GIBSON GENERAL HOSPITAL INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- GIBSON GENERAL HOSPITAL INC (EIN 35-0877575)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2013-10-17
- IRS object ID
- 201312909349300131
- Schema version
- 2010v3.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-10-17T13:57:09-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 N Illinois Street | AddressLine1 |
| City | Indianapolis | City |
| State | IN | State |
| ZIP Code | 46204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350877575 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gibson General Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GIBS | NameControl |
| Phone | 8123853401 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 Sherman Drive | AddressLine1 |
| City | Princeton | City |
| State | IN | State |
| ZIP Code | 47670 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | EMMETT C SCHUSTER | Name |
| Title | CEO | Title |
| Phone | 8123853092 | Phone |
| Date Signed | 2012-08-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3173834000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | EMMETT C SCHUSTER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1 |
| City | PRINCETON | City |
| State | IN | State |
| ZIP Code | 47670 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 51548072 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.GIBSONGENERAL.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1947 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF GIBSON GENERAL HOSPITAL AND THE SKILLED NURSING FACILITY IS TO PROVIDE HIGH QUALITY, PATIENT-CENTERED, COST-EFFECTIVE CARE FOR PEOPLE IN OUR COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 437 | TotalNbrEmployees |
| Total Nbr Volunteers | 56 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 511604 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 284895 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 51738507 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 51023336 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 33689 | InvestmentIncomePriorYear |
| Investment Income Current Year | -630378 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 57899 | OtherRevenuePriorYear |
| Other Revenue Current Year | 178922 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 52341699 | TotalRevenuePriorYear |
| Total Revenue Current Year | 50856775 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 102781 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 16626883 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 16795749 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 34734803 | OtherExpensePriorYear |
| Other Expenses Current Year | 36146793 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 51361686 | TotalExpensesPriorYear |
| Total Expenses Current Year | 53045323 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 980013 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -2188548 | RevenuesLessExpensesCY |
| Total Assets BOY | 26347833 | TotalAssetsBOY |
| Total Assets EOY | 23433250 | TotalAssetsEOY |
| Total Liabilities BOY | 14467262 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13899979 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 11880571 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 9533271 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MISSION OF GIBSON GENERAL HOSPITAL AND THE SKILLED NURSING FACILITY IS TO PROVIDE HIGH QUALITY, PATIENT-CENTERED, COST-EFFECTIVE CARE FOR PEOPLE IN OUR COMMUNITY. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 48047200 | Expense |
| Grants | 102781 | Grants |
| Revenue | 51023336 | Revenue |
| Description | THE HOSPITAL'S MISSION IS TO PROVIDE HIGH QUALITY AND COST EFFECTIVE HEALTHCARE, WHICH INCLUDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO THE RESIDENTS OF THE SURROUNDING TRI-STATE AREA. ALL EXPENSES RELATE TO COSTS ASSOCIATED WITH PROVIDING THESE SERVICES, AND MAINLY INCLUDE SALARIES AND WAGES TO STAFF AND SUPPLIES COST. APPROXIMATELY 34,210 PEOPLE SERVED. | Description |
