CENTRAL PENINSULA GENERAL HOSPITAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: CENTRAL PENINSULA GENERAL HOSPITAL INC (EIN 92-0077523)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-02-14
IRS object ID: 201330469349300948
Schema version: 2011v1.2
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R
Reasonable Cause Explanation

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-02-14T19:42:00-07:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	920077523	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CENTRAL PENINSULA GENERAL HOSPITAL INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	CENT	NameControl
Phone	9077144404	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	250 Hospital Place	AddressLine1
City	Soldotna	City
State	AK	State
ZIP Code	99669	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Shaun Keef	Name
Title	Chief Financial Officer	Title
Phone	9077144722	Phone
Date Signed	2013-02-15	DateSigned

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

Field	Value	IRS element (for citing)
Business Name Line1	Central Peninsula Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Richard Davis CEO	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	250 Hospital Place	AddressLine1
City	Soldotna	City
State	AK	State
ZIP Code	99669	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	199479298	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.cpgh.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1994	YearFormation
State Legal Domicile	AK	StateLegalDomicile
Activity Or Mission Description	We are a community initiated and community nurtured organization dedicated to promoting wellness and providing high quality health care that ensures the confidence and loyalty of our patients. We strive to improve individual and community health and achieve national standards of excellence.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	867	TotalNbrEmployees
Total Nbr Volunteers	246	TotalNbrVolunteers
Total Gross UBI	1020	TotalGrossUBI
Net Unrelated Business Txbl Income	34894	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	1164424	ContributionsGrantsPriorYear
Contributions Grants Current Year	1122562	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	160821053	ProgramServiceRevenuePriorYear
Program Service Revenue CY	196563665	ProgramServiceRevenueCY
Investment Income Prior Year	280501	InvestmentIncomePriorYear
Investment Income Current Year	267126	InvestmentIncomeCurrentYear
Other Revenue Prior Year	671090	OtherRevenuePriorYear
Other Revenue Current Year	1305676	OtherRevenueCurrentYear
Total Revenue Prior Year	162937068	TotalRevenuePriorYear
Total Revenue Current Year	199259029	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	139192	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	179256	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	59648477	SalariesEtcPriorYear
Salaries Etc Current Year	67350906	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	97675498	OtherExpensePriorYear
Other Expenses Current Year	122895004	OtherExpensesCurrentYear
Total Expenses Prior Year	157463167	TotalExpensesPriorYear
Total Expenses Current Year	190425166	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	5473901	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	8833863	RevenuesLessExpensesCY
Total Assets BOY	121920884	TotalAssetsBOY
Total Assets EOY	132450612	TotalAssetsEOY
Total Liabilities BOY	46955610	TotalLiabilitiesBOY
Total Liabilities EOY	48651475	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	74965274	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	83799137	NetAssetsOrFundBalancesEOY
Mission Description	We are a community initiated and community nurtured organization dedicated to promoting wellness and providing high quality health care that ensures the confidence and loyalty of our patients. We strive to improve individual and community health and achieve national standards of excellence. We are dedicated to providing the highest quality patient and resident centered care in a healing environment.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	170708016	Expense
Revenue	169281220	Revenue
Description	Our 49 bed hospital provided patient and ancillary services to 2,387 inpatients and 82,310 outpatients during the 2011 tax year. The hospital provides emergency medical services regardless of ability to pay. Emergency medical services were provided to 16,770 individuals, and 1,389 of those individuals were admitted to the hospital. 3,900 surgical procedures were performed in the hospital during the tax year. The imaging department performed 38,699 procedures. Over 57,000 physical therapy procedures were provided to area residents. During the 2011 tax year, free medical services in the amount of $7,050,090 were provided to patients eligible for charity care.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	10651180	Expense
Revenue	11456333	Revenue
Description	Skilled nursing and long term care services were provided by our 60 bed skilled nursing facility. Heritage Place provides healing and compassionate residential care in a home like setting. Total admissions for the 2011 tax year were 37 and total resident days of care were 20,449. An average of 56 residents per day were provided long term care and nursing. Ancillary services for residents included 10,971 physical therapy treatments, while outpatients received 3,431 therapy treatments.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	6681218	Expense
Revenue	13975958	Revenue
Description	The Hospital operates 9 family and specialty physician services clinics providing care in the following areas: Family medicine, Women's health, Pediatrics, Neurology, Pain Management, Surgery, and Orthopedics. Other outpatient clinics include Wound care, Sleep studies, Forensic services, and the provision of Durable medical equipment. During the 2011 tax year, physician and specialty services were provided for 22,682 patient visits. Over 2,700 wound care procedures, 145 forensic exams, and 215 sleep studies were also performed.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	0	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	0	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	0	TotalOfOtherProgramServiceRev
Total Program Service Expense	188040414	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	1	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	0	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	1	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	1	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	116	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	867	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	11	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
Own Website	X	OwnWebsite
Other Website	X	OtherWebsite

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	Central Peninsula Hospital	BusinessNameLine1
Business Name Line2	Finance Department	BusinessNameLine2

