FURP.ORG / PUBLIC DATA EXPLORER

SOUTH PENINSULA HOSPITAL INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SOUTH PENINSULA HOSPITAL INC (EIN 92-0037099)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-01-23
IRS object ID
201440239349300129
Schema version
2012v2.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-01-23T12:26:29-07:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN920037099EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOUTH PENINSULA HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSOUTNameControl
Phone9072358101Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14300 Bartlett StreetAddressLine1
CityHomerCity
StateAKState
ZIP Code99603ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRobert LetsonName
TitleCEOTitle
Phone9072350324Phone
Date Signed2014-01-08DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1South Peninsula HospitalBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14300 Bartlett StAddressLine1
CityHomerCity
StateAKState
ZIP Code99603ZIPCode
FieldValueIRS element (for citing)
Gross Receipts50840652GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.sphosp.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1969YearFormation
State Legal DomicileAKStateLegalDomicile
Activity Or Mission DescriptionSouth Peninsula Hospital promotes community health and wellness by providing personalized, high quality, locally coordinated healthcare.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees412TotalNbrEmployees
Total Nbr Volunteers40TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3750708ContributionsGrantsPriorYear
Contributions Grants Current Year4643740ContributionsGrantsCurrentYear
Program Service Revenue Prior Year39302350ProgramServiceRevenuePriorYear
Program Service Revenue CY46171122ProgramServiceRevenueCY
Investment Income Prior Year669InvestmentIncomePriorYear
Investment Income Current Year20790InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year43053727TotalRevenuePriorYear
Total Revenue Current Year50835652TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year23461645SalariesEtcPriorYear
Salaries Etc Current Year30165231SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year17352512OtherExpensePriorYear
Other Expenses Current Year19285368OtherExpensesCurrentYear
Total Expenses Prior Year40814157TotalExpensesPriorYear
Total Expenses Current Year49450599TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2239570RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1385053RevenuesLessExpensesCY
Total Assets BOY62058947TotalAssetsBOY
Total Assets EOY63920463TotalAssetsEOY
Total Liabilities BOY25097068TotalLiabilitiesBOY
Total Liabilities EOY25573531TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY36961879NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY38346932NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSouth Peninsula Hospital promotes community health and wellness by providing personalized, high quality, locally coordinated healthcare.MissionDescription
Significant New Program Services1SignificantNewProgramServices
Significant Change0SignificantChange
Expense26652661Expense
Grants0Grants
Revenue32490497Revenue
DescriptionOur 22 bed hospital provided inpatient services to 1034 patients for total patient days of 3,349 for the 2012 tax year. Total outpatient visits for the year were 19,113 and include 6,690 emergency department visits, 1,240 ambulatory surgery visits, and 4,582 imaging visits. Other outpatient services include laboratory, physical therapy, occupational therapy, infusion and chemotherapy, and sleep lab.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense4236001Expense
Grants0Grants
Revenue6863599Revenue
DescriptionOur Long Term Care facility served 34 residents during the 2012 tax year with an average daily census of 26 and total resident days of 9,348.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense6564876Expense
Grants0Grants
Revenue5901532Revenue
DescriptionThe hospital acquired an established family practice clinic during the 2012 tax year adding to the provider-based clinics established in 2011. The clinics had 17,629 patient visits during the 1021 tax year.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense1136097Expense
Grants0Grants
Revenue915494Revenue
DescriptionOur community health services department provides home health care, chore and respite services, and other home care services to more than 300 local residents. 3,276 visits were made to client homes in the 2012 yax year. Other program services include revenue from cafeteria and vendings machines, medical record copies, and other program related sources.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp1136097TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev915494TotalOfOtherProgramServiceRev
Total Program Service Expense38589635TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096114NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees412NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1South Peninsula HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9072358101TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14300 Bartlett StreetAddressLine1
CityHomerCity
StateAKState
ZIP Code99603ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
Julie Woodworth
Director3X180000
Kelly Cooper
Director2.5X120000
Clyde Boyer
Director3X120000
Thomas Clark
Director3X120000
Susan Drathman
Director2X120000
Matthew Hambrick
Director2X120000
Vickey Hodnick
Director6X120000
Matthew North
Director2X120000
Bernadette Wilson
Director3.5X120000
M Todd Boling DO
Director2.5X000
Robert F Letson
Chief Executive Officer501585650488130X
Lori Meyer
Chief Financial Officer45123025051194X
Brent Adcox
Medical Doctor40861003099317X
Larry R Tripp
CRNA40294649034865X
Gregory Hough
Medical Doctor40253154035993X
Shara Sutherlin
Director of Patient Care Services40146798034906X
Douglas Duncan
Pharmacy Manager40146139048764X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1994733TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation353852TotalOtherCompensation
Number Individuals GT100 K19NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Peak Imaging
4438 Towne Heights LnHomerAK99603Radiologist946414
Eris Radiology LLC
PO Box 2434HomerAK99603Radiologists348479
James Peterson
PO Box 58HomerAK99603Anesthesiologist295066
Raymond Fowler
40914 Crested Crane StHomerAK99603Anesthesiologist271984
Paul Raymond
4201 Bartlett St Unit 2HomerAK99603Emergency Physician235058
FieldValueIRS element (for citing)
Number Of Contractors GT100 K12NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants4532213GovernmentGrants
All Other Contributions111527AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions4643740TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Hospital62200032490497324904970$0
Long Term Care623000686359968635990$0
Physician Clinics621111590153259015320$0
Community Health Services6216106834436834430$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column232051TotalRevenueColumn
Related Or Exempt Function Income232051RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue46171122TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column10790TotalRevenueColumn
Related Or Exempt Function Income10790RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities0Securities
Other15000Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other5000Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other10000Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column10000TotalRevenueColumn
Related Or Exempt Function Income10000RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column50835652TotalRevenueColumn
Related Or Exempt Function Income46191912RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total318693Total
Program Services0ProgramServices
Management And General318693ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total21232522Total
Program Services17109109ProgramServices
Management And General4123413ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1276473Total
Program Services1021178ProgramServices
Management And General255295ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5799073Total
Program Services4595569ProgramServices
Management And General1203504ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1538470Total
Program Services1230776ProgramServices
Management And General307694ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total90164Total
Program Services90164ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total309837Total
Program Services0ProgramServices
Management And General309837ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total40467Total
Program Services0ProgramServices
Management And General40467ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5852720Total
Program Services4783257ProgramServices
Management And General1069463ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total138344Total
Program Services0ProgramServices
Management And General138344ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4681897Total
Program Services4142885ProgramServices
Management And General539012ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total552140Total
Program Services140278ProgramServices
Management And General411862ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1852973Total
Program Services336048ProgramServices
Management And General1516925ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total190930Total
Program Services110478ProgramServices
Management And General80452ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total186120Total
Program Services132183ProgramServices
Management And General53937ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total816777Total
Program Services816504ProgramServices
Management And General273ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2709036Total
Program Services2709036ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total564806Total
Program Services564806ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Repairs and Maintenance10881717661253220460
Dues Books Subscriptions210986412391697470

