VIRGINIA GAY HOSPITAL INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- VIRGINIA GAY HOSPITAL INC (EIN 42-1231996)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-02-03
- IRS object ID
- 201100349349300100
- Schema version
- 2009v1.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-02-03T07:15:06-06:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3999 PENNSYLVANIA AVE SUITE 100 | AddressLine1 |
| City | DUBUQUE | City |
| State | IA | State |
| ZIP Code | 52002 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421231996 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Virginia Gay Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | VIRG | NameControl |
| Phone | 3194726255 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 N 9th Avenue | AddressLine1 |
| City | Vinton | City |
| State | IA | State |
| ZIP Code | 523492254 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Michael Riege | Name |
| Title | CEO | Title |
| Phone | 3194726200 | Phone |
| Date Signed | 2011-01-25 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Carmen Krantz | Name |
| Phone | 5635561790 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Michael Riege | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 N 9th Avenue | AddressLine1 |
| City | Vinton | City |
| State | IA | State |
| ZIP Code | 523492254 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 19912894 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.vghinc.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1923 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | Provision for health care services | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 284 | TotalNbrEmployees |
| Total Nbr Volunteers | 34 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1077129 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1458927 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 16916577 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 18396585 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 69258 | InvestmentIncomePriorYear |
| Investment Income Current Year | 55159 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 18062964 | TotalRevenuePriorYear |
| Total Revenue Current Year | 19910671 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 8570 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9157218 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10179616 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 15000 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 42705 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 7261143 | OtherExpensePriorYear |
| Other Expenses Current Year | 8180769 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 16441931 | TotalExpensesPriorYear |
| Total Expenses Current Year | 18360385 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1621033 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1550286 | RevenuesLessExpensesCY |
| Total Assets BOY | 22079214 | TotalAssetsBOY |
| Total Assets EOY | 22529722 | TotalAssetsEOY |
| Total Liabilities BOY | 10546907 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9442947 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 11532307 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 13086775 | NetAssetsOrFundBalancesEOY |
| Mission Description | Our purpose is to provide quality health care services by using innovative, growth-oriented techniques and maintaining a sound financial base. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 16411503 | Expense |
| Revenue | 18396585 | Revenue |
| Description | Virginia Gay Hospital leads delivery of healthcare to its region through over 225 associates (including 9 Providers) which coordinate care to deliver patient care as an integrated unit. VGH and its affiliates (referred to collectively as VGH) also work seamlessly to meet the needs of the communities they serve. Requirements of the IRS community benefit standard for tax-exempt organizations are integral to VGH's larger charitable mission of improving health and quality of life. Specifically, VGH is governed by an independent board including community leaders, consumer representatives, business experts and clinical healthcare experts. The Board has a history of commitment to acting with the highest integrity and has been proactively evaluating opportunities to voluntarily adopt governance best practices to ensure the organization continues to operate with the highest of integrity for the benefit of the community. VGH also makes medical care accessible to the entire community it serves. VGH operates a full-time emergency room and provides emergency care regardless of ability to pay. VGH had over 2760 Emergency Room visits this year. VGH provides clinical services needed to operate the Emergency Room and provides on-site emergency medical care and medical transportation services through an area ambulance service, van service, and an onsite helipad. In addition, VGH, through its integrated network of providers, provides non-emergency services to the community it serves. It makes these services accessible to the community through participation in government programs like Medicare and Medicaid and by offering assistance through their Financial assistance program. VGH's Financial Assistance Policy provides discounted and free services to patients who lack the resources to be fully responsible for the health care they receive. The Financial Assistance Policy is designed to ensure the entire community served by VGH has access to needed healthcare services. Eligibility for discounted or free services under the Financial Assistance Policy is based on income levels and family size. The Federal Policy Income