CENTRAL PENINSULA GENERAL HOSPITAL INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL PENINSULA GENERAL HOSPITAL INC (EIN 92-0077523)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-01-28
- IRS object ID
- 201100289349300110
- Schema version
- 2009v1.2
- 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 M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-01-28T13:21:12-07:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | 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 | Jason Paret | Name |
| Title | Chief Financial Officer | Title |
| Phone | 9077144719 | Phone |
| Date Signed | 2011-01-28 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | 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 | Ryan K Smith 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 | 143398895 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| 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 | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 792 | TotalNbrEmployees |
| Total Nbr Volunteers | 210 | TotalNbrVolunteers |
| Total Gross UBI | 3488 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 2488 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2199558 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1086302 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 127001320 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 139479810 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 690647 | InvestmentIncomePriorYear |
| Investment Income Current Year | 349551 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4031202 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2458737 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 133922727 | TotalRevenuePriorYear |
| Total Revenue Current Year | 143374400 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 111950 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 122672 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 47241232 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 52650261 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 124343 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 84236916 | OtherExpensePriorYear |
| Other Expenses Current Year | 87918395 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 131590098 | TotalExpensesPriorYear |
| Total Expenses Current Year | 140691328 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2332629 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2683072 | RevenuesLessExpensesCY |
| Total Assets BOY | 120675626 | TotalAssetsBOY |
| Total Assets EOY | 121468958 | TotalAssetsEOY |
| Total Liabilities BOY | 53867326 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 51977585 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 66808300 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 69491373 | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 127339478 | Expense |
| Revenue | 127255382 | Revenue |
| Description | Our 49 bed hospital provided patient and ancillary services for 2156 inpatients and 70916 outpatients during the 2009 tax year. Emergency medical services were provided to 16358 individuals and 1284 of those patients were admitted. The surgery department performed over 3042 surgical cases. The imaging department performed 33506 procedures. Over 32000 physical therapy procedures were performed. The hospital provides emergency medical services regardless of ability to pay. Over 4.8 million in charity care services were provided to patients during the 2009 tax year. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 8694610 | Expense |
| Grants | 0 | Grants |
| Revenue | 8769126 | Revenue |
| Description | Skilled nursing and longterm care services were provided by our 60 bed skilled nursing facility, Heritage Place. Total admissions for the 2009 tax year were 59 while total resident days for the year were 18964. An average of 52 residents per day were provided care. Ancillary services for residents included 2777 physical therapy treatments. Heritage Place provides healing and compassionate residential care in a home like setting. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2652497 | Expense |
| Grants | 0 | Grants |
| Revenue | 3153358 | Revenue |
| Description | Our newest service line, Family and Specialty physician clinics, were added to the array of healthcare services provided by the Hospital during the tax year 2009. A community healthcare need exists for general and specialty practitioners that provide medical services to patients who are financially indigent. During the tax year the Hospital added five Family and Specialty physician clinics. During the tax year 11,535 patients were provided care at the various medical clinics. | 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 | 138686585 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 1 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 1 | 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 | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 1 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 121 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 792 | 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 |
