SAN GORGONIO MEMORIAL HOSPITAL: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- SAN GORGONIO MEMORIAL HOSPITAL (EIN 33-0420041)
- Tax period
- 2023-07-01 to 2024-06-30
- Filed
- 2025-04-23
- IRS object ID
- 202531139349300113
- Schema version
- 2023v6.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-04-23T09:18:29-05:00 | ReturnTs |
| Tax Period End | 2024-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 170 N RADNOR-CHESTER RD SUITE 200 | AddressLine1Txt |
| City | RADNOR | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19087 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 330420041 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAN GORGONIO MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SANG | BusinessNameControlTxt |
| Phone | 9518451121 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 NORTH HIGHLAND SPRINGS AVENUE | AddressLine1Txt |
| City | BANNING | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92220 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEVE BARRON | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9518451121 | PhoneNum |
| Signature | 2025-04-22 | 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 | SOLOMON MARDAKHAEV | PreparerPersonNm |
| PTIN | P01806552 | PTIN |
| Phone | 6105653930 | PhoneNum |
| Preparation | 2025-04-22 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVE BARRON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 NORTH HIGHLAND SPRINGS AVENUE | AddressLine1Txt |
| City | BANNING | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92220 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $94,398,927 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SGMH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | SAN GORGONIO MEMORIAL HOSPITAL IS A NONPROFIT PUBLIC BENEFIT CORPORATION FORMED FOR THE PURPOSE OF RESTORING HEALTH AND RELIEVING SUFFERING BY PROVIDING SAFE, HIGH-QUALITY, AFFORDABLE HEALTHCARE SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 785 | TotalEmployeeCnt |
| Total Volunteers | 68 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,026,136 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,397,081 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $92,441,288 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $95,823,909 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $334,311 | PYOtherRevenueAmt |
| CY Other Revenue | -$2,822,063 | CYOtherRevenueAmt |
| PY Total Revenue | $95,801,735 | PYTotalRevenueAmt |
| CY Total Revenue | $94,398,927 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $54,876,273 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $56,968,252 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $129,956 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $47,408,570 | PYOtherExpensesAmt |
| CY Other Expenses | $46,117,384 | CYOtherExpensesAmt |
| PY Total Expenses | $102,284,843 | PYTotalExpensesAmt |
| CY Total Expenses | $103,085,636 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$6,483,108 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$8,686,709 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,258,079 | TotalAssetsBOYAmt |
| Total Assets EOY | $33,962,200 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $70,315,649 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $83,706,479 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$41,057,570 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$49,744,279 | NetAssetsOrFundBalancesEOYAmt |
| Mission | SAN GORGONIO MEMORIAL HOSPITAL IS A NONPROFIT PUBLIC BENEFIT CORPORATION FORMED FOR THE PURPOSE OF RESTORING HEALTH AND RELIEVING SUFFERING BY PROVIDING SAFE, HIGH-QUALITY, AFFORDABLE HEALTHCARE SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $83,750,687 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $95,823,909 | RevenueAmt |
