ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME (EIN 42-0733472)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-10
- IRS object ID
- 201141309349300944
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-10T10:49:10-05:00 | 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 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 South Sixth Street Suite 2800 | AddressLine1 |
| City | Minneapolis | City |
| State | MN | State |
| ZIP Code | 55402 | 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 | 420733472 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Anthony Regional Hospital and Nursing Home | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STAN | NameControl |
| Phone | 7127928246 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 South Clark St PO Box 628 | AddressLine1 |
| City | Carroll | City |
| State | IA | State |
| ZIP Code | 51401 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Edward H Smith Jr | Name |
| Title | Chief Financial Officer | Title |
| Phone | 7127945230 | Phone |
| Date Signed | 2011-05-03 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6123974000 | 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 | Gary P Riedmann | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 Clark St PO Box 628 | AddressLine1 |
| City | Carroll | City |
| State | IA | State |
| ZIP Code | 51401 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 62386673 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.stanthonyhospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1905 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | Consistently providing high quality healthcare services to meet patient and community needs. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 733 | TotalNbrEmployees |
| Total Nbr Volunteers | 437 | TotalNbrVolunteers |
| Total Gross UBI | -1725 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -1725 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 813912 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 678649 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 53538840 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 52491546 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -1177385 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1307070 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -394703 | OtherRevenuePriorYear |
| Other Revenue Current Year | -326877 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 52780664 | TotalRevenuePriorYear |
| Total Revenue Current Year | 54150388 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 3500 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 26666832 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 26355471 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 24866812 | OtherExpensePriorYear |
| Other Expenses Current Year | 25670975 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 51533644 | TotalExpensesPriorYear |
| Total Expenses Current Year | 52029946 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1247020 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2120442 | RevenuesLessExpensesCY |
| Total Assets BOY | 110642994 | TotalAssetsBOY |
| Total Assets EOY | 113486595 | TotalAssetsEOY |
| Total Liabilities BOY | 28926100 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 26907443 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 81716894 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 86579152 | NetAssetsOrFundBalancesEOY |
| Mission Description | St. Anthony Regional Hospital is a Catholic healthcare organization sponsored by the Franciscan Sisters of Perpetual Adoration and is a regional leader in providing consistently high quality healthcare services responsive to patient and community needs. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 47123923 | Expense |
| Revenue | 52491546 | Revenue |
| Description | St. Anthony Regional Hospital is a 99-bed acute care facility and St. Anthony Nursing Home has 79 beds in Carroll, IA. In the year ended June 30, 2010, St. Anthony Regional Hospital and Nursing Home provided health care services to approximately 2,454 inpatients, 68,611 outpatients and and 23,986 clinic visits. St. Anthony Regional Hospital provided services for 1,839 acute care inpatients and provided psychiatric, swing bed, and nursing home services for the remainder of the inpatients. Outpatient services were provided to patients through ancillary departments, emergency room, and clinics.See Schedule O for continuationSt. Anthony Regional Hospital provides services of cardiac rehabilitation, dialysis, hospice care, laboratory, observation, chemotherapy, pathology, radiology, respiratory therapy, physical therapy, occupational therapy, speech therapy, diabetes, and surgery services. St. Anthony Regional Hospital's largest patient service area is physical therapy. In the year ended June 30, 2010, St. Anthony serviced 9,944 patients in physical therapy, 8,667 in laboratory, and 7,664 in radiology. The activities pursued by St. Anthony Regional Hospital and Nursing Home in the provision of health care services are consistent with its tax exempt purpose. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2561010 | Expense |