| Total Program Service Expense | 48047200 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | true | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 73 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 437 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | false | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | GIBSON GENERAL HOSPITAL | NamePerson |
| Telephone Number | 8123853401 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1 |
| City | PRINCETON | City |
| State | IN | State |
| ZIP Code | 47670 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| MR MICHAEL GREEN | |||||||
| FIRST VICE CHAIR | 1.0 | X | X | 0 | 0 | 0 | |
| MR LARRY JOHNSON | |||||||
| BOARD CHAIR | 1.0 | X | X | 0 | 0 | 0 | |
| MR ROBERT GIBSON JR | |||||||
| SECOND VICE CHAIR | 1.0 | X | X | 0 | 0 | 0 | |
| MR DONALD HAUKE | |||||||
| SECRETARY | 1.0 | X | X | 0 | 0 | 0 | |
| MR GEORGE ANKENBRAND | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| MR PHIL YOUNG | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| MR ROBERT HURST | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| MR STANLEY MADISON | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| MRS HELEN HAUKE | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| MS KRISHNA MD | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| MR ROBERT KINKLE | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| MR MARION JOCHIM | |||||||
| TREASURER | 1.0 | X | X | 0 | 0 | 0 | |
| THOMAS JOSEPH MD | |||||||
| CHIEF OF STAFF | 1.0 | X | X | 0 | 0 | 0 | |
| MR CT MONTGOMERY | |||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | ||
| EMMETT SCHUSTER | |||||||
| CHIEF EXECUTIVE OFFICER | 50.0 | X | 173807 | 0 | 13652 | ||
| SUSAN HAVERS | |||||||
| CFO FROM 1/11 - 9/11 | 50.0 | X | 115314 | 0 | 7377 | ||
| LORI PHILLIPS | |||||||
| CHIEF NURSING OFFICER | 50.0 | X | 68434 | 0 | 436 | ||
| RON HARRINGTON | |||||||
| CHIEF FINANCIAL OFFICER 12/11 | 50.0 | X | 2270 | 0 | 0 | ||
| MARK CARPENTER MD | |||||||
| PHYSICIAN | 40.0 | 340956 | 0 | 5313 | X | ||
| STEPHEN SHOEMAKER MD | |||||||
| PHYSICIAN | 40.0 | 221475 | 0 | 11303 | X | ||
| ROSABEL MANALO-IBAY | |||||||
| PHYSICIAN | 40.0 | 156426 | 0 | 4111 | X | ||
| STEVEN GRIFFITH MD | |||||||
| PHYSICIAN | 40.0 | 153617 | 0 | 0 | X | ||
| DANIEL BROWN MD | |||||||
| PHYSICIAN | 40.0 | 124988 | 0 | 3451 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1357287 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 45643 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| PRINCETON SURGERY CENTER | |||||
| 2030 SHERMAN DRIVE | PRINCETON | IN | 47670 | MEDICAL & HEALTH | 844814 |
| THOMAS JOSEPH MD | |||||
| 1808 SHERMAN DRIVE SUITE 2203 | PRINCETON | IN | 47670 | MEDICAL & HEALTH | 770385 |
| BLAKE TITZER D O PC | |||||
| PO BOX 130 | INGLEFIELD | IN | 476180130 | MEDICAL & HEALTH | 400907 |
| PHILOMINA THURUTHUMALY | |||||
| 1707 BRENTWOOD DRIVE | PRINCETON | IN | 47670 | MEDICAL & HEALTH | 325000 |
| CPSI INC | |||||
| 6600 WALL STREET | MOBILE | AL | 36695 | COMPUTER SYSTEM | 278252 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 12 | NumberOfContractorsGT100K |
| Related Organizations | 254738 | RelatedOrganizations |
| Government Grants | 22132 | GovernmentGrants |
| All Other Contributions | 8025 | AllOtherContributions |
| Noncash Contributions | 7780 | NoncashContributions |
| Total Contributions | 284895 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICES | 621110 | 50787954 | 50787954 |
| CAFETERIA SALES | 722210 | 179720 | 179720 |
| EDUCATION REVENUE | 611710 | 11094 | 11094 |
| COPIES | 519100 | 8355 | 8355 |
| MISCELLANEOUS | 900099 | 36213 | 36213 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 51023336 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 60919 | TotalRevenueColumn |
| Exclusion | $60,919 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 178922 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 178922 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 178922 | TotalRevenueColumn |
| Exclusion | $178,922 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 691297 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -691297 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -691297 | TotalRevenueColumn |
| Exclusion | -$691,297 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 50856775 | TotalRevenueColumn |