| Desc | THE HOSPITAL IS COMPRISED OF AN ACUTE CARE FACILITY WHICH PROVIDES HEALTHCARE SERVICES. THE HOSPITAL PROVIDED E/R VISITS (42,119), I/P DISCHARGES (2,107), O/P REGISTRATIONS (7,325), LESS E/R ADMITTED AS I/P (-2,273), AND BEHAVIORAL HEALTH VISITS (15,824) FOR A TOTAL OF 65,102 VISITS, AND PROVIDED 8,195 DAYS OF CARE DURING THE FISCAL YEAR. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT AN AMOUNT BELOW COST, AND PROVIDES CARE TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CHARITY $649,881. UNPAID MEDI-CAL PROGRAM CHARGES WERE $105,362,803. UNPAID MEDICARE PROGRAM CHARGES FOR THE FISCAL YEAR WERE $158,701,365. TOTAL QUANTIFIABLE COMMUNITY BENEFITS WERE $264,064,168. | Desc |
| Total Program Service Expenses | $83,750,687 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | Yes (1) | 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 | 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 | 182 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 785 | 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 | 9 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DANIEL HECKATHORNE CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9518451121 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 NORTH HIGHLAND SPRINGS AVENUE | AddressLine1Txt |
| City | BANNING | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92220 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| SUSAN DIBIASI | |||||||||
| CHAIRPERSON | 5.00 | Yes (X) | Yes (X) | $3,200 | $0 | $0 | |||
| RON RADER | |||||||||
| SECRETARY | 5.00 | Yes (X) | Yes (X) | $3,000 | $0 | $0 | |||
| STEVEN RUTHLEDGE | |||||||||
| VICE CHAIR | 5.00 | Yes (X) | Yes (X) | $2,700 | $0 | $0 | |||
| DARRELL PETERSON | |||||||||
| TREASURER | 3.00 | Yes (X) | Yes (X) | $1,800 | $0 | $0 | |||
| SHANNON MCDOUGALL | |||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $1,800 | $0 | $0 | ||||
| LANNY SWERDLOW | |||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $1,600 | $0 | $0 | ||||
| RANDAL STEVENS | |||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $1,400 | $0 | $0 | ||||
| PERRY GOLDSTEIN | |||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $1,200 | $0 | $0 | ||||
| DENNIS TANKERSLEY | |||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | ||||
| STEVE BARRON | |||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $513,785 | $0 | $28,495 | ||||
| KARAN SINGH | |||||||||
| CHIEF MEDICAL OFFICER | 40.00 | Yes (X) | $273,805 | $0 | $20,869 | ||||
| DANIEL HECKATHORNE | |||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $266,881 | $0 | $16,029 | ||||
| JOHN PELEUSES | |||||||||
| COO | 40.00 | Yes (X) | $211,163 | $0 | $12,412 | ||||
| ANGELA BRADY | |||||||||
| CHIEF OF NURSING | 40.00 | $261,970 | $0 | $14,125 | Yes (X) | ||||
| TZARIMNAH KARAM | |||||||||
| VP OF HUMAN RESOURCES | 40.00 | $227,785 | $0 | $33,542 | Yes (X) | ||||
| JOSE RUIZ | |||||||||
| IMAGING TECHNICIAN | 40.00 | $244,515 | $0 | $7,022 | Yes (X) | ||||
| EMMANUEL VIRAY | |||||||||
| IMAGING TECHNICIAN | 40.00 | $232,518 | $0 | $11,755 | Yes (X) | ||||
| ANNA KAMPANARTSANYAKORN | |||||||||
| REGISTERED NURSE | 40.00 | $215,203 | $0 | $11,822 | Yes (X) | ||||
| ANA VALDEZ | |||||||||
| DIRECTOR OF RISK/PERFORMANCE IMPROVEMENT | 40.00 | $213,149 | $0 | $10,786 | Yes (X) | ||||
| JOSE LOPEZ | |||||||||
| DIRECTOR OF PHARMACY | 40.00 | $195,710 | $0 | $9,815 | Yes (X) | ||||
| PATRICIA BROWN | |||||||||
| CNO/COO | 0.00 | $105,683 | $0 | $5,311 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,978,867 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $181,983 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 160 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | 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 |
|---|---|---|---|---|---|
| ALLSCRIPTS HEALTHCARE LLC | |||||
| 24630 NETWORK PL | CHICAGO | IL | 60673 | EHR SOFTWARE AND SUPPORT | $3,951,855 |
| BEAVER MEDICAL GROUP | |||||
| 5957 W RAMSEY ST | BANNING | CA | 92220 | PHYSICIAN/ANESTHESIA SERVICES | $2,733,621 |
| CONCORDANCE | |||||
| 14540 INNOVATION DR | RIVERSIDE | OH | 44101 | MEDICAL AND GENERAL SUPPLIES | $1,652,106 |
