2016-02-03T12:29:22-07:00 2015-06-30 990 2014-07-01 920037099 SOUTH PENINSULA HOSPITAL INC SOUT 9072358101 4300 Bartlett Street Homer AK 99603 Robert Letson CEO 9072350324 2016-01-29 2014 2016-04-25 22:37:26Z SOuth Peninsula Hospital Inc 4300 Bartlett St Homer AK 99603 61294402 0 X www.sphosp.org X 1969 AK South Peninsula Hospital promotes community health and wellness by providing personalized, high quality, locally coordinated healthcare. 10 10 453 0 4864841 3933828 50097257 57345704 10320 14870 0 0 54972418 61294402 0 0 0 0 33999714 37068291 0 0 0 20195284 21555316 54194998 58623607 777420 2670795 65102426 69160250 25978074 27930356 39124352 41229894 South Peninsula Hospital promotes community health and wellness by providing personalized, high quality, locally coordinated healthcare. 0 0 29798310 0 40177238 Our 22 bed hospital provided inpatient services to 992 patients for total patient days of 3,698 for the 2014 tax year. Total outpatient visits for the year were 50,248 and include 4,641 emergency department visits, 1,213 ambulatory surgery visits, and 12,925 imaging visits. Other outpatient services include laboratory, physical therapy, occupational therapy, infusion and chemotherapy, and sleep lab. 5490569 0 7638489 Our Long Term Care facility served 28 residents during the 2014 tax year with an average daily census of 28 and total resident days of 10,143. 8277818 0 8247394 The hospital has provider-based clinics including primary care, orthopedic and general surgery. The clinics had 20,318 patient visits during the 2014 tax year. 1839721 0 927086 Our community health services department provides home health care, chore and respite services, and other home care services to more than 250 local residents. 2,425 visits were made to client homes in the 2014 yax year. Other program services include revenue from cafeteria and vendings machines, medical record copies, and other program related sources. 1839721 0 927086 45406418 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 122 0 1 453 1 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 0 0 X South Peninsula Hospital 9072358101 4300 Bartlett Street Homer AK 99603 Julie Woodworth Director 3 0 X 1200 0 0 Thomas Clark Director 5 0 X 1800 0 0 Susan Drathman Director 2.5 0 X 1200 0 0 Matthew Hambrick Director 2 0 X 1200 0 0 Vickey Hodnick Director 2 X 1200 0 0 Matthew North Director 2 X 1200 0 0 Bernadette Wilson Director 5 0 X 1200 0 0 M Todd Boling DO Director 2 0 X 1200 0 0 Robert F Letson Chief Executive Officer 50 0 X 209437 0 71079 Lori Meyer Chief Financial Officer 45 0 X 144989 0 60123 Brent Adcox Medical Doctor 40 0 X 1215471 0 162867 Gregory Hough Medical Doctor 40 0 X 636405 0 110751 Larry R Tripp CRNA 40 0 X 364344 0 18839 Carl Seger Medical Doctor 40 0 X 295831 0 70602 William Bell Medical Doctor 40 0 X 286765 0 79283 Kelly Cooper Director 2 0 X 900 0 0 Jack Oudiz Director 2 0 X 800 0 0 Caroline Venuti Director 1.5 0 X 0 0 0 3165142 0 573544 33 1 1 0 Peak Imaging 4438 Towne Heights Ln Homer AK 99603 Radiologist 1127190 Raymond Fowler 40914 Crested Crane St Homer AK 99603 Anesthesiologist 520424 Peninsula Surgical Clinic Inc 203 W Pioneer Ave Ste 2 Homer AK 99603 Medical Doctor 254439 Q Radiology LLC 5643 Woodmansee Way Liberty TWP OH 45011 Radiologist 190977 Quest Diagnostics PO BOX 740709 Atlanta GA 303740709 Laboratory services 187560 14 0 0 0 0 3809032 124796 0 3933828 Hospital 622000 40177238 40177238 0 0 Physician Offices 621111 8247394 8247394 0 0 Long Term Care 623000 7638489 7638489 0 0 Home Health Care 621610 927086 927086 0 0 355497 355497 0 0 57345704 13415 13415 0 0 0 0 0 0 0 0 0 0 0 0 0 1455 0 0 0 1455 1455 1455 0 0 0 0 61294402 57360574 0 0 X 354426 0 354426 0 25210491 20190887 5019604 0 1265989 1000131 265858 0 8452993 5924494 2528499 0 1784392 1323579 460813 0 121492 121492 0 0 334845 0 334845 0 38381 0 38381 0 0 0 0 0 0 0 0 0 0 0 6750460 5686791 1063669 111868 0 111868 0 5679878 5087253 592625 0 662981 116120 546861 0 0 0 0 0 1605336 349291 1256045 0 195506 112926 82580 0 0 0 0 0 207171 136509 70662 0 796021 794942 1079 