2023-05-15T00:02:18-07:00 2022-06-30 990 2021-07-01 920077523 CENTRAL PENINSULA GENERAL HOSPITAL INC CENT 9077144404 250 Hospital Place Soldotna AK 99669 Michael Haggerty CFO 9077144722 2023-05-14 1 11 0 AAL2 2021 2023-04-26 12:10:37Z Central Peninsula Hospital Rick Davis 250 Hospital Pl Soldotna AK 99669 543906884 0 X www.cpgh.org X 1994 AK We are a community initiated and community nurtured organization dedicated to promoting wellness and providing high quality health care that ensures the confidence and loyalty of our patients. We strive to improve individual and community health and achieve national standards of excellence. 11 9 1290 22 0 0 6711148 10124702 445695829 527906761 76169 191332 6183898 4725227 458667044 542948022 116500 94600 0 0 110959040 116490870 0 0 0 339965839 403934445 451041379 520519915 7625665 22428107 268737849 288336932 79971786 77142762 188766063 211194170 X We are a community initiated and community nurtured organization dedicated to promoting wellness and providing high quality health care that ensures the confidence and loyalty of our patients. We strive to improve individual and community health and achieve national standards of excellence. We are dedicated to providing the highest quality patient and resident centered care in a healing environment. 1 0 451645213 0 459466891 Our 49 bed hospital provided patient and ancillary services to 2,602 inpatients and 166,021 outpatients during the 2021 tax year. The hospital provides emergency medical services regardless of ability to pay. Emergency medical services were provided to 17,438 individuals, and 2,061 of those individuals were admitted to the hospital. 4,575 surgical procedures were performed in the hospital during the tax year. The imaging department performed 52,320 procedures. 68,483 physical therapy 15-minute procedures were provided to area residents. During the 2021 tax year, free medical services in the amount of $7,853,209 (gross charges) were provided to patients eligible for charity care. 14502703 0 13234559 Skilled nursing and long term care services were provided by our 60 bed skilled nursing facility. Heritage Place provides healing and compassionate residential care in a home like setting. Total resident days of care for the 2021 tax year were 18,340 days. An average of 50 residents per day were provided long term care and nursing. Ancillary services for residents included 3,835 therapy treatments. 51089091 0 55205311 The hospital operates 12 family and specialty physician services clinics providing care in the following areas: Family Medicine, Pediatrics, Neurology, Surgery, Urology, Podiatry, Internal Medicine, Women's Health, Orthopedics, Oncology, Pain Management, and outpatient substance abuse treatment. During the 2021 tax year physician and specialty services were provided for 44,341 visits. The Urgent Care clinic which began operations in tax year 2020 to provide for emergent care visits outside of the hospital had 6,954 visits during the year. 0 0 0 517237007 1 1 0 1 0 0 1 0 0 0 1 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 1 111 0 1 1290 1 1 1 0 0 0 0 0 0 0 X 11 9 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X X Central Peninsula Hospital Finance Department 9077144627 250 Hospital Place Soldotna AK 99669 Michael Reyes Orthopedic Surgeon 40 X 1398527 0 26866 Darren Mullins Oncologist 40 0 X 1169749 0 26866 Robert Cadoff Urologist 40 0 X 1046130 0 17950 Gregory Hough Surgeon 40 0 X 867721 0 53836 David King Surgeon 40 0 X 869469 0 26866 Gregg Motonaga Anesthesiologist/Board Member 44 0 X X 852617 0 23164 Rick Davis CEO 40 0 X 632311 0 39520 John Bramante Physician/Board Member 40 0 X 483424 0 36691 Shaun Keef COO 40 0 X 329772 0 43383 Karen Scoggins CNO 40 0 X 293108 0 32825 Michael Haggerty CFO 40 0 X 262690 0 21546 James McHale Board President 8 X 15000 0 0 Lynda Columbia Board Member 4 0 X 3500 0 0 Carrie Couey Board Secretary/Treasurer 4 0 X 3300 0 0 Jay Rohloff Board Member 4 0 X 3300 0 0 Trena Richardson Board Member 4 0 X 3250 0 0 Steve Horn Board Vice President 8 0 X 3000 0 0 Mark Dixson Board Member 4 0 X 2850 0 0 Maxwell Best Board Member 4 0 X 2500 0 0 Mark Premo Board Member 4 0 X 2450 0 0 Paul Ostrander Board Member 4 0 X 0 0 0 Jesse Kincaid Board Member 4 0 X 0 0 0 8244668 0 349513 192 0 1 0 Medical Solutions LLC dba Focusone Solutions LLC 1010 N 102nd St Ste 300 Omaha NE 68114 Contract Labor Provider 1858131 Alaska Hospitalist Group LLC 4300 B Street Suite 200 Anchorage AK 99503 Physician Services - Hospitalist 