REGIONAL HOSPITAL FOR RESPIRATORY AND: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- REGIONAL HOSPITAL FOR RESPIRATORY AND (EIN 91-1170040)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-09
- IRS object ID
- 201233189349301963
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-09T19:08:25-07:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911170040 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | REGI | NameControl |
| Phone | 2062484604 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12844 Military Road South | AddressLine1 |
| City | Tukwila | City |
| State | WA | State |
| ZIP Code | 981683045 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Eric Jensen | Name |
| Title | Administrator | Title |
| Phone | 2062484542 | Phone |
| Date Signed | 2012-11-06 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Eric Jensen | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12844 Military Road S | AddressLine1 |
| City | Tukwila | City |
| State | WA | State |
| ZIP Code | 98168 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 20349899 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.regionalhospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | WA | StateLegalDomicile |
| Activity Or Mission Description | The Regional Hospital is committed to playing a critical role in the continuum of care by providing acute, long-term, complex care with the single goal of improving quality of life for our patients and their families. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 147 | TotalNbrEmployees |
| Total Nbr Volunteers | 4 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 23426003 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 20079399 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -1612 | InvestmentIncomePriorYear |
| Investment Income Current Year | -50148 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 270769 | OtherRevenuePriorYear |
| Other Revenue Current Year | 260500 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 23695160 | TotalRevenuePriorYear |
| Total Revenue Current Year | 20289751 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 10956555 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 11415563 | 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 | 11496944 | OtherExpensePriorYear |
| Other Expenses Current Year | 9983540 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 22453499 | TotalExpensesPriorYear |
| Total Expenses Current Year | 21399103 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1241661 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1109352 | RevenuesLessExpensesCY |
| Total Assets BOY | 14230254 | TotalAssetsBOY |
| Total Assets EOY | 12477917 | TotalAssetsEOY |
| Total Liabilities BOY | 4049540 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3406555 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 10180714 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 9071362 | NetAssetsOrFundBalancesEOY |
| Mission Description | The Regional Hospital is committed to playing a critical role in the continuum of care by providing acute, long-term, complex care with the single goal of improving quality of life for our patients and their families. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 17438836 | Expense |
| Grants | 0 | Grants |
| Revenue | 40825274 | Revenue |
| Description | The Regional Hospital for Respiratory and Complex Care (Regional Hospital) is a licensed, nonprofit, acute care hospital certified by Medicare as a long-term acute care hospital (LTACH). Regional Hospital's mission is to provide high quality, cost-effective care for a special population of patients requiring complex acute care for an extended period of time. Regional Hospital is commmitted to excellence in the delivery of specialized hospital care that improves the quality of life for our patients and their families. Therefore, in keeping with this commitment, free care and/or subsidized care is provided to persons covered by governmental programs at below cost and will be considered for other patients in need and when individuals are unable to pay for all of their care. Recognizing its mission to the community, services are provided to both Medicare and Medicaid patients. To the extent reimbursement is below cost, the Hospital recognizes these amounts as uncompensated care. The Hospital provides patient care to individuals in the communities it serves who do not have adequate resources to pay for healthcare services. Patient service charges incurred for charity care are defined by the Hospital to include all charges forgone for patients qualifying as medically indigent under the state Medicaid guidelines. During the year 2011, Regional Hospital provided nursing and ancillary services to 191 intermediate term patients for 8,343 patient days, and provided $20,979,065 in uncompensated services and contractual discounts. | Description |
| 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 | 17438836 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | 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 | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 56 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 147 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | 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 | 0 | 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 |
| States Where Copy Of Return Is Filed | WA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Gregg Terreson Highline Med Center | NamePerson |
| Telephone Number | 2062484758 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12844 Military Road South | AddressLine1 |
| City | Tukwila | City |
| State | WA | State |