| SAYCO BUILDERS | |||||
| 31566 RAILROAD CANYON RD STE 2 14 | CANYON LAKE | CA | 92587 | CONSTRUCTION SERVICES | $908,866 |
| CARDINAL HEALTH 110 LLC | |||||
| PO BOX 56412 | LOS ANGELES | CA | 90074 | PHARMACUTICALS | $777,582 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 60 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,397,081 | RelatedOrganizationsAmt |
| Total Contributions | $1,397,081 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $94,623,909 | $94,623,909 |
| MANAGEMENT FEE REVENUE | 900099 | $1,200,000 | $1,200,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $95,823,909 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LEGAL SETTLEMENT LOSS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | -$2,822,063 | TotalRevenueColumnAmt |
| Exclusion | -$2,822,063 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$2,822,063 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $94,398,927 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $95,823,909 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$2,822,063 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,970,361 | TotalAmt |
| Management And General | $1,970,361 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,328,494 | TotalAmt |
| Program Services | $36,561,403 | ProgramServicesAmt |
| Management And General | $8,677,468 | ManagementAndGeneralAmt |
| Fundraising | $89,623 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,091,090 | TotalAmt |
| Program Services | $1,691,521 | ProgramServicesAmt |
| Management And General | $395,423 | ManagementAndGeneralAmt |
| Fundraising | $4,146 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,256,352 | TotalAmt |
| Program Services | $3,328,321 | ProgramServicesAmt |
| Management And General | $919,872 | ManagementAndGeneralAmt |
| Fundraising | $8,159 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,321,955 | TotalAmt |
| Program Services | $2,574,847 | ProgramServicesAmt |
| Management And General | $740,796 | ManagementAndGeneralAmt |
| Fundraising | $6,312 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,021,892 | TotalAmt |
| Management And General | $1,021,892 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,544 | TotalAmt |
| Management And General | $49,544 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,429,560 | TotalAmt |
| Program Services | $8,859,052 | ProgramServicesAmt |
| Management And General | $2,548,792 | ManagementAndGeneralAmt |
| Fundraising | $21,716 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,186 | TotalAmt |
| Management And General | $36,186 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,916,350 | TotalAmt |
| Program Services | $1,628,897 | ProgramServicesAmt |
| Management And General | $287,453 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,724,190 | TotalAmt |
| Program Services | $4,015,561 | ProgramServicesAmt |
| Management And General | $708,629 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,393,246 | TotalAmt |
| Program Services | $2,034,259 | ProgramServicesAmt |
| Management And General | $358,987 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,018 | TotalAmt |
| Program Services | $8,807 | ProgramServicesAmt |
| Management And General | $13,211 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,982 | TotalAmt |
| Program Services | $24,895 | ProgramServicesAmt |
| Management And General | $58,087 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $518,982 | TotalAmt |
| Management And General | $518,982 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $721,553 | TotalAmt |
| Program Services | $613,320 | ProgramServicesAmt |
| Management And General | $108,233 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,545,694 | TotalAmt |
| Program Services | $1,452,952 | ProgramServicesAmt |
| Management And General | $92,742 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $10,619,147 | $10,619,147 | |
| MEDICAL SUPPLIES | $6,736,442 | $6,736,442 | |
