2025-05-06T14:57:00-07:00 2024-06-30 990 2023-07-01 920077523 CENTRAL PENINSULA GENERAL HOSPITAL INC CENT 9077144404 250 Hospital Place Soldotna AK 99669 Michael Haggerty CFO 9077144722 2025-05-06 1 2023 2025-03-06 01:10:19Z Central Peninsula Hospital Shaun Keef 250 Hospital Place Soldotna AK 99669 658287062 0 X www.cpgh.org X 1994 AK The mission of Central Peninsula Hospital is to nurture our community by promoting health and wellness through quality healthcare. Our vision is to focus on the needs of individuals guided by people's preferences and values, in a culture of quality, compassion, and partnership. 11 10 1378 92 0 0 2841792 1911646 597617379 647720535 1856232 4510277 3894443 3551276 606209846 657693734 98245 83900 0 0 123972966 136876964 0 0 0 460163046 504044907 584234257 641005771 21975589 16687963 308441653 318187566 75286912 68344862 233154741 249842704 The mission of Central Peninsula Hospital is to nurture our community by promoting health and wellness through quality healthcare. Our vision is to focus on the needs of individuals guided by people's preferences and values, in a culture of quality, compassion, and partnership. 0 0 548716429 554234458 Our 49 bed hospital provided patient and ancillary services to 2,681 inpatients and 187,334 outpatients during the 2023 tax year. The hospital provides emergency medical services regardless of ability to pay. Emergency medical services were provided to 17,081 individuals, and 2,021 of those individuals were admitted to the hospital. 5,500 surgical procedures were performed in the hospital during the tax year. The imaging department performed 59,755 procedures. 84,154 physical medicine 15-minute procedures were provided to area residents. During the 2023 tax year, free medical services in the amount of $9,514,847 (gross charges) were provided to patients eligible for charity care. 14647504 13602348 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 2023 tax year were 17,121 days. An average of 47 residents per day were provided long term care and nursing. Ancillary services for residents included 4,649 therapy treatments. 75601735 79883729 The hospital operates 16 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, Spine, Diabetes Management, Gastroenterology, and outpatient substance abuse treatment. During the 2023 tax year physician and specialty services were provided for 51,230 visits. The Urgent Care clinic which began operations in tax year 2020 to provide for emergent care visits outside of the hospital had 8,087 visits during the year. 0 0 0 638965668 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 1 149 0 1 1378 1 1 1 0 0 0 0 0 0 0 X 11 10 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 0 X X 1405512 0 31413 Herbert Bote Orthopedic Surgeon 40 0 X 1100877 0 29938 John Andreshak Spine Surgeon 40 0 X 1052197 0 32324 David King Surgeon 40 0 X 936044 0 30913 Robert Cadoff Urologist 40 0 X 945284 0 19122 Gregg Motonaga Anesthesiologist/Board Member 40 0 X X X 849041 0 31413 Jason Lattin Surgeon 40 0 X X 768531 0 84061 Gregory Hough Surgeon 40 0 X X 809721 0 42808 Darren Mullins Oncologist 40 0 X X 670945 0 22773 Shaun Keef CEO 40 0 X 559377 0 53555 John Bramante Physician/Board Member 40 0 X X 563158 0 42808 Karen Scoggins CNO/COO 40 0 X 333443 0 37701 Michael Haggerty CFO 40 0 X 305811 0 24760 Rick Davis CEO 40 0 X X 62390 0 7625 Denise Plano CNO 40 0 X 44616 0 392 Steve Horn Board President 8 0 X 15000 0 0 Carrie Couey Board Secretary/Treasurer 4 0 X 3550 0 0 Jay Rohloff Board Member 4 0 X 3500 0 0 Paul Ostrander Board Vice President 4 0 X 3450 0 0 Maxwell Best Board Member 4 0 X 3100 0 0 Trena Richardson Board Member 4 0 X 3050 0 0 Stephanie Queen Board Member 4 0 X 2900 0 0 Bradley Cross Board Member 4 0 X 2650 0 0 Silverio Mattero Board Member 4 0 X 2400 0 0 Jesse Kincaid Board Member 4 0 X 2000 0 0 10448547 0 491606 249 1 1 0 Medical Solutions LLC