HOSPITAL COMUNITARIO BUEN SAMARITANO INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- HOSPITAL COMUNITARIO BUEN SAMARITANO INC (EIN 66-0571457)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201443189349308114
- Schema version
- 2013v3.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-14T15:38:23-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 660703468 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FPV & GALINDEZ CPAS PSC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 364152 | AddressLine1 |
| City | SAN JUAN | City |
| State | PR | State |
| ZIP Code | 009364152 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 660571457 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPITAL COMUNITARIO BUEN | BusinessNameLine1 |
| Business Name Line2 | SAMARITANO INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOSP | BusinessNameControlTxt |
| Phone | 7876580000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4055 | AddressLine1 |
| City | AGUADILLA | City |
| State | PR | State |
| ZIP Code | 006054055 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ELYONEL PONTON | PersonNm |
| Person Title | EXE. DIRECTOR | PersonTitleTxt |
| Phone | 7876580000 | PhoneNum |
| Signature | 2014-11-12 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparation | 2014-11-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ELYONEL PONTON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4055 | AddressLine1 |
| City | AGUADILLA | City |
| State | PR | State |
| ZIP Code | 006054055 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $47,733,162 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | PR | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION WILL PROVIDE HEALTH SERVICES WITH EXCELLENCE THROUGH DEVELOPING ITS OWN RESOURCES IN AN EFFICIENT MANNER TO CONTRIBUTE TO THE WELL BEING AND IMPROVEMENT OF THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 545 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $4,923 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,945 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $42,716,179 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $44,697,976 | CYProgramServiceRevenueAmt |
| PY Investment Income | $331,627 | PYInvestmentIncomeAmt |
| CY Investment Income | $263,596 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,443,475 | PYOtherRevenueAmt |
| CY Other Revenue | $2,565,958 | CYOtherRevenueAmt |
| PY Total Revenue | $44,496,204 | PYTotalRevenueAmt |
| CY Total Revenue | $47,532,475 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,342,837 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,748,155 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $26,790,360 | PYOtherExpensesAmt |
| CY Other Expenses | $28,605,559 | CYOtherExpensesAmt |
| PY Total Expenses | $42,133,197 | PYTotalExpensesAmt |
| CY Total Expenses | $45,353,714 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,363,007 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,178,761 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $37,842,312 | TotalAssetsBOYAmt |
| Total Assets EOY | $37,383,105 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $31,207,000 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $28,569,032 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,635,312 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,814,073 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION WILL PROVIDE HEALTH SERVICES WITH EXCELLENCE THROUGH DEVELOPING ITS OWN RESOURCES IN AN EFFICIENT MANNER TO CONTRIBUTE TO THE WELL BEING AND IMPROVEMENT OF THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $29,874,189 | ExpenseAmt |
| Revenue | $47,268,879 | RevenueAmt |
| Desc | THE ORGANIZATION IS A NON-FOR-PROFIT HOSPITAL ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PUERTO RICO. WHICH PROVIDES INPATIENT AND OUTPATIENT SERVICES, INCLUDING EMERGENCY SERVICES. THE SERVICES ARE PROVIDED PRIMARILY TO THE POPULATION UNDER THE MEDICARE PROGRAM AND OTHER HEALTH PROVIDERS. | Desc |
| Total Program Service Expenses | $29,874,189 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 545 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | Yes (true) | LocalChaptersInd |