0 0 0 0 0 3027960 3027960 0 0 655151 655151 0 0 Repairs and Maintenance 1148883 837953 310930 0 Dues Books and Subscriptions 219383 40939 178444 0 58623607 45406418 13217189 0 2429 2429 7692665 12938774 0 0 12870008 11845605 0 0 0 0 0 0 1451479 1580787 1084885 567402 79125196 38731449 41672925 40393747 0 0 0 0 328035 1831506 65102426 69160250 8482048 9379275 0 338301 496591 17088217 16682450 0 0 0 0 0 285807 0 0 69508 1086233 25978074 27930356 X 39099066 41204608 25286 25286 0 0 39124352 41229894 65102426 69160250 2670795 0 0 0 -565253 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 3704067 3704067 0 54570845 22637559 31933286 0 80470 36914 43556 0 20141961 16056976 4084985 0 627853 0 627853 40393747 Net Pension Liability 1086233 1086233 61294402 0 0 0 0 0 61294402 0 0 0 61294402 58623607 0 0 0 0 0 58623607 0 0 0 58623607 1 1 1 X 1 X 1 1 0 0 875743 0 875743 0.015 0 0 0 0 0 0 0 0 0 0 875743 0 875743 0.015 175070 16652 164436 0.003 434211 0 434211 0.007 980984 204188 776796 0.013 0 0 0 0 48786 0 48786 0.0008 0 0 1639051 220840 1424229 0.0238 0 0 2514794 220840 2299972 0.0388 0 2333531 233353 9013137 8493835 519302 X 0 1 1 South Peninsula Hospital Inc 4300 Bartlett St Homer AK 99603 www.sphosp.org GACH-010 X X X X South Peninsula Hospital Inc 1 0 0 1 X X X X X X X X X 12 1 0 1 1 X www.sphosp.org X www.mappofskp.net X X 1 13 1 www.sphosp.org 0 0 1 X 100 300 X X X 1 1 X X X 1 X www.sphosp.org X www.sphosp.org X X X X X 1 0 X X X X 1 X 0 1 Schedule H, Part V, Section B, Line 5-South Peninsula Hospital Inc The hospital assured appropriate representation of the community in the following ways: a) By utilizing the MAPP framework (Mobilizing to Action through Planning and Partnerships) for the assessment, which is directed by a community Steering Committee and consists of four sub-assessments: Local Public Health System, Community Themes and Strengths, Health Status, and Forces of Change. b) By nature of the makeup of the Steering Committee which directed the assessment. Steering Committee members represent local agencies in the fields of physical health, public health, education, behavioral health, domestic violence prevention, substance abuse prevention, community health centers, environment sustainability, city planning, and economic development. c) The Community Themes and Strengths sub-assessment conducted a "Perceptions of Community Health" survey of 1,212 residents from throughout the service area. The majority of respondents were from households with two individuals and between 46-64 years old. Respondents' age and income closely mirrored that of our service area based on the US Census report. 24% of the respondents were in the less than $25,000 income range; 11% was in the $25,000 - $33,000; 11% was in the $33,000-$51,000; 20% was in the $51,000-$76,999; and 31% was in the $76,000 plus. d) The Community Themes and Strengths sub-assessment conducted interviews with 86 key informants in the community (100 invitations were sent) based on a broad definition of health: cultural, economic, educational, environmental, mental, physical, and spiritual. Informants included but were not limited to: police officers, mental health workers, pastors, daycare providers, public health nurses, physicians, senior care providers, senior center director, hospital director, clinic directors, city officials, business owners, prevention workers, EMT responders, public assistance providers, educators, and school nurses. e) The Health Status assessment includes data from 100 different service providers in the local and service area community, including hospital, clinics, police department, prevention agencies, churches, youth development programs, schools, economic development organizations, utility providers, local college, DOT and more. f) A complete breakdown of representatives can be found in the assessments, located at www.mappofskp.net Schedule H, Part V, Section B, Line 6b-South Peninsula Hospital Inc The hospital's Community Health Needs Assessment was conducted by a local coalition made up of the following partners: o