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total49450599Total
Program Services38589635ProgramServices
Management And General10860964ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2104BOY
EOY2104EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY7923929BOY
EOY6541240EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7712530BOY
EOY11359519EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1213604BOY
EOY1484407EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1065947BOY
EOY1020856EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis75772199LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec32627619LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY43733354BOY
EOY43144580EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY407479BOY
EOY367757EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY62058947BOY
EOY63920463EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5261363BOY
EOY6957606EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY298655BOY
EOY286112EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY19338987BOY
EOY18194344EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY198063BOY
EOY135469EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY25097068BOY
EOY25573531EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY36936593BOY
EOY38321646EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY25286BOY
EOY25286EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY36961879BOY
EOY38346932EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY62058947BOY
EOY63920463EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses1385053ReconcilationRevenueExpenses
Reconciliation Unrealized Invest0ReconciliationUnrealizedInvest
Reconcilation Donated Services0ReconcilationDonatedServices
Reconcilation Invest Expenses0ReconcilationInvestExpenses
Reconcilation Prior Adjustment0ReconcilationPriorAdjustment
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis188508OtherCostOrOtherBasis
Book Value188508BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis56712410OtherCostOrOtherBasis
Depreciation19625385Depreciation
Book Value37087025BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis80470OtherCostOrOtherBasis
Depreciation23641Depreciation
Book Value56829BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis17835660OtherCostOrOtherBasis
Depreciation12978593Depreciation
Book Value4857067BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis955151OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value955151BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings43144580TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO KENAI PENINSULA BOROUGHDescription
Amount$135,469Amount
FieldValueIRS element (for citing)
Total Of Amounts135469TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt50835652TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal50835652RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99050835652TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt49450599TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal49450599ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99049450599TotalExpensesPerForm990