| Nbr Voting Governing Body Members | 11 | 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 | 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 | 0 | 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 |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Central Peninsula General Hospital | BusinessNameLine1 |
| Business Name Line2 | Finance Department | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9077144404 | 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 (25 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 |
|---|---|---|---|---|---|---|---|
| John Bramante | |||||||
| Board member | 4 | X | 2350 | 0 | 0 | ||
| Thomas Boedeker | |||||||
| Board President | 8.00 | X | 16250 | 0 | 0 | ||
| Sue Carter | |||||||
| Board Member | 4 | X | 3800 | 0 | 0 | ||
| Loretta Flanders | |||||||
| Board Member | 4.00 | X | 2250 | 0 | 0 | ||
| John Hoyt | |||||||
| Board Member | 4.00 | X | 2900 | 0 | 0 | ||
| Russell Peterson | |||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||
| Richard Ross | |||||||
| Board member | 4.00 | X | 2800 | 0 | 0 | ||
| Judith Salo | |||||||
| Board members | 4.00 | X | 3100 | 0 | 0 | ||
| Alyson Stogsdill | |||||||
| Board secretary treasurer | 6.00 | X | 3950 | 0 | 0 | ||
| John Torgerson | |||||||
| Board member | 4.00 | X | 2550 | 0 | 0 | ||
| Loren Weimer | |||||||
| Board Vice president | 6 | X | 4200 | 0 | 0 | ||
| Silverio Mattero | |||||||
| Board Member | 4.00 | X | 0 | 0 | 0 | ||
| Trena Richardson | |||||||
| Board Member | 4 | X | 150 | 0 | 0 | ||
| Johnny Dodd | |||||||
| VP of Human Resources | 40 | 0 | 0 | 0 | X | ||
| Ryan Smith | |||||||
| CEO | 40.00 | 340307 | 0 | 34444 | X | ||
| Jason Paret | |||||||
| CFO | 40 | 183044 | 0 | 34672 | X | ||
| Andrea Posey | |||||||
| Chief Nursing Officer | 40.00 | 161730 | 0 | 34371 | X | ||
| Sally Walker | |||||||
| VP of Human Resources | 40.00 | 126274 | 0 | 9226 | X | ||
| Matthew Dammeyer | |||||||
| Assistant Administrator | 40.00 | 171290 | 0 | 34449 | X | ||
| Peter Brennan | |||||||
| Chief Philanthropy Officer | 40.00 | 89698 | 0 | 29565 | X | ||
| Gregg Motonaga | |||||||
| Anesthesia Physician | 40 | 548239 | 0 | 39226 | X | ||
| Charles Mickelson | |||||||
| Emergency Physician | 28.00 | 411047 | 0 | 31087 | X | ||
| Robert Ledda | |||||||
| Emergency Physician | 28.00 | 377635 | 0 | 31087 | X | ||
| Ned Magen | |||||||
| Emergency Physician | 33.00 | 418879 | 0 | 31087 | X | ||
| Angus Warren | |||||||
| Emergency Physician | 35.00 | 395499 | 0 | 13707 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3267942 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 322921 | TotalOtherCompensation |
| Number Individuals GT100 K | 47 | 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 | Address Line2AddressOfContractor/AddressUS/AddressLine2 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|---|
| Molloy Schmidt LLC | ||||||
| 110 South Willow St | Suite 101 | Kenai | AK | 99611 | Attorney Services | 348798 |
| Davis Wright Tremaine LLC | ||||||
| 1201 Third Ave Suite 2200 | Seattle | WA | 981013045 | Attorney Services | 257626 | |
| Wash Doctor | ||||||
| PO Box 3781 | Soldotna | AK | 99669 | Laundry Services | 150927 | |
| Booth's Landscaping | ||||||
| PO Box 2878 | Soldotna | AK | 99669 | Landscaping and grounds maintenance | 117443 | |
| Alaska Surgical Services | ||||||
| 6339 E Speedway Blvd | Ste 201 | Tucson | AZ | 85710 | Specialized Surgical Services | 112316 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 0 | MembershipDues |
| Fundraising Events | 0 | FundraisingEvents |
| Related Organizations | 319940 | RelatedOrganizations |
| Government Grants | 736362 | GovernmentGrants |
| All Other Contributions | 30000 | AllOtherContributions |
| Noncash Contributions | 74418 | NoncashContributions |
| Total Contributions | 1086302 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Hospital Service Revenue | 622000 | 127255382 | 127255382 | 0 | $0 |
| Nursing Home Revenue | 623000 | 8769126 | 8769126 | 0 | $0 |
| Physician Clinic Revenue | 621110 | 3153358 | 3153358 | 0 | $0 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 301944 | TotalRevenueColumn |
| Related Or Exempt Function Income | 301944 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 139479810 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 342720 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $342,720 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 712 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $712 | 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 | 4800 | Real |
| Personal | 0 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1312 | Real |
| Personal | 0 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 3488 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3488 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 3488 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 6119 | 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 | 6119 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6119 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6119 | 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 | 133952 | GrossSalesOfInventory |
