CRISP REGIONAL HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- CRISP REGIONAL HOSPITAL INC (EIN 58-2175978)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-13
- IRS object ID
- 201511339349303341
- 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
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-13T13:01:32-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 580914992 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1 |
| City | ALBANY | City |
| State | GA | State |
| ZIP Code | 317081309 | 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 | 582175978 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRISP REGIONAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CRIS | BusinessNameControlTxt |
| Phone | 2292763130 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 902 7TH STREET NORTH | AddressLine1 |
| City | CORDELE | City |
| State | GA | State |
| ZIP Code | 310153234 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEVEN GAUTNEY | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2292763130 | PhoneNum |
| Signature | 2015-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JACQUELINE G ATKINS | PreparerPersonNm |
| PTIN | P00861721 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2015-05-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVEN GAUTNEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 902 7TH STREET NORTH | AddressLine1 |
| City | CORDELE | City |
| State | GA | State |
| ZIP Code | 310153234 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $74,088,918 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CRISPREGIONAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE APPROPRIATE, QUALITY CARE AND ASSISTANCE IN MAINTAINING GOOD HEALTH IN AN EFFICIENT AND CARING MANNER TO ALL WHO NEED OUR SERVICES AND AS NEAR THEIR HOME AS POSSIBLE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 972 | TotalEmployeeCnt |
| Total Volunteers | 48 | TotalVolunteersCnt |
| Total Gross UBI | -$11,706 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$11,706 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,573 | PYContributionsGrantsAmt |
| CY Contributions Grants | $37,843 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $63,609,347 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $71,602,981 | CYProgramServiceRevenueAmt |
| PY Investment Income | $356,582 | PYInvestmentIncomeAmt |
| CY Investment Income | $293,215 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,739,189 | PYOtherRevenueAmt |
| CY Other Revenue | $2,067,773 | CYOtherRevenueAmt |
| PY Total Revenue | $65,708,691 | PYTotalRevenueAmt |
| CY Total Revenue | $74,001,812 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $216,370 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $208,781 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $30,323,098 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $32,699,457 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $34,340,487 | PYOtherExpensesAmt |
| CY Other Expenses | $37,331,571 | CYOtherExpensesAmt |
| PY Total Expenses | $64,879,955 | PYTotalExpensesAmt |
| CY Total Expenses | $70,239,809 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $828,736 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,762,003 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $99,541,315 | TotalAssetsBOYAmt |
| Total Assets EOY | $101,650,774 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $37,934,172 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $35,901,711 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $61,607,143 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $65,749,063 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE APPROPRIATE, QUALITY CARE AND ASSISTANCE IN MAINTAINING GOOD HEALTH IN AN EFFICIENT AND CARING MANNER TO ALL WHO NEED OUR SERVICES AND AS NEAR THEIR HOME AS POSSIBLE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $48,997,559 | ExpenseAmt |
| Grant | $208,781 | GrantAmt |
| Revenue | $72,711,881 | RevenueAmt |
| Desc | HOSPITAL, SNF & HHA; SHORT-TERM ACUTE CARE FOR IP & OP SERVICES FOR CRISP COUNTY AND SURROUNDING COUNTIES. TOTAL PATIENT DAYS FOR FYE 6/30/14 WERE 12,488; HHA VISITS FOR WERE 10,128; AND SNF PATIENT DAYS WERE 26,189; CORDELE HEALTH AND REHABILITATION (A FREE-STANDING SNF) PATIENT DAYS TOTAL 23,398. | Desc |
| Total Program Service Expenses | $48,997,559 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | 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 | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 | false | 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 | 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 | 187 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 972 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| 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 | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | 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 | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JESSICA CARTER | PersonNm |
| Phone | 2292763130 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 902 7TH STREET | AddressLine1 |
| City | CORDELE | City |
| State | GA | State |
| ZIP Code | 310153234 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| STEVE GAUTNEY | ||||||||
| PRES/CEO | 40.00 | 3.00 | Yes (X) | Yes (X) | $255,184 | $0 | $31,059 | |
| WILLIAM PANNELL MD | ||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $225,255 | $0 | $0 | ||
| SULE SALAMI MD | ||||||||
| ASST SEC/TRE | 1.00 | 1.00 | Yes (X) | Yes (X) | $2,700 | $0 | $0 | |
| ROE J DAVIS | ||||||||
| CHAIRMAN | 1.00 | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BETTYE ROBERSON | ||||||||
| FORMER BOARD | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RONNEY LEDFORD | ||||||||
| FRMR SECRETA | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| WAYNE MARTIN | ||||||||
| BOARD MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MIKE MILLER RPH | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PHIL BERRYMAN | ||||||||
| FORMER BOARD | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| NOEL WILLIAMS JR | ||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RANN FOLSOM | ||||||||
| SECRETARY/TR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JESSICA CARTER | ||||||||
| CFO | 40.00 | 3.00 | Yes (X) | $151,974 | $0 | $30,132 | ||
| SRILATHA NADIPINENI MD | ||||||||
| PHYSICIAN | 40.00 | $257,880 | $0 | $22,632 | Yes (X) | |||