| Policies Reference Chapters | false | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ELYONEL PONTN | PersonNm |
| Phone | 7878190800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ROAD 2 KM 141 | AddressLine1 |
| City | AGUADILLA | City |
| State | PR | State |
| ZIP Code | 00605 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| DR ARTURO CEDENO LLORENS | |||||||
| DIRECTOR | 40.00 | Yes (X) | $105,000 | $0 | $0 | ||
| DRA AIDA SANCHEZ MERCADO | |||||||
| SUBDIRECTOR | 40.00 | Yes (X) | $73,200 | $0 | $0 | ||
| ING JOSE ROSA | |||||||
| DIRECTOR | 40.00 | Yes (X) | $49,219 | $0 | $0 | ||
| SRA ENEIDA ALICEA | |||||||
| DIRECTOR | 40.00 | Yes (X) | $48,019 | $0 | $0 | ||
| ADA SOTO | |||||||
| DIRECTOR | 40.00 | Yes (X) | $36,906 | $0 | $0 | Yes (X) | |
| JUAN MIGUEL GMEZ TORRES | |||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| FLIX TORRES LEN | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| RAFAEL MRQUEZ PURAS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ELIZABETH SANDERS CLARK | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ANTONIO RAMOS VILLANUEVA | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARISA GUILLAMA DE LEN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARISOL MOURE RIVERA | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR PETER MELENDEZ | |||||||
| VICE-PRESIDE | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| SR RANDY GONZALEZ | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR ANIBAL APONTE | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR JOSE RAUL LATORRE | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOS A GARCA RIVERA | |||||||
| HUMAN RESOUR | 40.00 | $89,206 | $0 | $0 | Yes (X) | ||
| SARAH I VILLANUEVA CABRERA | |||||||
| ADMINISTRATO | 40.00 | $72,428 | $0 | $0 | Yes (X) | ||
| LUIS J TORRES RODRGUEZ | |||||||
| FINANCE DIRE | 40.00 | $48,305 | $0 | $0 | Yes (X) | ||
| ELYONEL PONTN CRUZ | |||||||
| EXECUTIVE DI | 40.00 | $141,034 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $663,317 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| JANI CLEAN SERVICES INC | |||||
| PO BOX 876 | MAYAGEZ | PR | 00681 | PURCHASE SERVIC | $718,964 |
| LAB CORP | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | PURCHASE SERVIC | $395,116 |
| SECURITY MAX | |||||
| PO BOX 6255 | HATILLO | PR | 00659 | PURCHASE SERVIC | $332,583 |
| PROFESSIONAL EMERGENCY | |||||
| 2053 AVE PEDRO ALBIZU | AGUADILLA | PR | 00603 | PROFESIONAL FEE | $254,100 |
| DJM MEDICAL IMAGING | |||||
| PO BOX 3049 | BAYAMON | PR | 00960 | PROFESIONAL FEE | $187,129 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $4,945 | AllOtherContributionsAmt |
| Noncash Contributions | $4,945 | NoncashContributionsAmt |
| Total Contributions | $4,945 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICES | Desc |
| Total Revenue Column | $44,697,976 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,697,976 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $44,697,976 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $366,949 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $366,949 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $366,949 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $366,949 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $464,283 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $200,687 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $263,596 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $263,596 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $263,596 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| OTHER INCOME | $1,174,750 | $1,174,750 |
| OTHER OPERATING INCOME | $1,024,259 | $1,024,259 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,199,009 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,532,475 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $47,527,530 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,086,423 | TotalAmt |
| Program Services | $9,352,502 | ProgramServicesAmt |