Guidelines are used to determine levels of discounts. Applications for coverage under the program may be obtained at any VGH patient registration area. VGH maintains records to identify and monitor the level of care provided under the Financial Assistance program. These records include the amount of charges for services and supplies furnished, and the amount of discount applied. VGH takes its mission to improve the health and quality of life of the people it serves a step further by reaching out to meet the broad health needs of the community. It strives to identify community needs beyond basic healthcare, then respond to them, aiming to make a positive, life-enhancing difference in the community. Contributing to Community Education: VGH's Nursing staff and Home Health Agency Nurses participate in county wide community health fairs. These events provide information and guidelines to those in need of Medical information.Preventive Care a Priority: VGH has taken steps to enhance preventive care for people of all ages by ensuring that those who come here for preventive care receive the screenings and recommendations appropriate to their personal and family history.Financial Summary: Charity Care (at cost) $ 9,000 Bad Debt (at cost) 286,896Community Benefit Programs: Community Health Improvement Services 11,556 Financial and in-kind contributions 6,313 Community Benefit Operations 5,000 Health Professions Education 6,467 Subsidized Health Services 287,157Total Community Benefits 612,389 | Description |
| Total Program Service Expense | 16411503 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | 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 | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 27 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 284 | 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 |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | 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 | IA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Julia Meadows | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3194726255 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 N 9th Avenue | AddressLine1 |
| City | Vinton | City |
| State | IA | State |
| ZIP Code | 52349 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 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 |
|---|---|---|---|---|---|---|---|
| Mark Mossman | |||||||
| Chairperson | 0.50 | X | X | 0 | 0 | 0 | |
| Marie Therese Foth | |||||||
| Vice Chairperson | 0.50 | X | X | 0 | 0 | 0 | |
| David Vermedahl | |||||||
| Secretary | 0.50 | X | X | 0 | 0 | 0 | |
| John Ketchen | |||||||
| Treasurer | 0.50 | X | X | 0 | 0 | 0 | |
| James Hodgson | |||||||
| Director | 0.50 | X | 0 | 0 | 0 | ||
| Brian W Meeker DO | |||||||
| Director | 0.50 | X | 486580 | 0 | 19515 | ||
| John Yundt | |||||||
| Director | 0.50 | X | 0 | 0 | 0 | ||
| John Watson | |||||||
| Director | 0.50 | X | 0 | 0 | 0 | ||
| Mark Dearden DO | |||||||
| Director | 0.50 | X | 264612 | 0 | 15659 | ||
| Michael Riege | |||||||
| CEO | 40.00 | X | 118898 | 0 | 22807 | ||
| Julia Meadows | |||||||
| CFO | 40.00 | X | 83114 | 0 | 2191 | ||
| Dr Michelle Elgin | |||||||
| DO | 40.00 | 161580 | 0 | 16117 | X | ||
| Michele Burnes | |||||||
| Physician Assistant | 40.00 | 187733 | 0 | 5747 | X | ||
| Rita Taylor-Stewart | |||||||
| Physician Assistant | 40.00 | 178817 | 0 | 5837 | X | ||
| Gene Lariviere | |||||||
| Surgeon | 40.00 | 153022 | 0 | 11506 | X | ||
| Matt Wilden | |||||||
| Physician Assistant | 40.00 | 112084 | 0 | 16378 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1746440 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 115757 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Alberici | |||||
| 8800 Page Avenue | St Louis | MO | 63114 | Construction Contractor | 3725527 |
| Rehab Visions | |||||
| 11623 Arbor Street | Omaha | NE | 68144 | PT, OT, ST | 826907 |
| Health Enterprises | |||||
| 4250 Glass Road | Cedar Rapids | IA | 524022513 | CRNA & Ultrasound | 331940 |
| Alliance Healthcare | |||||
| PO Box 96485 | Chicago | IL | 60693 | CT/MRI scans | 294216 |
| CPSI | |||||
| 6600 Wall Street | Mobile | IL | 36695 | Computer software/hardware | 165549 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 25 | NumberOfContractorsGT100K |
| Related Organizations | 1354662 | RelatedOrganizations |
| Government Grants | 104265 | GovernmentGrants |
| Total Contributions | 1458927 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Patient Service Revenu | 622110 | 12552391 | 12552391 |
| Rural health clinics | 621110 | 3670591 | 3670591 |
| Resident Service Reven | 623000 | 1993869 | 1993869 |
| Other supporting reven | 900099 | 145578 | 145578 |
| Outpatient clinics | 621400 | 34156 | 34156 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 18396585 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 43681 | TotalRevenueColumn |
| Exclusion | $43,681 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 13701 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2223 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 11478 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11478 | TotalRevenueColumn |
| Exclusion | $11,478 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 19910671 | TotalRevenueColumn |
| Related Or Exempt Function Income | 18396585 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $55,159 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 993149 | Total |
| Program Services | 770801 | ProgramServices |
| Management And General | 222348 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7769512 | Total |
| Program Services | 7181140 | ProgramServices |
| Management And General | 558779 | ManagementAndGeneral |