| VISHAL BURRA MD | ||||||||
| PHYSICIAN | 40.00 | $183,281 | $0 | $14,983 | Yes (X) | |||
| MARILYN CARTER MD | ||||||||
| PHYSICIAN | 40.00 | $166,857 | $0 | $0 | Yes (X) | |||
| MILTON JONES MD | ||||||||
| PHYSICIAN | 40.00 | $158,873 | $0 | $22,783 | Yes (X) | |||
| MARY ELLEN HANCOCK | ||||||||
| PHARMACIST | 40.00 | $123,759 | $0 | $13,604 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,525,763 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $135,193 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | 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 |
|---|---|---|---|---|---|
| ROBINS & MORTON | |||||
| P O BOX 59289 | BIRMINGHAM | AL | 35259 | CONSTRUCTION | $5,534,314 |
| INNOVATIVE THERAPY CONCEPTS LLC | |||||
| 2 MASHBURN ST SUITE 102 | HAWKINSVILLE | GA | 31036 | THERAPY | $1,309,981 |
| SONOCARE INC | |||||
| 155 OVERLOOK ROAD | AMERICUS | GA | 31709 | ULTRASOUND SVC | $434,215 |
| GT YOUNG LLC | |||||
| 79 ABERDEEN CIRCLE | CORDELE | GA | 31015 | ANESTHESIA | $402,400 |
| BOLD PERFORMANCE STRATEGIES LLC | |||||
| P O BOX 27697 | PANAMA CITY BEACH | FL | 32411 | CONSULTING SVC | $366,601 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 28 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $7,255 | GovernmentGrantsAmt |
| All Other Contributions | $30,588 | AllOtherContributionsAmt |
| Total Contributions | $37,843 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PROGRAM SERVICE REVENUE | 623000 | $68,975,227 | $68,975,227 |
| MEDICAID EHR INCENTIVES | 621990 | $2,037,554 | $2,037,554 |
| EMS OPERATIONS CONTRACT | 621910 | $590,200 | $590,200 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $71,602,981 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $347,341 | TotalRevenueColumnAmt |
| Exclusion | $347,341 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $186,113 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $32,073 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $154,040 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $154,040 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $165,746 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$11,706 | UnrelatedBusinessRevenueAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $907 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $55,033 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$54,126 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$54,126 | TotalRevenueColumnAmt |
| Exclusion | -$54,126 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $29,145 | GrossSalesOfInventoryAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,145 | TotalRevenueColumnAmt |
| Exclusion | $29,145 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| OTHER REVENUES | 621990 | $798,218 | $798,218 | |
| DIETARY/VENDING | 722513 | $527,136 | $527,136 | |
| DIETARY CATERING | 722513 | $303,130 | $303,130 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $256,104 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $144,936 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $111,168 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,884,588 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $74,001,812 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $72,711,881 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$11,706 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,263,794 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $208,781 | TotalAmt |
| Program Services | $208,781 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $696,304 | TotalAmt |
| Program Services | $222,700 | ProgramServicesAmt |
| Management And General | $473,604 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,242,852 | TotalAmt |
| Program Services | $18,628,648 | ProgramServicesAmt |
| Management And General | $6,614,204 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $575,199 | TotalAmt |
| Program Services | $507,935 | ProgramServicesAmt |
| Management And General | $67,264 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,734,995 | TotalAmt |
| Program Services | $2,111,750 | ProgramServicesAmt |
| Management And General | $1,623,245 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,450,107 | TotalAmt |
| Program Services | $1,636,230 | ProgramServicesAmt |
| Management And General | $813,877 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $486,734 | TotalAmt |
| Program Services | $45,000 | ProgramServicesAmt |
| Management And General | $441,734 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $407,284 | TotalAmt |
| Management And General | $407,284 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,776 | TotalAmt |
| Management And General | $158,776 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,801 | TotalAmt |
| Management And General | $9,801 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,592,536 | TotalAmt |
| Program Services | $10,894,024 | ProgramServicesAmt |
| Management And General | $2,698,512 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $182,927 | TotalAmt |
| Program Services | $77,299 | ProgramServicesAmt |
| Management And General | $105,628 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,339,601 | TotalAmt |
| Program Services | $3,476,899 | ProgramServicesAmt |
| Management And General | $862,702 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,247,857 | TotalAmt |
| Program Services | $192,612 | ProgramServicesAmt |
| Management And General | $2,055,245 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $589,273 | TotalAmt |
| Program Services | $381,162 | ProgramServicesAmt |
| Management And General | $208,111 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,017 | TotalAmt |
| Program Services | $34,630 | ProgramServicesAmt |
| Management And General | $28,387 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,158,646 | TotalAmt |
| Program Services | $1,827,123 | ProgramServicesAmt |
| Management And General | $2,331,523 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,032,729 | TotalAmt |
| Program Services | $537,687 | ProgramServicesAmt |
| Management And General | $495,042 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $7,739,461 | $7,739,461 | |
| LICENSES AND TAXES | $1,323,669 | $26,177 | $1,297,492 |
| REPAIRS & MAINTENANCE | $253,731 | $118,157 | $135,574 |
| HOSPITAL/NURSING HOME | $247,208 | $247,208 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $498,321 | TotalAmt |