| Cost Of Goods Sold | 23183 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 110769 | TotalRevenueColumn |
| Related Or Exempt Function Income | 110769 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Property Tax Revenue | 900099 | 2135217 | 2135217 | 0 | $0 |
| USAC telephone service grant | 900099 | 209263 | 209263 | 0 | $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 | 2344480 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 143374400 | TotalRevenueColumn |
| Related Or Exempt Function Income | 141941178 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 3488 | UnrelatedBusinessRevenue |
| Exclusion | $343,432 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 122672 | Total |
| Program Services | 122672 | 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 | 3560459 | Total |
| Program Services | 2327987 | ProgramServices |
| Management And General | 1108129 | ManagementAndGeneral |
| Fundraising | 124343 | 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 | 35768110 | Total |
| Program Services | 35768110 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1204967 | Total |
| Program Services | 1204967 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9395133 | Total |
| Program Services | 9395133 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2721592 | Total |
| Program Services | 2721592 | 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 | 688768 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 688768 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51069 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 51069 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32434 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 32434 | 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 | 2615236 | Total |
| Program Services | 2615236 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 200779 | Total |
| Program Services | 200779 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13657483 | Total |
| Program Services | 13657483 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1734717 | Total |
| Program Services | 1734717 | 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 | 2011525 | Total |
| Program Services | 2011525 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 304578 | Total |
| Program Services | 304578 | 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 | 292050 | Total |
| Program Services | 292050 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1776297 | Total |
| Program Services | 1776297 | 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 | 8376945 | Total |
| Program Services | 8376945 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 812147 | Total |
| Program Services | 812147 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Medicare patient deductions | 22879662 | 22879662 | 0 | 0 |
| Medicaid patient deductions | 10444642 | 10444642 | 0 | 0 |
| Charity care patient deductions | 4875739 | 4875739 | 0 | 0 |
| Commercial, government, other patient deductions | 6994996 | 6994996 | 0 | 0 |
| Bad debt expense | 7064140 | 7064140 | 0 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3105188 | Total |
| Program Services | 3105188 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140691328 | Total |
| Program Services | 138686585 | ProgramServices |
| Management And General | 1880400 | ManagementAndGeneral |
| Fundraising | 124343 | 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 | 25679283 | BOY |
| EOY | 23245962 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 337820 | BOY |
| EOY | 114102 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13300497 | BOY |
| EOY | 14831114 | 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 | 2236763 | BOY |
| EOY | 2699469 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 379428 | BOY |
| EOY | 486090 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 113584493 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 45226987 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 72701706 | BOY |
| EOY | 68357506 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 500000 | BOY |
| EOY | 501471 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5540129 | BOY |
| EOY | 11233244 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120675626 | BOY |
| EOY | 121468958 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11608226 | BOY |
| EOY | 11982197 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 291329 | BOY |
| EOY | 12642 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41967771 | BOY |
| EOY | 39982746 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53867326 | BOY |
| EOY | 51977585 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66308300 | BOY |
| EOY | 68991373 | 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 | 66808300 | BOY |
| EOY | 69491373 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120675626 | BOY |