| Management And General | $4,733,921 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,690 | TotalAmt |
| Program Services | $15,674 | ProgramServicesAmt |
| Management And General | $9,016 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $971,255 | TotalAmt |
| Program Services | $633,872 | ProgramServicesAmt |
| Management And General | $337,383 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,665,787 | TotalAmt |
| Program Services | $1,103,816 | ProgramServicesAmt |
| Management And General | $561,971 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,488 | TotalAmt |
| Management And General | $76,488 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,660 | TotalAmt |
| Management And General | $50,660 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,884,015 | TotalAmt |
| Program Services | $4,399,544 | ProgramServicesAmt |
| Management And General | $1,484,471 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,746 | TotalAmt |
| Management And General | $47,746 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $414,119 | TotalAmt |
| Program Services | $9,628 | ProgramServicesAmt |
| Management And General | $404,491 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,153 | TotalAmt |
| Program Services | $863 | ProgramServicesAmt |
| Management And General | $20,290 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,471,024 | TotalAmt |
| Management And General | $1,471,024 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,464,612 | TotalAmt |
| Management And General | $1,464,612 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $934,706 | TotalAmt |
| Management And General | $934,706 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MATERIALS | $10,898,776 | $10,407,475 | $491,301 |
| UTILITIES | $3,234,009 | $3,234,009 | |
| BAD DEBTS | $2,905,000 | $2,905,000 | |
| REPAIRS & MAINTENANCE | $716,806 | $716,806 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $486,445 | TotalAmt |
| Management And General | $486,445 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,353,714 | TotalAmt |
| Program Services | $29,874,189 | ProgramServicesAmt |
| Management And General | $15,479,525 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,135,657 | BOYAmt |
| EOY | $2,982,184 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,000,112 | BOYAmt |
| EOY | $11,817,650 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,211,101 | BOYAmt |
| EOY | $1,152,859 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $805,312 | BOYAmt |
| EOY | $775,798 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $32,064,509 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $13,724,700 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,231,337 | BOYAmt |
| EOY | $18,339,809 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,458,793 | BOYAmt |
| EOY | $2,314,805 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,842,312 | BOYAmt |
| EOY | $37,383,105 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,534,302 | BOYAmt |
| EOY | $6,572,194 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,780,658 | BOYAmt |
| EOY | $21,216,494 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $892,040 | BOYAmt |
| EOY | $780,344 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,207,000 | BOYAmt |
| EOY | $28,569,032 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,635,312 | BOYAmt |
| EOY | $8,814,073 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,635,312 | BOYAmt |
| EOY | $8,814,073 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,842,312 | BOYAmt |
| EOY | $37,383,105 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,178,761 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,067,500 | InvestmentCostOrOtherBasisAmt |
| Book Value | $1,067,500 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $14,591,872 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $4,261,405 | DepreciationAmt |
| Book Value | $10,330,467 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $3,640,009 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $1,303,104 | DepreciationAmt |
| Book Value | $2,336,905 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $11,888,589 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $7,876,845 | DepreciationAmt |