| Program Services | $84,076 | ProgramServicesAmt |
| Management And General | $414,245 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,239,809 | TotalAmt |
| Program Services | $48,997,559 | ProgramServicesAmt |
| Management And General | $21,242,250 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $173,273 | BOYAmt |
| EOY | $293,249 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,907,926 | BOYAmt |
| EOY | $8,733,146 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,383,619 | BOYAmt |
| EOY | $11,845,857 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,470,066 | BOYAmt |
| EOY | $1,419,945 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,181,283 | BOYAmt |
| EOY | $1,024,559 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $84,968,602 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $47,424,395 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,916,645 | BOYAmt |
| EOY | $37,544,207 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,965,560 | BOYAmt |
| EOY | $34,602,074 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $402,000 | BOYAmt |
| EOY | $415,865 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,787,041 | BOYAmt |
| EOY | $3,505,730 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,353,902 | BOYAmt |
| EOY | $2,266,142 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,541,315 | BOYAmt |
| EOY | $101,650,774 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,964,172 | BOYAmt |
| EOY | $5,015,456 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,970,000 | BOYAmt |
| EOY | $30,615,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $271,255 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,934,172 | BOYAmt |
| EOY | $35,901,711 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,607,143 | BOYAmt |
| EOY | $65,749,063 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,607,143 | BOYAmt |
| EOY | $65,749,063 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,541,315 | BOYAmt |
| EOY | $101,650,774 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,762,003 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $379,917 | NetUnrlzdGainsLossesInvstAmt |
| 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 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 | $9,801 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $9,801 | 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 PAYS MEMBERSHIP DUES TO NATIONAL AND STATE ORGANIZATIONS. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THOSE ORGANIZATIONS PARTICIPATE. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,102,410 | OtherCostOrOtherBasisAmt |
| Book Value | $2,102,410 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $44,729,592 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,571,880 | DepreciationAmt |
| Book Value | $26,157,712 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,070,174 | OtherCostOrOtherBasisAmt |
| Depreciation | $981,189 | DepreciationAmt |
| Book Value | $88,985 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $37,013,379 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,871,326 | DepreciationAmt |
| Book Value | $9,142,053 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,047 | OtherCostOrOtherBasisAmt |
| Book Value | $53,047 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $37,544,207 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD PARTY SETTLEMENTS | Desc |
| Amt | $271,255 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $271,255 | 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 | CRISP REGIONAL HEALTH SERVICES, INC., CRISP REGIONAL HOSPITAL, INC. AND CRISP REGIONAL DEVELOPMENT FOUNDATION, INC. ARE NOT-FOR-PROFIT CORPORATIONS THAT HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE CORPORATIONS APPLY ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THEY ONLY RECOGNIZE THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OR AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF JUNE 30, 2014 AND 2013 OR FOR THE YEARS THEN ENDED. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| 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 | 1.250000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | false | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $208,381 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $208,381 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,844,026 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,312,821 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$468,795 | NetCommunityBenefitExpnsAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,052,407 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,312,821 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$260,414 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,508,278 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,427,977 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,080,301 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05810 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,508,278 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,427,977 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,080,301 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05810 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,560,685 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,740,798 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,819,887 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06110 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $18,490,599 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $16,124,301 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $15,256,349 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $867,952 | 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 | CRISP HC ALLIANCE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | HEALTH SERVICES | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.80000 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.20000 | PhysiciansProfitOrOwnershipPct |
| 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 | CRISP REGIONAL HOSPITAL INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 902 7TH STREET NORTH | AddressLine1 |
| City | CORDELE | City |
| State | GA | State |