| Fundraising | 29593 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74331 | Total |
| Program Services | 47776 | ProgramServices |
| Management And General | 26555 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 770985 | Total |
| Program Services | 709017 | ProgramServices |
| Management And General | 61968 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 571639 | Total |
| Program Services | 514191 | ProgramServices |
| Management And General | 53947 | ManagementAndGeneral |
| Fundraising | 3501 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21658 | Total |
| Management And General | 21658 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62925 | Total |
| Management And General | 62925 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1500 | Total |
| Fundraising | 1500 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3736897 | Total |
| Program Services | 3494521 | ProgramServices |
| Management And General | 242376 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4035 | Total |
| Program Services | 2444 | ProgramServices |
| Management And General | 1501 | ManagementAndGeneral |
| Fundraising | 90 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2089555 | Total |
| Program Services | 1747094 | ProgramServices |
| Management And General | 334498 | ManagementAndGeneral |
| Fundraising | 7963 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 463784 | Total |
| Program Services | 342680 | ProgramServices |
| Management And General | 121104 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52273 | Total |
| Program Services | 44688 | ProgramServices |
| Management And General | 7527 | ManagementAndGeneral |
| Fundraising | 58 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23415 | Total |
| Program Services | 17870 | ProgramServices |
| Management And General | 5545 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 202562 | Total |
| Program Services | 27490 | ProgramServices |
| Management And General | 175072 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 991477 | Total |
| Program Services | 990474 | ProgramServices |
| Management And General | 1003 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Provision for bad debts | 481897 | 481897 | |
| Grant expenditures | 43875 | 34504 | 9371 |
| Miscellaneous expense | 4916 | 4916 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18360385 | Total |
| Program Services | 16411503 | ProgramServices |
| Management And General | 1906177 | ManagementAndGeneral |
| Fundraising | 42705 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2262744 | BOY |
| EOY | 1208448 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2136035 | BOY |
| EOY | 2390323 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 187647 | BOY |
| EOY | 242431 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42812 | BOY |
| EOY | 49282 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 23100414 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 8598167 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10852265 | BOY |
| EOY | 14502247 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6472644 | BOY |
| EOY | 3510690 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 108532 | BOY |
| EOY | 88718 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16535 | BOY |
| EOY | 537583 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22079214 | BOY |
| EOY | 22529722 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1280650 | BOY |
| EOY | 1530899 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6522545 | BOY |
| EOY | 6300885 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2743712 | BOY |
| EOY | 1611163 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10546907 | BOY |
| EOY | 9442947 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11415647 | BOY |
| EOY | 12970115 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116660 | BOY |
| EOY | 116660 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11532307 | BOY |
| EOY | 13086775 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22079214 | BOY |
| EOY | 22529722 | 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 | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 116600 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 2450 | InvestmentEarningsOrLosses |
| Other Expenditures | 2450 | OtherExpenditures |
| End Of Year Balance | 116600 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 116600 | BeginningOfYearBalance |
| End Of Year Balance | 116600 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 63494 | OtherCostOrOtherBasis |
| Book Value | 63494 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 151876 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 16122651 | OtherCostOrOtherBasis |
| Depreciation | 4960971 | Depreciation |
| Book Value | 11313556 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5356366 | OtherCostOrOtherBasis |
| Depreciation | 3343184 | Depreciation |
| Book Value | 2013182 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1406027 | OtherCostOrOtherBasis |
| Depreciation | 294012 | Depreciation |
| Book Value | 1112015 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 14502247 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Construction accounts payable | $625,383 |
| Capitalized lease obligations | $985,780 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1611163 | TotalOfAmounts |
| Total Revenue | 19910671 | TotalRevenue |
| Total Expenses | 18360385 | TotalExpenses |
| Excess Or Deficit For Year | 1550286 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 4182 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 4182 | TotalAdjustments |