dba Focusone Solutions LLC 1010 N 102nd St Ste 300 Omaha NE 68114 Contract Employee Provider 10581259 Heath Systems Informatics PO Box 10388 Bainbridge Island WA 98110 Healthcare Consulting Svcs 3111431 Alaska Hospitalist Group LLC 4300 B Street Suite 200 Anchorage AK 99503 Physician Services - Hospitalist 1877470 Tegria Services Group - US 1255 Fourier Drive Suite 101 Madison WI 53717 Healthcare Consulting Svcs 1554084 Ettain Group PO Box 60070 Charlotte NC 282600070 IT Professional Resourcing 1488308 31 0 0 0 88372 1823274 0 24389 1911646 Hospital Service Revenue 622000 554234458 554234458 0 0 Skilled Nursing Revenue 623000 13602348 13602348 0 0 Outpatient Physician Clinic Revenue 621110 79883729 79883729 0 0 0 0 0 0 647720535 4510277 4510277 0 0 0 0 0 0 0 0 0 0 432817 0 349853 0 82964 0 82964 82964 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1098248 243475 854773 854773 0 0 USAC Telephone Subsidy 622000 1172301 1172301 0 0 340b Pharmacy Rebate Program 622000 1389731 1389731 0 0 Property Tax Revenue 622000 51507 51507 0 0 0 0 0 0 2613539 657693734 655782088 0 0 83900 83900 0 0 0 0 0 0 10019708 8445098 1574610 0 0 0 0 0 97767199 97767199 0 0 2717939 2717939 0 0 19711906 19711906 0 0 6660212 6660212 0 0 0 0 0 0 192475 0 192475 0 251700 0 251700 0 21318 0 21318 0 0 0 0 0 0 0 21268196 21268196 0 0 445996 445996 0 0 2650785 2650785 0 0 10490854 10490854 0 0 0 0 0 0 4564003 4564003 0 0 297094 297094 0 0 0 0 0 0 482001 482001 0 0 1632860 1632860 0 0 0 0 0 0 16618613 16618613 0 0 1909069 1909069 0 0 Medicare Deductions 210586273 210586273 0 0 Medicaid Deductions 78660361 78660361 0 0 All other deductions 87471729 87471729 0 0 Charity & Bad Debt 20294609 20294609 0 0 46206971 46206971 0 641005771 638965668 2040103 0 56248801 51225887 6507397 4179400 452654 321093 38521664 48471732 0 0 0 0 0 0 8893820 10148167 2886578 2107661 256150320 143772787 113335343 112377533 0 5014 0 0 0 0 1177000 1177000 80418396 88174079 308441653 318187566 23595370 24455558 0 0 4797186 5344442 44507236 37468675 0 0 0 0 0 0 0 0 2387120 1076187 75286912 68344862 X 233154741 249842704 0 0 233154741 249842704 308441653 318187566 16687963 0 0 0 0 0 X 0 1 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 1087 0 1 20231 21318 0 Schedule C, Part II-B, Line 1 Line 1(g) consists of compensation for employees to meet with representatives regarding Medicaid expansion and the Medicare Rural Community 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 Alaska Hospital Healthcare Association and the American Hospital Association. X 1 40 0 0 0 1 0 0 0 0 6829914 0 6829914 113721334 0 63823858 49897476 2968693 0 783520 2185173 110201615 0 70429409 39772206 22428764 0 8736000 13692764 112377533 Plant Replacement Fund 75618801 Debt Service Account 2755954 Goodwill 3808352 Bond Reserve held in escrow 5095328 Cash from bond proceeds 895644 88174079 0 Due to third parties 1076187 1076187 273002245 0 0 0 1891574 1891574 271110671 0 386583063 386583063 657693734 255411728 0 0 0 639167 639167 254772561 0 386233210 386233210 641005771 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 the 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 as its net book value. Schedule D, Part XI, Line 2d Cost of goods sold in the amount of $243,475 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. Revenue from the Foundation in the amount of $1,648,099 is also included on 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 $386,233,210 are reported as expenses in Part IX lines 24a-d on the 990, however they are reported net of revenue on the audited financial statements. Rental expenses of $349,853 are deducted from Revenue in Part VIII. Rental expenses are recorded as an expense on the audited financial statements. Schedule D, Part XII, Line 2d Cost of goods sold in the amount of $243,475 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 $395,692 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 $386,233,210 are reported as expenses in Part IX lines 24a-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 0 770 2681855 0 2681845 0.011 1 0 35144537 38056087 0 0 0 0 0 0 0 0 1 770 37826392 38056087 2681845 0.011 521 54309 1264472 6070 1258402 0.0052 57 775 105443 5252 100192 0.0004 20 0 36282217 19099773 17182444 0.0707 3 105 4745 150 4595 0.00 565 3367 308418 0 308418 0.0013 1166 58556 37965295 19111245 18854051 0.0776 1167 59326 75791687 57167332 21535896 0.0886 0 0 0 0 0 0 1 10779762 0 60319134 76857800 -16538666 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 23 1 0 0 1 X www.cpgh.org 1 23 0 0 0 1 X 200 300 X X X X X 1 1 X X X 1 X www.cpgh.org/patientfinancialservices/financial-assistance/ X www.cpgh.org/patientfinancialservices/financial-assistance/ X www.cpgh.org/patientfinancialservices/financial-assistance/ X X X X X X 1 0 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 FY2023-FY2025 and indicates that the categories showing the largest increase in perceived need from the prior reporting period were Mental Health & Substance Abuse Services, Nutrition and Obesity, Cardiovascular Health, Access to Health Care Services, and Cancer Care. In response to these findings, the Hospital is actively recruiting for a staff Psychiatrist and opened a Mental Wellness Clinic in November 2023 staffed with two Psych Nurse Practitioners. Other service lines arising to address community needs, are the Diabetes Center which opened in October 2023 to allow for additional diabetes care services and the Gastroenterology Clinic which opened in January 2024. The Hospital also added additional family practice, neurology, and orthopedic physicians throughout the year to address Access to Health Care Services and signed an agreement in April 2023 with the University of Washington to implement an Internal Medicine Residency Program. Two Hematology/Oncology Physicians who are both dual Board Certified in Hematology and Oncology, began seeing patients in November 2023. In addition, the Care Transitions Detox Center has increased bed capacity from 7 beds to 10 beds and two Interventional Pain Physicians were added to focus on Chronic Pain. The Hospital has added several community health education activities such as a Women and Babies Health Fair and continues to partner with other local organizations in the community to promote outdoor activities and 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 FY2023-FY2025 and indicates that the categories showing the largest increase in perceived need from the prior reporting period were Mental Health & Substance Abuse Services, Nutrition and Obesity, Cardiovascular Health, Access to Health Care Services, and Cancer Care. In response to these findings, the Hospital is actively recruiting for a staff Psychiatrist and opened a Mental Wellness Clinic in November 2023 staffed with two Psych Nurse Practitioners. Other service lines arising to address community needs, are the Diabetes Center which opened in October 2023 to allow for additional diabetes care services and the Gastroenterology Clinic which opened in January 2024. The Hospital also added additional family practice, neurology, and orthopedic physicians throughout the year to address Access to Health Care Services and signed an agreement in April 2023 with the University of Washington to implement an Internal Medicine Residency Program. Two Hematology/Oncology Physicians who are both dual Board Certified in Hematology and Oncology, began seeing patients in November 2023. In addition, the Care Transitions Detox Center has increased bed capacity from 7 beds to 10 beds and two Interventional Pain Physicians were added to focus on Chronic Pain. The Hospital has added several community health education activities such as a Women and Babies Health Fair and continues to partner with other local organizations in the community to promote outdoor activities and 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. The financial assistance brochure is made available to community members at hospital sponsored community events (such as health fairs and Wendnesday in the Park). 