| Book Value | $4,011,744 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $876,539 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $283,346 | DepreciationAmt |
| Book Value | $593,193 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $18,339,809 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| MEDICAL OFFICE BUILDING | $1,917,129 |
| OTHER ASSETS | $397,676 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,314,805 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| OTHER CURRENT LIABILITIES | $780,344 |
| DUE TO RELATED PARTY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $780,344 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $47,532,475 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $47,532,475 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $47,532,475 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $45,353,714 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $45,353,714 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $45,353,714 | TotalExpensesPerForm990Amt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 1.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | false | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 25841 | PersonsServedCnt |
| Total Community Benefit Expns | $27,083,645 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $40,625,468 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$13,541,823 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.29890 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 25841 | PersonsServedCnt |
| Total Community Benefit Expns | $27,083,645 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $40,625,468 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$13,541,823 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.29890 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 25841 | PersonsServedCnt |
| Total Community Benefit Expns | $27,090,645 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $40,625,468 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$13,534,823 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.29910 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,905,000 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $4,294,682 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,949,319 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,345,363 | MedicareSurplusOrShortfallAmt |
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | false | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPITAL COMUNITARIO BUEN | BusinessNameLine1 |
| Business Name Line2 | SAMARITANO | BusinessNameLine2 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | APARTADO 4055 | AddressLine1 |
| City | AGUADILLA | City |
| State | PR | State |
| ZIP Code | 006054055 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPITAL COMUNITARIO BUEN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | false | CHNAConductedInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 100.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE HOSPITAL MAKES JUDGMENTS AS TO THE COLLECTABILITY OF ACCOUNTS RECEIVABLE BASED ON HISTORICAL TRENDS AND FUTURE EXPECTATIONS. MANAGEMENT ESTIMATES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS, WHICH REPRESENTS THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLES. THIS ALLOWANCE ADJUSTS GROSS PATIENT SERVICE ACCOUNTS RECEIVABLE DOWNWARD TO THEIR ESTIMATED NET REALIZABLE VALUE. TO DETERMINE THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND THE RELATED PROVISION FOR BAD DEBTS EXPENSE, MANAGEMENT REVIEW A SPECIFIC CUSTOMER RISKS; FOR PRIVATE PATIENTS ALL ACCOUNT OVER 185 DAYS AND FOR THIRD-PARTY PAYORS ALL ACCOUNTS OVER 365 DAYS, USING HOSPITAL'S ACCOUNT RECEIVABLE AGING THE HOSPITAL GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHO ARE LOCAL RESIDENTS AND ARE INSURED THIRD-PARTY PAYOR AGREEMENTS. THE HOSPITAL ESTABLISHES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A RELATED PROVISION FOR BAD DEBT BASED UPON FACTORS SURROUNDING THE CREDIT RISK OF SPECIFIC CUSTOMERS, HISTORICAL TRENDS AND OTHER INFORMATION. BAD DEBTS EXPENSE IS CALCULATED EVERY MONTH ACCORDING WITH THE BAD DEBTS POLICY: RESERVE OVER 180 DAYS FOR PATIENT'S ACCOUNTS AND OVER 365 DAYS INSURANCE'S ACCOUNT IN THE AGING REPORT RECONCILED WITH THE GL ALLOWANCE FOR BAD DEBTS ACCOUNT. THE BILLING AND COLLECTIONS SUPERVISOR SUBMIT THE ACCOUNTS TO BE WRITTEN OFF TO THE FINANCE DIRECTOR, WHO ANALYZES AND SUBMITS THEM TO THE BOARD OF DIRECTORS. THEY ARE THE ONLY RESPONSIBLE TO AUTHORIZE WRITE-OFFS OF UNCOLLECTIBLE ACCOUNTS RECEIVABLE. |
