SAN GORGONIO MEMORIAL HOSPITAL: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- SAN GORGONIO MEMORIAL HOSPITAL (EIN 33-0420041)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-01-09
- IRS object ID
- 201500099349300735
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-01-09T16:14:12-06:00 | ReturnTs |
| Tax Period End | 2014-06-30 | 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 | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12015 E MAIN AVE | AddressLine1 |
| City | SPOKANE VALLEY | City |
| State | WA | State |
| ZIP Code | 992066130 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 330420041 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAN GORGONIO MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SANG | BusinessNameControlTxt |
| Phone | 9517692103 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 NORTH HIGHLAND SPRINGS AVE | AddressLine1 |
| City | BANNING | City |
| State | CA | State |
| ZIP Code | 92220 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID RECUPERO | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9517692103 | PhoneNum |
| Signature | 2014-12-30 | 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 | 2015-01-09 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID RECUPERO CFO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 NORTH HIGHLAND SPRINGS AVE | AddressLine1 |
| City | BANNING | City |
| State | CA | State |
| ZIP Code | 92220 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $64,814,371 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SGMH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1990 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | SAN GORGONIO MEMORIAL HOSPITAL IS A NONPROFIT PUBLIC BENEFIT CORPORATION FORMED FOR THE PURPOSE OF OPERATING THE SAN GORGONIO ACUTE CARE FACILITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 712 | TotalEmployeeCnt |
| Total Volunteers | 110 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $965,874 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,433,204 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $45,082,703 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $62,467,274 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$39 | PYInvestmentIncomeAmt |
| CY Investment Income | $446,917 | CYInvestmentIncomeAmt |
| PY Other Revenue | $370,463 | PYOtherRevenueAmt |
| CY Other Revenue | $466,976 | CYOtherRevenueAmt |
| PY Total Revenue | $46,419,001 | PYTotalRevenueAmt |
| CY Total Revenue | $64,814,371 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $29,023,637 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $34,088,626 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $151,336 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $18,771,761 | PYOtherExpensesAmt |
| CY Other Expenses | $29,793,466 | CYOtherExpensesAmt |
| PY Total Expenses | $47,795,398 | PYTotalExpensesAmt |
| CY Total Expenses | $63,882,092 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,376,397 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $932,279 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,941,801 | TotalAssetsBOYAmt |
| Total Assets EOY | $27,446,354 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,760,385 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,332,659 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,181,416 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,113,695 | NetAssetsOrFundBalancesEOYAmt |
| Mission | SAN GORGONIO MEMORIAL HOSPITAL IS A NONPROFIT PUBLIC BENEFIT CORPORATION FORMED FOR THE PURPOSE OF OPERATING THE SAN GORGONIO ACUTE CARE FACILITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $54,271,833 | ExpenseAmt |
| Revenue | $62,467,274 | RevenueAmt |
| Desc | THE HOSPITAL IS COMPRISED OF AN ACUTE CARE FACILITY WHICH PROVIDES HEALTHCARE SERVICES. THE HOSPITAL PROVIDED 14,725 DAYS OF INPATIENT SERVICES, 37,580 EMERGENCY ROOM VISITS AND DELIVERED 397 BABIES DURING THE FISCAL YEAR. 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 1,832,524 FOR CHARITY CARE,60,611,910 FOR MEDICARE, 17,741,395 FOR MEDI-CAL, AND 102,545,845 FOR OTHER THIRD-PARTY PAYORS FOR THE FISCAL YEAR. | Desc |