25 River Tower Outpatient Imaging 240 Hospital Place Suite 102 Soldotna AK 99669 Outpatient imaging services Kenai Spine 240 Hospital Place Suite 104 Soldotna AK 99669 Spine clinic Heritage Place 232 Rockwell Ave Soldotna AK 99669 Skilled nursing facility, longterm care Central Peninsula Bone & Joint Center 240 Hospital Place Suite 204 Soldotna AK 99669 Orthopedic clinic Kenai Physical Medicine 260 Caviar St Kenai AK 99611 Physical therapy clinic Central Peninsula Internal Medicine 247 N Fireweed St Suite A Soldotna AK 99669 Internal Medicine physicians Central Peninsula Urology 240 Hospital Place Suite 303 Soldotna AK 99669 Urology clinic Serenity House 47480 Kristina Way Soldotna AK 99669 Chemical dependency treatment center Soldotna Physical Medicine 245 N Binkley Soldotna AK 99669 Physical Therapy clinic Central Peninsula Foot & Ankle 240 Hospital Place Suite 203 Soldotna AK 99669 Podiatry clinic Surgery Center 100 Trading Bay Road Kenai AK 99611 Outpatient surgery center Central Peninsula Women's Health 108 E Corral St Soldotna AK 99669 OB/Gyn Physician Medical Office Central Peninsula Urgent Care 10128 Kenai Spur Hwy Kenai AK 99611 Urgent Care clinic Central Peninsula Neurology 262 N Binkley Street Soldotna AK 99669 Neurology clinic Central Peninsula Family & Pediatrics 245 N Binkley St Suite 101 Soldotna AK 99669 Family practice clinic Central Peninsula Surgical Associates 240 Hospital Place Suite 305 Soldotna AK 99669 Surgical clinic Central Peninsula Hospital Transitional Living Ctr 362 Tyee Street Soldotna AK 99669 Transitional Living Center Central Peninsula Care Transitions 354 Tyee St Soldotna AK 99669 Detox Center River Tower Oncology 240 Hospital Place Suite 301 Soldotna AK 99669 Oncology services Central Peninsula Family Practice Kenai 506 Lake Street Kenai AK 99611 Family practice clinic Serenity House Medical Clinic 245 N Binkley St Soldotna AK 99669 Outpatient substance abuse treatment Central Peninsula Gastroenterology 240 Hospital Place Soldotna AK 99669 Gastroenterology clinic Central Peninsula Mental Wellness 291 N Fireweed St Soldotna AK 99669 Mental wellness clinic Kenai Health Center 630 Barnacle Way Kenai AK 99611 Diagnostic imaging, lab, and domestic violence services Diabetes Center 209 W Katmai Ave Soldotna AK 99669 Diabetes Clinic 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 are 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 $10,779,762 was reported in Part IX, line 25 functional expenses. However, they were reported at cost in Schedule H based on cost to charge ratio. Schedule H, Part I, Line 7g The Hospital included losses from subsidized Physician Clinics in Part 1, Line 7(g) for family practice and specialty physician practices. Losses are included as follows: Serenity House IP/OP ($1,189,935), Diabetes Clinic ($313,072), Gastroenterology ($104,606), Internal Medicine ($1,826,838), Mental Health ($524,320), Neurology ($737,309), Oncology ($1,944,341), Foot & Ankle ($292,983), Surgery Center ($65,886), Surgical Services ($702,761), Urgent Care ($1,242,736), Women's Health ($359,215), and Family & Peds (2) ($3,461,005). 