GIBSON GENERAL HOSPITAL INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- GIBSON GENERAL HOSPITAL INC (EIN 35-0877575)
- Tax period
- 2024-10-01 to 2025-09-30
- Filed
- 2026-08-17
- IRS object ID
- 202632309349301698
- Schema version
- 2024v5.5
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-08-17T17:48:23-05:00 | ReturnTs |
| Tax Period End | 2025-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 N MERIDIAN ST SUITE 200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350877575 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GIBS | BusinessNameControlTxt |
| Phone | 8123853401 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47670 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHANE HAYES | PersonNm |
| Person Title | CAO | PersonTitleTxt |
| Phone | 8123853401 | PhoneNum |
| Signature | 2026-08-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EMILIE M KNIERIEM CPA | PreparerPersonNm |
| PTIN | P01330194 | PTIN |
| Phone | 3176334705 | PhoneNum |
| Preparation | 2026-08-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEACONESS GIBSON HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHANE HAYES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47670 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $62,268,282 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | SEE SCHEDULE O | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1941 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY, PATIENT-CENTERED, COST-EFFECTIVE CARE FOR PEOPLE IN THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 259 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $57,293,340 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $60,958,086 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,073,456 | PYInvestmentIncomeAmt |
| CY Investment Income | $969,209 | CYInvestmentIncomeAmt |
| PY Other Revenue | $329,752 | PYOtherRevenueAmt |
| CY Other Revenue | $274,704 | CYOtherRevenueAmt |
| PY Total Revenue | $59,696,548 | PYTotalRevenueAmt |
| CY Total Revenue | $62,201,999 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $22,200 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,443,161 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $22,277,403 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $26,427,365 | PYOtherExpensesAmt |
| CY Other Expenses | $26,127,542 | CYOtherExpensesAmt |
| PY Total Expenses | $43,870,526 | PYTotalExpensesAmt |
| CY Total Expenses | $48,427,145 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $15,826,022 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $13,774,854 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $74,276,673 | TotalAssetsBOYAmt |
| Total Assets EOY | $82,574,568 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,462,559 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,985,600 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $56,814,114 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $70,588,968 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF GIBSON GENERAL HOSPITAL AND THE SKILLED NURSING FACILITY IS TO PROVIDE HIGH QUALITY, PATIENT-CENTERED, COST-EFFECTIVE CARE FOR PEOPLE IN OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $37,731,579 | ExpenseAmt |
| Grant | $22,200 | GrantAmt |
| Revenue | $60,989,357 | RevenueAmt |
| Desc | THE HOSPITAL'S MISSION IS TO PROVIDE HIGH QUALITY AND COST-EFFECTIVE HEALTHCARE, WHICH INCLUDES PATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO THE RESIDENTS OF THE SURROUNDING TRI-STATE AREA. ALL EXPENSES RELATE TO COSTS ASSOCIATED WITH PROVIDING THESE SERVICES, AND MAINLY INCLUDE SALARIES AND WAGES TO STAFF AND SUPPLIES COST. THERE WERE 582 ADMISSIONS AND 50,309 VISITS DURING THE YEAR. | Desc |
| Total Program Service Expenses | $37,731,579 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 50 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 259 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHERYL A WATHEN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8124503296 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 MARY STREET | AddressLine1Txt |
| City | EVANSVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47747 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| SUSAN STRAUB | ||||||||
| CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $1,200 | $0 | |
| DEREK MCGRAW | ||||||||
| VICE CHAIR | 40.00 | 0.00 | Yes (X) | Yes (X) | $74,232 | $0 | $2,874 | |
| STEPHEN LANKFORD | ||||||||
| SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GEORGE A BALLARD | ||||||||
| TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR DAVID PURDOM | ||||||||
| CHIEF OF STAFF (END 12/2024) | 40.00 | 0.00 | Yes (X) | Yes (X) | $345,760 | $0 | $50,399 | |
| JENNIFER BARTLEY | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| HENRY BREWSTER | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MARC JARED FLORENCE | ||||||||
| BOARD MEMBER | 5.00 | 60.00 | Yes (X) | $0 | $753,379 | $153,958 | ||
| BOB GIBSON | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVEN IVY | ||||||||
| BOARD MEMBER | 5.00 | 50.00 | Yes (X) | $0 | $380,818 | $48,672 | ||
| LYNN LINGAFELTER | ||||||||
| BOARD MEMBER | 5.00 | 61.00 | Yes (X) | $0 | $1,072,961 | $198,379 | ||
| DUSTIN PRIESTLY | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GREG WRIGHT | ||||||||
| BOARD MEMBER | 50.00 | 0.00 | Yes (X) | $192,643 | $0 | $26,868 | ||
| MARION JOCHIM | ||||||||
| BOARD MEMBER (BEG 01/2025) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DR ADRIAN CARTER | ||||||||
| CHIEF OF STAFF (BEG 01/2025) | 5.00 | 50.00 | Yes (X) | Yes (X) | $0 | $273,451 | $27,196 | |
| LOIS MORGAN | ||||||||
| CAO (END 12/2024) | 50.00 | 0.00 | Yes (X) | $262,392 | $0 | $35,629 | ||
| SHANE C HAYES | ||||||||
| CNO (PARTIAL YEAR)/CAO | 50.00 | 0.00 | Yes (X) | $137,410 | $0 | $36,453 | ||
| LYNDSI DUNN | ||||||||
| CNO (BEG 03/2025) | 40.00 | 0.00 | Yes (X) | $113,413 | $0 | $4,311 | ||
| COREY POTTS | ||||||||
| CRNA | 40.00 | 0.00 | $284,607 | $0 | $42,315 | Yes (X) | ||
| BETH N MCGRAW | ||||||||
| LEAD MULTI-MODALITY TECH | 40.00 | 0.00 | $148,067 | $0 | $7,696 | Yes (X) | ||
| MARILYN HARPER | ||||||||
| RN | 40.00 | 0.00 | $149,854 | $0 | $29,411 | Yes (X) | ||
| TAMMY WARMACK | ||||||||
| DIRECTOR NURSING DEPT CAH | 40.00 | 0.00 | $122,279 | $0 | $14,449 | Yes (X) | ||
| ASHLEY SMITH | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $926,925 | $0 | $26,995 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,757,582 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,481,809 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $705,605 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 20 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PROGRESSIVE HEALTH OF INDIANA | |||||
| 150 N ROSENBERGER | EVANSVILLE | IN | 47710 | THERAPY SERVICES | $2,265,053 |
| GREAT LAKES EMERGENCY PHYSICIANS PLLC | |||||
| 1602 AVENUE Q | LUBBOCK | TX | 794014732 | MEDICAL PROFESSIONAL FEES | $1,373,914 |
| TOTAL MSP LLC | |||||
| 221 W COLLEGE AVE FLOOR 2 | APPLETON | WI | 54911 | STAFFING | $962,678 |
| TRI-STATE GASTROENTEROLOGY PC | |||||