| Excess Or Deficit Per FS | 1554468 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 18513304 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -42705 | OtherRevenues |
| Revenue Not Rptd F990 | -42705 | RevenueNotRptdF990 |
| Revenue Subtotal | 18556009 | RevenueSubtotal |
| Other Revenues Not Included | 1354662 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 1354662 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 19910671 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 18317680 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 18317680 | ExpensesSubtotal |
| Other Expenses Not Included | 42705 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 42705 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 18360385 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part V, Line 4: | Description of Intended Use of Endowment Funds: | An endowment fund which can be loaned to the general fund for operating needs. |
| Part X: | Description of Uncertain Tax Positions Under FIN 48: | The Organization has adopted the provisions of FASB Accounting Standards Codification Topic ASC 740-10 (previously Financial Interpretation No. 48, Accounting for Uncertainty in Income Taxes) on July 1, 2009. The implementation of this standard had no impact on the financial statements. As of both the date of adoption, and as of June 30, 2010, the unrecognized tax benefit accrual was zero. The Organization will recognize future accrued interest and penalties related to unrecognized tax benefits in income tax expense if incurred. The Organization is no longer subject to Federal or state tax examinations by tax authorities for years before 2006. |
| Part XII, Line 2d - Other Adjustments: | Fundraising expenses included in revenue per financial statements: -42705. | |
| Part XII, Line 4b - Other Adjustments: | Transfers from affiliates included in revenue per Form 990: 1354662. | |
| Part XIII, Line 4b - Other Adjustments: | Fundraising expenses included in revenue per financial statements: 42705. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent350 | X | Pcent350 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 9000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1586960 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1575475 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11485 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1595960 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1575475 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 20485 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 5730 | PersonsServed |
| Total Community Benefit Expense | 16556 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 16556 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 27 | PersonsServed |
| Total Community Benefit Expense | 6467 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 6467 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1280295 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 993138 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 287157 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01610 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1969 | PersonsServed |
| Total Community Benefit Expense | 6313 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 6313 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7726 | PersonsServed |
| Total Community Benefit Expense | 1309631 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 993138 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 316493 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01740 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7726 | PersonsServed |
| Total Community Benefit Expense | 2905591 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2568613 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 336978 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01850 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $286,896 | BadDebtExpenseAmount |
| Amount Attributable To | 115 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5526864 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5419582 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 107282 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|
| Virginia Gay Hospital Inc | ||||||||
| 502 N 9th Avenue | Vinton | IA | 523492254 | X | X | X | X | |
| Virginia Gay Nursing & Rehab | ||||||||
| 502 N 9th Avenue | Vinton | IA | 52349 | Intermediate care facility | ||||
| Virginia Gay Hospital Home Health Agency | ||||||||
| 309 1st Avenue | Vinton | IA | 52349 | Skilled nursing care | ||||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Costing Method Used | Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio which addresses all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Community health improvement services, health professions education, and cash and in-kind contributions to community groups, lines 7e, 7f, and 7i are reported based on actual expenses recorded in the organization's general ledger. The cost for subsidized health services on line 7g was determined using the Medicare cost report.Total community benefit expense as a percentage of total expenses is 15.8%. | CostingMethodUsed |