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense924676TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense924676NetCommunityBenefitExpense
Percent Of Total Expense0.019PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense12374778TotalCommunityBenefitExpense
Direct Offsetting Revenue12817393DirectOffsettingRevenue
Net Community Benefit Expense-442615NetCommunityBenefitExpense
Percent Of Total Expense0PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense13299454TotalCommunityBenefitExpense
Direct Offsetting Revenue12817393DirectOffsettingRevenue
Net Community Benefit Expense482061NetCommunityBenefitExpense
Percent Of Total Expense0.019PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense104339TotalCommunityBenefitExpense
Direct Offsetting Revenue20709DirectOffsettingRevenue
Net Community Benefit Expense83549NetCommunityBenefitExpense
Percent Of Total Expense0.002PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense186120TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense186120NetCommunityBenefitExpense
Percent Of Total Expense0.003PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense617648TotalCommunityBenefitExpense
Direct Offsetting Revenue543168DirectOffsettingRevenue
Net Community Benefit Expense74480NetCommunityBenefitExpense
Percent Of Total Expense0.0015PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense18908TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense18908NetCommunityBenefitExpense
Percent Of Total Expense0.0003PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense927015TotalCommunityBenefitExpense
Direct Offsetting Revenue563877DirectOffsettingRevenue
Net Community Benefit Expense363057NetCommunityBenefitExpense
Percent Of Total Expense0.0068PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense14226469TotalCommunityBenefitExpense
Direct Offsetting Revenue13381270DirectOffsettingRevenue
Net Community Benefit Expense845118NetCommunityBenefitExpense
Percent Of Total Expense0.0258PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$1,746,190BadDebtExpenseAmount
Amount Attributable To174619AmountAttributableTo
Amount Reimbursed By Medicare8568195AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare13749778CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-5181583MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy0WrittenDebtCollectionPolicy
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1South Peninsula Hospital IncBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line14300 Bartlett StAddressLine1
CityHomerCity
StateAKState
ZIP Code99603ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1South Peninsula Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
OtherXOther
Needs Assessment Conducted09NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges1GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities3NumberOfOtherFacilities

Other Facilities OtherFacilities (3 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
South Peninsula Hospital Long Term Care
4300 Bartlett StHomerAK99603Long Term Care skilled nursing facility.
South Peninsula Hospital Provider Based Clinics
4300 Bartlett StHomerAK99603Provider based physician clinics.
South Peninsula Hospital Community Health Services
4300 Bartlett StHomerAK99603Home health care services.

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchH_P01_S00_L07Schedule H, Part I, Line 7Used worksheets provided in the instructions afor Schedule H andd cost to charge ratio.
SchH_P01_S00_L072fSchedule H, Part I, Line 7, Column fNo bad debt expense is included in Form 990, Part IX, line 25.
SchH_P01_S00_L07gSchedule H, Part I, Line 7gSubsidized health services do not include any costs attributable to a physician clinic.
SchH_P03_S0A_L04Schedule H, Part III, Section A, Line 4Bad debt and charity care are subtracted from patient service revenue to arrive at net patient service revenue (as noted on page 18). Line 2 is calculated by bad debt expense time cost to charge ratio. Line 3 is estimated at ten percent of bad debt cost.
SchH_P03_S0B_L08Schedule H, Part III, Section B, Line 8The shortfall should be treated as community benefit because it cost the hospital that amount to provide care to Medicare beneficiaries for which it was not compensated. The amount reported on line 6 was calculated by multiplying the total allowable costs on the cost report by the Medicare payer mix.
SchH_P05_S0B_L01Schedule H, Part V, Section B, Line 1Yes, our hospital is the sponsoring agency of the Southern Kenai Peninsula MAPP (Mobilizing to Action for Planning and Partnerships). MAPP is a framework for community health needs assessment and planning developed by the Centers for Disease Control and Prevention for the National Association of City and County Health Officials. We have conducted two health needs assessments using this framework, one in 2009 and one in 2012. MAPP utilizes four individual assessments to make up one complete assessment: Community Health Status; Community Themes and Strengths; Forces of Change, and; Local Public Health System. The 2012 assessment included only the first three since the changes in the facilities and resources within the community had not changed significantly outside the scope of hospital services.
SchH_P05_S0B_L03Schedule H, Part V, Section B, Line 3Deliberate effort was made to be sure the assessment reflected all areas of the community, including income levels, ages and area of residence. Steering Committee Representation - our project's steering committee represents a significant portion of the community. Representatives from the FQHC, public health, community mental health, city government, substance abuse agency, local college, comminuty hospital and family planning clinic all serve on the steering committee. Community surveys - 1,212 surveys were completed via hard copy and online. Questions were similar if not exact to the CHNA of 2009 so responses could be compared, and were both multiple choice and free responses. Surveys were distributed at the local health fair, both weekly newspapers, on www.mappofskp.net, in organization waiting room, in line at the food bank, at city hall, the public library and the hardware store. The survey remained open until the committee was certain that, based on US census data for our area, a proportionate range of income levels, ages and location of residence were represented. Key Informants - a key information survey was sent to more than 100 community leaders representing the broad community health perspectives of: physical, mental, spiritual, environmental, education, economic and cultural prespectives. MAPP Steering Committee members contacted via telephone all of these key informants in advvance of sending the survey. Anonimity was promised, however sector was tracked as best as possible. 86 key informants participated, and the following representation was confirmed: alternative healthcare - 1, arts -3, clergy - 1, education - 6, environment - 4, environmental edication - 2, government - 4, law enforcement - 2, healthcare -4, military - 2, senior - 1, social services - 10, and youth -2. It is uncertain exactly what sector the remaining 44 represented out of our definition of health. Both open-ended input was solcitied, as well as specific follow up questions from the prior assessment.
SchH_P05_S0B_L05Schedule H, Part V, Section B, Line 5Available at public meetings.
SchH_P05_S0B_L07Schedule H, Part V, Section B, Line 7Where possible, the hospital did take action to address specific needs. Some examples include: better publicizing our patient discount and financial aid programs, adding a lipidologist to our visiting specialist clinic, and adding an obstetrician/gynocologist to our primary care practice. However, the hospital is not able to address all of the needs from the assessment as many are beyond a hospital's scope of services. Community groups were formed to address the significant findings of the assessment that fall beyond the scope of just one agency or organization, and hospital representatives serve on such workgroups.
SchH_P05_S0B_L20Schedule H, Part V, Section B, Line 20All patient are charged at gross charges. Discounts are applied to gross charges for all patients.
SchH_P05_S0B_L22Schedule H, Part V, Section B, Line 22All patients are charges at gross charges. Discounts are applied to gross charges for all patients.
SchH_P06_S00_L02Schedule H, Part VI, Line 2The hospital served as the lead organization in a community assessment utilizing MAPP (Mobilizing to Action through Planning and Partnership). MAPP is the community assessment model endorsed by the CDC and the State of Alaska Department of Health and Social Srvices. MAPP uses four types of assessments to establish the overall community assessment: 1) community data (reportable statistics from numersous groups and agencies) 2) community leader/public opinion (community surveys and interviews) 3) local public health assessment (CDC scoring of our local public health) and 4) forces of change (a look at local, state, national and international forces which impact the community). All of this is compiled into one community assessment. The multi-year process is coordinated by the hospital, but utilizes a steering committee made up of representatives from local partners in health and wellness. Over 50 partnering agencies are involved in our community assessment and health improvement plan. A copy of the assessment can be found at www.mappofskp.net.
SchH_P06_S00_L03Schedule H, Part VI, Line 3During patient registration, each private pay patient is offered a Financial Assistance packet and business card for the financial counselor. The financial counselor assists any interested parties with Medicaid applications and/or the hospital's internal financial assistance application.
SchH_P06_S00_L04Schedule H, Part VI, Line 4The south Peninsula Hospital Service Area (SPHSA) was formed in 1969 by the Kenai Peninsula Borough. It was determined that hospital services were needed within the South Peninsula area and that such services would be best provided by the establishment of a service area. The population of the SPHSA is 13,136 and covers 8,317 square miles. South Peninsula Hospital is located in Homer, Alaska, at the southern tip of the Kenai Peninsula and close to the westerly most highway point in the country. The next closest hospital is Central Peninsula Hospital in Soldotna, 76 miles morth of South Peninsula Hospital but as many as 80-90 miles for many of the residents in the SPHSA. Close to half of the population is largely in or in close proximity to the City of Homer. The remaining half is scattered in small neighborhoods throughout the vast service area. Some of the communities in the SPHSA are accessible only by air and water. Homer is the commerce hub of the Service Area, and the area attracts over 100,000 visitors each year. According to Alaska Department of Labor, the 2010 census of the primary service area is 13,136. The primary and secondary service area combined, including Nanwalek, Port Graham, and Seldovia is 13,987.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org1CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Robert F Letson
Chief Executive Officer157565010000009514064599023267802080750
Lori Meyer
Chief Financial Officer1220250100000073820459230176330000
Brent Adcox
Medical Doctor7799390810640001500001790800105508304243380
Larry R Tripp
CRNA148999014565000015000048748035839702756130
Gregory Hough
Medical Doctor219110034044000150000152620283416000
Shara Sutherlin
Director of Patient Care Services1457980100000088080430680198674000
Douglas Duncan
Pharmacy Manager1451390100000087680728750227782000