| PO BOX 5068 | EVANSVILLE | IN | 47716 | MEDICAL PROFESSIONAL FEES | $529,667 |
| INTEGRIUS LLC | |||||
| 501 MAIN ST SUITE 305 | EVANSVILLE | IN | 477353646 | MEDICAL PROFESSIONAL FEES | $435,988 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENU | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $60,958,086 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $60,958,086 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $60,958,086 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $969,209 | TotalRevenueColumnAmt |
| Exclusion | $969,209 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $157,035 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $66,283 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $90,752 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $90,752 | TotalRevenueColumnAmt |
| Exclusion | $90,752 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA REVENUE | 900099 | $152,681 | $152,681 | |
| AMBULANCE DRUG CHARGES | 900099 | $12,771 | $12,771 | |
| CPR CARD REVENUE | 900099 | $6,413 | $6,413 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,087 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,087 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $183,952 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $62,201,999 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $60,989,357 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,212,642 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,200 | TotalAmt |
| Program Services | $22,200 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $565,956 | TotalAmt |
| Management And General | $565,956 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,789,065 | TotalAmt |
| Program Services | $15,031,061 | ProgramServicesAmt |
| Management And General | $2,758,004 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $518,194 | TotalAmt |
| Program Services | $421,853 | ProgramServicesAmt |
| Management And General | $96,341 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,228,784 | TotalAmt |
| Program Services | $1,229,791 | ProgramServicesAmt |
| Management And General | $998,993 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,175,404 | TotalAmt |
| Program Services | $971,595 | ProgramServicesAmt |
| Management And General | $203,809 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,800 | TotalAmt |
| Program Services | $5,353 | ProgramServicesAmt |
| Management And General | $1,447 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,794 | TotalAmt |
| Management And General | $141,794 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,958,779 | TotalAmt |
| Program Services | $9,414,708 | ProgramServicesAmt |
| Management And General | $2,544,071 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,930 | TotalAmt |
| Program Services | $206 | ProgramServicesAmt |
| Management And General | $51,724 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $460,429 | TotalAmt |
| Program Services | $337,764 | ProgramServicesAmt |
| Management And General | $122,665 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,123,118 | TotalAmt |
| Program Services | $1,998,146 | ProgramServicesAmt |
| Management And General | $2,124,972 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,323 | TotalAmt |
| Program Services | $21,363 | ProgramServicesAmt |
| Management And General | $2,960 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,895 | TotalAmt |
| Program Services | $47,895 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $335,983 | TotalAmt |
| Program Services | $252,316 | ProgramServicesAmt |
| Management And General | $83,667 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,764,609 | TotalAmt |
| Program Services | $1,325,186 | ProgramServicesAmt |
| Management And General | $439,423 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $431,013 | TotalAmt |
| Program Services | $57,294 | ProgramServicesAmt |
| Management And General | $373,719 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL & DRUG SUPPLIES | $5,264,652 | $5,216,694 | $47,958 |
| MEDICAID ASSESSMENT FEE | $1,026,966 | $1,026,966 | |
| DUES & SUBSCRIPTIONS | $127,191 | $84,278 | $42,913 |
| LICENSES AND FEES | $53,016 | $35,129 | $17,887 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $309,044 | TotalAmt |
| Program Services | $231,781 | ProgramServicesAmt |
| Management And General | $77,263 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,427,145 | TotalAmt |
| Program Services | $37,731,579 | ProgramServicesAmt |
| Management And General | $10,695,566 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,358,714 | BOYAmt |
| EOY | $23,604,513 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,627,504 | BOYAmt |
| EOY | $1,680,110 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,886,267 | BOYAmt |
| EOY | $6,918,401 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $391,135 | BOYAmt |
| EOY | $551,743 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $336,348 | BOYAmt |
| EOY | $212,403 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $22,055,760 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,574,044 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,296,123 | BOYAmt |
| EOY | $12,481,716 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,380,582 | BOYAmt |
| EOY | $37,125,682 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,276,673 | BOYAmt |
| EOY | $82,574,568 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,244,703 | BOYAmt |
| EOY | $3,191,197 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,842,952 | BOYAmt |
| EOY | $8,242,735 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,374,904 | BOYAmt |
| EOY | $551,668 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,462,559 | BOYAmt |
| EOY | $11,985,600 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,814,114 | BOYAmt |
| EOY | $70,588,968 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,814,114 | BOYAmt |
| EOY | $70,588,968 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,276,673 | BOYAmt |
| EOY | $82,574,568 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $13,774,854 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $7,544 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,544 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL PAID MEMBERSHIP DUES TO INDIANA HOSPITAL ASSOCATION "IHA AND THE AMERICAN HOSPITAL ASSOCIATION "AHA" IN FYE 2025. IHA ATTRIBUTED 19.01% OF THE TOTAL DUES TO LOBBYING EXPENSES. AHA ATTRIBUTED 36% OF THE TOTAL DUES TO LOBBYING EXPENSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $440,800 | OtherCostOrOtherBasisAmt |
| Book Value | $440,800 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,337,740 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,555,642 | DepreciationAmt |
| Book Value | $5,782,098 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,632,865 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,018,402 | DepreciationAmt |
| Book Value | $3,614,463 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,644,355 | OtherCostOrOtherBasisAmt |
| Book Value | $2,644,355 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,481,716 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| RIGHT OF USE ASSET | $184,804 |
