GOOD SHEPHERD HEALTH CARE SYSTEM: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SHEPHERD HEALTH CARE SYSTEM (EIN 93-0425580)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-14
- IRS object ID
- 202231349349300603
- Schema version
- 2020v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-14T01:11:34-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 200079326 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DINGUS ZARECOR & ASSOCIATES PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12015 E MAIN AVE | AddressLine1Txt |
| City | SPOKANE VALLEY | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930425580 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SHEPHERD HEALTH CARE SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GOOD | BusinessNameControlTxt |
| Phone | 5416673400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 NW 11TH STREET | AddressLine1Txt |
| City | HERMISTON | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97838 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRIAN SIMS | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 5416673400 | PhoneNum |
| Signature | 2022-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | BRIAN | PersonFirstNm |
| Person Last | SIMS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THOMAS DINGUS | PreparerPersonNm |
| PTIN | P00951009 | PTIN |
| Phone | 5092420874 | PhoneNum |
| Preparation | 2022-05-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SHEPHERD MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRIAN SIMS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 NW 11TH STREET | AddressLine1Txt |
| City | HERMISTON | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97838 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $166,919,687 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GSHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1953 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COMPASSIONATE, HIGH QUALITY, AND ACCESSIBLE HEALTH CARE AND TO PROMOTE A HEALTHY COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 887 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $8,078,365 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,946,311 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $105,294,750 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $119,674,829 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,394,654 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,569,241 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,690,449 | PYOtherRevenueAmt |
| CY Other Revenue | $1,522,082 | CYOtherRevenueAmt |
| PY Total Revenue | $119,458,218 | PYTotalRevenueAmt |
| CY Total Revenue | $132,712,463 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $165,090 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $240,721 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $66,488,728 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $70,079,375 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $164,974 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $44,534,829 | PYOtherExpensesAmt |
| CY Other Expenses | $49,208,196 | CYOtherExpensesAmt |
| PY Total Expenses | $111,188,647 | PYTotalExpensesAmt |
| CY Total Expenses | $119,528,292 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,269,571 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $13,184,171 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $232,869,052 | TotalAssetsBOYAmt |
| Total Assets EOY | $266,771,464 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $25,112,515 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $26,243,237 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $207,756,537 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $240,528,227 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE COMPASSIONATE, HIGH QUALITY, AND ACCESSIBLE HEALTH CARE AND TO PROMOTE A HEALTHY COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $104,990,313 | ExpenseAmt |
| Grant | $240,721 | GrantAmt |
| Revenue | $119,674,829 | RevenueAmt |
| Desc | GOOD SHEPHERD HEALTH CARE SYSTEM (GSHCS) SERVED 1,412 INPATIENTS OVER 4,373 PATIENT DAYS, 89,357 OUTPATIENTS, AND 18,529 PATIENTS IN OUR EMERGENCY CENTER DURING FISCAL YEAR 2020-2021. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATIONS AND STABILITY OF GSHCS, NOT ALL INDIVIDUALS HAVE THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. GSHCS PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT DEEPLY DISCOUNTED RATES AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 4,111,380 WRITTEN OFF AS BAD DEBT, AND AN ADDITIONAL 6,237,589 OF DIRECT CHARITY CARE TO OUR COMMUNITY. SEE CONTINUATION ON SCHEDULE O. | Desc |
| Total Program Service Expenses | $104,990,313 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (true) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 118 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 887 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAN PETER | PersonNm |
