ST MARYS HOSPITAL INC: Form 990, tax year 2025
View the entire original 990 at ProPublica ↗
- Organization
- ST MARYS HOSPITAL INC (EIN 82-0226453)
- Tax period
- 2025-01-01 to 2025-12-31
- Filed
- 2026-09-04
- IRS object ID
- 202602479349300345
- Schema version
- 2025v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-09-04T13:27:36-05:00 | ReturnTs |
| Tax Period End | 2025-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 393647910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI ADVISORY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 105 E PINE ST UPPER FLOOR | AddressLine1Txt |
| City | MISSOULA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59802 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2025-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 820226453 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STMA | BusinessNameControlTxt |
| Phone | 2089623251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 137 | AddressLine1Txt |
| City | COTTONWOOD | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83522 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JYL RULAND | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 2089623251 | PhoneNum |
| Signature | 2026-09-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SAM BRUNSON CPA | PreparerPersonNm |
| PTIN | P01696998 | PTIN |
| Phone | 4067281800 | PhoneNum |
| Preparation | 2026-09-04 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2025 | TaxYr |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LENNE BONNER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 137 | AddressLine1Txt |
| City | COTTONWOOD | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83522 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $31,657,064 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | SMH-CVH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1958 | FormationYr |
| Legal Domicile State | ID | LegalDomicileStateCd |
| Activity Or Mission | WE IMPROVE HEALTHCARE ONE PATIENT AT A TIME IN A FRIENDLY AND PROFESSIONAL CULTURE COMMITTED TO SUPERIOR QUALITY AND SAFETY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 214 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $790,713 | PYContributionsGrantsAmt |
| CY Contributions Grants | $269,008 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $28,900,957 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $30,817,223 | CYProgramServiceRevenueAmt |
| PY Investment Income | $559,007 | PYInvestmentIncomeAmt |
| CY Investment Income | $446,608 | CYInvestmentIncomeAmt |
| PY Other Revenue | $408,987 | PYOtherRevenueAmt |
| CY Other Revenue | $124,225 | CYOtherRevenueAmt |
| PY Total Revenue | $30,659,664 | PYTotalRevenueAmt |
| CY Total Revenue | $31,657,064 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $20,460 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $9,772 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $19,321,112 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,718,995 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,169,018 | PYOtherExpensesAmt |
| CY Other Expenses | $10,476,806 | CYOtherExpensesAmt |
| PY Total Expenses | $28,510,590 | PYTotalExpensesAmt |
| CY Total Expenses | $32,205,573 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,149,074 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$548,509 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $32,827,581 | TotalAssetsBOYAmt |
| Total Assets EOY | $33,838,230 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,742,347 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,958,391 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $26,085,234 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $25,879,839 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE IMPROVE HEALTHCARE ONE PATIENT AT A TIME IN A FRIENDLY AND PROFESSIONAL CULTURE COMMITTED TO SUPERIOR QUALITY AND SAFETY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $25,818,247 | ExpenseAmt |
| Grant | $9,772 | GrantAmt |
| Revenue | $30,817,223 | RevenueAmt |
| Desc | ST MARY'S HOSPITAL (SMH) IS CREATED AND ORGANIZED TO OWN, MAINTAIN, OPERATE AND CONDUCT, DIRECTLY OR INDIRECTLY, AND TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, EDUCATION, CARE FOR THE AGED AND SOCIAL SERVICES IN ACCORDANCE WITH THE CHARITABLE WORKS TRADITION OF THE ROMAN CATHOLIC CHURCH. IN KEEPING WITH THIS SPECIFIC PURPOSE, ALL WORKS SHALL BE CARRIED OUT IN ACCORDANCE WITH THE CHARISM OF THE BENEDICTINE SISTERS OF ST. SCHOLASTICA MONASTERY. SMH OPERATES A 25-BED CRITICAL ACCESS HOSPITAL AND PRIMARY CARE CLINICS THAT PROVIDE GENERAL MEDICAL AND SURGICAL CARE FOR INPATIENT, OUTPATIENT, AND EMERGENCY ROOM PATIENTS IN COTTONWOOD AND THE SURROUNDING AREAS OF KAMIAH, GRANGEVILLE, NEZPERCE, CRAIGMONT AND ELK CITY.THE HOSPITAL PROVIDED 688 HOSPITAL PATIENT DAYS, 27,014 OUTPATIENT VISITS, 2,143 ER VISITS, AND 27,029 CLINIC ENCOUNTERS DURING THE YEAR. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS $31,920 FOR CHARITY CARE, $4,896,437 FOR MEDICARE, $2,888,753 FOR MEDICAID, AND $5,253,116 FOR OTHER THIRD-PARTY PAYORS FOR THE YEAR. | Desc |
| Total Program Service Expenses | $25,818,247 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | 0 | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 103 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 214 | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JYL RULAND | PersonNm |
| Phone | 2089623251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 CEDAR | AddressLine1Txt |
| City | OROFINO | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83544 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 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 |
|---|---|---|---|---|---|---|---|---|
| KIM INGRAM | ||||||||
| BOARD CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SARA SWISHER | ||||||||
| BOARD VICE CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KELLY MCGRATH | ||||||||
| DIRECTOR/CMO | 20.00 | 20.00 | Yes (X) | $0 | $372,235 | $39,698 | ||
| MICHELE BOUIT | ||||||||
| DIRECTOR/KH CFO | 1.00 | 40.00 | Yes (X) | $0 | $760,206 | $32,125 | ||
| CINDY O'BRIEN | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MATT SARTINI | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SISTER LISA MAURER | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SISTER BARBARA JEAN GLODOWSKI | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK IMUS | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRISTOPHER RIGGERS | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JASON HUNTER | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LYNNANN BULLENE | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL NUSSER | ||||||||