| PART III, LINE 8 - MEDICARE EXPLANATION | ITEM 4 OF SECTION A (PART III); COSTING METHODOLOGY TO DETERMINE REVENUE FROM MEDICARE. INPATIENT CARE, OUTPATIENT CARE, HOME HEALTH CARE AND SKILLED NURSING SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. THE HOSPITAL IS REIMBURSED FOR BAD DEBTS AND DISPROPORTIONATE SHARE PATIENTS AT TENTATIVE RATES DETERMINED BY THE MEDICARE PROGRAM WITH FINAL SETTLEMENT DETERMINED AFTER SUBMISSION OF ANNUAL COST REPORTS BY THE HOSPITAL AND AUDITS THERE OF BY THE MEDICARE FISCAL INTERMEDIARY. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | COLLECTIONS ARISE MAINLY FROM TWO SOURCES: 1. PAYMENTS MADE IN THE HOSPITAL BY PATIENTS IN CASH, CHECKS OR DEBIT AND CREDIT CARDS AND; 2. PAYMENTS RECEIVED THROUGH MAIL AND ELECTRONIC TRANSFER FROM HEALTH INSURANCE COMPANIES LIKE MEDICARE, TRIPLE S AND MCS HMO AND COMMERCIAL. THE ADMINISTRATION CLERK RECEIVES THE MAIL AND PREPARES A LIST OF CHECKS WITH REMITTANCE ADVICES, SENT THE ORIGINAL REMITTANCE AND CHECK TO THE PRINCIPAL CASHIER, AND MAKES TWO PHOTOCOPIES WHICH WILL BE FURNISHED TO BILLING AND COLLECTIONS SUPERVISOR AND THE OTHER COPY TO ACCOUNTING CLERK. THEN THE PRINCIPAL CASHIER PREPARES THE DEPOSIT SLIP. APPROXIMATELY AT 1:30 PM EVERY DAY, THE ASSIGNED PERSONAL WITH PRINCIPAL CASHIER, VERIFY AND MAKE THE DAILY CASH COUNT OF MONEY PICK UP FROM THE AMBULATORY SERVICES BOX, THE DEPOSIT SLIP, REMITTANCE ADVISES AND THE CHECKS LIST PREPARED BY THE ADMINISTRATION CLERK BEFORE THE DEPOSIT IS SENT TO THE BANK WITH THE MESSENGER. ALL DEPOSIT IS SENT TO THE BANK IN THE SAME DATE. IF THE DEPOSIT COULD NOT BE MADE, THEN THE MONEY IS KEPT IN THE SECURITY LOCK BOX LOCATED IN THE FINANCE DEPARTMENT. THIS SECURITY LOCK BOX COULD BE ONLY OPEN BY A NUMBER COMBINATION WHICH IS KNOWN BY THE FINANCE DIRECTOR. THE DAILY COUNT REPORT IS SENT TO THE ACCOUNTING SECRETARY, WHO POST IT TO AN EXCEL SHEET WHICH CONTAINS A DETAILED DAILY CASH MOVEMENT FROM DEPOSIT AND ELECTRONIC TRANSFERS MADE TO AND THROUGH BANK ACCOUNTS. IN THE BILLING AND COLLECTIONS DEPARTMENT, IT'S PERSONNEL POST THE DETAIL OF THE REMITTANCE ADVICE TO THE COMPUTER SYSTEM, ANALYZE ACCOUNTS AND IF A BALANCE IS PENDING A SECOND BILLING IS DONE BEFORE 45 DAYS. AFTER THE MONTH IS CLOSED THE ACCOUNTS RECEIVABLE AGING AND RELATED REPORTS ARE PRINTED TO RECONCILE ALL THE ACCOUNTS RECEIVABLE SUBSIDIARIES AND PREPARED THE JOURNAL ENTRIES TO BE POST AT THE GENERAL LEDGER TO REFLECT THE CORRECT BALANCES. |
| ADDITIONAL INFORMATION | PART I, LINE 1A ALTHOUGH THE HOSPITAL HAS A WRITTEN FINANCIAL ASSISTANCE POLICY, THE ORGANIZATION IS TAKING THE NECESSARY STEPS TO ALIGN THE SAME WITH THE NEW REQUIREMENTS PUBLISHED ON JUNE 26, 2012 BY THE FIRST SEMESTER OF 2014. PART V LINE I- BASED ON THE PROVISIONS OF NOTICE 2011-52 AND THE PROPOSED REGULATIONS FOR SECTION 501(R)(I) OF THE INTERNAL REVENUE CODE, THE TERM "STATE", AS INCLUDED IN THE DEFINITION FOR "HOSPITAL FACILITY"INCLUDED ONLY THE 50 STATES AND THE DISTRICT OF COLUMBIA AND NOT ANY US TERRITORY. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 6 | THE BOARD OF MEMBERS (BOD) WHICH MEMBERS APPROVE SIFNIFICANT DECISIONS OF THE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE ORGANIZATION HAS MEMBERS WHO ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. ELECT FROM THE MEMBERS OF THE CORPORATION (THAT IS, FROM THE BOARD OF TRUSTEE OF THE PARENT COMPANY) SEVEN PERSONS TO BE MEMBERS OF THE BOARD OF DIRECTOR OF THE CORPORATION. THESE SEVEN DIRECTORS SHALL ELECT, IN CONSULTING WITH THE BOARD OF TRUSTEES OF THE PARENT COMPANY, THE REMAINING 6 DIRECTORS TO THE BOARD. SUCH SIX DIRECTORS SHALL AT ALL TIMES COMPLY WITH