| EOY | 121468958 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| 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 | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $6,930 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 6930 | 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, if any lobbying on an ongoing basis. However, educational discussions and general support of the 2010 Healthcare Reform Act did occur during the tax year. Specifically the provision to extend the Medicare Demonstration Project for rural hospitals was of great importance to the continued mission of the Hospital in supporting community initiatives which would not otherwise be supported. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preservation For Public Use | X | PreservationForPublicUse |
| Protection Of Natural Habitat | X | ProtectionOfNaturalHabitat |
| 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 | 1 | Sect170hRequirementsSatisfied |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1412817 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Book Value | 1412817 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 71997627 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 30908161 | Depreciation |
| Book Value | 41089466 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 673731 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 110180 | Depreciation |
| Book Value | 563551 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 37887712 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 13794052 | Depreciation |
| Book Value | 24093660 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1612606 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 414594 | Depreciation |
| Book Value | 1198012 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 68357506 | TotalOfBookValueLandBuildings |
Financial Derivatives FinancialDerivatives
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 501471 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 501471 | TotalOfBookValueSecurities |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Plant replacement funds | 10528599 |
| Bond Proceeds | 704645 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 11233244 | TotalBookValueOtherAssets |
| Total Revenue | 143374400 | TotalRevenue |
| Total Expenses | 140691328 | TotalExpenses |
| Excess Or Deficit For Year | 2683072 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 0 | NetUnrealizedGLOnInvestments |
| Donated Services And Facilities | 0 | DonatedServicesAndFacilities |
| Investment Expenses | 0 | InvestmentExpenses |
| Prior Period Adjustments | 0 | PriorPeriodAdjustments |
| Other | -$23,315 | OtherAmount |
| Total Adjustments | -23315 | TotalAdjustments |
| Excess Or Deficit Per FS | 2659757 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 143336283 | 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 | 143336283 | RevenueSubtotal |
| Investment Expenses Not Included | 0 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 38117 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 38117 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 143374400 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 140715820 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 0 | DonatedServicesUseOfFacilities |
| Prior Year Adjustments | 0 | PriorYearAdjustments |
| Losses Reported | 0 | LossesReported |
| Other Expenses Included | 24492 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 24492 | ExpensesNotRptdF990 |
| Expenses Subtotal | 140691328 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 0 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 0 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 140691328 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 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 which is subject to a 'perpetual covenant' for the benefit of all Alaska residents restricting the use of the land to agricultural purposes as defined in Alaska Statute 38.05.321. The building itself is used by the Hospital's chemical dependency department. There is no value placed upon the easement itself as either an asset or liability. However, the cost of the land and the cost of the building is recorded on the Hospital's balance sheet as its net book value. |
| SchD_P11_S00_L08 | Schedule D, Part XI, Line 8 | The Hospital's audited financial statements are consolidated with those of Central Peninsula Health Foundation, a related organization. This adjustment is the net loss for the tax year experienced by the Foundation, and must be subtracted in order to agree with the net income shown on the Hospital's audited financials. |
| SchD_P12_S00_L04b | Schedule D, Part XII, Line 4b | Certain reclassifications of revenues and expenses are made for the 990 which remove items from expenses and or revenues and report them in a different manner than in the Hospital's audited financial statements. For example, rental revenues and expenses are shown in Part VIII of Form 990. Additionally, Inventory sales for Durable Medical Equipment are shown net of Cost of Goods sold in Part VIII of Form 990. |
| SchD_P13_S00_L02d | Schedule D, Part XIII, Line 2d | Certain expenses are reclassified in the 990 under Part VIII Statement of Revenue, such as Rental expenses and Cost of goods sold for inventory. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| 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 | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 6203 | PersonsServed |