1194475 David Rankine 250 Hospital Pl Soldotna AK 99669 Physician Contractor 456795 CHG Companies Inc dba Comphealth PO Box 972651 Dallas TX 753972651 Contract Labor Provider 190222 Derek Leichliter dba Legacy Electric LLC 255 N Aspen Soldotna AK 99669 Electrical Contractor 157572 11 0 0 0 30203 1972376 8122123 0 10124702 Hospital service revenue 622000 459466891 459466891 0 0 Skilled nursing revenue 623000 13234559 13234559 0 0 Outpatient physician clinic revenue 621110 55205311 55205311 0 0 0 0 0 0 527906761 191332 191332 0 0 0 0 0 0 0 0 0 0 776141 0 755679 0 20462 0 20462 20462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630048 203183 426865 426865 0 0 USAC telephone subsidy 622000 925794 925794 0 0 340b pharmacy rebate program 622000 1162089 1162089 0 0 Property tax revenue 622000 57920 57920 0 0 2132097 2132097 0 0 4277900 542948022 532823320 0 0 94600 94600 0 0 0 0 0 0 8406713 5408423 2998290 0 0 0 0 0 82651165 82651165 0 0 2264592 2264592 0 0 17571165 17571165 0 0 5597235 5597235 0 0 0 0 0 0 150046 0 150046 0 119977 0 119977 0 14595 0 14595 0 0 0 0 0 18760801 18760801 0 0 181640 181640 0 0 659277 659277 0 0 9283179 9283179 0 0 0 0 0 0 3216009 3216009 0 0 70559 70559 0 0 0 0 0 0 345296 345296 0 0 1707501 1707501 0 0 0 0 0 0 13213350 13213350 0 0 664731 664731 0 0 Medicare deductions 153179341 153179341 0 0 Medicaid deductions 70845719 70845719 0 0 All other deductions 71854511 71854511 0 0 Charity & bad debt expense 14706669 14706669 0 0 44961244 44961244 0 0 520519915 517237007 3282908 0 43526661 45854334 4011943 4179194 393765 207870 31145401 32919187 0 0 0 0 0 0 7798125 9040421 3784743 2630874 222484344 114571767 114129115 107912577 0 0 500000 500000 0 0 0 0 63448096 85092475 268737849 288336932 17749020 17830996 0 0 14282 2583500 60397542 52488943 0 0 0 0 0 0 0 0 1810942 4239323 79971786 77142762 X 188766063 211194170 0 0 188766063 211194170 268737849 288336932 22428107 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 953 0 1 13642 14595 0 Schedule C, Part II-B, Line 1 Line 1(g) consists of compensation for employees for one trip to meet with representatives regarding Medicaid expansion and the Medicare Rural Community Hospital Demonstration project. Line 1(i) consists of the portion of membership dues paid to organizations that were spent on lobbying activities. These organizations were the American Hospital Association and the Alaska State Hospital & Nursing Home Association. X 1 40 0 0 0 1 0 0 0 0 5420257 0 5420257 114883170 0 53562446 61320724 459923 0 329488 130435 96430684 0 58110297 38320387 5290310 0 2569536 2720774 107912577 Plant Replacement Fund 75303336 Debt service account 6368962 Bond reserve held in escrow 2056203 Cash from bond proceeds 942501 Deferred loss on bond refunding 421473 85092475 0 Due to third parties 4239323 4239323 240192833 0 0 0 977591 977591 239215242 0 303732780 303732780 542948022 217947845 0 0 0 1160710 1160710 216787135 0 303732780 303732780 520519915 Schedule D, Part II, Line 9 In 2008, the Hospital purchased a building which resides on 40 acres of land subject to a perpetual covenant for the benefit of all Alaska residents, restricting the use of the land for agricultural purposes pursuant to AK Statute 38.05.321. The building on this property is used by the Hospital's chemical dependency unit. There is no value placed on the easement itself and therefore it does not appear on the financial statements. However, the cost of the real property is recorded on the Hospital's balance sheet at its net book value. Schedule D, Part XI, Line 2d Cost of goods sold in the amount of $684,395 are required to be reported at net for durable medical equipment on the 990, Part VIII line 10b. COGS is reported as an expense on the audited financial statements. Expenses from the Foundation in the amount of $293,196 are also included in the audited financial statements, however they are excluded from the Part VIII totals. The Foundation is a separate legal entity and although it is reported in consolidated statements with the Hospital, it files its own 990. Schedule D, Part XI, Line 4b Deductions from revenue in the amount of $303,732,780 are reported as expenses in Part IX lines 24 a-d on the 990, however they are reported net of revenue on the audited financial statements. Schedule D, Part XII, Line 2d Cost of goods sold in the amount of $684,395 are required to be reported at net for durable medical equipment on the 990, Part VIII line 10b. COGS is reported as an expense on the audited financial statements. Expenses from the Foundation in the amount of $476,315 are also included in the audited financial statements, however they are excluded from the Part VIII totals. The Foundation is a separate legal entity and although it is reported in consolidated statements with the Hospital, it files its own 990. Schedule D, Part XII, Line 4b Deductions from revenue in the amount of $303,732,780 are reported as expenses in Part IX lines 24 a-d on the 990, however they are reported net of revenue on the audited financial statements 1 1 X 1 X 1 X 1 1 1 0 0 1 545 2727592 0 2727592 0.0132 1 0 39708223 37773363 1934860 0.0093 0 0 0 0 0 0 2 545 42435815 37773363 4662452 0.0225 109 15924 860699 47090 813609 0.0039 44 544 52311 1850 50462 0.0002 21 0 27655463 16659339 10996124 0.0531 3 108 5638 750 4888 0 999 296 264737 0 264737 0.0013 1176 16872 28838848 16709029 12129820 0.0585 1178 17417 71274663 54482392 16792272 0.0810 1 6853461 1883007 54842139 62366579 -7524440 X 1 1 1 1 Central Peninsula Hospital 250 Hospital Place Soldotna AK 99669 www.cpgh.org X X X Central Peninsula Hospital 1 0 0 1 X X X X X X X X 20 1 0 0 1 X www.cpgh.org 1 20 1 www.cpgh.org 0 0 1 X 200 300 X X X X X 1 1 X X X 1 X www.cpgh.org/Patient Financial Services X www.cpgh.org/PatientFinancialServices X www.cpgh.org/PatientFinancialServices X X X X X X 1 X 1 X X X X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-Central Peninsula Hospital Every three years, the Hospital conducts a Community Health Needs Assessment to evaluate the needs of the community. This report is prepared by an independent contractor who conducts surveys and interviews community members. The most recent report was prepared for FY2020 - 2022 and indicates that the categories showing the largest increase in perceived need from the prior reporting period were Mental Health Services, Access to Primary Care providers, and Outpatient Urgent Care. In response to these findings, the Hospital has been working to recruit primary care physicians, and has successfully recruited 4 Family Medicine physicians and 2 Internal Medicine physicians. The Hospital also purchased an existing Internal Medicine practice so that Medicare patients can be seen more easily. An Urgent Care clinic was opened in January 2020 to meet emergent needs that do not need to be seen in the emergency department. This clinic is staffed by emergency department physicians. Regarding Mental Health Services, we have contracted with Alaska Regional Hospital to provide for tele-psychiatry services. We also have our detox unit in place, which is up and running with good success. We have also opened a new transitional housing facility. A new Cath Lab was also opened to provide services not previously available on the Kenai Peninsula; including most recently spine injections for long-term pain management. In addition, the Hospital continues to collaborate with local area medical providers, patients, hospital associations and local governments to determine whether community health needs are being met and where opportunities for improvement may exist. Schedule H, Part V, Section B, Line 11-Central Peninsula Hospital Every three years, the Hospital conducts a Community Health Needs Assessment to evaluate the needs of the community. This report is prepared by an independent contractor who conducts surveys and interviews community members. The most recent report was prepared for FY2020 - 2022 and indicates that the categories showing the largest increase in perceived need from the prior reporting period were Mental Health Services, Access to Primary Care providers, and Outpatient Urgent Care. In response to these findings, the Hospital has been working to recruit primary care physicians, and has successfully recruited 4 Family Medicine physicians and 2 Internal Medicine physicians. The Hospital also purchased an existing Internal Medicine practice so that Medicare patients can be seen more easily. An Urgent Care clinic was opened in January 2020 to meet emergent needs that do not need to be seen in the emergency department. This clinic is staffed by emergency department physicians. Regarding Mental Health Services, we have contracted with Alaska Regional Hospital to provide for tele-psychiatry services. We also have our detox unit in place, which is up and running with good success. We have also opened a new transitional housing facility. A new Cath Lab was also opened to provide services not previously available on the Kenai Peninsula. In addition, the Hospital continues to collaborate with local area medical providers, patients, hospital associations and local governments to determine whether community health needs are being met and where opportunities for improvement may exist. Schedule H, Part V, Section B, Line 13h-Central Peninsula Hospital Employment status, family size, and catastrophic circumstances. Schedule H, Part V, Section B, Line 16j-Central Peninsula Hospital Hospital admissions staff attempt to provide a financial assistance brochure to each patient during admission or discharge. The brochure is also available in hard copy at hospital entrances and in the various departments and clinics. It is also available on our website. Financial counselors personally contact all patients with past due balances to explain the policy and their options. They offer assistance with filling out the application and are able to set up monthly payment plans as needed. 20 Heritage Place 232 Rockwell Ave Soldotna AK 99669 Skilled nursing facility, longterm care Serenity House 47480 Kristina Way Soldotna AK 99669 Chemical dependency treatment center River Tower Oncology 240 Hospital Place Suite 301 Soldotna AK 99669 Oncology services River Tower Outpatient Imaging 240 Hospital Place Suite 102 Soldotna AK 99669 Outpatient imaging services Central Peninsula Internal Medicine 247 N Fireweed St Suite A Soldotna AK 99669 Internal Medicine physicians Central Peninsula Family Practice Kenai 506 Lake Street Kenai AK 99611 Family practice clinic Central Peninsula Family & Pediatrics 245 N Binkley St Suite 101 Soldotna AK 99669 Family practice clinic Central Peninsula Foot & Ankle 240 Hospital Place Suite 203 Soldotna AK 99669 Podiatry clinic Central Peninsula Surgical Associates 240 Hospital Place Suite 305 Soldotna AK 99669 Surgical clinic Central Peninsula Bone & Joint Center 240 Hospital Place Suite 204 Soldotna AK 99669 Orthopedic clinic Central Peninsula Urology 240 Hospital Place Suite 303 Soldotna AK 99669 Urology clinic Central Peninsula Women's Health 108 E Corral St Soldotna AK 99669 OB/Gyn Physician Medical Office Central Peninsula Neurology 262 N Binkley Street Soldotna AK 99669 Neurology clinic Central Peninsula Urgent Care 10128 Kenai Spur Hwy Kenai AK 99611 Urgent Care clinic Serenity House Medical Clinic 245 N Binkley St Soldotna AK 99669 Outpatient substance abuse treatment Central Peninsula Care Transitions 354 Tyee St Soldotna AK 99669 Detox Center - Undergoing remodel during tax year 2016 Central Peninsula Hospital Transitional Living Ctr 362 Tyee Street Soldotna AK 99669 Transitional Living Center Kenai Physical Medicine 260 Caviar St Kenai AK 99611 Physical therapy clinic Soldotna Physical Medicine 245 N Binkley Soldotna AK 99669 Physical Therapy clinic Kenai Health Center 630 Barnacle Way Kenai AK 99611 Diagnostic imaging, lab, and domestic violence services Schedule H, Part I, Line 7 In most cases, the costs listed in Line 7 are the actual costs associated with these programs. In cases where the costs for certain activities is too cumbersome to compile, the cost to charge ratio from the most recently filed Medicare Cost Report was used. Schedule H, Part I, Line 7, Column f Bad debt expense of $6,853,461 was reported gross in Part IX, line 25 functional expenses. However, they were reported at cost in Schedule H based on the cost to charge ratio. Schedule H, Part I, Line 7g The Hospital included losses from subsidized Physician Clinics in Part I, Line 7(g) for family practice and specialty physician practices. Losses included are as follows: Oncology ($1,090,941), Urgent Care ($929,448, Serenity House Detox Center ($515,356) and Medical Center ($929,448), Surgical Services ($171,119), Soldotna Family & Pediatrics ($1,068,425), Neurology ($345,213), Women's Health ($335,532), Foot & Ankle ($58,186), Internal Medicine ($1,219,729), and Kenai Family Practice ($1,096,592). Schedule H, Part III, Section A, Line 4 Bad debt provisions are made for the amount of revenue that will not be collected from patients to whom services were billed but not paid. The Hospital has determined these patients are neither medically nor financially indigent and do not qualify for the Hospital's charity care program. Bad debt provisions are determined by management's assessment with consideration of business and economic conditions, changes and trends in healthcare coverage, and other collection indicators. the adequacy of this provision is periodically reviewed and further modified based upon the accounts receivable payor composition and aging, and historical write-off experience by payor category. Schedule H, Part III amounts are based on the combined Medicare and Medicaid cost to charge ratio per our most recently filed cost report. It is our belief that all of these bad debts should be considered a community benefit because they provide a necessary and vital health benefit to the community members we serve, regardless of ability to pay. Schedule H, Part III, Section B, Line 8 It is our belief that the shortfall in actual receipts from Medicare compared to the cost to provide care to Medicare patients should be considered a community benefit. The Hospital is required to write off all contractual allowances for Medicare patients regardless of the amount of the shortfall. The Hospital may only collect the portion which is a patient's copay or deductible and may not engage in collection efforts on the remainder. Medicare patients comprise a significant percentage of our community members, and we must provide needed medical services to this population irrespective of the amount of payment we will receive. Schedule H, Part III, Section C, Line 9b The Hospital's collection policy addresses private pay patients and defines the individuals who are eligible to receive financial assistance based on either financial or medical indigence. The collection policy refers to the charity care policy for instruction for determining eligibility. As noted in Part I, the charity care policy is based on FPG which is the basis for a sliding scale between 200 and 300% of those guidelines. Applicants at the upper end of the scale are eligible for a discount on their bill, while those on the lower end of the scale are eligible for free care. Schedule H, Part VI, Line 2 In addition to the Community Health Needs Assessment and strategic plan, the Hospital also determines health deficiencies in the community in other ways. Hospital Administrators round on patients and meet regularly with an advisory committee comprised of area residents and former patients to determine the needs of the community. An open dialogue exists between Hospital management, community leaders, local governing bodies, patients, staff and medical providers. This community engagement fosters trust in addition to identifying community needs. Schedule H, Part VI, Line 3 Hospital admissions staff attempt to provide a financial assistance brochure to each patient during admission or discharge. The brochure is also available in hard copy at hospital entrances and in the various departments and clinics. It is also readily available on our website. Financial counselors personally contact all patients with past due balances to explain the policy and their options. They also offer assistance with filling out the application and can set up monthly payments as needed. Schedule H, Part VI, Line 4 The area served by the Hospital is located on the Kenai Peninsula in South Central Alaska. According to the Kenai Peninsula Borough's FY2022 budget, in 2021 the Kenai Peninsula Borough had a population of 58,934 residents. Schedule H, Part VI, Line 5 The Hospital engages in numerous community initiatives year-round to improve health and awareness in our service area. In addition to providing monetary donations, the Hospital makes public service announcements on important healthcare issues, provides health professional educational opportunities, holds health fairs and immunization clinics, publishes community health newsletters, and provides meeting space for health and community activities. 1 Hospice of the Central Peninsula Inc PO Box 2584 Soldotna AK 99669 920118643 501c3 36000 0 actual monetary donation Bereavement Program and Root Beer Fun Run sponsorship Kenai Peninsula Food Bank 33955 Community College Dr Soldotna AK 99669 943112445 501c3 13500 0 actual monetary donation Soup Supper sponsorship and 'It's Scary to be Hungry' donation American Cancer Society Inc PO Box 230148 Anchorage AK 99523 131788491 501c3 11000 0 actual monetary donation Hooked on a Cure and Relay for Life sponsorships ASHNHA 1049 W 5th Ave Ste 200 Anchorage AK 99501 920034538 501c6 10000 0 actual monetary donation FY22 and FY23 conference sponsorship Kenai Watershed Forum 44129 Sterling Hwy Soldotna AK 99669 911829284 501c3 7500 0 actual monetary donation 2021 Salmon Run Series sponsorship Bridges Community Resource Network PO Box 1612 Soldotna AK 99669 920151271 501c4 6600 0 actual monetary donation Imagination Library Program, DKM Alaskan Swimmer, Golf Tournament, and Kenai River Disc Golf Club sponsorship 9 9 Schedule I, Part I, Line 2 The Hospital provides cash contributions to local organizations which support community initiatives and healthy living on the Kenai Peninsula. Contributions are only made to organizations in good community standing. Hospital management is responsible for authorizing any assistance to outside organizations and do so with discretion. X 0 1 X X X X X 0 1 0 1 0 1 0 0 0 Michael Reyes Orthopedic Surgeon 1097821 0 163979 0 136727 0 6294 0 26265 0 1431086 0 0 0 Robert Cadoff Urologist 1035378 0 50 0 10702 0 6294 0 16387 0 1068811 0 0 0 David King Surgeon 688678 0 91822 0 88968 0 6294 0 24202 0 899964 0 0 0 Gregory Hough Surgeon 654857 0 99482 0 113382 0 6294 0 59031 0 933046 0 0 0 Gregg Motonaga Anesthesiologist/Board Member 796915 0 51746 0 3956 0 6294 0 25577 0 884488 0 0 0 Rick Davis CEO 438590 0 86621 0 107101 0 18948 0 24702 0 675962 0 0 0 Shaun Keef COO 251190 0 26554 0 52028 0 12986 0 35762 0 378520 0 0 0 Karen Scoggins CNO 222309 0 24115 0 46684 0 12253 0 25952 0 331313 0 0 0 Michael Haggerty CFO 207057 0 16294 0 39339 0 11572 0 12633 0 286895 0 0 0 Schedule J, Part I, Line 1a Gross up payments are made for certain taxable fringe benefits including life insurance over $50,000. A year-end wage adjustment is made for all employees to include the gross up for fringe benefits and excess life insurance benefits. The Hospital has historically paid all Social Security and Medicare taxes on such benefits while the employee is responsible for all federal income taxes. Schedule J, Part I, Line 1b The year-end gross up adjustment for fringe benefits and life insurance over $50,000 is based on historical practice and is not based on a written policy. Schedule J, Part I, Line 3 The Hospital contracts with an independent consultant every 3 years to perform a review of executive salaries and benefits. The most recent review was completed in August 2020. The resulting report is provided to the Board and Management for review. The Board then sets compensation levels for the CEO through a written employment agreement. The CEO is responsible for hiring the rest of the Hospital's executive team and for using comparable data studies to set competitive salary packages. Schedule J, Part I, Line 4 The Hospital provides a 457 top hat plan to certain key employees and executives. The individuals listed on Schedule J participated in the plan and either deferred their own compensation or received hospital contributions into the plan during the tax year. Schedule J, Part I, Line 5 In accordance with their employment agreements, Emergency Department physicians receive a percentage of their professional fees billed as compensation. The compensation is not based directly on the Hospital's overall revenue, but rather on individual charges that are generated by the Physician. The compensation method is considered reasonable and customary for these employed physicians. Schedule J, Part I, Line 6 The Hospital has an annual incentive plan for all employees. Incentive is based on a series of operational and quality measures in order to maintain the highest standard of patient care. One of the measures is meeting the Hospital's financial budget. The incentive is not calculated based on actual earnings. Other measures include Quality of Care indicators and Patient Satisfaction. A Kenai Peninsula Borough 920030894 01179PX51 2011-09-15 27905000 Refunding bonds - 2011 GO 0 0 1 B Kenai Peninsula Borough 920030894 01179RDP5 2014-02-20 32490000 2014 Medical Office Building construction bonds 0 0 1 C Kenai Peninsula Borough 920030894 001179RJV 2015-06-15 3200000 2015 Medical Office Building construction bonds 0 0 0 D Kenai Peninsula Borough 920030894 000000000 2016-06-09 3050000 2016 Medical Office Building construction bonds 0 0 0 A 0 0 32616814 0 0 0 201610 0 0 0 0 2008 0 1 1 1 B 0 0 34999563 3700147 1813599 1001345 127595 0 0 35043223 0 0 2016 0 0 1 1 C 0 0 3200000 544993 35169 121683 22868 0 0 3200000 0 0 2016 0 0 1 1 D 0 0 3076238 563191 0 184013 17500 0 0 2920881 0 155560 2016 0 0 0 1 A 0 0 0 0 0 0 0 0 0 1 B 0 1 0 0 0.11 0 0.11 1 0 1 C 0 1 0 0 0.11 0 0.11 1 0 1 D 0 1 0 0 0.11 0 0.11 1 0 1 A 0 0 0 0 1 0 0 0 0 B 0 1 0 0 1 0 0 0 1 C 0 1 0 0 1 0 0 0 1 D 0 1 0 0 1 0 0 0 1 A Kenai Peninsula Borough 920030894 01179RXH1 2017-11-29 28955000 2018 Cath Lab and OB construction bonds 0 0 1 B Kenai Peninsula Borough 920030894 000000000 2021-06-28 6927370 Refunding bonds - 2011 GO 0 0 1 A 0 0 29903168 2759082 0 699083 436394 0 0 29116867 0 786301 2020 0 0 0 1 B 0 0 6927370 0 0 0 26118 0 0 6927370 0 0 2021 1 0 1 1 A 0 1 0 0 0.11 0.11 1 0 1 B 0 1 0 0 0.11 0 0.11 1 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 Gregg Motonaga Employee and Board Member 852617 Total compensation and benefits 0 John Bramante Employee and Board Member 483424 Total compensation and benefits 0 Form 990, Part III, Line 2 The organization opened a new Pain Management Clinic staff with a part-time provider to offer interventional pain management services to the community. Form 990, Part VI, Section A, Line 7b The Executive team and Board Members complete annual conflict of interest statements which are reviewed by management and the Finance team to assess independence. The Board reviews and discusses any conflicts of interest which arise throughout the year and takes appropriate action. If a conflict arises, the Board Member in conflict will abstain from voting on the applicable resolution. Form 990, Part VI, Section B, Line 11b The 990 is prepared by the Hospital's Controller and submitted to Hospital Administration for review. Edits may be suggested and incorporated into the filing. Draft 990's and supporting schedules are then submitted to the Finance Committee and Board Members for review and comment before final filing. Form 990, Part VI, Section B, Line 12c The Executive team and Board Members complete annual conflict of interest statements which are reviewed by management and the Finance team to assess independence. The Board reviews and discusses any conflicts of interest which arise throughout the year and takes appropriate action. If a conflict arises, the Board Member in conflict will abstain from voting on the applicable resolution. Form 990, Part VI, Section B, Line 15 An independent professional executive compensation study is performed every 3 years. The most recent study was completed in May 2020. These reports are submitted to the Board for review and are used to set the wage scale for the CEO. Form 990, Part VI, Section C, Line 19 The Hospital makes it audited financial statements and governing documents available to the public for inspection upon request. Copies of the audited financial statements are supplied to the Executive team and Board Members, as well as the Kenai Peninsula Borough. The lead auditor presents a presentation to the Board discussing how the audit went and the overall results. The Hospital's 990 is widely available to the public on Guidestar.com and other websites. Central Peninsula Health Foundation 250 Hospital Place Soldotna AK 99669 202778670 To support quality healthcare activities AK 501(c)3 Public Charity N/A 0 Kenai Peninsula Borough 144 N Binkley Street Soldotna AK 99669 920030894 Local Government owns hospital assets AK 115 N/A 0 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 1 0 1 0 Central Peninsula Health Foundation c 30203 This amount represents total contributions received from the Foundation in payment for programs, capital and grants to individuals for assistance. The Hospital pays these expenses and is then reimbursed by the Foundation. Central Peninsula Health Foundation j 14184 The Hospital provides office space to the Foundation Director for the cost of $1,182 per month. This includes all costs to maintain the space, such as utilities and janitorial services. Central Peninsula Health Foundation m 30203 The Foundation performs fundraising activities for which substantially all of the donations are intended to benefit the Hospital and its various programs. Central Peninsula Health Foundation n 14184 The Hospital provides office space to the Foundation Director for the cost of $1,182 per month. This includes all costs to maintain the space, such as utilities and janitorial services. Central Peninsula Health Foundation o 126180 The Hospital shares employees for Directorship and Accounting functions necessary to operate the Foundation. This amount represents associated salaries and benefits. Kenai Peninsula Borough k 1 The Hospital is operated by Central Peninsula General Hospital, Inc. through an operating agreement with the Kenai Peninsula Borough. The amount of the agreement is $1.00 per annum. Kenai Peninsula Borough p 10254963 During the current tax year, the Hospital reimbursed the Kenai Peninsula Borough for bond debt service, insurance premiums, refuse, and sales tax payments. This amount represents those cash payments. Filed Form 8868 to extend due date to May 15, 2023. Received approval from IRS with notice date of August 22, 2022.