| REPAIRS & MAINTENANCE | $1,210,154 | $1,028,631 | $181,523 |
| NON-MEDICAL SUPPLIES | $1,067,894 | $854,315 | $213,579 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,021,550 | TotalAmt |
| Program Services | $1,718,317 | ProgramServicesAmt |
| Management And General | $303,233 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,085,636 | TotalAmt |
| Program Services | $83,750,687 | ProgramServicesAmt |
| Management And General | $19,204,993 | ManagementAndGeneralAmt |
| Fundraising | $129,956 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,578,613 | BOYAmt |
| EOY | $18,062,264 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,957 | BOYAmt |
| EOY | $18,338 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $278,224 | BOYAmt |
| EOY | $283,782 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,204,812 | BOYAmt |
| EOY | $9,681,423 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,311,781 | BOYAmt |
| EOY | $2,075,663 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,615 | BOYAmt |
| EOY | $364,122 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,331,263 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,910,196 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,142,620 | BOYAmt |
| EOY | $1,421,067 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $460,457 | BOYAmt |
| EOY | $2,055,541 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,258,079 | BOYAmt |
| EOY | $33,962,200 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,133,767 | BOYAmt |
| EOY | $11,831,076 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,852,624 | BOYAmt |
| EOY | $14,637,471 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,329,258 | BOYAmt |
| EOY | $57,237,932 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,315,649 | BOYAmt |
| EOY | $83,706,479 | 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 | -$41,057,570 | BOYAmt |
| EOY | -$49,744,279 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$41,057,570 | BOYAmt |
| EOY | -$49,744,279 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,258,079 | BOYAmt |
| EOY | $33,962,200 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$8,686,709 | 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 | 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 D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $92,062 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $14,750 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $1,083 | AdministrativeExpensesAmt |
| End Year Balance | $105,780 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $109,863 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$16,716 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $1,034 | AdministrativeExpensesAmt |
| End Year Balance | $92,113 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $97,072 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $13,950 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $1,159 | AdministrativeExpensesAmt |
| End Year Balance | $109,863 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $327,572 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$29,400 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $200,000 | OtherExpendituresAmt |
| Administrative Expenses | $1,100 | AdministrativeExpensesAmt |
| End Year Balance | $97,072 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $190,438 | BeginningYearBalanceAmt |
| Contributions | $98,883 | ContributionsAmt |
| Investment Earnings Or Losses | $40,973 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $2,723 | AdministrativeExpensesAmt |
| End Year Balance | $327,571 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,331,263 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,910,196 | DepreciationAmt |
| Book Value | $1,421,067 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,421,067 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| BENEFICIAL INTEREST IN NET ASSETS OF SAN GORGONIO HOSPITAL FOUNDATION | $855,541 |