| Total Community Benefit Expense | 2929925 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2929925 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0334 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 10963 | PersonsServed |
| Total Community Benefit Expense | 16374293 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14744586 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1629707 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0186 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 282 | PersonsServed |
| Total Community Benefit Expense | 95396 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 53594 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 41802 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0005 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 17448 | PersonsServed |
| Total Community Benefit Expense | 19399614 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14798180 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4601434 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0525 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 642 | NumberOfActivitiesOrPrograms |
| Persons Served | 29495 | PersonsServed |
| Total Community Benefit Expense | 491125 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 100887 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 390238 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0044 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 210 | NumberOfActivitiesOrPrograms |
| Persons Served | 682 | PersonsServed |
| Total Community Benefit Expense | 60271 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17225 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 43046 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.015 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 9 | NumberOfActivitiesOrPrograms |
| Persons Served | 12993 | PersonsServed |
| Total Community Benefit Expense | 2004485 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 683977 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1320508 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.015 | 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 | 136 | NumberOfActivitiesOrPrograms |
| Persons Served | 2810 | PersonsServed |
| Total Community Benefit Expense | 126660 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 126660 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0014 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 997 | NumberOfActivitiesOrPrograms |
| Persons Served | 45980 | PersonsServed |
| Total Community Benefit Expense | 2682541 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 802089 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1880452 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0358 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1000 | NumberOfActivitiesOrPrograms |
| Persons Served | 63428 | PersonsServed |
| Total Community Benefit Expense | 22082155 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15600269 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6481886 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0883 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 21 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 7268 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 7268 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.0001 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 21 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 7268 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 7268 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.0001 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $4,244,976 | BadDebtExpenseAmount |
| Amount Attributable To | 3183732 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 17535925 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 23409968 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -5874043 | 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 |
Form990 Schedule H Part V Form990ScheduleHPartV (12 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | OtherOther | Address Line2Address/AddressLine2 |
|---|---|---|---|---|---|---|---|---|
| Central Peninsula Hospital | ||||||||
| 250 Hospital Place | Soldotna | AK | 99669 | X | X | X | ||
| Heritage Place | ||||||||
| 232 Rockwell Ave | Soldotna | AK | 99669 | Skilled nursing facility, long term care | ||||
| Serenity House | ||||||||
| 47480 Kristina Way | Soldotna | AK | 99669 | Chemical dependency center | ||||
| Kenai Health Center | ||||||||
| 630 Barnacle Way | Kenai | AK | 99611 | Diagnostic imaging, lab, and sexual assault nursing services | ||||
| 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 | ||||
| Central Peninsula Family Practice Kobuk | ||||||||
| 431 S Kobuk Ave | Soldotna | AK | 99669 | Family practice clinic | Suite B | |||
| Central Peninsula Pediatrics | ||||||||
| 289 N Fireweed | Soldotna | AK | 99669 | Pediatric clinic | Unit C D | |||