| Total Program Service Expenses | $54,271,833 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | 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 | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | 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 | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | 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 | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 46 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 712 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | 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 | false | 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 | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID RECUPERO | PersonNm |
| Phone | 9517692103 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 NORTH HIGHLAND SPRINGS AVE | AddressLine1 |
| City | BANNING | City |
| State | CA | State |
| ZIP Code | 92220 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| JERILYNN KAIBEL DC | |||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $3,082 | $0 | $0 | |
| OLIVIA HERSHEY | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $2,600 | $0 | $0 | |
| DENAE REAGINS | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $2,000 | $0 | $0 | |
| ESTELLE LEWIS | |||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $1,850 | $0 | $0 | |
| ED HIETT | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $1,700 | $0 | $0 | ||
| ROBERT EWERT | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $200 | $0 | $0 | ||
| FARZAD FARROKHI MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $200 | $0 | $0 | ||
| LYNN BALDI | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOE DOTAN MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| N IRWIN REEVES | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LUDWIG CIBELLI MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK TURNER | |||||||
| CEO | 40.00 | Yes (X) | $415,346 | $0 | $24,601 | ||
| DAVID RECUPERO | |||||||
| CFO | 40.00 | Yes (X) | $240,271 | $0 | $14,025 | ||
| LYNN GOMEZ | |||||||
| DIRECTOR OF | 40.00 | $182,451 | $0 | $24,395 | Yes (X) | ||
| PATRICIA BROWN | |||||||
| CNO | 40.00 | $170,180 | $0 | $16,098 | Yes (X) | ||
| CARRIE ECHOLS | |||||||
| OB DIRECTOR | 40.00 | $165,440 | $0 | $19,153 | Yes (X) | ||
| PRINCE NNAH | |||||||
| ANCILLARY SE | 40.00 | $160,839 | $0 | $15,291 | Yes (X) | ||
| KARI SPOELSTRA | |||||||
| REGISTERED N | 40.00 | $144,728 | $0 | $23,000 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,490,887 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $136,563 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 36 | 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/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DESERT ANESTHESIS CONSULTING | |||||
| 1540 BARTON RD SUITE 434 | REDLANDS | CA | 92373 | ANESTHESIOLOGY | $904,412 |
| MCKESSON | |||||
| PO BOX 98347 | CHICAGO | IL | 60693 | IT SERVICES | $623,684 |
| ADEX MEDICAL STAFFING LLC | |||||
| 13083 TELECOM PARKWAY NORTH | TEMPLE TERRACE | FL | 33637 | NURSE STAFFING | $568,184 |
| EPIC MANAGEMENT | |||||
| 10393 ENTERPRISE DR | REDLANDS | CA | 92374 | MGMT CONSULTING | $559,838 |
| MISSION LINNEN | |||||
| 5400 ALTON ST | CHINO | CA | 91710 | LINEN & LAUNDRY | $351,669 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,433,204 | GovernmentGrantsAmt |
| Total Contributions | $1,433,204 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $62,467,274 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $62,467,274 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $62,467,274 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $446,917 | TotalRevenueColumnAmt |
| Exclusion | $446,917 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 722210 | $217,264 | $217,264 |
| OTHER REVENUE | 900099 | $214,312 | $214,312 |
| MEDICAL RECORDS | 900099 | $31,554 | $31,554 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,846 | TotalRevenueColumnAmt |
| Exclusion | $3,846 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $466,976 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $64,814,371 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $62,467,274 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $913,893 | 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 | $721,262 | TotalAmt |