Field	Value	IRS element (for citing)
Telephone Number	9077144525	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	250 Hospital Place	AddressLine1
City	Soldotna	City
State	AK	State
ZIP Code	99669	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
Henry Krull
Board Member	4	X	2125	0	0
Michael Navarre
Board Member	4	X	2000	0	0
John Hoyt
Board Member	4	X	3200	0	0
Silverio Mattero
Board Member	4	X	3125	0	0
Russell Peterson
Board Member	4	X	0	0	0
Richard Ross
Board Member	4	X	3425	0	0
Judith Salo
Board Member	4	X	3475	0	0
Alyson Stogsdill
Secretary/Treasurer	6	X	3425	0	0
Trena Richardson
Board Vice President	6	X	4375	0	0
John Torgerson
Board Member	4	X	2075	0	0
Loren Wiemer
Board President	6	X	12575	0	0
Irving Carlisle
Board Member	4	X	0	0	0
Henry Peter Sprague
Board Member	4	X	0	0	0
Stephen Craig Humphreys
Board Member	4	X	0	0	0
Ryan K Smith
CEO	40		420049	34506	0	X
Jason D Paret
CFO	40		162455	27955	0	X
Andrea D Posey
CNO	40		160859	36806	0	X
Johnny L Dodd
VP of Human Resources	40		132713	24695	0	X
Matthew Dammeyer
Chief Operating Officer	40		153374	35083	0	X
Michael Haggerty
Interim CFO/Controller	40		144895	17348	0	X
Richard Davis
CEO	40		109931	7480	0	X
Gregg Motonaga
Anesthesia PhD	40		571622	37796	0		X
Charles C Mickelson
Emergency PhD	28		517710	33543	0		X
David S Innes
Orthopedic Surgeon	40		1214672	33543	0		X
Cynthia Kahn
Pain Management Physician	40		534712	14555	0		X
Ned Magen
Emergency Room Physician	33		465902	33543	0		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	4628694	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	336853	TotalReportableCompFrmRltdOrgs
Total Other Compensation	0	TotalOtherCompensation
Number Individuals GT100 K	68	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation	Business Name Line2NameOfContractor/NameBusiness/BusinessNameLine2
Molloy Schmidt LLC
110 South Willow St Suite 101	Kenai	AK	99611	Attorney Services	435148
Sound Physicians
1123 Pacific Avenue	Tacoma	WA	98402	Physician Services	849555
C&A Industries
PO Box 3037	Omaha	NE	68103	Contract Labor Provider	304878	Aureus
Wash Doctor
PO Box 3781	Soldotna	AK	99669	Laundry Services	162040
Curtis Buchholz
44455 Sterling Hwy	Soldotna	AK	99669	Pathology Services	105200

Field	Value	IRS element (for citing)
Federated Campaigns	0	FederatedCampaigns
Membership Dues	0	MembershipDues
Fundraising Events	0	FundraisingEvents
Related Organizations	240848	RelatedOrganizations
Government Grants	860922	GovernmentGrants
All Other Contributions	20792	AllOtherContributions
Noncash Contributions	792	NoncashContributions
Total Contributions	1122562	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount
Hospital Service Revenue	622000	169218220	169218220	$0
Nursing Home Revenue	623000	11456333	11456333	$0
Physician clinic revenue	621110	13975958	13975958	$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	1913154	TotalRevenueColumn
Related Or Exempt Function Income	1913154	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	196563665	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	266277	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$266,277	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	102091	Real
Personal	0	Personal

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	101071	Real
Personal	0	Personal

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	1020	Real
Personal	0	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	1020	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	1020	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	0	Securities
Other	849	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	0	Securities
Other	0	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	0	Securities
Other	849	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	849	TotalRevenueColumn
Related Or Exempt Function Income	849	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Cntrbtns Rprtd Fundraising Events	0	CntrbtnsRprtdFundraisingEvents
Gross Sales Of Inventory	364884	GrossSalesOfInventory
Cost Of Goods Sold	119198	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	245686	TotalRevenueColumn
Related Or Exempt Function Income	245686	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount
Property tax revenue	900099	91686	91686	$0
USAC Telephone Svc rev	900099	518300	518300	$0
Medicaid EHR subsidy	900099	448984	448984	$0

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	1058970	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	199259029	TotalRevenueColumn
Related Or Exempt Function Income	197869170	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	1020	UnrelatedBusinessRevenue
Exclusion	$266,277	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	179256	Total
Program Services	179256	ProgramServices

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	5052012	Total
Program Services	3531523	ProgramServices
Management And General	1520489	ManagementAndGeneral
Fundraising	0	Fundraising

