AULTMAN HEALTH FOUNDATION: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- AULTMAN HEALTH FOUNDATION (EIN 34-0714581)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-10-03
- IRS object ID
- 201132769349300023
- Schema version
- 2010v3.4
- 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 | 2011-10-03T11:52:27-07:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 340714581 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLIANCE COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ALLI | NameControl |
| Phone | 3305966000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 East State Street | AddressLine1 |
| City | Alliance | City |
| State | OH | State |
| ZIP Code | 446014341 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dale Wells | Name |
| Title | Chief Financial Officer | Title |
| Phone | 3305967066 | Phone |
| Date Signed | 2011-10-03 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Dale Wells | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E State Street | AddressLine1 |
| City | Alliance | City |
| State | OH | State |
| ZIP Code | 44601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 100796092 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.achosp.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1901 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | Alliance Community Hospital is an acute care hospital providing care to all, regardless of ability to pay. The most significant activities include inpatient and outpatient care, surgical procedures, radiology, skilled nursing facility, lab and emergency treatment. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1234 | TotalNbrEmployees |
| Total Nbr Volunteers | 450 | TotalNbrVolunteers |
| Total Gross UBI | 26364 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 56236 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 199715 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 95805165 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 99744128 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -29805 | InvestmentIncomePriorYear |
| Investment Income Current Year | 11102 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 5622952 | OtherRevenuePriorYear |
| Other Revenue Current Year | 832711 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 101454548 | TotalRevenuePriorYear |
| Total Revenue Current Year | 100787656 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 51118612 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 53119832 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 43452439 | OtherExpensePriorYear |
| Other Expenses Current Year | 49051319 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 94571051 | TotalExpensesPriorYear |
| Total Expenses Current Year | 102171151 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 6883497 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1383495 | RevenuesLessExpensesCY |
| Total Assets BOY | 110648857 | TotalAssetsBOY |
| Total Assets EOY | 108955337 | TotalAssetsEOY |
| Total Liabilities BOY | 65215843 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 64784574 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 45433014 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 44170763 | NetAssetsOrFundBalancesEOY |
| Mission Description | Alliance Community Hospital's (ACH) mission is to provide our patients and guests with a safe, comforting, and healing environment. This mission is accomplished through our Planetree philosophy of caring, and provides for all patients to receive the appropriate care - physical, spiritual and social - regardless of their ability to pay. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 18775891 | Expense |
| Grants | 0 | Grants |
| Revenue | 8740135 | Revenue |
| Description | Inpatient Health Care Programs: In 2010, ACH provided medical services to patients from Alliance and surrounding communities who have health conditions such as Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disorder (COPD) and others. ACH admitted 4,618 patients (which includes 401 births) who received a total of 22,591 days of care from our staff. A total of $18.8 million of our resources was spent to provide inpatient care. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 10775344 | Expense |
| Grants | 0 | Grants |
| Revenue | 14969921 | Revenue |
| Description | Surgical Procedures: ACH provides surgical services to patients with a 24-hour availability to all. In 2010, ACH provided surgical procedures to 23,377 patients expending $10.8 million to provide these services. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 8247418 | Expense |
| Grants | 0 | Grants |
| Revenue | 14457754 | Revenue |
| Description | Radiology Services: ACH's radiology services included Imaging, Womens Wellness, Ultrasound, MRI, Nuclear Medicine, and CT Scans. ACH provides a full service Radiology Department for Alliance and the surrounding communities that is used not only for the routine daily images, but also to service our Emergency Room 24 hours a day, 7 days per week. ACH is also providing women's wellness services to promote women's health in our service area. In 2010, ACH provided 69,704 tests costing $8.2 million | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 49992536 | Expense |
| Grants | 0 | Grants |
| Revenue | 61572704 | Revenue |