| ZIP Code | 981683045 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (20 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 | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| Earl Sedlik | ||||||||
| President | 1 | X | X | 0 | 0 | 0 | ||
| Laurie Brown RN | ||||||||
| Board Member | 1 | X | 0 | 0 | 0 | |||
| Lloyd Musselman | ||||||||
| Treasurer and Secretary | 1 | X | X | 0 | 0 | 0 | ||
| Metta Schneider | ||||||||
| Board Member | 1 | X | 0 | 0 | 0 | |||
| Frederick Jackson MD | ||||||||
| Board Member | 1 | X | 0 | 0 | 0 | |||
| Sue Manfredi | ||||||||
| Vice President | 1 | X | X | 0 | 0 | 0 | ||
| Nicki Bly | ||||||||
| Board Member | 1 | X | 0 | 0 | 0 | |||
| Paul Hayes | ||||||||
| Board Member | 1 | X | 0 | 0 | 0 | |||
| JoEllen Vanatta | ||||||||
| Board Member | 1 | X | 0 | 0 | 0 | |||
| David Keller MD | ||||||||
| Board Member | 1 | X | 0 | 0 | 0 | |||
| Katherine Bechtold | ||||||||
| Board member | 1 | X | 0 | 0 | 0 | |||
| Eric Jensen | ||||||||
| CEO | 40 | X | 312399 | 0 | 22945 | |||
| Anne McBride | ||||||||
| CFO | 16 | X | 127360 | 0 | 0 | |||
| Robert Clark MD | ||||||||
| Chief Medical Officer | 27 | X | 812667 | 0 | 0 | |||
| Josephine Ramiro | ||||||||
| RN | 43 | 127258 | 0 | 27916 | X | |||
| Susan P Ferguson | ||||||||
| RN | 45 | 140899 | 0 | 24275 | X | |||
| Lerma Cua | ||||||||
| RN | 49 | 163116 | 0 | 32123 | X | |||
| Virginia Mondragon | ||||||||
| Registered Nurse | 46 | 132071 | 0 | 32597 | X | |||
| Richard Pedrick | ||||||||
| RN | 48 | 123551 | 0 | 16605 | X | |||
| Barbara Hostetler | ||||||||
| COO | 40 | 132497 | 0 | 17202 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2071818 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 173663 | TotalOtherCompensation |
| Number Individuals GT100 K | 16 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Highline Physical Therapy | |||||
| 31919 1st Avenue S Suite 101 | Federal Way | WA | 98003 | Physical Therapy Services | 360725 |
| Highline Medical Center | |||||
| 16251 Sylvester Road SW | Burien | WA | 98166 | Lease & Ancillary Services | 6740778 |
| Northwest Kidney Centers | |||||
| 700 Broadway | Seattle | WA | 98122 | Dialysis Services | 311277 |
| South Sound Inpatient Physicians PLLC | |||||
| PO BOX 742936 | Los Angeles | CA | 900742936 | Physician Services | 254163 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient Service Revenue | Description |
| Business Code | 622000 | BusinessCode |
| Total Revenue Column | 20079399 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20079399 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| 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 Program Service Revenue | 20079399 | TotalProgramServiceRevenue |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 10000 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 60148 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | -50148 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -50148 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$50,148 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Sales to Other Hospital | 622000 | 257466 | 0 | 0 | $257,466 |
| Medical Record Copies | 622000 | 2604 | 2604 | 0 | $0 |
| Interest Income | 622000 | 430 | 0 | 0 | $430 |
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 | 260500 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 20289751 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20082003 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $207,748 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | 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 | 1135445 | Total |
| Program Services | 38189 | ProgramServices |
| Management And General | 1097256 | 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 | 7739141 | Total |
| Program Services | 6581038 | ProgramServices |
| Management And General | 1158103 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 416082 | Total |
| Program Services | 308550 | ProgramServices |
| Management And General | 107532 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1387559 | Total |
| Program Services | 1028958 | ProgramServices |
| Management And General | 358601 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 737336 | Total |
| Program Services | 546779 | ProgramServices |
| Management And General | 190557 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95444 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 95444 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53617 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 53617 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 187094 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 187094 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | 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 | 5117469 | Total |
| Program Services | 5053332 | ProgramServices |
| Management And General | 64137 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 124918 | Total |
| Program Services | 675 | ProgramServices |
| Management And General | 124243 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 104740 | Total |
| Program Services | 33564 | ProgramServices |
| Management And General | 71176 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 329088 | Total |
| Program Services | 329088 | 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 | 542261 | Total |
| Program Services | 475081 | ProgramServices |
| Management And General | 67180 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115465 | Total |
| Program Services | 33277 | ProgramServices |
| Management And General | 82188 | 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 | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16774 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 16774 | 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 | 388669 | Total |