| Description | As part of its mission, St. Anthony Regional Hospital provides medical care to individuals who are unable to pay for services, incurs costs in excess of reimbursement for services to Medicaid beneficiaries, and carries out other activities and programs free of charge to support the community in which it operates. Community benefit projects include community health education, health care support services, behavioral health services, community health improvement advocacy, and other traditional charity care. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 49684933 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 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 | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| 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 | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 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 | 80 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 733 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | 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 | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| 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 | Edward H Smith Jr | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7127925246 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 S Clark St | AddressLine1 |
| City | Carroll | City |
| State | IA | State |
| ZIP Code | 51401 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Gary McMinimee | |||||||
| Board Member | 0.30 | X | 0 | 0 | 0 | ||
| Arthur A Neu | |||||||
| Chairman | 0.30 | X | 0 | 0 | 0 | X | |
| Sr Romana Klaubauf | |||||||
| Board Member | 0.30 | X | 0 | 0 | 0 | ||
| Jedd Hagen MD | |||||||
| Pathologist | 40.00 | X | 128500 | 0 | 0 | ||
| Tom Gronstal | |||||||
| Board Member | 0.30 | X | 0 | 0 | 0 | ||
| Sr Helen Elsbernd | |||||||
| Board Member | 0.30 | X | 0 | 0 | 0 | ||
| Sr Rita Heires | |||||||
| Board Member | 0.30 | X | 0 | 0 | 0 | ||
| Fred Dolezal | |||||||
| Vice-Chairman | 0.30 | X | 0 | 0 | 0 | X | |
| Sr Patricia Ann Shepler | |||||||
| Secretary-Treasurer | 0.30 | X | 0 | 0 | 0 | X | |
| Gary P Riedmann | |||||||
| CEO/President | 40.00 | 348750 | 0 | 62678 | X | ||
| Edward H Smith Jr | |||||||
| CFO/Vice President | 40.00 | 180441 | 0 | 10162 | X | ||
| Nelson H Lo | |||||||
| Physician | 40.00 | 317429 | 0 | 15125 | X | ||
| Dominick C Ervelli | |||||||
| Physician | 40.00 | 189185 | 0 | 12411 | X | ||
| John L Knorr | |||||||
| Anesthesist | 40.00 | 184572 | 0 | 6389 | X | ||
| David C Peterson | |||||||
| Anesthesist | 40.00 | 175971 | 0 | 10017 | X | ||
| Michael D Carabine | |||||||
| Physician | 40.00 | 178378 | 0 | 10332 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1703226 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 127114 | TotalOtherCompensation |
| Number Individuals GT100 K | 21 | 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 |
|---|---|---|---|---|---|
| Acute Care Inc | |||||
| PO Box 4130 | Des Moines | IA | 50333 | Physician Coverage Emergency Room | 1005025 |
| Shared Service Systems | |||||
| 1725 S 20th St | Omaha | NE | 681083889 | Laundry Service Fees | 711217 |
| Shared Medical Services Inc (ZBL Imagin | |||||
| PO Box 330 | Cottage Grove | WI | 53527 | Imaging Services | 430110 |
| Siouxland Community Blood Bank | |||||
| 1019 Jones Street | Sioux City | IA | 51102 | Blood Service Fees | 220657 |
| Horty Elving Associates | |||||
| 505 E Grant St | Minneapolis | MN | 554041490 | Architect Fees | 210684 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 11 | NumberOfContractorsGT100K |
| Related Organizations | 623265 | RelatedOrganizations |
| All Other Contributions | 55384 | AllOtherContributions |
| Total Contributions | 678649 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|---|
| Patient Service Rev | 621400 | 32740512 | 32740512 | ||
| Medicare/Medicaid Pmts | 621400 | 18954605 | 18954605 | ||
| Radiation Oncology Ser | 621400 | 522383 | 522383 | ||
| Cafeteria Sales | 621400 | 275771 | $275,771 | ||
| Income from Partnershi | 900004 | -1725 | -1725 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 52491546 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 850427 | TotalRevenueColumn |
| Exclusion | $850,427 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1213751 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1540628 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -326877 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -326877 | TotalRevenueColumn |
| Exclusion | -$326,877 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 7145898 | Securities |
| Other | 6402 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6613772 | Securities |
| Other | 81885 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 532126 | Securities |
| Other | -75483 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 456643 | TotalRevenueColumn |
| Exclusion | $456,643 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 54150388 | TotalRevenueColumn |
| Related Or Exempt Function Income | 52217500 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | -1725 | UnrelatedBusinessRevenue |
| Exclusion | $1,255,964 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3500 | Total |
| Program Services | 3500 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 642439 | Total |
| Program Services | 128500 | ProgramServices |
| Management And General | 513939 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21343101 | Total |
| Program Services | 20737574 | ProgramServices |
| Management And General | 605527 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 218415 | Total |