Public Health Office, State of Alaska o South Peninsula Behavioral Health o Haven House o Kachemak Bay Family Planning o Cook Inlet Council on Alcohol and Drug Abuse o Kachemak Bay Campus/Kenai Peninsula College o Sustainable Homer o Seldovia Village Tribe Health Clinic o City of Homer o South Peninsula Hospital o Sprout Family Services Schedule H, Part V, Section B, Line 7d-South Peninsula Hospital Inc A total of 120 bound reports were made and distributed as follows: CHNA reports were distributed to all board members and leadership positions of the partnership agencies listed above; CHNA reports are provided to all new physicians and mid level providers to South Peninsula Hospital; CHNA presentations and reports were provided to City of Homer Council, local Rotary meeting, Chamber of Commerce meetings and various other public meetings. Schedule H, Part V, Section B, Line 11-South Peninsula Hospital Inc South Peninsula Hospital has taken numerous actions based on the prominent findings of the CHNA. Listed here are but a few: *Economic and Affordability Issues -Developed and promoted attractive self pay and prompt pay discounts for patients -Provided free enrollment assistance for service area residents into the marketplace insurance plans -Continued special promotions of screenings -Work with the local rotary club to offer reduced rate and free health fair offerings, including comprehensive wellness blood panel, flu shots and more at the annual health fair *ACES (Adverse Childhood Experiences) & Family Issues -Recruited and employed a Behavioral Health Nurse Practitioner -Recruited and employed an Addiction Medicine provider, and offers a regular Addiction Medicine clinic -Adopted new intake tools in primary care to better screen for ACES (Adverse Childhood Experiences) in pediatric care -Provided ACES training for providers and hospital employees *Access to Care and Services (lack of insurance, transportation and awareness of services) -Supports the development and maintenance of www.POP411.org, an online listing of local service providers -Developed a Medical Staff Development Plan utilizing the results of the CHNA -Supported the development of Emergency Food & Housing Assistance booklet which is updated annually and lists resources which offer immediate assistance to those at risk. -Hospital is the matching agency for a local public transportation grant, in which every dollar the hospital spends on transporting a patient to or from care is matched by a grant to provide matched dollars for public taxi vouchers; hospital staff serves on leadership team of said grant. -Hospital provides free enrollment assistance for service area residents into the marketplace insurance plans; hospital offers certified enrollment specialists for Medicaid presumptive eligibility, to more quickly enroll patients in Medicaid. -Hospital sponsors numerous local specialty clinics, welcoming visiting specialists from all around Alaska for weekly and monthly clinics at the hospital. -Hospital sponsors a two-day a week VA Clinic, facilitating visiting VA providers to offer care at the local level. -Hospital co-sponsored a VA StandDown, in which over 100 veterans were enrolled into VA benefits -Received grant funding to transition hospital primary care practice into Patient Centered Medical Home model of care, which focused on increased care coordination -Developed a community task force Care Transitions, to ensure discharged patients are transitioned seamlessly to primary care, home health, hospice, or appropriate provider *Aging Population (rapidly growing senior segment of the population) -Hospital developed a 5-year Long Term Care Strategic Plan to better position the organization for the rapidly increase to our senior population -Hospital recruited numerous specialists to provide local clinics in areas of importance to senior health and chronic diseases, including urology, diabetes, cardiology, neurology, sleep medicine and more. -Hospital contracted with Providence Alaska Medical Center to offer e-ICU, to allow for local ICU