| ZIP Code | 310105007 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CRISPREGIONAL.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | SNF, NF, HHA, HOSPICE, RHC, RD | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRISP REGIONAL HOSPITAL INC | 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 | false | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.CRISPREGIONAL.ORG | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (true) | 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 | 125.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | 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 |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| 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 |
| 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 | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, CRISP REGIONAL HOSPITAL INC - PART V, LINE 3 | THE HOSPITALS CHIEF EXECUTIVE OFFICER APPOINTED INDIVIDUALS TO SERVE ON THE CHNA HOSPITAL STEERING COMMITTEE (CHSC). THE CHSC IDENTIFIED COMMUNITY LEADERS, PARTNERS, AND REPRESENTATIVES TO INCLUDE IN THE CHNA PROCESS. INDIVIDUALS, AGENCIES, PARTNERS, POTENTIAL PARTNERS, AND OTHERS WERE REQUESTED TO WORK WITH THE HOSPITAL TO 1) ASSESS THE NEEDS OF THE COMMUNITY, 2) REVIEW AVAILABLE COMMUNITY RESOURCES AND 3) PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. GROUPS OR INDIVIDUALS, WHO REPRESENT MEDICALLY-UNDERSERVED POPULATIONS, LOW INCOME POPULATIONS, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASES, WERE INCLUDED. THE HOSPITAL IDENTIFIED OVER 120 COMMUNITY MEMBERS TO PARTICIPATE IN THE CHNA PROCESS. TWO-HOUR COMMUNITY HEALTH INPUT MEETINGS (COMMUNITY MEETINGS) AND ONE-HOUR COMMUNITY STAKEHOLDER INTERVIEWS (INTERVIEWS) WERE ESSENTIAL PARTS OF THE CHNA PROCESS. THREE COMMUNITY MEETINGS AND 10 STAKEHOLDER INTERVIEWS WERE CONDUCTED IN ORDER TO OBTAIN THE COMMUNITYS INPUT INTO THE HEALTH NEEDS OF CRISP COUNTY. EACH COMMUNITY MEETING WAS DRIVEN BY AN AGENDA PLANNED IN ADVANCE. SIGN-IN SHEETS AND EVALUATIONS WERE ALSO USED. THE COMMUNITY HEALTH PROFILE WAS SHARED WITH THE PARTICIPANTS AT EACH MEETING. PARTICIPANTS WERE ASKED ABOUT THEIR OBSERVATIONS ON THE HEALTH DATA PRESENTED IN THE PROFILE. IN ADDITION, PARTICIPANTS WERE REQUESTED TO PROVIDE INPUT AS TO NEEDS THAT MAY NOT HAVE BEEN IDENTIFIED IN THE PROFILE. QUESTIONS AND DISCUSSION WERE ENCOURAGED, WITH THE OBJECTIVE THAT PARTICIPANTS WOULD INCREASE THEIR UNDERSTANDING OF WHAT THE DATA MEANT IN TERMS OF THE BURDEN OF CHRONIC DISEASES, THE IMPACT OF THE DEMOGRAPHICS OF THE POPULATION ON HEALTH SERVICES, HEALTH STATUS, HEALTH BEHAVIORS, AND, ACCESS TO HEALTH CARE. AS THE GROUP DISCUSSED THE HEALTH PROBLEMS OR HEALTH ISSUES, THE FACILITATOR MADE A LIST OF THE HEALTH PROBLEMS THE COMMUNITY PARTICIPANTS INDICATED WERE IMPORTANT. PRIORITY ISSUES WERE IDENTIFIED AT THE END OF THE DISCUSSION. THESE PRIORITIES DID NOT REFLECT PROGRAMS, SERVICES OR APPROACHES TO RESOLVING PROBLEMS, BUT RATHER HEALTH ISSUES TO BE ADDRESSED. COMMUNITY PARTICIPANTS INCLUDED PHYSICIANS AND OTHER MEDICAL PROFESSIONALS; EDUCATORS; ENTREPRENEURS AND OTHER BUSINESSMEN AND WOMEN; PROFESSIONALS; REPRESENTATIVES FROM THE DEPARTMENT OF LABOR, HOUSING AUTHORITY, LAW ENFORCEMENT, UNITED WAY, AND CHAMBER OF COMMERCE; RELIGIOUS LEADERS AS WELL AS JOURNALISTS. |
| FACILITY 1, CRISP REGIONAL HOSPITAL INC - PART V, LINE 20D | WHETHER OR NOT THE BALANCE IS WRITTEN OFF 100% OR LESS IS BASED ON INFORMATION RECEIVED FROM THE PATIENT VIA THE INDIGENT CARE APPLICATION AND WHAT TIERED LEVEL OF ELIGIBILITY WITHIN THE FEDERAL POVERTY GUIDELINES AND ASSOCIATED LEVEL OF DISCOUNTS UNDER WHICH THEY MAY QUALIFY. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 9 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| CRISP REGIONAL NURSING HOME & REHAB | ||||
| 902 BLACKSHEAR ROAD | CORDELE | GA | 31015 | NURSING FACILITY |
| CARESOUTH OF CRISP REGIONAL | ||||
| 906 5TH STREET NORTH | CORDELE | GA | 31015 | HOME HEALTH |
| CRISP REGIONAL HOSPICE | ||||
| 910 5TH STREET NORTH | CORDELE | GA | 31015 | HOSPICE |
| ARABI HEALTHCARE CENTER | ||||
| 4110 BEDGOOD AVENUE | ARABI | GA | 31712 | RHC |
| WARWICK HEALTHCARE CENTER | ||||
| 135 DOGWOOD STREET | WARWICK | GA | 31796 | RHC |
| CRISP REGIONAL DIALYSIS UNIT | ||||
| 1302 5TH STREET NORTH | CORDELE | GA | 31015 | DIALYSIS |
| CORDELE HEALTH & REHAB | ||||
| 1106 NORTH 4TH STREET | CORDELE | GA | 31015 | NURSING FACILITY |
| CRISP REGIONAL CONVENIENT CARE | ||||
| 902 NORTH 7TH STREET | CORDELE | GA | 31015 | RHC |
| BLACKSHEAR RETIREMENT VILLAS | ||||
| 1110 BLACKSHEAR ROAD | CORDELE | GA | 31015 | ASSISTED LIVING |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION | THIS SECTION INCLUDES NET ACTUAL COSTS FOR SUBSIDIZED PHYSICIAN AND RURAL HEALTH CLINICS OF 2,838,700. |
| PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 70,239,806 ADD: EXPENSES ON PART VIII 32,073 DENOMINATOR FOR COLUMN (F) 70,271,879 |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | COSTS FOR PART I, LINE 7A AND 7B AND PART III, SECTION A, LINE 2 WERE CALCULATED USING THE RCC CALCULATED IN WORKSHEET 2. OTHER COSTS WERE OBTAINED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. SEE ALSO THE DESCRIPTION FOR PART III, LINE 2 AND FOR PART III, LINE 4. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | AMOUNTS ON PART III, LINE 2 REPRESENT THE AMOUNT OF NET CHARGES WRITTEN OFF AS UNCOLLECTIBLE AND RECORDED AS BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE CORPORATION'S SELF-PAY WRITE-OFFS INCREASED APPROXIMATELY 1,181,000 FROM APPROXIMATELY 14,334,000 IN 2013 AND 15,515,000 IN 2014 AS A RESULT OF NEGATIVE TRENDS EXPERIENCED IN THE COLLECTION OF AMOUNTS FROM SELF-PAY PATIENTS IN FISCAL YEAR 2014. THE CORPORATION HAS NOT CHANGED ITS INDIGENT CARE POLICIES DURING FISCAL YEARS 2013 OR 2014. THE CORPORATION DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD-PARTY PAYORS. |