| Program Services | 205830 | ProgramServices |
| Management And General | 12585 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2601888 | Total |
| Program Services | 2466520 | ProgramServices |
| Management And General | 135368 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1549628 | Total |
| Program Services | 1468403 | ProgramServices |
| Management And General | 81225 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34791 | Total |
| Management And General | 34791 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 163329 | Total |
| Management And General | 163329 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3394787 | Total |
| Program Services | 2953014 | ProgramServices |
| Management And General | 441773 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 184581 | Total |
| Program Services | 63431 | ProgramServices |
| Management And General | 121150 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1428936 | Total |
| Program Services | 1328021 | ProgramServices |
| Management And General | 100915 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 350749 | Total |
| Program Services | 350749 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 556432 | Total |
| Program Services | 556432 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 268590 | Total |
| Program Services | 228010 | ProgramServices |
| Management And General | 40580 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1054783 | Total |
| Program Services | 1054783 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5064447 | Total |
| Program Services | 5064447 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 327154 | Total |
| Program Services | 278177 | ProgramServices |
| Management And General | 48977 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Medical Supplies | 9610704 | 9610704 | |
| Bad Debts | 1910005 | 1910005 | |
| Repair and Maintenance | 1318554 | 1274754 | 43800 |
| Miscellaneous | 3133 | 2079 | 1054 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52029946 | Total |
| Program Services | 49684933 | ProgramServices |
| Management And General | 2345013 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1594616 | BOY |
| EOY | 2520011 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9533253 | BOY |
| EOY | 9187773 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 171 | BOY |
| EOY | 116 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1245977 | BOY |
| EOY | 1114879 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 138850 | BOY |
| EOY | 149831 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 111542763 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 46468287 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66485524 | BOY |
| EOY | 65074476 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23412770 | BOY |
| EOY | 27762657 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4365411 | BOY |
| EOY | 3231168 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3866422 | BOY |
| EOY | 4445684 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 110642994 | BOY |
| EOY | 113486595 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5455726 | BOY |
| EOY | 5081712 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21926641 | BOY |
| EOY | 20406268 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 544264 | BOY |
| EOY | 215755 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 999469 | BOY |
| EOY | 1203708 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28926100 | BOY |
| EOY | 26907443 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 81300014 | BOY |
| EOY | 86016220 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 416880 | BOY |
| EOY | 562932 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 81716894 | BOY |
| EOY | 86579152 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 110642994 | BOY |
| EOY | 113486595 | 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 Separate | X | FinancialStatementSeparate |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $8,047 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 8047 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i: | Identifier |
| Return Reference | Explanation of Other Lobbying Activities: | ReturnReference |
| Explanation | St. Anthony Regional Hospital is a member of the Iowa Hospital Association. A percentage of the membership dues paid to IHA is related to lobbying activities. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 362632 | BeginningOfYearBalance |
| Contributions | 265297 | Contributions |
| Investment Earnings Or Losses | 55307 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2500 | GrantsOrScholarships |
| End Of Year Balance | 680736 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 207355 | BeginningOfYearBalance |
| Contributions | 196019 | Contributions |
| Investment Earnings Or Losses | -33742 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 7000 | GrantsOrScholarships |
| End Of Year Balance | 362632 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.85000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.15000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 616301 | OtherCostOrOtherBasis |
| Book Value | 616301 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 79419425 | OtherCostOrOtherBasis |
| Depreciation | 25207825 | Depreciation |
| Book Value | 54211600 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 27236585 | OtherCostOrOtherBasis |
| Depreciation | 19891095 | Depreciation |
| Book Value | 7345490 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4270452 | OtherCostOrOtherBasis |
| Depreciation | 1369367 | Depreciation |
| Book Value | 2901085 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 65074476 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Deferred Compensation | Description |
| Amount | $1,203,708 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1203708 | TotalOfAmounts |
| Total Revenue | 54150388 | TotalRevenue |
| Total Expenses | 52029946 | TotalExpenses |
| Excess Or Deficit For Year | 2120442 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 2792617 | NetUnrealizedGLOnInvestments |
| Other | -$50,801 | OtherAmount |
| Total Adjustments | 2741816 | TotalAdjustments |
| Excess Or Deficit Per FS | 4862258 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 58706892 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 2792617 | NetUnrealizedGainsInvestments |
| Other Revenues | 1763887 | OtherRevenues |
| Revenue Not Rptd F990 | 4556504 | RevenueNotRptdF990 |
| Revenue Subtotal | 54150388 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 54150388 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 53844634 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 53844634 | ExpensesSubtotal |
| Other Expenses Not Included | -1814688 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | -1814688 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 52029946 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part V, Line 4: | Description of Intended Use of Endowment Funds: | All restricted endowed funds held at St. Anthony Foundation are used for the benefit of St. Anthony Regional Hospital for pastoral care and scholarships. |
| Part X: Accounting for income taxes provides that a tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. The Hospital recorded no liabilities for unrecognized tax benefits as of June 30, 2010 and 2009. The Hospital is engaged in certain activities that result in unrelated business income. Part XI, Line 8: Change in beneficial interest of net assets of Foundation 146,051 Transfer to St. Anthony Foundation for Op. Cash Requirements (198,577) Income from Partnerships 1,725 Part XII, Line 2d: Rental expenses 1,540,628 Realized loss on sale of assets 75,483 Change in beneficial interest of net assets of Foundation 146,051 Income from Partnerships 1,725 Part XIII, Line 4b: Rental expenses (1,540,628) Transfer to St. Anthony Foundation for Op. Cash Requirements (198,577) Realized loss on sale of assets (75,483) |
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 |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 560000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 560000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01120 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3806634 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2678835 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1127799 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02250 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4366634 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2678835 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1687799 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03370 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 115672 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 49410 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 66262 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 235281 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 230281 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00460 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4522672 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2676440 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1846232 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03680 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 185018 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 60405 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 124613 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00250 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5058643 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2791255 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2267388 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04520 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9425277 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5470090 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3955187 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07890 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 14944 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 14944 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 41697 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 7048 | DirectOffsettingRevenue |
| Net Community Building Expense | 34649 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 4453 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4453 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2596 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2596 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 63690 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 7048 | DirectOffsettingRevenue |