| Description | All other program services | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 49992536 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 61572704 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 87791189 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 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 |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| 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 | 1 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | 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 | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 149 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 1234 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| 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 |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Dale Wells | NamePerson |
| Telephone Number | 3305967066 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E State Street | AddressLine1 |
| City | Alliance | City |
| State | OH | State |
| ZIP Code | 446014341 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 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 |
|---|---|---|---|---|---|---|---|
| Don McAlister | |||||||
| President | 1 | X | X | 0 | 0 | 0 | |
| David Lundgren | |||||||
| Vice-President | 1 | X | X | 0 | 0 | 0 | |
| Woody McCallum | |||||||
| Secretary | 1 | X | X | 0 | 0 | 0 | |
| Ron Lyons | |||||||
| Treasurer | 1 | X | X | 0 | 0 | 0 | |
| Stan Jonas | |||||||
| Chief Executive Officer | 40 | X | X | 379677 | 0 | 27002 | |
| Dan Davia | |||||||
| Trustee | 1 | X | 0 | 0 | 0 | ||
| Teresa GoldenMcClelland | |||||||
| Trustee | 1 | X | 0 | 0 | 0 | ||
| John Gross | |||||||
| Trustee | 1 | X | 0 | 0 | 0 | ||
| Mike Hoover | |||||||
| Trustee | 1 | X | 0 | 0 | 0 | ||
| Scott Ingledue | |||||||
| Trustee | 1 | X | 0 | 0 | 0 | ||
| Dr Duane Kuentz | |||||||
| Trustee | 1 | X | 0 | 0 | 0 | ||
| Dr Debra Lehrer | |||||||
| Trustee | 1 | X | 0 | 0 | 0 | ||
| Gary Wagner | |||||||
| Trustee | 1 | X | 0 | 0 | 0 | ||
| Dr David Mungo | |||||||
| Physician | 40 | X | 848737 | 0 | 14143 | X | |
| Dale Wells | |||||||
| Chief Financial Officer | 40 | X | 163215 | 0 | 18989 | ||
| Dr Steven Deutch | |||||||
| Physician | 40 | 473710 | 0 | 15443 | X | ||
| Dr Daniel Mitchell | |||||||
| Physician | 40 | 216539 | 73544 | 16465 | X | ||
| Dr David Kanagy | |||||||
| Physician | 40 | 455961 | 0 | 16643 | X | ||
| Dr John Park | |||||||
| Physician | 40 | 435989 | 0 | 14143 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2973828 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 73544 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 122828 | TotalOtherCompensation |
| Number Individuals GT100 K | 18 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation | Business Name Line2NameOfContractor/NameBusiness/BusinessNameLine2 | Address Line2AddressOfContractor/AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|---|
| Anesthesia Associates of Alliance LLC | |||||||
| PO Box 182255 | Columbus | OH | 432182255 | Anesthesiologists | 993627 | ||
| Salem Surgical Services LLC | |||||||
| 2241 Porter Rd | Atwater | OH | 44201 | Lithotripsy and Medical Director Services | 686850 | ||
| Healthcare Services Management | |||||||
| 1 Batterymarch Park | Quincy | MA | 02169 | Consulting Services | 468644 | DBA HSM Consulting | Suite 403 |
| ARUP Laboratories Inc | |||||||
| 500 Chipeta Way | Salt Lake City | UT | 84127 | Lab Services | 452644 | PO Box 27964 | |
| BKD LLP | |||||||
| PO Box 5367 | Cincinnati | OH | 45201 | Home Health Billing | 326927 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 12 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 0 | MembershipDues |
| Fundraising Events | 0 | FundraisingEvents |
| Related Organizations | 197510 | RelatedOrganizations |
| Government Grants | 0 | GovernmentGrants |
| All Other Contributions | 2205 | AllOtherContributions |
| Noncash Contributions | 0 | NoncashContributions |
| Total Contributions | 199715 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Patient Revenue | 622000 | 98413759 | 98413759 | 0 | $0 |
| Cafeteria | 722100 | 635165 | 0 | 0 | $635,165 |
| Other Hospital Services | 900099 | 579498 | 0 | 0 | $579,498 |
| Program Related Investment Income | 900099 | 75247 | 75247 | 0 | $0 |
| Patient Education | 900099 | 40459 | 40459 | 0 | $0 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 99744128 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3870 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $3,870 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 446249 | Real |
| Personal | 0 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 446249 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 446249 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $446,249 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 15668 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 8436 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 7232 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7232 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $7,232 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrbtns Rprtd Fundraising Events | 0 | CntrbtnsRprtdFundraisingEvents |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Deferred Revenue Earned | 900099 | 360000 | 360000 | 0 | $0 |
| Catering | 722320 | 26364 | 0 | 26364 | $0 |
| Other | 900099 | 98 | 98 | 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 | 386462 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 100787656 | TotalRevenueColumn |
| Related Or Exempt Function Income | 98889563 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 26364 | UnrelatedBusinessRevenue |