| DIRECTOR (THRU 06/25) | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JYL RULAND | ||||||||
| CFO | 30.00 | 30.00 | Yes (X) | $0 | $185,466 | $33,488 | ||
| LENNE BONNER | ||||||||
| CEO | 30.00 | 30.00 | Yes (X) | $0 | $355,796 | $38,856 | ||
| DR NICHOLAS HENRIE | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $484,591 | $0 | $27,831 | Yes (X) | ||
| DR THOMAS WONDERLICH | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $435,574 | $0 | $31,612 | Yes (X) | ||
| DR JUSTIN JONES | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $423,862 | $0 | $40,130 | Yes (X) | ||
| DR TEMA JESSUP | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $374,926 | $0 | $40,126 | Yes (X) | ||
| DR ANDREW SCHWEITZER | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $383,234 | $0 | $24,359 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,102,187 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,673,703 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $308,225 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 39 | 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 |
|---|---|---|---|---|---|
| PALOUSE IMAGING CONSULTANTS PL | |||||
| PO BOX 9583 | MOSCOW | ID | 83843 | RADIOLOGY READS | $368,560 |
| QUALIVIS LLC | |||||
| 5930 CORNERSTONE COURT W STE 300 | SAN DIEGO | CA | 92121 | RN COVERAGE | $364,540 |
| HERITAGE IMAGING LLC | |||||
| 12554 W GRIDGER ST 118 | BOISE | ID | 83713 | MRI RADIOLOGY READS | $287,954 |
| ASPIRION HEALTHCARE RESOURCES LLC | |||||
| PO BOX 739167 | DALLAS | TX | 753739167 | DEBT COLLECTIONS | $195,312 |
| NEWPORT HEALTH SERVICES LLC | |||||
| 4 CORPORATE PLAZA SUITE 150 | NEWPORT BEACH | CA | 92660 | SLEEP LAB MANAGEMENT | $151,900 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $261,744 | GovernmentGrantsAmt |
| All Other Contributions | $7,264 | AllOtherContributionsAmt |
| Total Contributions | $269,008 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $30,195,509 | $30,195,509 |
| PHARMACY 340B REVENUE | 456110 | $621,714 | $621,714 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $30,817,223 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $440,908 | TotalRevenueColumnAmt |
| Exclusion | $440,908 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $640 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $640 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $640 | TotalRevenueColumnAmt |
| Exclusion | $640 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,700 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,700 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,700 | TotalRevenueColumnAmt |
| Exclusion | $5,700 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $33,481 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,481 | TotalRevenueColumnAmt |
| Exclusion | $33,481 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MEDICARE SHARED SAVINGS | 900099 | $85,421 | $85,421 |
| MISCELLANEOUS REVENUE | 900099 | $4,683 | $4,683 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $90,104 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,657,064 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $30,817,223 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $570,833 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,772 | TotalAmt |
| Program Services | $9,772 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,494,242 | TotalAmt |
| Program Services | $14,196,946 | ProgramServicesAmt |
| Management And General | $3,297,296 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $518,863 | TotalAmt |
| Program Services | $421,068 | ProgramServicesAmt |
| Management And General | $97,795 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,629,391 | TotalAmt |
| Program Services | $2,133,806 | ProgramServicesAmt |
| Management And General | $495,585 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,076,499 | TotalAmt |
| Program Services | $873,602 | ProgramServicesAmt |
| Management And General | $202,897 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,757 | TotalAmt |
| Management And General | $8,757 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,495 | TotalAmt |
| Management And General | $1,495 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,630 | TotalAmt |
| Management And General | $1,630 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,427,849 | TotalAmt |
| Program Services | $2,790,757 | ProgramServicesAmt |
| Management And General | $637,092 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,041 | TotalAmt |
| Management And General | $79,041 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $351,472 | TotalAmt |
| Program Services | $206,317 | ProgramServicesAmt |
| Management And General | $145,155 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $747,653 | TotalAmt |
| Program Services | $37,593 | ProgramServicesAmt |
| Management And General | $710,060 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $334,190 | TotalAmt |
| Program Services | $328,870 | ProgramServicesAmt |
| Management And General | $5,320 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,564 | TotalAmt |
| Program Services | $70,023 | ProgramServicesAmt |
| Management And General | $40,541 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,927 | TotalAmt |
| Program Services | $112,770 | ProgramServicesAmt |
| Management And General | $17,157 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $823,463 | TotalAmt |
| Program Services | $714,721 | ProgramServicesAmt |
| Management And General | $108,742 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $128,468 | TotalAmt |
| Program Services | $111,503 | ProgramServicesAmt |
| Management And General | $16,965 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACEUTICALS | $1,270,626 | $1,270,626 | |
| MEDICAL SUPPLIES | $949,729 | $949,729 | |
| BAD DEBT EXPENSE | $577,765 | $577,765 | |
| DUES & SUBSCRIPTIONS | $526,348 | $53,842 | $472,506 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,007,829 | TotalAmt |
| Program Services | $958,537 | ProgramServicesAmt |
| Management And General | $49,292 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,205,573 | TotalAmt |
| Program Services | $25,818,247 | ProgramServicesAmt |
| Management And General | $6,387,326 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,293,525 | BOYAmt |
| EOY | $1,386,651 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,357,216 | BOYAmt |
| EOY | $3,459,421 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,118 | BOYAmt |
| EOY | $29,174 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,554,357 | BOYAmt |
| EOY | $5,525,682 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,067 | BOYAmt |
| EOY | $418,442 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $352,786 | BOYAmt |
| EOY | $176,793 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $223,865 | BOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $27,382,360 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $13,838,598 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,244,263 | BOYAmt |
| EOY | $13,543,762 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,852,385 | BOYAmt |
| EOY | $8,546,718 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $833,999 | BOYAmt |
| EOY | $751,587 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,827,581 | BOYAmt |
| EOY | $33,838,230 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,068,952 | BOYAmt |
| EOY | $2,152,201 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1 | BOYAmt |
| EOY | $1 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,385,143 | BOYAmt |
| EOY | $3,141,245 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,288,251 | BOYAmt |
| EOY | $2,664,944 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,742,347 | BOYAmt |
| EOY | $7,958,391 | 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 | $26,085,234 | BOYAmt |
| EOY | $25,879,839 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,085,234 | BOYAmt |
| EOY | $25,879,839 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,827,581 | BOYAmt |
| EOY | $33,838,230 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$548,509 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $359,147 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$16,033 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
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 | $1,495 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,495 | 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 DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $195,511 | OtherCostOrOtherBasisAmt |
| Book Value | $195,511 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,513,922 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,387,838 | DepreciationAmt |
| Book Value | $11,126,084 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,388,151 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,432,890 | DepreciationAmt |
| Book Value | $1,955,261 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $284,776 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,870 | DepreciationAmt |
| Book Value | $266,906 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,543,762 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | POOLED INVESTMENT FUND | Desc |
| Book Value | $8,546,718 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $8,546,718 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED ORGANIZATION | $2,285,555 |
| CAPITAL LEASE LIABILITY | $75,733 |
| DEFERRED COMPENSATION | $271,851 |
| OTHER LONG-TERM LIABILITIES | $31,805 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,664,944 | TotalLiabilityAmt |
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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 175.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| 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 | $22,869 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $22,869 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,902,398 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,310,220 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,592,178 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05030 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,925,267 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,310,220 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,615,047 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05100 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 388 | PersonsServedCnt |
| Total Community Benefit Expns | $3,599 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,599 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,669,949 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,186,260 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,483,689 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04690 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 388 | PersonsServedCnt |
| Total Community Benefit Expns | $5,673,548 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,186,260 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,487,288 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04700 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 388 | PersonsServedCnt |
| Total Community Benefit Expns | $9,598,815 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,496,480 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,102,335 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09800 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $577,765 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $13,771,308 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,865,019 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$93,711 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | ST MARY'S HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 LEWISTON STREET | AddressLine1Txt |
| City | COTTONWOOD | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83522 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SMH-CVH.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| 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 | ST MARY'S HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 | 25 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | 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.SMH-CVH.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 25 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.SMH-CVH.ORG | 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 | 175.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | 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 |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.SMH-CVH.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.SMH-CVH.