| Program Services | 388669 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 203795 | Total |
| Program Services | 201278 | ProgramServices |
| Management And General | 2517 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Medical Supplies | 1118569 | 1115437 | 3132 | 0 |
| Equipment Rental and Maintenance | 391573 | 359890 | 31683 | 0 |
| Provision for Bad Debt | 233190 | 233190 | 0 | 0 |
| License & Taxes | 178612 | 35 | 178577 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 782262 | Total |
| Program Services | 711806 | ProgramServices |
| Management And General | 70456 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21399103 | Total |
| Program Services | 17438836 | ProgramServices |
| Management And General | 3960267 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5036849 | BOY |
| EOY | 5591202 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6851699 | BOY |
| EOY | 4411589 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | 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 | 175383 | BOY |
| EOY | 176716 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 165650 | BOY |
| EOY | 156813 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 5117090 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2975493 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2000673 | BOY |
| EOY | 2141597 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14230254 | BOY |
| EOY | 12477917 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3658510 | BOY |
| EOY | 2604875 | 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 | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 391030 | BOY |
| EOY | 801680 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4049540 | BOY |
| EOY | 3406555 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10180714 | BOY |
| EOY | 9071362 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | 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 | 10180714 | BOY |
| EOY | 9071362 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14230254 | BOY |
| EOY | 12477917 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -1109352 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $6,334 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 6334 | 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 | For the calendar year 2011, the Washington State Hospital Association determined that 21.6% of the membership dues were expended in activities that meet the Medicare definition of lobbying. 24.42% of of the American Hospital Association and 5.49% of the National Association of Long Term Hospitals dues for fiscal year 2011, were determined as used for lobbying activities. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Book Value | 0 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 0 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1169756 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 981256 | Depreciation |
| Book Value | 188500 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 3941209 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 1994237 | Depreciation |
| Book Value | 1946972 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 6125 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 6125 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2141597 | TotalOfBookValueLandBuildings |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1 | PersonsServed |
| Total Community Benefit Expense | 15783 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15783 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0007 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1524815 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 608565 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 916250 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0433 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 1 | PersonsServed |
| Total Community Benefit Expense | 1540598 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 608565 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 932033 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0440 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1375 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1375 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0001 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 1375 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1375 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0001 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 1 | PersonsServed |
| Total Community Benefit Expense | 1541973 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 608565 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 933408 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0441 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $114,740 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 11833758 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5822760 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 6010998 | 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 | Regional Hospital for Respiratory and Complex Care | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12844 Military Road South | AddressLine1 |
| City | Tukwila | City |
| State | WA | State |
| ZIP Code | 98168 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Other | Long-term acute care hospital | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Regional Hospital for Respiratory and Complex Care | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 250 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Medicaid Medicare | X | MedicaidMedicare |
| Other Factors | X | OtherFactors |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 0 | NondiscrimEmergencyCarePolicy |