| Phone | 5416673400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 NW 11TH STREET | AddressLine1Txt |
| City | HERMISTON | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97838 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| SUE DAGGETT | |||||||||
| CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JON LORENCE | |||||||||
| VICE CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| BILL ELFERING | |||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | 1.00 | ||
| ARNELL EYNON | |||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| BOB CARLSON | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| RACHEL ARCHER | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| NANCY MABRY | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| DEREK EARL | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| TOM WAMSLEY | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| LISA MITTELSDORF | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| JEFF WENHOLZ | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| STEVE ELDRIGE | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| BRIAN SIMS | |||||||||
| PRESIDENT/CE | 40.00 | Yes (X) | $399,890 | $0 | $65,223 | ||||
| DENNIS-BURKE | |||||||||
| CEO THRU SEP | 40.00 | Yes (X) | $470,712 | $0 | $146,453 | ||||
| JAN PETER | |||||||||
| CFO | 40.00 | Yes (X) | $293,130 | $0 | $65,424 | ||||
| JIM SCHLENKER | |||||||||
| COO | 40.00 | $268,022 | $0 | $51,891 | Yes (X) | ||||
| JEREMY ANDERSON | |||||||||
| SURGEON | 40.00 | $803,181 | $0 | $62,385 | Yes (X) | ||||
| JAMES WHITTUM | |||||||||
| SURGEON | 40.00 | $790,836 | $0 | $25,011 | Yes (X) | ||||
| STEPHEN IACOBONI | |||||||||
| PHYSICIAN | 40.00 | $478,430 | $0 | $2,116 | Yes (X) | ||||
| CHRISTOPHER SCOTT | |||||||||
| CHIROPRACTIC | 40.00 | $453,336 | $0 | $33,398 | Yes (X) | ||||
| THOMAS HOLT | |||||||||
| UROLOGIST | 40.00 | $449,273 | $0 | $51,965 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,406,810 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $503,866 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 144 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NORTHWEST EMERGENCY PHYSICIANS | |||||
| PO BOX 634850 | CINCINNATI | OH | 45263 | ER PHYSICIANS | $3,046,660 |
| TUALATIN IMAGING | |||||
| 7427 SW COHO CT SUITE 200 | TUALATIN | OR | 97062 | DIAGNOSTIC IMAG | $1,584,734 |
| TRI-CITIES LABORATORY | |||||
| PO BOX 2688 | SPOKANE | WA | 99220 | LAB SERVS | $614,911 |
| LOCUMTENENSCOM | |||||
| PO BOX 405547 | ATLANTA | GA | 30384 | LOCUM SERVICES | $574,172 |
| FAVORITE HEALTHCARE STAFFING INC | |||||
| PO BOX 26225 | OVERLAND PARK | KS | 66225 | STAFFING | $478,128 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $16,600 | RelatedOrganizationsAmt |
| Government Grants | $5,873,696 | GovernmentGrantsAmt |
| All Other Contributions | $56,015 | AllOtherContributionsAmt |
| Total Contributions | $5,946,311 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 624100 | $119,589,343 | $119,589,343 |
| SUPPORTING PATIENT SERVICES | 624100 | $85,486 | $85,486 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $119,674,829 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,143,261 | TotalRevenueColumnAmt |
| Exclusion | $3,143,261 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,800 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,800 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,800 | TotalRevenueColumnAmt |
| Exclusion | $1,800 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $36,421,020 | SecuritiesAmt |
| Other | $212,184 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $33,840,621 | SecuritiesAmt |
| Other | $366,603 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,580,399 | SecuritiesAmt |
| Other | -$154,419 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,425,980 | TotalRevenueColumnAmt |
| Exclusion | $2,425,980 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA | 722210 | $707,910 | $707,910 |
| DAYCARE | 900099 | $311,257 | $311,257 |
| OTHER REVENUE | 900099 | $277,213 | $277,213 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $223,902 | TotalRevenueColumnAmt |
| Exclusion | $223,902 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,520,282 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $132,712,463 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $119,674,829 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $7,091,323 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $213,164 | TotalAmt |
| Program Services | $213,164 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,557 | TotalAmt |
| Program Services | $27,557 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $968,242 | TotalAmt |