admissions, with monitoring done by the Providence ICU team in Anchorage, allowing for ICU care close to home. -The hospital's community health educator has developed an education plan tailored to address the needs of the senior population -The hospital has recommitted to Home Health services, contracting a consultant to assess the service and organizational model and make changes to the department to best meet the needs of the patients we serve in a sustainable manner -The hospital was the recipient of a Senior In Home Services grant, which provided supplemental coverage for uninsured and underinsured senior residents for in-home nursing care -SPH Foundation provides subsidies for underinsured and uninsured patients seeking diabetes education and needed supplies *Substance Abuse (lack of treatment options and prevention) -Recruited and employed an Addiction Medicine provider, and offers a regular Addiction Medicine clinic -Recruited and employed a Behavioral Health Nurse Practitioner; offering independent appointments, as well as care as part of the Patient Centered Medical Home -Hospital staff served on the leadership team and implementation team of the Homer Prevention Project, a SAMSHA funded grant aimed at reducing underage drinking and adult heavy and binge drinking Schedule H, Part V, Section B, Line 22d-South Peninsula Hospital Inc All patients are charged gross charges. Discounts are applied to gross charges for all patients. Schedule H, Part V, Section B, Line 24-South Peninsula Hospital Inc All patients are charged gross charges. Discounts are applied to gross charges for all patients. 3 South Peninsula Hospital Long Term Care 4300 Bartlett St Homer AK 99603 Long Term Care skilled nursing facility. South Peninsula Hospital Provider Based Clinics 4300 Bartlett St Homer AK 99603 Provider based physician clinics. South Peninsula Hospital Community Health Services 4300 Bartlett St Homer AK 99603 Home health care services. Schedule H, Part I, Line 7 Used worksheets provided in the instructions for schedule H and cost to charge ratio. Schedule H, Part I, Line 7, Column f Bad Debt expense was not included in form 990 Part IX line 25. Schedule H, Part I, Line 7g The organization did not include physician clinics in subsidized health services. Schedule H, Part III, Section A, Line 4 Bad debt and charity care are subtracted from patient service revenue to arrive at net patient revenue (as noted on page 17). Line 2 is calculated by bad debt expense times cost to charge ratio. Line 3 is estimated at ten percent of bad debt. Schedule H, Part III, Section B, Line 8 The amount reported on line 6 is from the organizations cost report. Schedule H, Part VI, Line 2 Community input about healthcare needs is encouraged at all times. Annually, community needs are considered when developing strategic plan action items. Schedule H, Part VI, Line 3 During patient registration, each private pay patient is offered a financial assistance packet and business card for financial counselor. The hospital has certified application counselors to assist with marketplace enrollment and presumptive eligibility determinations for Medicaid. The financial counselors also assist with the hospital internal financial assistance applications as needed. Schedule H, Part VI, Line 4 The South Kenai Peninsula Hospital Service Area (SKPHSA) was formed in 1969 by the Kenai Peninsula Borough. It was determined that hospital services were needed within the South Peninsula area and that such services would be best provided by the establishment of a service area. The population of the SKPHSA is 13,899 and covers 8,317 square miles. South Peninsula Hospital is located in Homer, Alaska at the southern tip of the Kenai Peninsula and close to the westerly most highway point in the country. The next closest hospital is Central Peninsula Hospital in Soldotna, 76 miles north of South Peninsula Hospital but as many as 80-90 miles for many of the residents is the SKPHSA. Close to half of the population is largely in or in close proximity to the City of