| Related Or Exempt Function Income | 51023336 | RelatedOrExemptFunctionIncome |
| Exclusion | -$451,456 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102781 | Total |
| Program Services | 102781 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 381290 | Total |
| Program Services | 342517 | ProgramServices |
| Management And General | 38773 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13264144 | Total |
| Program Services | 11915333 | ProgramServices |
| Management And General | 1348811 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 141462 | Total |
| Program Services | 120795 | ProgramServices |
| Management And General | 20667 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1993279 | Total |
| Program Services | 1702074 | ProgramServices |
| Management And General | 291205 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1015574 | Total |
| Program Services | 867205 | ProgramServices |
| Management And General | 148369 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 152186 | Total |
| Program Services | 68250 | ProgramServices |
| Management And General | 83936 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67411 | Total |
| Management And General | 67411 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4382845 | Total |
| Program Services | 3875156 | ProgramServices |
| Management And General | 507689 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 315537 | Total |
| Management And General | 315537 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2420664 | Total |
| Program Services | 2382240 | ProgramServices |
| Management And General | 38424 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1776737 | Total |
| Program Services | 1427815 | ProgramServices |
| Management And General | 348922 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 354701 | Total |
| Program Services | 336966 | ProgramServices |
| Management And General | 17735 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1822566 | Total |
| Program Services | 1731438 | ProgramServices |
| Management And General | 91128 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 394319 | Total |
| Program Services | 64555 | ProgramServices |
| Management And General | 329764 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| CONTRACTUALS & OTHER | 19486909 | 19486909 | |
| UNCOLLECTIBLE ACCOUNTS | 3093490 | 3093490 | |
| COLLECTION EXPENSE | 110695 | 110695 | |
| RECRUITING | 51484 | 10 | 51474 |
| SETTLEMENT COSTS | 1112714 | 1112714 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 604535 | Total |
| Program Services | 418971 | ProgramServices |
| Management And General | 185564 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53045323 | Total |
| Program Services | 48047200 | ProgramServices |
| Management And General | 4998123 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1775 | BOY |
| EOY | 1775 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7488306 | BOY |
| EOY | 3083593 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3450214 | BOY |
| EOY | 3129781 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 281513 | BOY |
| EOY | 189851 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 641822 | BOY |
| EOY | 638110 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 164983 | BOY |
| EOY | 238137 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 30561162 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 18297580 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14280847 | BOY |
| EOY | 12263582 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 3843104 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38373 | BOY |
| EOY | 45317 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26347833 | BOY |
| EOY | 23433250 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2216794 | BOY |
| EOY | 2981208 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 4853 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11628440 | BOY |
| EOY | 10467385 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 216028 | BOY |
| EOY | 174830 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 406000 | BOY |
| EOY | 271703 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14467262 | BOY |