| Management And General | $968,242 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,615,265 | TotalAmt |
| Program Services | $47,615,016 | ProgramServicesAmt |
| Management And General | $6,883,271 | ManagementAndGeneralAmt |
| Fundraising | $116,978 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,214,058 | TotalAmt |
| Program Services | $1,947,190 | ProgramServicesAmt |
| Management And General | $262,084 | ManagementAndGeneralAmt |
| Fundraising | $4,784 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,865,471 | TotalAmt |
| Program Services | $7,697,752 | ProgramServicesAmt |
| Management And General | $1,148,808 | ManagementAndGeneralAmt |
| Fundraising | $18,911 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,416,339 | TotalAmt |
| Program Services | $2,934,451 | ProgramServicesAmt |
| Management And General | $474,679 | ManagementAndGeneralAmt |
| Fundraising | $7,209 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,634 | TotalAmt |
| Management And General | $41,634 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,276 | TotalAmt |
| Management And General | $70,276 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $347,270 | TotalAmt |
| Management And General | $347,270 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,076,792 | TotalAmt |
| Program Services | $17,567,334 | ProgramServicesAmt |
| Management And General | $1,503,152 | ManagementAndGeneralAmt |
| Fundraising | $6,306 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $335,178 | TotalAmt |
| Program Services | $36,246 | ProgramServicesAmt |
| Management And General | $296,008 | ManagementAndGeneralAmt |
| Fundraising | $2,924 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,666,080 | TotalAmt |
| Program Services | $1,313,927 | ProgramServicesAmt |
| Management And General | $348,705 | ManagementAndGeneralAmt |
| Fundraising | $3,448 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,844,133 | TotalAmt |
| Program Services | $2,794,467 | ProgramServicesAmt |
| Management And General | $49,666 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,118,172 | TotalAmt |
| Program Services | $987,674 | ProgramServicesAmt |
| Management And General | $129,662 | ManagementAndGeneralAmt |
| Fundraising | $836 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $314,583 | TotalAmt |
| Program Services | $296,171 | ProgramServicesAmt |
| Management And General | $18,405 | ManagementAndGeneralAmt |
| Fundraising | $7 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,962 | TotalAmt |
| Program Services | $2,470 | ProgramServicesAmt |
| Management And General | $4,492 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,764,563 | TotalAmt |
| Program Services | $5,773,960 | ProgramServicesAmt |
| Management And General | $987,036 | ManagementAndGeneralAmt |
| Fundraising | $3,567 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $670,339 | TotalAmt |
| Program Services | $399,214 | ProgramServicesAmt |
| Management And General | $271,125 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $14,042,581 | $14,042,581 | |
| DIETARY & FOOD | $866,577 | $816,069 | $50,508 |
| RECRUITMENT | $632,927 | $400,994 | $231,933 |
| DUES & SUBSCRIPTIONS | $147,226 | $62,438 | $84,788 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $262,903 | TotalAmt |
| Program Services | $61,638 | ProgramServicesAmt |
| Management And General | $201,261 | ManagementAndGeneralAmt |
| Fundraising | $4 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,528,292 | TotalAmt |
| Program Services | $104,990,313 | ProgramServicesAmt |
| Management And General | $14,373,005 | ManagementAndGeneralAmt |
| Fundraising | $164,974 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,628,020 | BOYAmt |
| EOY | $20,783,388 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,635,452 | BOYAmt |
| EOY | $17,363,103 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $298,816 | BOYAmt |
| EOY | $206,380 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,285,158 | BOYAmt |
| EOY | $3,745,012 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,307,763 | BOYAmt |
| EOY | $2,024,807 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $149,440,070 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $88,182,362 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,149,911 | BOYAmt |
| EOY | $61,257,708 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,316,643 | BOYAmt |
| EOY | $150,377,835 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,560,000 | BOYAmt |
| EOY | $1,560,000 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,675,090 | BOYAmt |
| EOY | $8,101,738 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,012,199 | BOYAmt |
| EOY | $1,351,493 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,869,052 | BOYAmt |
| EOY | $266,771,464 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,364,746 | BOYAmt |