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchJ_P01_S00_L01aSchedule J, Part I, Line 1aReimbursement of health club dues at 50% of cost up to a maximum of $500 per year.
SchJ_P01_S00_L03Schedule J, Part I, Line 3Annually, an evaluation committee comprised of board members is appointed and they review the existing evaluation form and make any necessary adjustments to the format and content of questions asked. The entire board of directors and senior management are asked to do a confidential evaluation as well as having the CEO complete a self-evaluation. The CEO's compensation is reviewed annually and any increases are a board decision based on performance and salary survey data.
SchJ_P01_S00_L05Schedule J, Part I, Line 5The CRNA may receive a bonus based on revenue generated from his services.
SchJ_P01_S00_L06Schedule J, Part I, Line 6The medical doctors may receive a bonus based on net earnings of their clinic operations.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Kenai Peninsula Borough
A9200308942003-09-3010621278Hospital Expansion000
Kenai Peninsula Borough
B9200308942007-04-053086211Hospital Expansion000
Kenai Peninsula Borough
C9200308942007-08-2814703525Hospital Expansion000
Kenai Peninsula Borough
D9200308942011-09-013285000Retire oustanding debt000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A00000000000020070011
B00000000000020090111
C00000000000020090011
D00000000000020110011

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A0000000000
B0000000000
C0000000000
D0000000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A000000000
B000000000
C000000000
D000010000

Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1
C1

Schedule K IRS990ScheduleK

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Woodworth ElectricBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipFamily member of current directorRelationship
Amount Of Transaction122161AmountOfTransaction
Description Of TransactionElectrical Contracting ServicesDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P03_S00_L02Form 990, Part III, Line 2Acquisition of a family practice physician clinic.
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bForm 990 is prepared by the organization Chief Financial Officer with input from other members of hte organization. The form is reviewed by the Finance Committee of the board of directors. The final form 990 is approved by the board of directors before submission to the internal revenue service.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cAll employees complete a conflict of interest questionnaire upon hire. Officers, directors, and managers complete a conflict of interest questionnaire annually each December. The possible existence of conflicts are required to be reported to the corporate compliance officer for investigation.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15Annually, an evaluation committee comprised of board members is appointed and they review the existing evaluation form and make any necessary adjustments to the format and content of the questions being asked. The entire board of directors and senior managment team are asked to do a confidential evaluation as well as having the CEO complete a self evaluation. The CEO's compensation is reviewed annually and any increases are a board decision based on performance.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19All governing documents, conflict of interest policy, and financial statements are available to the public by providing copies upon request. Board of directors meeting minutes are available on the hospital website www.sphosp.org.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Kenai Peninsula BoroughBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1144 N Binkley StreetAddressLine1
CitySoldotnaCity
StateAKState
ZIP Code99669ZIPCode
FieldValueIRS element (for citing)
EIN920030894EIN
Primary ActivitiesLocal GovernmentPrimaryActivities
Legal Domicile StateAKLegalDomicileState
Exempt Code Section115ExemptCodeSection
Direct Controlling Entity NAN/ADirectControllingEntityNA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Kenai Peninsula BoroughBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypecTransactionType
Amount Involved3744093AmountInvolved