| EOY | 13899979 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11842198 | BOY |
| EOY | 9487954 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38373 | BOY |
| EOY | 45317 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11880571 | BOY |
| EOY | 9533271 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26347833 | BOY |
| EOY | 23433250 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -2188548 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -158752 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 421244 | OtherCostOrOtherBasis |
| Book Value | 421244 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17141173 | OtherCostOrOtherBasis |
| Depreciation | 8731562 | Depreciation |
| Book Value | 8409611 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12630437 | OtherCostOrOtherBasis |
| Depreciation | 9430431 | Depreciation |
| Book Value | 3200006 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 368308 | OtherCostOrOtherBasis |
| Depreciation | 135587 | Depreciation |
| Book Value | 232721 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 12263582 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO MEDICARE | Description |
| Amount | $271,703 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 271703 | TotalOfAmounts |
| Total Revenue | 50856775 | TotalRevenue |
| Total Expenses | 53045323 | TotalExpenses |
| Excess Or Deficit For Year | -2188548 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -158751 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -158751 | TotalAdjustments |
| Excess Or Deficit Per FS | -2347299 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 32061163 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 691297 | OtherRevenues |
| Revenue Not Rptd F990 | 691297 | RevenueNotRptdF990 |
| Revenue Subtotal | 31369866 | RevenueSubtotal |
| Other Revenues Not Included | 19486909 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 19486909 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 50856775 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 34249711 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 691297 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 691297 | ExpensesNotRptdF990 |
| Expenses Subtotal | 33558414 | ExpensesSubtotal |
| Other Expenses Not Included | 19486909 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 19486909 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 53045323 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FIN 48 DISCLOSURE | SCHEDULE D, PART X | Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. |
| OTHER ADJUSTMENTS | SCHEDULE D, PART XII AND XIII LINE 4B | CONTRACTUALS & OTHER = 19,486,909 |
| OTHER ADJUSTMENTS | SCHEDULE D, PART XII AND XIII LINE 2D | LOSS ON SALE OF FIXED ASSETS = $691,297 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 280. | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 670142 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 670142 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01340 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4288433 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1955314 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2333119 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04670 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4958575 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1955314 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3003261 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06010 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 30055 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4020 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 26035 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7788 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7788 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 37843 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4020 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 33823 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4996418 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1959334 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3037084 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06080 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense | $1,934,978 | BadDebtExpenseAmount |
| Amount Attributable To | 483745 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 7144418 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 7016726 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 127692 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 Sherman Drive | AddressLine1 |
| City | Princeton | City |
| State | IN | State |
| ZIP Code | 47670 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 5 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (5 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| GGH - SKILLED NURSING FACILITY | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | SKILLED NURSING REHAB CENTER |
| STAR ONE REHAB | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | PHYSICAL THERAPY OCCUPATIONAL THERAPY SPEECH THERAPY |
| HOPE HOUSE | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | GERIATRIC CONSULTING MEDICATION MANAGEMENT |
| LIFESTYLES DIABETES CENTER | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | DIABETES EDUCATION COUNSELING |
| PHYSICIAN OUTPATIENT CLINICS | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | SUBSIDIZED CARE PHYSICIAN PRACTICES |
Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PERCENT OF TOTAL EXPENSE | SCHEDULE H, PART I, LINE 7, COLUMN F | $3,093,490 OF BAD DEBT EXPENSE IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN A (TOTAL FUNCTIONAL EXPENSES), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. |
| DESCRIPTION OF BAD DEBT EXPENSE AND METHODOLOGY | SCHEDULE H, PART III, LINE 4 | THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT. THE HOSPITAL IS USING THE COST CALCULATION AS DETERMINED BY WORKSHEET 1. THERE ARE NO OTHER BAD DEBT AMOUNTS INCLUDED IN COMMUNITY BENEFIT BEYOND LINE 2 ABOVE. |
| TREATMENT OF MEDICARE SHORTFALL AS COMMUNITY BENEFIT | SCHEDULE H, PART III, LINE 8 | THE GIBSON GENERAL HOSPITAL IS A CAH AND IS REIMBURSED 101% OF MEDICARE ALLOWABLE COSTS FOR INPATIENT SERVICES, SWING BED, AND OUTPATIENT PART B SERVICES. THE REVENUE SHORTFALL ABOVE IS THE DIFFERENCE BETWEEN THE ALLOWABLE COST FOR THE SKILLED NURSING FACILITY AND THE PPS REIMBURSEMENT ALLOWED FOR THAT SKILLED NURSING FACILITY. |
| NEEDS ASSESSMENT | SCHEDULE H, PART VI, LINE 2 | THE HOSPITAL HAS WORKED WITH THE GIBSON COUNTY PUBLIC HEALTH OFFICER AND THE INDIANA DEPARTMENT OF HEALTH AND OTHER REGIONAL PROVIDERS ON A COMMUNITY ASSESSMENT IN THE PAST AND WILL BE PARTICIPATING IN SUCH A PROJECT IN THE NEAR FUTURE. THIS ENGAGEMENT NORMALLY INCLUDES TERTIARY REFERRAL CENTERS IN EVANSVILLE, IN AND EMERGENCY RESPONSE SERVICES AS WELL. |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | SCHEDULE H, PART VI, LINE 3 | THE HOSPITAL HAS POSTERS IN THE CENTRAL REGISTRATION AND ER WAITING AREA INFORMING PATIENTS THAT WE SEE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND ALSO PROVIDE FINANCIAL ASSISTANCE TO UNINSURED AND UNDERINSURED. IN COMPLIANCE WITH EMTALA ALL ER PATIENTS ARE SEEN BY A PRACTITIONER PRIOR TO SOLICIATION OF FINANCIAL OR INSURANCE INFORMATION. ALL PATIENTS WHO DO NOT HAVE INSURANCE AND PATIENTS WHO HAVE BALANCES AFTER INSURANCE ARE CONTACTED BY OUR PATIENT FINANCIAL COUNSELOR BY MAIL WITH A FINANCIAL ASSISTANCE APPLICATION. |
| COMMUNITY INFORMATION | SCHEDULE H, PART VI, LINE 4 | THE HOSPITAL'S PRIMARY SERVICE AREA ENCOMPASSES GIBSON COUNTY, INDIANA, SW PIKE COUNTY AND POSEY COUNTY, INDIANA. GIBSON COUNTY HAS A POPULATION DENSITY OF 66/SQ. MILE. SW PIKE COUNTY HAS A POPULATION DENSITY OF 38/SQ. MILE. GIBSON GENERAL HOSPITAL HAS TWO LARGE COMPETING HEALTH CARE SYSTEMS 35 MILES TO ITS SOUTH. TRADITIONALLY, THE HOSPITAL HAS BEEN RELIED UPON AS A SAFETY NET HOSPITAL FOR OLDER PATIENTS, LOW-INCOME PATIENTS, AND PATIENTS WITH LIMITED MEANS TO TRAVEL TO THE LARGER CITY OF EVANSVILLE, IN. MUCH OF GIBSON COUNTY IS RURAL WITH AGRICULTURE AND COAL MINING AS PRIMARY INDUSTRIES. GIBSON COUNTY DOES ENJOY ECONOMIC BENEFIT FROM TOYOTA MANUFACTURING OF INDIANA, HOWEVER MORE THAN 50% OF THE TOYOTA WORKFORCE TRAVELS IN FROM THE EVANSVILLE METROPOLITAN AREA. PER CAPITA INCOME IN GIBSON COUNTY IS $18,169, 12% OR $2,468 LOWER THAN THE EVANSVILLE AREA. IN ADDITION, APPROXIMATELY 77% OF THE HOSPITAL'S PATIENT POPULATION IS FUNDED BY MEDICARE, MEDICAID, AND OTHER GOVERNMENT SUBSIDIZED PLANS. WITH THESE DEMOGRAPHICS AND THE ECONOMIC PRESSURES, THE HOSPITAL HAS SEEN A DRAMATIC INCREASE IN ITS CHARITY, BAD DEBT, AND MEDICAID LOSSES OVER THE LAST FEW YEARS. |