| FUNDS HELD BY TRUSTEE | $169,365 |
| BENEFICIAL INTEREST IN TRUST | $2,610,316 |
| PHYSICIAN 457F | $85,300 |
| RECEIVABLE FROM AFFILIATE - DHS | $34,029,897 |
| THIRD PARTY RECEIVABLE | $46,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $37,125,682 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| RIGHT OF USE LIABILITIES | $466,368 |
| PHYSICIAN 457F | $85,300 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $551,668 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2025 AND 2024, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $534,803 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $534,803 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01100 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,033,479 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,386,134 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,647,345 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03400 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,568,282 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,386,134 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,182,148 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04500 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,051 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $29,051 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 20 | PersonsServedCnt |
| Total Community Benefit Expns | $28,196 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $28,196 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $400,436 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $400,436 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00830 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 152 | PersonsServedCnt |
| Total Community Benefit Expns | $525,836 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $525,836 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01090 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 172 | PersonsServedCnt |
| Total Community Benefit Expns | $983,519 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $983,519 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02040 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 172 | PersonsServedCnt |
| Total Community Benefit Expns | $8,551,801 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,386,134 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,165,667 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06540 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 95 | PersonsServedCnt |
| Total Community Benefit Expns | $3,794 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,794 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 95 | PersonsServedCnt |
| Total Community Benefit Expns | $3,794 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,794 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,215,433 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $28,146,734 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $22,984,710 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $5,162,024 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47670 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.DEACONESS.COM/DEACONESS-GIBSON-HOS | WebsiteAddressTxt |
| State License | 24-005019-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 23 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.DEACONESS.COM/CHNA | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 23 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.DEACONESS.COM/CHNA | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GIBSON GENERAL HOSPITAL INC | PART V, SECTION B, LINE 5: DEACONESS GIBSON HOSPITAL (DGH), IN CONJUNCTION WITH TULIP TREE FAMILY HEALTH CARE (TTFHC), CONTRACTED WITH THE INDIANA RURAL HEALTH ASSOCIATION (IRHA) TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). IRHA FIRST IDENTIFIED THE COMMUNITY SERVED BY DGH THROUGH CONVERSATIONS WITH HOSPITAL STAFF. BASED ON A REVIEW OF PATIENT ZIP CODES, HOSPITAL STAFF DEFINED THE COMMUNITY SERVED AS ALL POSTAL CODES WITHIN THE GEOGRAPHIC AREA OF GIBSON COUNTY. TO QUANTIFIABLY DESCRIBE THE COMMUNITY, CENSUS REPORTS WERE PULLED FROM THE UNITED STATES CENSUS BUREAU. QUANTIFIABLE STATISTICS AND REPORTS FOR HEALTH-RELATED COMMUNITY DATA WERE OBTAINED FROM THE U.S. CENSUS BUREAU, INDIANA BUSINESS RESEARCH CENTER, INDIANA UNIVERSITY, ROBERT WOOD JOHNSON COUNTY HEALTH RANKINGS & ROADMAPS, INDIANA DEPARTMENT OF TRANSPORTATION, U.S. BUREAU OF ECONOMIC ANALYSIS, AND INDIANA FAMILY AND SOCIAL SERVICES ADMINISTRATION. THE DATA TABLES AND CITATIONS FOR THESE REPORTS CAN BE VIEWED IN APPENDIX A. ADDITIONAL REPORTS ON CHRONIC DISEASE WERE PULLED FROM THE CENTERS FOR DISEASE CONTROL AND THE INDIANA STATE CANCER REGISTRY. EXCERPTS FROM THESE REPORTS CAN ALSO BE FOUND IN APPENDIX A.NEXT, AN IN-PERSON FOCUS GROUP OF GIBSON COUNTY REPRESENTATIVES WERE ORGANIZED WITH THE HELP OF THE DEACONESS GIBSON HOSPITAL DIRECTOR OF MARKETING AND COMMUNICATION, PAM HIGHT, AND EXECUTIVE DIRECTOR, KRISTINE GEORGES. COMMUNITY LEADERS, COUNTY HEALTH DEPARTMENT REPRESENTATIVES, BUSINESS OWNERS, LOCAL OFFICIALS, HEALTHCARE PROVIDERS, MINORITY LEADERS, CLERGY, STUDENT REPRESENTATIVES, AND ANY OTHER INTERESTED PARTIES WERE INVITED TO ATTEND THE MEETINGS TO DISCUSS THE HEALTH-RELATED NEEDS OF THE COUNTY WITH THE INTENT TO IDENTIFY AREAS OF GREATEST CONCERN. THE LIST OF ALL MEETING ATTENDEES, ALONG WITH THE ORGANIZATIONS THEY REPRESENT, IS IN APPENDIX B. FROM THE INFORMATION OBTAINED IN THE FOCUS GROUPS, A 46-QUESTION SURVEY WAS DEVELOPED TO GAIN THE PERSPECTIVE OF THE INHABITANTS OF THE COMMUNITY (SEE APPENDIX C). QUESTIONS INCLUDED QUERIES ABOUT THE EFFECT OF VARIOUS FACTORS (SUCH AS SUBSTANCE USE, TRANSPORTATION, HOUSING, AND MENTAL HEALTH), AS WELL AS PROBES INTO THE PERCEIVED NEED FOR VARIOUS SERVICES AND FACILITIES IN THE COUNTY. THE SURVEY WAS WIDELY DISSEMINATED TO THE RESIDENTS OF GIBSON COUNTY THROUGH INCLUSION ON THE DEACONESS GIBSON HOSPITAL TE, NEWSLETTERS, AND SOCIAL MEDIA WHERE IT WAS MADE PUBLICLY AVAILABLE ON REDCAP.COM. HARD COPIES OF THE SURVEY WERE MADE AVAILABLE IN VARIOUS WAITING ROOMS AROUND THE COUNTY, AND TWO IRHA STAFF MEMBERS CONDUCTED IN-PERSON POLLING AT THE GIBSON COUNTY FAIR TO REACH PEOPLE WHO WERE UNAWARE OF THE SURVEY OR DID NOT HAVE INTERNET ACCESS TO COMPLETE IT. TO IDENTIFY ALL HEALTHCARE FACILITIES AND RESOURCES THAT ARE CURRENTLY RESPONDING TO THE HEALTHCARE NEEDS OF THE COMMUNITY, IRHA CONTACTED DGH AND TULIP TREE. THE TWO HEALTHCARE ENTITIES WERE ABLE TO PROVIDE A LISTING OF THE FACILITIES AND RESOURCES, INCLUDING BUT NOT LIMITED TO CLINICS, FAMILY PRACTICES, AND NURSING FACILITIES THAT ARE CURRENTLY AVAILABLE WITHIN GIBSON COUNTY. SEE APPENDIX D FOR EXISTING COMMUNITY RESOURCES. THE COMPLETED CHNA WAS THEN PUBLICLY POSTED ON BOTH THE DEACONESS GIBSON HOSPITAL AND TULIP TREE FAMILY HEALTH CARE WEBSITES. HARD COPIES OF THE REPORT ARE AVAILABLE UPON REQUEST.LISTINGS OF THOSE COMMUNITY PARTNERS ARE INCLUDED IN THE APPENDICES SECTION OF THE CHNA REPORT (APPENDIX B) AND ALSO LISTED IN THE PRIORITIZATION PROCESS SECTION AS APPLICABLE (SECTION 6). |
