JANE PHILLIPS NOWATA HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- JANE PHILLIPS NOWATA HOSPITAL INC (EIN 73-1440267)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-13
- IRS object ID
- 201541339349303094
- 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 B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-13T13:15:53-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 East Fifth Street Suite 1900 | AddressLine1 |
| City | Cincinnati | City |
| State | OH | State |
| ZIP Code | 45202 | 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 | 731440267 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jane Phillips Nowata Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JANE | BusinessNameControlTxt |
| Phone | 9182733102 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 237 South Locust | AddressLine1 |
| City | Nowata | City |
| State | OK | State |
| ZIP Code | 74048 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Lex Anderson | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9182733102 | PhoneNum |
| Signature | 2015-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Alicia Janish | PreparerPersonNm |
| PTIN | P00741382 | PTIN |
| Phone | 5137847100 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jane Phillips Nowata Health Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Mike Moore | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 237 South Locust | AddressLine1 |
| City | Nowata | City |
| State | OK | State |
| ZIP Code | 74048 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,997,433 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.jpmc.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1946 | FormationYr |
| Legal Domicile State | OK | LegalDomicileStateCd |
| Activity Or Mission | Providing medical excellence and compassionate care to all who need it. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 58 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $9,057 | PYContributionsGrantsAmt |
| CY Contributions Grants | $27,216 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,794,940 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,959,370 | CYProgramServiceRevenueAmt |
| PY Investment Income | $83 | PYInvestmentIncomeAmt |
| CY Investment Income | $586 | CYInvestmentIncomeAmt |
| PY Other Revenue | $19,950 | PYOtherRevenueAmt |
| CY Other Revenue | $10,261 | CYOtherRevenueAmt |
| PY Total Revenue | $2,824,030 | PYTotalRevenueAmt |
| CY Total Revenue | $3,997,433 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,857,769 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,552,555 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $817,848 | PYOtherExpensesAmt |
| CY Other Expenses | $1,247,280 | CYOtherExpensesAmt |
| PY Total Expenses | $2,675,617 | PYTotalExpensesAmt |
| CY Total Expenses | $3,799,835 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $148,413 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $197,598 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,149,342 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,926,794 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $164,902 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $138,749 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,984,440 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,788,045 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To continue the healing ministry of Jesus Christ by providing medical excellence and compassionate care to all who need it with a special emphasis for the poor and powerless. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,705,331 | ExpenseAmt |
| Revenue | $3,959,512 | RevenueAmt |
| Desc | Jane Phillips Nowata Hospital, Inc. ("the Hospital") is a Medicare designated critical access hospital that provides medical services to the residents of Nowata and Northeastern Oklahoma. The Hospital operates a 24-hour emergency department and a variety of other health care services and is an affiliate of Jane Phillips. As such it is part of St. John Health System, Inc.St. John Health System, Inc. ("St. John"), and affiliates, own and operate a comprehensive tertiary health care delivery system which provides a full spectrum of health-related services throughout Northeastern Oklahoma. St. John, headquartered in Tulsa, Oklahoma, is a wholly-owned subsidiary of Ascension Health. St. John conducts its operations through several wholly-owned or wholly-controlled subsidiaries, including: St. John Medical Center, Inc. (the "Medical Center"), St. John Sapulpa, Inc. ("St. John Sapulpa"), Jane Phillips Memorial Medical Center ("Jane Phillips"), Utica Services, Inc. ("Utica"), St. John Villas, Inc. ("St. John Villas"), Owasso Medical Facility, Inc. ("St. John Owasso"), St. John Health System Foundation, Inc. ("St. John Foundation"), St. John Building Corporation ("SJBC"), and St. John Broken Arrow, Inc. ("St. John Broken Arrow"). St. John, these subsidiaries, and all other subsidiaries under St. John's direct or indirect control or ownership are referred to herein as "the St. John System".Mission and Values:As a Catholic healthcare organization, St. John carries on the mission of its sponsors, through Ascension Health, of continuing the healing ministry of Jesus Christ. It aspires to provide health care that works, health care that is safe, and health care that leaves no one behind, with a promise to our patients and the communities we serve of providing medical excellence and compassionate care. It operates in conformance with "the ethical and religious directives for Catholic health facilities." Faithful to the sponsorship mission, philosophy and values, St. John's mission is to provide healthcare and related ministries for the people served, especially the sick, the poor and the powerless. The board of directors, management and employees of St. John are guided in their day-to-day actions and interactions with those who serve and who are served by the values of service to the poor, wisdom, reverence, creativity, dedication and integrity.St. John and the Hospital collaborate with other individuals and institutions in the various communities served to ascertain community needs and provide a broad range of services along the healthcare continuum to help meet those needs. Programs and services include preventive, diagnostic, therapeutic and rehabilitative programs, including emphasis on health promotion and disease prevention. St. John also advocates for public policies which advance a healthy and just society. St. John works with local, state and national leaders and organizations to bring about a healthcare delivery system that provides dignified access to and affordable, high quality healthcare for all persons.Community Needs Assessment:Each owned hospital in the St. John System has completed a Community Health Needs Assessment and plan of response and those have been posted to each Hospital's website and also the Health System website. St. John continues to look for ways to meet unmet community needs in a sustainable and collaborative way with other organizations to build healthier communities.Governance:The administrative powers of the Hospital are vested in its board of directors, which controls and manages the properties, affairs and funds of the Hospital, subject to reservation of certain powers by St. John. The board meets when needed and it works in concert with, and when appropriate, under the direction of the St. John Health System, Inc. board.Community Benefit:In measuring and reporting quantifiable community benefit, St. John follows guidelines promulgated by the Catholic Health Association of the United States and endorsed by other organizations. Uncompensated care and other elements of community benefit are measured at the unreimbursed estimated cost of services or resources provided.The Hospital is an integral part of the mission of service and the continuum of medical care provided by St. John.Patients seen in the St. John System for the fiscal year ended June 30, 2014:Beds in Service (including 37 newborn bassinets) - 782Total Discharges (excluding normal newborn) - 38,704Total Observation Days - 19,086Combined Discharges and Observation Days - 57,790Total Patient Days (excl. normal newborn & observation) - 176,450Average Length of Stay in Days (excl. normal newborn and obs.) - 4.56 Births: 3,248Emergency Room Visits - 140,150Outpatient Visits (excl. emergency room & one day surgeries) - 394,526Inpatient Surgical Cases - 9,855Outpatient Surgical Cases - 15,545Physician Office Patient Visits - 617,023Urgent Care Clinic Patient Visits - 58,368Combined Physician Office and Urgent Care Visits - 675,391Total Laboratory Procedures (incl. hospital & reference labs) - 8,184,993Patients seen at the Hospital for the fiscal year ended June 30, 2014:Beds in Service - 16Total Discharges - 200Emergency Room Visits - 2,413In its fiscal year ended June 30, 2014, St. John was able to identify and quantify an initial estimate of more than $81.1 million of total net consolidated quantifiable community benefit provided to thousands of individuals directly served. This represents more than 8% of total St. John System operating expenses. In addition to the quantifiable community benefit described above, the St. John System charged millions of dollars to the consolidated provision for bad debts in 2014 which were not included in the total quantifiable community benefit for the year. Also, unlike many other non-profit health systems based in states other than Oklahoma, the St. John System is not exempt from state and local sales taxes and, in fact, pays sales tax on many equipment, supplies and other purchases. When payments from certain government programs for direct graduate medical education and Oklahoma Trauma Fund participation are applied to community benefit expense, the net consolidated quantifiable community benefit expense for St. John Health System, Inc. for 2014 was estimated to be at least $74.9 million.The St. John System considers care for the poor to be an essential part of its mission of service to the community. The total cost of care for the poor includes the cost of charity care, the unreimbursed cost of services to Medicaid beneficiaries (together referred to as "uncompensated care for the poor") and the cost of special programs or other activities specifically targeted to increase access to care or provide other services to the poor. "Care for the Poor" includes the estimated cost of care classified as charity care plus the estimated excess of the cost of services provided to Medicaid beneficiaries over the payments received from Medicaid. "Care for the Poor" does not include the cost of services classified and written off as bad debts or the excess of the cost of services provided to Medicare beneficiaries over the payments received from Medicare.Charity and Uncompensated Care:The St. John System's Hospitals, senior-care and other facilities provide services without regard to a patient's ability to pay. In 2014, the St. John System Hospitals provided a discount of at least 30% of billed charges to all uninsured patients. Uninsured patients also could qualify for an additional 15% prompt pay discount. In addition to these automatic discounts, patients can apply for financial assistance up to and including free care. The determination of the patient's qualification for financial assistance is based on an objective determination of the patient's financial resources and ability to pay. In general, all uninsured patients with household incomes of less than 300% of the federal poverty guidelines qualify for free or substantially discounted care. Other entities in the St. John System also provide charity care based on individual determinations of need. Management for St. John believes that all of its billing and collection policies and procedures comply with IRS guidelines and directives.Summary:The St. John System's role as one of the significant safety-net health care providers for the region continues to grow in prominence. St. John reinvests 100% of any profits derived into new and expanded services to the community. The St. John System is very proud of its history of service to the community and views its responsibility to continue to provide medical services to everyone, especially the poor and disadvantaged, very seriously. As the St. John System continues to face growing financial challenges, it becomes increasingly difficult to sustain our mission of service. Nevertheless, we believe that the quantifiable community benefit as well as the many other areas of service provided by the St. John System and the Hospital, conti | Desc |
| Total Program Service Expenses | $2,705,331 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 58 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OK | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lex Anderson | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9187442740 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1923 South Utica Avenue | AddressLine1 |
| City | Tulsa | City |
| State | OK | State |
| ZIP Code | 741046502 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| John B Kane | ||||||||
| Chairperson | 0.10 | 0.80 | Yes (X) | $0 | $0 | $0 | ||
| Charles Bowerman | ||||||||
| Vice Chairperson | 0.10 | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| Robert Baughman | ||||||||
| Director | 0.10 | 0.60 | Yes (X) | $0 | $0 | $0 | ||
| Bill Beierschmitt | ||||||||
| Director | 0.10 | 0.60 | Yes (X) | $0 | $0 | $0 | ||
| Jean Bloomfield | ||||||||
| Director | 0.10 | 0.80 | Yes (X) | $0 | $0 | $0 | ||
| Glenn Bonner | ||||||||
| Director | 0.10 | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| Stan DeFehr MD | ||||||||
| Director | 0.10 | 0.60 | Yes (X) | $0 | $0 | $0 | ||
| Robert Kane | ||||||||
| Director | 0.10 | 0.80 | Yes (X) | $0 | $0 | $0 | ||
| Joseph V LeBlanc MD | ||||||||
| Director | 0.10 | 1.10 | Yes (X) | $0 | $0 | $0 | ||
| H Michael May | ||||||||
| Director | 0.10 | 0.60 | Yes (X) | $0 | $0 | $0 | ||
| David Sigmon | ||||||||
| Director | 0.10 | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| Scott Williams DO | ||||||||
| Director | 0.10 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Charles Anderson | ||||||||
| VP OP/Ex-Officio | 0.10 | 43.70 | Yes (X) | $0 | $543,250 | $42,282 | Yes (X) | |
| David Stire | ||||||||
| President & COO | 0.10 | 40.00 | $0 | $406,087 | $41,913 | Yes (X) | ||
| Mike Moore | ||||||||
| CFO/VP Finance | 0.10 | 40.00 | $0 | $201,337 | $31,033 | Yes (X) | ||
| Lex Anderson | ||||||||
| Treasurer/Sr. VP & SJHS CFO | 0.10 | 46.10 | $0 | $630,463 | $12,798 | Yes (X) | ||
| Kevin Steck | ||||||||
| Secretary/Corp. Resp. Off. | 0.10 | 54.90 | $0 | $303,108 | $46,620 | Yes (X) | ||
| Vicky Usher | ||||||||
| RN | 40.00 | 0.00 | $101,132 | $0 | $5,606 | Yes (X) | ||
| Debra Robnett-Bell | ||||||||
| Physician's Assistant | 40.00 | 0.00 | $113,700 | $0 | $6,803 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $214,832 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,084,245 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $187,055 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $18,000 | RelatedOrganizationsAmt |
| Government Grants | $7,416 | GovernmentGrantsAmt |
| All Other Contributions | $1,800 | AllOtherContributionsAmt |
| Total Contributions | $27,216 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Net Patient Revenue | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $3,959,370 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,959,370 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,959,370 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $586 | TotalRevenueColumnAmt |
| Exclusion | $586 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Cafeteria | 722320 | $10,119 | $10,119 | |
| Transcription | 900099 | $128 | $128 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $10,261 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,997,433 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,959,512 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $10,705 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,096,106 | TotalAmt |
| Program Services | $1,765,852 | ProgramServicesAmt |
| Management And General | $330,254 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,128 | TotalAmt |
| Program Services | $17,677 | ProgramServicesAmt |
| Management And General | $54,451 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $232,617 | TotalAmt |
| Program Services | $191,970 | ProgramServicesAmt |
| Management And General | $40,647 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,704 | TotalAmt |
| Program Services | $127,687 | ProgramServicesAmt |
| Management And General | $24,017 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,829 | TotalAmt |
| Management And General | $2,829 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $568 | TotalAmt |
| Management And General | $568 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $270,378 | TotalAmt |
| Program Services | $179,917 | ProgramServicesAmt |
| Management And General | $90,461 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,763 | TotalAmt |
| Program Services | $55 | ProgramServicesAmt |
| Management And General | $11,708 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $323,271 | TotalAmt |
| Program Services | $240,839 | ProgramServicesAmt |
| Management And General | $82,432 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164 | TotalAmt |
| Program Services | $164 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,232 | TotalAmt |
| Management And General | $93,232 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,184 | TotalAmt |
| Program Services | $8,904 | ProgramServicesAmt |
| Management And General | $1,280 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11 | TotalAmt |
| Management And General | $11 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $320,098 | TotalAmt |
| Program Services | $34,201 | ProgramServicesAmt |
| Management And General | $285,897 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249 | TotalAmt |
| Program Services | $249 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Repairs | $79,956 | $36,290 | $43,666 | $0 |
| Food | $60,269 | $58,257 | $2,012 | $0 |
| Patient Transportation | $25,167 | $25,167 | $0 | $0 |
| Sales and Use Tax | $16,473 | $13,733 | $2,740 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,668 | TotalAmt |
| Program Services | $4,369 | ProgramServicesAmt |
| Management And General | $28,299 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,799,835 | TotalAmt |
| Program Services | $2,705,331 | ProgramServicesAmt |
| Management And General | $1,094,504 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,610 | BOYAmt |
| EOY | $250,394 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $860,011 | BOYAmt |
| EOY | $558,228 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,858 | BOYAmt |
| EOY | $69,201 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,390 | BOYAmt |
| EOY | $10,920 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,121,132 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $303,911 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,918,763 | BOYAmt |
| EOY | $1,817,221 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,142 | BOYAmt |
| EOY | $929,124 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $154,568 | BOYAmt |
| EOY | $291,706 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,149,342 | BOYAmt |
| EOY | $3,926,794 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $164,902 | BOYAmt |
| EOY | $138,749 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $164,902 | BOYAmt |
| EOY | $138,749 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,984,440 | BOYAmt |
| EOY | $3,788,045 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,984,440 | BOYAmt |
| EOY | $3,788,045 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,149,342 | BOYAmt |
| EOY | $3,926,794 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $197,598 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $606,007 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $568 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $568 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Jane Phillips Nowata Hospital, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $170,000 | OtherCostOrOtherBasisAmt |
| Book Value | $170,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,734,854 | OtherCostOrOtherBasisAmt |
| Depreciation | $228,471 | DepreciationAmt |
| Book Value | $1,506,383 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $176,278 | OtherCostOrOtherBasisAmt |
| Depreciation | $69,885 | DepreciationAmt |
| Book Value | $106,393 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,000 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,555 | DepreciationAmt |
| Book Value | $34,445 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,817,221 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| CIP | $78,182 |
| Other Assets | $213,524 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $291,706 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | From the consolidated audited financial statements of St. John Health System, Inc., which includes the activity of Jane Phillips Nowata Hospital, Inc.: The Health Ministry accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $290,031 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $290,031 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07630 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $379,789 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $211,203 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $168,586 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04440 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $669,820 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $211,203 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $458,617 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12070 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $669,820 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $211,203 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $458,617 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12070 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Expense | 0.00000 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Expense | 0.00000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Expense | 0.00000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Expense | 0.00000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $198,863 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,785,424 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,797,894 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$12,470 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jane Phillips Nowata Health Center | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 237 South Locust | AddressLine1 |
| City | Nowata | City |
| State | OK | State |
| ZIP Code | 74084 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.jpmc.org | WebsiteAddressTxt |
| State License | 2187 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jane Phillips Nowata Health Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Narrative | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | 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 |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | 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 (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Jane Phillips Nowata Health Center | Part V, Section B, Line 3: The Tulsa County Health Departmet led the completion of the Community Health Needs Assessment. The determination of priority needs was based on research findings, and priorities were developed in collaboration with many other stakeholders, including other hospitals, community service agencies, state and local leaders, interested philantropists, universities and associated medical schools, and other parties, including public health experts and representatives of the communities served. In addition, the Tulsa County Health Department's research included randomly selected households for one on one interviews and some "county resident" focus groups. St. John sits on a Pathways to Health Steering Committee and Working Group to coordinate and direct community health activities in the service area. |
| Jane Phillips Nowata Health Center | Part V, Section B, Line 4: The other hospital facilities with which the reporting Hospital facility conducted its CHNA, include:St. John Medical Center, Inc. (Tulsa)St. John Broken Arrow, Inc.St. John Sapulpa, Inc.Jane Phillips Memorial Medical Center (Bartlesville)Owasso Medical Facility, Inc. |
| Jane Phillips Nowata Health Center | Part V, Section B, Line 7: The Hospital facility's Implementation Strategy is listed on the following website:http://www.stjohnhealthsystem.com/about/community-needs-health-assessment |
| Jane Phillips Nowata Health Center | Part V, Section B, Line 14g: Signs are posted in waiting rooms and at the admissions offices to notify patients that the Hospital has a Financial Assistance Policy. In addition, every billing statement, the Hospital's website, and admission packets include information regarding the Financial Assistance Policy. The Policy is provided at the request of the patient. |
| Jane Phillips Nowata Health Center | Part V, Section B, Line 20d: Jane Phillips Nowata Hospital, Inc. provides a 30% discount on gross charges and a 15% prompt pay discount to all uninsured patients. Patients who are determined to be eligible for financial assistance receive an additional charity care discount equal to 100% of the remaining amount due. |
| Part V, Section B, Line 5a: | The Hospital facility's CHNA is listed on the following website: http://www.stjohnhealthsystem.com/about/community-needs-health-assessment |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6a: | The Hospital is a wholly-owned (wholly-sponsored) subsidiary of St. John Health System, Inc. - EIN 73-1215174 - ("SJHS"). SJHS prepared a consolidated community benefit report for the consolidated organization for this tax year. The report is made available on demand and is referenced by the Organization in a number of public meetings and community outreach activities. |
| Part I, Line 7: | Costs were determined using a cost to charge ratio derived from Worksheet 2, Patient Care Cost to Charges. |
| Part III, Line 2: | Accounts are written off to bad debt after all internal collection efforts have been exhausted. Attempts to resolve these outstanding balances can include, but are not limited to statements being sent, phone calls and letters being sent. Account follow up protocol is based on personal pay balance size owed. |
| Part III, Line 3: | Jane Phillips Nowata Hospital, Inc. has a very robust financial assistance program; therefore, no estimate is made for bad debt attributed to financial assistance eligible patients. |
| Part III, Line 4: | From the consolidated audited financial statements of St. John Health System, Inc., which includes the activity of Jane Phillips Nowata Hospital, Inc.:The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Health Ministry follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms or certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Health Ministry's policies.The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. The Health Ministry has not experienced material changes in write-off trends and has not materially changed its charity care policy in the current fiscal year. |
| Part III, Line 8: | Jane Phillips Nowata Hospital, Inc. follows the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. |
| Part III, Line 9b: | The Organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply. |
| Part VI, Line 2: | The Hospital conducted a Community Health Needs Assessment jointly with its parent entity - SJHS. SJHS participates in ongoing community-based needs assessments. Some of the most significant recent activity includes commissioning of a Community Health Needs Assessment and plan for improving community health care conducted by the Tulsa County Health Department and released in 2013. The 2013 assessment has been posted to the Hospital and Health System websites: www.jpmc.org. Many major community health care service organizations participated in these studies. In addition to the above, SJHS through, its subsidiary, St. John Medical Center, Inc. has established a Medical Access Program ("MAP") that is attempting to improve and expand access to health care services to the most vulnerable members of the Tulsa community. All SJHS Tulsa Hospitals including St. John Medical Center, Inc. (Tulsa), Owasso Medical Facility, Inc., St. John Sapulpa, Inc., and St. John Broken Arrow, Inc. participate in this initiative. This program is overseen by representatives of St. John, the George Kaiser Family Foundation, trustees of the Chapman trusts and The University of Oklahoma Tulsa School of Community Medicine. The MAP program includes participation of other health care providers including Good Samaritan clinics, Day Center for the Homeless, Community Health Connections FQHC, Morton Health FQHC, and a network of volunteer physician providers and other organizations. The MAP program regularly receives input from all these organizations on needed services in the community which helps to prioritize the limited resources available to address community needs. |
| Part VI, Line 3: | The Hospital has a team of financial counselors who, prior to discharge, attempt to visit in person with all uninsured inpatients and all inpatients likely to qualify for medical indigency to explain our financial assistance policies and help guide them through the process of applying for financial assistance. We also attempt to meet with all the families of all Medicaid beneficiaries or individuals who we believe could potentially qualify for Medicaid to help them apply for coverage. The Hospital mentions the existence of the Financial Assistance Policy and provides a phone number to call: on its website, in admitting materials, on all invoices for services sent to patients, and in other ways. |
| Part VI, Line 4: | As described above the Hospital is part of St. John Health System, Inc. ("SJHS"). Although SJHS provides a full spectrum of health related services throughout Northeastern Oklahoma, its tertiary operations and a large part of its other services are concentrated in the Tulsa Metropolitan Statistical Area (the "Tulsa MSA"). According to the 2010 Census, the State of Oklahoma had a resident population of 3,751,351 persons compared to 3,450,654 persons in 2000. This is an 8.7% increase. The U.S. Census Bureau estimated that in 2009 13.5% of the Oklahoma resident population was eligible for Medicare, compared to 14.7% in 2000.Tulsa County, Oklahoma and the counties that make up the Tulsa MSA, according to the 2010 Census, had populations of 603,403 and 1,006,460, respectively. This compares to populations of 563,299 and 803,235 persons, respectively in 2000 and represents population growth of 7.1% and 25.5%, respectively. The data shows that the counties in the Tulsa MSA that surround Tulsa County grew much faster from 2000 to 2010. At the same time, the population within Tulsa County shifted away from the city of Tulsa and to suburbs such as Owasso and Broken Arrow. The cities of Broken Arrow and Owasso were two of the fastest growing communities in Oklahoma between 2000 and 2010. The population of the city of Owasso grew 56% to 28,915 from 2000 to 2010 and the population of the city of Broken Arrow grew 32% to 98,850 from 2000 to 2010. Wagoner County (southeast ofTulsa) and Rogers County (northeast of Tulsa) showed the two highest population growth rates from 2000 to 2010. Every county in the 8 county Tulsa MSA except Pawnee County grew in population from 2000 to 2010. Washington County, directly north of Tulsa County and which includes the city of Bartlesville (and Jane Phillips Memorial Medical Center), also grew in population from 2000 to 2010. When the population of Washington County is added to the population of Tulsa County, the 2010 combined population was 1,059,436.There is significant disparity in the general health of populations within the service area depending upon where an individual lives and to what socioeconomic and ethnic group they belong. Citizens who reside in "North" Tulsa and in some areas of "East" and "West" Tulsa generally have poorer health and shorter life spans than individuals who live in "South" Tulsa. Members of minority groups (many of whom reside in the geographic areas described above) share these same health characteristics. It has been demonstrated that these individuals have less access to regular health care services, including specialty care, and many seek even their primary care in hospital emergency rooms, including all of the SJHS Hospitals. Some significant minority groups in the Hospital's and SJHS's principal service area include Native Americans, Hispanics and African Americans. Each of these groups share common socioeconomic challenges making them more likely to be poor and be uninsured for health care. Each of these groups has unique ethnic health risk factors that contribute to health status that is generally poorer than their White counterparts. However, even among the White population in the Hospital's service area, there is significant adverse health care status. In general, Oklahoma (including the Hospital's service area) ranks near the bottom in many if not most measures of health status in the U.S. There are high rates of smoking, diabetes, obesity, upper respiratory illness, chronic heart conditions and many other factors. There are high rates of uninsured and underinsured individuals and families in the communities and geographies served by the Hospital which create many challenges in meeting the demand for basic services and in improving the health status of the population. |
| Part VI, Line 5: | St. John is a growing integrated delivery system that serves Northeastern Oklahoma and the surrounding area. It has grown significantly in recent years, with increasing revenues from outpatient and physician professional services as well as other post-acute services. Acute care services are provided on six hospital campuses that are owned by St. John. The owned hospitals are St. John Medical Center, Inc. (the tertiary center in Tulsa, Oklahoma), Jane Phillips Memorial Medical Center in Bartlesville, St. John Owasso in Owasso, Oklahoma, St. John Broken Arrow, Inc., this Hospital, and St. John Sapulpa, Inc., a critical access hospital in Sapulpa, Oklahoma. Acute care services are also provided at two additional rural critical access hospitals which are managed by Jane Phillips. Diagnostic services and certain acute care services are also provided in a variety of free standing (including hospital-based) settings. The St. John System now includes more than 450 employed physicians and "mid-level providers", and several urgent care clinics, as well as retirement and skilled nursing facilities, including some targeted specifically to serve low-income and physically disabled individuals and other health care providers.St. John is attempting to promote community health in several ways. Most of the affiliated primary care physicians have or are establishing "medical home" models of care that are attempting to improve health status of their patients by better emphasizing preventive care and health screening and by better management of chronic disease. This includes participation in the Medicare Comprehensive Primary Care Initiative. The affiliated primary care physicians utilize a sophisticated electronic medical record that helps provide real time information to make it easier to manage patients' care. The Hospital and the other hospitals in the System have invested heavily in clinical information systems and electronic medical records to better manage patient care during each episode of acute care. St. John is investing in new systems of care to provide better coordination of care between all the different providers responsible for portions of each patient's care with an emphasis on prevention, screening and coordination of chronic care. The Hospital and SJHS have invested in tertiary services that are needed by the community. Examples of which include development of Oklahoma's only ACS Level II Trauma Center (the highest accredited center in Tulsa), Northeastern Oklahoma's only JCAHO-accredited stroke center, neonatal intensive care, sophisticated medical technology including all-digital diagnostic radiology, cyberknife and other forms of radiation therapy, DaVinci robotic surgery, an endovascular operating suite, orthopedic and neurosurgical centers of excellence, sophisticated cardiovascular care that emphasizes rapid and effective intervention for heart attack victims and preventive care for those with chronic heart conditions. The Hospital has an open medical staff and has community, religious and physician representatives serving on its board. SJHS has created and is continuing to create systems and policies to promote better coordination of care and allocation of resources throughout the System. The Hospital participates in many community-wide health screening and health education events as well as hosting many such events that are open to the public. The Hospital and SJHS continue to invest in medical education to support the expansion of physicians, nurses and allied health professionals that will serve the current and future generations of patients in the service area. The Hospital participates in SJHS's coordinated effort to assess community need collaboratively with other interested parties in the community and to allocate capital and human resources to address the needs of the entire service area.Finally as one of only two major tax-exempt health systems in our service area, St. John reinvests 100% of any profits generated into new or expanded services for the community. |
| Part VI, Line 6: | St. John Health System, Inc. ("St. John" or "the Health Ministry") is a member of Ascension Health. St. John became a member of Ascension Health on April 1, 2013. In December 2011, Ascension Health Alliance, doing business as Ascension, became the sole corporate member and parent organization of Ascension Health, a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. In addition to serving as the sole corporate member of Ascension Health, Ascension serves as the member or shareholder of various other subsidiaries. Ascension, its subsidiaries, and the Health Ministries are referred to collectively from time to time hereafter as the System.Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. The participating entities of Ascension Sponsor are the Daughters of Charity of St. Vincent de Paul, St. Louise Province, the Congregation of St. Joseph, the Congregation of the Sisters of St. Joseph of Carondelet, the Congregation of Alexian Brothers of the Immaculate Conception Province - American Province and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province.Until April 1, 2013, St. John Health System, Inc. was a wholly owned subsidiary of Marian Health System, Inc. ("Marian"). Effective April 1, 2013, Marian transferred its ownership of St. John to Ascension whereby St. John Health System, Inc. became a subsidiary of Ascension Health. The transaction was a membership substitution transaction, such that Ascension Health became the sole member of St. John, holding essentially the same reserved powers over St. John as Marian previously held. The transfer of ownership has been accounted for as a purchase. As such, on April 1, 2013, the assets and liabilities of St. John were adjusted to estimated fair market value. Also as a result of this transaction, St. John adopted a June 30 fiscal year for financial reporting purposes from its previous September 30 fiscal year. Due to the adjustment of asset and liability values to fair market value on April 1, 2013, the accompanying consolidated financial statements as of and for the year ended June 30, 2014, are not presented with comparative prior year information.St. John, headquartered in Tulsa, Oklahoma, and with facilities located throughout Northeastern Oklahoma is an Oklahoma nonprofit health system. It owns and operates an integrated tertiary health care delivery system that provides services primarily in Northeastern Oklahoma. St John Health System, Inc. and its subsidiaries, affiliates, and employed and affiliated physicians, provide health care services for patients of all ages across the broad continuum of care, from physician primary care and specialty services to ambulatory and inpatient acute and post-acute services, and including senior nursing and senior living services. The Health Ministry is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of the Health Ministry are related to providing health care services.The accompanying consolidated financial statements include the accounts of the St. John Health System, Inc. and its subsidiaries. Principal subsidiaries as of June 30, 2014, include the following:- St. John Medical Center, Inc.- Jane Phillips Memorial Medical Center- Owasso Medical Facility, Inc.- St. John Broken Arrow, Inc.- St. John Health System Foundation, Inc.- St. John Villas, Inc. - St John Sapulpa, Inc.- St. John Building Corporation- Utica Services, Inc. and subsidiaries- SJFI, LLCJane Phillips Nowata Hospital, Inc., located in Tulsa, Oklahoma, consists of one nonprofit acute care hospital. The hospital within Jane Phillips Nowata Hospital, Inc. provides inpatient, outpatient, and emergency care services for the residents of Tulsa, Oklahoma. Admitting physicians are primarily practitioners in the local area. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services. Mission:The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains andimproves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs:- Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of inadequate resources and/or who are underinsured.- Unpaid cost of public programs represents the unpaid cost of services provided to persons covered by public programs for the persons living in poverty and other vulnerable persons.- Cost of other programs for the persons living in poverty and other vulnerable persons includes programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the communityincluding substance abusers, the homeless, victims of child abuse and persons with acquired immune deficiency syndrome.- Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for persons living in poverty and other vulnerable persons, includinghealth promotion and education, health clinics and screenings and medical research.Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and other community benefit programs. The cost of providing care to persons living in poverty and other community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care.The amount of traditional charity care provided, determined on the basis of cost, was approximately $32,442,000 for the year ended June 30, 2014. |
| Community Benefit Report: | St. John Health System, Inc.'s (the "St. John System" or "St. John") mission is to improve the health status of the individuals who live in the communities we serve with a special emphasis on the poor and vulnerable among us; faithful to the teaching of Jesus Christ and the values of our Sponsors and the Catholic Church. Our promise to our patients and to our communities is to provide medical excellence and compassionate care. We strive to provide healthcare that works, healthcare that is safe and healthcare that leaves no one behind.To meet this mission the St. John System has operated since the 1920's; growing from a fledgling community hospital in what was then the southern edge of Tulsa, Oklahoma to an integrated health care delivery system serving Northeastern Oklahoma and surrounding states. The St. John System includes: 7,000 associates, 450 employed physicians and advanced practice providers, hundreds more independent physicians and dozens of volunteers. They serve patients in six owned hospitals operating nearly 800 beds; several senior nursing and housing facilities; dozens of physician offices, clinics and urgent care centers; a reference laboratory, and partnerships and ventures that include a health insurance company, several ambulatory surgery centers and other health care activities. Together, our associates, physicians and volunteers touch the lives of thousands of patients every day; including the poor and the vulnerable.In each of the last four fiscal years, the St. John System provided total estimated community benefit (utilizing the measurement criteria of the U.S. Catholic Health Association) of more than $81.1 million. These amounts represented more than 8% of total operating expenses in each year. The St. John System is committed to continue the legacy of health care excellence and service started by our original founders and sponsors the Sisters of the Sorrowful Mother by continuing to provide vital services to the communities with continued emphasis on service to the poor and powerless.Our Mission and Values: Our mission of service and our Catholic values compel us to fulfill our promise of medical excellence and compassionate care to all who need our services with a special emphasis on service to the poor and the powerless. We will do this by providing: health care that works; health care that is safe; and health care that leaves no one behind. We will endeavor to establish trusted relationships with our patients over their entire lives: seeking to improve their health and working to health their minds and bodies when afflicted by injury or illness.Health Care that Works:Our vision calls us to ensure service that is committed to health and well-being for our communities and that responds to the needs of individuals throughout their lives. Healthcare that Works includes establishing a trusted relationship between each patient and their health care professionals so that they receive the care they need, including preventative care, when they need it and in a manner that meets their service expectations. We expect our patients to be actively involved in their own health care participating in informed decisions that will strive to make them healthier. Health care that works assumes that the care provided is person-centered and based on the best available medical evidence, reliably delivered. Becoming truly person-centered requires shifts in focus from traditional models of health care to build an effective and trusted relationship with each patient over their lifetime across the continuum of care emphasizing prevention and wellness, disease management, and a medical home that promotes a spiritually-centered, holistic approach to supporting a person's health and well-being. Health care that works strives to make sure the value of the care received is exceptional but at an acceptable economic cost both to the individual and to society.Health Care that is Safe:St. John is striving to become a "high reliability" organization. High reliability means that we will be exceptionally consistent in accomplishing goals and avoiding catastrophic errors in everything we do. In providing health care services, this means reducing medical errors by providing our clinicians and our patients with decision support tools to ensure the care provided is consistently based on sound scientific evidence of effectiveness. Physicians and nurses are leading our quality efforts. Among our clinical areas of focus for improvement are goals to reduce hospital acquired conditions and hospital readmissions. Some specific areas of clinical focus include reducing: - Adverse Drug Events (ADE),- Catheter Urinary Tract Infections (CAUTI),- Central Line Blood Stream Infections (CLABSI),- Surgical Site Infections (SSI),- Ventilator Associated Pneumonia (VAP),- Injuries from Falls and Immobility,- Obstetrical Adverse Events,- Pressure Ulcers, and- Venous Thromboembolism (VTE).Healthcare that Leaves No One Behind:We will continue to advocate for state and federal public policy that recognizes the inherent value of all members of society and provides support systems and adequate funding sources to ensure all of those among us have access to the health care they need. This includes providing affordable access to health care for everyone in the U.S. in a financially sustainable way.Our Enabling Strengths:We will use our enabling strengths to achieve our mission and vision. Those strengths include: a model community of inspired people working to provide our services and achieve our mission; empowering knowledge clinical and business information systems that provide our associates actionable, timely data and information upon which they can make informed decisions; the creation of trusted partnerships with external partners to expand our capabilities, complement our service offerings and fulfill our mission; and achieving vital presence in the communities we serve. This vital presence contemplates creation and continuation of important safety net services, world-class centers of clinical excellence and creation of medical homes that promote each individual's participation in their own health and well-being and which create and sustain the infrastructure for promoting health communities.Our Point of View:Health care delivery and financing in the U.S. must change. The cost of the current system relative to the value that communities and individuals are receiving is not sustainable. In order to meet the health care needs and contribute to economic vitality of communities, with special attention to the poor and vulnerable, health care providers must fundamentally reconfigure delivery systems, care processes and cost structures. Delivering safe, high-quality care that is low cost with an exceptional patient experience will increasingly require providers to have a strong regional presence, integrated physician relationships and capabilities across the care continuum. Sustaining the St. John mission into the future will require a more continuous, dynamic relationship with those we serve and the ability to share risk with healthcare purchasers, as opportunities for inpatient growth or commercial rate increases will be limited. The movement to managing health of defined populations demands massive transformational change. This requires rapid assessment, assembly and deployment of the necessary capabilities. We believe the St. John System is well positioned to lead this transformation.Community Needs Assessment:The St. John System and each St. John Hospital have completed a Community Health Needs Assessment to help us identify the priorities for the limited resources we have to address community need. We partnered with the Tulsa County Health Department, other public and private health care, educational and community service organizations throughout the service area to complete the assessments and we are now working to enhance our response to the identified needs. Additional information will be forthcoming about our specific future responses to our assessment of community need.Community Benefit:The community benefit provided by the St. John System includes: uncompensated care for the poor, support for the education of medical professionals, provision of subsidized health services, support for other community organizations, initiatives to improve community health, and medical research to be some of the key areas of focus for providing community benefit. The St. John System does not include amounts recorded as bad debt; shortfalls in the difference between payment for and cost of service to Medicare beneficiaries; payment of property, sales, use, income, payroll, and other taxes; considerable economic value provided to the local communities in which we operate as components of community benefit.Care for the Poor:"Care for the Poor" (which includes the estimated cost of services provided to patients who qualify for financial assistance (charity) and the uncompensated co |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Charles Anderson | ||||||||||||||
| VP OP/Ex-Officio | $0 | $460,609 | $0 | $34,282 | $0 | $48,359 | $0 | $23,000 | $0 | $19,282 | $0 | $585,532 | $0 | $31,269 |
| David Stire | ||||||||||||||
| President & COO | $0 | $348,668 | $0 | $57,419 | $0 | $0 | $0 | $22,423 | $0 | $19,490 | $0 | $448,000 | $0 | $32,504 |
| Mike Moore | ||||||||||||||
| CFO/VP Finance | $0 | $171,941 | $0 | $29,396 | $0 | $0 | $0 | $20,217 | $0 | $10,816 | $0 | $232,370 | $0 | $17,021 |
| Lex Anderson | ||||||||||||||
| Treasurer/Sr. VP & SJHS CFO | $0 | $490,729 | $0 | $73,048 | $0 | $66,686 | $0 | $0 | $0 | $12,798 | $0 | $643,261 | $0 | $39,712 |
| Kevin Steck | ||||||||||||||
| Secretary/Corp. Resp. Off. | $0 | $231,739 | $0 | $33,913 | $0 | $37,456 | $0 | $38,731 | $0 | $7,889 | $0 | $349,728 | $0 | $24,863 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | St. John Health System, Inc., an affiliate organization of Jane Phillips Nowata Hospital, Inc., uses the following methods to establish the compensation of the Organization's President: - Compensation Committee - Independent Compensation Consultant - Compensation Survey or Study - Approval by the Board or Compensation Committee |
| Part I, Line 4b | Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the Organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individuals received current year distributions of: David Stire $32,504 Mike Moore $17,021 Lex Anderson $39,712 Kevin Steck $24,863 Charles Anderson $31,269 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part V, Line 2a: | Statements Regarding Other IRS Filings and Tax Compliance The salaries reflected on Form 990 were all reported on the Form 941 Employer's Quarterly Federal Tax Return of Jane Phillips Memorial Medical Center (JPMMC). These salaries were reimbursed to JPMMC by the filing organization and were included in the number of employees on JPMMC's calendar year 2013 Form W-3. The number of employees reported on Part V, Line 2a of Form 990 by the filing organization represents the number of employees providing services to the filing organization during calendar year 2013. |
| Form 990, Part VI, Section A, line 2 | Many of the persons listed on Part VII have a "business relationship" with each other by virtue of employment by St. John Health System, Inc. related entities. Robert Kane, Director, and John B. Kane, Director, have a family relationship. |
| Form 990, Part VI, Section A, line 4 | On June 30, 2013, Jane Phillips Health Corporation merged into St. John Health System, Inc. As such in FY14, Jane Phillips Memorial Medical Center supersedes Jane Phillips Health Corporation as the sole corporate member of Jane Phillips Nowata Hospital, Inc. |
| Form 990, Part VI, Section A, line 6 | Jane Phillips Nowata Hospital, Inc. has a single corporate member, Jane Phillips Memorial Medical Center. |
| Form 990, Part VI, Section A, line 7a | Jane Phillips Nowata Hospital, Inc. has a single corporate member, Jane Phillips Memorial Medical Center, who has the ability to elect members to the governing body of Jane Phillips Nowata Hospital, Inc. |
| Form 990, Part VI, Section A, line 7b | All decisions that have a material impact to Jane Phillips Nowata Hospital, Inc.'s financial information or corporation as a whole are subject to approval by its sole corporate member, Jane Phillips Memorial Medical Center. Ascension Health, the sole corporate member of St. John Health System, Inc., has designated a system authority matrix which assigns authority for key decisions that are necessary in the operation of the System. Specific areas that are identified in the authority matrix are: new organizations and major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic and financial plans; assets; system policies and procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. |
| Form 990, Part VI, Section B, line 11 | Jane Phillips Nowata Hospital, Inc. (JP Nowata) is an affiliate of St. John Health System, Inc. (SJHS). SJHS has hired a third party preparer experienced in the preparation of Form 990 to assist in the preparation of the return. The Executive Vice President/Chief Financial Officer and Controller of SJHS will work closely with the paid preparer in gathering the information for the return and will perform the initial detailed review of the return. The return will then be reviewed by the SJHS Audit Committee (as delegated by the Board of the filing organization). A copy of the return will be provided to all voting Board Members of the filing Organization prior to filing. |
| Form 990, Part VI, Section B, line 12c | At every fiscal year end, St. John Health System, Inc. (SJHS) distributes a copy of the current Conflict of Interest Policy and Procedure Bulletin, together with an explanation and questionnaire to the members of the Board of Directors, administrative officers and key employees of SJHS, its subsidiaries and affiliates, including Jane Phillips Nowata Hospital, Inc. The Board Members, administrative officers and key employees of SJHS, its subsidiaries and affiliates must complete the questionnaire and return it to the designated SJHS official within two weeks of receipt. Completed questionnaires are reviewed and summarized by the Vice President, Corporate Compliance and Integrity, or his/her designee. That individual then presents the questionnaire results to the heads of each hospital for further provision to the various boards' Audit and Compliance Committees. The Audit and Compliance Committees, as appropriate, submit a confidential report to their Board Chairman summarizing the questionnaire results. The Board Chairman, as appropriate, may review with the Executive Committee the responses to the questionnaire results. Members of a committee with governing board delegated powers annually sign a statement which affirms such person has received a copy of the Conflict of Interest Policy, has read and understands the Policy, has agreed to comply with the Policy, and understands that the Organization is charitable and, in order to maintain its federal tax exemption, it must engage primarily in activities which accomplish its tax-exempt purpose. |
| Form 990, Part VI, Section B, line 15 | Compensation for all executives in St. John Health System, Inc. (SJHS), of which Jane Phillips Nowata Hospital, Inc. is a part, is analyzed by an independent health care consulting firm. The analysis includes a fair market value assessment and establishment of a range for each position based on research of comparable health care systems of similar size. The report and recommended compensation levels for each executive management position is reviewed and approved by the Executive Compensation Committee of the SJHS Board of Directors. |
| Form 990, Part VI, Section C, line 19 | The Organization will provide any documents open to public inspection upon request. |
| Form 990, Part VII, Section B: | Independent Contractor Reporting: Compensation of independent contractors is paid by and reported on Form 1096, Annual Summary and Transmittal of U.S. Information Returns, of Jane Phillips Memorial Medical Center EIN 73-0606129. Expenses are allocated to and reimbursed by the filing organization to Jane Phillips Memorial Medical Center. As such, the organization has not reported independent contractors paid of Form 990, Part VII, Section B. |
| Form 990, Part XI, line 9: | Transfer from Affiliates 606,007. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (18 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Ascension Health Alliance | |||||||||||
| PO Box 45998 | St Louis | MO | 631455998 | 453358926 | National Health System | MO | 501(c)(3) | Schedule A, Line 11a | N/A | 0 | |
| Ascension Health | |||||||||||
| PO Box 45998 | St Louis | MO | 63134 | 311662309 | National Health System | MO | 501(c)(3) | Schedule A, Line 11a | 0 | Ascension Health Alliance | |
| St John Health System Inc | |||||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 731215174 | System Parent | OK | 501(c)(3) | Schedule A, Line 11a | 0 | Ascension Health | |
| Craig County Medical Services Corp | |||||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 731487478 | Health Care | OK | 501(c)(3) | Schedule A, Line 9 | 0 | St John Health System Inc | |
| St John Sapulpa Inc | |||||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 730662663 | Health Care | OK | 501(c)(3) | Schedule A, Line 3 | 0 | St John Health System Inc | |
| Jane Phillips Memorial Medical Center | |||||||||||
| 3500 E Frank Phillips Blvd | Bartlesville | OK | 74006 | 730606129 | Health Care | OK | 501(c)(3) | Schedule A, Line 3 | 0 | St John Health System Inc | |
| Jane Phillips Health Care Foundation | |||||||||||
| 3500 E Frank Phillips Blvd | Bartlesville | OK | 74006 | 731250611 | Rural Health Clinics | OK | 501(c)(3) | Schedule A, Line 3 | Yes (1) | Jane Phillips Memorial Medical Center | |
| Bartlett Homes Inc | |||||||||||
| 1008 E Cleveland | Sapulpa | OK | 74066 | 731301822 | HUD Housing | OK | 501(c)(3) | Schedule A, Line 7 | 0 | St John Sapulpa Inc | |
| Bethel Manor Inc | |||||||||||
| 619 S Division | Sapulpa | OK | 74066 | 731216617 | HUD Housing | OK | 501(c)(3) | Schedule A, Line 7 | 0 | St John Sapulpa Inc | |
| St John Building Corporation | |||||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 611659782 | Real Estate | OK | 501(c)(2) | N/A | 0 | St John Health System Inc | |
| St John Health System Foundation Inc | |||||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 731133139 | Health Care | OK | 501(c)(3) | Schedule A, Line 7 | 0 | St John Health System Inc | |
| St John Medical Center Inc | |||||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 730579286 | Health Care | OK | 501(c)(3) | Schedule A, Line 3 | 0 | St John Health System Inc | |
| St John Management Services Inc | |||||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 203742040 | Health Care | OK | 501(c)(3) | Schedule A, Line 7 | 0 | St John Health System Inc | |
| St John Villas Inc | |||||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 731077367 | Nursing Home | OK | 501(c)(3) | Schedule A, Line 9 | 0 | St John Health System Inc | |
| Owasso Medical Facility Inc | |||||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 203700131 | Health Care | OK | 501(c)(3) | Schedule A, Line 3 | 0 | St John Health System Inc | |
| St John Broken Arrow Inc | |||||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 383833117 | Health Care | OK | 501(c)(3) | Schedule A, Line 3 | 0 | St John Health System Inc | |
| St John Auxiliary | |||||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 730999759 | Health Care | OK | 501(c)(3) | Schedule A, Line 9 | 0 | St John Health System Inc | |
| St Teresa of Avila Villas Inc | |||||||||||
| 6859 South Canton Avenue | Tulsa | OK | 74136 | 204791422 | HUD Housing | OK | 501(c)(3) | Schedule A, Line 7 | 0 | St John Villas Inc | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| Platnum Fitness & Rehab Center LLC | |||||||
| 4804 South 109th East Avenue | Tulsa | OK | 74146 | 201879493 | Health Club | OK | N/A |
| Memorial Surgery Center LLC | |||||||
| 8131 South Memorial | Tulsa | OK | 74033 | 201167151 | Operate ASC | OK | N/A |
| Broken Arrow Development LLC | |||||||
| 1924 South Utica Avenue | Tulsa | OK | 74104 | 260748994 | Medical Services | OK | N/A |
| UticaUSP Tulsa LLC | |||||||
| 15305 Dallas Pkwy Ste 1600 LB 28 | Addison | TX | 75001 | 270408231 | Medical Services | TX | N/A |
| JPHC LLC | |||||||
| 3500 SE Frank Phillips Blvd | Bartlesville | OK | 74006 | 611498699 | Medical Services | OK | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (17 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Utica Services Inc | |||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 731057650 | Medical Services | OK | N/A | C | 0 |
| Regional Medical Laboratories Inc | |||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 731131608 | Medical Services | OK | N/A | C | 0 |
| Physician Support Services Inc | |||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 731437252 | Medical Services | OK | N/A | C | 0 |
| OMNI Medical Group Inc | |||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 731335536 | Medical Services | OK | N/A | C | 0 |
| Outbound Medical Network Inc | |||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 731255463 | Medical Services | OK | N/A | C | 0 |
| St John Urgent Care Clinic Inc | |||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 204990275 | Medical Services | OK | N/A | C | 0 |
| St John Anesthesia Services Inc | |||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 203690446 | Medical Services | OK | N/A | C | 0 |
| St John Physicians Inc | |||||||||
| 1923 South Utica Avenue | Tulsa | OK | 74104 | 731321032 | Medical Services | OK | N/A | C | 0 |
| Ceres Medical Practice Inc | |||||||||
| 3400 E Frank Phillips Blvd | Bartlesville | OK | 74006 | 731522656 | Medical Services | OK | N/A | C | 0 |
| Doctors Building of Bartlesville | |||||||||
| 3500 State Street | Bartlesville | OK | 74006 | 730759185 | Building Rental | OK | N/A | C | 0 |
| Gemini Medical Group Inc | |||||||||
| 3400 E Frank Phillips Blvd | Bartlesville | OK | 74006 | 731503529 | Medical Services | OK | N/A | C | 0 |
| Gemini After Hours Clinic Inc | |||||||||
| 3400 E Frank Phillips Blvd | Bartlesville | OK | 74006 | 300375407 | Medical Services | OK | N/A | C | 0 |
| Jane Phillips Specialty Physicians Inc | |||||||||
| 3400 E Frank Phillips Blvd | Bartlesville | OK | 74006 | 010879962 | Medical Services | OK | N/A | C | 0 |
| Professional Credit Recovery | |||||||||
| 4100 SE Adams Blvd | Bartlesville | OK | 74006 | 731057187 | Collections Services | OK | N/A | C | 0 |
| Synergy Hospitalist Grp Inc | |||||||||
| 3400 E Frank Phillips Blvd | Bartlesville | OK | 74006 | 300375404 | Medical Services | OK | N/A | C | 0 |
| Professional Medical Insurance Risk Retention Group Inc | |||||||||
| 201 Merchant Street Suite 2400 | Honolulu | HI | 96813 | 731525831 | Insurance | HI | N/A | C | 0 |
| Jane Phillips Support Services Inc | |||||||||
| 3400 E Frank Phillips Blvd | Bartlesville | OK | 74006 | 751530296 | Holding Company | OK | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Jane Phillips Memorial Medical Center | ||
| P | $4,154,834 | FMV |
| Jane Phillips Memorial Medical Center | ||
| L | $3,185,056 | FMV |
| Jane Phillips Memorial Medical Center | ||
| O | $1,500,740 | FMV |
| Jane Phillips Memorial Medical Center | ||
| S | $787,398 | FMV |
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