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	41310081	Total
Program Services	41310081	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	1428342	Total
Program Services	1428342	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	16463307	Total
Program Services	16463307	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	3097164	Total
Program Services	3097164	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	795891	Total
Program Services	0	ProgramServices
Management And General	795891	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	55316	Total
Program Services	0	ProgramServices
Management And General	55316	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	13056	Total
Program Services	0	ProgramServices
Management And General	13056	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total
Fundraising	0	Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	2713410	Total
Program Services	2713410	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	563745	Total
Program Services	563745	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	17725726	Total
Program Services	17725726	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	3366289	Total
Program Services	3366289	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2350382	Total
Program Services	2350382	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	331129	Total
Program Services	331129	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	270281	Total
Program Services	270281	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	1103590	Total
Program Services	1103590	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	7977536	Total
Program Services	7977536	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	973887	Total
Program Services	973887	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
Medicare Deductions from revenue	34948132	34948132
Medicaid deductions from revenue	17842691	17842691
Charity care write-offs	7050090	7050090
Commercial, govmt, and other deductions from rev	13063444	13063444

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	11750409	Total
Program Services	11750409	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	190425166	Total
Program Services	188040414	ProgramServices
Management And General	2384752	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	21281704	BOY
EOY	27803487	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	200722	BOY
EOY	128492	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	15114899	BOY
EOY	19371223	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	322465	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	3133692	BOY
EOY	3539385	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	715429	BOY
EOY	1341753	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	113121143	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	48267250	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	67835573	BOY
EOY	64853893	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	500000	BOY
EOY	500000	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	13138865	BOY
EOY	14589914	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	121920884	BOY
EOY	132450612	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	8708436	BOY
EOY	12807111	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	12136	BOY
EOY	14194	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	38235038	BOY
EOY	35830170	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	0	BOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	46955610	BOY
EOY	48651475	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	74465274	BOY
EOY	83299137	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	500000	BOY
EOY	500000	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	74965274	BOY
EOY	83799137	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	121920884	BOY
EOY	132450612	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	8833863	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

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 C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	1	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	1	DirectContactLegislators
Direct Contact Legislators	$3,272	DirectContactLegislatorsAmount
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$9,785	OtherActivitiesAmount
Total Lobbying Expenditures IIB	13057	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	SchC_P2B_S00_L01	Identifier
Return Reference	Schedule C, Part II-B, Line 1	ReturnReference
Explanation	The Hospital engages in very little lobbying on an ongoing basis. However, educational discussions with lawmakers and general support of healthcare legislation do occur on occasion. Lobbying expenses for tax year 2011 consisted of one trip to the US Capitol, and one trip to the State Capitol to meet with legislators ($3,272). Other lobbying expenses consist of the % of dues paid to the American Hospital Association and the Alaska State Hospital and Nursing Home Association which were reportedly used for lobbying expenses ($9,785).	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Preservation For Public Use	X	PreservationForPublicUse
Total Number Of Easements	1	TotalNumberOfEasements
Total Acreage	40	TotalAcreage
Nmbr Hist Struct Easements	0	NmbrHistStructEasements
Nmbr Hist Struct Easements After	0	NmbrHistStructEasementsAfter
Nmbr Easements Modified	0	NmbrEasementsModified
Nmbr States In Which Easements Held	1	NmbrStatesInWhichEasementsHeld
Written Policy Monitoring	0	WrittenPolicyMonitoring
Staff Hours Spent On Enforcement	0	StaffHoursSpentOnEnforcement
Expenses Incurred For Enforcement	0	ExpensesIncurredForEnforcement
Sect170h Requirements Satisfied	0	Sect170hRequirementsSatisfied

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	1825517	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Book Value	1825517	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	70354228	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	31578316	Depreciation
Book Value	38775912	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	625797	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	206955	Depreciation
Book Value	418842	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	37735616	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	15832922	Depreciation
Book Value	21902694	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	2579985	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	649057	Depreciation
Book Value	1930928	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	64853893	TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescription	Book ValueBookValue
Plant replacement fund	11421461
Longterm investment (Certificate of Deposit)	3034960
Bond issuance costs (refunding bonds)	133493

Field	Value	IRS element (for citing)
Total Book Value Other Assets	14589914	TotalBookValueOtherAssets
Total Revenue	199259029	TotalRevenue
Total Expenses	190425166	TotalExpenses
Excess Or Deficit For Year	8833863	ExcessOrDeficitForYear
Net Unrealized GL On Investments	0	NetUnrealizedGLOnInvestments
Donated Services And Facilities	0	DonatedServicesAndFacilities
Investment Expenses	0	InvestmentExpenses
Prior Period Adjustments	0	PriorPeriodAdjustments
Other	$0	OtherAmount
Total Adjustments	0	TotalAdjustments
Excess Or Deficit Per FS	8833863	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	126354672	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	0	NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities	0	DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants	0	RecoveriesOfPriorYearGrants
Other Revenues	0	OtherRevenues
Revenue Not Rptd F990	0	RevenueNotRptdF990
Revenue Subtotal	126354672	RevenueSubtotal
Investment Expenses Not Included	0	InvestmentExpensesNotIncluded
Other Revenues Not Included	72904357	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	72904357	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	199259029	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	117520809	TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities	0	DonatedServicesUseOfFacilities
Prior Year Adjustments	0	PriorYearAdjustments
Losses Reported	0	LossesReported
Other Expenses Included	0	OtherExpensesIncluded
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	117520809	ExpensesSubtotal
Investment Expenses Not Included2	0	InvestmentExpensesNotIncluded2
Other Expenses Not Included	72904357	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	72904357	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	190425166	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchD_P02_S00_L09	Schedule D, Part II, Line 9	In 2008 the hospital purchased a building which resides on 40 acres of land subject to a 'perpetual covenant' for the benefit of all AK residents, restricting the use of the land for agricultural purposes pursuant to AK statute 38.05.321. The building is used by the hospital's chemical dependency dept. There is no value placed on the easement itself and therefore it does not appear on the hospital financial statements or footnotes. However the cost of the real property is recorded as an asset on the balance sheet.
SchD_P12_S00_L04b	Schedule D, Part XII, Line 4b	Amounts reported on line 1 are net of certain allowances and deductions for third party payors such as Medicare, Medicaid, VA, Charity Care, and Other insurance classes.
SchD_P13_S00_L04b	Schedule D, Part XIII, Line 4b	Amounts reported on line 1 are not inclusive of certain allowances and deductions from revenue which are reported in Part IX line 25 expenses. These allowances and deductions represent amounts charged to payers which must be written off. They include Medicare, Medicaid, VA, Charity care, and other insurance classes.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	0	AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	6382	PersonsServed
Total Community Benefit Expense	3640751	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	3640751	NetCommunityBenefitExpense
Percent Of Total Expense	0.0339	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	22557	PersonsServed
Total Community Benefit Expense	19572217	TotalCommunityBenefitExpense
Direct Offsetting Revenue	17966444	DirectOffsettingRevenue
Net Community Benefit Expense	1605773	NetCommunityBenefitExpense
Percent Of Total Expense	0.015	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	198	PersonsServed
Total Community Benefit Expense	27002	TotalCommunityBenefitExpense
Direct Offsetting Revenue	15216	DirectOffsettingRevenue
Net Community Benefit Expense	11786	NetCommunityBenefitExpense
Percent Of Total Expense	0.0001	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	3	NumberOfActivitiesOrPrograms
Persons Served	29137	PersonsServed
Total Community Benefit Expense	23239970	TotalCommunityBenefitExpense
Direct Offsetting Revenue	17981660	DirectOffsettingRevenue
Net Community Benefit Expense	5258310	NetCommunityBenefitExpense
Percent Of Total Expense	0.0490	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	479	NumberOfActivitiesOrPrograms
Persons Served	22393	PersonsServed
Total Community Benefit Expense	657404	TotalCommunityBenefitExpense
Direct Offsetting Revenue	70267	DirectOffsettingRevenue
Net Community Benefit Expense	587138	NetCommunityBenefitExpense
Percent Of Total Expense	0.0055	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	100	NumberOfActivitiesOrPrograms
Persons Served	764	PersonsServed
Total Community Benefit Expense	99534	TotalCommunityBenefitExpense
Direct Offsetting Revenue	62944	DirectOffsettingRevenue
Net Community Benefit Expense	36590	NetCommunityBenefitExpense
Percent Of Total Expense	0.0003	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	9	NumberOfActivitiesOrPrograms
Persons Served	9720	PersonsServed
Total Community Benefit Expense	2563343	TotalCommunityBenefitExpense
Direct Offsetting Revenue	872205	DirectOffsettingRevenue
Net Community Benefit Expense	1691138	NetCommunityBenefitExpense
Percent Of Total Expense	0.0158	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	286	NumberOfActivitiesOrPrograms
Persons Served	1908	PersonsServed
Total Community Benefit Expense	184388	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	184388	NetCommunityBenefitExpense
Percent Of Total Expense	0.0017	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	874	NumberOfActivitiesOrPrograms
Persons Served	34785	PersonsServed
Total Community Benefit Expense	3504669	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1005416	DirectOffsettingRevenue
Net Community Benefit Expense	2499254	NetCommunityBenefitExpense
Percent Of Total Expense	0.0233	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	877	NumberOfActivitiesOrPrograms
Persons Served	63922	PersonsServed
Total Community Benefit Expense	26744639	TotalCommunityBenefitExpense
Direct Offsetting Revenue	18987076	DirectOffsettingRevenue
Net Community Benefit Expense	7757564	NetCommunityBenefitExpense
Percent Of Total Expense	0.0723	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	300	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	300	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	300	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	300	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$4,696,386	BadDebtExpenseAmount
Amount Attributable To	3626138	AmountAttributableTo
Amount Reimbursed By Medicare	26096414	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	27440839	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-1344425	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	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	Central Peninsula Hospital	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	250 Hospital Place	AddressLine1
City	Soldotna	City
State	AK	State
ZIP Code	99669	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Central Peninsula Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Information Gaps	X	InformationGaps
Needs Assessment Conducted	09	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	0	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Other Method	X	OtherMethod
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
Other Needs Addressed	X	OtherNeedsAddressed
All Needs Addressed	0	AllNeedsAddressed
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	400	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	1	ActionsOnNonpayment
Permit Report To Credit Agency	X	PermitReportToCreditAgency
Collection Activities	1	CollectionActivities
Report To Credit Agency	X	ReportToCreditAgency
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Other Actions Taken	X	OtherActionsTaken
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	16	NumberOfOtherFacilities