| PROMOTION OF COMMUNITY HEALTH | SCHEDULE H, PART VI, LINE 5 | THE HOSPITAL PARTICIPATES IN MANY ORGANIZATIONS AND ACTIVITIES DESIGNED TO IMPROVE THE HEALTH AND WELFARE OF THE SURROUNDING COMMUNITY. IN ADDITION TO PARTICIPATION ON VARIOUS BOARDS AND CIVIC ORGANIZATIONS FOCUSED ON ECONOMIC DEVELOPMENT, THE HOSPITAL'S LEADERSHIP PARTICIPATES IN THE INDIANA PATIENT SAFETY COALITION, THE DEPARTMENT OF HOMELAND SECURITY DISTRICT 10 EMERGENECY PREPAREDNESS, AND NATIONAL INCIDENT MANAGEMENT SYSTEMS PROGRAMS. AS MEMBERS OF THE INDIANA RURAL HEALTH ASSOCIATION AND INDIANA STATE RURAL HEALTH NETWORK, THE HOSPITAL PARTICIPATES IN PROGRAMS DESIGNED TO ASSIST RURAL HEALTH CARE ORGANIZATIONS STATEWIDE AND HAS ASSISTED IN OBTAINING AND IMPLEMENTING COMMUNICATION, INFORMATION SHARING, AND OTHER INITIATIVES TO IMPROVE ACCESS TO HEALTH CARE IN RURAL AREAS. THE HOSPITAL WORKS WITH OTHER AREA AGENCIES SUCH AS GCARC, SEVERAL UNIVERSITIES AND COLLEGES AND SCHOOL DISTRICTS TO OFFER COOPERATIVE LEARNING ENVIRONMENTS FOR UNDERDEVELOPED NURSING, IMAGING TECHNOLOGY, AND PHARMACY STUDENTS. THE HOSPITAL PROVIDES VOLUNTEERS TO ASSIST IN ENVIRONMENTAL CLEAN-UP AND HOUSING PROJECTS AS WELL. |
| AFFILIATED HEALTH CARE SYSTEM | SCHEDULE H, PART VI, LINE 6 | GIBSON GENERAL HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. THE HOSPITAL DOES PARTICIPATE IN SEVERAL COALITIONS AND COOPERATIVES WITH OTHER PROVIDERS AND OFTEN COLLABORATES WITH THE TERTIARY SYSTEMS IN EVANSVILLE TO PROVIDE ACCESS TO SERVICES THE HOSPITAL CANNOT PROVIDE SUCH AS CARDIAC AND NEUROLOGICAL SURGERY. |
| STATE FILING OF COMMUNITY BENEFIT REPORT | 990 SCHEDULE H, PART VI | IN, |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HEALTH FOUNDATION INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1 |
| City | PRINCETON | City |
| State | IN | State |
| ZIP Code | 47670 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 350950175 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 102781 | AmountOfCashGrant |
| Purpose Of Grant | SUPPORT MISSION & ASSIST WITH PAYMENT OF EXPENSES | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | MONITORING USE OF FUNDS | Identifier |
| Return Reference | SCHEDULE I, PART I, LINE 2 | ReturnReference |
| Explanation | THE HOSPITAL MONITORS THE USE OF THE FUNDS PROVIDED TO THE FOUNDATION BY HAVING THE FOUNDATION SUBMIT INVOICES FOR APPROVAL. THE HOSPITAL THEN PAYS THE INVOICES ON THE FOUNDATION'S BEHALF AND PROVIDES THE FOUNDATION WITH COPIES OF THESE PAYMENTS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EMMETT SCHUSTER | |||||||||||||
| 173807 | 0 | 0 | 0 | 0 | 0 | 3191 | 0 | 10461 | 0 | 187459 | 0 | 0 | 0 |
| MARK CARPENTER MD | |||||||||||||
| 340956 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 5313 | 0 | 346269 | 0 | 0 | 0 |
| STEPHEN SHOEMAKER MD | |||||||||||||
| 221475 | 0 | 0 | 0 | 0 | 0 | 0 | 11303 | 0 | 232778 | 0 | 0 | 0 | |
| ROSABEL MANALO-IBAY | |||||||||||||
| 156426 | 0 | 0 | 0 | 0 | 0 | 3247 | 0 | 864 | 0 | 160537 | 0 | 0 | 0 |
| STEVEN GRIFFITH MD | |||||||||||||
| 153617 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 153617 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)
| Issuer EINIssuerEIN | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|
| CITY OF PRINCETON | ||||||
| 356001169 | 2005-06-01 | 7100000 | Capital improvements | false | false | false |
| CITY OF PRINCETON | ||||||
| 356001169 | 2007-10-01 | 2096000 | Energy conservation project | false | false | false |
| RENOVATIONS - EMERGENCY DEPARTMENT | ||||||
| 356001169 | 2008-12-01 | 2500000 | Renovations - emergency depart | false | false | false |
| INDIANA HEALTH & ED FACILITY FINANCING AUTHORITY | ||||||
| 521698917 | 2007-03-01 | 2500000 | Purchase diagnostic equipment | false | false | false |
Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)