| Net Community Building Expense | 56642 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $899,844 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 13934487 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 17260177 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3325690 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (6 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|
| St Anthony Regional Hospital | |||||||
| 311 S Clark Street PO Box 628 | Carroll | IA | 51401 | X | X | X | |
| St Anthony Regional Hospice | |||||||
| 318 South Maple St | Carroll | IA | 51401 | X | HOSPICE | ||
| St Anthony Regional Hospital | |||||||
| 311 S Clark Street PO Box 628 | Carroll | IA | 51401 | X | DIALYSIS | ||
| St Anthony Regional Home Health Agengy | |||||||
| 311 S Clark Street PO Box 628 | Carroll | IA | 51401 | X | HOME HEALTH | ||
| St Anthony Regional Hospital | |||||||
| 311 S Clark Street PO Box 628 | Carroll | IA | 51401 | X | PSYCH | ||
| Wall Lake Medical Clinic | |||||||
| 311 First St | Wall Lake | IA | 51466 | RHC | |||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Part I, Line 3c: The patients family or household income must be less than or equal to 200% of the FPG to qualify for free care. For discounted care the family or household income must be less than or equal to the FPG as follows, 201% - 250% for a 75% discount, 251%-300% for 50% discount, and 301%-399% for a 25% discount. | IncomeBasedCriteria |
| Annual Community Benefit Expln | Part I, Line 6a: | AnnualCommunityBenefitExpln |
| Costing Method Used | Part I, Line 7: The cost-to-charge ratio method was used when calculating the amounts reported on Part I, Line 7, with the exception of Line 7g, Subsidized Health Services. Subsidized Health Services are reported using the departmental costs from the 2010 Medicare cost report. | CostingMethodUsed |
| Subsidized Health Services Expln | Part I, Line 7g: St. Anthony Regional Hospital has eight physician clinics that are included in subsidized health services where the costs exceed the reimbursements. | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | Part I, Line 7f: Bad debt expense of 1,910,005 was subtracted for purposes of calculating the percentage in Schedule H, Part I, Line 7, column (f).Part III, Line 3: St. Anthony Regional Hospital works with those qualifying for charity care along every step of the process including accepting application for financial assistance after previous attempts to work with the patient fail. Every effort is made to work with the patient to provide financial assistance when appropriate. While there are people who do not cooperate with the Hospital regarding payment plans, financial assistance or with those trying to help them get on government programs. For individuals not providing the necessary information it is impossible to know their reason for not cooperating and therefore know whether they may have qualified for charity care. St. Anthony Regional Hospital is unable to reasonably determine whether any amount of bad debt could have been classified as charity care if individuals do not provide the necessary information to evaluate their situation to determine qualification with the charity care policy. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: The the financial statements for St. Anthony Regional Hospital do not include a footnote regarding bad debts; however, the bad debt expense from the financial statement is a percent of revenue that is an estimate of historical bad debt written off. The bad debt at cost amount is calculated with the same cost to charge ratio used for the charity care at cost, times the estimated bad debt charges. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: The amount of the Medicare short fall on line 7 should be included in community benefit because Medicare pays less than the cost for rendering services. The Medicare allowable costs are taken from the Medicare cost report and determined based on the cost to charge ratios form the Medicare report. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: The policy states that St. Anthony Regional Hospital offers charity care to all patients who meet the criteria for financial aid and want assistance. Patients who do not have insurance may quality for St. Anthony Cares based on annual income and family size. Patients with insurance may also qualify for St. Anthony Cares for bills not covered by insurance. Charity information is available upon admission and disclosed in monthly billing statements. An application is completed by the patient and based on the income and family size the amount of charity is determined based on the federal povery guidelines. Patients receive statements and make payment arrangements with Preferred Medical Deposits (PMD). Accounts at PMD with no activity after 60 days are then turned over to our collection agency Avadyne Health. | DebtCollectionPolicy |
| Number Of Facility Type Expln | Part V: In addition to the facilities listed, St. Anthony Regional Hospital has a long term care attached nursing home and alzheimers unit. St. Anthony Regional Hospital also has 8 physican medical clinics. | NumberOfFacilityTypeExpln |