Other Facilities OtherFacilities (16 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType	Address Line2Address/AddressLine2
Heritage Place
232 Rockwell Ave	Soldotna	AK	99669	Skilled nursing facility, longterm care
Serenity House
47480 Kristina Way	Soldotna	AK	99669	Chemical dependency treatment center
Central Peninsula Pain Management
289 N Fireweed	Soldotna	AK	99669	Pain management clinic	Unit C/D
Central Peninsula Neurology
198 West Corral	Soldotna	AK	99669	Neurology clinic
Central Peninsula Family Practice Kenai
506 Lake Street	Kenai	AK	99611	Family practice clinic
Kenai Physical Medicine
130 Willow Street	Kenai	AK	99611	Physical therapy clinic	Unit 1
Soldotna Physical Medicine
35551 Kenai Spur Hwy	Soldotna	AK	99669	Physical Therapy clinic
Kenai Health Center
630 Barnacle Way	Kenai	AK	99611	Diagnostic imaging, lab, and domestic violence services
Central Peninsula Family Practice Kobuk
245 N Binkley St	Soldotna	AK	99669	Family practice clinic	Suite 101
Central Peninsula Surgical Services
289 N Fireweed St	Soldotna	AK	99669	Surgical clinic	Unit B
Central Peninsula Family Practice Fireweed
245 N Binkley Street	Soldotna	AK	99669	Family practice clinic	Suite 101
Serenity House intake office
245 N Binkley Street	Soldotna	AK	99669	Chemical dependency intake, behavioral health clinic	Suite 203
Peninsula Medical Center
265 N Binkley Street	Soldotna	AK	99669	Owned medical office building
Central Peninsula Medical Center
245 N Binkley Street	Soldotna	AK	99669	Owned medical office building
Vacant building
158 Corral Street	Soldotna	AK	99669	Vacant building for remodel
Vacant building
166 W Corral Street	Soldotna	AK	99669	Vacant building for remodel

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchH_P01_S00_L07	Schedule H, Part I, Line 7	In activities where costs were reasonably able to be compiled, we used actual costs. For activities such as charity care, and the cost to provide such care, we used the cost to charge ratio as calculated by our most current medicare cost report figures.
SchH_P01_S00_L072f	Schedule H, Part I, Line 7, Column f	Total bad debt (at gross charges) reported were $9,094,261. However applying a cost to charge ratio of 51.7% we reduced bad debt to $4,696,386 to report the 'cost' to the organization for unpaid accounts. Of this balance approximately 73% is estimated to be attributable to patients who may be eligible for free or discounted care under the organizations charity care policy.
SchH_P02_S00_L00	Schedule H, Part II	The Hospital performs most of its community building activities through monetary support to local non-profits reported in another section of the Schedule H.
SchH_P03_S0A_L04	Schedule H, Part III, Section A, Line 4	Footnote: Bad debt provisions are made for the amount of revenue that will not be collected from patients to whom services were billed but not paid. The Hospital has determined these patients are neither medically nor financially indigent and do not qualify for the Hospital's charity care program. Bad debt provisions are determined by management's assessment with consideration of business and economic conditions, changes and trends in healthcare coverage, and other collection indicators. The adequacy of this provision is periodically reviewed and further modified based upon the accounts receivable payor composition and aging, and historical write-off experience by payor category. The amount reported on line 1 is based on total gross charges written off to bad debt ($9,094,261) times the cost to charge ratio, to arrive at Cost of services written off to bad debt. The amount reported on line 2 is based on an estimated 73% of bad debts which may be attributable to patients that qualify for a discount or free care under our financial assistance policy. Because bad debts are primarily related to uninsured and underinsured patients to which services are provided despite the ability to pay, we believe that bad debts are also considered a community benefit.
SchH_P03_S0B_L08	Schedule H, Part III, Section B, Line 8	The cost to charge ratio has been calculated based on current charges and costs reported on our 2012 Medicare Cost Report. The ratio is slightly lower than that reported due to the removal of community benefit expenses from the total 'costs' (for the purposes of the 990 Sch H). It is the position of management that virtually all of the shortfall of medicare costs vs reimbursement are considered a community benefit. The reason for this stance is that the hospital is required to write off contractual allowances for medicare patients regardless of the shortfall created to provide those services. The hospital may only collect the portion which is patient co-pay or deductible and may not engage in collection efforts for the remainder.
SchH_P03_S0C_L09b	Schedule H, Part III, Section C, Line 9b	The hospital's collection policy PFS-546 addresses the various classes of private pay patients and defines the individuals which may request financial assistance based on either financial or medical indigence. The collection policy refers the collector first to the charity care policy for instruction on determining eligibility. As noted in Part I, the charity care policy is based on FPG which is the basis for a sliding scale between 200% and 400% of those guidelines. Applicants on the upper end of the scale (400%) are eligible for partial write-off, while those on the lower end (200%) are eligible for free care.
SchH_P05_S0B_L05	Schedule H, Part V, Section B, Line 5	In addition to the above methods of disbursement, the Health Needs Assessment was also provided via email to Administrators, Hospital Board members, and supervisory staff of Central Peninsula Hospital.
SchH_P05_S0B_L06	Schedule H, Part V, Section B, Line 6	Hospital management and the board of directors address the needs assessment findings through frequent strategic planning and the implementation of new services whenever financially viable. Additionally, the hospital supports the provision of health services by community health partners when it cannot supply those needs itself.
SchH_P05_S0B_L07	Schedule H, Part V, Section B, Line 7	Four of the health findings require long-term planning to reach the intended goal, they are: 1. Smoking rates of Central Kenai Peninsula residents remain elevated (although a non-smoking hospital campus has been revived, and smoking cessation methods are provided to patients --community wide initiated have yet to be planned and implemented) 2. Cancer risks on the Central Kenai Peninsula are elevated, requiring the promotion of screening (The construction of a radiation oncology center is underway for patients in need of cancer treatment, however detection and prevention efforts require additional attention) 3. Mental Health Needs are an issue on the Central Kenai Peninsula due to elevated depression/anxiety (Continued program expansion and funding for women's and children's behavioral health needs have been achieved - however additional mental health providers are needed to meet the demand) 4. Barriers to oral health care due to cost exists for a large number of residents (The hospital has not yet developed a solution for reducing the cost of oral health care for area residents. Currently Peninsula Community Health services is meeting this need through the provision of dental care through means based programs)
SchH_P05_S0B_L13	Schedule H, Part V, Section B, Line 13	The hospital employs 2 full time financial counselors that meet personally with patients to review their bills, set up payment arrangements, explain the financial assistance policy, and assist with the financial assistance application process.
SchH_P05_S0B_L17	Schedule H, Part V, Section B, Line 17	Our financial counselors make every effort to contact patients via phone and mail to communicate the various options for either payment arrangements or financial assistance prior to sending an account to collections.
SchH_P05_S0B_L19	Schedule H, Part V, Section B, Line 19	The hospital offers all self pay patients a prompt pay discount of 25% on hospital charges. Additionally, those patients which are uninsured, underinsuraed, or medically indigent may qualify for either free care or discounted care.
SchH_P06_S00_L02	Schedule H, Part VI, Line 2	In addition to the Health Needs Assessment report, the Hospital also determines health needs of the community through a variety of ways. A patient advisory committee comprised of area residents and hospital representatives assists in determining the adequacy of facilities and services to meet health needs of the community. The Hospital periodically employs consultants to determine the physician and specialty physician needs of the community to direct physician recruiting and strategic planning.
SchH_P06_S00_L03	Schedule H, Part VI, Line 3	The hospital attempts to provide a financial assistance program brochure to every patient during discharge. The brochure is also available on our website under Patient Financial Services. Additionally, the hospital's Financial counselors personally contact patients and explain the financial assistance policy, assist with the completion of the application, or set up payment plans if necessary.
SchH_P06_S00_L04	Schedule H, Part VI, Line 4	The area served by the the hospital is comprised of 13 Census designated places or towns and has a total population of approximately 35,000 residents according to the 2008 census. The geographic region is in the Central Kenai Peninsula in the state of Alaska. Based on the 2000 Census, approximately 7 percent of the population is age 65 or older, 25 percent are between 45 and 64, and 37 percent are between ages 18 and 44. Basic social and economic characteristics of the region indicate high unemployment and uninsured rates, nearly 3 percent higher than the US average and 2 percent higher than the state average.
SchH_P06_S00_L05	Schedule H, Part VI, Line 5	The hospital engages in numerous community efforts to improve the health of the region served. Monetary and personnel support of local non-profits, public service announcements, healthy choice advertising campaigns, child safety programs, low cost health fairs, physician speakers bureaus, community health newsletters, and many other programs and initiatives.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (8 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Purpose Of GrantPurposeOfGrant	Business Name Line2RecipientNameBusiness/BusinessNameLine2	Address Line2AddressUS/AddressLine2
City of Soldotna
117 North Birch	Soldotna	AK	99669	920030328	RR 78-276, 1978	10000	0	Contribution toward community library expansion.
Kenai Peninsula Borough
PO Box 7116	Nikiski	AK	99635	920030894	RR 78-276, 1978	15000		Contribution toward construction of Nikiski Community Playground.	North Peninsula Recreation Service Area
Southcentral Foundation
4501 Diplomacy Drivie	Anchorage	AK	99508	920086076	501(c)3	7500		Sponsorship for the All Alaska Pediatric Partnership.
Kenai River Professional Guide association
PO Box 3674	Soldotna	AK	99669	920162358	501(c)3	10000		Sponsorship for the Wounded Warrior progam.
Kenai Peninsula Food Bank
33955 Community College Dr	Soldotna	AK	99669	943112445	501(c)3	10500		The Food Bank provides low-cost or free food to families with financial need. This contribution supports the provision of nutritional help to area residents.
Hospice of the Central Peninsula
PO Box 2584	Soldotna	AK	99669	920118694	501(c)3	28350		Funding for the Hospice Bereavement Program, and general contributions.
Boys and Girls Club
705 Frontage Rd	Kenai	AK	99611	943067142	501(c)3	20550		Contribution to support the provision of safe after-school programs and healthy activities for Peninsula children.		Suite B
Kenai Peninsula Youth Foundation
PO Box 2605	Soldotna	AK	99669	262580744	501(c)3	7500		2011/2012 Season sponsor. The Kenai Peninsula Youth Foundation is an organization dedicated to providing developmental programs for aspiring student athletes. This contribution was made to Kenai River Brown Bears to support their Breast Cancer Awareness sporting event.	Kenai River Brown Bears