| GIBSON GENERAL HOSPITAL INC | PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN CONJUNCTION WITH TULIP TREE FAMILY HEALTH CARE AND THE INDIANA RURAL HEALTH ASSOCIATION. |
| GIBSON GENERAL HOSPITAL INC | PART V, SECTION B, LINE 11: DEACONESS GIBSON HOSPITAL CONDUCTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2024, IDENTIFYING FOUR PRIORITY AREAS: TRANSPORTATION, MENTAL HEALTH SERVICES, SUBSTANCE USE/MISUSE, AND ACCESS AND AVAILABILITY. THE FOLLOWING DESCRIBES ACTIONS TAKEN IN 2025 TO ADDRESS THESE NEEDS IN ALIGNMENT WITH THE HOSPITAL'S ADOPTED IMPLEMENTATION STRATEGY.PRIORITY 1: TRANSPORTATIONTHE 2024 CHNA IDENTIFIED TRANSPORTATION AVAILABILITY AND AFFORDABILITY AS A TOP PRIORITY, WITH AVAILABILITY OF PUBLIC TRANSPORTATION RANKING AMONG THE MOST NEGATIVELY RATED FACTORS AFFECTING COMMUNITY HEALTH AND RESIDENTS CITING UNRELIABLE OPTIONS AS A DIRECT BARRIER TO ATTENDING MEDICAL APPOINTMENTS.-CASE MANAGEMENT AND CLINICAL TEAMS CONTINUE TO CONNECT PATIENTS WITH LOCAL TRANSPORTATION RESOURCES TO SUPPORT ACCESS TO FOLLOW-UP CARE AND OUTPATIENT SERVICES, CONSISTENT WITH THE IMPLEMENTATION STRATEGY'S FOCUS ON LINKING PATIENTS WITH AVAILABLE COMMUNITY PROGRAMS.-DEACONESS GIBSON HOSPITAL FACILITATES RIDES THROUGH GARLING MOBILITY FOR PATIENTS WITH TRANSPORTATION BARRIERS, PROVIDING A TANGIBLE OPTION FOR NON-EMERGENCY MEDICAL TRANSPORTATION.-THE HOSPITAL HAS BEGUN WORKING WITH ITS FOUNDATION TO EVALUATE POTENTIAL FUNDING FOR A TRANSPORT VAN IN COLLABORATION WITH TOYOTA, REPRESENTING A NEW INITIATIVE TO DEVELOP A SUSTAINABLE LOCAL TRANSPORTATION SOLUTION FOR GIBSON COUNTY RESIDENTS.PRIORITY 2: MENTAL HEALTH SERVICESTHE 2024 CHNA IDENTIFIED MENTAL HEALTH AVAILABILITY, AFFORDABILITY AND STIGMA AS CRITICAL BARRIERS, WITH ADDITIONAL MENTAL HEALTH SERVICES, AFFORDABLE MENTAL HEALTH CARE AND SUICIDE PREVENTION RANKING AMONG THE TOP FIVE AREAS OF GREATEST NEED IDENTIFIED BY SURVEY RESPONDENTS.-DEACONESS GIBSON HOSPITAL UTILIZES TELE-PSYCHIATRY SERVICES FOR INPATIENT, OUTPATIENT AND EMERGENCY DEPARTMENT PATIENTS, EXPANDING ACCESS TO BEHAVIORAL HEALTH CARE FOR RESIDENTS WHO WOULD OTHERWISE FACE SIGNIFICANT BARRIERS TO IN-PERSON SERVICES.-THE HOSPITAL IS PARTICIPATING IN THE GROW GRANT TO HELP BUILD THE LOCAL MENTAL HEALTH WORKFORCE, DIRECTLY ADDRESSING THE PROVIDER SHORTAGE IDENTIFIED IN THE CHNA AS A ROOT CAUSE OF LIMITED MENTAL HEALTH ACCESS IN GIBSON COUNTY.-GIBSON IS STRENGTHENING PARTNERSHIPS WITH DEACONESS MEMORIAL AND SYSTEM BEHAVIORAL HEALTH RESOURCES TO EXPAND THE CONTINUUM OF MENTAL HEALTH SERVICES AVAILABLE TO GIBSON COUNTY RESIDENTS.-MENTAL HEALTH PROVIDERS HAVE BEEN ENGAGED AT COMMUNITY OUTREACH EVENTS TO INCREASE AWARENESS OF AVAILABLE SERVICES AND REDUCE THE STIGMA IDENTIFIED IN THE CHNA AS A BARRIER TO CARE.PRIORITY 3: SUBSTANCE USE/MISUSETHE 2024 CHNA IDENTIFIED SUBSTANCE USE AND MISUSE AS THE HIGHEST NEGATIVELY RATED FACTOR AFFECTING COMMUNITY HEALTH, WITH SUBSTANCE USE EDUCATION AND SUICIDE PREVENTION AMONG THE TOP AREAS OF GREATEST NEED AND FOCUS GROUP PARTICIPANTS EXPRESSING CONCERN ABOUT USE ACROSS ALL AGE GROUPS INCLUDING YOUTH.-DEACONESS GIBSON HOSPITAL HAS PARTNERED WITH ADDICTION SOLUTIONS TO SUPPORT INDIVIDUALS IN RECOVERY, CONSISTENT WITH THE IMPLEMENTATION STRATEGY'S EMPHASIS ON COLLABORATION WITH TREATMENT FACILITIES AND RECOVERY RESOURCES.-HOSPITAL STAFF HAVE BEEN ACTIVELY CONNECTING WITH LOCAL SCHOOLS TO BUILD RELATIONSHIPS AND ENGAGE STUDENTS IN SUBSTANCE USE PREVENTION AND AWARENESS EFFORTS, WITH A FOCUS ON REACHING YOUTH POPULATIONS IDENTIFIED IN THE CHNA AS PARTICULARLY AT RISK.PRIORITY 4: ACCESS AND AVAILABILITYTHE 2024 CHNA IDENTIFIED SPECIALTY CARE ACCESS AND AVAILABILITY FOR MEDICAID PATIENTS AS A SIGNIFICANT UNMET NEED, WITH COMMUNITY MEMBERS NOTING THAT RESIDENTS FREQUENTLY TRAVEL OUTSIDE GIBSON COUNTY FOR CARE AND THAT PROVIDER AVAILABILITY HAS NOT KEPT PACE WITH THE COUNTY'S GROWING POPULATION.-DEACONESS GIBSON HOSPITAL HAS INCREASED ONCOLOGY COVERAGE, IMPROVING LOCAL ACCESS TO CANCER CARE AND REDUCING THE NEED TO TRAVEL TO REGIONAL CENTERS FOR TREATMENT.-THE HOSPITAL ADDED FULL-TIME CARDIOLOGY COVERAGE, DIRECTLY ADDRESSING THE SPECIALIST ACCESS GAP IDENTIFIED AS A PRESSING COMMUNITY NEED.-EXPANDED GI SERVICES HAVE BEEN IMPLEMENTED TO IMPROVE PATIENT ACCESS TO GASTROENTEROLOGY CARE WITHIN THE COUNTY, CONSISTENT WITH THE IMPLEMENTATION STRATEGY'S FOCUS ON ROTATING SPECIALISTS INTO THE PRINCETON CAMPUS. |
| GIBSON GENERAL HOSPITAL INC | PART V, SECTION B, LINE 15E: WELL FUND IS AVAILABLE TO DEACONESS HEALTH SYSTEM PATIENTS TO ASSIST WITH APPLYING FOR MEDICAID OR EXCHANGE PRODUCTS. |
| GIBSON GENERAL HOSPITAL INC | PART V, SECTION B, LINE 16J: DEACONESS HOSPITAL SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS HOSPITAL SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTIBILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES. |
| GIBSON GENERAL HOSPITAL, INC.: | SCHEDULE H, PART V, LINE 16A:HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCESCHEDULE H, PART V, LINE 16A:HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCESCHEDULE H, PART V, LINE 16A:HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - STAR ONE REHAB | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY |
| 2 - PHYSICIAN OUTPATIENT CLINICS | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | SUBSIDIZED CARE PHYSICIAN PRACTICES |
| 3 - LIFESTYLES DIABETES CENTER | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | DIABETES EDUCATION COUNSELING |
| 4 - GGH-FAMILY PRACTICE | ||||
| 510 N MAIN ST | PRINCETON | IN | 47670 | FAMILY MEDICINE |
| 6 - FORT BRANCH WELLNESS CLINIC | ||||
| 7851 S PROFESSIONAL DR | FORT BRANCH | IN | 47648 | FAMILY PRACTICE |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | GIBSON GENERAL HOSPITAL USES THE FOLLOWING FACTORS, IN ADDITION TO THE FPG, TO DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY: MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS. ADDITIONALLY, IF AN INDIVIDUAL IS HOMELESS, DECEASED, RECENTLY FILED FOR OR COMPLETED BANKRUPTCY, OR MEETS SPECIAL CIRCUMSTANCES RELATED TO ABILITY TO PAY, THE INDIVIDUAL MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. |
| PART I, LINE 7: | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED VARY ACCORDING TO THE INFORMATION REQUESTED AND THE MOST ACCURATE MEANS OF GATHERING THE REQUIRED INFORMATION. THE IRS PROVIDED WORKSHEET NUMBER 2 WAS USED TO CALCULATE A COST TO CHARGE RATIO USING INFORMATION FROM THE ORGANIZATION'S GENERAL LEDGER AND COST REPORTS. THAT RATIO WAS THEN USED IN CONJUNCTION WITH IRS WORKSHEET NUMBER 1 TO CALCULATE THE COST OF FINANCIAL ASSISTANCE PROVIDED AND WORKSHEET NUMBER 3 WAS USED TO CALCULATE UNREIMBURSED MEDICAID AMOUNTS. HEALTH IMPROVEMENT AND COMMUNITY BENEFIT PROGRAMS, HEALTH EDUCATION, AND CONTRIBUTIONS ARE CALCULATED BASED ON ACTUAL COSTS. |