| Amount RetiredAmountRetired | Amount Bond DefeasedAmountBondDefeased | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Capitalized InterestCapitalizedInterest | Refunding EscrowRefundingEscrow | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Working Capital ExpendituresWorkingCapitalExpenditures | Capital ExpendituresCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Amount UnspentAmountUnspent | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0 | 0 | 7100000 | 0 | 0 | 0 | 55566 | 0 | 0 | 3146250 | 0 | 0 | 2009 | false | true | true | true |
| 0 | 0 | 2096000 | 0 | 0 | 0 | 0 | 0 | 0 | 2002380 | 0 | 0 | 2008 | false | false | true | true |
| 0 | 0 | 2500000 | 0 | 0 | 0 | 31500 | 0 | 0 | 2500000 | 0 | 0 | 2009 | false | false | true | true |
| 0 | 0 | 2500000 | 0 | 0 | 0 | 0 | 0 | 0 | 2500000 | 0 | 0 | 2007 | false | false | true | true |
Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|---|
| false | false | false | false | false | 0.00000 | 0.00000 | 0.00000 | false |
| false | false | false | false | false | 0.00000 | 0.00000 | 0.00000 | false |
| false | false | false | false | false | 0.00000 | 0.00000 | 0.00000 | false |
| false | false | false | false | false | 0.00000 | 0.00000 | 0.00000 | false |
Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Exception To RebateExceptionToRebate |
|---|---|---|---|---|
| false | true | false | false | true |
| false | true | false | false | true |
| false | true | false | false | true |
| false | true | false | false | true |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | THOMAS JOSEPH MD | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | CHIEF OF STAFF | Relationship |
| Amount Of Transaction | 770385 | AmountOfTransaction |
| Description Of Transaction | INDEPENDENT CONTRACTOR | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS | Identifier |
| Return Reference | SCHEDULE L, PART IV | ReturnReference |
| Explanation | THOMAS JOSEPH, M.D. PROVIDES MEDICAL AND HEALTH SERVICES ON A CONTRACT BASIS TO THE HOSPITAL. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OFFICER RELATIONSHIPS | FORM 990, PART VI, QUESTION 2 | DONALD AND HELEN HAUKE HAVE A FAMILY RELATIONSHIP. |
| PROCESS TO REVIEW THE FORM 990 | FORM 990, PART VI, QUESTION 11A | THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES IS INFORMED OF THE NEED TO AND DUE DATE FOR FILING THE FORM 990 AND THAT IT IS AVAILABLE FOR INSPECTION AND REVIEW AT ANY TIME BY CONTACTING THE CFO OR THE CEO. THE CFO AND CEO DO A DETAIL OF THE RETURN BEFORE IT IS FILED. |
| PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY | FORM 990, PART VI, QUESTION 12C | THE BOARD OF TRUSTEES SIGNS A CONFLICT OF INTEREST STATEMENT ANNUALLY. THE CEO OR A COMPLIANCE OFFICER REVIEWS THE SIGNED STATEMENTS. ANY BOARD MEMBER WHO HAS A CONFLICT OF INTEREST RECUSES HIMSELF OR HERSELF FROM VOTING ON THE RELATED ISSUE. |
| REVIEW OF CEO OR TOP MGMT OFFICIAL COMPENSATION | FORM 990, PART VI, QUESTION 15A | THE CEO'S COMPENSATION IS REVIEWED ANNUALLY AND APPROVED BY THE BOARD OF TRUSTEES COMPENSATION COMMITTEE. THE COMMITTEE USES A COMPENSATION CONSULTANT, COMPENSATION SURVEY, AND COMPARATIVE DATA FROM SIMILAR ORGANIZATIONS TO DETERMINE THE CEO'S COMPENSATION. THE LAST REVIEW WAS COMPLETED IN MARCH 2010. |
| REVIEW OF OTHER OFFICER OR KEY EMPLOYEES COMPENSATION | FORM 990, PART VI, QUESTION 15B | OFFICER COMPENSATION IS REVIEWED ANNUALLY BY THE CEO. COMPENSATION SURVEYS ARE USED IN DETERMINING OFFICER COMPENSATION. THE LAST REVIEWS WERE CONDUCTED IN MARCH 2010. |
| AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND F/S | FORM 990, PART IV, QUESTION 19 | GIBSON GENERAL HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| OTHER CHANGES IN NET ASSETS OR FUND BALANCES | FORM 990, PART XI, LINE 5 | UNREALIZED GAIN/(LOSS) = ($158,752) |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HEALTH FOUNDATION INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1 |
| City | PRINCETON | City |
| State | IN | State |
| ZIP Code | 47670 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350950175 | EIN |
| Primary Activities | SUPPORT | PrimaryActivities |
| Legal Domicile State | IN | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11A | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
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