ASHLAND COMMUNITY HEALTH SERVICES: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- ASHLAND COMMUNITY HEALTH SERVICES (EIN 93-1213059)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-02-08
- IRS object ID
- 201420399349300722
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-02-08T17:53:41-06:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3000 NORTHUP WAY SUITE 200 | AddressLine1 |
| City | BELLEVUE | City |
| State | WA | State |
| ZIP Code | 98004 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 931213059 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHLAND COMMUNITY HEALTHCARE SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ASHL | NameControl |
| Phone | 5412014000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 280 MAPLE STREET | AddressLine1 |
| City | ASHLAND | City |
| State | OR | State |
| ZIP Code | 97520 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PATRICK HOCKING | Name |
| Title | CHIEF ADMIN & FINANCE OFFICER | Title |
| Phone | 5412014000 | Phone |
| Date Signed | 2014-02-04 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DANIEL M FREIN | Name |
| PTIN | P01581995 | PTIN |
| Phone | 4252506100 | Phone |
| Date Prepared | 2014-02-04 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHLAND COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | SHEILA CLOUGH | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 280 MAPLE STREET | AddressLine1 |
| City | ASHLAND | City |
| State | OR | State |
| ZIP Code | 97520 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 45539898 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ASHLANDHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1996 | YearFormation |
| State Legal Domicile | OR | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HIGH QUALITY CARE THAT IMPROVES THE HEALTH OF PATIENTS, FAMILIES, AND THE COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 477 | TotalNbrEmployees |
| Total Nbr Volunteers | 168 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 456062 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 435584 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 49625110 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 44549432 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 18139 | InvestmentIncomePriorYear |
| Investment Income Current Year | 26613 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 591483 | OtherRevenuePriorYear |
| Other Revenue Current Year | 528269 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 50690794 | TotalRevenuePriorYear |
| Total Revenue Current Year | 45539898 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 27489851 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 26905442 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 26210626 | OtherExpensePriorYear |
| Other Expenses Current Year | 21959665 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 53700477 | TotalExpensesPriorYear |
| Total Expenses Current Year | 48865107 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3009683 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -3325209 | RevenuesLessExpensesCY |
| Total Assets BOY | 38286714 | TotalAssetsBOY |
| Total Assets EOY | 34553207 | TotalAssetsEOY |
| Total Liabilities BOY | 15494028 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 15064984 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 22792686 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 19488223 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MISSION OF ASHLAND COMMUNITY HOSPITAL IS TO PROVIDE COMPASSIONATE, HIGH QUALITY CARE THAT IMPROVES THE OVERALL HEALTH OF OUR PATIENTS, THEIR FAMILIES AND THE COMMUNITY BY WORKING IN PARTNERSHIP WITH OUR PHYSICIANS AND OTHER REGIONAL HEALTHCARE PROVIDERS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 35888519 | Expense |
| Revenue | 44549432 | Revenue |
| Description | PROVISION OF HEALTHCARE SERVICES TO RESIDENTS WITHIN OUR GEOGRAPHIC REGION, INCLUDING A SIGNIFICANT PORTION OF SERVICES TO MEDICARE/MEDICAID PATIENTS AND CHARITY CARE. | Description |
| Total Program Service Expense | 35888519 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 591 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 477 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | OR | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | CHRISTY NIKOLA | NamePerson |
| Telephone Number | 5412014000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 280 MAPLE STREET | AddressLine1 |
| City | ASHLAND | City |
| State | OR | State |
| ZIP Code | 97520 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| DOUGLAS DIEL MD | |||||||
| CHAIR ELECT | 10.00 | X | X | 0 | 0 | 0 | |
| DOUGLAS GENTRY | |||||||
| PAST CHAIR | 5.00 | X | X | 0 | 0 | 0 | |
| ANNE GOLDEN | |||||||
| BOARD CHAIR | 10.00 | X | X | 0 | 0 | 0 | |