| PART I, LINE 7G: | $400,436 OF LOSSES FROM RURAL HEALTH CLINICS OPERATED BY GIBSON GENERAL HOSPITAL ARE INCLUDED IN SUBSIDIZED HEALTH SERVICES. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | DEACONESS HOSTED AND ATTEND PUBLIC EVENTS, SUCH AS OUR ANNUAL ORAL, HEAD AND NECK CANCER SCREENINGS; COLON CANCER SCREENINGS, LOW DOSE CT SCREENINGS AND MORE OUTLINED BELOW. ADDITIONALLY, WE CREATED AND DISTRIBUTED WRITTEN AND VISUAL CONTENT THAT ADDRESSED SPECIFIC ISSUES AND HEALTH CONCERNS FOR OUR COMMUNITY.SOCIAL MEDIA POSTS:BREAST CANCER AWARENESS 10/1/2024WISE CHOICE 10/8/2024MENTAL HEALTH AWARENESS 10/10/2024PRIMARY CARE WEEK 10/11/2024GLOBAL HANDWASHING DAY 10/15/2024NATIONAL MAMMOGRAPHY DAY 10/18/2024MEGA BREAST TOUR 10/18/2024BREAST CANCER SURVIVOR TESTIMONY 10/25/2024BREAST CANCER SURVIVOR TESTIMONY 10/31/2024LUNG CANCER AWARENESS 11/1/2024LUNG CANCER SCREENING 11/8/2024WORLD DIABETES DAY 11/14/2024GREAT AMERICAN SMOKEOUT 11/24/2024WORLD AIDS DAY SCREENING 11/22/2024NO SHAVE NOVEMBER 11/22/2024SAFE TOYS AND GIFTS MONTH 12/2/2024SAFESITTER 12/4/2024HAND HYGIENE 12/6/2024ANXIETY 12/6/2024WHOOPING COUGH (PERTUSSIS) VACCINE AWARENESS 12/10/2024WHOOPING COUGH (PERTUSSIS) VACCINE AWARENESS 12/18/2024CROHN'S DISEASE AWARENESS 12/19/2024WHOOPING COUGH (PERTUSSIS) VACCINE AWARENESS 12/23/2024ANXIETY 1/3/2025WINTER STORM PREPAREDNESS 1/5/2025SLEDDING SAFETY 1/10/2025WEIGHT LOSS 1/10/2025HEAD AND NECK CANCER AWARENESS 1/15/2025LUNG DISEASE SUPPORT 1/16/2025FROSTBITE/HYPOTHERMIA AWARENESS 1/20/2025MOBILE MAMMOGRAM 1/29/2025GO RED FOR WOMEN (HEART DISEASE) 1/31/2025GO RED FOR WOMEN (HEART DISEASE) 2/1/2025AMERICAN HEART MONTH 2/3/2025GO RED FOR WOMEN (HEART DISEASE) 2/5/2025GO RED FOR WOMEN (HEART DISEASE) 2/6/2025HEART ATTACK SIGNS AND SYMPTOMS 2/8/2025IMPELLA HEART PUMP 2/11/2025CARDIAC REHAB 2/15/2025WINTER WEATHER SAFETY 2/18/2025NATIONAL CAREGIVERS DAY 2/21/2025COLON CANCER SCREENING 3/3/2025MEDICARE SEMINAR 3/3/2025NATIONAL KIDNEY MONTH 3/6/2025COLON CANCER AWARENESS MONTH 3/6/2025COLONOSCOPY AWARENESS 3/7/2025KIDNEY HEALTH 3/11/2025WORLD KIDNEY DAY / CHRONIC KIDNEY DISEASE 3/13/2025PULMONARY REHAB EDUCATION 3/15/2025FLU SEASON AWARENESS 3/18/2025KIDNEY DISEASE AWARENESS 3/20/2025AMERICAN DIABETES ALERT DAY 3/20/2025KIDNEY HEALTH 3/25/2025COLON CANCER SCREENING 3/26/2025HEAD AND NECK CANCER AWARENESS 4/1/2025HEAD AND NECK CANCER SCREENINGS 4/7/2025HEAD AND NECK CANCER SCREENINGS 4/15/2025STRESS AND ALCOHOL USE 4/18/2025STROKE AWARENESS MONTH 5/1/2025SPOT A STROKE F.A.S.T. 5/2/2025WORLD OVARIAN CANCER DAY 5/8/2025MENTAL HEALTH AND NURSING 5/9/2025SANE EDUCATION 5/9/2025SKIN CANCER AWARENESS 5/14/2025F.A.S.T. EXPERIENCE 5/14/2025STROKE AWARENESS MONTH 5/21/2025MENTAL HEALTH FOR WOMEN 5/22/2025BLOOD DONATION 5/24/2025CANCER SURVIVORSHIP 6/1/2025MEN'S HEALTH AWARENESS MONTH 6/2/2025MEN'S HEALTH AWARENESS MONTH 6/4/2025MEN'S HEALTH AWARENESS MONTH 6/9/2025MEN'S HEALTH AWARENESS MONTH 6/11/2025MEN'S HEALTH AWARENESS MONTH 6/12/2025MEN'S HEALTH AWARENESS MONTH 6/12/2025WORLD BLOOD DONATION DAY 6/14/2025HEAT SAFETY AWARENESS 6/23/2025MEN'S CANCERS 6/24/2025MEN'S HEALTH AWARENESS MONTH 6/27/2025SUMMER SAFETY 6/28/2025MEN'S HEALTH AWARENESS MONTH 6/30/2025FIREWORKS SAFETY 7/2/2025SKIN HEALTH AWARENESS 7/17/2025PEDIATRIC PHYSICAL THERAPY 7/18/2025HEATH SAFETY 7/19/2025BLOOD DONATION 7/21/2025INFANT MORTALITY 7/23/2025UV SAFETY AWARENESS 7/25/2025BACK-TO-SCHOOL HEALTH 7/28/2025PEDIATRIC PHYSICAL THERAPY 7/30/2025BACK-TO-SCHOOL HEALTH 7/30/2025WORLD LUNG CANCER DAY 8/1/2025NATIONAL BREASTFEEDING MONTH 8/16/2025BITE THERAPY 9/4/2025WORLD SEPSIS DAY 9/13/2025TIF PROCEDURE FOR GERD 9/17/2025BLOOD DONATION 9/17/2025BREAST CANCER AWARENESS 9/19/2025PROSTATE CANCER DETECTION 9/23/2025COCHLEAR IMPLANTS 9/26/2025MAMMOGRAMS 9/29/20252025 NUMBER SCREENED:117 ACROSS MULTIPLE EVENTS2025 NUMBERS SCREENED AT EVENTS:SKIN CANCER - 32ORAL, HEAD AND NECK CANCER - 85THE MEDICAL ASSISTANCE PROGRAM FOR DEACONESS GIBSON HOSPITAL PROVIDED PATIENTS WITH NEARLY $3,000 IN ASSISTANCE.LOCAL SPONSORSHIPS AS A SYSTEM IN FY 24-25, DEACONESS SPONSORED PROGRAMS AND ACTIVITIES FOR MORE THAN 170,000 PEOPLE, CONTRIBUTING $2.1 MILLION IN SUPPORT OF CLUBS, GROUPS, SOCIAL SERVICE ORGANIZATIONS, AND OTHERS STRIVING TO MAKE OUR COMMUNITY A BETTER PLACE. |
| PART III, LINE 2: | METHODOLOGY USED TO ESTIMATE BAD DEBT: MANAGEMENT ANALYZES THIRD-PARTY PAYOR SOURCES AND MAKES AN ESTIMATE BASED ON AGING OF ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO ITS SERVICE AREA. ADDITIONALLY, A SIGNIFICANT PROVISION IS ESTIMATED AND RECORDED FOR SELF-PAY PAYMENTS BASED ON PAST EXPERIENCE. |
| PART III, LINE 3: | THE HOSPITAL DOES NOT PURSUE COLLECTION AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. THESE AMOUNTS ARE NOT REPORTED AS NET PATIENT REVENUE BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. GIBSON GENERAL HOSPITAL DOES NOT ATTRIBUTE ANY BAD DEBT EXPENSE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP), THEREFORE NO PORTION OF BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE INDIVIDUALS IS CONSIDERED A COMMUNITY BENEFIT. |
| PART III, LINE 4: | THE FOOTNOTE DESCRIBING BAD DEBT EXPENSES IS INCLUDED IN THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER FOOTNOTE "CHARITY CARE, COMMUNITY BENEFIT AND ASSISTANCE TO THE UNINSURED" STARTING ON PAGE 13 AND "PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE" ON PAGES 11-12. |
| PART III, LINE 8: | MEDICARE SHORTFALL:THE HOSPITAL IS A CRITICAL ACCESS HOSPITAL AND IS REIMBURSED 101%, LESS 2% SEQUESTRATION, OF MEDICARE ALLOWANCE COSTS FOR INPATIENT SERVICES, SWING BED, AND OUTPATIENT PART B SERVICES. THE REVENUE SHORTFALL IS THE DIFFERENCE BETWEEN THE ALLOWABLE COST FOR THE SKILLED NURSING FACILITY AND THE PPS REIMBURSEMENT ALLOWED FOR THAT SKILLED NURSING FACILITY. THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED SEPTEMBER 30, 2025: HOSPITAL STATEMENT OF REIMBURSABLE COST. |
| PART III, LINE 9B: | COLLECTION PRACTICES:COLLECTION PRACTICES ARE APPLIED TO ALL PATIENTS AT GIBSON GENERAL HOSPITAL. ONCE PATIENTS RECEIVE SERVICES, THE PATIENTS' ACCOUNTS ARE BILLED TO THE APPROPRIATE INSURANCE COMPANY. ONCE PAYMENT IS RECEIVED FROM THE INSURANCE COMPANY, THE REMAINING BALANCE, IF ANY, BECOMES THE PATIENT'S RESPONSIBILITY. NOTIFICATION OF THE BALANCE DUE IS SENT VIA WRITTEN CORRESPONDENCE. IF THE BALANCE IS NOT PAID AND THE ACCOUNT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE, THE ACCOUNT IS SENT TO A COLLECTION AGENCY TO CONTINUE EFFORTS TO COLLECT THE REMAINING BALANCE DUE. IF THE BALANCE DUE IS NOT PAID WITHIN A CERTAIN NUMBER OF MONTHS, THE ACCOUNT IS RETURNED TO THE HOSPITAL AND THE ACCOUNT IS WRITTEN OFF AS UNCOLLECTIBLE. |
| PART VI, LINE 2: | DEACONESS RELIES HEAVILY ON ITS RELATIONSHIPS WITH COMMUNITY PARTNERS, LIKE TULIP TREE AND OTHERS, AND THE FEEDBACK FROM SAME, TO INFORM OUR CARE PRIORITIES. |
| PART VI, LINE 3: | THIS IS LISTED ON OUR WEBSITE AT HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE AND IS POSTED IN EVERY CLINIC OFFICE AND FACILITY. |