| Needs Assessment | Part VI, Line 2: The hospital and county perform a community needs assessment every three years to identify specific health concerns of the county. Meetings are held with community partners to identify needs from their daily work with clients, students, educators, health care, volunteer services, case management, behavior medicine and others in the county. A survey was developed to gather county residents identified needs. The survey was placed in the Carroll County website and hard copies were placed in the courthouse and public library. There was a link to the web and survey on the St. Anthony Hospital web site. The goal was to recieve 300 surveys and just under 300 were received. The survey data results were reviewed and top areas of concern identified for the county. The community partners were invited to a meeting to review needs and assigned the to work groups. These needs will be assigned to committees and assessed over the next 3 years and action plans will be developed. Reports will be sent to the state to report progress and action. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: The financal counselor from the organization informs and educates patients about eligibility of federal, state, and local government programs and charity care policies. The charity care policy is made available to patients in the admissions office and provided in the admission packets. If patients have questions they can stop in the business office and discuss them with a financial counselor. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: The Hospital is located in the city of Carroll in West Central Iowa with a population of 10,000, which is in Carroll County with a population of approximatedly 21,500. St. Anthony Regional Hospital also serves portions of 6 surrounding counties within a radius of 50 miles. St. Anthony Regional Hospital operates 5 satellite physician clinics in the service area, in addition to the 3 physician clinics included in the Hospital. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: The hospital CEO and CFO participate in the Carroll Area Development board that is active in workforce development. The hospital emergency room director attends regional meetings on disaster readiness and we also provide emergency medical equipment to the community. The CEO is a board member of the Iowa Hospital Association board of directors. There are managers of the hospital that serve on the area community college advisory boards local health boards. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: St. Anthony Regional Hospital has demonstrated a commitment to promoting heatlh care to further its exempt purpose providing quality health care in the community and surrounding countries for one hundred and five years. The majority of the hospital's board members are from local businesses and reside in the community and are committed to promoting health care in the community. The hospital's medical staff consists of 28 active staff, 5 associate staff in the community and over 100 courtesy staff from outside community. St. Anthony Regional Hospital is a regional hospital provider and is committed to providing health care to the community. | OtherInformation |
| Reports Filed With States | IA | ReportsFiledWithStates |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 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 (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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Gary P Riedmann | |||||||||||||
| 297440 | 0 | 32718 | 0 | 18592 | 0 | 59428 | 0 | 3250 | 0 | 411428 | 0 | 0 | 0 |
| Edward H Smith Jr | |||||||||||||
| 173000 | 0 | 6500 | 0 | 941 | 0 | 5486 | 0 | 4676 | 0 | 190603 | 0 | 0 | 0 |
| Nelson H Lo | |||||||||||||
| 315242 | 0 | 0 | 0 | 2187 | 0 | 9199 | 0 | 5926 | 0 | 332554 | 0 | 0 | 0 |
| Dominick C Ervelli | |||||||||||||
| 187917 | 0 | 0 | 0 | 1268 | 0 | 5835 | 0 | 6576 | 0 | 201596 | 0 | 0 | 0 |
| John L Knorr | |||||||||||||
| 182486 | 0 | 0 | 0 | 2086 | 0 | 5501 | 0 | 888 | 0 | 190961 | 0 | 0 | 0 |
| David C Peterson | |||||||||||||
| 173346 | 0 | 0 | 0 | 2625 | 0 | 5341 | 0 | 4676 | 0 | 185988 | 0 | 0 | 0 |
| Michael D Carabine | |||||||||||||
| 171951 | 0 | 0 | 0 | 6427 | 0 | 5018 | 0 | 5314 | 0 | 188710 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 4a | Part I, Line 4b: St. Anthony Regional Hospital and Nursing Home had an IRC Section 457(f) Deferred Compensation Plan. The following participants of the plan received payments during the year: Gary P. Riedmann: $0 |
| Part I, Line 7 | In their roles as executives employed by St. Anthony Regional Hospital, the executives are eligible for incentive payouts. The incentive award will be percentage of base pay compensation for the CEO, CFO, and other executives. The ultimate payout includes a reduction/increase multiplier depending on whether the organization reached specified performance metrics identified by the Board of Directors. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer |
|---|---|---|---|---|---|---|
| Carroll County Iowa | ||||||
| 426004323 | NoneAvail | 2003-09-29 | 10000000 | Construction of Hospital Addition | 0 | 0 |
| Carroll County Iowa | ||||||
| 426004323 | 144813AB8 | 2006-11-22 | 6672573 | Construction of Hospital Addition | 0 | 0 |
| City of Carroll Iowa | ||||||
| 426004322 | 145181CK7 | 2006-11-22 | 5402508 | Construction of Hospital Addition | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)
| Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Working Capital ExpendituresWorkingCapitalExpenditures | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|
| 10445730 | 35220 | 10410510 | 10410510 | 2006 | 0 | 0 | 1 | 1 |