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 or 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 the 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 a 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 the 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 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 FY2024 budget, in 2023 the Kenai Peninsula Borough had a population of 60,017 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 36400 0 Actual monetary donation Bereavement Program and Annual Wine Event sponsorship American Cancer Society PO Box 230148 Anchorage AK 99523 131788491 501c3 20000 Actual monetary donation Hooked on a Cure sponsorship Soldotna Chamber of Commerce 44790 Sterling Hwy Soldotna AK 99669 920061612 501c6 11000 Actual monetary donation Diamond Level Community Partner sponsorship and Music in the Park Sponsor Kenai Peninsula Food Bank 33955 Community College Drive Soldotna AK 99669 943112445 501c3 25000 Actual monetary donation Sponsorship of Soup Supper, Spring Festival, and It's Scary to be Hungry Bridges Community Resource Network PO Box 1612 Soldotna AK 99669 920151271 501c4 6500 Actual monetary donation Sponsorship of Imagination Library, Soldotna Equestrian, and Women's Rugby Team Kenai Watershed Forum 44128 Sterling Hwy Soldotna AK 99669 911829284 501c3 10000 Actual monetary donation Salmon run sponsorship 4 2 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 Robert Cadoff Urologist 938196 0 10 0 7078 0 7056 0 18457 0 970797 0 0 0 Herbert Bote Orthopedic Surgeon 930015 0 107081 0 63781 0 7056 0 35082 0 1143015 0 0 0 Michael Reyes Orthopedic Surgeon 1039204 0 226967 0 139341 0 7056 0 35817 0 1448385 0 0 0 John Andreshak Spine Surgeon 805122 0 112683 0 134392 0 7056 0 29728 0 1088981 0 0 0 David King Surgeon 644832 0 196019 0 95193 0 7056 0 28068 0 971168 0 0 0 Jason Lattin Surgeon 520069 0 175064 0 73398 0 7056 0 90595 0 866182 0 0 0 Gregg Motonaga Anesthesiologist/Board Member 788806 0 58953 0 1282 0 7056 0 35818 0 891915 0 0 0 John Bramante Physician/Board Member 384620 0 139552 0 38986 0 7056 0 41973 0 612187 0 0 0 Gregory Hough Surgeon 635571 0 83891 0 90259 0 7056 0 49223 0 866000 0 0 0 Darren Mullins Oncologist 294238 0 267551 0 109156 0 11135 0 17267 0 699347 0 0 0 Rick Davis CEO 40189 0 0 0 22201 0 3746 0 4751 0 70887 0 0 0 Shaun Keef CEO 409385 0 78480 0 71513 0 18303 0 41473 0 619154 0 0 0 Denise Plano CNO 19616 0 25000 0 0 0 392 0 0 0 45008 0 0 0 Michael Haggerty CFO 227496 0 37112 0 41203 0 13194 0 14507 0 333512 0 0 0 Karen Scoggins CNO/COO 262099 0 42435 0 28908 0 13843 0 30680 0 377965 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 January 2023. 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 throughout 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 01179RDP5 2014-02-20 32490000 2014 Medical Office Building construction bonds 0 0 1 B Kenai Peninsula Borough 920030894 01179RXH1 2017-11-29 28955000 2018 Cath Lab and OB construction bonds 0 0 1 C Kenai Peninsula Borough 920030894 000000000 2021-06-28 6335000 Refunding bonds - 2011 GO 0 0 1 A 19640000 0 34999563 3028236 1813599 1470824 127595 0 0 35212215 0 0 2016 0 0 1 1 B 6120000 0 29140645 1541107 762523 2062538 436394 0 0 29139606 29706 0 2020 0 0 0 1 C 6335000 0 6927370 0 0 0 26118 0 0 6901252 0 0 1 0 1 1 A 0 1 0 0 0.11 0 0.11 1 0 1 B 0 0 0 0 0 0 0 1 0 1 C 0 0 0 0 0 0 0 1 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 C 0 1 0 0 1 0 0 0 1 Schedule K, Part I, Column b-02/20/2014 32,490,000 Kenai Peninsula Borough Par amount of Bond was $32,490,000 - lower than proceeds from issue. Michael Reyes Employee and Board Member 1405512 Total compensation and benefits 0 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 accounting department and reviewed by the Controller. It is 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 actions. 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 January 2023. 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 its 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 Guidstar.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 88371 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 88371 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 138792 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 8013488 During the 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, 2025. Received approval from the IRS with Notice date September 16, 2024.