THE CUALIFICATION REQUIRED TO EACH MEMBERS OF THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 7B | THE DECISION OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE MEMBERS: A) MAKE, ALTER OR REPEAL THE BY LAWS OF THE CORPORATION. B) AUTHORIZE AND CAUSE TO BE EXECUTED MORGAGES AND LIENS UPON THE REAL AND PUSMAL PROPERTY OF THE CORPORATION. C) SET APART ANY OF THE FUNDS OF THE CORPORATION, A RESCUE OR RESERVES FOR ANY PROPER PURPOSE AND TO ABOLISH ANY REVENUE IN THE MANNER IN WHICH IT WAS CREATED. D) BY MAJORITY, TO DESIGNATE ONE OR MORE COMMITTEES, EACH COMMITTEE TO CONCIST OF ONE OR MORE OF THE DIRECTORS OF THE CORPORATION. E) TO HOLD MEETING OUTSIDE THE COMMONWEALTH OF PR. F) INCREASE THE NUMBER OF MEMBERS OF THE BOD. G) ELECTION OF THE BOD. H) AMEND THE BY LAWS OF THE CORPORATION. I) APPROVE ANY PLAN OF DISSOLUTION, MERGER, OR DISPOSITION OF THE TOTAL ASSETS OF THE CORPORATION. J) APPROVE THE SELECTION OF THE INDEPENDENT AUDITORS OF THE CORPORATION. |
| FORM 990, PAGE 6, PART VI, LINE 10B | PLEASE SUBMIT INFORMATION. |
| FORM 990, PAGE 6, PART VI, LINE 11B | ORGANIZATION REVIEW PROCESS FOR 990 FORM. THIS IS THE FIRST YEAR OF FILING THE FORM 990 THE BOD ASSIGNED THE DUTY TO REVISE THIS FORM TO THE EXECUTIVE & FINANCE COMMITTEES OF THE BOD. |
| FORM 990, PAGE 6, PART VI, LINE 12C | EACH YEAR THE ENTITY SENDS COMMUNICATIONSTO ITS EMPLOYEES DETAILING THE ENTITY'S RULING ABOUT THE CONFLICT OF INTEREST POLICY. IF ANY SITUATION EXISTS THE MATTER SHOULD BE COMMUNICATED TO THE BOARD OF DIRECTORS IMMEDIATELY TO TAKE REMEDIAL ACTIONS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE MEMBER OF THE BOD OF THE CORPORATION SHALL BE ENTITLED TO THE FOLLOWING COMPENSATION AND BENEFITS WHILE SERVING AS DIRECTORS OF THE CORPORATION: A) PAYMENT OF A PERDIEM ALLOWANCES AS ESTABLISHED BY THE BOD FOR EACH MEETINGS OF THE BOD IN WHICH THE DIRECTORS IS PRESENT. B) MEDICAL AND HOSPITAL SERVICES PROVIDED BY THE HOSPITALS OPERATED BY THE CORPORATION FREE OF ANY CHARGE FOR THE DIRECTOR, HIS/HER SPOUSE AND CHILDREN UNDER 21 YEARS OLD WHO ARE DEPENDENTS OF THE DIRECTOR. C) LIFE INSURANCE POLICY FOR THE AMOUNT OF 100,000 OF WHICH 50,000 ARE UNDER A GROUP LIFE INSURANCE POLICY AND THE OTHER 50,000 ARE UNDER AN INDIVIDUAL LIFE INSURANCE POLICY FOR EACH DIRECTORS. D) ANY ACTUAL EXPENSES INCURRED IN THE PERFORMANCE OF THEIR DUTIES AS DIRECTORS UPON PRESENTATION FOR APPROVAL OF THE CORRESPONDING INVOICE TO THE BOD. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE MEMBER OF THE BOD OF THE CORPORATION SHALL BE ENTITLED TO THE FOLLOWING COMPENSATION AND BENEFITS WHILE SERVING AS OFFICERS OF THE CORPORATION: A) PAYMENT OF A PERDIEM ALLOWANCES AS ESTABLISHED BY THE BOD FOR EACH MEETINGS OF THE BOD IN WHICH THE DIRECTORS IS PRESENT. B) MEDICAL AND HOSPITAL SERVICES PROVIDED BY THE HOSPITALS PERATED HY THE CORPORATION FREE OF ANY CHARGE FOR THE DIRECTOR, HIS/HER SPOUSE AND CHILDREN UNDER 21 YEARS OLD WHO ARE DEPENDENTS OF THE DIRECTOR. C) LIFE INSURANCE POLICY FOR THE AMOUNT OF 100,000 OF WHICH 50,000 ARE UNDER A GROUP LIFE INSURANCE POLICY AND THE OTHER 50,000 ARE UNDER AN INDIVIDUAL LIFE INSURANCE POLICY FOR EACH DIRECTORS. D) ANY ACTUAL EXPENSES INCURRED IN THE PERFORMANCE OF THEIR DUTIES AS DIRECTORS UPON PRESENTATION FOR APPROVAL OF THE CORRESPONDING INVOICE TO THE BOD. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION UPON REQUEST PROVIDE COPY OF ANY OF ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS OR ANY OTHER POLICY. |
| FORM 990, PART IX, LINE 11G | 4,399,544 1,484,471 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPITAL SAN CARLOS INC | BusinessNameLine1 |
Foreign Address ForeignAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 68 | AddressLine1 |
| City | MOCA | City |
| Country | RQ | Country |
| Postal Code | 00676-0068 | PostalCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 660371418 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | PR | LegalDomicileStateCd |
| Exempt Code Section | 501 C | ExemptCodeSectionTxt |
| Public Charity Status | 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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