| 6969080 | 119276 | 6849804 | 6849804 | 2009 | 0 | 0 | 1 | 1 |
| 5637865 | 96573 | 5541292 | 5541292 | 2009 | 0 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 | 1 |
| 0 | 0 | 0 | 0 | 1 | 1 |
| 0 | 0 | 0 | 0 | 1 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate | Term Of GICTermOfGIC | Regulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied |
|---|---|---|---|---|---|---|---|
| (no name) | |||||||
| 0 | 0 | 0 | 0 | 0 | 0 | ||
| Citi Group | |||||||
| 0 | 0 | 0 | 1 | 0 | 0 | 2.000000000000 | 1 |
| Citi Group | |||||||
| 0 | 0 | 0 | 1 | 0 | 0 | 2.000000000000 | 1 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mid-Iowa Insurance | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Fred Dolezal: Vice President | Relationship |
| Amount Of Transaction | 301876 | AmountOfTransaction |
| Description Of Transaction | Insurance: Mid-Iowa Insurance provided insurance services for St. Anthony Regional Hospital | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 6 | The members of the St. Anthony Regional Hospital are the Sisters of the religious community known as the Congregation of the Sisters of the Third Order of St. Francis of Perpetual Adoration (FSPA). The members have the power to elect the Board of Directors, amend the Articles of Incorporation and Bylaws of the organizations, and dissolve the organization. |
| Form 990, Part VI, Section A, line 7a | The Franciscan Sisters of Perpetual Adoration, as members of St. Anthony Regional Hospital, elect and approve the Board of Directors for St. Anthony Regional Hospital. |
| Form 990, Part VI, Section A, line 7b | All decisions, including dissolution of the organization, made by the Board of Directors of St. Anthony Regional Hospital are subject to the approval of the Franciscan Sisters of Perpetual Adoration. |
| Form 990, Part VI, Section B, line 11 | St. Anthony Regional Hospital gathers the necessary information for the completion of the Form 990 within the finance department and with assistance from the human resources and operations. The form was prepared by the St. Anthony Regional Hospital's accounting firm. Drafts of the form were reviewed by the CFO and the audit committee. After the internal reviews were complete, the final version of the Form 990 was given to each member of the Board of Directors prior to filing the return. |
| Form 990, Part VI, Section B, line 12c | The board members annually disclose in writing, "any interest which would be inconsistent with the expeditious, proper, and impartial performance of duties." Defining disclosable conflict or duality of interest as any matter in which the corporations are "interested which affects the financial interest or employment of such member, a member of his/her family by blood or marriage, or any business enterprise in which he/she or such family member is employed or has a financial interest." Board members are required to disclose the facts surrounding any possible conflict of interest throughout the year. |
| Form 990, Part VI, Section B, line 15 | At the direction of the Board of Directors the CEO gathers compensation information (salary and benefits) from various sources including Iowa Hospital Association and benefit consultants for like sized organizations. The executive committee then determines the annual compensation for the CEO, other officers, and key employees for total board approval. |
| Form 990, Part VI, Section C, line 19 | St. Anthony Regional Hospital mails its audited financial statements to financial institutions, governmental institutions, board members, and the Iowa Hospital Association. The Form 990 is available at guidestar.org. St. Anthony Regional Hospital discloses financial statements to bondholders, the IHA, and the Iowa Attorney General's office. St. Anthony Regional Hospital's governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part VII: Jedd Hagen, board member, is a pathologist at St. Anthony Regional Hospital. Gary P. Riedmann, CEO, and Edward H. Smith, Jr., CFO, hold positions at both St. Anthony Regional Hospital and St. Anthony Foundation. On average, 40 hours per week are spent completing work within these roles. |
| Form 990, Part XI, Line 2c | The Board of Directors is responsible for overseeing the audit of the financial statements as well as the selection of the independent accountants used to complete the audit. This process remains consistent with prior years. |
| Schedule R, Part V, Line 2: | Transactions between related organizations are computed using the cost method to determine value. |
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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|
| St Anthony Foundation | ||||||||||
| 311 S Clark Street PO Box 628 | Carroll | IA | 51401 | 421419695 | Fundraising | IA | 501(C)(3) | 11, Type I | St Anthony Regional Hospital and Nursing Home | |
| Franciscan Sisters of Perpetual Adoration | ||||||||||
| 912 Market St | La Crosse | WI | 546014782 | 390806386 | Religious Order | WI | 501(C)(3) | 1 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 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 | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | 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 | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| St Anthony Foundation | |
| C | 623265 |
| St Anthony Foundation | |
| O | 198577 |
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