| ACCRUED MANAGEMENT FEES | $1,200,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,055,541 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| LEGAL SETTLEMENT LIABILITY | $3,471,561 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $5,384,956 |
| LEASES PAYABLE | $533,200 |
| DUE TO RELATED PARTY | $47,076,411 |
| SUBSCRIPTION-BASED LIABILITIES | $437,722 |
| HOSPITAL CP LEASE | $334,082 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $57,237,932 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | SAN GORGONIO MEMORIAL HOSPITAL FOUNDATION HOLDS FUNDS RESTRICTED FROM THE MORONGO TRIBE TO BE USED FOR SPECIFIC HOSPITAL PURPOSES. | 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 |
| Percent400 | Yes (X) | Percent400Ind |
| 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 | $15,624,243 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,596,768 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,027,475 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14090 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,859,890 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,170,241 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $51,238,512 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $106,636,184 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $70,722,645 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $115,403,193 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,027,475 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14090 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,983 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,983 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $653,732 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $106,688 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $547,044 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00590 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $686,715 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $106,688 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $580,027 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $71,409,360 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $115,509,881 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,607,502 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14710 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $10,619,147 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $10,380,516 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $18,116,040 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$7,735,524 | 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 | SAN GORGONIO MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 NORTH HIGHLAND SPRINGS AVE | AddressLine1Txt |
| City | BANNING | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92220 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SGMH.ORG | WebsiteAddressTxt |
| State License | 1568469997 | StateLicenseNum |
| Subordinate Hospital EIN | 330420041 | SubordinateHospitalEIN |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAN GORGONIO MEMORIAL HOSPITAL | 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 |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, LINE 7D: | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, LINE 7D: | 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 | 400.000000000000 | 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| 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 |
|---|---|
| SAN GORGONIO MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: DISTRICT BOARD AND COMMUNITY LEADERS WERE CONTACTED FOR INFORMATION AND THE NEEDS ASSESSMENT WAS PRODUCED BY AND WITH OTHER HOSPITALS IN THE AREA. |
| SAN GORGONIO MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6A: THE ASSESSMENT WAS CONDUCTED IN COLLABORATION WITH LOMA LINDA UNIVERSITY HOSPITAL. |
| SAN GORGONIO MEMORIAL HOSPITAL | PART V, SECTION B, LINE 7D: HTTPS://WWW.SGMH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-AND-IMPLEMENTATION-STRATEGY-REPORT |