| PART III, LINE 8 - MEDICARE EXPLANATION | MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | PATIENTS, WHO MEET ALL THE REQUIREMENTS TO BE CLASSIFIED AS MEDICALLY INDIGENT UNDER THE ORGANIZATION'S ICTF POLICY, WILL HAVE THEIR ACCOUNTS WRITTEN OFF ON A SLIDING SCALE FEE (100% OF ACCOUNTS AT 125% OF THE FEDERAL POVERTY SCALE, 7% OF ACCOUNTS WHEN INCOME IS AT 200% OF THE SCALE, UP TO THE MAXIMUM ALLOWED PER PATIENT PER YEAR). ANY AMOUNT NOT ADJUSTED OFF PER POLICY, WOULD FOLLOW THE COLLECTION PRACTICE AS ANY OTHER ACCOUNT. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | CRISP REGIONAL ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY BY EVALUATING DISEASE INCIDENCES IN THE POPULATION AS WELL AS ECONOMIC AND DEMOGRAPHIC CHARACTERISTICS OF THE POPULATION IN COMPARISON TO THE UTILIZATION AND AVAILABILITY OF APPLICABLE SERVICES. PRIMARY SOURCE FOR ASSESSMENT INFORMATION IS THE COMMUNITY HEALTH STATUS INDICATORS PUBLISHED BY THE U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES AND INTERNAL INFORMATION PRODUCED BY HOSPITAL RECORDS. CRISP REGIONAL IS CLASSIFIED AS A HEALTH MANPOWER SHORTAGE AREA DUE TO THE DISPROPORTIONALLY LARGE LOW INCOME POPULATION. IN ADDITION, CRISP'S SERVICE HAS A SIGNIFICANT NUMBER OF MIGRANT AND UNDOCUMENTED FARM WORKS THAT PRESENT EPISODIC COMMUNITY HEALTH NEEDS. THE ORGANIZATION COMPLETED ITS FIRST COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY PLAN. BOTH DOCUMENTS CAN BE FOUND ON ITS WEBSITE AT HTTP://CRISPREGIONAL.ORG ON THE HOME PAGE UNDER 2013 COMMUNITY HEALTH NEEDS ASSESSMENT. PROGRESS ON CHNA IMPLEMENTATION STRATEGIES 2013-2014: SENIOR HEALTH -CRISP REGIONAL OFFERS MANY HEALTH FAIRS THROUGHOUT THE COMMUNITY. WE OFFER DISCOUNTED BLOOD TESTS WHICH INCLUDES LIPID PROFILE, BLOOD SUGAR, COMPLETE BLOOD COUNT, PULMONARY FUNCTION, PROSTATE SPECIFIC ANTIGEN, AND MAMMOGRAMS TESTING. EACH HEALTH FAIR INCLUDES FREE EDUCATION ON NUTRITION, DIABETES, EXERCISE PROGRAMS, VISION SCREENINGS, CHIROPRACTIC SCREENINGS AND MUCH MORE. CRH OFFERS THESE ON A QUARTERLY BASIS AND ALSO OFFERS A DISCOUNTED TEST OF THE MONTH EACH MONTH OF THE YEAR. -MONTHLY SOLAS (SENIORS OUT LEARNING AND SOCIALIZING) PROGRAMS LED BY A PHYSICIAN OR MEDICAL EXPERT TO EDUCATE SENIORS ON VARIOUS HEALTH TOPICS. THESE EDUCATIONAL TOPICS INCLUDE HEART DISEASE, ORTHOPEDICS, GERIATRICS, RADIOLOGY, NEPHROLOGY, UROLOGY, VEIN SCREENING AND WOUND CARE. -CRH OFFERS TRIPS FOR SENIORS TO VARIOUS SHOWS TO HELP MOTIVATE, ENTERTAIN AND KEEP THEM ACTIVE. ACCESS TO CARE -COMBINED MANY OF OUR DOCTOR OFFICES INTO CARE CENTERS SO THAT THEY HAVE ACCESS TO MORE THAN ONE DOCTOR. -IMPLEMENTED A DOCTOR'S TABLE TO INCLUDE A MINIMUM OF ONE DOCTOR OR PHYSICIAN ASSISTANT DURING TWO OF OUR LARGEST COMMUNITY HEALTH FAIRS. THIS PROVIDES AN OPPORTUNITY FOR PEOPLE TO ASK QUESTIONS TO DOCTORS OR PHYSICIAN ASSISTANTS WITHOUT HAVING TO HAVE AN APPOINTMENT. CANCER AND DIABETES -CRISP REGIONAL OFFERS AN ANNUAL LADIES CONFERENCE DAY EACH OCTOBER TO EDUCATE THE WOMEN OF THE COMMUNITY ON THE IMPORTANCE OF GOOD HEALTH. WE HAVE MANY SPEAKERS, WHICH INCLUDE DOCTORS, INSPIRATIONAL SPEAKERS AND COMMUNITY LEADERS. -CRH OFFERS TEST OF THE MONTH FOR DIABETES TO HELP KEEP A WATCH ON BLOOD SUGAR LEVELS. THIS IS AT A REDUCED COST TO THE PATIENTS. -CRH CONDUCTED A DIABETIC HEALTH FAIR IN THE MONTH OF NOVEMBER DURING DIABETIC MONTH TO MAKE PEOPLE MORE AWARE OF THE DIFFERENT WAYS TO CONTROL, MANAGE, AND HELP ELIMINATE THIS DISEASE THAT HAS TAKEN OVER OUR COMMUNITY. OBESITY -WE OFFER SEVERAL WELLNESS WALKS AT THE PERRY BUSBEE WALKING TRACK LOCATED ON THE HOSPITAL CAMPUS, FREE OF COST. THIS ENCOURAGES WEIGHT LOSS AT A SLOWER PACE. -CRH SPONSORS SEVERAL 5K RUNS THROUGHOUT THE YEAR TO HELP ACTIVE PEOPLE STAY ACTIVE. A FEW OF THOSE RUNS ARE RUN FOR YOUR LUNGS, CANCER COALITION WALK/RUN, WATERMELON RUN AND CAMP SUNSHINE RUN. -CRH HAS PLACED AN ATHLETIC TRAINER AT CRISP COUNTY HIGH SCHOOL TO HELP IN GUIDING THE STUDENTS AND ATHLETES IN A HEALTHIER WAY OF LIFE, MENTORING THE STUDENTS ON EATING HABITS AND MAINTAINING AN IDEAL WEIGHT AS WELL AS PROTECTING THEM FROM INJURY DUE TO SPORTS. -CRH RAISED FUNDS TO PLACE AN AED DEVICE IN EVERY SCHOOL IN CRISP COUNTY. THESE DEVICES HELP PROTECT THE STUDENTS AT PE AND SPORTING EVENTS. HEART DISEASE -AT SEVERAL COMMUNITY HEALTH FAIRS WE OFFER A DISCOUNTED SCREENING FOR CAROTID ARTERIES. -WE EDUCATE OUR SENIORS ON THE IMPORTANCE OF A HEALTHY HEART AS WELL AS THE SIGNS AND SYMPTOMS OF HEART DISEASE. TEEN PREGNANCY -CRH SPONSORS A TEEN MAZE EVENT IN OUR LOCAL HIGH SCHOOL EVERY OTHER YEAR. THE TEEN MAZE IS A LARGE, INTERACTIVE LIFE SIMULATION WHERE STUDENTS ARE SHOWN THE POSITIVE AND NEGATIVE CONSEQUENCES OF THEIR BEHAVIOR AND LIFE CHOICES. EACH PARTICIPANT DRAWS RANDOM CHOICES ABOUT LIFE DECISIONS THEY MAKE REGARDING RISKY BEHAVIORS. CARDS ARE DRAWN, DICE ARE ROLLED, OR A WHEEL IS SPUN TO LEARN THE CONSEQUENCES OF THESE ACTIONS, BOTH GOOD AND BAD. THOSE WHO DRAW CARDS AVOIDING RISKY BEHAVIORS ARE REWARDED BY MOVING ON TO GRADUATION. OTHERS LEARN THE POTENTIAL CONSEQUENCES OF RISKY BEHAVIOR, LOSS OF FREEDOM, MEDICAL PROBLEMS, PREGNANCY, STD'S, DROPPING OUT OF SCHOOL, PRISON, UNEMPLOYMENT AND POSSIBLE DEATH. PATHS ARE RANDOMLY ASSIGNED, SO NO TWO PARTICIPANTS HAVE THE SAME EXPERIENCE SUCH AS IN REAL LIFE. ADOLESCENT -CAMP SUNSHINE IS HELD IN JULY. THIS IS A GRIEF COUNSELING CAMP FOR KIDS WHO HAVE LOST A LOVED ONE AND ARE GRIEVING THE LOSS OF THAT PERSON. REFLECTIONS HOSPICE GOALS IS TO LET THE KIDS KNOW THAT THEY ARE NOT ALONE IN THEIR GRIEF. CAMP SUNSHINE GIVES THEM TOOLS TO LEARN HOW TO SHARE AND MOVE THROUGH THEIR GRIEF. ALL ACTIVITIES FOCUSED ON EXPRESSING FEELINGS AND SHARING EXPERIENCES. RESPIRATORY -PULMONARY FUNCTION SCREENING IS OFFERED AT SEVERAL HEALTH FAIRS ANNUALLY. THIS IS DISCOUNTED FOR EVERYONE WHO PARTICIPATES IN THE HEALTH FAIR. ACCESS TO CARE - TRANSPORTATION -CRISP REGIONAL HOSPITAL PARTNERS WITH PHOEBE PUTNEY, ALBANY, GA, TO HELP TRANSPORT PATIENTS TO AND FROM ALBANY TO RECEIVE THEIR RADIATION. OUR CRH AUXILIARY ALSO DONATES MONEY TO OUR ONCOLOGY DEPARTMENT TO HELP PATIENTS WHO ARE RECEIVING CHEMO TAKE TAXIS TO AND FROM THEIR HOMES. WE ARE IN THE PROCESS OF OFFERING A TRANSPORTATION SYSTEM THROUGH OUR HOSPITAL. MENTAL HEALTH -THIS IS A GREAT NEED IN OUR COMMUNITY. AT PRESENT, WE EXPLORE EVERY OPPORTUNITY TO ASSIST OUR PATIENTS TO FIND A SUITABLE ALTERNATIVE TO THEIR NEED AT HAND. A FEW EXAMPLES ARE THE PHOENIX HOUSE IN WARNER ROBINS, GA, GREENLEAF IN VALDOSTA, GA AND PINE WOODS IN BARNESVILLE, GA. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | CRISP REGIONAL HOSPITAL HAS A CLEARLY DEFINED PROCESS FOR ADDRESSING INDIGENT AND/OR SELF-PAY PATIENTS. PATIENTS THAT PRESENT AT THE REGISTRATION DESK AS SELF PAY PATIENTS RECEIVING OUTPATIENT SERVICES ARE DIRECTED TO OUR PATIENT FINANCIAL COUNSELOR FOR ADVISEMENT. AT THIS POINT, A FINANCIAL COUNSELOR REVIEWS THE APPLICATION FOR THE INDIGENT CARE TRUST FUND ASSISTANCE. IF THIS ASSISTANCE APPLIES, THE COUNSELOR WILL ASSIST IN THE APPLICATION PROCESS AND ASSURE COMPLETION OF THE APPLICATION FOR REVIEW. IF THIS ASSISTANCE DOES NOT APPLY, WE REFER TO A LIST OF SERVICES THAT REQUIRE A CERTAIN AMOUNT TO BE PAID BEFORE THE SERVICE IS RENDERED. WE ALSO ASSIST IN SETTING UP A CONTRACT TO INITIATE A MONTHLY PAYMENT PLAN. FOR A PATIENT THAT PRESENTS IN CRISP REGIONAL HOSPITAL AS AN INPATIENT AND IS SELF PAY, THE PATIENT FINANCIAL COUNSELOR GOES TO THE PATIENT'S ROOM TO ASSURE THAT THEY ARE CORRECTLY CLASSIFIED AS A SELF PAY PATIENT. SELF PAY PATIENTS ARE THEN REFERRED TO CHAMBERLIN AND EDMONDS TO ASSESS ELIGIBILITY FOR MEDICAID ASSISTANCE. IF NOT ELIGIBLE FOR MEDICAID, WE ASSIST THEM WITH AN APPLICATION FOR INDIGENT CARE TRUST FUND ASSISTANCE. IF NOT ELIGIBLE FOR THE INDIGENT PROGRAM, THEN WE ASSIST WITH A CONTRACT TO START MONTHLY PAYMENTS. POLICY: INDIGENT CARE TRUST FUND POLICY PURPOSE: TO PROVIDE GUIDELINES AND CRITERIA FOR USE IN DETERMINING A PATIENT'S FINANCIAL STATUS, WITH A DISTINCTION MADE BETWEEN A PATIENT'S UNWILLINGNESS TO PAY (BAD DEBT) AND A PATIENT'S INABILITY TO PAY (INDIGENT CARE). INDIGENT CARE IS DEFINED AS A TOTAL OR PARTIAL WRITE-OFF OF A PATIENT'S ACCOUNT BALANCES FOR A PATIENT WHO IS DETERMINED TO BE MEDICALLY INDIGENT. POLICY STATEMENT: CLASSIFY AS MEDICALLY INDIGENT, THOSE PATIENTS WITH AN INCOME NO GREATER THAN 200% OF THE FEDERAL POVERTY LEVEL GUIDELINES AS PUBLISHED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES. PATIENTS WHO ARE CLASSIFIED AS MEDICALLY INDIGENT, WHO HAVE MET ALL REQUIREMENTS SET FORTH, WILL HAVE THEIR ACCOUNTS WRITTEN OFF ON A SLIDING SCALE FEE (100% OF THE ACCOUNTS AT 125% OF THE FEDERAL POVERTY SCALE, TO 7% OF ACCOUNTS WHEN INCOME IS AT 200% OF THE SCALE, UP TO THE MAXIMUM ALLOWED AMOUNT PER PATIENT, PER YEAR. 1. GUIDELINES FOR THE INDIGENT CARE TRUST FUND FINANCIAL ASSISTANCE PROGRAM. THE INTENT OF THESE GUIDELINES IS TO PROVIDE ALL AFFECTED PARTIES WITH DEFINITIONS, INTERPRETATIONS AND STANDARDS FOR THE UNIFORM ADMINISTRATION OF CRISP REGIONAL HOSPITAL'S INDIGENT CARE TRUST FUND (ICTF). DEFINITIONS: A.INDIGENT/CHARITY PATIENT: A PATIENT WHO IS A RESIDENT OF GEORGIA, WHOSE FAMILY INCOME DOES NOT EXCEED 200% OF THE FEDERAL POVERTY LEVELS AS ESTABLISHED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR THE CURRENT YEAR. B.RESIDENCY REQUIREMENTS: A PATIENT MUST BE A RESIDENT OF THE STATE OF GEORGIA FOR SIX MONTHS TO MEET RESIDENCY REQUIREMENTS. EVIDENCE OF RESIDENCY, SUCH AS A LIGHT BILL, MUST BE PROVIDED (PHYSICAL ADDRESSES, NO POST OFFICE BOXES ALLOWED). C.GROSS INCOME: THE INDIVIDUAL AND FAMILY FEDERAL ADJUSTED GROSS INCOME AS SHOWN ON THE MOST RECENT FEDERAL OR STATE INCOME TAX RETURN AND THE PATIENTS LAST 3 MONTHS PAY STUBS. INCOME INCLUDES SALARIES. TIPS, WAGES, ETC; INTEREST AND DIVIDEND INCOME; UNEMPLOYMENT COMPENSATION, RETIREMENT PAY AND ANY OTHER TAXABLE INCOME. D.HOUSEHOLD: THE NUMBER OF PERSONS CLAIMED ON INCOME TAX FILING, OR THE PERSONS THE APPLICANT IS LEGALLY RESPONSIBLE FOR. 2. LEVELS OF ASSISTANCE: TWO LEVELS OF ASSISTANCE ARE OFFERED AND ARE DEFINED BELOW: A.INDIGENT FINANCIAL ASSISTANCE: PATIENTS WHOSE INCOME IS BELOW 125% OF THE FEDERAL POVERTY LEVELS ARE CLASSIFIED AS MEDICALLY INDIGENT. B.CHARITABLE FINANCIAL ASSISTANCE: PATIENTS WHOSE INCOME LEVEL IS BETWEEN 126%-200% OF THE FEDERAL POVERTY LEVELS WILL BE CLASSIFIED AS CHARITABLE CASES. THESE PATIENTS WILL BE RESPONSIBLE FOR A PERCENTAGE OF HOSPITAL CHARGES AND ARE REQUIRED TO SIGN (AND MAINTAIN CURRENT PAYMENTS ON) A REPAYMENT CONTRACT WITH THE BUSINESS OFFICE. C.ALL PATIENTS MUST COMPLETE A DETERMINATION OF INDIGENT CARE WORKSHEET PRIOR TO BEING CONSIDERED FOR FINANCIAL ASSISTANCE. DISCLOSURE OF ALL CIRCUMSTANCES CONCERNING INSURANCE, THIRD PARTY LIABILITY, ASSETS, LIABILITIES, AND ANY OTHER FACTORS ARE REQUIRED. REFUSAL TO DISCLOSE ALL REQUIRED INFORMATION WILL RESULT IN AUTOMATIC INELIGIBILITY. D.ALL PATIENTS ARE REQUIRED TO APPLY FOR STATE AND FEDERAL PROGRAMS (E.G. MEDICAID) IN CONJUNCTION WITH THE APPLICATION FOR FINANCIAL ASSISTANCE. REFUSAL TO APPLY WILL RENDER A PATIENT INELIGIBLE. PROOF OF APPROVAL OR DENIAL FROM STATE AND/OR FEDERAL PROGRAMS MUST BE PROVIDED TO DETERMINE FINAL ELIGIBILITY FOR FINANCIAL ASSISTANCE. 3. CATEGORY OF PATIENTS: INDIGENT CARE TRUST FUNDS HAVE SEEN A SIGNIFICANT DECREASE IN THE RECENT PAST. IN AN EFFORT TO PROVIDE AS MUCH ASSISTANCE TO AS MANY PATIENTS AS POSSIBLE, TWO CATEGORIES OF ASSISTANCE HAVE BEEN DEVELOPED. EACH CATEGORY HAS MONETARY LIMITATIONS. A.CATEGORY 1: PATIENTS WHO ARE CHRONICALLY ILL OR WHOSE CONDITION IS LIFE THREATENING. B.CATEGORY 2: PATIENT WHO HAVE SHORT TERM ILLNESSES OR WHOSE CONDITIONS ARE NOT LIFE THREATENING. 4. INELIGIBLE PATIENTS/NON-COVERED CHARGES: CERTAIN TYPES OF CHARGES AND/OR CONDITIONS ARE NOT COVERED. THOSE ARE OUTLINED BELOW: A.PREGNANT WOMEN ARE NOT ELIGIBLE FOR INDIGENT TRUST CARE FINANCIAL ASSISTANCE. B.ACCOUNTS COVERED UNDER LIABILITY OR WORKER'S COMPENSATION. C.VICTIMS OF CRIME, UNLESS THE PATIENT HAS PURSUED ASSISTANCE FROM THE STATE AND/OR FEDERAL VICTIMS ASSISTANCE PROGRAM AND BEEN DENIED. D.PATIENTS WHO HAVE INSURANCE COVERAGE INCLUDING COBRA. E.UNDOCUMENTED IMMIGRANTS ARE NOT ELIGIBLE. F.CHARGES NOT COVERED ARE AS FOLLOWS: PRIVATE ROOM DIFFERENCES; ELECTIVE SURGERY, PLASTIC SURGERY, FEES CHARGED BY YOUR PHYSICIAN, RADIOLOGY, ANESTHESIOLOGIST AND PATHOLOGIST. AMBULANCE, PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY AND WOUND CARE ARE ALSO NOT COVERED. 5. CAPS ON ASSISTANCE: LIMITATIONS OF ASSISTANCE ARE FOR ONE CONSECUTIVE YEAR. ONCE A PATIENT REACHES THEIR CATEGORY CAP, NO FURTHER ASSISTANCE WILL BE PROVIDED UNTIL THE NEW CALENDAR YEAR BEGINS. A.CATEGORY 1 PATIENTS' ASSISTANCE IS CAPPED AT 15,000 FOR 12 MONTHS. B.CATEGORY 2 PATIENTS' ASSISTANCE IS CAPPED AT 7,000 FOR 12 MONTHS. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | CRISP REGIONAL HOSPITAL SERVES CRISP, DOOLY AND WILCOX COUNTIES AS OUR PRIMARY SERVICE AREAS. THESE AREAS ACCOUNT FOR 91% OF PATIENT ACTIVITY. THE OTHER FOUR CONTIGUOUS COUNTIES, SUMTER, WORTH, TURNER AND LEE, ARE SECONDARY GEOGRAPHIC MARKET AREAS. CORDELE IS THE ECONOMIC AND MEDICAL HUB OF THIS AREA AND DRAWS ON A POPULATION APPROACHING 136,000. THE TOTAL SCHOOL ENROLLMENT IN CRISP COUNTY WAS 6,233. NURSERY SCHOOL AND KINDERGARTEN ENROLLMENT WAS 862 AND ELEMENTARY OR HIGH SCHOOL ENROLLMENT WAS 4,029 CHILDREN. COLLEGE OR GRADUATE SCHOOL ENROLLMENT WAS 1,342. INDUSTRIES: IN 2012, FOR THE EMPLOYED POPULATION 16 YEARS AND OLDER, THE LEADING INDUSTRIES IN CRISP COUNTY WERE HEALTHCARE, SOCIAL ASSISTANCE, EDUCATIONAL SERVICES, MANUFACTURING, AND RETAIL TRADE. INCOME: THE MEDIAN INCOME OF HOUSEHOLDS IN CRISP COUNTY WAS 32,320. 69% OF THE HOUSEHOLDS RECEIVED EARNINGS AND 15% RECEIVED RETIREMENT INCOME OTHER THAN SOCIAL SECURITY. 35% OF THE HOUSEHOLDS RECEIVED SOCIAL SECURITY. THE AVERAGE INCOME FROM SOCIAL SECURITY WAS 15,297. THESE INCOME SOURCES ARE NOT MUTUALLY EXCLUSIVE; THAT IS, SOME HOUSEHOLDS RECEIVED INCOME FROM MORE THAN ONE SOURCE. POVERTY AND PARTICIPATION IN GOVERNMENT PROGRAMS: IN 2012, 31% OF PEOPLE WERE IN POVERTY. 53% OF RELATED CHILDREN UNDER 18 WERE BELOW THE POVERTY LEVEL, COMPARED WITH 14% OF PEOPLE 65 YEARS OLD AND OVER. RESIDENTS WITH INCOME BELOW 50% OF THE POVERTY LEVEL IN 2012 WERE 12%. 23% OF ALL FAMILIES AND 51% OF FAMILIES WITH A FEMALE HOUSEHOLDER AND NO HUSBAND PRESENT HAD INCOMES BELOW THE POVERTY LEVEL. FOR PEOPLE REPORTING ONE RACE ALONE, 51% WAS WHITE; 44% WAS BLACK OR AFRICAN AMERICAN; 3% WAS HISPANIC OR LATINO; 1% WAS ASIAN; AND 1% WAS CLASSIFIED AS OTHER RACE. 1% REPORTED TWO OR MORE RACES. HOUSING COSTS: THE MEDIAN MONTHLY HOUSING COSTS FOR MORTGAGED OWNERS WAS 1,023, NON-MORTGAGED OWNERS 325, AND RENTERS 576. 29% OF OWNERS WITH MORTGAGES, 8% OF OWNERS WITHOUT MORTGAGES, AND 47% OF RENTERS IN CRISP COUNTY SPENT 35% OR MORE OF HOUSEHOLD INCOME ON HOUSING. NATIVITY AND LANGUAGE: LESS THAN 1.2% OF THE PEOPLE LIVING IN CRISP COUNTY IN 2008-2012 WERE FOREIGN BORN. 99% WAS NATIVE, INCLUDING 85% WHO WERE BORN IN GEORGIA. AMONG PEOPLE AT LEAST 5 YEARS OLD LIVING IN CRISP COUNTY IN 2008-2012, 4.2% SPOKE A LANGUAGE OTHER THAN ENGLISH AT HOME. OF THOSE SPEAKING A LANGUAGE OTHER THAN ENGLISH AT HOME, 63% SPOKE SPANISH. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | CRISP REGIONAL IS SERVED BY A VOLUNTEER GOVERNING BOARD COMPOSED OF COMMUNITY MEMBERS FROM CRISP AND DOOLY COUNTIES. TWO BOARD MEMBERS ARE MEMBERS OF THE ACTIVE MEDICAL STAFF. A PRIMARY FOCUS OF THE BOARD IS TO ADDRESS THE ACCESSIBILITY OF HEALTHCARE SERVICES AND ACCESS TO QUALIFIED HEALTHCARE PROFESSIONALS. THE ORGANIZATION OPERATES A 24HR/7DAY A WEEK EMERGENCY DEPARTMENT THAT SERVES OVER 20,000 PATIENTS ANNUALLY. AS A MEANS TO ALLEVIATE ED OVERCROWDING AND CREATE A MORE APPROPRIATE TREATMENT ENVIRONMENT, THE BOARD ALSO FUNDS FINANCIALLY OPERATING DEFICITS AT THE CRISP CONVENIENT CARE CLINIC. THE ED PATIENT POPULATION INCLUDES 26% THAT ARE CLASSIFIED AS INDIGENT OR NON-INSURED. THE CONVENIENT CARE CLINIC EXPERIENCES NEARLY 17% INDIGENT OR SELF-PAY POPULATION AND REQUIRES 333,000 IN NON- COMPENSATED FUNDING FROM THE ORGANIZATION'S GENERAL FUNDS. CRISP REGIONAL PROMOTES HEALTH AND ADDRESSES HEALTH PROFESSIONAL ACCESS IN SEVERAL COMMUNITY SERVICES. THE HOSPITAL PROVIDES HOUSING WITHOUT COST TO MEDICAL RESIDENTS AND STUDENTS ENGAGED IN CLINICAL EXPERIENCE AT CRISP REGIONAL. THE BOARD FURNISHES THREE APARTMENTS AS A MEANS TO ASSURE MEDICAL STUDENTS AND MEDICAL RESIDENTS ARE EXPOSED TO THE SPECIAL NEEDS OF RURAL POPULATIONS AND AGRICULTURE ECONOMY. IN ADDITION TO THESE SERVICES, CRISP REGIONAL PARTNERS WITH COLLEGES TO OFFER PRACTICAL EXPERIENCE IN A VARIETY OF AREAS THROUGHOUT THE HOSPITAL - FROM PROVIDING BEDSIDE CARE ON PATIENT FLOORS TO THE INTENSIVE CARE UNIT (ICU) AND EMERGENCY DEPARTMENT (ED). DURING THEIR CLINICAL ROTATIONS, STUDENTS CAN DIRECTLY APPLY WHAT THEY ARE LEARNING ABOUT THE CAUSES OF CERTAIN HEALTH CONDITIONS AND HOW TO DIAGNOSE AND TREAT THEM. CRISP REGIONAL HOSPITAL OFFERS THE OPPORTUNITY FOR AN ADDITIONAL FELLOWSHIP FOR ONE YEAR IN THE SPECIALTY OF THE PHYSICIAN. THIS IS A VALUABLE TRANSITION YEAR TO GAIN NEEDED EXPERIENCE UNDER AN EXPERIENCED GENERAL SURGEON WHO SERVES AS MENTOR DURING THE FELLOWSHIP YEAR. THROUGH ITS RURAL HEALTH CLINIC PROGRAM, CRISP REGIONAL HEALTH SERVICES OFFERS MEDICAL CARE TO SURROUNDING RURAL COMMUNITIES. TWO RURAL HEALTH CARE CLINICS PROVIDE COVERAGE FOR PRIMARY HEALTH CARE, CHRONIC AND ACUTE ILLNESS, MINOR SUTURING, OB-GYN SERVICES, VARIOUS VACCINATIONS, LAB DRAWINGS AND PHYSICALS. THE PROGRAM ALLOWS RURAL RESIDENTS TO RECEIVE EXCELLENT HEALTH CARE PROVIDED BY HIGH-QUALITY HEALTH CARE PROFESSIONALS CLOSE TO HOME. IT ALSO OFFERS AFFORDABLE HEALTH CARE COVERAGE TO THESE RESIDENTS. LAST YEAR, BOTH CLINICS TREATED A TOTAL OF 2,677 PATIENTS. CRISP REGIONAL HEALTH SERVICES HOSTS FOUR ANNUAL COMMUNITY HEALTH FAIRS, OFFERING INFORMATION, EDUCATION AND BASIC TESTS FOR FREE OR AT DEEPLY- REDUCED COSTS. TESTS INCLUDE BODY MASS INDEX, BLOOD PRESSURE SCREENING, HEIGHT AND WEIGHT CHECKS, BLOOD GLUCOSE, AND PULMONARY LUNG FUNCTION. ALSO INCLUDED IS DIAGNOSTIC LAB WORK, CONSISTING OF LIPID PROFILE, THYROID, PROSTATE AND IRON PANEL SCREENINGS. WE PROVIDE THIS TO OUR COMMUNITY BECAUSE THE IMPORTANCE OF PRE-SCREENING, INCREASED AWARENESS AND EDUCATING THE COMMUNITY CONTRIBUTES TO RESIDENTS' BETTER OVERALL HEALTH. CRISP REGIONAL HOSPITAL SPONSORED "LET'S HEAR IT FOR THE GIRLS" WITH THE ALBANY CANCER COALITION TO PROMOTE CANCER AWARENESS TO THE LADIES OF THE COMMUNITY. |
| ADDITIONAL INFORMATION | PART III LINE 6A COMMUNITY BENEFIT REPORT THE ORGANIZATION DOES NOT HAVE A FORMALIZED WRITTEN COMMUNITY BENEFIT REPORTING PROCESS, BUT DOES PUBLICIZE A COMMUNITY BENEFIT REPORT. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| EMPLOYEE EDUCATION LOANS | 29 | $44,577 |
| PHYSICIAN EDUCATION LOANS | 10 | $164,204 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION OFFERS TO PROMOTE HEALTH CARE CAREERS FOR PEOPLE IN CRISP AND SURROUNDING COUNTIES BY PROVIDING SCHOLARSHIPS WITHIN CERTAIN GUIDELINES. EACH APPLICANT MUST PROVIDE A COMPLETED APPLICATION, SCHOOL TRANSCRIPTS, LETTER OF RECOMMENDATION, COMPLETION OF PREREQUISITES AND LETTER OF ACCEPTANCE TO A SPECIFIC PROGRAM, INTENT TO BECOME EMPLOYED BY THE ORGANIZATION, INTERVIEW BY APPROPRIATE VICE PRESIDENT, AND OBTAIN APPROVAL BY THE EDUCATIONAL LOAN REVIEW BOARD. REIMBURSEMENT FOR THE COST OF TUITION, BOOKS, AND REQUIRED COURSE MATERIALS PER SEMESTER WILL BE GIVEN FOR A CURRENT GPA OF 2.0 OR BETTER. A REIMBURSEMENT REQUEST INCLUDING EVIDENCE OF ACTUAL EXPENSES MUST BE SUBMITTED FOR APPROVAL. DEFAULT OF THE TERMS REQUIRES FULL OR PARTIAL PAYBACK OF THE SCHOLARSHIP FUNDS. AMOUNTS REPORTED REFLECT ASSISTANCE FORGIVEN BASED ON YEARS OF EMPLOYMENT PROVIDED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|
| STEVE GAUTNEY | |||||
| PRES/CEO | $250,219 | $4,965 | $8,427 | $22,632 | $286,243 |
| WILLIAM PANNELL MD | |||||
| BOARD MEMBER | $225,255 | $225,255 | |||
| JESSICA CARTER | |||||
| CFO | $151,749 | $225 | $7,500 | $22,632 | $182,106 |
| SRILATHA NADIPINENI MD | |||||
| PHYSICIAN | $257,880 | $22,632 | $280,512 | ||