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.SMH-CVH.ORG | 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 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 Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ST. MARY'S HEALTH | PART V, SECTION B, LINE 5: AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS, ST. MARY'S HEALTH SOLICITED AND CONSIDERED INPUT FROM INDIVIDUALS AND ORGANIZATIONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITIES SERVED, INCLUDING INDIVIDUALS WITH SPECIAL KNOWLEDGE AND EXPERTISE IN PUBLIC HEALTH. THE CHNA PROCESS WAS CONDUCTED IN COLLABORATION WITH CLEARWATER VALLEY HEALTH, SYRINGA HOSPITAL, THE UNIVERSITY OF WASHINGTON AND THE INSTITUTE OF TRANSLATIONAL HEALTH SCIENCES, WHICH PROVIDED EXPERTISE AND SUPPORT IN COMMUNITY HEALTH ASSESSMENT, DATA COLLECTION, ANALYSIS, AND COMMUNITY ENGAGEMENT.COMMUNITY INPUT WAS OBTAINED THROUGH ELECTRONICALLY DISTRIBUTED AND PAPER SURVEYS, COMMUNITY LISTENING SESSIONS, STAKEHOLDER ENGAGEMENT MEETINGS, SOCIAL MEDIA OUTREACH, LOCAL NEWSPAPER PROMOTION, AND OUTREACH CONDUCTED THROUGH THE COMMUNITY HEALTH WORKER PROGRAM.STAKEHOLDERS PROVIDING INPUT INCLUDED REPRESENTATIVES FROM LOCAL AND REGIONAL PUBLIC HEALTH AGENCIES, HEALTHCARE PROVIDERS, EMERGENCY MEDICAL SERVICES, BEHAVIORAL HEALTH PROVIDERS, EDUCATIONAL INSTITUTIONS, SENIOR SERVICES, SOCIAL SERVICE ORGANIZATIONS, FOOD ASSISTANCE PROGRAMS, TRIBAL REPRESENTATIVES, COMMUNITY LEADERS, AND ORGANIZATIONS SERVING MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY, AND OTHER VULNERABLE POPULATIONS.INFORMATION GATHERED FROM THESE STAKEHOLDERS, TOGETHER WITH DEMOGRAPHIC, HEALTH STATUS, UTILIZATION, AND COMMUNITY HEALTH INDICATOR DATA, WAS USED TO IDENTIFY AND PRIORITIZE SIGNIFICANT COMMUNITY HEALTH NEEDS AND TO DEVELOP IMPLEMENTATION STRATEGIES DESIGNED TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITIES SERVED. |
| ST. MARY'S HEALTH | PART V, SECTION B, LINE 6A: ST. MARY'S HEALTH COLLABORATED WITH A VARIETY OF COMMUNITY ORGANIZATIONS, PUBLIC HEALTH AGENCIES, HEALTHCARE PROVIDERS, EDUCATIONAL INSTITUTIONS, AND COMMUNITY STAKEHOLDERS IN CONDUCTING ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). |
| ST. MARY'S HEALTH | PART V, SECTION B, LINE 6B: ST. MARY'S HEALTH COLLABORATED WITH NUMEROUS ORGANIZATIONS AND STAKEHOLDERS IN CONDUCTING ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA PROCESS WAS CONDUCTED IN COLLABORATION WITH THE UNIVERSITY OF WASHINGTON AND THE INSTITUTE OF TRANSLATIONAL HEALTH SCIENCES, WHICH PROVIDED EXPERTISE AND SUPPORT RELATED TO COMMUNITY HEALTH ASSESSMENT, DATA COLLECTION, ANALYSIS, AND COMMUNITY ENGAGEMENT.ADDITIONAL COLLABORATING ORGANIZATIONS AND STAKEHOLDERS INCLUDED NORTH CENTRAL PUBLIC HEALTH DISTRICT, THE NEZ PERCE TRIBE, GRANGEVILLE MIDDLE SCHOOL, GRANGEVILLE HIGH SCHOOL, PRAIRIE HIGH SCHOOL, JOINT SCHOOL DISTRICT NO. 171 (INCLUDING OROFINO ELEMENTARY SCHOOL AND OROFINO HIGH SCHOOL), THE CAMAS PRAIRIE FOOD BANK, THE ST. MARY'S HEALTH FOOD BANK, CAMAS PRAIRIE PROFESSIONAL COUNSELING, KAMIAH AMBULANCE SERVICE, ST. MARY'S HEALTH AMBULANCE SERVICE, LOCAL HEALTHCARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, COMMUNITY HEALTH WORKERS, LOCAL BUSINESS OWNERS, LAW ENFORCEMENT REPRESENTATIVES, CLERGY, AND OTHER COMMUNITY LEADERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITIES SERVED, INCLUDING MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY, AND VULNERABLE POPULATIONS.INPUT OBTAINED FROM THESE ORGANIZATIONS AND STAKEHOLDERS, TOGETHER WITH DEMOGRAPHIC, HEALTH STATUS, UTILIZATION, AND COMMUNITY HEALTH INDICATOR DATA, WAS USED TO IDENTIFY AND PRIORITIZE SIGNIFICANT COMMUNITY HEALTH NEEDS AND DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS THOSE NEEDS. |
| ST. MARY'S HEALTH | PART V, SECTION B, LINE 11: FOLLOWING COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), ST. MARY'S HEALTH DEVELOPED AN IMPLEMENTATION STRATEGY TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED WITHIN THE COMMUNITIES SERVED. THE IMPLEMENTATION STRATEGY WAS FORMALLY REVIEWED AND ADOPTED BY THE ORGANIZATION'S BOARD OF DIRECTORS ON APRIL 23, 2026, AND SERVES AS A ROADMAP FOR ADDRESSING PRIORITY COMMUNITY HEALTH NEEDS.THE SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE CHNA PROCESS INCLUDED IMPROVING ACCESS TO SPECIALTY CARE, ADDRESSING TRANSPORTATION BARRIERS AFFECTING ACCESS TO HEALTHCARE SERVICES, AND PROMOTING DISEASE PREVENTION AND HEALTH EDUCATION. STRATEGIES TO ADDRESS THESE PRIORITIES INCLUDE COLLABORATION WITH COMMUNITY PARTNERS, EXPANSION OF CARE COORDINATION AND COMMUNITY HEALTH WORKER SERVICES, SUPPORT OF COMMUNITY HEALTH EDUCATION INITIATIVES, AND EFFORTS TO IMPROVE ACCESS TO HEALTHCARE AND PREVENTIVE SERVICES THROUGHOUT THE SERVICE AREA.PROGRESS TOWARD IMPLEMENTATION GOALS IS MONITORED THROUGH PROGRAM UTILIZATION DATA, HEALTH OUTCOMES MEASURES, PATIENT AND COMMUNITY FEEDBACK, AND REGULAR REVIEW BY ORGANIZATIONAL LEADERSHIP AND THE BOARD OF DIRECTORS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 9 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - ST MARY'S COTTONWOOD MEDICAL CLINIC | ||||
| 701 LEWISTON STREET | COTTONWOOD | ID | 83522 | OUTPATIENT CLINIC |
| 2 - ST MARY'S KAMIAH MEDICAL CLINIC | ||||
| 518 OAK STREET | KAMIAH | ID | 83536 | OUTPATIENT CLINIC |
| 3 - ST MARY'S KAMIAH PHYSICAL THERAPY | ||||
| 518 OAK STREET | KAMIAH | ID | 83536 | OUTPATIENT CLINIC |
| 4 - ST MARY'S GRANGEVILLE MEDICAL CLINIC | ||||
| 617 W 2ND STE 2 | GRANGEVILLE | ID | 83530 | OUTPATIENT CLINIC |
| 5 - ST MARY'S GRANGEVILLE PHYSICAL THERAPY | ||||
| 617 W 2ND STE 2 | GRANGEVILLE | ID | 83530 | OUTPATIENT CLINIC |
| 6 - ST MARY'S CRAIGMONT MEDICAL CLINIC | ||||
| 320 N DIVISION | CRAIGMONT | ID | 83523 | OUTPATIENT CLINIC |
| 7 - ST MARY'S NEZPERCE MEDICAL CLINIC | ||||
| 501 OAK | NEZPERCE | ID | 83543 | OUTPATIENT CLINIC |
| 8 - ST MARY'S ELK CITY MEDICAL CLINIC | ||||
| 131 MAIN STREET | ELK CITY | ID | 83525 | OUTPATIENT CLINIC |
| 9 - ST MARY'S COTTONWOOD PHYSICAL THERAPY | ||||
| 701 LEWISTON STREET | COTTONWOOD | ID | 83522 | OUTPATIENT CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | ASSETS WILL BE CONSIDERED ALONG WITH THE PATIENT'S INCOME TO DETERMINE ELIGIBILITY FOR THE FINANCIAL ASSISTANCE PROGRAM. ASSETS MAY INCLUDE, BUT ARE NOT LIMITED TO, SUCH ITEMS AS CHECKING AND SAVINGS ACCOUNTS, IRAS, 401(K)S, 403(B)S, PENSIONS, HEALTH SAVINGS ACCOUNTS, ADDITIONAL PROPERTY, AND ANY OTHER RETIREMENT FUNDING. |
| PART I, LINE 7: | THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES (WORKSHEET 2) FOR FIGURES REPORTED IN THE TABLE RELATED TO CHARITY CARE AND UNREIMBURSED MEDICAID (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, TOTAL COMMUNITY BENEFIT, AND TOTAL COMMUNITY BUILDING EXPENSES). ACTUAL COSTS WERE USED FOR THE REMAINDER OF THE COMMUNITY BENEFITS REPORTED. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 577,765. |
| PART III, LINE 2: | THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. IF, DURING THE COLLECTION PROCESS, IT BECOMES KNOWN THAT THE PATIENT QUALIFIES FOR CHARITY CARE, THE AMOUNTS INCLUDED WITHIN BAD DEBT EXPENSE WOULD BE RECLASSIFIED TO CHARITY CARE. |
| PART III, LINE 3: | IF, DURING THE COLLECTION PROCESS, IT BECOMES KNOWN THAT A PATIENT QUALIFIES FOR CHARITY CARE, THE AMOUNTS INCLUDED WITHIN BAD DEBT EXPENSE WOULD BE RECLASSIFIED TO CHARITY CARE. THEREFORE, NO AMOUNTS RECORDED AS BAD DEBT EXPENSE ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. THE HOSPITAL INCORPORATES THE COST OF BAD DEBT AS A COMMUNITY BENEFIT. AS A TAX-EXEMPT HOSPITAL, WE MUST PROVIDE THE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THAT CARE. IN DOING SO, WE MAKE QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS. |
| PART III, LINE 4: | PAGE 17 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS CONTAINS THE FOOTNOTE DESCRIBING BAD DEBT EXPENSE. |
| PART III, LINE 8: | THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. THE REPORTED MEDICARE ALLOWABLE COSTS ARE OBTAINED FROM THE HOSPITAL'S GENERAL LEDGER AND THEN ADJUSTED AND REPORTED IN ACCORDANCE WITH CENTERS FOR MEDICARE SERVICES (CMS) "COST FINDING" GUIDELINES AS PUBLISHED IN THEIR PROVIDER REIMBURSEMENT MANUAL. ONCE THE MEDICARE ALLOWABLE COSTS ARE DETERMINED FROM THE HOSPITAL'S COST REPORT, ANY COSTS ATTRIBUTED TO SUBSIDIZED HEALTH SERVICES, AND MEDICAL EDUCATION, ARE REMOVED AND REPORTED SEPARATELY. EXPLANATION FOR ANY PRIOR YEAR SETTLEMENTS FOR MEDICARE-RELATED SERVICES IN THE CURRENT TAX YEAR: THE HOSPITAL IS REQUIRED TO FILE A MEDICARE COST REPORT 5 MONTHS AFTER THE CLOSE OF THEIR FISCAL YEAR. THE COST REPORT PROVIDES MEDICARE WITH INFORMATION THAT IS USED TO DETERMINE UTILIZATION AND SPENDING TRENDS BUT ALSO IS USED TO SET FUTURE PAYMENT RATES FOR MOST MEDICARE SERVICES. IF THE INTERIM PAYMENTS PAID TO A HOSPITAL ARE HIGHER OR LOWER THAN THE FILED COST REPORT ALLOWABLE REIMBURSEMENT THERE WILL BE A SETTLEMENT FOR THAT FISCAL YEAR. THIS CAN BE DUE TO CHANGES IN UTILIZATION OR COST OF PROVIDING SERVICES FOR CRITICAL ACCESS HOSPITALS (CAH) OR DIFFERENCES BETWEEN INTERIM AND FINAL PAYMENT FACTORS FOR DISPROPORTIONATE SHARE, BAD DEBTS, OR INDIRECT MEDICAL EDUCATION FOR NON-CAH HOSPITALS. AN ESTIMATE FOR THESE SETTLEMENTS IS RECORDED AT THE CLOSE OF THE FISCAL YEAR. IF THE ESTIMATE VARIES FROM THE FINAL SETTLEMENT RECEIVED 6-7 MONTHS AFTER THE FISCAL YEAR ENDS, THEN THESE AMOUNTS ARE RECORDED AS PRIOR YEAR MEDICARE REVENUE.ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS REPORTED IN PART III, LINE 7 ARE TREATED AS COMMUNITY BENEFIT. THE RATIONALE FOR THE HOSPITAL'S OPINION IS PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE AND IT IS LIKELY TO GET WORSE. MANY MEDICARE BENEFICIARIES ARE POOR AND ARE ELIGIBLE FOR MEDICAID IN ADDITION TO MEDICARE. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY. |
| PART III, LINE 9B: | THE POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR THE FINANCIAL ASSISTANCE POLICY (FAP) AND FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR FINANCIAL ASSISTANCE, AND THE PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS. THE HOSPITAL OFFERS EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS AND WILL NOT CHARGE A PATIENT THE GROSS AMOUNT OF CHARGES FOR ANY UNINSURED TREATMENT. UNINSURED DISCOUNTS WILL BE APPLIED TO THE GROSS CHARGES PRIOR TO ANY FINANCIAL ASSISTANCE OR OTHER DISCOUNTS. IF AT ANY TIME THE HOSPITAL RECOGNIZES THAT A PATIENT MAY BE ELIGIBLE FOR STATE OR FEDERAL PROGRAMS, A REPRESENTATIVE WILL ASSIST THE PATIENT IN OBTAINING INFORMATION ABOUT THESE PROGRAMS OR PROVIDE CONTACT INFORMATION FOR THESE PROGRAMS. THE HOSPITAL CONTRACTS WITH AN OUTSIDE PATIENT ADVOCACY AGENCY, WHICH MAY PROVIDE ASSISTANCE TO THE UNINSURED PATIENT IN APPLYING TO CERTAIN STATE AND FEDERAL PROGRAMS. AT ANY STAGE OF THE PATIENT EXPERIENCE AND UP THROUGH THE COLLECTION PROCESS, THE PATIENT MAY EXPRESS A CONCERN THAT THEY ARE UNABLE TO PAY THEIR BILL IN FULL OR MEET THE PAYMENT PLAN REQUIREMENTS. AT THAT TIME, THE PATIENT WILL BE GIVEN EVERY OPPORTUNITY TO COMPLETE AND SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE HOSPITAL TRAINS ITS OUTSIDE DEBT COLLECTION AGENCIES AND ATTORNEYS ABOUT THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION ABOUT THE FAP OR SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE HOSPITAL REQUIRES IT'S OUTSIDE COLLECTION AGENCIES AND ATTORNEYS TO REFER PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BACK TO THE HOSPITAL. IF A PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, THE HOSPITAL SUSPENDS ALL COLLECTION ACTIVITY UNTIL THE PATIENT'S FINANCIAL ASSISTANCE APPLICATION HAS BEEN PROCESSED AND THE HOSPITAL HAS NOTIFIED THE PATIENT OF ITS DECISION. PATIENTS ARE ADVISED AT THAT TIME TO NOTIFY THE COLLECTION AGENCY TO HOLD THEIR ACCOUNT. THE OUTSIDE DEBT COLLECTION AGENCIES ARE NOTIFIED BY THE HOSPITAL ONCE AN ACCOUNT ADJUSTMENT HAS BEEN MADE. |
| PART VI, LINE 2: | WE ASSESS AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE THROUGH MANY WAYS INCLUDING THE FOLLOWING:MARKETING RESEARCH - CLEARWATER VALLEY HEALTH AND ST. MARY'S HEALTH REVIEW INTERNAL DATA TO BETTER UNDERSTAND THE NEEDS AND USES(S) OF OUR SERVICES. THIS INCLUDES ACCESS TO SERVICE AREAS (I.E. PRIMARY CARE), PAYOR INFORMATION, AND OVERALL GAPS IN SERVICES. ASSESSMENTS HAVE RESULTED IN STRATEGIC PLANS FOR GROWING SERVICES, AS WELL AS CHANGES TO INTERNAL PROCESSES FOR HEALTH CARE ACCESS.POPULATION CARE MANAGEMENT - WE REGULARLY COMPARE OUR HEALTH RANKINGS AND RATINGS TO STATE AND NATIONAL DATA TO IDENTIFY THE GREATEST AREAS OF HEALTH CARE NEEDS. WE PREPARE INTERVENTIONS TARGETED TO AREAS OF GREATEST NEED, SUCH AS UNCONTROLLED DIABETES OR PRE-DIABETES. WE THEN MEASURE THE EFFECT OF INTERVENTIONS COMPARED TO OVERALL COUNTY RANKINGS. WE USE THIS DATA TO ASSESS THE IMPLICATIONS OF EXPANDING PILOT PROGRAMS.PLANNED INTERACTION WITH VARIOUS COMMUNITY HEALTH, HEALTHCARE, AND SOCIAL WELFARE GROUPS - AN UMBRELLA COALITION OF COMMUNITY HEALTH, HEALTHCARE, AND SOCIAL WELFARE GROUPS MEET REGULARLY TO SHARE PERSPECTIVES ON COMMUNITY NEEDS AND THE ROLE THE HOSPITAL CAN PLAY IN ADDRESSING THOSE NEEDS AS A COLLABORATIVE PARTNER. INTERACTIONS HAVE RESULTED IN SUCCESSFUL PROGRAMS FOR NURSE CASE MANAGEMENT, COMMUNITY REFERRAL COORDINATOR, COMMUNITY HEALTH WORKER, AND BENEFITS COUNSELOR POSITIONS.INTERNAL QUALITY INDICATORS - WE TRACK DATA THAT LEAD TO THE IMPROVED CARE AND TREATMENT OF PATIENTS WITH CHRONIC DISEASES, TOBACCO USE, AND MENTAL HEALTH CONDITIONS. THIS INCLUDES PATIENT ACTIVITY AND OUTCOMES, ALLOWING FOR THE HOSPITAL TO BETTER IDENTIFY THE NEEDS OF THE PATIENTS, WHICH CAN BE UTILIZED TO ASSESS THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE. HEALTH DATA PROVIDED BY PAYOR ORGANIZATIONS, NAMELY GOVERNMENT AND COMMERCIAL HEALTH INSURERS - THIS HEALTH DATA TYPICALLY INVOLVES MEDICAL TREATMENT AND OUTCOMES THAT REFLECT TRENDS OF UNHEALTHY LIFESTYLES AND BEHAVIORS. OUR OBJECTIVE IS TO UNDERSTAND THESE RELATIONSHIPS AND TO DEVELOP ACTION STEPS TO INTERVENE ON THE FRONT END TO PREVENT SUCH MEDICAL SITUATIONS FROM OCCURRING. EXAMPLES INCLUDE MANAGEMENT OF DIABETES, INCREASE ACCESS TO CANCER SCREENINGS, AND EXPANDED BEHAVIORAL HEALTH.THE CHNA CAN BE FOUND ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTPS://SMH-CVH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ |
| PART VI, LINE 3: | PATIENTS MAY OBTAIN INFORMATION REGARDING FINANCIAL ASSISTANCE THROUGH THE ORGANIZATION'S WEBSITE AND BY CONTACTING THE FINANCIAL ASSISTANCE OFFICE DIRECTLY. INFORMATION REGARDING FINANCIAL ASSISTANCE IS ALSO MADE AVAILABLE TO PATIENTS DURING THE REGISTRATION AND BILLING PROCESSES.LANGUAGE ASSISTANCE AND ACCESSIBILITY SERVICES ARE AVAILABLE THROUGH INTERPRETER AND TRANSLATION SERVICES. INFORMATION REGARDING THESE SERVICES, INCLUDING CONTACT INFORMATION, IS PROVIDED THROUGH THE PATIENT RIGHTS AND RESPONSIBILITIES MATERIALS. IN ADDITION, PRINTED MATERIALS AND ASSISTANCE RESOURCES ARE AVAILABLE TO PATIENTS AT REGISTRATION AREAS AS NEEDED.COLLECTION ACTIVITIES FOR UNPAID ACCOUNTS ARE MANAGED THROUGH A THIRD-PARTY COLLECTION AGENCY IN ACCORDANCE WITH THE ORGANIZATION'S POLICIES AND PROCEDURES.THE FAP, FAP APPLICATION AND FAP PLAIN LANGUAGE SUMMARY CAN BE FOUND ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTPS://APPS.PARA- HCFS.COM/PTT/FINALLINKS/STMARYS_V2.ASPX |
| PART VI, LINE 4: | THE HOSPITAL IS LOCATED IN COTTONWOOD, IDAHO AND OPERATES A CRITICAL ACCESS HOSPITAL AND SIX (6) CLINICS THAT SERVE THE COMMUNITIES OF CLEARWATER, LEWIS, AND IDAHO COUNTIES COVERING 11,500 SQUARE MILES. THE OVERALL COMMUNITY IS DESIGNATED NOT ONLY AS RURAL, BUT ALSO AS FRONTIER. FRONTIER REGIONS ARE DEFINED AS THE MOST GEOGRAPHICALLY REMOTE, SPARSELY POPULATED, AND UNDEVELOPED TERRAIN IN THE UNITED STATES.THE SERVICE AREA IS APPROXIMATELY 30,000 PEOPLE WITH AN AGE DISTRIBUTION OF 19% UNDER THE AGE OF 18; 52% BETWEEN THE AGES OF 18 AND 65; AND 29% OVER THE AGE OF 65. THE RACIAL MAKEUP OF THE SERVICE AREA IS 87% CAUCASIAN; 4% HISPANIC, AND 9% OTHER. THE GENDER SPLIT RATIO IS 48% WOMEN AND 52% MEN. THE AVERAGE INCOME FOR THE SERVICE AREA IS APPROXIMATELY $59,300. THE HOSPITAL IS COMMITTED TO SERVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. APPROXIMATELY 3.0% GROSS REVENUE DOLLARS WERE FROM SELF-PAY PATIENTS AND 12.0% FROM MEDICAID RECIPIENTS. THE HOSPITAL HAS A CLINIC IN THE ELK CITY SERVICE AREA THAT IS CURRENTLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA. THERE ARE TWO (2) OTHER HOSPITALS THAT SERVE THE COMMUNITY. |
| PART VI, LINE 5: | THE HOSPITAL BOARD OF DIRECTORS IS COMPOSED MAINLY OF VOLUNTEER REPRESENTATIVES FROM THE PRIMARY SERVICE AREA AND DEDICATES TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY WHO ARE PROPERLY SCREENED. ALL APPLICANTS THAT APPLY MUST MEET THE CREDENTIALING STANDARDS AND BE APPROVED BY THE GOVERNING BOARD TO PROVIDE SERVICES AT THE HOSPITAL. IN ADDITION, THE HOSPITAL SERVES AS A CLINICAL PRACTICE SITE FOR MANY STUDENTS IN X-RAY TECHNOLOGY, NURSING, PHYSICIAN ASSISTANT, NURSE PRACTITIONER, AND MEDICAL RESIDENCY PROGRAMS. THIS IS ESPECIALLY IMPORTANT BECAUSE IDAHO HAS ONE OF THE LOWEST PHYSICIANS PER CAPITAL RATES IN THE NATION. ANY SURPLUS FUNDS ARE REINVESTED INTO THE FACILITY, EQUIPMENT, AND EMPLOYEE EDUCATION. WE REGULARLY REVIEW FACILITIES AND EQUIPMENT AND DEVELOP AN ATTRITION PROCESS TO REPLACE AGING PLANT OPERATIONS AND EQUIPMENT. WE ARE ALSO LOOKING FOR OPPORTUNITIES TO BRING NEW SERVICES TO THE COMMUNITIES VIA INVESTING IN NEW SKILLS AND TECHNOLOGY WHERE APPROPRIATE.THE HOSPITAL ENGAGED COMMUNITIES IN COMING TOGETHER AND CREATING SOCIAL CONNECTIVITY THROUGH SUPPORT OF LOCAL EVENTS AND COMMUNITY PROGRAMS. THESE INCLUDE THE FORMATION OF COMMUNITY AND SCHOOL GARDENS, HEALTH TALKS, SPONSORSHIP OF RACES, AND PARTICIPATION IN COUNTY FAIR ACTIVITIES.WE PROMOTE BETTER MENTAL HEALTH BY BRINGING CHILDREN AND ADULT PSYCHIATRISTS TO OUR FRONTIER COMMUNITIES USING TELEMEDICINE. THIS MODEL HAS WON STATE AND NATIONAL AWARDS FOR INNOVATION IN REACHING THE MEDICALLY UNDERSERVED. WE ARE ALSO ACTIVE PARTICIPANTS IN NATIONAL DEMONSTRATION PROJECTS AND OTHER COLLABORATIONS TO PROVIDE AN EVIDENCE BASE FOR EFFECTIVE PROCESSES PROMOTING RURAL HEALTH.IN ADDITION TO THE ACTIVITIES LISTED IN PART I, LINE 7 AS WELL AS PART V, SECTION B, LINE 11, SOME OTHER PROJECTS UNDERTAKEN BY SMH INCLUDE THE FOLLOWING:MOST MONTHS WE HAVE AN OVERALL THEME TARGETING A CHRONIC DISEASE STATE WITH SPECIAL PROGRAMS AND OUTREACH TO OUR COMMUNITIES (I.E. FEBRUARY IS HEART MONTH, OCTOBER IS BREAST CANCER AWARENESS, NOVEMBER IS DIABETES AWARENESS, ETC.). DOC TALKS ARE GEARED TO THE MONTHLY THEME WITH SCREENINGS AND INFORMATION PROVIDED AT THE EVENTS. OUR CARE MANAGERS, REFERRAL COORDINATORS, AND QUALITY DIRECTORS ARE ESPECIALLY ACTIVE IN COORDINATING THESE ACTIVITIES AND REACHING OUT TO PATIENTS WHO MAY NOT BE AWARE OF THE SERVICES OFFERED. COMMUNITY HEALTH WORKERS ARE HOSTING CHRONIC DISEASE SELF-MANAGEMENT AND CHRONIC PAIN SELF-MANAGEMENT CLASSES THROUGHOUT OUR SERVICE AREA. COLON CANCER AWARENESS AND SCREENING HAS BEEN A MAJOR OUTREACH EFFORT AT HEALTH FAIRS, LOCAL BAZAARS, SOME OF THE FARMER'S MARKET DAYS, AND WITHIN ALL THE CLINICS OVER THE PAST YEAR.THE HOSPITAL IS AN ACTIVE PARTICIPANT IN ATTENDING AND SITTING ON THE BOARDS OF THE LOCAL HUMAN NEED COUNCILS WITHIN THE SERVICE AREAS. WE HAVE A PRESENCE ON MULTIPLE COALITIONS THROUGHOUT THE NORTHERN AND NORTH CENTRAL IDAHO. THIS IS OFTEN ACCOMPLISHED BY PHONE CONFERENCING TO PARTICIPATE IN THE DISCUSSIONS AND GROWTH WITHOUT INCURRING TRAVEL EXPENSES. WE ARE ALSO ACTIVELY ENGAGED IN STATE COALITIONS ON CHRONIC DISEASE AND COMMUNITY HEALTH WORKER PROGRAMS (OFTEN SEEN AS MENTORS WITHIN THESE GROUPS FOR THE ACCOMPLISHMENTS ACHIEVED OVER THE PAST FEW YEARS). FUNDRAISERS AND VOLUNTEER EFFORTS ARE ESTABLISHED AND ONGOING WITH LOCAL FOOD BANKS, CLOTHING DISTRIBUTION DRIVES, AND OTHER VOLUNTEERS THAT ARE GEARED AROUND NATURAL DISASTERS AND OTHER NEEDS WITHIN OUR AREA. EFFORTS ARE BEING MADE TO BRING SAFE WALKING AND BIKE TRAILS TO COMMUNITIES WITHIN OUR SERVICE AREAS. A RESULT OF ALMOST EVERY SURVEY AND CONVERSATION IS THAT THE COMMUNITIES WANT MORE WAYS TO ENGAGE SAFELY IN PHYSICAL ACTIVITY AT LITTLE OR NO EXPENSE. COMMUNITY HEALTH WORKERS HAVE WORKED WITH COMMUNITY PARTNERS TO HOST WEEKLY WALKS THROUGHOUT THE REGION PROVIDING BOTH AN EDUCATION COMPONENT AND A SAFE WALKING PATH FOR THE DAY. COMMUNITY HEALTH WORKERS COORDINATE AND HOST SCREENING EVENTS IN VARIOUS LOCATIONS THROUGHOUT THE SERVICE AREA TO HELP SCREEN FOR DIABETES, DEPRESSION, SDOH ISSUES, AND COLON CANCER. SOME OF THE SCREENING EVENTS ARE HELD IN CONJUNCTION WITH A FOOD BANK DISTRIBUTION SITE.THE HOSPITAL IS PART OF KOOTENAI HOSPITAL DISTRICT DBA KOOTENAI HEALTH, A FULLY INTEGRATED HEALTH SYSTEM WITH FACILITIES IN IDAHO. KOOTENAI HEALTH REINVESTS SURPLUS REVENUES INTO TECHNOLOGY, INFRASTRUCTURE AND CLINICAL PROGRAMS TO INCREASE THE HEALTH AND VITALITY OF THE COMMUNITIES WE SERVE. KOOTENAI HEALTH PROVIDES SERVICES IN RURAL COMMUNITIES AND IS COMMITTED TO ELIMINATING GEOGRAPHIC BARRIERS TO CARE. WE INVEST IN FACILITY UPGRADES, TECHNOLOGY, AND STAFFING THAT ENHANCE CARE IN THESE COMMUNITIES TO ENSURE PATIENTS CAN RECEIVE AS MUCH CARE AS POSSIBLE CLOSE TO HOME. TELEHEALTH ALLOWS PATIENTS TO RECEIVE CARE FROM A PROVIDER IN THEIR HOME. TELEHEALTH APPOINTMENTS TAKE PLACE IN LOCAL CLINICS OR HOSPITALS THROUGH SECURE INTERACTIVE VIDEOCONFERENCING. PATIENTS FEEL LIKE THEY ARE IN THE SAME ROOM AS THEIR DOCTOR. THIS EXPERIENCE OFFERS THE SAME HIGH-QUALITY CARE THAT PATIENTS EXPECT DURING AN IN-PERSON VISIT.ON MAY 26, 2015, THE DISTRICT BOARD VOTED TO DEVELOP A CLINICAL INTEGRATION NETWORK CALLED KOOTENAI CARE NETWORK, LLC, (KCN) A NON-PROFIT, WHOLLY OWNED SUBSIDIARY. THE GOAL OF THE NETWORK IS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY THROUGH THE DELIVERY OF EFFICIENT, HIGH-QUALITY CARE THROUGH THE INTEGRATION OF INDEPENDENT AND EMPLOYED PHYSICIANS, HOSPITALS, POST-ACUTE CARE PROVIDERS AND PAYERS. AS OF DECEMBER 31, 2023, THERE WERE OVER 600 PROVIDERS PARTICIPATING AND 61,500 COVERED LIVES IN THE NETWORK. KOOTENAI ACCOUNTABLE CARE, LLC WAS FORMED IN 2017 WITH KCN AS ITS SOLE MEMBER, FOR PURPOSES OF PARTICIPATING AS A MEDICARE SHARED SAVINGS PROGRAM. IN ADDITION, KOOTENAI VALUE CARE, LLC WAS FORMED IN 2021 WITH KCN AS ITS SOLE MEMBER, FOR PURPOSES OF PARTICIPATING IN THE IDAHO MEDICAID VALUE CARE PROGRAM.KCN HAS A TEAM OF CARE MANAGERS TO HELP PATIENTS WITH CHRONIC CONDITIONS TO MANAGE THEIR CARE. THESE CHRONIC CONDITIONS INCLUDE CHRONIC OBSTRUCTIVE PULMONARY DISEASE, HEART FAILURE, DEPRESSION, AND ANXIETY. THE CARE MANAGERS WORK WITH A VARIETY OF PATIENTS, CAREGIVERS, AND HEALTHCARE EXPERTS WITHIN KCH TO PROVIDE EFFICIENT, HIGH-QUALITY CARE FOR THE COMMUNITY.EACH YEAR KOOTENAI HEALTH MAKES SUBSTANTIAL FINANCIAL AND IN-KIND DONATIONS THAT BENEFIT THE COMMUNITY. THESE INCLUDE DONATIONS TO GROUPS SUCH AS THE SUICIDE PREVENTION ACTION NETWORK AND THE COMMUNITY CANCER FUND. KOOTENAI HEALTH PROVIDES FREE AND LOW-COST HEALTH SCREENINGS AND SUPPORT GROUPS FOR PATIENTS WITH DIABETES, CANCER, MENDED HEARTS, PARKINSON'S, AND PULMONARY DISEASE. KOOTENAI HEALTH PROVIDES TRAINING OPPORTUNITIES FOR PHYSICIANS, NURSES, AND OTHER HEALTHCARE WORKERS. TOGETHER, THESE SERVICES ARE IMPROVING HOW PEOPLE ARE CARED FOR IN THE GEOGRAPHICALLY DIVERSE COMMUNITIES WE SERVE. |
| PART VI, LINE 6: | ST. MARY'S HEALTH IS PART OF KOOTENAI HOSPITAL DISTRICT (THE DISTRICT). THE DISTRICT IS ORGANIZED AND EXISTS AS A POLITICAL SUBDIVISION UNDER THE LAWS OF THE STATE OF IDAHO TO PROVIDE HEALTH CARE SERVICES WITHIN THE DISTRICT WHICH INCLUDES ALL OF KOOTENAI COUNTY AS WELL AS ADDITIONAL COUNTIES WITHIN IDAHO. THE DISTRICT IS INVOLVED IN SEVERAL JOINT RELATIONSHIPS TO PROVIDE NEEDED HEALTH SERVICES TO NORTH IDAHO RESIDENTS. THESE RELATIONSHIPS ARE IN THE AREAS OF IMAGING SERVICES, MAGNETIC RESONANCE IMAGING SERVICES, REHABILITATION SERVICES, AMBULATORY SURGICAL SERVICES, AND RADIATION THERAPY SERVICES.WE ALSO SUPPORT COMMUNITY HEALTH THROUGH THE KOOTENAI HEALTH FOUNDATION AND THROUGH CONTRIBUTIONS THAT FOCUS ON PROGRAMS AND SERVICES THAT BENEFIT THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHELE BOUIT | ||||||||||||||
| DIRECTOR/KH CFO | $0 | $545,483 | $0 | $191,025 | $0 | $23,698 | $0 | $10,377 | $0 | $21,748 | $0 | $792,331 | $0 | $0 |
| DR NICHOLAS HENRIE | ||||||||||||||
| PHYSICIAN | $315,332 | $0 | $153,942 | $0 | $15,317 | $0 | $0 | $0 | $27,831 | $0 | $512,422 | $0 | $0 | $0 |
| DR THOMAS WONDERLICH | ||||||||||||||
| PHYSICIAN | $306,200 | $0 | $129,374 | $0 | $0 | $0 | $6,832 | $0 | $24,780 | $0 | $467,186 | $0 | $0 | $0 |
| DR JUSTIN JONES | ||||||||||||||
| PHYSICIAN | $288,275 | $0 | $135,587 | $0 | $0 | $0 | $12,299 | $0 | $27,831 | $0 | $463,992 | $0 | $0 | $0 |
| DR TEMA JESSUP | ||||||||||||||
| PHYSICIAN | $293,497 | $0 | $81,429 | $0 | $0 | $0 | $12,295 | $0 | $27,831 | $0 | $415,052 | $0 | $0 | $0 |
| KELLY MCGRATH | ||||||||||||||
| DIRECTOR/CMO | $0 | $349,189 | $0 | $11,874 | $0 | $11,172 | $0 | $10,867 | $0 | $28,831 | $0 | $411,933 | $0 | $0 |
| DR ANDREW SCHWEITZER | ||||||||||||||
| PHYSICIAN | $325,668 | $0 | $55,365 | $0 | $2,201 | $0 | $10,494 | $0 | $13,865 | $0 | $407,593 | $0 | $0 | $0 |
| LENNE BONNER | ||||||||||||||
| CEO | $0 | $305,067 | $0 | $46,297 | $0 | $4,432 | $0 | $9,416 | $0 | $29,440 | $0 | $394,652 | $0 | $0 |
| JYL RULAND | ||||||||||||||
| CFO | $0 | $176,372 | $0 | $9,094 | $0 | $0 | $0 | $7,556 | $0 | $25,932 | $0 | $218,954 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | KOOTENAI HOSPITAL DISTRICT DBA KOOTENAI HEALTH IS THE SOLE MEMBER OF ST. MARY'S HOSPITAL AND CLINICS, INC. AND MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7. KOOTENAI HEALTH AND BENEDICTINE SISTERS OF SCHOLASTICA MONASTERY HAVE RESERVED POWERS WITH RESPECT TO ST. MARY'S HOSPITAL, INC. AS DESCRIBED IN SCHEDULE O, PART VI. LINE 7B. |
| FORM 990, PART VI, SECTION A, LINE 7A | KOOTENAI HOSPITAL DISTRICT APPOINTS AND REMOVES ST. MARY'S HOSPITAL, INC. GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | KOOTENAI HOSPITAL DISTRICT HAS RESERVED POWERS AS FOLLOWS: STRATEGIC AND BUSINESS PLANS - AUTHORITY TO CREATE AND TO APPROVE SMH'S STRATEGIC AND BUSINESS PLANS. MISSION - AUTHORITY TO CREATE AND TO APPROVE THE MISSION PURPOSE AND VISION STATEMENT FOR SMH. DEBT - APPROVAL OF THE INCURRENCE OF DEBT BY AND THE CREATION OF ALL MORTGAGES, LIENS, SECURITY INTERESTS, OR OTHER ENCUMBRANCES ON THE ASSETS OF SMH IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE KH BOARD OF DIRECTORS. GOVERNING INSTRUMENTS - AUTHORITY TO CAUSE AND APPROVE AMENDMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS OF SMH. MERGERS AND ACQUISITIONS - AUTHORITY TO CAUSE AND TO APPROVE ALL MERGERS, CONSOLIDATIONS, AND DISSOLUTIONS OF SMH. AFFILIATIONS AND JOINT VENTURES - AUTHORITY TO CAUSE AND APPROVE ALL AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES BETWEEN THIRD PARTIES AND SMH. TRANSFER OF ASSETS - AUTHORITY TO CAUSE AND TO APPROVE THE SALE, LEASE, OR OTHER TRANSFER OF SMH ASSETS WHEN THE ASSET'S VALUE EXCEEDS THE SINGLE OR AGGREGATE DOLLAR LIMIT PRESCRIBED IN WRITING BY THE KH BOARD OF DIRECTORS. SERVICES - AUTHORITY TO CAUSE AND TO APPROVE THE DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS OF SMH. BUDGETS - APPROVAL OF CAPITAL AND OPERATING BUDGETS OF SMH. PROFESSIONAL SERVICES - SELECTION OF THE GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS OF SMH. ACQUISITIONS - AUTHORITY TO CAUSE AND TO APPROVE ALL ACQUISITIONS BY AND FORMATIONS OF ENTITIES BY SMH. MARKETING AND BRANDING - AUTHORITY TO IMPLEMENT SMH MARKETING, BRANDING, AND PROMOTIONAL ACTIVITIES. COMPLIANCE PLANS - AUTHORITY TO CREATE AND TO APPROVE CORPORATE COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS FOR SMH. QUALITY PLAN - AUTHORITY TO CREATE TO APPROVE SMH'S QUALITY PLAN. NON-BUDGETED PURCHASES - APPROVAL OF NON-BUDGETED CAPITAL PURCHASES, OPERATING EXPENSES, AND LEASES IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY KH FOR SMH. HUMAN RESOURCES - AUTHORITY TO CREATE HUMAN RESOURCE POLICIES AND PROCEDURES FOR SMH. RESERVED POWERS - AUTHORITY TO CREATE ADDITIONAL KH RESERVED POWERS BY THE AFFIRMATIVE VOTE OF AT LEAST 75% OF THE KH BOARD OF DIRECTORS (EXCLUDING THE KH PRESIDENT); PROVIDED, HOWEVER THAT ANY ADDITIONAL KH RESERVED POWERS SHALL NOT CONTRAVENE OR HINDER THE SSM RESERVED POWERS. AS A SPONSOR TO SMH, THE SISTERS OF ST. SCHOLASTICA MONASTERY (SSM) ALSO HAS CERTAIN RESERVED POWERS OVER SMH. SSM'S RESERVED POWERS ARE AS FOLLOWS: MISSION - AUTHORITY TO APPROVE THE MISSION AND PURPOSE STATEMENTS FOR SMH. ADHERENCE TO ERDS - AUTHORITY TO REVIEW AND APPROVE THE METHODS, POLICIES AND PROCEDURES PERTAINING TO ADHERENCE OF SMH TO THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (ERDS). OFFICIAL CATHOLIC DIRECTOR - AUTHORITY TO OVERSEE THE LISTING OF SMH IN THE OFFICIAL CATHOLIC DIRECTORY, SUBJECT TO THE APPROVAL OF APPLICABLE CATHOLIC AUTHORITIES. CATHOLIC HEALTH ASSOCIATION - AUTHORITY TO REQUIRE SMH TO JOIN THE MEMBERSHIP OF THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES IF SMH QUALIFIES AND SUCH MEMBERSHIP DOES NOT IMPOSE AN UNREASONABLE BURDEN ON SMH AS DETERMINED BY KOOTENAI HEALTH. ALIENATION OF STABLE PATRIMONY OR ECCLESIASTICAL GOODS - AUTHORITY TO APPROVE ALIENATION OF EITHER STABLE PATRIMONY OR OTHER ECCLESIASTICAL GOODS AT SMH HAVING A DOLLAR VALUE EQUAL TO OR GREATER THAN 70% OF THE AMOUNT ESTABLISHED FROM TIME TO TIME THAT REQUIRES APPROVAL FROM THE HOLY SEE; PROVIDED, HOWEVER, THAT IT IS THE INTENT OF THE PARTIES THAT THIS PROVISION NOT BE APPLIED TO RESTRICT OR TO IMPEDE SMH FROM ACTING AND MAKING DECISIONS IN THE ORDINARY COURSE OF BUSINESS; INSTEAD IT IS INTENDED TO PREVENT THE TRANSFER OF SUBSTANTIAL ASSETS OF SMH TO SUPPORT THE SECULAR ENTITIES OF KOOTENAI HEALTH WITHOUT THE PRIOR APPROVAL OF SSM. MISSION EFFECTIVENESS -AUTHORITY TO APPROVE ANNUAL PLANS AND EVALUATIONS RELATING TO MISSION EFFECTIVENESS AND CHAPLAINCY FOR SMH INCLUDING THE USE OF RELIGIOUS SYMBOLS AND PRAYERS. AMENDMENTS - AUTHORITY TO APPROVE ANY AMENDMENTS TO THE GOVERNING DOCUMENTS OF SMH WHICH COULD MATERIALLY AFFECT SSM'S SERVED POWERS, INCLUDING WITHOUT LIMITATION ANY AMENDMENT THAT WOULD ALTER THE NUMBER OF DULUTH BENEDICTINES OR SSM BOARD OF DIRECTOR MEMBERS OR OTHER APPOINTEES OF DULUTH BENEDICTINES SERVING AS MEMBERS OF SMH'S BOARD OF DIRECTORS. SSM RESERVED POWERS - AUTHORITY TO TRANSFER OR TERMINATE THE SSM RESERVED POWERS APPLICABLE TO SMH. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE 990 IS PROVIDED TO THE CEO AND CFO WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PROVIDED TO THE BOARD OF DIRECTORS. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CFO SIGNS THE FORM 8879-TE AUTHORIZING THE PREPARER TO E-FILE THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE HOSPITAL REQUIRES BOARD MEMBERS AND OFFICERS OF THE ORGANIZATION TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS. IF A POTENTIAL CONFLICT EXISTS, THEY ARE REVIEWED BY THE BOARD AND THE INDIVIDUAL WITH THE POTENTIAL CONFLICT ABSTAINS FROM VOTING ON THE ISSUE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS IS AUTHORIZED TO FULFILL THE BOARD'S RESPONSIBILITIES REGARDING EXECUTIVE COMPENSATION. THE EXECUTIVE COMPENSATION COMMITTEE RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO, ESTABLISHING, REVIEWING AND MODIFYING, AS APPROPRIATE, REASONABLE COMPENSATION AND BENEFITS FOR DESIGNATED EXECUTIVES WHO ARE OFFICERS OR KEY EMPLOYEES WHICH MAY BE PAID BY RELATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE ENGAGES QUALIFIED INDEPENDENT COMPENSATION ADVISORS TO PROVIDE OBJECTIVE AND IMPARTIAL COMPARATIVE DATA AND TO EXPRESS OPINION ON TOTAL COMPENSATION REASONABLENESS. THE EXECUTIVE COMPENSATION COMMITTEE MAY REQUEST ITS INDEPENDENT ADVISORS TO MONITOR COMPARABILITY DATA AND MARKETPLACE TRENDS, MAKE APPROPRIATE RECOMMENDATIONS REGARDING SALARY RANGES, AND PERIODICALLY REVIEW THE MARKET COMPETITIVENESS OF EXECUTIVE COMPENSATION PACKAGES PRIOR TO ESTABLISHING OR ADJUSTING EXECUTIVE COMPENSATION. THE EXECUTIVE COMPENSATION COMMITTEE WILL OBTAIN AND RELY UPON APPROPRIATE DATA AS TO COMPARABILITY OF THE PROPOSED COMPENSATION OR ADJUSTMENTS. THE EXECUTIVE COMPENSATION COMMITTEE WILL ADEQUATELY DOCUMENT THE BASIS FOR ITS DETERMINATION CONCURRENTLY WITH MAKING THOSE DETERMINATIONS. THE EXECUTIVE COMPENSATION COMMITTEE MINUTES WILL INCLUDE THE TERMS OF THE APPROVED COMPENSATION AND THE DATE APPROVED. THE EXECUTIVE COMPENSATION COMMITTEE MEMBERS PRESENT DURING THE REVIEW, DISCUSSION AND APPROVAL OF THE PROPOSED COMPENSATION AND THOSE WHO VOTED ON THE PROPOSED COMPENSATION IDENTIFICATION OF THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE EXECUTIVE COMPENSATION COMMITTEE AND HOW THE DATA WAS OBTAINED, ANY ACTIONS BY A MEMBER OF THE EXECUTIVE COMPENSATION COMMITTEE HAVING CONFLICT OF INTEREST, AND DOCUMENTATION OF THE BASIS FOR DETERMINATION THE YEAR THIS PROCESS WAS LAST UNDERTAKEN. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,165,501. MANAGEMENT AND GENERAL EXPENSES 613,092. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,778,593. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,625,256. MANAGEMENT AND GENERAL EXPENSES 24,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,649,256. |
| FORM 990, PART XI, LINE 9: | TRANSFERS -16,033. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CLEARWATER VALLEY HOSPITAL & CLINIC | |||||||||||
| 301 CEDAR | OROFINO | ID | 83544 | 820497771 | HOSPITAL | ID | 501(C)(3) | LINE 3 | KOOTENAI HEALTH | Yes (1) | |
| KOOTENAI HEALTH | |||||||||||
| 2003 KOOTENAI HEALTH WAY | COEUR DALENE | ID | 83814 | 820380784 | HOSPITAL | ID | 501(C)(3) | LINE 3 | 0 | N/A | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|
| KOOTENAI URGENT CARE LLC | ||||||||
| 700 IRONWOOD DR SUITE 120E | COEUR DALENE | ID | 83814 | MEDICAL | ID | N/A | 0 | 0 |
| KOOTENAI OUTPATIENT SURGERY | ||||||||
| 707 IRONWOOD DR | COEUR DALENE | ID | 83814 | SURGERY | ID | N/A | 0 | 0 |
| KOOTENAI OUTPATIENT IMAGING | ||||||||
| 700 W IRONWOOD DR SUITE 175 | COEUR DALENE | ID | 83814 | IMAGING | ID | N/A | 0 | 0 |
| 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 | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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