| PART VI, LINE 4: | DEACONESS DEFINES ITS COMMUNITY AS ALL PEOPLE LIVING IN GIBSON COUNTY IN INDIANA ANY TIME DURING THE YEAR.THE UNITED STATES CENSUS BUREAU ESTIMATES THE 2023 POPULATION OF GIBSON COUNTY AT 32,904. FEMALES COMPRISE 49.1% OF THE POPULATION. THE MEDIAN AGE OF THE COUNTY IS 40.3 YEARS OLD. THE MEDIAN HOUSEHOLD INCOME FOR GIBSON COUNTY IS $64,153; AND APPROXIMATELY 9.7% OF THE POPULATION IS LIVING IN POVERTY. THE UNEMPLOYMENT RATE FOR GIBSON COUNTY IS 2.5% AS OF APRIL 2024. UNDERSERVED POPULATIONS GIBSON COUNTY HAS A RELATIVELY HOMOGENOUS RACIAL AND ETHNIC PROFILE. MINORITY POPULATIONS MAKE UP APPROXIMATELY 6.4% OF THE TOTAL INHABITANTS OF GIBSON COUNTY ACCORDING TO 2022 CENSUS DATA ESTIMATES. THE SECOND LARGEST POPULATION AFTER WHITE IS THE BLACK POPULATION, REPRESENTING APPROXIMATELY ONLY 2.6% OF THE OVERALL RESIDENTS. UNFORTUNATELY, DATA REGARDING LANGUAGES SPOKEN IN THE COMMUNITIES WAS SUPPRESSED DUE TO POPULATION THRESHOLD REQUIREMENTS. HOWEVER, REPORTS FROM THE INDIANA DEPARTMENT OF TRANSPORTATION DOES SHOW THAT THE PERCENTAGE OF RESIDENTS THAT SPEAK ENGLISH "LESS THAN VERY WELL" IS ONLY 0.92% IN GIBSON. WHILE THIS IS A LOW PERCENTAGE, IT DOES REPRESENT JUST UNDER 300 PEOPLE WHO MAY NEED LANGUAGE SERVICES TO EFFECTIVELY COMMUNICATE AND RECEIVE INFORMED CARE. |
| PART VI, LINE 5: | DEACONESS HOSTED AND ATTEND PUBLIC EVENTS, SUCH AS OUR ANNUAL ORAL, HEAD AND NECK CANCER SCREENINGS; COLON CANCER SCREENINGS, LOW DOSE CT SCREENINGS AND MORE OUTLINED BELOW. ADDITIONALLY, WE CREATED AND DISTRIBUTED WRITTEN AND VISUAL CONTENT THAT ADDRESSED SPECIFIC ISSUES AND HEALTH CONCERNS FOR OUR COMMUNITY. SOCIAL MEDIA POSTS: BREAST CANCER AWARENESS - 10/1/2024 WISE CHOICE - 10/8/2024 MENTAL HEALTH AWARENESS - 10/10/2024 PRIMARY CARE WEEK - 10/11/2024 GLOBAL HANDWASHING DAY - 10/15/2024 NATIONAL MAMMOGRAPHY DAY - 10/18/2024 MEGA BREAST TOUR - 10/18/2024 BREAST CANCER SURVIVOR TESTIMONY - 10/25/2024 BREAST CANCER SURVIVOR TESTIMONY - 10/31/2024 LUNG CANCER AWARENESS - 11/1/2024 LUNG CANCER SCREENING - 11/8/2024 WORLD DIABETES DAY - 11/14/2024 GREAT AMERICAN SMOKEOUT - 11/24/2024 WORLD AIDS DAY SCREENING - 11/22/2024 NO SHAVE NOVEMBER - 11/22/2024 SAFE TOYS AND GIFTS MONTH - 12/2/2024 SAFESITTER - 12/4/2024 HAND HYGIENE - 12/6/2024 ANXIETY - 12/6/2024 WHOOPING COUGH (PERTUSSIS) VACCINE AWARENESS - 12/10/2024 WHOOPING COUGH (PERTUSSIS) VACCINE AWARENESS - 12/18/2024 CROHN'S DISEASE AWARENESS - 12/19/2024 WHOOPING COUGH (PERTUSSIS) VACCINE AWARENESS - 12/23/2024 ANXIETY - 1/3/2025 WINTER STORM PREPAREDNESS - 1/5/2025 SLEDDING SAFETY - 1/10/2025 WEIGHT LOSS - 1/10/2025 HEAD AND NECK CANCER AWARENESS - 1/15/2025 LUNG DISEASE SUPPORT - 1/16/2025 FROSTBITE/HYPOTHERMIA AWARENESS - 1/20/2025 MOBILE MAMMOGRAM - 1/29/2025 GO RED FOR WOMEN (HEART DISEASE) - 1/31/2025 GO RED FOR WOMEN (HEART DISEASE) - 2/1/2025 AMERICAN HEART MONTH - 2/3/2025 GO RED FOR WOMEN (HEART DISEASE) - 2/5/2025 GO RED FOR WOMEN (HEART DISEASE) - 2/6/2025 HEART ATTACK SIGNS AND SYMPTOMS - 2/8/2025 IMPELLA HEART PUMP - 2/11/2025 CARDIAC REHAB - 2/15/2025 WINTER WEATHER SAFETY - 2/18/2025 NATIONAL CAREGIVERS DAY - 2/21/2025 COLON CANCER SCREENING - 3/3/2025 MEDICARE SEMINAR - 3/3/2025 NATIONAL KIDNEY MONTH - 3/6/2025 COLON CANCER AWARENESS MONTH - 3/6/2025 COLONOSCOPY AWARENESS - 3/7/2025 KIDNEY HEALTH - 3/11/2025 WORLD KIDNEY DAY / CHRONIC KIDNEY DISEASE - 3/13/2025 PULMONARY REHAB EDUCATION - 3/15/2025 FLU SEASON AWARENESS - 3/18/2025 KIDNEY DISEASE AWARENESS - 3/20/2025 AMERICAN DIABETES ALERT DAY - 3/20/2025 KIDNEY HEALTH - 3/25/2025 COLON CANCER SCREENING - 3/26/2025 HEAD AND NECK CANCER AWARENESS - 4/1/2025 HEAD AND NECK CANCER SCREENINGS - 4/7/2025 HEAD AND NECK CANCER SCREENINGS - 4/15/2025 STRESS AND ALCOHOL USE - 4/18/2025 STROKE AWARENESS MONTH - 5/1/2025 SPOT A STROKE F.A.S.T. - 5/2/2025 WORLD OVARIAN CANCER DAY - 5/8/2025 MENTAL HEALTH AND NURSING - 5/9/2025 SANE EDUCATION - 5/9/2025 SKIN CANCER AWARENESS - 5/14/2025 F.A.S.T. EXPERIENCE - 5/14/2025 STROKE AWARENESS MONTH - 5/21/2025 MENTAL HEALTH FOR WOMEN - 5/22/2025 BLOOD DONATION - 5/24/2025 CANCER SURVIVORSHIP - 6/1/2025 MEN'S HEALTH AWARENESS MONTH - 6/2/2025 MEN'S HEALTH AWARENESS MONTH - 6/4/2025 MEN'S HEALTH AWARENESS MONTH - 6/9/2025 MEN'S HEALTH AWARENESS MONTH - 6/11/2025 MEN'S HEALTH AWARENESS MONTH - 6/12/2025 MEN'S HEALTH AWARENESS MONTH - 6/12/2025 WORLD BLOOD DONATION DAY - 6/14/2025 HEAT SAFETY AWARENESS - 6/23/2025 MEN'S CANCERS - 6/24/2025 MEN'S HEALTH AWARENESS MONTH - 6/27/2025 SUMMER SAFETY - 6/28/2025 MEN'S HEALTH AWARENESS MONTH - 6/30/2025 FIREWORKS SAFETY - 7/2/2025 SKIN HEALTH AWARENESS - 7/17/2025 PEDIATRIC PHYSICAL THERAPY - 7/18/2025 HEATH SAFETY - 7/19/2025 BLOOD DONATION - 7/21/2025 INFANT MORTALITY - 7/23/2025 UV SAFETY AWARENESS - 7/25/2025 BACK-TO-SCHOOL HEALTH - 7/28/2025 PEDIATRIC PHYSICAL THERAPY - 7/30/2025 BACK-TO-SCHOOL HEALTH - 7/30/2025 WORLD LUNG CANCER DAY - 8/1/2025 NATIONAL BREASTFEEDING MONTH - 8/16/2025 BITE THERAPY - 9/4/2025 WORLD SEPSIS DAY - 9/13/2025 TIF PROCEDURE FOR GERD - 9/17/2025 BLOOD DONATION - 9/17/2025 BREAST CANCER AWARENESS - 9/19/2025 PROSTATE CANCER DETECTION - 9/23/2025 COCHLEAR IMPLANTS - 9/26/2025 MAMMOGRAMS - 9/29/2025 2025 - NUMBER SCREENED 117 ACROSS MULTIPLE EVENTS 2025 NUMBERS SCREENED AT EVENTS SKIN CANCER - 32 ORAL, HEAD AND NECK CANCER - 85 THE MEDICAL ASSISTANCE PROGRAM FOR THE DEACONESS SYSTEM SERVICED 4,105 INDIVIDUALS FOR 7,079 UNIQUE MEDICATIONS/PRESCRIPTIONS PROVIDED AT A TOTAL DOLLAR VALUE OF MORE THAN $102.6 MILLION IN FREE DRUGS TO PATIENTS. AN ADDITIONAL $172,763 IN COPAY/FOUNDATION ASSISTANCE WAS ALSO PROVIDED. LOCAL SPONSORSHIPS AS A SYSTEM IN FY 24-25, DEACONESS SPONSORED PROGRAMS AND ACTIVITIES FOR MORE THAN 170,000 PEOPLE, CONTRIBUTING $2.1 MILLION IN SUPPORT OF CLUBS, GROUPS, SOCIAL SERVICE ORGANIZATIONS, AND OTHERS STRIVING TO MAKE OUR COMMUNITY A BETTER PLACE. |
| PART VI, LINE 6: | GIBSON GENERAL HOSPITAL IS AFFILIATED WITH DEACONESS HEALTH SYSTEM, COOPERATING TO PROVIDE HEALTH CARE SERVICES TO THEIR COMMUNITIES. ADDITIONALLY, THE HOSPITAL DOES PARTICIPATE IN SEVERAL COALITIONS AND COOPERATIVES WITH OTHER PROVIDERS AND OFTEN COLLABORATES WITH THE LARGER SYSTEM IN THE EVANSVILLE AREA TO PROVIDE ACCESS TO SERVICES THE HOSPITAL CANNOT PROVIDE SUCH AS CARDIAC AND NEUROLOGICAL SURGERY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IN |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SPONSORSHIPS | GrantTypeTxt |
| Recipient | 15 | RecipientCnt |
| Cash Grant | $22,200 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AT GIBSON, OUR APPROACH TO GRANTS AND SPONSORSHIPS IS CENTERED ON SUPPORTING INITIATIVES THAT BENEFIT THE BROADER COMMUNITY GIVEN WE ARE THE ONLY HOSPITAL IN THE COUNTY. WE PRIORITIZE ORGANIZATIONS AND PROGRAMS WITH A COUNTY-WIDE IMPACT. IN ADDITION, WE REGULARLY SPONSOR EVENTS AFFILIATED WITH OTHER HOSPITAL FOUNDATIONS, PARTICULARLY WHEN THEY SUPPORT OR PARTNER WITH OUR INITIATIVES. WE ALSO CONSISTENTLY PROVIDE SUPPORT TO EACH OF THE THREE LOCAL SCHOOL CORPORATIONS IN THE COUNTY, RECOGNIZING THEIR IMPORTANT ROLE IN OVERALL COMMUNITY HEALTH AND DEVELOPMENT. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LYNN LINGAFELTER | ||||||||||||||
| BOARD MEMBER | $0 | $694,891 | $0 | $216,135 | $0 | $161,935 | $0 | $162,333 | $0 | $36,046 | $0 | $1,271,340 | $0 | $158,553 |
| ASHLEY SMITH | ||||||||||||||
| PHYSICIAN | $904,409 | $0 | $0 | $0 | $22,516 | $0 | $16,075 | $0 | $10,920 | $0 | $953,920 | $0 | $0 | $0 |
| MARC JARED FLORENCE | ||||||||||||||