| Management And General | $721,262 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,167,441 | TotalAmt |
| Program Services | $23,232,543 | ProgramServicesAmt |
| Management And General | $3,875,408 | ManagementAndGeneralAmt |
| Fundraising | $59,490 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $692,940 | TotalAmt |
| Program Services | $600,214 | ProgramServicesAmt |
| Management And General | $91,189 | ManagementAndGeneralAmt |
| Fundraising | $1,537 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,758,522 | TotalAmt |
| Program Services | $2,309,558 | ProgramServicesAmt |
| Management And General | $443,050 | ManagementAndGeneralAmt |
| Fundraising | $5,914 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,748,461 | TotalAmt |
| Program Services | $2,276,025 | ProgramServicesAmt |
| Management And General | $466,585 | ManagementAndGeneralAmt |
| Fundraising | $5,851 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $687,301 | TotalAmt |
| Management And General | $687,301 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $268,752 | TotalAmt |
| Management And General | $268,752 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,874 | TotalAmt |
| Management And General | $63,874 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,112,874 | TotalAmt |
| Program Services | $4,556,258 | ProgramServicesAmt |
| Management And General | $2,556,466 | ManagementAndGeneralAmt |
| Fundraising | $150 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,613 | TotalAmt |
| Management And General | $46,613 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,669,657 | TotalAmt |
| Program Services | $1,848,076 | ProgramServicesAmt |
| Management And General | $816,990 | ManagementAndGeneralAmt |
| Fundraising | $4,591 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,880,640 | TotalAmt |
| Program Services | $1,572,129 | ProgramServicesAmt |
| Management And General | $287,876 | ManagementAndGeneralAmt |
| Fundraising | $20,635 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,745 | TotalAmt |
| Program Services | $38,467 | ProgramServicesAmt |
| Management And General | $17,233 | ManagementAndGeneralAmt |
| Fundraising | $1,045 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,552 | TotalAmt |
| Program Services | $29,715 | ProgramServicesAmt |
| Management And General | $76,837 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,458 | TotalAmt |
| Management And General | $211,458 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $620,829 | TotalAmt |
| Program Services | $580,850 | ProgramServicesAmt |
| Management And General | $39,979 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| INTERGOVERNMENTAL FEES | $7,984,493 | $7,984,493 | ||
| MEDICAL SUPPLIES & DRUGS | $6,225,541 | $6,225,541 | ||
| OTHER OPERATING EXPENSES | $1,858,137 | $344,931 | $1,496,167 | $17,039 |
| ALLOC. OF INDIRECT COSTS | $2,673,033 | -$2,708,117 | $35,084 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,882,092 | TotalAmt |
| Program Services | $54,271,833 | ProgramServicesAmt |
| Management And General | $9,458,923 | ManagementAndGeneralAmt |
| Fundraising | $151,336 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $422,787 | BOYAmt |
| EOY | $2,990,318 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $183,655 | BOYAmt |
| EOY | $45,850 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,730,089 | BOYAmt |
| EOY | $8,998,142 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,232,204 | BOYAmt |
| EOY | $1,373,972 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,559 | BOYAmt |
| EOY | $20,820 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $169,194 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,352,507 | BOYAmt |
| EOY | $13,848,058 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,941,801 | BOYAmt |
| EOY | $27,446,354 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,175,467 | BOYAmt |
| EOY | $5,672,659 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,584,918 | BOYAmt |
| EOY | $17,660,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,760,385 | BOYAmt |
| EOY | $23,332,659 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,181,416 | BOYAmt |