| Subsidized Health Services Expln | Part I, Line 7g: The organization did not include as subsidized health services any costs attributable to a physician clinic. | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | Part I, Line 7f: The amount of bad debt expense backed out of total expenses to determine the percentage was $481,897. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: The organization's bad debt expense was converted to cost using the cost-to-charge ratio derived from Worksheet 2.Prior to any account being classified as bad debt, all payments are applied including contractual allowances and discounts, and every effort is made with the patient in an attempt to collect the outstanding balance. Payments on accounts that were written off as bad debt reduces bad debt expense. Virginia Gay Hospital continues to serve patients even after the patients have generated significant bad debt and does not refuse service to patients that generate bad debt.Virginia Gay Hospital monitors the level of charity care it provides. The estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's charity care policy is calculated based on an estimate of charity care to gross charges. Footnote to financial statements:The carrying amount of patient and resident receivables is reduced by a valuation allowance that reflects management's estimate of amounts that will not be collected from patients, residents, and third-party payors. Management reviews patient and resident receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third parties under contractual agreements and amounts that will not be collected from patients and residents due to bad debts. Management considers historical write off and recovery information in determining the estimated bad debt provision. Management also reviews accounts to determine if classification as charity care is appropriate. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: Virginia Gay Hospital did not have a Medicare shortfall in FY 2010. In years where there is a shortfall this would be treated as a community benefit. The organization provides services to patients under the Medicare program knowing they will not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services.Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: For patients who are known to qualify for charity care or financial assistance and who qualify for 100% discount, there will be no collection efforts.Virginia Gay Hospital tries to identify patients who are uninsured or under-insured and patients who meet the presumptive eligibility criteria. Acceptable programs are: the Food Stamp program, Mothers and Children (MAC), Iowa Family Planning Network (IFPN), Medically Needy Program, Limited eligibility, County relief programs, and deceased patients with no known estate. Monthly statements are sent to all patients. When the account has had three monthly statements billed to them and no payments are made, a final letter is sent to the patient which tells them the accounts will be turned over to the collection agency if payment is not received or a call made to the Business Office to set up a payment plan within 10 days. Virginia Gay Hospital's policy and procedure for collection practices takes into account the extent to which the patient qualifies for charity. If a patient enters into an extended payment plan, Virginia Gay Hospital will not impose wage garnishments, or liens on primary residences, and will not send unpaid bills to outside collection agencies, and will cease all collection efforts, as long as the patient complies with their payment agreement, or contacts Virginia Gay Hospital with changed financial information. | DebtCollectionPolicy |
| Number Of Facility Type Expln | Part V: The organization also has the following types of facilites other than those required to be licensed as healthcare facilities in the state of Iowa:3 rural health clinics | NumberOfFacilityTypeExpln |
| Needs Assessment | Part VI, Line 2: Every three to five years, Virginia Gay Hospital and the Benton County Public Health division meet with other local agencies and business leaders for their opinions on meeting the needs of our community. The intent of this meeting is to assess the needs of the underserved and the most vulnerable populations that would impact their economic, social and health needs. The most recent meeting was held in September of this year. During this assessment meeting, the organizations identified four areas to be focused on. Those areas of concern are educating teens on sex and promiscuity, STD's, teen drinking and the area of educating the citizens of Benton County on public health issues. An area that showed great improvement since the last needs assessment was in the area of identifying and reducing the number of patients with colon cancer. The reduction in colon cancer for this area was in part due to the aggressive plan established through the needs assessment process whereby Virginia Gay Hospital increased the number of colonoscopy screenings. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: Virginia Gay Hospital is committed to providing charity care to persons who have healthcare needs and are uninsured, underinsured, ineligible for a government program, or otherwise unable to pay for medically necessary care based on their individual financial situation. Virginia Gay Hospital strives to ensure that the financial capacity of people who need health care services does not prevent them from seeking or receiving care. Patients are expected to cooperate with Virginia Gay Hospital's procedures for obtaining charity care or other forms of payment of financial assistance, and to contribute to the cost of their care based on their individual ability to pay. The charity care policy includes all departments of the facility, including the Vinton Family Medical Clinic, the Urbana Family Medical Clinic, the Van Horne Family Medical Clinic, and the Nursing and Rehab. The Virginia Gay Hospital Home Health Agency has a separate financial assistance procedure, due to their Public Health role in the community.Notification about charity care is available by the publication of notices in patient bills, posting of notices in emergency rooms, admitting and registration departments, the Business Office, and other public places the Hospital may elect. Information is also included on the facility website, and in the patient information packets. A request for charity may be made by the patient or a family member, close friend or associate of the patient, subject to the applicable privacy laws. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: Virginia Gay Hospital is a Critical access hospital serving an estimated population of 27,000. Virginia Gay Hospital is located in Vinton, Iowa, the county seat of Benton County. Vinton has a population of approximately 5,000 people. The closest hospitals are located 37 miles away in Cedar Rapids, Iowa. Virginia Gay Hospital currently operates three separate clinics; one clinic is located on the hospital campus in Vinton, another clinic is located in the rural town of Van Horne, Iowa which is 15 miles from Vinton and the other clinic is located in the rural community of Urbana, 13 miles from Vinton. The hospital and clinics serve a large number of Medicare and Medicaid patients that represent admissions and registrations of 65% and 10% respectively. In 2005, Benton County reported that 10.8% of our residents under 65 were uninsured and the poverty level in 2008 was 9.8 with 4.5% living below 50% of the poverty level. Poverty in Vinton is 0.7% higher in Vinton than the state average. The recession has had a heavy impact on Vinton and Benton County and unemployment rates are up as a result. | CommunityInformation |
| Other Information | Part VI, Line 6: Virginia Gay Hospital is proudly recognized as having one of the lowest costs per stay rates in the state of Iowa. The hospital offers twenty-five beds in an acute care setting with state of the art technology and professional services. Virginia Gay Hospital also offers 24 hour acute care, short term skilled nursing services, radiology, respiratory care, cardio-pulmonary rehabilitation, physical therapy, occupational therapy, speech therapy, laboratory services, surgical services, outpatient clinics and emergency care. In addition, our staff has contributed multiple hours providing uncompensated time in areas such as family/parenting/sibling education, medical expertise for the schools athletic teams, health fairs, information and referrals to community services, safety classes, sports physicals and many other uncompensated services. Our Board of Trustees is comprised of local business leaders who reside in our primary service area and physicians. To meet the needs of our community, the hospital extends privileges to medical staff that are qualified through licensure in the state of Iowa. Virginia Gay's Home Health Agency offers a variety of services to the aging rural population of Benton County. The hospital also offers such services as skilled service home care, immunization clinics, well child and group teaching classes such as cardiopulmonary resuscitation (CPR), Advanced Life Support (ALS) and Pediatric Advanced Life Support (PALS). Excess funds are reinvested and used for patient care and facility upgrades. | OtherInformation |
| Reports Filed With States | IA | ReportsFiledWithStates |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| 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 | 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 | 1 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Brian W Meeker DO | |||||||||||||
| 280312 | 0 | 206268 | 0 | 0 | 0 | 4653 | 0 | 14862 | 0 | 506095 | 0 | 0 | 0 |
| Mark Dearden DO | |||||||||||||
| 192428 | 0 | 72184 | 0 | 0 | 0 | 2518 | 0 | 13141 | 0 | 280271 | 0 | 0 | 0 |
| Dr Michelle Elgin | |||||||||||||
| 108629 | 0 | 52951 | 0 | 0 | 0 | 1353 | 0 | 14764 | 0 | 177697 | 0 | 0 | 0 |
| Michele Burnes | |||||||||||||
| 86113 | 0 | 101620 | 0 | 0 | 0 | 1368 | 0 | 4379 | 0 | 193480 | 0 | 0 | 0 |
| Rita Taylor-Stewart | |||||||||||||
| 73119 | 0 | 105698 | 0 | 0 | 0 | 1488 | 0 | 4349 | 0 | 184654 | 0 | 0 | 0 |
| Gene Lariviere | |||||||||||||
| 153022 | 0 | 0 | 0 | 0 | 0 | 254 | 0 | 11252 | 0 | 164528 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 4a | Michael Riege, CEO, has a single premium annuity with an annual purchase of $10,000. |
| Part I, Line 7 | Certain members of the medical staff are eligible to receive additional compensation by exceeding predetermined production figures. Only consultations and procedures personally performed by these individuals count toward the bonus. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | City of Vinton Iowa | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 426005303 | IssuerEIN |
| Date Issued | 2008-02-28 | DateIssued |
| Issue Price | 6800000 | IssuePrice |
| Description Of Purpose | New Patient Unit, Emergency, Physical/Occupational Therapy, and Imaging Dept | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 6800000 | TotalProceeds |
| Year Of Subst Completion | 2010 | 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 | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 0 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Bev Riege | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Wife of CEO of organization | Relationship |
| Amount Of Transaction | 22509 | AmountOfTransaction |
| Description Of Transaction | Salary and benefits as an employee | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 2 | John Ketchen, Treasurer of the board, and Mark Mossman, Chairperson of the board, have a business relationship. |
| Form 990, Part VI, Section B, line 11 | The Form 990 is distributed to the board members prior to filing. The 990 is reviewed by the Hospital's CEO and CFO. |
| Form 990, Part VI, Section B, line 12c | Any director, officer, key employee, Medical Staff member or committee member having an existing or potential interest in a contract or other transaction presented to the Board of Directors for deliberation, authorization, approval, or ratification, or any such person who reasonably believes such an interest exists in another person should make a prompt, full, and frank disclosure of the interest to the Board or committee prior to its acting on such contract or transaction. The interested party is required to disclose the nature and extent of his/her interest and any relevant and material facts known to him/her about the contract or transaction which might reasonably be construed to be adverse to the organization's interest. The body to which such disclosure is made determines, by majority vote, whether the disclosure shows that the non-voting and non-participation provisions below must be observed. If so, such persons should not vote on, nor use his/her personal influence on, nor participate (other than to present factual information or to respond to questions) in the discussions or deliberations with respect to such contract or transaction. Such persons may not be counted in determining the existence of a quorum at any meeting where the contract or transaction is under discussion or is being voted upon. The minutes of the meeting reflect the disclosure made and, where applicable, the abstention from voting and participation and whether a quorum was present. The Board must adopt duality of interest policies requiring: a. regular annual statements from directors, officers, key employees and key members of the Medical Staff that disclose existing and potential dualities of interest. The board Chair and CEO review the statements and follow up on any potential conflicts. b. corrective and disciplinary action with respect to transgressions of such policies. A person shall be deemed to have an "interest" in a contract or other transaction if he/she is the party (or one of the parties) contracting or dealing with the organization, or if he/she is a director, trustee, or officer of, or has a significant financial or influential interest in the entity contracting or dealing with the organization, or if he is otherwise reasonably likely to gain a significant financial or other personal benefit if the contract or transaction is approved. |
| Form 990, Part VI, Section B, line 15 | The Board Wage & Salary Committee reviews compensation increases for the CEO and physicians based on annual evaluations and the IHA Salary Survey. The CEO turns in a compensation packet to the Board outlying all provider's salaries broken down, and comparisons to state averages. This process is completed at the main budget meeting every May. The CEO determines compensation for the CFO and key employees, with approval from the Board Wage & Salary committee, based on annual performance evaluations and the IHA Salary Survey. Contemporaneous substantiation of the deliberation and decision is provided for any actions taken regarding compensation. The process is completed annually and was last completed in May 2010. |
| Form 990, Part VI, Section C, line 19 | The organization's governing documents, conflict of interest policy, and financial statements are not available to the public. Financial information is available through the public disclosure copy of the 990. |
| Form 990, Page 7, Part VII | The following individuals devoted time providing services to related organizations. Virginia Gay Health Care Foundation Dr. Michelle Elgin .3 hours per week Dr. Mark Dearden .3 hours per week James Hodgson .3 hours per week Michael Riege 2 hours per week Julia Meadows 2 hours per week Virginia Gay Trust Mark Mossman .3 hours per week David Vermedahl .3 hours per week John Ketchen .3 hours per week John Watson .3 hours per week James Hodgson .3 hours per week Dr. Mark Dearden .3 hours per week Marie Therese Foth .3 hours per week Michael Riege 1 hour per week Julia Meadows 1 hour per week Cedar View, Inc. Michael Riege 1 hour per week |
| Form 990, Schedule R, Part V, line 2 | The method used to determine the amount on line 2 was cash transfers noted in the audited financial statements. |
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 |
|---|---|---|---|---|---|---|---|---|---|
| Virginia Gay Trust | |||||||||
| 502 N 9th Avenue | Vinton | IA | 523492299 | 426367590 | Provide financial support for Virginia Gay Hospital Inc. | IA | 501(c)(3) | 11b | N/A |
| Virginia Gay Hospital Health Care Foundation | |||||||||
| 502 N 9th Avenue | Vinton | IA | 52349 | 421391891 | Develop and extend facilities and services of Virginia Gay Hospital Inc. | IA | 501(c)(3) | 7 | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Vernon S Flechner Trust | |||||||||||
| 110 E Fourth St | Vinton | IA | 523490508 | 426351376 | Provide income for maint of the Hospital and annex buildings | IA | N/A | T | 107338 | 1504114 | 1.00000 |
| JW Fry Trust | |||||||||||
| 110 E Fourth St | Vinton | IA | 523490508 | 426287710 | Provide unrestricted and corpus restricted income for Hospital additions | IA | N/A | T | 133232 | 1370807 | 1.00000 |
| Cedar View Inc | |||||||||||
| 502 N 9th Avenue | Vinton | IA | 52349 | 421398570 | Provide an 18-unit housing alternative for the elderly | IA | N/A | C | 150596 | 1645234 | 1.00000 |
| 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 | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | 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 | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Vernon S Flechner Trust | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 80000 | AmountInvolved |