| BOARD MEMBER | $0 | $517,418 | $0 | $139,337 | $0 | $96,624 | $0 | $111,246 | $0 | $42,712 | $0 | $907,337 | $0 | $92,724 |
| STEVEN IVY | ||||||||||||||
| BOARD MEMBER | $0 | $309,811 | $0 | $69,781 | $0 | $1,226 | $0 | $12,075 | $0 | $36,597 | $0 | $429,490 | $0 | $0 |
| DR DAVID PURDOM | ||||||||||||||
| CHIEF OF STAFF (END 12/2024) | $334,017 | $0 | $0 | $0 | $11,743 | $0 | $16,075 | $0 | $34,324 | $0 | $396,159 | $0 | $0 | $0 |
| COREY POTTS | ||||||||||||||
| CRNA | $256,266 | $0 | $27,950 | $0 | $391 | $0 | $10,166 | $0 | $32,149 | $0 | $326,922 | $0 | $0 | $0 |
| DR ADRIAN CARTER | ||||||||||||||
| CHIEF OF STAFF (BEG 01/2025) | $0 | $209,609 | $0 | $61,157 | $0 | $2,685 | $0 | $14,008 | $0 | $13,188 | $0 | $300,647 | $0 | $0 |
| LOIS MORGAN | ||||||||||||||
| CAO (END 12/2024) | $211,933 | $0 | $39,678 | $0 | $10,781 | $0 | $10,351 | $0 | $25,278 | $0 | $298,021 | $0 | $0 | $0 |
| GREG WRIGHT | ||||||||||||||
| BOARD MEMBER | $174,660 | $0 | $15,840 | $0 | $2,143 | $0 | $2,260 | $0 | $24,608 | $0 | $219,511 | $0 | $0 | $0 |
| MARILYN HARPER | ||||||||||||||
| RN | $126,247 | $0 | $22,801 | $0 | $806 | $0 | $5,377 | $0 | $24,034 | $0 | $179,265 | $0 | $0 | $0 |
| SHANE C HAYES | ||||||||||||||
| CNO (PARTIAL YEAR)/CAO | $127,923 | $0 | $8,271 | $0 | $1,216 | $0 | $5,012 | $0 | $31,441 | $0 | $173,863 | $0 | $0 | $0 |
| BETH N MCGRAW | ||||||||||||||
| LEAD MULTI-MODALITY TECH | $123,220 | $0 | $2,007 | $0 | $22,840 | $0 | $5,231 | $0 | $2,465 | $0 | $155,763 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE FOLLOWING METHODS WERE USED BY DEACONESS HEALTH SYSTEM, A RELATED NON-PROFIT ORGANIZATION, TO DETERMINE THE COMPENSATION FOR THE CEO: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION STUDY OR SURVEY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 4B | NONQUALIFIED PAYMENTS: MARC J. FLORENCE 23,000 DAVID PURDOM 23,000 LYNN LINGAFELTER 23,000 PART I, 4B: MARC J. FLORENCE: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $99,171. SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $92,724. LYNN LINGAFELTER: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $150,258. SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $158,553. |
| PART I, LINE 6 | COMPENSATION CONTINGENT UPON NET EARNINGS: INCENTIVE COMPENSATION PAYMENTS MADE BY THE ORGANIZATION ARE BASED UPON SUCCESSFUL ACHIEVEMENT OF ESTABLISHED INPATIENT SATISFACTION MEASURES, OUTPATIENT SATISFACTION MEASURES, COMPLIANCE WITH PUBLICLY REPORTED QUALITY INDICATORS, OPERATING MARGIN AS WELL AS OTHER TECHNICAL AND PERSONAL FUNCTIONAL GOALS OF BOTH THE ORGANIZATION AND RELATED ORGANIZATIONS. GIBSON GENERAL HOSPITAL'S INCENTIVE COMPENSATION PROGRAMS ARE FORMULATED TO REWARD BEHAVIOR THAT BALANCES PATIENT NEEDS AND EFFICIENT DELIVERY OF PATIENT CARE TO ENSURE THE BEST OUTCOMES ARE ACHIEVED. |
| PART I, LINE 7 | PHYSICIANS ARE ELIGIBLE FOR INCENTIVE COMPENSATION. THE PHYSICIAN IS COMPENSATED FOR EACH WORK RVU PERFORMED BY A PHYSICIAN IN A CALENDAR YEAR IN EXCESS OF THE PHYSICIAN'S WORK RVU INCENTIVE THRESHOLD FOR THE CALENDAR YEAR MULTIPLIED BY THE INCENTIVE RVU PAYMENT. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE J | WWW.DEACONESS.COM/INDIANA/DEACONESS-GIBSON-HOSPITAL |
| FORM 990, PART VI, SECTION A, LINE 6 | CLASSES OF MEMBERS OR STOCKHOLDERS: DEACONESS HEALTH SYSTEM, INC., A TAX EXEMPT 501(C)(3) ORGANIZATION, IS THE SOLE CORPORATE MEMBER OF GIBSON GENERAL HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | POWER TO ELECT OR APPOINT: DEACONESS HEALTH SYSTEM, THE SOLE MEMBER OF THE ORGANIZATION, HAS THE POWER TO APPOINT AND REMOVE EACH MEMBER. THE ORGANIZATION GOVERNING DOCUMENTS ALLOWS FOR THE COUNTY COMMISSIONERS OF GIBSON COUNTY, INDIANA TO SELECT ONE (1) MEMBER OF THE BOARD OF TRUSTEES; THREE (3) REPRESENTATIVES FROM THE ORGANIZATION'S SOLE MEMBER; THE MAYOR OF PRINCETON, INDIANA; THE PRESIDENT OF GIBSON GENERAL HOSPITAL FOUNDATION; THE CHIEF OF STAFF OF GIBSON GENERAL HOSPITAL TO SERVE AS EX-OFFICIO MEMBER; AND TWO MEMBERS OF THE MEDICAL COMMUNITY. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING GOVERNANCE DECISIONS ARE RESERVED TO THE SOLE MEMBER OF THE ORGANIZATION, DEACONESS HEALTH SYSTEM. - APPROVAL OF ANNUAL OR LONG-TERM CAPITAL BUDGETS, OPERATING BUDGETS AND STRATEGIC PLANS, OR ANY EXPENDITURE IN EXCESS OF $150,000 NOT INCLUDED IN AN APPROVED BUDGET. - THE SALE OR TRANSFER OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY KEY OPERATIONAL ASSETS. - THE FILING OF BANKRUPTCY OR SIMILAR INSOLVENCY PROCESS WITH RESPECT TO THE CORPORATION. - ANY TRANSFER OF SUBSTANTIAL MANAGEMENT RESPONSIBILITY WITH RESPECT TO THE CORPORATION. - ANY AMENDMENT TO THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS. - ANY BORROWING EQUAL TO OR GREATER THAN $150,000, OR ANY AMENDMENT TO FINANCING OR LOAN DOCUMENTS TO WHICH THE CORPORATION IS A PARTY. - ANY DECISION TO CHANGE THE NAME OF THE HOSPITAL, CHANGE THE HOSPITAL CAMPUS FROM A CRITICAL ACCESS HOSPITAL STATUS, RELOCATE OR SUBSTANTIALLY REDUCE OR TERMINATE SERVICES TO THE COMMUNITY. - ANY DECISION TO REDUCE THE LEVEL OF CHARITABLE SERVICES TO THE COMMUNITY. - ANY DECISION RELATING TO THE TERMINATION OF THE CORPORATION'S EMPLOYEE RETIREMENT PLAN. - ADOPTION OF ANY POLICIES RELATING TO THE OPERATION OF THE BOARD, THE CORPORATION, OR THE HOSPITAL THAT ARE INCONSISTENT WITH POLICIES OF DEACONESS. - ANY OF THE FOREGOING ACTIONS BY THE CORPORATION AS THE OWNER, MEMBER OF ANY OF THE CORPORATION'S SUBSIDIARIES OR AFFILIATES, INCLUDING THE HOSPITAL. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS: THE PROCESS OF REVIEWING THE FORM 990 INCLUDES A DETAILED REVIEW OF THE FORM AND REQUIRED SCHEDULES BY THE CHIEF FINANCIAL OFFICER AND MANAGEMENT. AFTER THIS REVIEW IS PERFORMED AND ALL QUESTIONS ARE ANSWERED, THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS OF DEACONESS HEALTH SYSTEM AT THE BOARD MEETING PRIOR TO THE FILING DATE OF THE FORM 990. ANY ADDITIONAL QUESTIONS ARE ANSWERED AND THE FINAL FILING IS THEN COMPLETED. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: THE CONFLICT OF INTEREST POLICY IS INCLUDED WITHIN THE BYLAW OF THE ORGANIZATION AND COVERS ALL BOARD OF TRUSTEES. THE POLICY PROVIDES PROCEDURES TO PREVENT THOSE WITH DUALITY OF INTEREST OR POSSIBLE CONFLICTS OF INTEREST FROM PARTICIPATING IN ANY ACTION THAT COULD PERSONALLY BENEFIT THE INDIVIDUAL TRUSTEE. THE CEO AND/OR BOARD COMPLIANCE OFFICER REVIEW ANNUAL WRITTEN AND SIGNED CONFLICT OF INTEREST STATEMENTS THAT PROVIDE ANY DUALITY OF INTEREST OR POSSIBLE CONFLICTS OF INTEREST DISCLOSED BY ALL BOARD OF TRUSTEES. THE INDIVIDUAL TRUSTEE WILL AGAIN DISCLOSE TO THE BOARD WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION AND RECUSES HIMSELF OR HERSELF FROM VOTING ON THE RELATED ISSUE. THE BOARD MEETING MINUTES DOCUMENT THE DISCLOSURE MADE, WHO ABSTAINED FROM VOTING, AND THE QUORUM SITUATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION PROCESS: CEO: THE CEO EVALUATION COMMITTEE, CONSISTING OF FOUR INDEPENDENT AND BOARD CHAIR APPOINTMENT TRUSTEE MEMBERS, EVALUATES THE PERFORMANCE OF THE CEO ON AN ANNUAL BASIS AND MAKES COMPENSATION-RELATED RECOMMENDATIONS TO THE BOARD PRIOR TO THE CEO'S ANNUAL REVIEW DATE FOR APPROVAL. THE EVALUATION COMMITTEE USES A COMPENSATION CONSULTANT, COMPENSATION SURVEY, AND COMPARATIVE DATA FROM SIMILAR ORGANIZATIONS TO DETERMINE THE CEO'S COMPENSATION PACKAGE. ALL DELIBERATION AND DECISIONS ARE DOCUMENTED IN THE EVALUATION COMMITTEE'S MINUTES. OFFICERS AND/OR KEY EMPLOYEES: ANNUAL REVIEWS FOR TOP MANAGEMENT OFFICIALS ARE CONDUCTED BY THE CEO. THE COMPENSATION IS ANNUALLY REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST AND BOARD OF TRUSTEES APPROVAL. WRITTEN REQUESTS SHOULD BE SENT TO ATTN: JAMES CHILDERS, AT THE ADDRESS LISTED ON PAGE 1 OF THE FORM 990. |