| MARIE DONOVAN | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| ALAN DEBOER | |||||||
| SECRETARY | 10.00 | X | X | 0 | 0 | 0 | |
| SAUNDRA THEIS | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| CAROL CHRISTLIEB | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| LINDA BUTLER | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| STEVE MINER | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| MARK MARCHETTI | |||||||
| FORMER CEO | 50.00 | X | X | 235297 | 0 | 25161 | |
| MIRIAM SORIANO | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| JOHN DELGADO | |||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| MARVIN HAAS | |||||||
| INTERIUM CEO | 50.00 | X | 0 | 0 | 0 | ||
| AGNIESKA DOBIECKA | |||||||
| HOSPITALIST | 40.00 | 213514 | 0 | 25144 | X | ||
| BETH LEONE | |||||||
| HOSPITALIST | 40.00 | 198062 | 0 | 20065 | X | ||
| DAVID CANDELARIA | |||||||
| HOSPITALIST | 40.00 | 212409 | 0 | 24914 | X | ||
| PAM ATOR | |||||||
| HOSPITALIST | 40.00 | 211384 | 0 | 6493 | X | ||
| MOLLEY GRAMLEY | |||||||
| PHYSICIAN PROVIDER | 30.00 | 189871 | 0 | 5332 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1260537 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 107109 | TotalOtherCompensation |
| Number Individuals GT100 K | 28 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| BE SMITH INC | |||||
| 9777 RIDGE DRIVE SUITE 300 | LENESA | KS | 66219 | TEMP STAFFING/RECRUITING | 955312 |
| ASHLAND ANESTHESIA ASSOCIATES | |||||
| 638 NORTH MAIN ST | ASHLAND | OR | 97520 | ANESTHESIA PROVIDERS | 603510 |
| ASHLAND EMERGENCY ASSOCITATES PC | |||||
| 1370 LITHIA WAY | TALENT | OR | 97540 | ER PHYSICIANS | 440635 |
| FAVORITE HEALTHARE STAFFING | |||||
| 825 NE MULTNOMAH SUITE 285 | PORTLAND | OR | 97232 | TEMP STAFFING/RECRUITING | 376819 |
| DIVERSIFIED CLINICAL SERVICES | |||||
| 4500 SALISBURY RD STE 300 | JACKONVILLE | FL | 32216 | MANAGEMENT/STAFFING WOUND CLINIC | 369878 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 11 | NumberOfContractorsGT100K |
| Government Grants | 7838 | GovernmentGrants |
| All Other Contributions | 427746 | AllOtherContributions |
| Total Contributions | 435584 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICARE/MEDICAID SERVICES | 621990 | 23443985 | 23443985 |
| HOSPITAL SERVICES | 621990 | 21105447 | 21105447 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 44549432 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 26613 | TotalRevenueColumn |
| Exclusion | $26,613 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | 83568 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | 0 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | 83568 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 83568 | TotalRevenueColumn |
| Exclusion | $83,568 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| NONPATIENT FOOD SALES | 722210 | 260293 | $260,293 |
| OTHER REVENUE | 900099 | 126929 | $126,929 |
| PASSTHROUGH INCOME | 621990 | 57479 | $57,479 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 444701 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 45539898 | TotalRevenueColumn |
| Related Or Exempt Function Income | 44549432 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $554,882 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 387866 | Total |
| Management And General | 387866 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20370623 | Total |
| Program Services | 15942572 | ProgramServices |
| Management And General | 4428051 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1381126 | Total |
| Program Services | 1061941 | ProgramServices |
| Management And General | 319185 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3162655 | Total |
| Program Services | 2450269 | ProgramServices |
| Management And General | 712386 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1603172 | Total |
| Program Services | 1232671 | ProgramServices |
| Management And General | 370501 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 347607 | Total |
| Management And General | 347607 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61660 | Total |
| Management And General | 61660 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7120382 | Total |
| Program Services | 4824739 | ProgramServices |
| Management And General | 2295643 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43840 | Total |
| Program Services | 1224 | ProgramServices |
| Management And General | 42616 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 776667 | Total |
| Program Services | 221157 | ProgramServices |
| Management And General | 555510 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 767723 | Total |
| Program Services | 110944 | ProgramServices |
| Management And General | 656779 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1061764 | Total |