| EOY | $4,113,695 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,181,416 | BOYAmt |
| EOY | $4,113,695 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,941,801 | BOYAmt |
| EOY | $27,446,354 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $932,279 | ReconcilationRevenueExpnssAmt |
| 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 D IRS990ScheduleD
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INTERGOVERNMENTAL RECEIVABLE | $9,978,467 |
| MALPRACTICE INSURANCE RECOVERIES | $2,645,211 |
| THIRD-PARTY SETTLEMENTS | $812,651 |
| TAX AND OTHER RECEIVABLES | $411,729 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $13,848,058 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERGOVERNMENTAL PAYABLE | $5,704,493 |
| BANK LINE OF CREDIT | $5,000,000 |
| PAYABLE TO AFFILIATE | $4,264,832 |
| MALPRACTICE CLAIMS PAYABLE | $2,690,675 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $17,660,000 | 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 SYSTEM IS EXEMPT FROM FEDERAL INCOME TAX. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE SYSTEM EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF JUNE 30, 2014 AND 2013, THE SYSTEM HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. | 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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $421,481 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $421,481 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00660 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,491,281 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,491,281 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,912,762 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,491,281 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $421,481 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00660 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 97 | PersonsServedCnt |
| Total Community Benefit Expns | $7,526 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,526 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 223 | PersonsServedCnt |
| Total Community Benefit Expns | $98,048 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $98,048 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,064 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,064 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 320 | PersonsServedCnt |
| Total Community Benefit Expns | $113,638 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $113,638 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 320 | PersonsServedCnt |
| Total Community Benefit Expns | $22,026,400 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,491,281 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $535,119 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00840 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,114,765 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $11,830,598 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $14,209,059 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,378,461 | 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 | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | SAN GORGONIO MEMORIAL HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 N HIGHLAND SPRINGS AVE | AddressLine1 |
| City | BANNING | City |
| State | CA | State |
| ZIP Code | 92220 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAN GORGONIO MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.SGMH.ORG | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 350.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, SAN GORGONIO MEMORIAL HOSPITAL - PART V, LINE 3 | WE PARTNERED WITH LLUMC COMMUNITY HEALTH DEVELOPMENT DEPARTMENT AND THE RIVERSIDE COUNTY DEPARTMENT OF PUBLIC HEALTH LOOKING AT BOTH QUANTITATIVE AND QUALITATIVE DATA IMPACTING THE HEALTH OF THE COMMUNITY. THE TEAM CONDUCTING THE ASSESSMENT INCLUDED PUBLIC HEALTH PROFESSIONALS AND THE ASSESSMENT INCLUDED INPUT FROM COMMUNITY MEMBERS, COMMUNITY AGENCIES, AND COMMUNITY MEMBERS THEMSELVES. |
| FACILITY 1, SAN GORGONIO MEMORIAL HOSPITAL - PART V, LINE 4 | THE ASSESSMENT WAS CONDUCTED IN COLLABORATION WITH LOMA LINDA UNIVERSITY, AS WELL AS, RIVERSIDE AND SAN BERNARDINO COUNTY PUBLIC HEALTH DEPARTMENTS. |
| FACILITY 1, SAN GORGONIO MEMORIAL HOSPITAL - PART V, LINE 7 | IT WOULD BE IMPOSSIBLE FOR THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS OF THE COMMUNITY BUT WE WILL BE WORKING IN COLLABORATION WITH OTHER COMMUNITY AGENCIES TO IDENTIFY THE PRIORITY AREAS WHERE THEY CAN MAKE THE MOST IMPACT. THE HOSPITAL HAS IDENTIFIED ACCESS TO HEALTH CARE, BEHAVIORAL HEALTH, AND CHRONIC DISEASE WITH A SPECIAL EMPHASIS ON HEART DISEASE AS THEIR PRIORITY AREAS. THESE WERE CHOSEN AS BROAD PRIORITIES TO ADDRESS A WIDE SPECTRUM OF INTERVENTIONS IN PARTNERSHIP WITH THE COMMUNITY. A FOCUS WILL ALLOW TRUE IMPACT VERSES BEING FRAGMENTED AND INEFFECTIVE. A DETAILED COMMUNITY HEALTH PLAN HAS BEEN DEVELOPED WITH KEY METRICS FOR EACH OF THE PRIORITY AREAS. |
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, TOTAL COMMUNITY BENEFIT, AND TOTAL COMMUNITY BUILDING EXPENSES). |
| PART II - COMMUNITY BUILDING ACTIVITIES | THE HOSPITAL PROVIDES DIET COUNSELING FREE OF CHARGE TO PATIENTS. HOSPITAL STAFF LECTURE ON HEALTHCARE RELATED TOPICS AT VARIOUS SUPPORT GROUPS INCLUDING DIABETIC AND CANCER SURVIVORS SUPPORT GROUPS AND AT THE SOROPTOMIST CLUB OF BEAUMONT/BANNING. THE HOSPITAL HAS ALSO PARTICIPATED IN COMMUNITY HEALTH FAIRS. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED INCLUDES THE COST TO CHARGE RATIO OF PATIENT CARE. |
| PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE | THE HOSPITAL DID NOT TRACK THE AMOUNT OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY BUT FOR WHOM SUFFICIENT INFORMATION WAS NOT OBTAINED TO MAKE DETERMINATION OF THEIR ELIGIBILITY DURING THE FISCAL YEAR. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 4 ON PAGE 13 OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS ALSO INCLUDED IN FOOTNOTE 4 OF THE AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8 - MEDICARE EXPLANATION | 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 III, LINE 9B - COLLECTION PRACTICES EXPLANATION | THE HOSPITAL'S BUSINESS OFFICE STAFF FOLLOW UP ON ACCOUNTS 15 TO 30 DAYS AFTER THE ACCOUNTS ARE BILLED. THE STAFF CONTACT THE INSURERS TO VERIFY CLAIMS HAVE BEEN RECEIVED AND TO RESEND THE CLAIMS IF NECESSARY. AFTER VERIFYING CLAIMS HAVE BEEN RECEIVED, THE STAFF CONTINUE TO CONTACT THE INSURERS EVERY 30 DAYS, AS NECESSARY, TO FOLLOW UP ON THE STATUS OF THE CLAIMS. ALL CLAIMS NOT RESOLVED WITHIN 60 DAYS OF BILLING ARE REVIEWED BY A SUPERVISOR OR MANAGER FOR ADDITIONAL GUIDANCE AND CONSIDERATION. ACCOUNTS NOT RESOLVED WITHIN SIXTY DAYS OF BILLING ARE CONSIDERED DELINQUENT. THE SUPERVISOR OR MANAGER WILL DETERMINE WHETHER THE ACCOUNTS SHOULD BE WRITTEN OFF AS BAD DEBT, FURTHER COLLECTION PROCEDURES SHOULD BE ATTEMPTED, AND/OR THE STATE INSURANCE COMMISSION OFFICE SHOULD BE CONTACTED. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | MANAGEMENT, HOSPITAL DEPARTMENT STAFF AND MANAGERS, AND THE BOARD OF DIRECTORS ARE COMPRISED OF MEMBERS WITHIN THE COMMUNITY. THEY ARE ABLE TO GATHER AND COMMUNICATE THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES AND CONTINUALLY ADDRESS THEM AT STAFF AND BOARD MEETINGS. THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY AND COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT THE FOLLOWING URL HTTP://WWW.SGMH.ORG/DOCS/CHNA_COMMUNITY_NEEDS_ASSESSMENT_11-14- 13_SGMH_CHNA_(V2).PDF |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | IT IS THE HOSPITAL'S POLICY THAT WHEN IT BECOMES APPARENT THAT A PATIENT MAY HAVE DIFFICULTY IN MEETING HIS/HER FINANCIAL RESPONSIBILITY TO THE HOSPITAL, THE PATIENT WILL BE REQUESTED TO COMPLETE THE APPLICATION PROCESS FOR CALIFORNIA MEDI-CAL AND/OR OTHER AVAILABLE PROGRAMS. HOSPITAL STAFF ASSIST IN THE APPLICATION PROCESS. PATIENTS WHO DO NOT QUALIFY FOR CALIFORNIA MEDI-CAL OR OTHER ASSISTANCE MAY APPLY FOR THE HOSPITAL'S ASSISTANCE PROGRAM. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | THE HOSPITAL IS A RURAL HOSPITAL LOCATED IN THE PASS AREA OF RIVERSIDE COUNTY. IT PRIMARILY SERVES THE CITIES OF BANNING, BEAUMONT, CABAZON, AND CALIMESA, CALIFORNIA. THE POPULATION SERVED IS HIGH RISK DUE TO POVERTY LEVEL INCOMES, LOW EDUCATION LEVELS, AND HIGH DRUG USE. THE COUNTY HAS AN UNEMPLOYMENT RATE OF 14.2%. THE HOSPITAL'S PAYOR MIX INCLUDES APPROXIMATELY 23% MEDI-CAL RECIPIENTS AND 11% UNINSURED. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | THE HOSPITAL HOLDS COMMUNITY EDUCATION COURSES SUCH AS CPR CERTIFICATION, SMOKING CESSATION, CHILDBIRTH PREPARATION, ETC. THE HOSPITAL ALSO HAS SEVERAL CONTRACTS WITH VARIOUS SCHOOLS TO PROVIDE TEACHING PROGRAMS FOR NURSING STUDENTS. THIS TRAINING CONTRIBUTES TO HEALTHCARE PROFESSIONAL DEVELOPMENT OF THE STUDENTS. THE HOSPITAL ALSO PROVIDES USAGE OF MEETING ROOMS AT NO CHARGE TO VARIOUS COMMUNITY GROUPS. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | N/A |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| 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 | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| MARK TURNER | ||||
| CEO | $335,005 | $80,341 | $24,601 | $439,947 |
| DAVID RECUPERO | ||||
| CFO | $206,818 | $33,453 | $14,025 | $254,296 |
| LYNN GOMEZ | ||||
| DIRECTOR OF HR | $159,138 | $23,313 | $24,395 | $206,846 |
| PATRICIA BROWN | ||||
| CNO | $147,780 | $22,400 | $16,098 | $186,278 |
| CARRIE ECHOLS | ||||
| OB DIRECTOR | $165,440 | $19,153 | $184,593 | |
| PRINCE NNAH | ||||
| ANCILLARY SERVICE DI | $160,839 | $15,291 | $176,130 | |
| KARI SPOELSTRA | ||||
| REGISTERED NURSE | $144,728 | $23,000 | $167,728 | |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART III | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL CONTRACTS WITH EPIC MANAGEMENT LP (EPIC) FOR MANAGEMENT SERVICES. HOWEVER, THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER ARE EMPLOYEES OF THE HOSPITAL. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FARZAD FARROKHI | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBER | RelationshipDescriptionTxt |
| Transaction | $904,412 | TransactionAmt |
| Transaction | PHYS. GROUP PARTNER | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 1, PART I, LINE 6 | THE HOSPITAL VOLUNTEERS HELP IN THE GIFT SHOP, CAFETERIA, AND RECEPTION BOOTHS, AS WELL AS MATERIALS MANAGEMENT DELIVERIES AND MAILING. |
| FORM 990, PAGE 6, PART VI, LINE 3 | THE HOSPITAL CONTRACTS WITH EPIC MANAGEMENT LP (EPIC) FOR MANAGEMENT SERVICES. HOWEVER, THE HOSPITAL'S CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER ARE EMPLOYEES OF THE HOSPITAL. |
| FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE 990 IS PROVIDED TO THE CFO, WHO REVIEWS THE FORM, SCHEDULES, AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE FORM 8879-EO IS SIGNED BY AN AUTHORIZED SIGNER BEFORE THE RETURN IS E-FILED BY THE PREPARER. |
| FORM 990, PAGE 6, PART VI, LINE 12C | BOARD MEMBERS, ADMINISTRATOR AND OTHER DESIGNATED POSITIONS ARE REQUIRED TO SUBMIT AN ANNUAL CONFLICT OF INTEREST STATEMENT. THE CONFLICT OF INTEREST GUIDELINES ARE MONITORED AND ENFORCED BY THE SECRETARY OF THE DISTRICT. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD OF DIRECTORS REVIEW AND APPROVE MANAGEMENT WAGES EACH YEAR DURING THE BUDGET PROCESS. SOURCES UTILIZED BY THE BOARD WHEN REVIEWING FAIR MARKET VALUE IN COMPENSATION INCLUDE MARKET SURVEYS AND SALARY RANGES PROVIDED BY THE MANAGEMENT COMPANY. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SEE FORM 990, PART VI, LINE 15A. |
| FORM 990, PAGE 6, PART VI, LINE 19 | SAN GORGONIO MEMORIAL HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES & PRO FEES 4,556,258 2,556,466 150 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAN GORGONIO HEALTH CARE DISTRICT | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 N HIGHLAND SPRINGS AVE | AddressLine1 |
| City | BANNING | City |
| State | CA | State |
| ZIP Code | 922203090 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 956004149 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Exempt Code Section | 501C | ExemptCodeSectionTxt |
| Public Charity Status | 3 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| 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 | false | 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 | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAN GORGONIO HEALTH CARE DISTRICT | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | K | TransactionTypeTxt |
| Involved | $823,141 | InvolvedAmt |
| Method Of Amount Determination | ACTUAL | MethodOfAmountDeterminationTxt |
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