| SAN GORGONIO MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: IT WOULD BE FISCALLY IMPOSSIBLE FOR THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS OF THE COMMUNITY, BUT THROUGH CONTINUED COLLABORATION WITH OTHER COMMUNITY AGENCIES THE HOSPITAL HOPES TO CONTINUE TO IDENTIFY PRIORITY AREAS WHERE THEY CAN MAKE THE MOST IMPACT. THE HOSPITAL HAS IDENTIFIED ACCESS TO HEALTH CARE, BEHAVIORAL HEALTH, WOMEN'S HEALTH SERVICES, AND CHRONIC DISEASE WITH A SPECIAL EMPHASIS ON HEART DISEASE AS THEIR PRIORITY AREAS. THESE WERE CHOSEN AS BROAD PRIORITIES TO ADDRESS A WIDE SPECTRUM OF INTERVENTIONS IN PARTNERSHIP WITH THE COMMUNITY. A FOCUS WILL ALLOW TRUE IMPACT VERSUS BEING FRAGMENTED AND INEFFECTIVE. A DETAILED COMMUNITY HEALTH PLAN HAS BEEN DEVELOPED WITH KEY METRICS FOR EACH OF THE PRIORITY AREAS. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 $ 10,619,147. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | WE SUPPLIED HEALTHY BALANCES MEALS TO OUR HOMEBOUND SENIORS THAT NEEDED ASSISTANCE AND TO OUR AUXILIARY MEMBERS WHO GRACIOUSLY DONATE THEIR TIME TO ASSIST AT THE HOSPITAL. ALSO, WE HAVE HAD MANY CLASSES FOR OUR ASSOCIATES AS WELL AS TUITION ASSISTANCE TO FURTHER THEIR CAREER. |
| PART III, LINE 2: | THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED INCLUDES THE COST TO CHARGE RATIO OF PATIENT CARE. |
| PART III, LINE 3: | BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE POLICY CANNOT BE DETERMINED. THE HOSPITAL DID NOT TRACK THE AMOUNT OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY, AND FURTHERMORE SUFFICIENT INFORMATION WAS NOT OBTAINED FROM ALL PATIENTS THAT MIGHT BE ELIGIBLE TO MAKE THIS DETERMINATION AND CALCULATION. |
| PART III, LINE 4: | THE FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE DESCRIBING BAD DEBT EXPENSE. HOWEVER, THERE IS A FOOTNOTE THAT DISCUSSES CHARITY CARE AND COMMUNITY BENEFIT EXPENSE. |
| PART III, LINE 8: | ANY SHORTFALL IS DEEMED A COMMUNITY BENEFIT IN ITS ENTIRETY. |
| PART III, LINE 9B: | IT IS THE POLICY OF SAN GORGONIO MEMORIAL HOSPITAL THAT ALL PATIENTS WILL BE TREATED FAIRLY IN PRICING AND COLLECTION PRACTICES. THE HOSPITAL'S REGISTRATION AND PATIENT FINANCIAL SERVICES STAFF WILL MAKE A REASONABLE ATTEMPT TO ESTIMATE EACH PATIENT'S LIABILITY. THE HOSPITAL'S PFS STAFF, IN CONJUNCTION WITH CONTRACTED EARLY OUT AGENCIES WILL MAKE A SUBSEQUENTLY ATTEMPT TO COLLECT EACH PATIENT'S LIABILITY AND TO OFFER DISCOUNT AND CHARITY CARE APPLICATIONS. THIS IS OFFERED IN COMPLIANCE WITH CALIFORNIA ASSEMBLY BILL 774 (STATUTES OF 2006) AND SB 1276 (CHAPTER 758, STATUES OF 2014). THIS POLICY DOES NOT APPLY TO ANY PHYSICIAN SERVICES RENDERED AT SGMH. |
| PART VI, LINE 2: | THE MANAGEMENT TEAM, HOSPITAL DEPARTMENT STAFF AND MANAGERS, AND THE BOARD OF DIRECTORS ARE COMPRISED OF COMMUNITY MEMBERS. THEY ARE ABLE TO GATHER AND COMMUNICATE THE HEALTH CARE NEEDS OF THE COMMUNITY THE HOSPITAL SERVES AND CONTINUALLY ADDRESS THEM AT STAFF AND BOARD MEETINGS. THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS PUBLICLY AVAILABLE ON THE INTERNET AT: HTTP://WWW.SGMH.ORG. THE HOSPITAL CONDUCTED A CHNA/IMPLEMENTATION STRATEGY IN 2022 THAT IS ALSO POSTED ON THE ORGANIZATION'S WEBSITE, AND WILL BE APPLICABLE TO THE COMING FEW YEARS' FORM 990S. |
| PART VI, LINE 3: | IT IS THE HOSPITAL'S POLICY THAT WHEN IT BECOMES APPARENT THAT A PATIENT MAY HAVE DIFFICULTY IN MEETING HIS/HER FINANCIAL RESPONSIBILITY TO THE HOSPITAL, THE PATIENT WILL BE REQUESTED TO COMPLETE THE APPLICATION PROCESS FOR CALIFORNIA MEDI-CAL AND/OR OTHER AVAILABLE PROGRAMS. HOSPITAL STAFF ASSIST IN THE APPLICATION PROCESS. PATIENTS WHO DO NOT QUALIFY FOR CALFORNIA MEDI-CAL OR OTHER ASSISTANCE MAY APPLY FOR THE HOSPITAL'S ASSISTANCE PROGRAM. |
| PART VI, LINE 4: | THE HOSPITAL IS A RURAL HOSPITAL LOCATED IN THE PASS AREA OF RIVERSIDE COUNTY. IT PRIMARILY SERVES THE CITIES OF BANNING, BEAUMONT, CABAZON, AND CALIMESA, CALIFORNIA. THE POPULATION SERVED IS HIGH-RISK DUE TO POVERTY LEVEL INCOMES, LOW EDUCATION LEVELS, AND HIGH DRUG USE. THE COUNTY HAS AN UNEMPLOYMENT RATE OF 8.7%. THE HOSPITAL'S PAYOR MIX INCLUDED APPROXIMATELY 31% MEDI-CAL RECIPIENTS AND 5% UNINSURED. |