| FORM 990, PART VI, LINE 16B, JOINT VENTURE POLICY: | THE ORGANIZATION DOES NOT HAVE A FORMAL WRITTEN POLICY ON EVALUATING PARTICIPATION IN A JOINT VENTURE, HOWEVER, THE ORGANIZATION PERFORMS DUE DILIGENCE AND INVOLVES LEGAL COUNSEL TO REVIEW ANY PARTNERSHIPS ENSURING THAT THE JOINT VENTURE WOULD BE ORGANIZED AND OPERATED IN A MANNER CONSISTENT WITH THE HOSPITAL'S EXEMPT PURPOSE AND STATUS. |
| FORM 990, PART VII & SCHEDULE J, PART II: | WE DO NOT USE A COMMON PAYMASTER. ALL SHARED STAFF AND DUAL-OFFICERS ARE PAID AND W-2'D SOLELY BY DHS. GIBSON GENERAL HOSPITAL REPORTS ALL SUCH COMPENSATION AS RELATED ORGANIZATION COMPENSATION IN PART VII COL (E) AND SCHEDULE J ROW (II). THE INTERCOMPANY ALLOCATION AND SUBSIDY ARE REPORTED AS OPERATIONAL TRANSFERS/ALLOCATIONS, NOT AS DIRECT COMPENSATION BY THE SUBSIDIARY. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES AND PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 9,414,708. MANAGEMENT AND GENERAL EXPENSES 2,544,071. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,958,779. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| DEACONESS ILLINOIS CLINIC INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 920574205 | HEALTHCARE | IL | 501(C)(3) | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS ILLINOIS SPECIALTY CLINIC INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 920904755 | HEALTHCARE | IL | 501(C)(3) | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS SPECIALTY PHYSICIANS INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 824503095 | HEALTHCARE | IN | 501(C)(3) | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS VNA PLUS LLC | |||||||||||
| 611 HARRIET ST | EVANSVILLE | IN | 47710 | 465223267 | HEALTHCARE | IN | 501(C)(3) | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS HEALTH SYSTEM INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 351532889 | HEALTHCARE | IN | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 800 WEST NINTH STREET | JASPER | IN | 47546 | 351359445 | SUPPORT DEACONESS MEMORIAL MEDICAL CENTER, INC. | IN | 501(C)(3) | LINE 12A, I | DEACONESS MEMORIAL MEDICAL CENTER INC | 0 | |
| UNION COUNTY METHODIST HOSPITAL FOUNDATION | |||||||||||
| 4604 US HWY 60 WEST | MORGANFIELD | KY | 42437 | 611230297 | SUPPORT METHODIST HOSPITAL | KY | 501(C)(3) | LINE 10 | DEACONESS HEALTH KENTUCKY | 0 | |
| DEACONESS CLINIC INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 263083364 | HEALTHCARE | IN | 501(C)(3) | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS HEALTH KENTUCKY INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | KY | 47747 | 830966826 | HEALTHCARE | KY | 501(C)(3) | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS HOSPITAL INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 350593390 | HEALTHCARE | IN | 501(C)(3) | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS MEMORIAL MEDICAL CENTER INC | |||||||||||
| 800 WEST NINTH STREET | JASPER | IN | 47546 | 350985964 | HEALTHCARE | IN | 501(C)(3) | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS UNION COUNTY HOSPITAL INC | |||||||||||
| 4604 US HWY 60 WEST | MORGANFIELD | KY | 42437 | 862614124 | HEALTHCARE | KY | 501(C)(3) | LINE 3 | DEACONESS HEALTH KENTUCKY | 0 | |
| DEACONESS WOMEN'S HOSPITAL OF SOUTHERN INDIANA LLC | |||||||||||
| 4199 GATEWAY BLVD | NEWBURGH | IN | 47630 | 352062016 | HEALTHCARE | IN | 501(C)(3) | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| METHODIST HEALTH INC | |||||||||||
| PO BOX 48 | HENDERSON | KY | 42419 | 610461753 | HEALTHCARE | KY | 501(C)(3) | LINE 3 | DEACONESS HEALTH KENTUCKY | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| BOSTON IVF FERTILITY SERVICES AT THE WOMEN'S HOSPITAL | |||||||||
| 4199 GATEWAY BLVD | NEWBURGH | IN | 47630 | 455549778 | HEALTHCARE | IN | N/A | 0 | 0 |
| BAPTIST HEALTH DEACONESS LLC | |||||||||
| 1901 CAMPUS PLACE | LOUISVILLE | KY | 40299 | 872361058 | HEALTHCARE | KY | N/A | 0 | 0 |
| BURKHARDT CANCER CENTER LLC | |||||||||
| 4972 LINCOLN AVENUE STE 100 | EVANSVILLE | IN | 47715 | 300256432 | HEALTHCARE | IN | N/A | 0 | 0 |
| DEACONESS HEALTH PLANS LLC | |||||||||
| 7100 EAGLE CREST BLVD | EVANSVILLE | IN | 47715 | 383492529 | PREFERRED PROVIDER NETWORK | IN | N/A | 0 | 0 |
| DEACONESS HOME HEALTH LLC | |||||||||
| 6281 TRI RIDGE BLVD STE 300 | LOVELAND | OH | 45140 | 843167946 | HEALTHCARE | OH | N/A | 0 | 0 |
| DUBOIS PSYCH PROPERTIES LLC | |||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47710 | 992349209 | MENTAL HEALTH SERVICES | IN | N/A | 0 | 0 |
| ENCOMPASS HEALTH DEACONESS REHABILIATION | |||||||||
| 9001 LIBERTY PARKWAY | BIRMINGHAM | AL | 35242 | 721375246 | OUTPATIENT | AL | N/A | 0 | 0 |
| EVANSVILLE SURGERY SERVICES LLC | |||||||||
| 520 MARY STREET | EVANSVILLE | IN | 47747 | 994656829 | HEALTHCARE | IN | N/A | 0 | 0 |
| INNOVATIVE HEALTHCARE COLLABORATIVE OF INDIANA LLC | |||||||||
| 7330 SHADELAND STATION STE 200 | INDIANAPOLIS | IN | 46256 | 833592473 | HEALTHCARE | IN | N/A | 0 | 0 |
| LOFIELD DIALYSIS LLC | |||||||||
| PO BOX 4388 | FEDERAL WAY | WA | 98063 | 812592834 | HEALTHCARE | WA | N/A | 0 | 0 |
| MAINSPRING MANAGERS LLC | |||||||||
| 4011 GATEWAY BLVD | NEWBURGH | IN | 47630 | 464601001 | NEUROLOGY SERVICES | IN | N/A | 0 | 0 |
| MEMORIAL HOSPITAL OUTPATIENT SURGERY CENTER | |||||||||
| 600 WEST 13TH STREET | JASPER | IN | 47546 | 274828606 | OUTPATIENT | IN | N/A | 0 | 0 |
| ORTHOALIGN LLC | |||||||||
| 4011 GATEWAY BLVD | NEWBURGH | IN | 47630 | 812816013 | HEALTHCARE | IN | N/A | 0 | 0 |
| ORTHOPRIME LLC | |||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 993575306 | HEALTHCARE | IN | N/A | 0 | 0 |
| PROGRESSIVE HEALTH OF INDIANA LLC | |||||||||
| 150 N ROSENBERGER | EVANSVILLE | IN | 47712 | 208480988 | OUTPATIENT | IN | N/A | 0 | 0 |
| TRI-STATE HEALTHCARE CONSULTANTS LLC | |||||||||
| 4199 GATEWAY BLVD | NEWBURGH | IN | 47630 | 922120911 | HEALTHCARE | IN | N/A | 0 | 0 |
| TRI-STATE RADIATION ONCOLOGY CENTERS LLC | |||||||||
| PO BOX 819067 TAX DEPT | DALLAS | TX | 75381 | 263706834 | OUTPATIENT | DE | N/A | 0 | 0 |
| VASCMED LLC | |||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 472578168 | VASCULAR SERVICES | IN | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROSSROADS HEALTH SERVICES RECIPROCAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 BANK STREET SUITE 500 | AddressLine1Txt |
| City | BURLINGTON | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 814762330 | EIN |
| Primary Activities | INDUSTRIAL INSURANCE RECIPROCAL REINSURANCE | PrimaryActivitiesTxt |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |