VIRGINIA GAY HOSPITAL INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- VIRGINIA GAY HOSPITAL INC (EIN 42-1231996)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-03-08
- IRS object ID
- 202340679349300909
- Schema version
- 2021v4.2
- 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 D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-03-08T08:27:33-06:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421231996 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Virginia Gay Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | VIRG | BusinessNameControlTxt |
| Phone | 3194726255 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 N 9th Ave | AddressLine1Txt |
| City | Vinton | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 523492254 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Michele Schoonover | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3194726255 | PhoneNum |
| Signature | 2023-03-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Michele | PersonFirstNm |
| Person Last | Schoonover | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2023-03-02 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Michele Schoonover | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 N 9th Ave | AddressLine1Txt |
| City | Vinton | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 523492254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $35,333,852 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.myvghinc.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1923 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | Provision of health care services | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 389 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $8,280,776 | PYContributionsGrantsAmt |
| CY Contributions Grants | $734,726 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $30,350,427 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $34,020,155 | CYProgramServiceRevenueAmt |
| PY Investment Income | $264,471 | PYInvestmentIncomeAmt |
| CY Investment Income | $578,971 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $38,895,674 | PYTotalRevenueAmt |
| CY Total Revenue | $35,333,852 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $8,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $12,500 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,872,708 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,567,174 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $92,615 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,526,513 | PYOtherExpensesAmt |
| CY Other Expenses | $15,626,030 | CYOtherExpensesAmt |
| PY Total Expenses | $31,407,221 | PYTotalExpensesAmt |
| CY Total Expenses | $34,205,704 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,488,453 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,128,148 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $40,007,620 | TotalAssetsBOYAmt |
| Total Assets EOY | $40,884,116 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,541,402 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,580,946 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $36,466,218 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $36,303,170 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Our purpose is to provide quality health care services by using innovative, growth-oriented techniques and maintaining a sound financial base. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $29,600,874 | ExpenseAmt |
| Grant | $12,500 | GrantAmt |
| Revenue | $34,020,155 | RevenueAmt |
| Desc | Virginia Gay Hospital is a 25-bed acute care hospital and a 40-bed long-term care facility located in Vinton, Iowa. The Hospital leads delivery of healthcare to its region through over 300 associates (including 18 providers) who coordinate care to deliver patient care as an integrated unit. Virginia Gay Hospital and its affiliates also work seamlessly to meet the needs of the communities they serve. The Hospital provides care to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The amounts of charges foregone for services provided under the Hospital's charity care policy were $158,433 for the year ended June 30, 2022. Total direct and indirect costs related to these charges foregone were approximately $81,000 at June 30, 2022, based on an average ratio of cost to gross charges.In addition, the Hospital provides services to other patients under certain government-reimbursed public aid programs. Such programs pay providers amounts which are less than established charges for the services provided to the recipients, and for some services the payments are less than the cost of rendering the services provided.The Hospital also commits significant time and resources to endeavors and critical services which meet otherwise unfulfilled community needs. Many of these activities are sponsored with the knowledge that they will not be self-supporting or financially viable.Virginia Gay Hospital also makes medical care accessible to the entire community it serves. The Hospital operates a full-time emergency room and provides emergency care regardless of ability to pay. The Hospital provides clinical services needed to operate the emergency room and provides on-site emergency medical care and medical transportation services through an area ambulance service, van service, and an onsite helipad.The Hospital had 38,641 outpatient visits and the rural health clinics had 40,481 visits. | Desc |
| Total Program Service Expenses | $29,600,874 | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 35 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 389 | 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 | 7 | 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 | Yes (1) | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Barry Dietsch | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3194726255 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 N 9th Ave | AddressLine1Txt |
| City | Vinton | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52349 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| Dr Brian Meeker DO | ||||||||
| Director | 40.00 | 0.00 | Yes (X) | $676,828 | $0 | $29,540 | ||
| Dr Erica Silbernagel DO | ||||||||
| Family Medicine | 40.00 | 0.00 | $321,894 | $0 | $5,275 | Yes (X) | ||
| Dr Michelle Elgin DO | ||||||||
| Director | 40.50 | 0.30 | Yes (X) | $262,497 | $0 | $28,249 | ||
| Tammy Madsen PA-C | ||||||||
| ER/Hospitalist | 40.00 | 0.00 | $239,487 | $0 | $13,040 | Yes (X) | ||
| Rita Taylor-Stewart PA-C | ||||||||
| Family Medicine | 40.00 | 0.00 | $236,866 | $0 | $10,689 | Yes (X) | ||
| Michele Burnes PA-C | ||||||||
| Family Medicine | 40.00 | 0.00 | $223,062 | $0 | $23,851 | Yes (X) | ||
| Matthew Wilden PA-C | ||||||||
| ER/Hospitalist | 40.00 | 0.00 | $204,050 | $0 | $28,627 | Yes (X) | ||
| Michele Schoonover | ||||||||
| CEO | 40.00 | 3.30 | $171,164 | $0 | $26,581 | Yes (X) | ||
| Barry Dietsch | ||||||||
| CFO | 40.00 | 3.30 | $165,824 | $0 | $4,295 | Yes (X) | ||
| John Yundt | ||||||||
| Chair | 0.50 | 1.30 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| John Ketchen | ||||||||
| Chair (Until Oct 2021) | 0.50 | 1.30 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| David Vermedahl | ||||||||
| Vice Chair | 0.50 | 0.90 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Sara Stuefan | ||||||||
| Secretary | 0.50 | 0.30 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| John Mossman | ||||||||
| Treasurer | 0.90 | 0.30 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Marie Therese Foth | ||||||||
| Director | 0.50 | 0.30 | Yes (X) | $0 | $0 | $0 | ||
| Bud Maynard | ||||||||
| Director | 0.50 | 0.30 | Yes (X) | $0 | $0 | $0 | ||
| Kyle Koeppen | ||||||||
| Director | 0.50 | 0.30 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,501,672 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $170,147 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 23 | 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 |
|---|---|---|---|---|---|
| Modern Piping Inc | |||||
| 500 Walford Road SW | Cedar Rapids | IA | 52404 | Construction | $1,632,263 |
| National Therapeutic Association | |||||
| 11623 Arbor Street | Omaha | NE | 68144 | Speech/Occupational/Physical Therapy | $1,150,663 |
| Iowa Anesthesia LC | |||||
| PO Box 1665 | Cedar Rapids | IA | 52406 | CRNA & Ultrasound | $520,416 |
| ProLink Healthcare | |||||
| 4600 Montgomery Rd Ste 300 | Cincinnati | OH | 45212 | Contract Staffing | $352,364 |
| Grapetree Medical Staffing | |||||
| PO Bxo 5340 | Sioux Falls | SD | 57117 | Contract Staffing | $303,510 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $620,863 | GovernmentGrantsAmt |
| All Other Contributions | $113,863 | AllOtherContributionsAmt |
| Total Contributions | $734,726 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient & resident revenue | 621110 | $32,031,471 | $32,031,471 |
| Pharmacy Revenue | 900099 | $1,663,250 | $1,663,250 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $325,434 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $325,434 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $34,020,155 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $526,971 | TotalRevenueColumnAmt |
| Exclusion | $526,971 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $52,000 | 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 | $52,000 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,000 | TotalRevenueColumnAmt |
| Exclusion | $52,000 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,333,852 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $34,020,155 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $578,971 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,500 | TotalAmt |
| Program Services | $12,500 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,346,578 | TotalAmt |
| Program Services | $967,536 | ProgramServicesAmt |
| Management And General | $379,042 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $162,379 | TotalAmt |
| Program Services | $68,088 | ProgramServicesAmt |
| Management And General | $94,291 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,423,766 | TotalAmt |
| Program Services | $13,195,278 | ProgramServicesAmt |
| Management And General | $1,169,980 | ManagementAndGeneralAmt |
| Fundraising | $58,508 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,490 | TotalAmt |
| Program Services | $165,959 | ProgramServicesAmt |
| Management And General | $12,816 | ManagementAndGeneralAmt |
| Fundraising | $715 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,399,031 | TotalAmt |
| Program Services | $1,249,271 | ProgramServicesAmt |
| Management And General | $144,557 | ManagementAndGeneralAmt |
| Fundraising | $5,203 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,055,930 | TotalAmt |
| Program Services | $936,586 | ProgramServicesAmt |
| Management And General | $115,518 | ManagementAndGeneralAmt |
| Fundraising | $3,826 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,260 | TotalAmt |
| Management And General | $6,260 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,387 | TotalAmt |
| Management And General | $58,387 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,617,707 | TotalAmt |
| Program Services | $5,617,891 | ProgramServicesAmt |
| Management And General | $997,116 | ManagementAndGeneralAmt |
| Fundraising | $2,700 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,512 | TotalAmt |
| Program Services | $7,596 | ProgramServicesAmt |
| Management And General | $67,088 | ManagementAndGeneralAmt |
| Fundraising | $17,828 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,617,059 | TotalAmt |
| Program Services | $1,298,170 | ProgramServicesAmt |
| Management And General | $315,707 | ManagementAndGeneralAmt |
| Fundraising | $3,182 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $506,338 | TotalAmt |
| Program Services | $102,393 | ProgramServicesAmt |
| Management And General | $403,945 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,906 | TotalAmt |
| Program Services | $64,082 | ProgramServicesAmt |
| Management And General | $1,778 | ManagementAndGeneralAmt |
| Fundraising | $46 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,860 | TotalAmt |
| Program Services | $65,267 | ProgramServicesAmt |
| Management And General | $2,433 | ManagementAndGeneralAmt |
| Fundraising | $160 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,961 | TotalAmt |
| Program Services | $6,813 | ProgramServicesAmt |
| Management And General | $2,148 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,026,908 | TotalAmt |
| Program Services | $1,695,994 | ProgramServicesAmt |
| Management And General | $330,907 | ManagementAndGeneralAmt |
| Fundraising | $7 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,120 | TotalAmt |
| Program Services | $6,240 | ProgramServicesAmt |
| Management And General | $238,880 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $3,496,690 | $3,491,646 | $5,044 |
| Repairs and maintenance | $465,842 | $371,377 | $94,465 |
| Food | $181,453 | $181,453 | |
| Grant Expense | $8 | $8 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,019 | TotalAmt |
| Program Services | $96,734 | ProgramServicesAmt |
| Management And General | $71,845 | ManagementAndGeneralAmt |
| Fundraising | $440 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,205,704 | TotalAmt |
| Program Services | $29,600,874 | ProgramServicesAmt |
| Management And General | $4,512,215 | ManagementAndGeneralAmt |
| Fundraising | $92,615 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,384,420 | BOYAmt |
| EOY | $8,962,248 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,172,121 | BOYAmt |
| EOY | $2,919,926 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,000 | BOYAmt |
| EOY | $10,000 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $376,730 | BOYAmt |
| EOY | $366,126 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $345,507 | BOYAmt |
| EOY | $284,616 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $37,016,637 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $20,960,757 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,122,043 | BOYAmt |
| EOY | $16,055,880 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,501,109 | BOYAmt |
| EOY | $11,356,783 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,037,142 | BOYAmt |
| EOY | $580,593 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $407,718 | BOYAmt |
| EOY | $347,944 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $640,830 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,007,620 | BOYAmt |
| EOY | $40,884,116 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,191,279 | BOYAmt |
| EOY | $2,411,727 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $597,846 | BOYAmt |
| EOY | $1,235,700 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $752,277 | BOYAmt |
| EOY | $523,519 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $410,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,541,402 | BOYAmt |
| EOY | $4,580,946 | 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 | $36,332,885 | BOYAmt |
| EOY | $36,165,738 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $133,333 | BOYAmt |
| EOY | $137,432 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,466,218 | BOYAmt |
| EOY | $36,303,170 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,007,620 | BOYAmt |
| EOY | $40,884,116 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,128,148 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,291,196 | NetUnrlzdGainsLossesInvstAmt |
| 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 | $116,660 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $13,007 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $13,007 | OtherExpendituresAmt |
| End Year Balance | $116,660 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $116,660 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $16,513 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $16,513 | OtherExpendituresAmt |
| End Year Balance | $116,660 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $116,660 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,251 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,251 | OtherExpendituresAmt |
| End Year Balance | $116,660 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $116,660 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $7,544 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $7,544 | OtherExpendituresAmt |
| End Year Balance | $116,660 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $116,660 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $5,813 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,813 | OtherExpendituresAmt |
| End Year Balance | $116,660 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $141,794 | OtherCostOrOtherBasisAmt |
| Book Value | $141,794 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $151,876 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $25,168,873 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,797,845 | DepreciationAmt |
| Book Value | $12,522,904 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,282,115 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,284,585 | DepreciationAmt |
| Book Value | $2,997,530 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,271,979 | OtherCostOrOtherBasisAmt |
| Depreciation | $878,327 | DepreciationAmt |
| Book Value | $393,652 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $16,055,880 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Estimated Third Party Payor | Desc |
| Amt | $410,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $410,000 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | Income from the endowment funds is to be used for repairs and maintenance and capital improvements. |
| Part X, Line 2: | The Organization believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. |
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 | 220.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| 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 | $81,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $81,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $81,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $81,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,479,722 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,856,187 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $623,535 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01820 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,479,722 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,856,187 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $623,535 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01820 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,560,722 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,856,187 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $704,535 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02060 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $554,194 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $158,433 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,277,475 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,188,051 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $89,424 | 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 | Virginia Gay Hospital Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 N 9th Avenue | AddressLine1Txt |
| City | Vinton | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 523492254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | myvghinc.org | WebsiteAddressTxt |
| State License | 060178H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | 4 provider based rural health clinics | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Virginia Gay Hospital Inc | 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 | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | 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 Supplemental Info | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | https://www.bentoncountyia.gov/public_health/ | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V Supplemental Info | 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 | 220.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| 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 | https://myvgh.org/financial-assistance/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://myvgh.org/financial-assistance/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://myvgh.org/financial-assistance/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back 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 |
|---|---|
| Virginia Gay Hospital, Inc. | Part V, Section B, Line 5: A strategic planning session for fiscal year 2022 was held on 2/18/22. Key members of VGH including but not limited to senior management, members of the VGH Board of Directors, and medical providers discussed the future needs and actions of the organization to ensure our service area's health needs continued to be met.Senior management meets twice monthly to discuss the current and future needs for our service area and the actions necessary to meet the needs of our communities served. The most recent meeting was held on 8/1/22. Obtaining input from key stakeholders was another crucial step in the assessment process. These stakeholders were drawn from private and public organizations that serve people in the Benton County area and were invited to identify the top health issues confronting the populations they served. The health issues these various groups and individuals identified reflected the overarching theme of social determinants/health equity. Analysis of the input received was completed to help determine the priority health needs. Meetings were held to discuss the following Public Health topics to help assess and prioritize the community health needs: Promotion of Healthy Living Prevent Injuries/Violence Protect Against Environmental Hazards Prevent Epidemics/Spread of Disease Prepare for Respond to/Recover from Public Health Emergencies Strengthen the Health Infrastructure. Discussions, correspondence, strategizing, and implementation continue amongst members of the above groups to address the identified health needs and concerns.VGH engaged several tactics to ensure different members of our community were contacted, including those knowledgeable of health care needs of vulnerable populations. This was completed through personal interviews, emails, surveys, and meetings that occurred between the Fall of 2020 to Spring of 2022. The following community partners were involved in the CHNA process: Virginia Gay Hospital, Clinics, Home Health, and Nursing & Rehab VGH Board of Directors Benton County Board of Supervisors Benton County Board of Health Benton County Public Health Benton County Environmental Health Benton County Emergency Management Benton County Disaster Recovery Coalition Benton County Coalition Benton County Social Services Benton County Department of Human Services Benton County TransportationBenton County School Districts Benton County Development Group Benton County Wellness CoalitionRegion 6 Emergency Preparedness CoalitionVinton Unlimited Above the Influence Coalition (Substance Abuse) Iowa State Benton County Extension Office Benton County Police DepartmentsBenton County School DistrictsBetter Tomorrows (Early Childhood Iowa) Benton-Iowa Decategorization Hawkeye Area Community Action Programs (HACAP)Area Substance Abuse Council (ASAC)Vinton Parks & Recreation DepartmentAbbe Center for Community Mental Health |
| Virginia Gay Hospital, Inc. | Part V, Section B, Line 11: Highest Priority Health NeedsA survey was conducted March 2022 resulting in 118 completed surveys. The surveys were from anonymous participants. The goal of this survey was to better help us understand the health concerns and needs in Benton County.Following the collection of statistical data and community input, each health indicator was analyzed by comparing it to the state rates to determine our county's priority health concerns.It was determined that Mental Health 78.81%, Obesity 64.41% along with Chronic Health conditions 53.35% and Substance abuse 38.14% were the top health priorities in Benton County. We will continue our current goals for Mental Health, Substance Abuse and have added Health Prevention as our top three priorities. Health prevention will encompass our previous objectives on obesity while including other chronic illness needs as identified from the Benton County 2022 CHNA survey data.1.Preventive HealthGoal 1: Promote current Health programs and provide education to residents of Benton CountyActions: *Community events held to provide information, resources, and support in relation to preventive health. *Quarterly education per provider, in-person and/or recorded. Spotlight services/monthly awareness. VGH promotion through news articles and local media. *Promote current services; Diabetes program, Gifts of Hope, PT, Yoga, Childcare, Health Fair, Financial navigator/SHIP, 3D Mammograms *VGH Diabetes prevention program 2019-present. *Benton County Food pantry Flier distributions monthly. HACAP partnership, Feeding America: 10/2022 *The City and Vinton Park and Recreation Department have been working on plans for a new Wellness Center that would be located adjacent to the high school and combine, indoor/outdoor pool areas, gym, walking track, meeting rooms and exercise. This is a partnership that will benefit the community as well as allow Virginia Gay to provide services: diabetes prevention/weight loss/cooking demos/ CPR-first Aide/Baby-sitting/ Coordination support groups/Mental Health peer support/ Grieving/Ministerial services *Daycare partnership in progress *Cancer Screening clinics in collaboration with Mercy HPCCGoal 2: Increase Health prevention services to the residents of Benton CountyActions:*PH clinics: Sexual Health Clinic 8/22 (quarterly), SHIP program 9/22, BP clinics 9/22, Vaccine clinics *Promotion of services events2.Mental HealthGoal 1: Reduce intentional injuries among Benton County residents; reduce percent of Benton County students who have in the past 12 months seriously considered suicide by 1%. Actions: *Community events held to provide information, resources, and support in relation to suicide prevention. *VGH depression screenings on every patient that is 12 years or older. *HACAP 1st Five program offered the ACES training. ASAC, ACES training *Benton County Community School Districts Opportunity for ACES training and Mental health first aide to all teachers and administrators along with suicide awareness. *Depression Screenings at WIC clinics. *Benton County Rural Access promotionGoal 2: Increase mental health services for Benton County residentsActions: *Actively recruiting/hiring behavioral health specialist at Vinton Family Medical Clinic. *Promotion of the mental health services available in Benton County. *Second VGH Full time ARNP hired for Behavioral Health 11/2020. *Promoting and support of The Benton County CISM (Critical Incident Stress Management) Team established 2020.3.Substance AbuseGoal 1: Decrease substance abuse among Benton County Youth; Decrease the percentage of 11th graders who reported it was "easy/very easy" to have access to alcohol by 3%.Actions: *ASAC, Benton County Schools: "What you cannot see" trailer, Upcoming Community Speaker "Steered Straight" *Above the Influence Core Measurement Survey-Benton County Data collection monitoring Iowa Youth Survey Data review and monitoring *Community events held to provide information, resources, and support in relation to substance abuse and prevention.Goal 2: Decrease prescription drug abuse among Benton County residents; increase the number of pounds of prescription medications collected through drop boxes by 50 pounds. Actions: *Provide information to the community on Count, Lock-Up, Dispose campaign through various forms of media and sustainable locations. Example: Benton County Health Fair, Community events. *Posters/fliers distributed to the health care locations throughout the county, including medical clinics and pharmacies. *Promote Take Back Days for prescription medications. *Benton County Above the Influence Coalition. ASAC; Generation Rx and drug drop box materials distributed at 6 locations 9/2021 *Continue to work with Benton County Above the Influence Coalition subcommittees for Substance prevention, Mental HealthResults: *2021: 187 pounds |
| Virginia Gay Hospital, Inc. | Part V, Section B, Line 16j: A summary of the policy and financial assistance information is posted in the emergency, admitting and waiting rooms, admissions and business offices, included with patient bills and information is available on our website. |
| Schedule H, Part V, Section B, Line 7a and 10a: | CHNA and Implementation Strategy:https://myvgh.org/community-health-needs-assessment/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Virginia Gay Nursing & Rehab | ||||
| 502 N 9th Avenue | Vinton | IA | 52349 | Intermediate care facility |
| 2 - Virginia Gay Hosp Home Health Agency | ||||
| 502 N 9th Avenue | Vinton | IA | 52349 | Skilled nursing care, PT, OT, ST, home health aide, homemaker services |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 6a: | The community benefit report is available upon request. |
| Part I, Line 7: | Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio which addresses all patient segments. The cost for subsidized health services on line 7g was determined using the Medicare cost report. |
| Part III, Line 2: | The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. |
| Part III, Line 3: | Virginia Gay Hospital used the percentage of applications denied due to lack of information. |
| Part III, Line 4: | The footnote to the Organization's financial statements can be found on pages 10 and 11 of the attached audited financial statements. |
| Part III, Line 8: | There was a Medicare shortfall for the fiscal year. Even at a loss the Hospital continues to provide services to these patients because access to healthcare and individual's health is important. Therefore, the Hospital considers the Medicare shortfall a community benefit.Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services.Hospital services reimbursed on a fee schedule are not included in the Medicare calculation per the 990 instructions. Had this been reported the total loss from Medicare services would have been $324,350.Medicare fee schedule revenue $ 187,938Medicare estimated costs of care relating to payments (560,595)Net (Shortage) $ (372,657) |
| Part III, Line 9b: | Statements are sent out every 30 days. Up to four statements are sent. Accounts are sent to collections at 121 days, with all collection practices adhering to 501(r) guidelines. If an approved application is received between 122-240 days the account is cancelled from the collection agency. |
| Part VI, Line 2: | The Hospital provides staff to attend Community Coalitions and Advisory Committees which are focused on specific populations and/or community health issues. Examples of the committees include but are not limited to the Benton County (Provider) Coalition, the Benton County Disaster Recovery Coalition, Above the Influence (substance abuse) Coalition and the Benton County Wellness Coalition. These coalitions meet regularly throughout the year, gather/assess data to identify problems, and work towards resolution of the identified problems. Virginia Gay Hospital's staff participates in the community needs assessment process for public health. The target area for the 2022 Community Health Needs Assessment (CHNA) is Benton County, Iowa. Special attention was paid to recruiting diverse subsets of the population to help accurately identify the most critical issues in the area. Following the collection of all the statistical data, each health indicator was analyzed by comparing it regionally, to the state average rate, and national rates to determine the community's priority health concerns. Preventive Health, Mental Health, and Substance Abuse were identified as the highest priority health needs in Benton County. The CHNA and implementation strategy are posted on our website and can be viewed in their entirety at www.myvghinc.org . |
| Part VI, Line 3: | Virginia Gay Hospital is committed to providing charity care to persons who have healthcare needs and are uninsured, underinsured, ineligible for a government program, or otherwise unable to pay for medically necessary care based on their individual financial situation. Virginia Gay Hospital strives to ensure that the financial capacity of people who need health care services does not prevent them from seeking or receiving care. Patients are expected to cooperate with Virginia Gay Hospital's procedures for obtaining charity care or other forms of payment of financial assistance, to contribute to the cost of their care based on their individual ability to pay. The charity care policy includes all departments of the facility, including Vinton Family Medical Clinic, Urbana Family Medical Clinic, Van Horne Family Medical Clinic, Atkins Family Medical Clinic and the Nursing and Rehab. The Virginia Gay Hospital Home Health Agency has a separate financial assistance procedure, due to their Public Health role in the community. VGH has a commitment to establish/maintain effective partnerships throughout the county and work with all entities that influence community health. To improve and strengthen the local planning process multiple community partners have been involved in the CHNA process. Notification about charity care is available by the publication of notices in patient bills, posting of notices in the emergency rooms, admitting and registration departments, the Business Office, and other public places the Hospital may elect. Information is also included on the facility website, and in the patient information packets. A request for charity may be made by the patient or a family member, close friend or associate of the patient, subject to the applicable privacy laws |
| Part VI, Line 4: | The community VGH serves, as defined for the CHNA, is based on the primary service area of our hospital. The major service area is Benton County, serving an estimated population of nearly 26,000 with an area of 716.27 square miles. VGH also services several other counties and states. Per the Iowa Hospital Association Dimensions Program (2020) 82.70% of the 26,070 outpatient visits, were from residents of Benton County and of the 288 VGH inpatient discharges, 82.70% were Benton County residents.Unique to Benton County population is the presence of an AmeriCorps National Civilian Community Corps (NCCC) training campus. AmeriCorps NCCC strengthens communities and develops leaders through direct, team-based national and community service. In partnership with non-profitssecular and faith basedlocal municipalities, state governments, federal government, national and state parks, Indian tribes, and schools, members complete service projects throughout the region they are assigned. AmeriCorps NCCC is a full-time, team-based residential program for men and women ages 18-24.The closest hospitals are located 37 miles away in Cedar Rapids, Iowa. Virginia Gay Hospital currently operates four separate clinics; one clinic is located on the hospital campus in Vinton, another located in the rural town of Van Horne, Iowa which is 15 miles from Vinton, another located in the rural community of Urbana, 13 miles from Vinton, and the other located in the rural community of Atkins which is 19 miles from Vinton. The Hospital and clinics serve a large number of Medicare and Medicaid patients. The median household income for Benton County was $67,729. The 2022 unemployment rate was 5.0%. |
| Part VI, Line 5: | Virginia Gay Hospital is proudly recognized as having one of the lowest costs per stay rates in the state of Iowa. The Hospital offers twenty-five beds in an acute care setting with state of the art technology and professional services. Virginia Gay Hospital also offers 24 hour acute care, short term skilled nursing services, radiology, respiratory care, cardio-pulmonary rehabilitation, physical therapy, occupational therapy, speech therapy, laboratory services, surgical services, outpatient clinics and emergency care. In addition, our staff has contributed multiple hours providing uncompensated time in areas such as family/parenting/sibling education, medical expertise for the schools' athletic teams, health fairs, information and referrals to community services, safety classes, sports physicals and many other uncompensated services.Requirements of the IRS community benefit standard for tax-exempt organizations are integral to the Hospital's larger charitable mission of improving health and quality of life. Specifically, Virginia Gay Hospital is governed by an independent board including community leaders, physicians, consumer representatives, business experts and clinical healthcare experts who reside in our primary service area. The Board has a history of commitment to acting with the highest integrity and has been proactively evaluating opportunities to voluntarily adopt governance best practices to ensure the organization continues to operate with the highest of integrity for the benefit of the community.To meet the needs of our community, the Hospital extends privileges to medical staff that are qualified through licensure in the state of Iowa.Excess funds are reinvested and used for patient care and facility upgrades.Virginia Gay's Home Health Agency offers a variety of services to all ages in the rural population of Benton County, Including Skilled nursing, Home Care Aide and Homemaking services. The Hospital also offers such services as skilled and non-skilled service home care, blood pressure checks, and group teaching classes such as cardiopulmonary resuscitation (CPR), Advanced Life Support (ALS) and Pediatric Advanced Life Support (PALS).In addition, Virginia Gay Hospital, through its integrated network of providers, provides non-emergency services to the community it serves. It makes these services accessible to the community through participation in government programs like Medicare and Medicaid and by offering assistance through their Financial assistance program.Virginia Gay Hospital's Financial Assistance Policy provides discounted and free services to patients who lack the resources to be fully responsible for the health care they receive. The Financial Assistance Policy is designed to ensure the entire community served by the Hospital has access to needed healthcare services.Virginia Gay Hospital takes its mission to improve the health and quality of life of the people it serves a step further by reaching out to meet the broad health needs of the community. It strives to identify community needs beyond basic healthcare, respond to them, aiming to make a positive, life-enhancing difference in the community.Contributing to Community Education: The nursing staff and Home Health Agency nurses participate in several county wide events and community health fairs. These events provide information and guidelines to those in need of medical information.Preventive Care is a Priority: The Hospital has taken steps to enhance preventive care for people of all ages by ensuring that those who come here for preventive care receive the screenings and recommendations appropriate to their personal and family history. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | High School Scholarships | GrantTypeTxt |
| Recipient | 12 | RecipientCnt |
| Cash Grant | $12,500 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | Scholarships were awarded to high school applicants received from 3 school districts in the area. Awards were based on pursuing a career in health related studies, applicant showing a need in support, success in completion of prior class work, and participation in extracurricular activities. A scholarship committee reviewed applications and made recommendations to the VGH Board of Directors for approval to extend scholarships. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dr Brian Meeker DO | ||||||||||||||
| Director | $402,856 | $0 | $273,972 | $0 | $0 | $0 | $6,182 | $0 | $23,374 | $0 | $706,384 | $0 | $0 | $0 |
| Dr Erica Silbernagel DO | ||||||||||||||
| Family Medicine | $289,727 | $0 | $32,167 | $0 | $0 | $0 | $3,727 | $0 | $1,563 | $0 | $327,184 | $0 | $0 | $0 |
| Dr Michelle Elgin DO | ||||||||||||||
| Director | $172,630 | $0 | $89,867 | $0 | $0 | $0 | $1,873 | $0 | $26,392 | $0 | $290,762 | $0 | $0 | $0 |
| Tammy Madsen PA-C | ||||||||||||||
| ER/Hospitalist | $239,487 | $0 | $0 | $0 | $0 | $0 | $3,953 | $0 | $9,103 | $0 | $252,543 | $0 | $0 | $0 |
| Rita Taylor-Stewart PA-C | ||||||||||||||
| Family Medicine | $163,210 | $0 | $73,656 | $0 | $0 | $0 | $3,199 | $0 | $7,506 | $0 | $247,571 | $0 | $0 | $0 |
| Michele Burnes PA-C | ||||||||||||||
| Family Medicine | $153,738 | $0 | $69,324 | $0 | $0 | $0 | $3,243 | $0 | $20,624 | $0 | $246,929 | $0 | $0 | $0 |
| Matthew Wilden PA-C | ||||||||||||||
| ER/Hospitalist | $204,050 | $0 | $0 | $0 | $0 | $0 | $3,631 | $0 | $25,012 | $0 | $232,693 | $0 | $0 | $0 |
| Michele Schoonover | ||||||||||||||
| CEO | $171,164 | $0 | $0 | $0 | $0 | $0 | $3,573 | $0 | $23,024 | $0 | $197,761 | $0 | $0 | $0 |
| Barry Dietsch | ||||||||||||||
| CFO | $165,824 | $0 | $0 | $0 | $0 | $0 | $3,095 | $0 | $1,216 | $0 | $170,135 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dr Michelle Elgin DO | PersonNm |
| Relationship With Org | Director | RelationshipWithOrgTxt |
| Loan Purpose | Forgivable medical educational loan | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $20,000 | OriginalPrincipalAmt |
| Balance Due | $10,000 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $10,000 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Kelly Henkle | |||
| Daughter of Chair, John Ketchen | $94,291 | Compensation as an employee | 0 |
| Shannon Maynard | |||
| Spouse of Director, Bud Maynard | $26,743 | Compensation as an employee | 0 |
| Autumn Conrad | |||
| Family member of Treasurer, John Yundt | $33,905 | Compensation as an employee | 0 |
| Payton Dietsch | |||
| Family member of CFO, Barry Dietsch | $7,440 | Compensation as an employee | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 1a | The Executive Committee consists of the officers of the Board of Directors. The Executive Committee has the power to transact all regular business of the Hospital during the period between the meetings of the Governing Board, subject to any prior limitation imposed by the Governing Board and with the understanding that all matters of major importance will be referred to the Governing Board. The Executive Committee must submit to the Governing Board at its last meeting before the end of the fiscal year, a budget showing the expected receipts, income, and expense for the coming year. Minutes of the Executive Committee meetings must be submitted to the Board, and its actions are subject to approval or disapproval at the next regular board meeting. |
| Form 990, Part VI, Section A, line 7a | One of the Directors of the Board is the Mayor of the city of Vinton, Iowa. Two Directors are appointed by the Mayor and approved by the City Council of the City of Vinton for such terms as the City Council determines. One of these appointments is a physician in active practice and a resident of Benton County, Iowa. The second Director appointed by the City of Vinton is a resident of Benton County, Iowa. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is distributed to the Board members prior to filing. The 990 is reviewed by the Hospital's CEO and CFO. |
| Form 990, Part VI, Section B, line 12c | Any director, officer, key employee, Medical Staff member or committee member having an existing or potential interest in a contract or other transaction presented to the Board of Directors for deliberation, authorization, approval, or ratification, or any such person who reasonably believes such an interest exists in another person should make a prompt disclosure of the interest to the Board or committee prior to its acting on such contract or transaction. The interested party is required to disclose the nature and extent of his/her interest and any relevant and material facts known to him/her about the contract or transaction which might reasonably be construed to be adverse to the organization's interest. The Board requires annual statements from officers, directors, key employees, and key members of the Medical Staff. The body to which such disclosure is made determines, by majority vote, whether the disclosure shows that the non-voting and non-participation provisions below must be observed. If so, such persons should not vote on, nor use his/her personal influence on, nor participate (other than to present factual information or to respond to questions) in the discussions or deliberations with respect to such contract or transaction. Such persons may not be counted in determining the existence of a quorum at any meeting where the contract or transaction is under discussion or is being voted upon. The minutes of the meeting reflect the disclosure made and, where applicable, the abstention from voting and participation and whether a quorum was present. |
| Form 990, Part VI, Section B, line 15 | The Board Wage & Salary Committee and full board reviews compensation increases for the CEO based on annual evaluations and the IHA Salary Survey. Comparisons to state averages are used. Substantiation of the deliberation and decision is documented in the Board minutes. The process is completed annually. The CEO determines compensation for the CFO with approval from the Board Wage & Salary committee and full Board, based on annual performance evaluations and the IHA Salary Survey. Contemporaneous substantiation of the deliberation and decision is provided for any actions taken regarding compensation. The process is completed annually. |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents, conflict of interest policy, and financial statements are not available to the public. Financial information is available through the public disclosure copy of the 990. |
| Form 990, Part IX, line 11g | Purchased services: Program service expenses 5,617,891. Management and general expenses 997,116. Fundraising expenses 0. Total expenses 6,615,007. OTHER PURCHASED SVCS-FOUNDATN: Program service expenses 0. Management and general expenses 0. Fundraising expenses 2,700. Total expenses 2,700. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Virginia Gay Trust | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 502 N 9th Avenue | AddressLine1Txt |
| City | Vinton | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52349 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 426367590 | EIN |
| Primary Activities | Provide financial support for Virginia Gay Hospital, Inc. | PrimaryActivitiesTxt |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 12c, III-FI | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Virginia Gay Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Share Of EOY AssetsShareOfEOYAssetsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Vernon S Flechner Trust | ||||||||||||
| 502 N 9th Avenue | Vinton | IA | 52349 | 426351376 | Provide income for maint of the Hospital and annex buildings | IA | Virginia Gay Hospital Inc | T | $43,839 | 1.00000 | Yes (1) | |
| JW Fry Trust | ||||||||||||
| 502 N 9th Avenue | Vinton | IA | 52349 | 426287710 | Provide unrestricted and corpus restricted income for Hospital additions | IA | Virginia Gay Hospital Inc | T | $182,656 | 1.00000 | Yes (1) | |
| Cedar View Retirement Community Inc | ||||||||||||
| 502 N 9th Avenue | Vinton | IA | 52349 | 421398570 | Provide an 18-unit housing alternative for the elderly | IA | Virginia Gay Hospital Inc | C | $32,155 | 1.00000 | Yes (1) | $423,247 |
| 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 | 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 | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | 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 |