| Exclusion | $1,672,014 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 598116 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 598116 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42368725 | Total |
| Program Services | 36322515 | ProgramServices |
| Management And General | 6046210 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1391221 | Total |
| Program Services | 1192687 | ProgramServices |
| Management And General | 198534 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5757293 | Total |
| Program Services | 4935701 | ProgramServices |
| Management And General | 821592 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3004477 | Total |
| Program Services | 2558197 | ProgramServices |
| Management And General | 446280 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 339613 | Total |
| Program Services | 176440 | ProgramServices |
| Management And General | 163173 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 363649 | Total |
| Program Services | 125 | ProgramServices |
| Management And General | 363524 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 93520 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 93520 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Fundraising | 0 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1078685 | Total |
| Program Services | 676182 | ProgramServices |
| Management And General | 402503 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 427534 | Total |
| Program Services | 408319 | ProgramServices |
| Management And General | 19215 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20931559 | Total |
| Program Services | 19795173 | ProgramServices |
| Management And General | 1136386 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 948473 | Total |
| Program Services | 814067 | ProgramServices |
| Management And General | 134406 | 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 | 2032042 | Total |
| Program Services | 1801189 | ProgramServices |
| Management And General | 230853 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 356618 | Total |
| Program Services | 308956 | ProgramServices |
| Management And General | 47662 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2195522 | Total |
| Program Services | 1858509 | ProgramServices |
| Management And General | 337013 | 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 | 4343724 | Total |
| Program Services | 3676962 | ProgramServices |
| Management And General | 666762 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1308746 | Total |
| Program Services | 1168519 | ProgramServices |
| Management And General | 140227 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Purchased Services | 6970058 | 4816341 | 2153717 | 0 |
| Provision for Uncollectible Accounts | 5501896 | 5501896 | 0 | 0 |
| Change in Fair Value of Interest Rate | 1038799 | 879343 | 159456 | 0 |
| Loss on Extinguishment of Debt | 801928 | 678832 | 123096 | 0 |
| Minor Equipment | 192162 | 158775 | 33387 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 126791 | Total |
| Program Services | 62461 | ProgramServices |
| Management And General | 64330 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102171151 | Total |
| Program Services | 87791189 | ProgramServices |
| Management And General | 14379962 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6871631 | BOY |
| EOY | 3489932 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10743830 | BOY |
| EOY | 12448103 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 58333 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2862374 | BOY |
| EOY | 2452005 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 783570 | BOY |
| EOY | 853360 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 595725 | BOY |
| EOY | 882767 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 113086054 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 29662332 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 81925090 | BOY |
| EOY | 83423722 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 134100 | BOY |
| EOY | 134100 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6732537 | BOY |
| EOY | 5213015 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 110648857 | BOY |
| EOY | 108955337 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10277818 | BOY |
| EOY | 10541822 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3240000 | BOY |
| EOY | 2880000 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 51698025 | BOY |
| EOY | 51362752 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65215843 | BOY |
| EOY | 64784574 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45220607 | BOY |
| EOY | 43930522 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 212407 | BOY |
| EOY | 240241 | 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 | 45433014 | BOY |
| EOY | 44170763 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 110648857 | BOY |
| EOY | 108955337 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1383495 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 121244 | ReconcilationOtherChanges |
| 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
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 15562377 | OtherCostOrOtherBasis |
| Book Value | 15562377 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 63191007 | OtherCostOrOtherBasis |
| Depreciation | 8337362 | Depreciation |
| Book Value | 54853645 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 27769504 | OtherCostOrOtherBasis |
| Depreciation | 19040631 | Depreciation |
| Book Value | 8728873 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 6563166 | OtherCostOrOtherBasis |
| Depreciation | 2284339 | Depreciation |
| Book Value | 4278827 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 83423722 | TotalOfBookValueLandBuildings |
| Total Revenue | 100787656 | TotalRevenue |
| Total Expenses | 102171151 | TotalExpenses |
| Excess Or Deficit For Year | -1383495 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 0 | NetUnrealizedGLOnInvestments |
| Donated Services And Facilities | 0 | DonatedServicesAndFacilities |
| Investment Expenses | 0 | InvestmentExpenses |
| Prior Period Adjustments | 0 | PriorPeriodAdjustments |
| Other | $0 | OtherAmount |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | -1383495 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 99306696 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 0 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 0 | DonatedSrvcAndUseOfFacilities |
| Recoveries Of Prior Year Grants | 0 | RecoveriesOfPriorYearGrants |
| Other Revenues | 366999 | OtherRevenues |
| Revenue Not Rptd F990 | 366999 | RevenueNotRptdF990 |
| Revenue Subtotal | 98939697 | RevenueSubtotal |
| Investment Expenses Not Included | 0 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 1847959 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 1847959 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 100787656 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 100690191 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 0 | DonatedServicesUseOfFacilities |
| Prior Year Adjustments | 0 | PriorYearAdjustments |
| Losses Reported | 0 | LossesReported |
| Other Expenses Included | 366999 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 366999 | ExpensesNotRptdF990 |
| Expenses Subtotal | 100323192 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 0 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 1847959 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 1847959 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 102171151 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchD_P12_S00_L02d | Schedule D, Part XII, Line 2d | Net Assets Released from Restriction $366,999. |
| SchD_P12_S00_L04b | Schedule D, Part XII, Line 4b | Fixed Asset Gain $7,232 Interest Swap Rate $1,038,799 and Loss on Extinguishment of Debt $801,928 |
| SchD_P13_S00_L02d | Schedule D, Part XIII, Line 2d | Net Assets Released from Restriction $366,999 |
| SchD_P13_S00_L04b | Schedule D, Part XIII, Line 4b | Fixed Asset Gain $7,232 Interest Swap Rate $1,038,799 and Loss on Extinguishment of Debt $801,928 |
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 |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| 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 | 2640104 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 553439 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2086655 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0216 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12399193 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9312983 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3086210 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0319 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 15039304 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9866427 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5172867 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0535 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 203286 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 203286 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0021 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 477154 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 298279 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 178875 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0019 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 42059578 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 28976300 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13083278 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.1353 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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) |
|---|---|---|
| Total Community Benefit Expense | 101977 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 67984 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 33993 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0004 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 42841995 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 29342563 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13499432 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.1397 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 57881299 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 39208990 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 18672299 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.1932 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 13834 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 13834 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.0001 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 13834 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 13834 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.0001 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,725,909 | BadDebtExpenseAmount |
| Amount Attributable To | 1166973 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 12422893 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 12606624 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -183731 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Alliance Community Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E State Street | AddressLine1 |
| City | Alliance | City |
| State | OH | State |
| ZIP Code | 44601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | Visiting Nurse Association, Hospice, Skilled Nursing Facility | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Alliance Community Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Lowest Negotiated Rates | X | LowestNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Alliance Community Medical Foundation | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E State Street | AddressLine1 |
| City | Alliance | City |
| State | OH | State |
| ZIP Code | 44601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | Physician Practices | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchH_P01_S00_L06a | Schedule H, Part I, Line 6a | Alliance Community Hospital's (ACH) community benefit report is contained in a report prepared by Alliance Community Hospital Foundation, a related organization. |
| SchH_P01_S00_L07 | Schedule H, Part I, Line 7 | ACH's cost accounting system was used to calculate the amounts reported in the table for line 7. The cost accounting system addresses all patient segments specific to ACH. Where applicable, a cost to charge ratio was used and the ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. |
| SchH_P01_S00_L072f | Schedule H, Part I, Line 7, Column f | Bad debt expense included on form 990 Part IX line 25 column (A) is $5,501,896 and is subtracted from total expense for purposes of calculating the percentage in this column. |
| SchH_P01_S00_L07g | Schedule H, Part I, Line 7g | Subsidized health services data on line 7g does not include any costs attributable to a physician clinic; thus there are no cost to report in Part VI. |
| SchH_P02_S00_L00 | Schedule H, Part II | ACH's Hospitalilty Program is a 16 week program offered annually during the spring school semester. It is geared to teach handicapped high school students job, life, and personal skills. Students are mentored by an ACH colleague. |
| SchH_P03_S0A_L04 | Schedule H, Part III, Section A, Line 4 | Line 2, Bad debt expense at cost was calculated by multiplying bad debt expense per the audited financial statements times the cost to charge ratio derived from Worksheet 2. Line 3, estimated bad debt expense attributable to patients eligible under ACH's charity care policy, was calculated based on the estimated percentage determined by reviewing patient demographics, historical collections rates, current economic conditions, and employee experience in our patient accounts and credit department. |
| SchH_P03_S0B_L08 | Schedule H, Part III, Section B, Line 8 | Part III lines 5 & 6 were derived based on Worksheet B, thus presenting the Medicare shortfall (based on Medicare Cost Report data) excluding subsidized programs included on Part I line 7g. The shortfall showing on Part III line 7 should be considered community benefit since ACH provided benefit greater than the reimbursement for services. |
| SchH_P03_S0C_L09b | Schedule H, Part III, Section C, Line 9b | ACH's collection practices for patients identified as qualifying for charity care would be based on the account balance net of the charity write-off. As long as the patient makes a minimal monthly payment, the account is considered current. If payment is not received monthly, a call from our credit department will be made along with receiving a monthly statement. If payment is then received, the account returns to "current". If there are six consecutive months without payment, then the account is turned over to our collection agency to attempt to collect the balance due. |
| SchH_P06_S00_L02 | Schedule H, Part VI, Line 2 | ACH has played an active role in a county-wide health needs assessment group who is addressing the health care needs of the community from a local perspective. Members of the group include other health care and health-related nonprofit organizations. The top three community health needs are identified based on a recent study as 1)access to health, 2)behavior health, and 3)childhood obesity. The group is in the process of deciding who will collect and analyze the data, and creating an action plan based on the results. The goal is to begin implementation of the action plan by the beginning of 2012. |
| SchH_P06_S00_L03 | Schedule H, Part VI, Line 3 | During the registration process, the patient's initial financial responsibility is determined based on insurance coverage, deductibles, etc. supplied by the patient. If it is determined that the patient will be partially or fully responsible for their medical charges, then the patient will receive personal credit counseling. ACH follows EMTALA standards for emergency room visits. A Patient Billing brochure is available in the admissions and emergency room areas to all patients. The brochure provides information on financial assistance along with phone numbers so that an individual can speak to a member of the patient billing team and/or set up a personal appointment for financial assistance. In addition, monthly billing statements include a financial assistance application on the back plus phone numbers for assistance. We refer patients who we believe are eligible for Medicaid to RevCare which is an agency specializing in Medicaid eligibility and application so the patient receives the financial expertise needed for financial assistance. |
| SchH_P06_S00_L04 | Schedule H, Part VI, Line 4 | Alliance Community Hospital is located in Alliance, Ohio and serves Stark, Mahoning, Carroll and other surrounding counties. The geographic service area is made up of urban, suburban, and rural areas. In 2010, our patient charges consisted of the following financial classes: 19% from individuals on Means-tested government programs or uninsured; 28% from commercial insurance, health maintenance and preferred provider organizations; and 53% from Medicare programs. Persons below the poverty level was 15.5% per the latest census data available at www.census.gov. For the three-county area, the average household size was 2.43 and the average household income was $39,065. Persons under the age of 18 accounted for 22.4% of the population, and 16.5% of the population was 65 years and older. |
| SchH_P06_S00_L05 | Schedule H, Part VI, Line 5 | ACH in conjunction with its Foundation promote the health of the community by giving back both time and dollars to charitable organizations such as the local YMCA, Alliance Neighborhood Center, the Stark County Interagency Council on Homelessness, the Alliance Area Develpment Foundation and others. Carnation Days in the Park allowed volunteers to offer free blood pressure screenings, and health information/handouts. The hospital's Health Caring Resources Library offers free blood pressure screenings to the community each week as well as a reference library for medical questions. A mock disaster drill gave our community emergency and police departments a chance to test and enhance its response efforts. Several community health fairs were offered by renting booth space at the local mall where shoppers could pick up information about services and free seminars offered by ACH. Our Foundation staff served on the Stark County Minority Health coalition committee and contributed time for compiling information and printing programs for the 2010 Minority Health kick-off dinner. Our volunteer department coordinates ACH's participation in a local high school health sciences technology program, a Hospitality program which offers mentoring to local handicapped high school students, Federal Work study programs with the local university, and volunteer training to local high school students. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Stan Jonas | |||||||||||||
| 363177 | 0 | 0 | 0 | 16500 | 0 | 16351 | 0 | 17557 | 0 | 413585 | 0 | 0 | 0 |
| Dale Wells | |||||||||||||
| 163215 | 0 | 0 | 0 | 0 | 0 | 8393 | 0 | 12925 | 0 | 184533 | 0 | 0 | 0 |
| Dr David Mungo | |||||||||||||
| 783509 | 0 | 48728 | 0 | 16500 | 0 | 8000 | 0 | 7562 | 0 | 864299 | 0 | 0 | 0 |
| Dr Steven Deutch | |||||||||||||
| 473710 | 0 | 0 | 0 | 0 | 0 | 8000 | 0 | 11579 | 0 | 493289 | 0 | 0 | 0 |
| Dr David Kanagy | |||||||||||||
| 412204 | 0 | 27257 | 0 | 16500 | 0 | 8000 | 0 | 14371 | 0 | 478332 | 0 | 0 | 0 |
| Dr John Park | |||||||||||||
| 435989 | 0 | 0 | 0 | 0 | 0 | 8000 | 0 | 6143 | 0 | 450132 | 0 | 0 | 0 |
| Dr Daniel Mitchell | |||||||||||||
| 216539 | 73544 | 0 | 0 | 0 | 0 | 8000 | 0 | 14525 | 0 | 239064 | 73544 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| City of Alliance Ohio | |||||||
| 346000043 | 018744AA0 | 2008-01-25 | 51150000 | Refund the 2003 bond issue | 0 | 0 | 0 |
| City of Alliance Ohio | |||||||
| 346000043 | 2010-12-28 | 16350000 | Refund a portion of the refunded 2003 bond issue | 0 | 0 | 0 | |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Amount RetiredAmountRetired | Amount Bond DefeasedAmountBondDefeased | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Capitalized InterestCapitalizedInterest | Refunding EscrowRefundingEscrow | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Working Capital ExpendituresWorkingCapitalExpenditures | Capital ExpendituresCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Amount UnspentAmountUnspent | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 17120000 | 0 | 51150000 | 2259788 | 0 | 0 | 0 | 0 | 0 | 44016542 | 0 | 0 | 2005 | 1 | 0 | 1 | 1 |
| 0 | 0 | 16350000 | 0 | 0 | 0 | 200000 | 0 | 0 | 0 | 16150000 | 0 | 2005 | 1 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0.001 | 0.001 | 1 |
| 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Term Of HedgeTermOfHedge | Superintegrated HedgeSuperintegratedHedge | Hedge TerminatedHedgeTerminated | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|---|---|---|
| JP Morgan Chase | ||||||||
| 0 | 1 | 1 | 24.8 | 0 | 0 | 0 | 0 | 0 |
| (no name) | ||||||||
| 0 | 0 | 0 | 0 | 0 | 0 | |||
Schedule L IRS990ScheduleL
Loan Table LoanTable (2 entries)
| Purpose Of LoanPurposeOfLoan | Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|---|
| Dr David Kanagy | ||||||
| Sign On Bonus | X | $25,000 | 25000 | 0 | 1 | 1 |
| Dr Steven Deutch | ||||||
| Sign On Bonus | X | $50,000 | 33333 | 0 | 1 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 58333 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P06_S0B_L11a | Form 990, Part VI, Section B, Line 11a | The Form 990 is reviewed by the CFO of Alliance Community Hospital and the Hospital also hires an independent accounting firm to review the Form 990 and schedules. Prior to filing, the 990 is also distributed to the Board of Trustees for their review and comments. It is then discussed as part of the financial report at the next board meeting where any questions/concerns can be addressed |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | Members of the Board of Trustees are required to annually review and sign a conflict of interest policy. Under that policy, the Board member (i) has a duty to disclose any conflict, and (ii) must recuse themselves from a vote and or decision when such conflict arises. If this policy is violated, then the Board shall take appropriate action which may include an investigation and disciplinary action. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | Compensation of officers is determined by an independent (non-compensated) committee from the Board of Trustees. This committee annually reviews compensation by obtaining market surveys of the positions. |
| F990_P06_S0C_L17 | Form 990, Part VI, Section C, Line 17 | Ohio does not require the Form 990 to be filed with the Ohio Attorney General's Office. Instead, a "Verification of Filing with the Internal Revenue Service" form is completed stating that we did file Form 990 by the required due date. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | The organization makes its governing documents available to the public via the Ohio Secretary of State's website. Financial statements are available in the NRMSIR filing database at www.emma.msrb.org. The conflict of interest policy is available upon request. |
| F990_P11_S00_L05 | Form 990, Part XI, Line 5 | Restricted contributions received of $394,833 less net assets released from restriction of $366,999 plus net transfers from affiliates of $100,000 less change in fair value of interest rate swap agreement of $6,590 equals a $121,244 increase in Net Assets at 12/31/2010. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Alliance Community Medical Foundation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E State Street | AddressLine1 |
| City | Alliance | City |
| State | OH | State |
| ZIP Code | 44601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263646817 | EIN |
| Primary Activities | Physician offices | PrimaryActivities |
| Legal Domicile State | OH | LegalDomicileState |
| Total Income | 3855224 | TotalIncome |
| EOY Assets | 1154270 | EOYAssets |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Alliance Citizens' Health Association | ||||||||||
| 200 E State Street | Alliance | OH | 44601 | 341531815 | Manage Healthcare Facilities | OH | 501(c)(3) | Sch A, Line 11b, II | N/A | 0 |
| Alliance Community Hospital Foundation | ||||||||||
| 200 E State Street | Alliance | OH | 44601 | 341531817 | Fundraising | OH | 501(c)(3) | Sch A, Line 11a, I | N/A | 0 |
| Alliance Community Hospital Auxiliary | ||||||||||
| 200 E State Street | Alliance | OH | 44601 | 340777659 | Volunteer services | OH | 501(c)(3) | Sch A, Ln 11c,III-FI | N/A | 0 |
| Caring Hands Inc | ||||||||||
| 885 Sawburg Rd | Alliance | OH | 44601 | 341505340 | Private Duty Nursing | OH | 501(c)(3) | Sch A, Ln 11c,III-FI | N/A | 0 |
| Alliance Health Institute | ||||||||||
| 200 E State Street | Alliance | OH | 44601 | 341932972 | Support ACH and its charitable purpose | OH | 501(c)(3) | Sch A, Line 11a,I | N/A | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| Alliance Health Partners | ||||||||
| 200 E State Street | Alliance | OH | 44601 | 341884059 | Phys. Hospital Org | OH | N/A | C |
| Alliance Hospitalist Group | ||||||||
| 200 E State Street | Alliance | OH | 44601 | 203188585 | Physician Offices | OH | N/A | C |
| Alliance Community Radiologists Inc | ||||||||
| 200 E State Street | Alliance | OH | 44601 | 205698786 | Physician Offices | OH | N/A | C |
| Alliance Medical Associates Inc | ||||||||
| 200 E State Street | Alliance | OH | 44601 | 911889215 | Physician Offices | OH | N/A | C |
| Alliance Pulmonary Associates Inc | ||||||||
| 200 E State Street | Alliance | OH | 44601 | 204083441 | Physician Offices | OH | N/A | C |
| Health Alliance Inc | ||||||||
| 200 E State Street | Alliance | OH | 44601 | 341531993 | Urgent Care | OH | N/A | C |
| NEO Surgical Associates Inc | ||||||||
| 200 E State Street | Alliance | OH | 44601 | 200760723 | Physician Offices | OH | N/A | C |
| Alliance Obstetrics Physicians Inc | ||||||||
| 200 E State Street | Alliance | OH | 44601 | 203095412 | Physician Offices | OH | N/A | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | 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 | 1 | 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 | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (10 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Alliance Community Radiologists Inc | ||
| a-i | 27046 | Interest is calculated monthly and equals prime interest rate at the beginning of the year plus 1 percent times the loan balance. |
| Alliance Hospitalist Group | ||
| a-i | 1771 | Interest is calculated monthly and equals prime interest rate at the beginning of the year plus 1 percent times the loan balance. |
| Alliance Pulmonary Associates Inc | ||
| a-i | 22739 | Interest is calculated monthly and equals prime interest rate at the beginning of the year plus 1 percent times the loan balance. |
| NEO Surgical Associates Inc | ||
| a-i | 9551 | Interest is calculated monthly and equals prime interest rate at the beginning of the year plus 1 percent times the loan balance. |
| Alliance Pulmonary Associates Inc | ||
| a-iv | 18263 | Fair value based on area rentals of similar square footage and type of facility. |
| Alliance Community Radiologists Inc | ||
| d | 361000 | Current year loan advances |
| Alliance Pulmonary Associates Inc | ||
| d | 369000 | Current year loan advances |
| NEO Surgical Associates Inc | ||
| d | 167000 | Current year loan advances |
| Alliance Hospitalist Group | ||
| o | 746000 | Current year subsidy to cover entitiy's expenses. |
| Alliance Medical Associates Inc | ||
| o | 149500 | Current year subsidy to cover entitiy's expenses. |