| Program Services | 310018 | ProgramServices |
| Management And General | 751746 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 116877 | Total |
| Program Services | 97102 | ProgramServices |
| Management And General | 19775 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3036 | Total |
| Program Services | 365 | ProgramServices |
| Management And General | 2671 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 362315 | Total |
| Management And General | 362315 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2366884 | Total |
| Program Services | 1305591 | ProgramServices |
| Management And General | 1061293 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 289977 | Total |
| Management And General | 289977 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES AND EQ | 4502858 | 4499145 | 3713 |
| OTHER EXPENSES | 2314257 | 2074729 | 239528 |
| PHARMACEUTICAL DRUGS | 848829 | 848829 | |
| BAD DEBT | 841463 | 841463 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 133526 | Total |
| Program Services | 65760 | ProgramServices |
| Management And General | 67766 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48865107 | Total |
| Program Services | 35888519 | ProgramServices |
| Management And General | 12976588 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 603880 | BOY |
| EOY | 877106 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 603529 | BOY |
| EOY | 943568 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8336474 | BOY |
| EOY | 6301201 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120000 | BOY |
| EOY | 120000 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135411 | BOY |
| EOY | 146199 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1419732 | BOY |
| EOY | 1328667 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 500145 | BOY |
| EOY | 411585 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 50273162 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 28218624 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23366829 | BOY |
| EOY | 22054538 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 205310 | BOY |
| EOY | 223080 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2995404 | BOY |
| EOY | 2147263 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38286714 | BOY |
| EOY | 34553207 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6468896 | BOY |
| EOY | 6527615 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8438113 | BOY |
| EOY | 8136911 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 587019 | BOY |
| EOY | 400458 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15494028 | BOY |
| EOY | 15064984 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22570441 | BOY |
| EOY | 19097440 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 222245 | BOY |
| EOY | 390783 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22792686 | BOY |
| EOY | 19488223 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38286714 | BOY |
| EOY | 34553207 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -3325209 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 20745 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 306411 | OtherCostOrOtherBasis |
| Book Value | 306411 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 509382 | OtherCostOrOtherBasis |
| Depreciation | 291396 | Depreciation |
| Book Value | 217986 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 26983874 | OtherCostOrOtherBasis |
| Depreciation | 8860526 | Depreciation |
| Book Value | 18123348 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 20233095 | OtherCostOrOtherBasis |
| Depreciation | 16826302 | Depreciation |
| Book Value | 3406793 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2240400 | OtherCostOrOtherBasis |
| Depreciation | 2240400 | Depreciation |
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 22054538 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| RESTRICTED CASH | 1922929 |
| INVESTMENT IN JOINT VENTURE | 166084 |
| MISCELLANEOUS RECEIVABLES | 58250 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2147263 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED MEDICAL MALPRACTICE LIABILITY | $100,000 |
| CAPITAL LEASE OBLIGATIONS | $300,458 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 400458 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 44407834 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 20745 | NetUnrealizedGainsInvestments |
| Other Revenues | -841463 | OtherRevenues |
| Revenue Not Rptd F990 | -820718 | RevenueNotRptdF990 |
| Revenue Subtotal | 45228552 | RevenueSubtotal |
| Other Revenues Not Included | 311346 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 311346 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 45539898 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 48023643 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 48023643 | ExpensesSubtotal |
| Other Expenses Not Included | 841463 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 841463 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 48865106 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | THE HOSPITAL HAS ADOPTED GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE STANDARD REQUIRES THE HOSPITAL TO DETERMINE WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE HOSPITAL RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS A RESULT OF THE ADOPTION OF THE STANDARD. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE NETTED WITH REVENUE ON FINANCIAL STATEMENTS -841,463. | |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CAPITAL CONTRIBUTIONS AS NET ASSETS ON FINANCIAL STATEMENTS 311,346. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE NETTED WITH REVENUE ON FINANCIAL STATEMENTS 841,463. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent350 | X | Pcent350 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 971951 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 971951 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01990 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3903724 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4767633 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -863909 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4875675 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4767633 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 108042 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01990 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 343773 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 95088 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 248685 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00510 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3531 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3531 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6914192 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5608499 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1305693 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02670 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11022 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 11022 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7272518 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5703587 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1568931 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03210 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12148193 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10471220 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1676973 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05200 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2380 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2380 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2976 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2976 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 5252 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5252 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 20617 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 20617 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 37225 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 37225 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $841,464 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 10787939 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 17607399 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -6819460 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHLAND COMMUNITY HEALTHCARE SERVICES | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 280 MAPLE STREET | AddressLine1 |
| City | ASHLAND | City |
| State | OR | State |
| ZIP Code | 97520 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHLAND COMMUNITY HEALTHCARE SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 0 | ExplainsBasis |
| Explains Application Method | 0 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Other Actions Taken | X | OtherActionsTaken |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 4 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (4 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| CENTER FOR INTERNAL MEDICINE | ||||
| 530 CATALINA STREET | ASHLAND | OR | 97520 | INTERNAL MEDICINE CLINIC |
| CENTER FOR FAMILY MEDICINE | ||||
| 628 N MAIN STREET | ASHLAND | OR | 97520 | FAMILY MEDICINE CLINIC |
| CENTER FOR FAMILY MEDICINE | ||||
| 49 TALENT AVE | TALENT | OR | 97540 | FAMILY MEDICINE CLINIC |
| ACH AQUATIC THERAPY | ||||
| 540 YMCA WAY | ASHLAND | OR | 97520 | THERAPY CENTER |
Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)
| ExplanationExplanation | Return ReferenceReturnReference | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 7: THE AMOUNTS REPORTED IN PART I, LINE 7 WERE COMPUTED USING A RATIO OF COST TO CHARGES THAT WAS DERIVED FROM USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. | ||
| PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE THE EMERGENCY ROOM, OBSTETRICS, HOME HEALTH, HOSPICE, INTERNAL MEDICINE CLINIC, AND FAMILY PRACTICE CLINIC. | ||
| PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A,) BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $1,860,331. | ||
| ASHLAND COMMUNITY HOSPITAL PREPARES A COMMUNITY BENEFIT REPORT FOR THE STATE OF OREGON. | PART 1, LINE 6A | |
| PART II: IN LATE 2009, THE CITY OF ASHLAND CREATED AN ECONOMIC DEVELOPMENT COMMITTEE TO BRING TOGETHER BUSINESS LEADERS AND COMMUNITY REPRESENTATIVES FOR THE PURPOSE OF CREATING A COMPREHENSIVE ECONOMIC DEVELOPMENT STRATEGY FOR THE CITY. MEMBERS OF THE COMMITTEE WERE APPOINTED BY THE MAYOR. THE COMMITTEE IS CHAIRED BY A MEMBER OF ASHLAND CITY COUNCIL AND STAFF SUPPORT IS PROVIDED BY CITY PLANNING DEPARTMENT STAFF. THE COMMITTEE CONTINUED TO MEET THOUGHOUT CALANDER YEAR 2010 AND THE FIRST-HALF OF CALENDAR 2011. THE CHARGE TO THE ECONOMIC DEVELOPMENT COMMITTEE INCLUDED:- REVIEW OF CURRENT COUNCIL GOALS RELATED TO ECONOMIC DEVELOPMENT- CONSIDERATION OF CITY GOVERNMENT'S ROLE IN ECONOMIC DEVELOPMENT- IDENTIFICATION OF OVERALL GOALS FOR ECONOMIC DEVELOPMENT- IDENTIFICATION OF SPECIFIC ACTIONS/TACTICS TO REACH IDENTIFIED GOALSTHE ECONOMY OF ASHLAND IS LARGELY DRIVEN BY TOURISM, BASED ON THE PRESENCE OF THE OREGON SHAKESPEARE FESTIVAL, AND TO A LESSER EXTENT BY THE AVAILABILITY OF A WIDE RANGE OF OUTDOOR ACTIVITIES SUCH AS SKIING, WHITE WATER RAFTING, AND FISHING. THESE ARE SEASONAL ACTIVITIES SUPPORTING RELATIVELY LOW-PAID, SEASONAL, SERVICE SECTOR JOBS. THE GOAL OF CITY ECONOMIC DEVELOPMENT EFFORTS IS TO DIVERSIFY THE ECONOMY, REDUCE SEASONAL FLUCTUATIONS IN ECONOMIC ACTIVITY, AND CREATE A STABLE BASE OF HIGHER-WAGE PROFESSIONAL AND TECHNICAL JOBS. ASHLAND COMMUNITY HOSPITAL IS THE CITY'S THIRD LARGEST EMPLOYER. THE HOSPITAL IS BOTH A SIGNIFICANT CONTRIBUTOR TO AND RELIANT ON THE CITY'S ECONOMIC WELL BEING. SINCE A HEALTHY AND SUSTAINABLE ECONOMY IS CRITICAL TO THE HEALTH AND WELL BEING OF ANY COMMUNITY, THE HOSPITAL CONTRIBUTES TO THE CITY'S COMMUNITY DEVELOPMENT EFFORTS AS PART OF ITS LARGER MISSION OF IMPROVING THE OVERALL HEALTH OF THE COMMUNITY.ASHLAND COMMUNITY HOSPITAL PROVIDES SEVERAL COMMUNITY HEALTH IMPROVEMENT ACTIVITIES THROUGHOUT THE YEAR INCLUDING CLASSES FOR NEW PARENTS AND SIBLINGS, CONSULTING WITH THE LOCAL SCHOOLS ON CARBOHYDRATES COUNTING, IN-SERVICES ON A MULTITUDE OF TOPICS AT THE ASSISTED LIVING CENTERS, PARTICIPATION AT LOCAL HEALTH FAIRS, AND GRIEF SUPPORT GROUPS. ALL OF THESE ACTIVES PROMOTE BETTER HEALTH HABITS, A BETTER UNDERSTANDING OF HEALTH RELATED ISSUES AND GUIDANCE ON HOW TO LIVE A HEALTHIER LIFE.ASHLAND COMMUNITY HOSPITAL ALSO PROVIDES SOME FINANCIAL SUPPORT FOR LIKE MINDED NON-PROFIT ORGANIZATIONS IN OUR AREA. THESE DONATIONS HELP TO SUPPORT A VARIETY OF ISSUES LIKE CHILD WELFARE, COMMUNITY OUTREACH PROGRAMS, SUPPORT FOR SEXUAL/PHYSICAL ABUSE VICTIMS, AND OTHER LOCAL HEALTHCARE PROVIDERS.ASHLAND COMMUNITY HOSPITAL ALSO PROVIDES MENTORING PROGRAMS IN THE MEDICAL/SURGICAL, EMERGENCY, SAME DAY SURGERY, RADIOLOGY, AND LABORATORY DEPARTMENTS. THIS EXPERIENCE PROVIDES REAL WORLD, HANDS ON EXPERIENCE FOR MEDICAL STUDENTS. | ||
| PART III, LINE 4: THE FOLLOWING IS FROM THE "PATIENT ACCOUNTS RECEIVABLES, NET" PARAGRAPH IN NOTE 1 OF THE HOSPITAL'S FINANCIAL STATEMENTS: "THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE SELF-PAY AND MISCELLANEOUS COMMERCIAL INSURANCE ACCOUNTS. PATIENTS ARE NOT REQUIRED TO PROVIDE COLLATERAL FOR SERVICES RENDERED. PAYMENT FOR SERVICES IS REQUIRED UPON RECEIPT OF AN INVOICE, AFTER PAYMENT BY INSURANCE, IF ANY. SELF-PAY ACCOUNTS ARE ANALYZED FOR COLLECTABILITY BASED ON THE MONTHS PAST DUE AND PAYMENT HISTORY. AN ALLOWANCE IS ESTIMATED FOR THESE ACCOUNTS BASED ON THE HISTORICAL EXPERIENCE OF THE HOSPITAL. ACCOUNTS THAT ARE DETERMINED TO BE UNCOLLECTIBLE ARE SENT TO A COLLECTION AGENCY AND WRITTEN OFF AT THAT TIME."THE AMOUNT OF BAD DEBT EXPENSE REPORTED IN PART III, LINE 2 IS CALCULATED AS FOLLOWS: PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD PARTY PAYORS. | ||
| PART III, LINE 8: OVER THE PAST 20 YEARS, THE POPULATION OF ASHLAND HAS AGED CONSIDERABLY AS THE CITY HAS GAINED THE REPUTATION AS A DESIRABLE "RETIREMENT" COMMUNITY. THIS IS EVIDENCED BY THE CLOSURE OF TWO OF THE CITY'S FIVE ELEMENTARY SCHOOLS WITHIN THE PAST TEN YEARS AND THE SIGNIFICANT INCREASE IN THE PERCENTAGE OF THE HOSPITAL'S REVENUE THROUGH THE MEDICARE PROGRAM FROM 40% IN 2003-2004 TO 54.1% TODAY. THIS SHIFT IN PAYOR MIX HAS HAD A SIGNIFICANT NEGATIVE IMPACT ON THE HOSPITAL'S FINANCIAL PERFORMANCE, RESULTING IN A NEGATIVE OPERATING MARGIN. WHILE THE INCREASED RELIANCE ON REIMBURSEMENT THROUGH THE MEDICARE PROGRAM HAS CREATED FINANCIAL STRESS FOR THE ORGANIZATION, THE HOSPITAL REMAINS COMMITTED TO ITS MISSION OF MEETING THE HEALTH CARE NEEDS OF ITS COMMUNITY. THE HOSPITAL CREATED THE ACH CENTER FOR INTERNAL MEDICINE AND ACH CENTER FOR FAMILY MEDICINE, A PROVIDER-BASED CLINICS TO ADDRESS THE LACK OF ACCESS TO PRIMARY CARE FOR MEDICARE RECIPIENTS. DESPITE ENHANCED REIMBURSEMENT FROM MEDICARE AS A PROVIDER-BASED MODEL, THE CLINICS OPERATES AT A LOSS. SIMILARLY, THE HOSPITAL PROVIDES HOME HEALTH AND HOSPICE SERVICES, BOTH AT NEGATIVE MARGIN, YET BOTH VALUABLE SERVICES TO THE COMMUNITY. OTHER OF THE HOSPITAL'S SERVICES HEAVILY DEPENDENT ON REIMBURSEMENT THROUGH THE MEDICARE PROGRAM, SUCH AS ORTHOPEDIC JOINT REPLACEMENT AND RETINA SURGERY, RESULT IN NEGATIVE MARGINS BUT CONTINUE TO BE PROVIDED BY THE HOSPITAL BECAUSE THEY ARE CONSIDERED VITAL TO "THE OVERALL HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITY" CONSISTENT WITH THE HOSPITAL'S MISSION. BY PROVIDING THESE SERVICES TO THE MEDICARE POPULATION AND IN COMES CASES EVEN TARGETING THE MEDICARE POPULATION FOR SERVICES, THE HOSPITAL ENSURES THAT WE ARE MEETING THE NEEDS OF OUR COMMUNITY. IF THE HOSPITAL WERE TO ELIMINATE OR REDUCES THESE SERVICES WE WOULD NOT SUSTAIN SUCH A SHORTFALL, BUT THE COMMUNITY WOULD SUFFER AT THE LOSS OF THESE SERVICES AND HAVE TO TRAVEL OUTSIDE ASHLAND TO TRY AND RECEIVE CARE. | ||
| PART III, LINE 9B: THE HOSPITAL HAS A WRITTEN DEBT COLLECTION POLICY. THE POLICY DOES NOT CONTAIN PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. | ||
| PART V, SECTION B, LINE 3: AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACTS REQUIREMENT TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS, ASANTE HEALTH SYSTEM OF MEDFORD, OREGON AND ASHLAND COMMUNITY HOSPITAL PARTNERED TO COMPLETE 600 COMMUNITY SURVEYS IN FISCAL YEAR 2012. THAT YEAR, WE ALSO HELD A FOCUS GROUP COMPRISED OF 12 KEY COMMUNITY LEADERS FROM JACKSON AND JOSEPHINE COUNTIES. THE FOCUS GROUP DISCUSSED THE INDIVIDUAL LEADERS' EXPERIENCES AND PERCEPTIONS OF THE TOP HEALTH CONCERNS IN OUR COMMUNITY. ALSO REQUIRED IS THE DEVELOPMENT AND EXECUTION OF AN IMPLEMENTATION STRATEGY TO ADDRESS THESE CONCERNS. | ASHLAND COMMUNITY HEALTHCARE SERVICES | |
| PART V, SECTION B, LINE 4: THE COMMUNITY NEEDS ASSESSMENT WAS DONE IN CONJUNCTION WITH ROGUE REGIONAL MEDICAL CENTER OF MEDFORD, OREGON AND THREE RIVERS MEDICAL CENTER OF GRANTS PASS, OREGON. | ASHLAND COMMUNITY HEALTHCARE SERVICES | |
| PART V, SECTION B, LINE 19C: ASHLAND COMMUNITY HOSPITAL PROVIDES A FLAT 30% DISCOUNT TO INDIVIDUALS THAT DO NOT HAVE ANY INSURANCE COVERAGE. THIS IS AN AUTOMATIC DISCOUNT THAT DOES NOT NEED TO BE APPLIED FOR BY THE PATIENT. THE 30% WAS DETERMINED BY LOOKING AT OUR CONTRACTED RATES WITH OUR INSURANCE RATES, DETERMINING THE LOWEST NEGOTIATED RATE, THEN INCREASING SEVERAL PERCENTAGE POINTS TO ENSURE COMPLIANCE AND PROVIDING ADDITIONAL BENEFIT FOR PATIENTS. | ASHLAND COMMUNITY HEALTHCARE SERVICES | |
| PART VI, LINE 2: ASHLAND COMMUNITY HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES THROUGH ITS PLANNING PROCESSES, INCLUDING THE LONG-RANGE STRATEGIC PLAN, MEDICAL STAFF DEVELOPMENT PLAN, MARKETING PLAN, AND PROGRAM/BUSINESS PLANNING. PLANNING INPUTS INCLUDE: SERVICE AREA DEMOGRAPHICS INCLUDING POPULATION AND AGE PROJECTIONS; MEDICAL STAFF INTERVIEW FINDINGS; MEDICAL STAFF COMPOSITION, PRACTICE PATTERNS, AND AGE TO PROJECT PROVIDER NEEDS BY SPECIALTY; CURRENT AND HISTORIC SERVICE VOLUMES AND TRENDS; COMMUNITY PERCEPTION SURVEY DATA; MARKET SHARE ANALYSIS; COMPETITOR POSITIONS; PATIENT SURVEY DATA; COMMUNITY INPUT THROUGH THE BOARD OF DIRECTORS; AND FOCUS GROUPS OF FORMER PATIENTS AND COMMUNITY MEMBERS. | ||
| PART VI, LINE 3: ASHLAND COMMUNITY HOSPITAL EDUCATES PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE IN A NUMBER OF WAYS. THERE ARE SIGNS POSTED IN ADMITTING AREAS THAT ADVISE PATIENTS OF OUR CHARITY CARE POLICY. OHP APPLICATIONS ARE GIVEN TO ANYONE UNDER THE AGE OF 18 THAT PROCESSES THROUGH THE E.R. STATEMENTS ADVISE PATIENTS THAT THEY MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE AND THE PHONE NUMBER TO CONTACT FOR FURTHER INFORMATION. MEETINGS ARE HELD AT LOCAL PHYSICIAN OFFICES TO INFORM THEM OF OUR FINANCIAL ASSISTANCE PROGRAMS SO THEY MAY PASS THE INFORMATION ALONG TO THEIR PATIENTS. PATIENTS ARE ALSO NOTIFIED OF FINANCIAL OPTIONS WHEN SPEAKING WITH OUR PATIENT ACCOUNTS OFFICE. ASHLAND COMMUNITY HOSPITAL ALSO INCLUDES THE FINANCIAL ASSITINCE POLICY AND NECESSARY FORMS ON ITS WEBSITE. | ||
| PART VI, LINE 4: ASHLAND COMMUNITY HOSPITAL IS A 49-BED ACUTE CARE COMMUNITY HOSPITAL LOCATED IN ASHLAND, OREGON, A COMMUNITY OF APPROXIMATELY 20,000 RESIDENTS LOCATED IN THE SOUTHERN-MOST PART OF THE STATE, APPROXIMATELY 15 MILES FROM THE CALIFORNIA BORDER. FOUNDED IN 1907, ASHLAND COMMUNITY HOSPITAL EXISTS TODAY AS A PRIVATE, NON-PROFIT 501-C-3 CORPORATION. GOVERNANCE OF THE ORGANIZATION IS PROVIDED BY A 12-MEMBER BOARD OF DIRECTORS, APPOINTED BY THE ASHLAND CITY COUNCIL, WHO VOLUNTEER THEIR TIME AND EXPERTISE ON BEHALF OF THE COMMUNITY. THE HOSPITAL IS ACCREDITED BY DNV HEALTHCARE INC AND IS CERTIFIED FOR PARTICIPATION IN THE MEDICARE PROGRAM.ASHLAND COMMUNITY HOSPITAL PROVIDES A WIDE RANGE OF HEALTH CARE AND RELATED SERVICES AS DEEMED APPROPRIATE IN ACCORDANCE WITH THE HOSPITAL'S MISSION, VISION AND STRATEGIC PLANS, AVAILABLE RESOURCES, COMMUNITY NEED, FEDERAL AND STATE LAW AND REGULATION AND PROFESSIONAL PRACTICE STANDARDS. THESE SERVICES INCLUDE INPATIENT AND OUTPATIENT CARE, EMERGENCY CARE, DIAGNOSTIC AND TREATMENT SERVICES, HOME HEALTH AND HOSPICE CARE, AND HEALTH OUTREACH SERVICES. ASHLAND COMMUNITY HOSPITAL DEFINES ITS PRIMARY SERVICES AREAS AS THE COMMUNITIES OF ASHLAND AND TALENT AND AREAS SOUTH TO THE CALIFORNIA BORDER, COMPRISED OF POSTAL ZIP CODES 97520 AND 97540, WITH A POPULATION OF APPROXIMATELY 35,000. THE SECONDARY SERVICE AREA INCLUDES THE COMMUNITIES OF PHOENIX AND MEDFORD NORTH OF ASHLAND, WITH POSTAL ZIP CODES 97504, 97501, AND 97535 AND A POPULATION OF APPROXIMATELY 92,000. THE HOSPITAL DRAWS FROM A BROADER GEOGRAPHIC AREA FOR CERTAIN SPECIALTY SERVICES NOT WIDELY AVAILABLE, INCLUDING COMPREHENSIVE WOUND CARE AND RETINA SURGERY.THE POPULATION OF THE HOSPITAL'S PRIMARY SERVICE IS PROJECTED TO INCREASE BY APPROXIMATELY 6.3% OVER THE FIVE YEAR PERIOD 2009-2014. SIMILARLY, THE POPULATION OF THE SECONDARY SERVICE AREA IS PROJECTED TO INCREASE BY 6.7% OVER THE SAME PERIOD. ALMOST 50% OF THE POPULATION GROWTH IN BOTH THE PRIMARY AND SECONDARY SERVICE AREAS IS PROJECTED TO OCCUR IN THE 65+ AGE COHORT. THE SIGNIFICANT INCREASE IN THE PORTION OF THE HOSPITAL'S TOTAL REVENUE DERIVING FROM THE MEDICARE PROGRAM, FROM APPROXIMATELY 40% OF GROSS REVENUE IN 2004 TO 54% IN 2013, SUPPORTS THESE PROJECTIONS. | ||
| PART VI, LINE 5: AS A NON-PROFIT, MISSION DRIVEN ORGANIZATION, ASHLAND COMMUNITY HOSPITAL IS COMMITTED TO THE PROVISION OF COMPASSIONATE, HIGH-QUALITY CARE THAT IMPROVES THE OVERALL HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITY AND TO THE FURTHERANCE OF ITS EXEMPT PURPOSE. 1. THE HOSPITAL MAINTAINS A CURRENT STRATEGIC PLAN TO GUIDE THE LONG-TERM STRATEGIC DIRECTION OF THE HOSPITAL TO BEST MEET THE NEEDS OF THE COMMUNITY. 2. THE HOSPITAL'S MEDICAL STAFF IS OPEN TO ANY PHYSICIAN OR ALLIED HEALTH PROVIDER WHO IS LICENSED IN THE STATE OF OREGON AND ABLE TO DEMONSTRATE CURRENT COMPETENCE.3. THE HOSPITAL HAS CREATED A MEDICAL STAFF DEVELOPMENT PLAN TO DEFINE THE NUMBER AND TYPES OF PHYSICIANS NEEDED TO MEET COMMUNITY NEED. THE PLAN IS UPDATED ON A REGULAR BASIS. 4. THE HOSPITAL'S PHYSICIAN RECRUITMENT SUPPORT PROGRAM PROVIDES FINANCIAL ASSISTANCE FOR NEW PHYSICIANS ESTABLISHING PRACTICES WITHIN THE COMMUNITY, WITHIN THE CONSTRAINTS OF FEDERAL LAW AND REGULATION.5. IN 2008, THE HOSPITAL ESTABLISHED THE ASHLAND CENTER FOR INTERNAL MEDICINE TO ADDRESS ACCESS ISSUES FOR MEDICARE PATIENTS. ADDITIONAL PHYSICIANS ARE ADDED TO THE CLINICS AS PATIENT NEED INCREASES. 6. THE HOSPITAL MAINTAINS A PHYSICIAN HOSPITALIST PROGRAM TO SUPPORT THE AVAILABILITY OF IN-PATIENT CARE, AT A NET COST OF APPROXIMATELY $600,000 PER YEAR. 7. HOSPITAL GOVERNANCE IS PROVIDED BY A 13-MEMBER BOARD OF DIRECTORS, APPOINTED BY THE ASHLAND CITY COUNCIL. DIRECTORS OF ARE MEMBERS OF THE HOSPITAL'S SERVICE AREA AND RECEIVE NO COMPENSATION FOR THEIR SERVICES.8. THROUGH THE HOSPITAL AND ITS FOUNDATION, FUNDS ARE USED TO SUPPORT A VARIETY OF HEALTH AND RELATED COMMUNITY ORGANIZATIONS AND ACTIVITIES INCLUDING HEALTH CARE COALITION-VOLPACT PROGRAM AND HEART AND VINES.9. THE HOSPITAL OPERATES HEALTH CLINICS IN MIDDLE-SCHOOLS AND HIGH SCHOOLS IN ASHLAND AND TALENT.10. THROUGH FUNDING, IN KIND CONTRIBUTIONS, AND/OR STAFF PARTICIPATION THE HOSPITAL SUPPORTS A VARIETY OF COMMUNITY ACTIVITIES SUCH AS THE 4TH OF JULY CELEBRATION AND HOLIDAY FESTIVAL OF LIGHTS.11. THE HOSPITAL'S TUITION REIMBURSEMENT PROGRAM PROVIDES EMPLOYEES UP TO $3,000 PER SCHOOL YEAR FOR TUITION, BOOKS AND FEES THEREBY SUPPORTING THE DEVELOPMENT OF NEEDED HEALTH CARE PROFESSIONALS.12. THE HOSPITAL SUPPORTS A MONTHLY MEDICAL EDUCATION PROGRAM FOR MEMBERS OF THE MEDICAL STAFF.13. THE HOSPITAL'S CHARITY CARE PROGRAM PROVIDES FINANCIAL ASSISTANCE TO ASSIST WITH MEDICAL EXPENSES.14. THE HOSPITAL PARTICIPATES IN THE VOLPACT PROGRAM, A PATIENT FINANCIAL AIDE PROGRAM SPONSORED BY THE JACKSON COUNTY MEDICAL SOCIETY. | ||
| OR | PART VI, LINE 7 | REPORTS FILED WITH STATES |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 0 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK MARCHETTI | ||||||||||||||
| FORMER CEO | 224759 | 0 | 0 | 0 | 10538 | 0 | 6384 | 0 | 18777 | 0 | 260458 | 0 | 0 | 0 |
| AGNIESKA DOBIECKA | ||||||||||||||
| HOSPITALIST | 207508 | 0 | 0 | 0 | 6006 | 0 | 5885 | 0 | 19259 | 0 | 238658 | 0 | 0 | 0 |
| BETH LEONE | ||||||||||||||
| HOSPITALIST | 191508 | 0 | 0 | 0 | 6554 | 0 | 5947 | 0 | 14118 | 0 | 218127 | 0 | 0 | 0 |
| DAVID CANDELARIA | ||||||||||||||
| HOSPITALIST | 210818 | 0 | 0 | 0 | 1591 | 0 | 5788 | 0 | 19126 | 0 | 237323 | 0 | 0 | 0 |
| PAM ATOR | ||||||||||||||
| HOSPITALIST | 201574 | 0 | 0 | 0 | 9810 | 0 | 6224 | 0 | 269 | 0 | 217877 | 0 | 0 | 0 |
| MOLLEY GRAMLEY | ||||||||||||||
| PHYSICIAN PROVIDER | 161834 | 0 | 0 | 0 | 28037 | 0 | 5131 | 0 | 201 | 0 | 195203 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | MARK MARCHETTI, DAVID CANDELARIA AND BETH LEONE RECEIVED HELATH CLUB REIMBURSEMENT OF $111, $300 AND $63 RESPECTIVELY. |
| PART I, LINE 4A | MARK MARCHETTI RECEIVED SEVERANCE PAYMENT OF $101,130 FROM ASLAND COMMUNITY HEALTHCARE SERVICES. |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MARK MARCHETTI | NamePerson |
| Purpose Of Loan | HOUSE LOAN | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $120,000 | OriginalPrincipalAmount |
| Balance Due | 120000 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 120000 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | MANAGEMENT CONTRACT INITIATED WITH ASANTE HEALTH SYSTEM FOR CEO, DIRECTOR OF HR AND ACUTE CARE DIRECTOR. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS ONE MEMBER, THE CITY OF ASHLAND. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION'S MEMBER HAS THE AUTHORITY AND RESPONSIBILITY TO APPOINT, AND REMOVE FOR CAUSE, THE ORGANIZATION'S DIRECTORS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ORGANIZATION'S MEMBER HAS THE AUTHORITY AND RESPONSIBILITY TO APPROVE OR DISAPPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION WHICH HAVE BEEN PROPOSED OR CONCURRED IN BY THE BOARD. THE MEMBER ALSO HAS THE AUTHORITY TO DISSOLVE THE CORPORATION IN THE EVENT OF AN UNCURED BREACH BY THE CORPORATION IN THE FACILITIES LEASE TO WHICH THE CITY AND THE CORPORATION ARE PARTIES. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FINANCE COMMITTEE REVIEWS FORM 990 AND A COPY IS SENT OUT TO THE FULL BOARD PRIOR TO FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY DOING AN ANNUAL REVIEW OF THE POLICY AND OBTAINING NEW ACKNOWLEDGEMENT SIGNATURES ON THE POLICY BY THE BOARD OF DIRECTORS. THE ORGANIZATION FOLLOWS UP ON ANY POTENTIAL CONFLICT AS NEEDED. WHENEVER ANY DIRECTOR FIRST BECOMES AWARE THAT HE OR SHE HAS OR MAY HAVE ANY CONFLICT OF INTEREST, THAT DIRECTOR MUST PROMPTLY DISCLOSE THE EXISTENCE OF THAT CONFLICT TO THE BOARD OF DIRECTORS. FULL DISCLOSURE OF ALL MATERIAL FACTS CONCERNING THE CONFLICT IS ENCOURAGED, AND DISCLOSURE WILL BE DULY RECORDED IN THE BOARD MINUTES. IF THE DIRECTOR MAKES FULL DISCLOSURE AS DESCRIBED ABOVE, THE DIRECTOR MAY THEREAFTER ENGAGE IN ANY DISCUSSION ON THE MATTER AND MAY VOTE, UNLESS THE BOARD OF DIRECTORS BELIEVES THAT THE NATURE AND EXTENT OF THE CONFLICT OF INTEREST WARRANTS THE DIRECTOR'S EXCLUSION FROM EITHER OR BOTH OF THE DISCUSSION AND VOTE. IF THE DIRECTOR DOES NOT MAKE FULL DISCLOSURE, HE OR SHE THEREAFTER MUST LEAVE THE MEETING ROOM DURING ANY DISCUSSION OR VOTE ON THE MATTER. | |
| FORM 990, PART VI, SECTION B, LINE 15A | THE CEO'S COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS. THE VP OF HUMAN RESOURCES GATHERS WAGE AND BENEFIT DATA FROM THE OREGON HOSPITAL ASSOCIATION SALARY SURVEY (WAGE WATCH) AND THE NORTHWEST HOSPITAL EXECUTIVE SURVEY CONDUCTED BY OLNEY ASSOCIATES, INC. THE DATA IS PROVIDED TO THE BOARD CHAIR AND REVIEWED BY THE EXECUTIVE COMMITTEE. THE BOARD THEN DETERMINES THE COMPENSATION FOR THE CEO. COMPENSATION FOR THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES IS BASED ON THE OREGON HOSPITAL ASSOCIATION SALARY SURVEY (WAGE WATCH) AND LOCAL SURVEYS. THE VP OF HUMAN RESOURCES MAKES A RECOMMENDATION TO THE CEO FOR ALL ADJUSTMENTS TO SALARY RANGES. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. | |
| FORM 990, PART IX, LINE 11G | OTHER PROFESSIONAL SERVICE: PROGRAM SERVICE EXPENSES 4,824,739. MANAGEMENT AND GENERAL EXPENSES 2,295,643. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,120,382. | OTHER FEES |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHLAND COMMUNITY HOSPITAL FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 280 MAPLE STREET | AddressLine1 |
| City | ASHLAND | City |
| State | OR | State |
| ZIP Code | 97520 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930691238 | EIN |
| Primary Activities | SUPPORT ASHLAND COMMUNITY HOSPITAL | PrimaryActivities |
| Legal Domicile State | OR | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 7 | PublicCharityStatus |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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