| Central Peninsula Pain Management Clinic | ||||||||
| 289 N Fireweed | Soldotna | AK | 99669 | Pain management clinic | Unit B | |||
| Central Peninsula Neurology | ||||||||
| 198 West Corral St | Soldotna | AK | 99669 | Neurology clinic | ||||
| Serenity House Intake Office | ||||||||
| 245 N Binkley Street | Soldotna | AK | 99669 | Chemical dependency intake, counselling, behavioral health services | Suite 203 | |||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Costing Method Used | The costing methodology for Line 7 a - d is based on a Cost-to-charge ratio using figures from the Medicare Cost Report for the same tax year. The Cost-to-charge ratio is slightly different from the cost report because it excludes nonpatient care activities and community building expenses. The costing methodology for Line 7 e - i is based on actual costs recorded per program or event. | CostingMethodUsed |
| Subsidized Health Services Expln | N/A. | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | The amount of bad debt expense included in Form 990, Part IX, line 25 at gross charges is $7,064,140. The amount reported in Schedule H, Part III, line 2 (at cost) is $4,244,976 for a difference of $2,819,164. | PercentOfTotalExpenseExpln |
| Bad Debt 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 assessed and further modified based upon the accounts receivable payor composition and aging, and historical write-off experience by payor category. | BadDebtFootnote |
| Shortfall As Community Benefit | It is the position of management that virtually all of the shortfall of medicare costs vs revenues be considered community benefit. The reason for this stance is that the organization 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. The costs reported on line 6 are the actual amounts reported on the Medicare Cost Report for the same year as this tax filing. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | 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 indigences. 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 the FPG which is the basis for a sliding scale between 200% and 400% of FPG. Applicants on the lower end of the scale (200%) are eligible for partial write-off, while those on the upper end (400%) are eligible for a full write-off. | DebtCollectionPolicy |
| Needs Assessment | The Hospital engages an independent third party to prepare a Community Health Needs Assessment every three years (at a minimum). The most recently completed report was prepared by The Center for Health Policy, Planning and Research University of New England and is dated January 6, 2010. The resulting document, Central Kenai Peninsula Community Health Planning Report was reviewed by Management and the Board of Directors for strategic planning and development. The report is also available to the public on our website at http://www.cpgh.org/workfiles/CKP%20Health%20Assessment%202009%20-%20Final%20Report.pdf | NeedsAssessment |
| Patient Education Assistance | 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 has two financial counsellors who personally contact patients and explain the hospital's financial assistance policy, assist with the completion of the application, and set up payment plans if necessary. | PatientEducationAssistance |
| Community Information | The area served by Central Peninsula Hospital is comprised of 13 Census Designated Places (CDPs) or towns with a total population of nearly 35,000 residents according to 2008 census estimates. The geographic region is in the Central Kenai Peninsula of the State of Alaska. Based on the 2000 census, approximately 7 percent of the population was age 65 or older, 25 percent were between ages 45 and 64, while 37 percent were between ages 18 and 44. Basic social and economic characteristics of the region indicate high unemployment and uninsured rates for the Central Kenai Peninsula. | CommunityInformation |
| Community Building Activities | The hospital engages in numerous community coalition efforts to improve the health of the region served. The largest single community initiative activity performed during tax year 2009 was the planning and performance of community wide H1N1 vaccine distribution. Nursing managers, infection control nurses, and emergency personnel were highly active in both the planning stages of rolling out the H1N1 vaccine and also in the actual distribution of the vaccine. | CommunityBuildingActivities |
| Other Information | The Hospital has an operating board comprised of Community members which are elected by the Board. Surplus earnings at year-end are re-invested into the hospital and into the community. Nearly all new capital acquisitions are funded with Hospital operating cash. | OtherInformation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (7 entries)
| Business Name Line2RecipientNameBusiness/BusinessNameLine2 | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant | Address Line2AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|---|---|---|
| Kenai Peninsula Youth Foundation | |||||||||