| EOY | $12,971,364 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,747,769 | BOYAmt |
| EOY | $13,271,873 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,112,515 | BOYAmt |
| EOY | $26,243,237 | 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 | $207,224,216 | BOYAmt |
| EOY | $239,964,682 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $532,321 | BOYAmt |
| EOY | $563,545 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $207,756,537 | BOYAmt |
| EOY | $240,528,227 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,869,052 | BOYAmt |
| EOY | $266,771,464 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $13,184,171 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $19,556,295 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $31,224 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $14,630 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $14,630 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | LINE 1I - THE HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $2,860,961 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $951,448 | OtherCostOrOtherBasisAmt |
| Book Value | $3,812,409 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $79,047,482 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,164,965 | DepreciationAmt |
| Book Value | $41,882,517 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,050,163 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,069,495 | DepreciationAmt |
| Book Value | $980,668 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $58,580,683 | OtherCostOrOtherBasisAmt |
| Depreciation | $48,947,902 | DepreciationAmt |
| Book Value | $9,632,781 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,949,333 | OtherCostOrOtherBasisAmt |
| Book Value | $4,949,333 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $61,257,708 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| MEDICARE ACCELERATED PAYMENTS | $12,550,873 |
| THIRD-PARTY SETTLEMENTS | $721,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $13,271,873 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | GSHCS IS EXEMPT FROM FEDERAL INCOME TAX. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. GSHCS EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF JUNE 30, 2021 AND 2020, GSHCS HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,432,660 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,432,660 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02040 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,724,240 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,724,240 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,156,900 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,724,240 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,432,660 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02040 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 11118 | PersonsServedCnt |
| Total Community Benefit Expns | $4,008,305 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $279,052 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,729,253 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03120 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $331,982 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,491 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $326,491 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $40,195,552 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,839,409 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,356,143 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.17030 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $213,164 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $213,164 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 11118 | PersonsServedCnt |
| Total Community Benefit Expns | $44,749,003 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,123,952 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $24,625,051 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.20600 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 11118 | PersonsServedCnt |
| Total Community Benefit Expns | $66,905,903 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $39,848,192 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $27,057,711 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.22640 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $984,132 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $29,819 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $31,740,365 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $33,467,258 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,726,893 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 | GOOD SHEPHERD HEALTH CARE SYSTEM | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 NW 11TH STREET | AddressLine1Txt |