| Other Reason | X | OtherReason |
| Medicare Rate | X | MedicareRate |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchH_P01_S00_L07 | Schedule H, Part I, Line 7 | Worksheet 2 Ratio of Patient Care Cost to Charges from the IRS Instructions to Schedule H was used to calculate the amounts reported in the Table for Line 7 of Schedule H. |
| SchH_P01_S00_L072f | Schedule H, Part I, Line 7, Column f | The total bad debt expense included in Form 990, Part IX, line 25, column (A), but removed from the total expense for purposes of calculating the percentage in Schedule H, Part I, Line 7, column (f) was $233,190. |
| SchH_P01_S00_L07g | Schedule H, Part I, Line 7g | Not applicable. |
| SchH_P03_S0A_L04 | Schedule H, Part III, Section A, Line 4 | The Hospital provides for an allowance against patient accounts receivable for amounts that could become uncollectible whereby such receivables are reduced to their estimated net realizable value. The Hospital estimates this allowance based on the aging of accounts receivable and other relevant factors. |
| SchH_P03_S0B_L08 | Schedule H, Part III, Section B, Line 8 | The cost to charge ratio as calculated in Worksheet 2 was applied to the total patient revenue, net of contractual adjustments, received from Medicare, reported on line 5. |
| SchH_P03_S0C_L09b | Schedule H, Part III, Section C, Line 9b | During the patient registration process, Regional Hospital makes an initial determination regarding Charity Care eligibility based on an oral or written application for Charity Care. If a Charity Care application is started at this point, either in writing or verbally, Regional Hospital will suspend all collection efforts and will not require any deposit pending an initial determination of Charity Care eligibility. In the event that a responsible party pays a portion of all of the charges related to appropriate hospital-based medical care services, and is subsequently found to have met the Charity Care criteria at the time services were provided, any payments in excess of the amount eligible for discount shall be refunded to the patient within thirty days of establishing Charity Care eligibility. |
| SchH_P05_S0B_L11 | Schedule H, Part V, Section B, Line 11 | State and Federal disabillity |
| SchH_P05_S0B_L13 | Schedule H, Part V, Section B, Line 13 | Written notice regarding the existance of the financial assistance policy is provided to patients upon admittance to the hospital. |
| SchH_P05_S0B_L18 | Schedule H, Part V, Section B, Line 18 | Regional Hospital is a long-term acute care hospital which does not operate an emergency room, which precluded it from providing care for emergency medical conditions. |
| SchH_P06_S00_L02 | Schedule H, Part VI, Line 2 | Regional Hospital employs two full time clinical liaison nurses whose primary responsibilities are to represent the hospital at clinical conferences on pulmonary care, trauma care, and critical care. They are frequently present to talk with physicians and other practitioners on the standard of care for ventilator dependent patients and the positive results achieved from the hospital's weaning methodology. In addition, these individuals provide educational seminars to clinical professionals at local area hospitals on a rotating basis. Through this process, Regional Hospital has been able to identify critical unmet needs of patients on ventilators. Additionally, on a weekly basis, the two full time clinical liaison nurses visit other not-for-profit hospitals in King and Pierce counties to evaluate critical care patients for admission to Regional Hospital and to maintain ICU availability for the acute care hospitals. |
| SchH_P06_S00_L03 | Schedule H, Part VI, Line 3 | Understanding that all patients admitted to Regional Hospital are transferred in from other Pacific Northwest area hospitals, the communication regarding Regional Hospital's Charity Care program occurs with the patient and their family during the admitting process. Specifically, in the admitting packet of information, the patient/family is informed that Regional Hospital will help the family understand the federal/state/local assistance programs available to them. In addition, Regional Hospital provides charity care to those individuals meeting the hospital's charity care policy criteria. If a family member requests information about charity care, the social worker contacts the financial counselor who provides additional information through a personal visit or telephone call with the family. |
| SchH_P06_S00_L04 | Schedule H, Part VI, Line 4 | Regional Hospital is one of only two long-term acute care hospitals in the state of Washington, enabling admissions of patients from a broad geographic area, who are in need of ventilator weaning, or who have complex medical, respiratory and wound care needs requiring an extended hospital stay and recovery. |