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	36	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	16	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	SchI_P01_S00_L02	Identifier
Return Reference	Schedule I, Part I, Line 2	ReturnReference
Explanation	The hospital does not provide 'grants' but cash contributions to local organizations which support community initiatives and healthy living on the Kenai Peninsula. The hospital provides funding to organizations in good community standing. Hospital officers are responsible for approving all assistance payments to organizations, and do so with discretion.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Payments	X	IdemnificationGrossUpPayments
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	0	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	1	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	1	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 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 Related OrgsCompReportPrior990RelatedOrgs
Gregg Motonaga
544633	0	27277	0	1837	0	21783	0	21251	0	616781	0	0
Charles C Mickelson
519559	0	60	0	1230	0	5283	0	31401	0	557533	0	0
David S Innes
773386	0	378957	0	65469	0	5283	0	31401	0	1254496	0	0
Ned Magen
466083	0	60	0	2899	0	5283	0	31401	0	505726	0	0
Ryan K Smith
213241	0	127477	0	82209	0	11722	0	28784	0	463433	0	0
Richard Davis
82434	0	22817	0	5388	0	1105	0	7084	0	118828	0	0
Jason D Paret
99467	0	13124	0	52218	0	7937	0	22373	0	195119	0	0
Michael Haggerty
113424	0	4502	0	27999	0	8076	0	10303	0	164304	0	0
Andrea D Posey
132511	0	12092	0	19396	0	8545	0	31401	0	203945	0	0
Johnny L Dodd
116758	0	4882	0	13197	0	5570	0	21251	0	161658	0	0
Cynthia Kahn
427523	0	61646	0	46573	0	5283	0	10303	0	551328	0	0
Matthew Dammeyer
108737	0	15575	0	32202	0	6822	0	31401	0	194737	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchJ_P01_S00_L01a	Schedule J, Part I, Line 1a	Gross up payments are made for certain taxable fringe benefits and for the value of life insurance over $50,000. A year-end wage adjustment is made for all affected employees to include the gross up for fringe benefits and excess life insurance benefits. The Hospital has historically paid all social security and medicare taxes on such benefits. The employee is responsible for federal income taxes. Also among the fringe benefits offered to employees are health club discounts. The hospital pays for one-half of gym membership fees to promote the health and welfare of its employees and their family members.
SchJ_P01_S00_L01b	Schedule J, Part I, Line 1b	The year end gross up adjustment for fringe benefits and life insurance over $50,000 is based on historical practice of the hospital and is not governed by written policy. The hospital maintains that at some future date, employees may be required to pay their own FICA taxes on fringe benefits. Similarly, payment of one-half of gym membership fees is not a written policy. Although the hospital currently extends this benefit to employees, it may not always do so.
SchJ_P01_S00_L03	Schedule J, Part I, Line 3	The hospital contracts with an independent consultant to perform a review of executive wages and benefits using comparable studies. The resulting report is provided to the Board of Directors for review. The Board sets compensation levels for the CEO through a written employment contract with the organization. The CEO is responsible for hiring the remainder of the Hospital's executive staff.
SchJ_P01_S00_L04	Schedule J, Part I, Line 4	The hospital provides a 457 Top Hat plan to certain key employees and executives. The following individuals on Schedule J participated in the 457 plan and either deferred their own compensation or received hospital contributions into the plan during the tax year; Gregg Motonaga ($17,228), Ryan Smith ($3,846), Richard Davis ($3,181), Jason Paret ($1,017), Michael Haggerty ($3,226), Andrea Posey ($3,423), Johnny Dodd ($2,909), and Matthew Dammeyer ($1,588).
SchJ_P01_S00_L05	Schedule J, Part I, Line 5	In accordance with their employment contract, Emergency Room Physicians receive a percentage of their professional physician fees billed. This compensation is not based on the entity's overall revenue.
SchJ_P01_S00_L06	Schedule J, Part I, Line 6	The hospital pays an annual incentive plan bonus to all employees, supervisors, and executives based on a series of 4 operational and quality measures. One of these 4 measures is meeting the hospital's net earnings budget. This element comprises only one-fourth of the potential incentive plan bonus payment. The remaining measures are 1)patient satisfaction, 2)quality, and 3)utilitzation.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
Kenai Peninsula Borough
920030894	488530NF9	2003-12-18	47985000	Hospital expansion project 2003 GO bonds	0	0	0
Kenai Peninsula Borough
920030894	01179PX51	2011-09-15	27905000	Refunding bonds - 2011 GO	0	0	1

Form990 Schedule K Part II Form990ScheduleKPartII (2 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
43635000	0	53963243	0	3376615	32472362	544896	0	0	53418347	0	0	2008	0	0	1	1
0	0	32616814	0	0	0	201610	0	0	0	0	0	2008	0	1	1	1

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
0	0	0	0	0	0	0	1
0	0	0	0	0	0	0	1

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiled	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Exception To RebateExceptionToRebate
1	1	0	0	1	0
0	1	0	0	0	0

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
Charles Weimer
Spouse of Board President	12000	Mr. Weimer Rents real estate at FMV to the hospital	0
Henry Krull
Board member	125268	Mr. Krull is the majority shareholder in KRG Development which leases real estate at FMV to the hospital	0
S Craig Humphreys
Board member	322465	Dr. Humphreys is currently repaying a physician guarantee loan arrangement to the hospital for practice start up expenses	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
F990_P06_S0A_L07b	Form 990, Part VI, Section A, Line 7b	Central Peninsula General Hospital Inc. operates the Hospital through a lease and operating agreement (LOA) with the Kenai Peninsula Borough. CPGH Inc Board decisions regarding the acquisition of significant capital assets and plant expansion are subject to approval by the Borough Assembly. Bonds, loans, and capital expenditures not funded through the Hospital's plant replacement funds must be approved by a vote of Borough constituents if greater than $1.0 million.
F990_P06_S0B_L11b	Form 990, Part VI, Section B, Line 11b	The 990 is prepared by the Hospital Finance Department and submitted to management for review. Management then returns all edits to the Finance Committee for the 2nd draft. The 2nd Draft and all schedules and statements are then submitted to each Board Member for review and comment. Final edits are provided to the Finance Dept and made prior to electronic submission by the CFO or Board President.
F990_P06_S0B_L12c	Form 990, Part VI, Section B, Line 12c	Both senior leadership and members of the Board of Directors complete annual conflict of interest statements which are reviewed by the management and Finance teams. The board also reviews and discusses any conflicts of interest which arise throughout the year and appropriate action is taken.
F990_P06_S0B_L15	Form 990, Part VI, Section B, Line 15	An independent professional Executive remuneration study was performed for 2012 by the HayGroup. Remuneration reports are submitted to the Board for review and used to set wage scales for the CEO, CFO, CNO, COO, and VP of Human Resources. Contemporaneous documentation exists for this study.
F990_P06_S0C_L19	Form 990, Part VI, Section C, Line 19	The Hospital publishes its 3 most recent 990s on its own website at www.cpgh.org. The 990 is also available at Guidestar.com. The Hospital provides its governing documents, conflict of interest policy, and audited financial statements in electronic format upon request.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg
Central Peninsula Health Foundation
250 Hospital Place	Soldotna	AK	99669	202778670	To support quality healthcare activities	AK	501(c)3	Public Charity	N/A	0
Kenai Peninsula Borough
144 N Binkley Street	Soldotna	AK	99669	920030894	Local Government which owns the hospital assets.	AK	115		N/A	0

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
Central Peninsula Health Foundation
c	34706	Actual cash value of capital contributions received from Central Peninsula Health Foundation.
Kenai Peninsula Borough
j	1	Central Peninsula General Hospital Inc operates the Hospital through a lease and operating agreement with the Kenai Peninsula Borough. Ultimately the borough owns the hospital facility and all related assets under the agreement and leases them to CPGH Inc to operate on its behalf. The amount stated in the lease and operating agreement is $1 per annum.
Central Peninsula Health Foundation
m	15419	Central Peninsula Hospital provides office space to Central Peninsula Health Foundation. The value of that space is determined based on our most recently filed Medicare Cost Report (2011) expenses for facility, administration, support services allocated per square foot.
Central Peninsula Health Foundation
n	60463	Central Peninsula Hospital shares certain paid employees for the directorship, and accounting functions necessary to operate Central Peninsula Health Foundation.
Central Peninsula Health Foundation
p	48487	Actual expenses incurred by Central Peninsula Hospital are stated at the dollar value paid which is reimbursed at cost by Central Peninsula Health Foundation.
Kenai Peninsula Borough
q	7610126	Per the Lease and Operating agreement with the Kenai Peninsula Borough, all cash >90 days operating must be transferred to an account held by the Kenai Peninsula Borough. This is the total amount of cash transferred to that account during FY12.

Reasonable Cause Explanation ReasonableCauseExplanation

Field	Value	IRS element (for citing)
Explanation	Extension was obtained because audited financial statements had not yet been issued as of the initial 990 reporting deadline.	Explanation