| City | HERMISTON | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97838 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.GSHEALTH.ORG | WebsiteAddressTxt |
| State License | 055598-6 | 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 |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SHEPHERD HEALTH CARE SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.GSHEALTH.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART VI | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | 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 (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V | 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 |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| 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 (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 3E | IDENTIFICATION OF HEALTH NEEDS ARE ADDRESSED IN APPENDIX VII, OF THE LATEST CHNA LOCATED ON THE HOSPITAL'S WEBSITE. |
| FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 5 | THE NEEDS ASSESSMENT WAS ENVISIONED, DESIGNED, AND EXECUTED BY COMMUNITY LEADERS AND MEMBERS REPRESENTING HEALTHCARE, PUBLIC HEALTH, LAW ENFORCEMENT, EDUCATION, AND SOCIAL SERVICES. THE ASSESSMENT WAS CONDUCTED IN PARTNERSHIP WITH ST. ANTHONY HOSPITAL IN PENDLETON, OR. THE ASSESSMENT PROCESS INCLUDED REGULAR CONSULTATION WITH THE LOCAL CHILD DEVELOPMENT COALITION AND COUNTY PUBLIC HEALTH DEPARTMENTS. TWO SURVEY INSTRUMENTS WERE USED IN THIS ASSESSMENT: ONE FOR ADULTS 19-YEARS-OF-AGE AND OLDER AND ONE FOR PARENTS OF CHILDREN AGES 0 THROUGH 11. A TOTAL OF 1,200 ADULT AND 2,400 PARENT SURVEYS WERE MAILED TO RESIDENTS OF UMATILLA COUNTY. |
| FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 6A | THE CHNA WAS CONDUCTED WITH ST. ANTHONY HOSPITAL LOCATED IN PENDLETON, OR. |
| FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 6B | THE CHNA WAS ALSO CONDUCTED WITH OREGON CHILD DEVELOPMENT COALITION, UMATILLA COUNTY PUBLIC HEALTH, AND HOSPITAL COUNCIL OF NORTHWEST OHIO. |
| FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 7D | THE CHNA WAS MADE WIDELY AVAILABLE THROUGH A NEWSPAPER ARTICLE PROVIDING A SYNOPSIS OF THE ASSESSMENT'S FINDINGS, PUBLIC FORUMS DISCUSSING THE ASSESSMENT'S FINDINGS, AS WELL AS AVAILABLE ON OUR WEBSITE. |
| FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 11 | THE MOST RECENT CHNA IDENTIFIED THE FOLLOWING SIGNIFICANT HEALTH NEEDS ALONG WITH SERVICES, PROGRAMS, AND RESOURCES AVAILABLE TO RESPOND TO THESE NEEDS INCLUDE: ACCESS TO SERVICES SOCIAL DETERMINANT OF HEALTH/HEALTH EQUITY: WE WILL CONTINUE OFFERING URGENT CARE SERVICES, CONNEXIONS PROGRAM (CASE MANAGEMENT AND RESOURCE REFERRAL), HERMISTON HIGH SCHOOL WELLNESS CLINIC, MEMBERSHIP IN THE LOCAL COMMUNITY ADVISORY COUNCIL (LCAC) AND SUPPORT OF LCAC OBJECTIVES. WE WILL IMPLEMENT NEW STRATEGIES INCLUDING COMMUNITY EDUCATION ON APPROPRIATE USE OF THE EMERGENCY DEPARTMENT, URGENT CARE, AND PRIMARY CARE PROVIDERS (PCPS), INCREASE EFFORTS TO RECRUIT HEALTHCARE PROVIDERS TO MEET THE GROWING POPULATION, AND MAKE URGENT CARE SERVICES MORE ACCESSIBLE. OBESITY/CHRONIC DISEASE: WE WILL CONTINUE OFFERING BMI MEASUREMENTS AT COMMUNITY SCREENING EVENTS, ENCOURAGING COMMUNITY PARTNERS TO PROMOTE HEALTHY GARDENING AND FOOD CHOICES, CONTINUE TO PROMOTE COMMUNITY-BASED EXERCISE AND FITNESS EDUCATION OPPORTUNITIES. WE WILL IMPLEMENT NEW STRATEGIES INCLUDING NORTHEAST OREGON PRESCRIPTION TRAILS PROGRAM, SUGAR-SWEETENED BEVERAGE EDUCATION AT 75% OF COMMUNITY OUTREACH EVENTS, FEASIBILITY ANALYSIS OF METABOLIC AND BARIATRIC PROGRAM, AND CREATION OF COMMUNITY CANCER PREVENTION STRATEGIC PLAN. VIOLENCE: WE WILL CONTINUE OFFERING SAFE COMMUNITIES PARTICIPATION AND START BY BELIEVING CAMPAIGN. WE WILL IMPLEMENT NEW STRATEGIES INCLUDING COLLABORATE WITH DOMESTIC VIOLENCE SERVICES TO HOST ONE IN HER SHOES EVENT ON SITE ANNUALLY, INTEGRATE ABUSE SCREENING QUESTIONNAIRE INTO EPIC, EXPANSION OF AWARENESS AND SCOPE OF START BY BELIEVING CAMPAIGN LED BY SANE TEAM. BEHAVIORAL HEALTH: WE WILL CONTINUE OFFERING SAFE COMMUNITIES AND DEVELOPMENTAL ADOLESCENT RESIDENTIAL TREATMENT (DART) PARTICIPATION, MEMBERSHIP IN THE LOCAL COMMUNITY ADVISORY COUNCIL (LCAC), SUPPORT OF LCAC OBJECTIVES, TOBACCO TREATMENT SPECIALIST (TTS) COUNSELING, AND COMMUNITY TOBACCO EDUCATION AND EVENTS. WE WILL IMPLEMENT NEW STRATEGIES INCLUDING ENSURING UNIFORM COMPLIANCE WITH GSHCS POLICIES REGARDING PRESCRIPTION DRUG MONITORING PROGRAM (PDMP) DASHBOARD USAGE BEFORE PRESCRIBING OPIOIDS OR OTHER ADDICTIVE PRESCRIPTIONS, ENSURING UNIFORM COMPLIANCE WITH GSHCS POLICIES REGARDING REQUIRING DOCTOR/PATIENT AGREEMENT WHEN ON LONG-TERM OPIOID PRESCRIPTIONS, OBTAINING ONE GSHCS EMPLOYED MEDICATION ASSISTED TREATMENT (MAT) PROVIDER, TRAINING SELECT GSHCS STAFF IN NALOXONE ADMINISTRATION, CREATING ON-SITE SAFE MEDICATION DISPOSAL SITE, AND DISTRIBUTING ACCURATE INFORMATION ON DRUGS AT VARIOUS COMMUNITY EVENTS. THE HOSPITAL DOES NOT HAVE ADEQUATE RESOURCES TO SOLVE ALL THE PROBLEMS IDENTIFIED. SOME ISSUES ARE BEYOND THE MISSION OF THE HOSPITAL AND ACTION IS BEST SUITED FOR A RESPONSE BY OTHERS OR WILL REQUIRE PERSONAL ACTIONS BY INDIVIDUALS RATHER THAN THE RESPONSE OF AN ORGANIZATION. WE VIEW THE ABOVE STRATEGIES FOR HOW WE, ALONG WITH OTHER ORGANIZATIONS AND AGENCIES, CAN COLLABORATE TO BRING THE BEST EACH HAS TO OFFER TO ADDRESS THE MORE PRESSING IDENTIFIED NEEDS. |
| FACILITY 1, GOOD SHEPHERD HEALTH CARE SYSTEM - PART V, LINE 16J | A SUMMARY OF THE FAP IS DISTRIBUTED IN UNEMPLOYMENT OFFICES AND OTHER AREAS IN THE COMMUNITY THAT TARGET THE ELIGIBLE POPULATION. A SUMMARY IS ALSO AVAILABLE AT LOCAL PHYSICIAN OFFICES, ADMISSIONS OFFICES, AND SENT WITH BILLING INVOICES. ALSO, UPON DISCHARGE, A PATIENT FINANCIAL REPRESENTATIVE MEETS WITH PATIENTS TO DISCUSS THEIR ABILITY TO PAY FOR SERVICES. INCLUDED AS PART OF THIS DISCUSSION IS A SUMMARY OF THE FAP. A PLAIN LANGUAGE SUMMARY OF THE FAP WAS ALSO WIDELY AVAILABLE ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTPS://WWW.GSHEALTH.ORG/PUB/GSHCS-CHARITY-CARE-POLICY.PDF FINANCIAL ASSISTANCE INFORMATION CAN BE FOUND WIDELY AVAILABLE ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTPS://WWW.GSHEALTH.ORG/PAYING-FOR-YOUR-CARE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| GOOD SHEPHERD MEDICAL GROUP | ||||
| 610 NW 11TH STREET | HERMISTON | OR | 97838 | CLINIC |
| VANGE JOHN MEMORIAL HOSPICE | ||||
| 610 NW 11TH STREET | HERMISTON | OR | 97838 | HOSPICE |
| GOOD SHEPHERD HOME HEALTH | ||||
| 610 NW 11TH STREET | HERMISTON | OR | 97838 | HOME HEALTH |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART III, LINE 2 | THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON SCHEDULE H, PART III, LINE 2 INCLUDES THE COST TO CHARGE RATIO OF PATIENT CARE. |
| SCHEDULE H, PART III, LINE 3 | MANAGEMENT CONSIDERS HISTORICAL WRITE OFF AND RECOVERY INFORMATION IN DETERMINING THE ESTIMATED BAD DEBT PROVISION. THE ESTIMATE OF BAD DEBT ATTRIBUTABLE TO CHARITY PATIENTS IS BASED ON AN OVERALL CHARITY CARE PERCENTAGE OF GROSS REVENUE. |
| SCHEDULE H, PART III, LINE 4 | THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE FY2021 AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 3, ON PAGE 13, OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 6, ON PAGE 14 - 17 OF THE AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, LINE 8 | ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES & REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES. GSHCS PROVIDES SERVICES TO PATIENTS UNDER THE MEDICARE PROGRAM KNOWING THEY WILL NOT RECOVER ALL THE COSTS ASSOCIATED WITH PROVIDING THESE SERVICES. PROVIDING THESE SERVICES IS ESSENTIAL TO THESE PATIENTS AND THE COMMUNITY AND INCREASES THEIR ACCESS TO HEALTHCARE SERVICES. |
| SCHEDULE H, PART III, LINE 9B | THE ORGANIZATIONS COLLECTION PROCEDURES REQUIRES A FINANCIAL ADVISOR TO WORK WITH ANY PATIENT WHO IS IDENTIFIED AS POTENTIALLY BEING ELIGIBLE FOR FINANCIAL ASSISTANCE PRIOR TO SENDING THE ACCOUNT TO COLLECTION. IF DURING THE COURSE OF THE COLLECTION PROCESS THE COLLECTION AGENCY DETERMINES AN ACCOUNT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, IT IS REFERRED BACK TO THE HOSPITAL FOR FURTHER DISCUSSION WITH THE PATIENT OR FOR WRITE OFF. ALL FURTHER COLLECTION ACTION IS CEASED. |
| SCHEDULE H, PART VI, LINE 2 | GOOD SHEPHERD HEALTH CARE SYSTEM HAS PARTNERED WITH ST. ANTHONY HOSPITAL, UMATILLA COUNTY HEALTH DEPARTMENTS, AND OREGON CHILD DEVELOPMENT COALITION, AND CONTRACTED WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO TO CONDUCT A UMATILLA COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT. OUR COMMUNITY HEALTHCARE NEEDS ASSESSMENT PROCESS HAS FIVE COMPONENTS THAT ARE CONDUCTED EVERY THIRD YEAR: 1. THE ONGOING COLLECTION AND EVALUATION OF COMMUNITY FEEDBACK FROM PATIENT SURVEYS AND COMMENT FORMS. 2. PATIENT AND COMMUNITY-MEMBER HEALTHCARE NEEDS FOCUS GROUPS. 3. A HEALTHCARE NEEDS SURVEY COMPLETED BY EMPLOYERS AND OTHER COMMUNITY LEADERS. 4. A FORMAL TELEPHONE SURVEY. 5. A DEMOGRAPHIC STUDY CONDUCTED BY THE OREGON OFFICE OF RURAL HEALTH. HARD COPIES OF THE LATEST COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE UPON REQUEST WITHOUT CHARGE AND ALSO POSTED ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTP://WWW.GSHEALTH.ORG/COMMUNITYBENEFIT HARD COPIES OF THE MOST RECENTLY ADOPTED COMMUNITY HEALTH IMPLEMENTATION PLAN IS AVAILABLE UPON REQUEST WITHOUT CHARGE AND ALSO POSTED ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTP://WWW.GSHEALTH.ORG/COMMUNITYBENEFIT |
| SCHEDULE H, PART VI, LINE 3 | OUR FINANCIAL COUNSELORS INFORM AND EDUCATE THE PEOPLE WE SERVE WITH RESPECT TO CHARITY CARE AND GOVERNMENTAL ASSISTANCE PROGRAMS. ALL PATIENTS AND RESPONSIBLE PARTIES, WHERE POSSIBLE, ARE APPRISED OF THE AVAILABILITY OF FINANCIAL COUNSELING SERVICES AT THE TIME AND POINT OF SERVICE. WE HAVE ARRANGED OUR PATIENT FLOW TO MAXIMIZE THE CONVENIENCE OF VISITING OUR FINANCIAL COUNSELORS AS PART OF THE GOOD SHEPHERD TREATMENT REGIME. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY IS PROVIDED IN WRITING TO THE PATIENTS UPON REQUEST, AND WHEN THE HOSPITAL IS ABLE TO IDENTIFY A POTENTIAL FAP-ELIGIBLE INDIVIDUAL UPON ADMISSIONS. |
| SCHEDULE H, PART VI, LINE 4 | GOOD SHEPHERD HEALTH CARE SYSTEM (GSHCS) IS THE CORPORATE NAME FOR AN ORGANIZATION MADE UP OF SEVERAL ENTITIES, INCLUDING GOOD SHEPHERD MEDICAL CENTER, VANGE JOHN MEMORIAL HOSPICE, GOOD SHEPHERD HOME HEALTH, GOOD SHEPHERD MEDICAL GROUP, AND GOOD SHEPHERD CLINIC PHARMACY. GOOD SHEPHERD SERVES A CORE POPULATION OF ALMOST 50,000 PEOPLE IN THE CITY OF HERMISTON, OREGON AND IN 14 OUTLYING SMALLER TOWNS WITHIN A ROUGH 50-MILE RADIUS. THIS POPULATION IS LARGELY RURAL, WITH AGRICULTURE DOMINATING INDUSTRIAL ENTERPRISES. THE AVERAGE HOUSEHOLD INCOME IN HERMISTON IS 35,865. 17.1% OF RESIDENTS HAVE INCOMES BELOW FEDERAL POVERTY GUIDELINES. 31.3% OF RESIDENTS IDENTIFY AS NON-WHITE HISPANIC ETHNICITY, WITH A SIZABLE NUMBER OF SPANISH-PRIMARY SPEAKERS. |
| SCHEDULE H, PART VI, LINE 5 | GOOD SHEPHERD MAINTAINS OPEN, ACTIVE, AFFILIATE, AND COURTESY MEDICAL STAFFS, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED AND INTERESTED PHYSICIANS IN THE COMMUNITIES WE SERVE. GSHCS IS GOVERNED BY A TWELVE- MEMBER BOARD OF TRUSTEES. THE BOARD IS COMPRISED OF INDEPENDENT REPRESENTATIVES OF THE COMMUNITY, WITH AN EMPHASIS ON MAINTAINING A TRUE CROSS-SECTION OF CORE POPULATION COMMUNITIES WITHIN ITS MEMBERSHIP. OUR SURPLUS FUNDS ARE USED TO FUND COMMUNITY HEALTH EDUCATION CLASSES, AS WELL AS FUNDING BUILDING AND EQUIPMENT UPGRADES TO MAINTAIN THE HIGHEST QUALITY HEALTHCARE FOR OUR COMMUNITY. SURPLUS FUNDS ARE ALSO APPLIED TO ONGOING PROFESSIONAL EDUCATION AMONG OUR CLINICAL STAFF TO REMAIN CURRENT IN THE BEST PRACTICES OF MODERN HEALTHCARE. WE OPERATE A FULLY-STAFFED 24-HOUR EMERGENCY ROOM, AVAILABLE TO THE PUBLIC REGARDLESS OF ABILITY TO PAY. WE LIVE OUR MISSION TO PROMOTE A HEALTHY COMMUNITY. GOOD SHEPHERD IS THE HOST AND DRIVING FORCE BEHIND THE GOOD SHEPHERD WELLNESS COALITION, A GRASS-ROOTS GROUP OF COMMUNITY LEADERS THAT IDENTIFY, ANALYZE, AND ADDRESS PRESSING HEALTHCARE ISSUES IN THE COMMUNITY. WE MAINTAIN A DIALOGUE WITH THE PEOPLE WE SERVE THROUGH A BIWEEKLY RADIO SHOW, WITH AN EMPHASIS ON WELLNESS AND PREVENTATIVE CARE. GOOD SHEPHERD HOSTS AN ANNUAL FAMILY HEALTH AND FITNESS DAY, WITH FREE ACCESS TO HEALTHCARE PROFESSIONALS, FREE SCREENINGS, AND A WEALTH OF HEALTH AND WELLNESS INFORMATION AVAILABLE TO THE PUBLIC. WE ARE ACTIVE IN COMMUNITY HEALTH-RELATED ACTIVITIES, INCLUDING THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE, THE MARCH OF DIMES' MARCH FOR BABIES, AND THE UMATILLA COUNTY FAIR, WHERE WE PROVIDE HEALTH INFORMATION AND HEALTHCARE-RELATED GIVEAWAYS. |
| SCHEDULE H, PART VI, LINE 7 | OREGON |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| GOOD SHEPHERD COMMUNITY HEALTH FDN | |||||||
| 610 NW 11TH STREET | HERMISTON | OR | 97838 | 931170546 | 501C3 | $43,164 | FINANCIAL SUPPORT |
| BLUE MOUNTAIN COMMUNITY COLLEGE | |||||||
| 975 SE COLUMBIA DRIVE | HERMISTON | OR | 97838 | 930506536 | GOV | $40,000 | NURSING PROGRAM |
| UMATILLA COUNTY FIRE DISTRICT | |||||||
| 320 S 1ST STREET | HERMISTON | OR | 97838 | 812661780 | GOV | $30,000 | EMS TRAINING |
| OREF | |||||||
| 4000 KRUSE WAY PLACE 2-100 | LAKE OSWEGO | OR | 97035 | 930999777 | 501C3 | $50,000 | FINANCIAL SUPPORT |
| AMERICAN RED CROSS | |||||||
| 3131 N VANCOUVER AVE | PORTLAND | OR | 97227 | 530196605 | 501C3 | $50,000 | FINANCIAL SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 5 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 19 | RecipientCnt |
| Cash Grant | $27,557 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | REQUESTS FOR FINANCIAL ASSISTANCE ARE APPROVED BY THE BOARD PRIOR TO DISBURSEMENT. ANY ORGANIZATION RECEIVING AN AWARD MUST SIGN AN AGREEMENT BEFORE THE FUNDS ARE DISPURSED STATING THE FUNDS WILL BE USED FOR THE STATED PURPOSE AS LISTED IN THEIR GRANT APPLICATION. GRANTS AWARDED TO GOOD SHEPHERD COMMUNITY HEALTH FOUNDATION, A RELATED ORGANIZATION WHICH IS TAX EXEMPT UNDER SECTION 501(C)(3), ARE REQUIRED TO SUBMIT REGULAR REPORTS UNTIL ALL FUNDS HAVE BEEN SPENT. THESE REPORTS ARE REVIEWED AT THE FOUNDATION MEETINGS OF WHICH BOARD MEMBERS WHO SERVE ON BOTH THE HOSPITAL AND THE FOUNDATION BOARDS ATTEND. THERE ARE NO REPORTING REQUIREMENTS REQUIRED TO BE SENT TO THE HOSPITAL FROM THE OTHER ORGANIZATIONS LISTED ON SCHEDULE I. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|
| BRIAN SIMS | ||||||
| PRESIDENT/CEO | $317,160 | $63,230 | $19,500 | $19,022 | $46,201 | $465,113 |
| DENNIS-BURKE | ||||||
| CEO THRU SEPT | $470,712 | $146,453 | $617,165 | |||
| JAN PETER | ||||||
| CFO | $258,070 | $23,018 | $12,042 | $32,145 | $33,279 | $358,554 |
| JIM SCHLENKER | ||||||
| COO | $233,684 | $22,672 | $11,666 | $23,047 | $28,844 | $319,913 |
| JEREMY ANDERSON | ||||||
| SURGEON | $784,982 | $18,199 | $37,558 | $24,827 | $865,566 | |
| JAMES WHITTUM | ||||||
| SURGEON | $775,159 | $15,677 | $25,011 | $815,847 | ||
| STEPHEN IACOBONI | ||||||
| PHYSICIAN | $460,000 | $18,430 | $2,116 | $480,546 | ||
| CHRISTOPHER SCOTT | ||||||
| CHIROPRACTIC | $418,315 | $35,021 | $16,733 | $16,665 | $486,734 | |
| THOMAS HOLT | ||||||
| UROLOGIST | $439,810 | $9,463 | $35,157 | $16,808 | $501,238 | |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PAGE 1, PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | AT THE END OF THE FISCAL YEAR THE BOARD DETERMINES THE AMOUNT OF FUNDS THAT WILL BE DISBURSED FOR BONUSES BASED ON THE ACHIEVEMENT OF SPECIFIED GOALS. MANAGEMENT THEN DETERMINES THE PERCENTAGE OF BONUSES ALLOCATED TO EACH LEVEL AND EACH INDIVIDUAL. THE HOSPITAL MAY ALSO PAY THE CEO A DISCRETIONARY ANNUAL BONUS IN AN MOUNT TO BE DETERMINED BY THE BOARD OR COMMITTEE BASED UPON THE CEO'S ANNUAL REVIEW. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NANCY MABRY | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBER | RelationshipDescriptionTxt |
| Transaction | $481,327 | TransactionAmt |
| Transaction | COLLECTIONS CO OWNER | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | CREDITS INC. IS A COLLECTION SERVICE AGENCY USED BY GSHCS WHICH IS OWNED 100% BY A BOARD MEMBER. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III | RECOGNIZING OUR MISSION TO THE COMMUNITY, SERVICES WERE ALSO PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS DURING THE YEAR WAS 60,464,353. THE UNREIMBURSED AMOUNTS ARE VALUED AT CHARGES FOREGONE. OUR EMERGENCY CENTER IS OPEN AROUND-THE-CLOCK TO ALL COMMUNITY MEMBERS, VISITORS, AND TRAVELERS, WITHOUT REGARD TO ONE'S ABILITY TO PAY. |
| FORM 990, PART VI | THE FOLLOWING BOARD MEMBERS OF GSHCS ARE ALSO BOARD MEMBERS OF GOOD SHEPHERD COMMUNITY HEALTH FOUNDATION, A RELATED ORGANIZATION: TOM WAMSLEY, BILL ELFERING, AND LISA MITTLESDORF. |
| FORM 990, PAGE 6, PART VI, LINE 2 | SEE ABOVE BUSINESS RELATIONSHIP |
| FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE 990 IS PROVIDED TO THE CFO AND CONTROLLER WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PRESENTED TO THE BOARD OF DIRECTORS WHO THEN APPROVE THE 990. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO SIGNS THE FORM 8879-EO AUTHORIZING THE PREPARER TO E-FILE THE RETURN. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES WITH CONFLICTS ARE EXPECTED TO DISCLOSE CONFLICTS OF INTEREST ON A VOLUNTARY BASIS AND REFRAIN FROM DISCUSSION AND/OR VOTING ON RELATED MATTERS AS NECESSARY. THESE DISCLOSURES ARE REVIEWED AND DETERMINED TO EXIST OR NOT TO EXIST BY THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE CEOS COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS BASED ON SURVEY INFORMATION. THIS PROCESS IS COMPLETED ANNUALLY IN THE MONTH OF OCTOBER. THE COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES IS DETERMINED BY THE CEO BASED ON SURVEY INFORMATION. THIS PROCESS IS COMPLETED ANNUALLY ON THE ANNIVERSARY DATE OF THE INDIVIDUALS HIRE DATE. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SEE FORM 990, PART VI, LINE 15A ABOVE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | 17,567,334 1,503,152 6,306 |
| FORM 990, PART XI, LINE 9 | CHANGE IN RESTRICTED NET ASSETS 31,224 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SHEPHERD COMMUNITY HEALTH FOUN | BusinessNameLine1Txt |
| Business Name Line2 | DATION | BusinessNameLine2Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 NW 11TH STREET | AddressLine1Txt |
| City | HERMISTON | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97838 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 931170546 | EIN |
| Primary Activities | FUNDRAISIN | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Exempt Code Section | 501C3 | ExemptCodeSectionTxt |
| Public Charity Status | 7 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GSHCS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SHEPHERD MEDICAL SERVICE CORP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 NW 11TH STREET | AddressLine1Txt |
| City | HERMISTON | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97838 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 900688940 | EIN |
| Primary Activities | PHARMACY | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| GOOD SHEPHERD MEDICAL SERVICE CORP | ||
| A | $424,854 | GAAP ACCOUNTING |
| GOOD SHEPHERD COMMUNITY HEALTH FOUN | ||
| B | $43,164 | GAAP ACCOUNTING |
| GOOD SHEPHERD COMMUNITY HEALTH FOUN | ||
| C | $16,600 | GAAP ACCOUNTING |
| GOOD SHEPHERD COMMUNITY HEALTH FOUN | ||
| O | $112,520 | GAAP ACCOUNTING |