| SchH_P06_S00_L05 | Schedule H, Part VI, Line 5 | Regional Hospital has an open medical staff and a ten member Board of Directors, which includes hospital executives from other local area hospitals, community leaders, and physicians. These individuals are volunteers who serve out of their civic commitment to ensure the long-term benefit of the hospital in the community it serves. Regional Hospital also has an open medical staff with privileges available to all qualified physicians. Established in 1993 as the first long-term acute care hospital in the Pacific Northwest, Regional Hospital has provided state-of-the-art hospital care for over 17 years to patients in need of ventilator weaning, or who have complex medical, respiratory and wound care needs requiring an extended hospital stay and recovery. Over the years, Regional Hospital has grown to serve the increasing demand for these services from the growing populations of Seattle and other Puget Sound communities. Originally a 17-bed facility, Regional is now a licensed 40-bed facility and the premier long-term acute care hospital in the Pacific Northwest. As a Long Term Acute Care Hospital (LTACH) serving medically complex and critically ill patients who are experiencing prolonged recoveries, Regional Hospital's mission is to restore the quality of life for patients and their families. Regional Hospital specializes in extended critical care, and is the regional expert in mechanical ventilator weaning, commonly referred to as life support, for patients experiencing respiratory complications or respiratory failure. As a part of Regional's dedication to individualized care, each patient is recognized as unique and hospital staff work to provide a personalized level of care based on their unique medical needs and augmented, when appropriate, with activities designed to heal the spirit. Our specialized, evidence-based medicine utilizes the latest in medical technology combined with a highly skilled clinical staff to accomplish this mission. Our dedicated and compassionate staff are committed to helping every patient achieve their full potential within the limitations of their illness, whether that is a complete recovery, or intensive medical care and rehabilitation that allows them to bridge the gap to the next level of recovery and care. At Regional Hospital, patients and families can expect from each member of our team compassion, optimism and honest concern for them as patients and family members. Through its unique blend of medical technology and compassionate care, Regional Hospital has established a reputation for producing outstanding results, and is well known throughout the Pacific Northwest for delivering the highest standards of clinical quality and patient safety. Helping patients recover with dignity and care is central to Regional Hospital's mission along with ensuring that hospital providers throughout the Seattle region can rely on Regional Hospital as a referral resource for their ICU patients allowing them to keep their ICU beds available for the more acutely ill patients. |
| SchH_P06_S00_L06 | Schedule H, Part VI, Line 6 | Not applicable. |
| SchH_P06_S00_L07 | Schedule H, Part VI, Line 7 | Not applicable. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Eric Jensen | |||||||||||||
| 291159 | 0 | 22800 | 0 | 999 | 0 | 0 | 0 | 24088 | 0 | 339046 | 0 | 0 | 0 |
| Lerma Cua | |||||||||||||
| 164026 | 0 | 0 | 0 | 0 | 0 | 7841 | 0 | 24398 | 0 | 196265 | 0 | 0 | 0 |
| Susan P Ferguson | |||||||||||||
| 140899 | 0 | 0 | 0 | 0 | 0 | 9861 | 0 | 14530 | 0 | 165290 | 0 | 0 | 0 |
| Virginia Mondragon | |||||||||||||
| 129939 | 0 | 0 | 0 | 1882 | 0 | 9225 | 0 | 23488 | 0 | 164534 | 0 | 0 | 0 |
| Josephine Ramiro | |||||||||||||
| 128169 | 0 | 0 | 0 | 0 | 0 | 3634 | 0 | 24398 | 0 | 156201 | 0 | 0 | 0 |
| Barbara Hostetler | |||||||||||||
| 132076 | 0 | 0 | 0 | 421 | 0 | 9243 | 0 | 10066 | 0 | 151806 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Northwest Critical Care Physicians | |||
| Robert Clark MD, a former member of the Board, is a partner in Northwest Critical Care Physicians | 287667 | Medical Services | 0 |
| Northwest Critical Care Physicians | |||
| Robert Clark MD, a former member of the Board, is a partner in Northwest Critical Care Physicians. | 525000 | Legal Settlement | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P06_S0B_L11b | Form 990, Part VI, Section B, Line 11b | Form 990 was prepared by the organization and reviewed by an independent CPA. Upon completion of 2011 form 990, the return was provided to the Executive Committee, for their review and approval prior to its filing. The Executive Committee comprises members of the Board. The approved form 990 was provided to all hospital Board members, voting and nonvoting, prior to filing with the IRS. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | Regional Hospital has a Conflict of Interest policy which is updated from time to time in order to be current with its requirements. The Board undergoes training in a variety of topics each year including governance and governance best practices. Each year, a Conflict of Interest form is completed by all officers, directors and others, in a position to exercise substantial influence over its decisions and affairs. When matters are discussed at the Board or subcommittee level, any conflicted person excuses themselves from the discussion and the vote with respect to the matter under consideration. Officers and directors are encouraged to bring any new conflicts to the Board during the year. The Board follows up on any new conflicts of interest that may come to its attention during the year. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | Compensation for Regional's leadership team and contracts with Board members and other medical staff are the responsibility of Regional's Executive Committee. The Executive Committee comprises certain members of Regional's Board who are independent with respect to such responsibilities. Compensation is determined by a review of the performance of the individuals as well as by reference to comparable market data as well as other Form 990s for comparable hospitals. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | Regional Hospital makes its Form 990 and Form 1023 available to the public in accordance with the public disclosure requirements of the Internal Revenue Code. At present the organization does not make its conflict of interest policy and financial statements available to the public. |
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