| dba Kenai River Brown Bears | PO Box 2605 | Soldotna | AK | 99669 | 262580744 | 501(c)3 | 7500 | The Kenai Peninsula Youth Foundation is an organization dedicated to providing developmental programs for aspiring student athletes. The cash grant was made to the youth foundation-owned Kenai River Brown Bears to support a Breast Cancer Awareness sporting event. All proceeds from the event were donated to the Breast Cancer fund of the Central Peninsula Health Foundation, a related organization. | |
| Kenai Peninsula United Way | |||||||||
| 11355 Frontage Road | Kenai | AK | 99611 | 920111698 | 501(c)3 | 20000 | To support the United Way on the Kenai Peninsula which provides support to the financially indigent, and to other local non-profits. | Benco Building Suite 101 | |
| Boys & Girls Club of the Kenai Peninsula | |||||||||
| 705 Frontage Road Suite B | Kenai | AK | 99611 | 943067142 | 501(c)3 | 11000 | To support the provision of safe after-school programs and healthy activities and events for peninsula children. | ||
| Kenai River Sportfishing Assn Corp | |||||||||
| 224 Kenai Ave | Soldotna | AK | 99669 | 920142688 | 501(c)3 | 6000 | To support the annual Kenai River Women's Classic a KRSA fundraising event dedicated to ensuring the sustainability of the Kenai River through programs focused on habitat, fishing management, research and education. | Ste 102 | |
| Kenai River Professional Guide Association | |||||||||
| PO Box 3674 | Soldotna | AK | 99669 | 920162358 | 501(c)6 | 10000 | To support the Wounded Warrior program held by the Kenai River Professional Guide Association. | ||
| Kenai Watershed Forum | |||||||||
| PO Box 2937 | Soldotna | AK | 99669 | 911829284 | 501(c)3 | 6500 | To support the mission of the Kenai Watershed Forum to provide for the healthy watersheds on the Kenai Peninsula. | ||
| Soldotna Chamber of Commerce | |||||||||
| 44790 Sterling Hwy | Soldotna | AK | 99669 | 920061612 | 501(c)6 | 8680 | Support of the Soldotna Chamber of Commerce including several fundraising initiatives, funding scholarships for area teens, community partnership programs, and Toys for Tots. | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 5 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 2 | 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 of 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 (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Gregg Motonaga | |||||||||||||
| 523303 | 0 | 26251 | 0 | 630 | 0 | 21720 | 0 | 19451 | 0 | 591355 | 0 | 0 | 0 |
| Charles Mickelson | |||||||||||||
| 413290 | 0 | 20 | 0 | 32600 | 0 | 5220 | 0 | 28741 | 0 | 479871 | 0 | 0 | 0 |
| Robert Ledda | |||||||||||||
| 379877 | 0 | 20 | 0 | 28612 | 0 | 5220 | 0 | 28741 | 0 | 442470 | 0 | 0 | 0 |
| Ned Magen | |||||||||||||
| 420794 | 0 | 20 | 0 | 37044 | 0 | 5220 | 0 | 28741 | 0 | 491819 | 0 | 0 | 0 |
| Angus Warren | |||||||||||||
| 396139 | 0 | 20 | 0 | 12168 | 0 | 5220 | 0 | 9430 | 0 | 422977 | 0 | 0 | 0 |
| Ryan Smith | |||||||||||||
| 216026 | 0 | 52933 | 0 | 82494 | 0 | 11869 | 0 | 28741 | 0 | 392063 | 0 | 0 | 0 |
| Jason Paret | |||||||||||||
| 137639 | 0 | 25232 | 0 | 50487 | 0 | 8805 | 0 | 28741 | 0 | 250904 | 0 | 0 | 0 |
| Andrea Posey | |||||||||||||
| 124265 | 0 | 23186 | 0 | 21385 | 0 | 8504 | 0 | 28741 | 0 | 206081 | 0 | 0 | 0 |
| Sally Walker | |||||||||||||
| 97647 | 0 | 11560 | 0 | 34494 | 0 | 2184 | 0 | 7825 | 0 | 153710 | 0 | 0 | 0 |
| Matthew Dammeyer | |||||||||||||
| 129973 | 0 | 23731 | 0 | 47578 | 0 | 8582 | 0 | 28741 | 0 | 238605 | 0 | 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 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. Among the fringe benefits offered to employees are health club discounts. The hospital pays for one-half of gym membership fees. |
| 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 a hospital 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 health club memberships is also not a written policy. Although the hospital currently extends this benefit to its employees, it may not always choose to do so. |
| SchJ_P01_S00_L03 | Schedule J, Part I, Line 3 | The Hospital contracts with an independent consultant to perform a review of CEO wages and benefits using comparable data. The resulting report is provided to the Board of Directors for review. The Board then sets the compensation for the CEO. The CEO has a written employment contract with the organization. |
| SchJ_P01_S00_L04 | Schedule J, Part I, Line 4 | The hospital provides a 457 Top hat plan to certain key employees and management. The following individuals on Schedule J participated in the 457 plan and either deferred their own compensation or received hospital contribution into the plan during the tax year: Gregg Motonaga $12,255, Charles Mickelson $15,600, Robert Ledda $14,000, Ned Magen $15,507, Ryan Smith $14,786, Jason Paret $15,725, Andrea Posey $3,340, John Dodd $725, Sally Walker $1,154, and Matthew Dammeyer $15,535. |
| SchJ_P01_S00_L05 | Schedule J, Part I, Line 5 | In accordance with their employment contract, Emergency Room Physicians receive a percentage of their physician fees billed. However, physician compensation is not based on the entity's overall performance or revenues. |
| SchJ_P01_S00_L06 | Schedule J, Part I, Line 6 | The Hospital pays an annual incentive plan bonus to all employees, supervisors, and officers based on a series of 4 operational quality measures. One of these 4 measures is based on the hospital meeting its 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 measures, and 3)utilization. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kenai Peninsula Borough | BusinessNameLine1 |
| Business Name Line2 | Central Peninsula Hospital Service Area | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 920030894 | IssuerEIN |
| CUSIP Number | 488530NF9 | CUSIPNumber |
| Date Issued | 2003-12-18 | DateIssued |
| Issue Price | 47985000 | IssuePrice |
| Description Of Purpose | To expand the hospital building | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 53952406 | TotalProceeds |
| Amount In Reserve Fund | 518266 | AmountInReserveFund |
| Amount Defeased | 0 | AmountDefeased |
| Amount Unspent | 0 | AmountUnspent |
| Issuance Costs From Proceeds | 544896 | IssuanceCostsFromProceeds |
| Working Capital Expenditures | 0 | WorkingCapitalExpenditures |
| Capital Expenditures | 52889244 | CapitalExpenditures |
| Year Of Subst Completion | 2008 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 0 | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 0 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 1 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 1 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Dr John Bramante | |||
| Board and Medical Staff member and part owner of Peninsula Internal Medicine | 74434 | The Hospital paid for medical services provided by Peninsula Internal Medicine | 0 |
| John Hoyt | |||
| Mr. Hoyt is a member of the Wells Fargo management team | 0 | Wells Fargo is the Hospital's primary financial institution holding cash and investments | 0 |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 59543 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | Cost | MethodOfDeterminingRevenues |
Cars And Other Vehicles CarsAndOtherVehicles
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 2500 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | Oncology Garden | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 12375 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | Actual Cost | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
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. manages the hospital through a Lease and Operating Agreement with the Kenai Peninsula Borough. CPGH Inc Board decisions regarding significant capital purchases and plant expansion are subject to approval by the Kenai Peninsula Borough Assembly. Bonds, loans, and capital expenditures not funded through the hospital plant replacement funds must go to the voters if greater than $1.0 million. |
| F990_P06_S0B_L11 | Form 990, Part VI, Section B, Line 11 | The Finance Department prepares the first draft of Form 990 and submits it to management for review. Management edits are made to the 990. The second draft of Form 990 and all schedules and statements is then printed and provided to each Board Member for review and comment. Final edits are made to the 990 prior to online submission by the CFO. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | Directors, officers and trustees annually complete a conflict of interest questionnaire. If any conflicts of interest are identified on the questionnaire they are reviewed by the board of directors. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | The Hospital contracts with an independent consultant to review the wages and benefits of the CEO and other Officers using comparative data. This report is submitted to the Board of Directors for review and is used for setting the wage scale for the CEO, CFO, CNO, and Assistant Administrator. Contemporaneous documentation exists for this process. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | The Hospital publishes the most recent 990 on it's website. The 990 is also available on Guidestar.com. The Hospital stores its governing documents, conflict of interest policy, and financial statements in electronic format. It provides these documents, upon request, to interested parties via email, fax, or in hard copy. |
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 |
|---|---|---|---|---|---|---|---|---|---|
| Central Peninsula Health Foundation | |||||||||
| 250 Hospital Place | Soldotna | AK | 99669 | 202778670 | To support quality healthcare activities on the Kenai Peninsula. | AK | 501(c)3 | Public Charity | N/A |
| Kenai Peninsula Borough | |||||||||
| 144 N Binkley St | Soldotna | AK | 99669 | 920030894 | Central Peninsula Hospital operates the hospital through a lease and operating agreement with KPB. | AK | 115 | N/A | |
| 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 | 1 | 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 | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| Central Peninsula Health Foundation | |
| c | 319940 |
| Central Peninsula Health Foundation | |
| h | 71918 |
| Kenai Peninsula Borough | |
| j | 1 |
| Central Peninsula Health Foundation | |
| n | 124343 |
| Central Peninsula Health Foundation | |
| p | 51242 |