONDE HOSPITAL REGIONAL MEDI | ||||
| 506 4TH STREET | LA GRANDE | OR | 97850 | PHYSICIAN CLINIC |
| GRANDE RONDE HOSPITAL REGIONAL MEDI | ||||
| 710 SUNSET DRIVE | LA GRANDE | OR | 97850 | PHYSICIAN CLINIC |
| GRANDE RONDE HOSPITAL WOMENS CLINIC | ||||
| 610 SUNSET DRIVE | LA GRANDE | OR | 97850 | PHYSICIAN CLINIC |
| GRANDE RONDE HOSPITAL CHILDRENS | ||||
| 612 SUNSET DRIVE | LA GRANDE | OR | 97850 | PHYSICIAN CLINIC |
| GRANDE RONDE HOSPITAL HOME CARE | ||||
| 2502 COVE AVENUE | LA GRANDE | OR | 97850 | HOME HEALTH & HOSPICE |
| GRANDE RONDE HOSPITAL SLEEP CLINIC | ||||
| 701 SUNSET DRIVE | LA GRANDE | OR | 97850 | SLEEP CLINIC |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES FOR AMOUNTS REPORTED IN THE TABLE (TOTAL OPERATING EXPENSES, LESS NON-PATIENT CARE ACTIVITIES AND TOTAL COMMUNITY BENEFIT EXPENSES) FOR LINES 7A AND 7B. THE COSTS ON LINE 7E, 7F AND 7I INCLUDE THE DIRECT AND INDIRECT COSTS AS ALLOWED FOR IN WORKSHEETS 4, 5 AND 8. LINE 7G UTILIZED A COST-TO-CHARGE RATIO USING THE MEDICARE COST REPORT AS FILED. |
| PART II - COMMUNITY BUILDING ACTIVITIES | THE HOSPITAL DONATED PROPERTY AND OTHER ITEMS TO VARIOUS LOCAL NON-PROFIT AGENCIES. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE HOSPITAL USED THE RATIO OF PATIENT CARE COSTS-TO-CHARGES TO DETERMINE THE COST OF BAD DEBT EXPENSE. |
| PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE | THE ESTIMATED AMOUNT OF BAD DEBT THAT IS ATTRIBUTED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS EQUAL TO THE AVERAGE OF ACTUAL DISCOUNTS ON FULLY EXECUTED PATIENT ACCOUNTS WITH FINANCIAL ASSISTANCE. THE RATE FOR THE TAX YEAR IS 85.24%. THE RATIONALE FOR APPLYING THE SAME AVERAGE DISCOUNT AMOUNT TO BAD DEBT IS DUE TO THE FACT THAT MULTIPLE FINANCIAL APPLICATIONS ARE SENT TO THE FINANCIAL GUARANTOR PRIOR TO DETERMINING BAD DEBT STATUS. THEREFORE, IF ALL APPLICATIONS WERE TO BE RETURNED, THE EXPERIENCE RATE IS ESTIMATED TO BE SIMILAR. NO BAD DEBT WAS CLASSIFIED AS A COMMUNITY BENEFIT. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND ON PAGE 10 OF THE AUDITED FINANCIAL STATEMENTS AND ALSO INCLUDES THE PROVISION FOR BAD DEBTS. |
| PART III, LINE 8 - MEDICARE EXPLANATION | ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | THE BOARD ESTABLISHED A COMMUNITY BENEFIT SUBCOMMITTEE TO PERFORM A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL BY UTILIZING A COMMITTEE OF BENEFIT SUBCOMMITTEE (CBSC) WHICH IS A GROUP COMPOSED OF COMMUNITY STAKEHOLDERS REPRESENTING BOTH HOSPITAL AND COMMUNITY INTERESTS IN THE CHNA PROCESS. THE GROUP INCLUDES INDIVIDUALS WITH BACKGROUNDS IN PUBLIC HEALTH, GOVERNMENT, THE NON-PROFIT SECTOR, BUSINESS, CHURCHES, HOSPITAL ADMINISTRATION MEMBERS, AND LONG-STANDING MEMBERS OF THE COMMUNITY. THE CBSC PROVIDED INPUT INTO THE CHNA PROCESS FROM START TO FINISH. THE CHNA IS UPDATED ANNUALLY. THE MOST RECENTLY ADOPTED COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND AT THE FOLLOWING URL: HTTP://WWW.GRH.ORG/COMMUNITY-BENEFIT.ASPX |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PATIENTS ARE INFORMED OF THE HOSPITALS FINANCIAL ASSISTANCE PROGRAM VERBALLY AT ADMISSION AS WELL AS THROUGH LITERATURE PROVIDED IN THE ADMITTING AREAS OF PATIENT CARE FACILITIES. IN ADDITION, ALL ACCOUNTS THAT ARE TURNED OVER TO INTERNAL COLLECTIONS RECEIVE A FINANCIAL ASSISTANCE APPLICATION THROUGH THE MAIL WHICH IS FOLLOWED-UP WITH A TELEPHONE CALL. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | GRANDE RONDE HOSPITAL, INC. IS LOCATED IN UNION COUNTY, OREGON, WHICH IS ISOLATED BY MOUNTAIN RANGES IN BOTH FREEWAY DIRECTIONS. THE MOUNTAIN PASSES ARE FREQUENTLY CLOSED DURING THE WINTER. GRANDE RONDE HOSPITAL IS LOCATED 42 MILES AWAY AND 50 MILES AWAY FROM ITS TWO CLOSEST HOSPITALS. THE CLOSEST REFERRAL HOSPITAL IS 87 MILES AWAY. THE HOSPITAL ALSO REFERS CARE TO BOISE, IDAHO, AND PORTLAND, OREGON, WHICH ARE 3 AND 4 HOURS AWAY RESPECTIVELY. THE APPROXIMATE POPULATION BASE FOR THE HOSPITALS PRIMARY SERVICE AREA IS 26,485 WITH A REGIONAL SERVICE AREA OF 49,650. FOR THE PRIMARY SERVICE AREA OF UNION COUNTY, THE AGE IN YEARS OF THE POPULATION IS 6.1% UNDER 5, 22.0% UNDER 18, 53.8% UNDER 65 AND 18.1% OVER 65. THE RACIAL MAKEUP OF THE COUNTY IS 93.3% WHITE, 0.6% BLACK OR AFRICAN AMERICAN, 1.2% NATIVE AMERICAN, 1.1% ASIAN, 1.3% PACIFIC ISLANDER, AND 2.5% FROM TWO OR MORE RACES. ADDITIONALLY, THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY 42,542 WITH 13.8% OF THE POPULATION LIVING BELOW THE POVERTY LEVEL AS ESTIMATED THROUGH 2013. DURING THE FISCAL YEAR, THE COUNTYS SEASONALLY ADJUSTED UNEMPLOYMENT RATE HAS BEEN AS HIGH AS 7.5% AND AS LOW AS 5.8% AND WAS AT 5.8% AT YEAR END. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | GRANDE RONDE HOSPITAL, INC. HAS A TWELVE MEMBER BOARD OF TRUSTEES THAT GOVERNS ITS ACTIVITIES. OF THOSE TWELVE MEMBERS, TEN ARE FROM THE COMMUNITY AT LARGE. THE REMAINING TWO MEMBERS ARE THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND THE PROFESSIONAL STAFF PRESIDENT. THE TEN COMMUNITY MEMBERS USE THEIR UNIQUE EXPERIENCE AND ABILITIES TO LEAD THE HOSPITAL IN DIRECTIONS THAT SUPPORT THE NEEDS OF THE COMMUNITY. THE STATED MISSION OF THE ORGANIZATION IS AS FOLLOWS: "WE WILL ENSURE ACCESS TO HIGH-QUALITY, COST-EFFECTIVE HEALTH CARE IN A SAFE, CUSTOMER-FRIENDLY ENVIRONMENT FOR ALL THOSE IN NEED OF OUR SERVICES." |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | THE HOSPITAL IS AFFILIATED WITH SAINT ALPHONSUS HEALTH SYSTEM WHICH IS A MEMBER OF THE TRINITY HEALTHCARE SYSTEM IN A NON-MANAGEMENT CAPACITY. THE AFFILIATION IS FOR THE BENEFIT OF IMPROVING HEALTHCARE AND PROVIDING ACCESS TO AFFORDABLE SPECIALIZED CARE TO THE RURAL COMMUNITY. |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | OREGON |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|
| AARON SPRACKLEN | ||||||
| TRUSTEE/MEDICAL DIR | $262,116 | $38,084 | $25,200 | $13,250 | $36,201 | $374,851 |
| JAMES MATTES | ||||||
| TRUSTEE/CEO | $281,825 | $24,500 | $20,400 | $28,869 | $355,594 | |
| MICHAEL HETRICK | ||||||
| TRUSTEE/PHYSICIAN | $144,311 | $14,138 | $24,000 | $9,008 | $33,436 | $224,893 |
| WADE WEIS | ||||||
| FINANCE SENIOR DIR | $139,165 | $11,296 | $8,068 | $29,663 | $188,192 | |
| BENJAMIN OLSON | ||||||
| PHYSICIAN | $470,380 | $193,325 | $36,000 | $13,250 | $36,212 | $749,167 |
| SEYMOUR BRONSTEIN | ||||||
| PHYSICIAN | $351,929 | $100,000 | $23,000 | $12,750 | $17,441 | $505,120 |
| ANDREW PEARSON | ||||||
| PHYSICIAN | $280,048 | $151,366 | $18,000 | $13,250 | $29,562 | $492,226 |
| GERRY FUNK | ||||||
| PHYSICIAN | $354,672 | $29,004 | $24,000 | $13,250 | $36,410 | $457,336 |
| CHRISTOPHER WOODWORTH | ||||||
| PHYSICIAN | $249,221 | $80,478 | $23,000 | $12,750 | $28,865 | $394,314 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PAGE 1, PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | CERTAIN MEDICAL PROVIDERS ARE COMPENSATED BASED ON THE GROSS PROFESSIONAL CHARGES GENERATED BY THEIR SERVICES. | ExplanationTxt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GERRY FUNK | PersonNm |
| Relationship With Org | HIGHEST COMPENSATED | RelationshipWithOrgTxt |
| Loan Purpose | PRODUCTIVITY ADVANCE | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $200,000 | OriginalPrincipalAmt |
| Balance Due | $170,623 | BalanceDueAmt |
| Default | false | DefaultInd |
| Board Or Committee Approval | Yes (true) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (true) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $170,623 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TRISHA ALEXANDER | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY MEMBER | RelationshipDescriptionTxt |
| Transaction | $150,725 | TransactionAmt |
| Transaction | EMPLOYMENT | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4A | ADDITIONALLY, GRH PROVIDED SERVICES TO 228 PATIENTS IN THE HOME HEALTH PROGRAM, 78 PATIENTS IN THE HOSPICE PROGRAM AS WELL AS RECORDING 69,912 VISITS TO ITS PROVIDER-BASED CLINICS. DURING THE TAX YEAR, GRH WAS ABLE TO PROVIDE CHARITY CARE SERVICES TO THOSE WHO COULD NOT OTHERWISE AFFORD NECESSARY MEDICAL CARE. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 2,053,106 FOR CHARITY CARE, 22,467,695 FOR MEDICARE, 12,060,550 FOR MEDICAID, AND 7,735,696 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR ENDED APRIL 30, 2016. ADDITIONALLY, GRH PUBLISHES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS AVAILABLE ON THE HOSPITAL'S WEB SITE AND UPON REQUEST. THE REPORT PROVIDES ADDITIONAL DETAILS REGARDING ITS SERVICES AND ACTIVITIES. |
| FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE 990 IS PROVIDED TO THE SENIOR DIRECTOR FINANCE/CFO WHO REVIEWS THE FORM, SCHEDULES, AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A REVISED DRAFT IS THEN REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO SIGNS OFF ON THE FORM 8879-EO BEFORE THE RETURN IS E-FILED BY THE PREPARER. |
| FORM 990, PAGE 6, PART VI, LINE 12C | EACH CURRENT MANAGER AND EACH CURRENT AND FORMER OFFICER, TRUSTEE, DIRECTOR, AND KEY EMPLOYEE ARE REQUIRED TO COMPLETE A DISCLOSURE STATEMENT IDENTIFYING ANY POSSIBLE CONFLICT OF INTEREST EACH FISCAL YEAR. THE FORMS ARE REVIEWED BY THE CORPORATION'S COMPLIANCE OFFICER AND/OR THE BOARD OF TRUSTEES. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, A DISINTERESTED PERSON OR COMMITTEE IS APPOINTED TO INVESTIGATE ALTERNATIVES TO THE BUSINESS TRANSACTION OR ARRANGEMENT IF A REASONABLE ALTERNATIVE IS NOT ATTAINABLE, A DECISION IS MADE AS TO WHETHER THE ARRANGEMENT IS FAIR AND REASONABLE AND IN THE CORPORATION'S BEST INTEREST, AND THEREFORE WHETHER OR NOT TO ENTER INTO THE BUSINESS TRANSACTION IN CONFORMITY WITH SUCH DETERMINATIONS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE HOSPITAL BOARD OF TRUSTEES APPOINTS INDEPENDENT INDIVIDUAL TRUSTEES TO THE CONTRACT AND COMPENSATION COMMITTEE. THE COMMITTEE DIRECTS THE PROCESS TO ESTABLISH REASONABLE COMPENSATION FOR THE PRESIDENT/CEO, CFO, EXECUTIVES, AND KEY EMPLOYEES. THE COMMITTEE ANNUALLY EVALUATES THE COMPENSATION OF THESE INDIVIDUALS AS COMPARED TO FAIR MARKET VALUE. AN INDEPENDENT THIRD-PARTY CONSULTANT IS HIRED AS NEEDED TO CONDUCT A FULL SALARY AND BENEFITS SURVEY OF COMPARABLE ORGANIZATIONS AND TO RECOMMEND COMPENSATION RANGES FOR THESE INDIVIDUALS. THE COMMITTEE ANALYZES THE RESULTS OF THE THIRD-PARTY SURVEY AND/OR MARKET UPDATE REPORT AND DECIDES ON A RECOMMENDED COMPENSATION PACKAGE FOR THE PRESIDENT/CEO AND CFO. THESE RECOMMENDATIONS ARE THEN PRESENTED TO THE BOARD OF TRUSTEES FOR APPROVAL. ALL FINAL DECISIONS ARE MADE IN EXECUTIVE SESSION AND ARE DOCUMENTED IN DETAILED MINUTES. AFTER REVIEWING THE RESULTS OF THE SURVEY, THE COMMITTEE DECIDES ON AND PRESENTS A SALARY RANGE FOR EACH EXECUTIVE AND KEY EMPLOYEE TO THE PRESIDENT/CEO, WHO THEN DETERMINES EACH INDIVIDUAL'S COMPENSATION WITHIN THE COMMITTEE'S RECOMMENDED RANGE. THE BOARD OF TRUSTEES APPROVES THE BENEFITS AND PERQUISITES FOR THESE INDIVIDUALS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SEE ABOVE EXPLANATION - FORM 990, PART VI, LINE 15A. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE HOSPITAL'S FORM 1023 AND THREE MOST RECENT FORM 990'S ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST, WHICH CAN BE MADE EITHER IN PERSON, BY US MAIL, FAX, EMAIL, OR BY PRIVATE DELIVERY SERVICE. ADDITIONALLY, THE FORM 990 IS AVAILABLE AT WWW.GUIDESTAR.COM. THE HOSPITAL DOES NOT MAKE AVAILABLE TO THE PUBLIC ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, OR FINANCIAL STATEMENTS, ALTHOUGH LIMITED FINANCIAL INFORMATION IS PROVIDED TO THE PUBLIC ON THE HOSPITAL'S WEB SITE, WWW.GUIDESTAR.COM, AND THE OREGON DEPARTMENT OF JUSTICE CHARITABLE ACTIVITIES WEB SITE. |
| FORM 990, PART XI, LINE 9 | CHANGE IN BENEFICIAL INTEREST IN TRUST -53,714 TOTAL -53,714 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| GRANDE RONDE HOSPITAL FOUNDATION | ||||||||||
| 900 SUNSET DRIVE | LA GRANDE | OR | 97850 | 931174357 | SUPPORT | OR | C3 | 11A | N/A | Yes (true) |
| GRANDE RONDE HOSPITAL AUXILIARY | ||||||||||
| 900 SUNSET DRIVE | LA GRANDE | OR | 97850 | 237090684 | SUPPORT | OR | C3 | 11B | N/A | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EASTERN OREGON COORDINATED CARE | BusinessNameLine1Txt |
| Business Name Line2 | ORGANIZATION LLC | BusinessNameLine2Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 SW SECOND AVENUE | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 800835179 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $1,563,719 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $4,068,608 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
| Ownership | 0.10000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DISPROPORTIONATE SHARE HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | 3 TRUST | BusinessNameLine2Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4000 KRUSEWAY PLACE BLDG 2 | AddressLine1Txt |
| Address Line2 | SUIET 100 | AddressLine2Txt |
| City | LAKE OSWEGO | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97035 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 456822739 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | TRUST | EntityTypeTxt |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| GRANDE RONDE HOSPITAL FOUNDATION | ||
| C | $59,068 | ACTUAL |
| GRANDE RONDE HOSPITAL FOUNDATION | ||
| O | $53,827 | ACTUAL |
Comments