| VISHAL BURRA MD | |||||
| PHYSICIAN | $183,281 | $14,983 | $198,264 | ||
| MARILYN CARTER MD | |||||
| PHYSICIAN | $166,857 | $166,857 | |||
| MILTON JONES MD | |||||
| PHYSICIAN | $158,873 | $7,800 | $14,983 | $181,656 | |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Business Name Line2IssuerName/BusinessNameLine2 | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|---|
| HOSPITAL AUTH OF CRISP COUNTYGA | |||||||||
| A | CRH REV CERTIFICATES PAYABLE 2008A | 586003098 | 226688BY4 | 2008-05-29 | $10,000,000 | REFUND/CONSTRUCTION | false | Yes (true) | false |
| HOSPITAL AUTH OF CRISP COUNTY GA | |||||||||
| B | CRH REV CERTIFICATES PAYABLE 2008B | 586003098 | 226688CE7 | 2008-05-29 | $3,000,000 | CONSTRUCTION | false | Yes (true) | false |
| HOSPITAL AUTH OF CRISP COUNTY GA | |||||||||
| C | CRH REV CERTIFICATES PAYABLE 2013 | 586003098 | 226688CS6 | 2013-06-18 | $16,500,000 | CONSTRUCTION | false | Yes (true) | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $935,000 | $7,743,975 | $9,830,000 | $525,885 | $1,772,086 | 2008 | Yes (true) | false | Yes (true) | Yes (true) |
| B | $3,000,000 | $157,765 | $2,735,973 | 2009 | false | false | Yes (true) | Yes (true) | ||
| C | $16,500,000 | $847,137 | $16,170,000 | 2013 | false | false | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | false | false | false | false | false | false | Yes (true) |
| B | false | false | false | false | false | false | Yes (true) |
| C | false | false | false | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | false | false | false | false | false |
| B | false | false | false | false | false | false | false | false | false |
| C | false | false | false | false | false | false | false | false | false |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | ALL BOARD MEMBERS RECEIVE A COPY OF THE FORM 990 BEFORE IT IS FILED. IF ANY MEMBER HAS ANY CONCERNS, THEY MUST INFORM ADMINISTRATION. AN EXTENSIVE REVIEW IS PERFORMED BY MANAGEMENT. THE BOARD MEMBERS PERFORM ONLY A BASIC REVIEW OF THE RETURN PRIOR TO ITS FILING WITH THE IRS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY IS DIRECTED NOT ONLY TO DIRECTORS AND OFFICERS, BUT TO ALL EMPLOYEES WHO CAN INFLUENCE THE ACTIONS OF CRISP REGIONAL HOSPITAL, INC. A CONFLICTING INTEREST MAY BE DEFINED AS AN INTEREST, DIRECT OR INDIRECT, WITH ANY PERSONS OR FIRMS. IT IS THE POLICY OF THE BOARD THAT THE EXISTENCE OF ANY OF THE INTERESTS SHALL BE DISCLOSED BEFORE ANY TRANSACTION IS CONSUMMATED. IT SHALL BE THE CONTINUING RESPONSIBILITY OF THE BOARD, OFFICERS, AND MANAGEMENT EMPLOYEES TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES. DISCLOSURES OF CONFLICTS SHOULD BE MADE TO THE BOARD OR A COMMITTEE THEREOF, WHO WILL DETERMINE WHETHER A CONFLICT EXISTS, AND IN THE CASE OF AN EXISTING CONFLICT, DETERMINE APPROPRIATE ACTION. THE INDIVIDUAL WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTIONS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION FOR THE CEO. THE BOARD USES COMPARABLE COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS AT SIMILARLY SIZED ORGANIZATIONS. THE GHA ANNUAL SALARY SURVEY AND OTHER DATA IS USED TO DETERMINE COMPENSATION FOR MANAGEMENT. THE DECISION IS DOCUMENTED BY THE BOARD. THIS PROCESS IS PERFORMED ANNUALLY. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE CEO REVIEWS AND APPROVES THE COMPENSATION FOR THE CFO AND OTHER TOP OFFICERS. THE CEO USES COMPARABLE COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS AT SIMILARLY SIZED ORGANIZATIONS. THE GHA ANNUAL SALARY SURVEY AND OTHER DATA IS ALSO UTILIZED. THIS PROCESS IS PERFORMED ANNUALLY. CRISP REGIONAL'S COMPENSATION PHILOSOPHY IS THE SAME FOR ALL OFFICERS AND EMPLOYEES - TO PROVIDE APPROPRIATE COMPENSATION TO EMPLOYEES BASED ON MARKET DRIVEN DATA AS WELL AS DEMAND WITHIN THE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION WILL MAKE AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS TO ANY MEMBER OF THE PUBLIC WHO MAKES THEIR REQUEST AT THE ADMINISTRATIVE OFFICE OF THE FILING ENTITY. |
| FORM 990, PART IX, LINE 11G | COLLECTION AGENCIES 0 277,834 0 SERVICE CONTRACTS 1,041,756 889,681 0 LAUNDRY/LINEN SERVICES 68,164 194,458 0 OTHER PURCHASED SERVICES 3,870,671 1,336,539 0 PHYSICIAN FEES 5,649,403 0 0 THERAPY CONTRACT FEES 264,030 0 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Business Name Line2DirectControllingEntityName/BusinessNameLine2 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CRISP REGIONAL HEALTH SERVICE INC | |||||||||||
| 902 7TH STREET NORTH | CORDELE | GA | 310153234 | 582175975 | HOLDING CO | GA | 501C3 | 11A | NA | false | |
| CRISP REGIONAL HOSP DEV FNDN INC | |||||||||||
| 902 7TH STREET NORTH | CORDELE | GA | 310153234 | 582175978 | FOUNDATION | GA | 501C3 | 11A | CRH | Yes (true) | CRISP REGIONAL HOSPITAL |
| HOSPITAL AUTHORITY OF CRISP COUNTY | |||||||||||
| 902 7TH STREET NORTH | CORDELE | GA | 310153234 | 586003098 | AUTHORITY | GA | 501C3 | 6 | NA | false | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRISP HEALTHCARE ALLIANCE LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 5007 | AddressLine1 |
| City | CORDELE | City |
| State | GA | State |
| ZIP Code | 310105007 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582307830 | EIN |
| Primary Activities | PURCHASING | PrimaryActivitiesTxt |
| Legal Domicile State | GA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRH | BusinessNameLine1 |
| Business Name Line2 | CRISP REGIONAL HOSPITAL INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $40,003 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $611,704 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
| Ownership | 0.80000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRISP MEDICAL SERVICES INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 902 7TH STREET NORTH | AddressLine1 |
| City | CORDELE | City |
| State | GA | State |
| ZIP Code | 310153234 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582175987 | EIN |
| Primary Activities | DORMANT | PrimaryActivitiesTxt |
| Legal Domicile State | GA | LegalDomicileStateCd |
| 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 | 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
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRISP REGIONAL HOSPITAL DEVELOPMENT | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionTypeTxt |
| Involved | $56,424 | InvolvedAmt |
| Method Of Amount Determination | NET FUNDS RAISED | MethodOfAmountDeterminationTxt |