Homer. The remaining half is scattered in small neighborhoods throughout the vast service area. Some of the communities is the SKPHSA are accessible only by air and water. Homer is the commercial hub of the service area, and the area attracts over 100,000 visitors each year. According to Alaska Department of Labor, the 2010 census of the primary service area is 13,136. The southern Kenai Peninsula has become a retirement destination. Currently, 13% of the SKPHSA population is age 65 or greater. That number is expected to increase to 29% by 2025. X 1 1 X X X 0 0 0 0 0 1 0 1 0 Robert F Letson Chief Executive Officer 189940 0 19497 0 0 0 0 0 71079 0 280516 0 0 0 Lori Meyer Chief Financial Officer 144989 0 0 0 0 0 0 0 60123 0 205112 0 0 0 Brent Adcox Medical Doctor 846775 0 368696 0 0 0 0 0 162867 0 1378338 0 0 0 Gregory Hough Medical Doctor 554780 0 81605 0 0 0 0 0 110751 0 747136 0 0 0 Larry R Tripp CRNA 295831 0 0 0 0 0 0 0 18839 0 314670 0 0 0 Carl Seger Medical Doctor 295831 0 0 0 0 0 0 0 70602 0 366433 0 0 0 William Bell Medical Doctor 167478 0 119287 0 0 0 0 0 79283 0 366048 0 0 0 Schedule J, Part I, Line 1a Reimbursement of health club dues at 50% of cost up to a maximum of $500 per year. Schedule J, Part I, Line 3 Annually, an evaluation committee comprised of board members is appointed and they review the existing evaluation form and make any necessary adjustments to the format and content of questions asked. The entire board of directors and senior management are asked to do a confidential evaluation as well as having the CEO complete a self-evaluation. The CEO's compensation is reviewed annually and any increases are a board decision based on performance and salary survey data. Schedule J, Part I, Line 6 The medical doctors may receive a bonus based on net earnings of their clinic operations. Schedule J, Part I, Line 7 Medical Doctors may receive a productivity bonus based on Relative Value Units performed. A Kenai Peninsula Borough 920030894 2003-09-30 10290000 Hospital Expansion 0 0 0 B Kenai Peninsula Borough 920030894 2007-08-28 14555000 Hospital Expansion 0 0 0 A 0 0 0 0 0 0 0 0 0 0 0 0 2009 0 0 1 1 B 0 0 0 0 0 0 0 0 0 0 0 0 2010 0 0 1 1 A 0 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 A 1 B 1 WOODWORTH ELECTRIC Spouse of board member 148843 Electrical contracting 0 Form 990, Part VI, Section B, Line 11b Form 990 is prepared by the organization Chief Financial Officer with input from other staff. The form is reviewed by the finance committee of the board of directors. The final form 990 is approved by the board of directors before submission to the internal revenue service. Form 990, Part VI, Section B, Line 12c All employees complete a conflict of interest questionnaire upon hire. Officers, directors, and managers complete a conflict of interest questionnaire annually each December. The possible existence of conflicts are required to be reported to the corporate compliance officer for investigation. Form 990, Part VI, Section B, Line 15 Annually, an evaluation committee comprised of board members is appointed and they review the existing evaluation form and make any necessary adjustments to the format and content of the questions being asked. The committee also reviews industry salary surveys. The entire board of directors and senior management team are asked to do a confidential evaluation as well as having the CEO complete a self evaluation. The CEO's compensation is reviewed annually and any increases are a board decision based on performance. Form 990, Part VI, Section C, Line 19 All governing documents, conflict of interest policy, and financial statements are available to the public by providing copies upon request. Board of directors meeting minutes are available on the hospital website www.sphosp.org. Form 990, Part IX, Line 11g Includes contract staffing, physician fees, other professional fees. Kenai Peninsula Borough 144 N Binkley Street Soldotna AK 99669 920030894 Local Government AK 115 N/A 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 Kenai Peninsula Borough c 3757249