| PART VI, LINE 5: | THE HOSPITAL CONTINUES TO STRIVE TO MEET THE HEALTH NEEDS OF ITS COMMUNITY AS THESE NEEDS EVOLVE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | CA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEVE BARRON | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $513,785 | $0 | $0 | $0 | $0 | $0 | $25,689 | $0 | $2,806 | $0 | $542,280 | $0 | $0 | $0 |
| KARAN SINGH | ||||||||||||||
| CHIEF MEDICAL OFFICER | $273,805 | $0 | $0 | $0 | $0 | $0 | $13,690 | $0 | $7,179 | $0 | $294,674 | $0 | $0 | $0 |
| DANIEL HECKATHORNE | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $266,881 | $0 | $0 | $0 | $0 | $0 | $13,344 | $0 | $2,685 | $0 | $282,910 | $0 | $0 | $0 |
| ANGELA BRADY | ||||||||||||||
| CHIEF OF NURSING | $261,970 | $0 | $0 | $0 | $0 | $0 | $13,099 | $0 | $1,026 | $0 | $276,095 | $0 | $0 | $0 |
| TZARIMNAH KARAM | ||||||||||||||
| VP OF HUMAN RESOURCES | $227,785 | $0 | $0 | $0 | $0 | $0 | $11,389 | $0 | $22,153 | $0 | $261,327 | $0 | $0 | $0 |
| JOSE RUIZ | ||||||||||||||
| IMAGING TECHNICIAN | $244,515 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $7,022 | $0 | $251,537 | $0 | $0 | $0 |
| EMMANUEL VIRAY | ||||||||||||||
| IMAGING TECHNICIAN | $232,518 | $0 | $0 | $0 | $0 | $0 | $11,626 | $0 | $129 | $0 | $244,273 | $0 | $0 | $0 |
| ANNA KAMPANARTSANYAKORN | ||||||||||||||
| REGISTERED NURSE | $215,203 | $0 | $0 | $0 | $0 | $0 | $10,760 | $0 | $1,062 | $0 | $227,025 | $0 | $0 | $0 |
| ANA VALDEZ | ||||||||||||||
| DIRECTOR OF RISK/PERFORMANCE IMPROVE | $213,149 | $0 | $0 | $0 | $0 | $0 | $10,657 | $0 | $129 | $0 | $223,935 | $0 | $0 | $0 |
| JOHN PELEUSES | ||||||||||||||
| COO | $211,163 | $0 | $0 | $0 | $0 | $0 | $10,558 | $0 | $1,854 | $0 | $223,575 | $0 | $0 | $0 |
| JOSE LOPEZ | ||||||||||||||
| DIRECTOR OF PHARMACY | $195,710 | $0 | $0 | $0 | $0 | $0 | $9,785 | $0 | $30 | $0 | $205,525 | $0 | $0 | $0 |
| PATRICIA BROWN | ||||||||||||||
| CNO/COO | $105,683 | $0 | $0 | $0 | $0 | $0 | $5,284 | $0 | $27 | $0 | $110,994 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WILL BE PROVIDED ELECTRONICALLY TO ALL BOARD MEMBERS FOR AT LEAST A 10 DAY REVIEW AND COMMENTS. |
| FORM 990, PART VI, SECTION B, LINE 12C | EXECUTIVE ASSISTANT/COMPLIANCE OFFICER MONITORS AND DOCUMENTS CONFLICTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS REVIEW AND APPROVE MANAGEMENT WAGES EACH YEAR DURING THE BUDGET PROCESS. SOURCES UTILIZED BY THE BOARD WHEN REVIEWING FAIR MARKET VALUE IN COMPENSATION INCLUDE MARKET SURVEYS AND SALARY RANGES PROVIDED BY THE HR DEPARTMENT. |
| FORM 990, PART VI, SECTION C, LINE 19 | PUBLISHED ON WEBSITE WWW.SGMH.ORG OR AVAILABLE BY REQUEST FROM THE CEO, CFO, CONTROLLER, OR EXECUTIVE ASSISTANT. |
| FORM 990, PART IX, LINE 11G | NURSING AND OTHER CONTRACT LABOR: PROGRAM SERVICE EXPENSES 4,574,323. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,574,323. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 2,602,150. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,602,150. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,682,579. MANAGEMENT AND GENERAL EXPENSES 2,548,792. FUNDRAISING EXPENSES 21,716. TOTAL EXPENSES 4,253,087. |
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 | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| SAN GORGONIO HEALTH CARE DISTRICT | ||||||||||
| 600 N HIGHLAND SPRINGS AVE | BANNING | CA | 92220 | 956004149 | HEALTHCARE | CA | GOVERNMENT | N/A | 0 | |
| SAN GORGONIO MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| 600 N HIGHLAND SPRINGS AVE | BANNING | CA | 92220 | 953863230 | SUPPORT SAN GORGONIO MEMORIAL HOSPITAL | CA | 501(C)(3) | N/A | 0 | LINE 7 |
| 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | 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 | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |