ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME (EIN 42-0733472)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-17
- IRS object ID
- 202111379349307856
- Schema version
- 2019v5.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-17T15:34:58-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 South Sixth Street Suite 2800 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420733472 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Anthony Regional Hospital | BusinessNameLine1Txt |
| Business Name Line2 | and Nursing Home | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STAN | BusinessNameControlTxt |
| Phone | 7127945246 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 South Clark Street PO Box 628 | AddressLine1Txt |
| City | Carroll | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51401 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | John Munson | PersonNm |
| Person Title | CFO/Vice President | PersonTitleTxt |
| Phone | 7127945246 | PhoneNum |
| Signature | 2021-05-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHAWNA M JANSONS | PreparerPersonNm |
| PTIN | P01222873 | PTIN |
| Phone | 6123974000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Edward H Smith Jr | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 South Clark Street PO Box 628 | AddressLine1Txt |
| City | Carroll | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $115,786,489 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.stanthonyhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1905 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | Consistently providing high quality healthcare services to meet patient and community needs. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 871 | TotalEmployeeCnt |
| Total Volunteers | 367 | TotalVolunteersCnt |
| Total Gross UBI | $937 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,133,496 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,037,456 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $72,907,722 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $78,805,328 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,052,254 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,453,119 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$1,130,779 | PYOtherRevenueAmt |
| CY Other Revenue | -$214,277 | CYOtherRevenueAmt |
| PY Total Revenue | $77,962,693 | PYTotalRevenueAmt |
| CY Total Revenue | $84,081,626 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $8,500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $8,500 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $43,367,439 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $42,941,731 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $36,917,900 | PYOtherExpensesAmt |
| CY Other Expenses | $35,970,679 | CYOtherExpensesAmt |
| PY Total Expenses | $80,293,839 | PYTotalExpensesAmt |
| CY Total Expenses | $78,920,910 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,331,146 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,160,716 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $167,687,985 | TotalAssetsBOYAmt |
| Total Assets EOY | $196,663,793 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $29,465,938 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $51,215,791 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $138,222,047 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $145,448,002 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | St. Anthony Regional Hospital is inspired by faith and committed to excellence. We are dedicated to improving the health of the people we serve. We will lead in providing high quality, high value healthcare services responsive to the needs of our patients and the region. We are committed to the health ministry of our sponsors, St. Anthony Ministries. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $51,333,527 | ExpenseAmt |
| Grant | $8,500 | GrantAmt |
| Revenue | $64,163,699 | RevenueAmt |
| Desc | St. Anthony Regional Hospital is a 99 bed acute care facility and St. Anthony Nursing Home has 79 beds in Carroll, IA. In the year ended June 30, 2020, St. Anthony Regional Hospital and Nursing Home provided health care services to approximately 2,436 inpatients, 70,341 outpatients, and 41,034 clinic visits. St. Anthony Regional Hospital provided services for 1,407 acute care inpatients, and provided psychiatric, swing bed, and nursing home services for the remainder of inpatients. Outpatient services were provided to patients through ancillary departments, emergency room, and clinics.See Schedule O.St. Anthony Hospital provides services of cardiac rehabilitation, dialysis, hospice care, laboratory, observation, chemotherapy, pathology, radiology, respiratory therapy, physical therapy, occupational therapy, speech therapy, diabetes, medical oncology, radiation therapy, and surgical services. St. Anthony's largest patient service area is physical therapy. In the year ended June 30, 2020, St. Anthony serviced 7,020 patients in physical therapy, 5,847 in emergency room, and 5,643 in radiology. The activities pursued by St. Anthony Regional Hospital and Nursing Home in the provision of health care services are consistent with its exempt purpose. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $23,178,634 | ExpenseAmt |
| Revenue | $14,641,629 | RevenueAmt |
| Desc | As part of its mission, St. Anthony Regional Hospital provides medical care to individuals who are unable to pay for services, incurs costs in excess of reimbursement for services to Medicaid beneficiaries, and carries out other activities and programs free of charge to support the community in which it operates. Community benefit projects include community health education, health care support services, behavioral health services, community health improvement advocacy, and other traditional charity care. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $74,512,161 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 153 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 871 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | IA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | John R Munson | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7127945115 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 South Clark St | AddressLine1Txt |
| City | Carroll | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 514010628 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| Randal O Hess MD | ||||||||
| Physician | 40.00 | 0.00 | Yes (X) | $466,372 | $0 | $38,489 | ||
| Patricia Teschke | ||||||||
| Physician | 40.00 | 0.00 | Yes (X) | $455,620 | $0 | $9,357 | ||
| Edward H Smith Jr | ||||||||
| CEO/President | 40.00 | 0.30 | $376,354 | $0 | $52,564 | Yes (X) | ||
| Richard C Sazama MD | ||||||||
| Physician | 40.00 | 0.00 | Yes (X) | $402,422 | $0 | $11,932 | ||
| Nelson H Lo MD | ||||||||
| Physician | 40.00 | 0.00 | Yes (X) | $355,914 | $0 | $36,209 | ||
| Nicholas Kuiper | ||||||||
| Physician | 40.00 | 0.00 | Yes (X) | $355,247 | $0 | $18,592 | ||
| John Munson | ||||||||
| CFO/Vice President | 40.00 | 0.30 | $203,011 | $0 | $35,011 | Yes (X) | ||
| Nick Badding | ||||||||
| Chairman | 0.30 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| Peggy White | ||||||||
| Vice-Chairman | 0.30 | 0.30 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| Sr Romona Klaubauf | ||||||||
| Secretary | 0.30 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| Howard J Drees | ||||||||
| Treasurer | 0.30 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| Fred Dolezal | ||||||||
| Board Member | 0.30 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Jeff Scharfenkamp | ||||||||
| Board Member (Beg 07/19) | 0.30 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Karl Eischeid DDS | ||||||||
| Board Member | 0.30 | 0.30 | $0 | $0 | $0 | Yes (X) | ||
| Sr Donna Venteicher | ||||||||
| Board Member | 0.30 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Sr Maris Kerwin | ||||||||
| Board Member | 0.30 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Sr Theresa Keller | ||||||||
| Board Member | 0.30 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,614,940 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $202,154 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 48 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Acute Care Inc | |||||
| PO Box 3288 | Des Moines | IA | 50316 | Emergency Physician Services | $1,489,771 |
| Medical Oncology | |||||
| 1221 Pleasant St | Des Moines | IA | 50309 | Oncology Services | $681,365 |
| Medical Information Technology | |||||
| Meditech Circle | Westwood | MA | 02090 | EMR Services | $388,025 |
| Shared Service Systems Inc | |||||
| 1725 S 20th St | Omaha | NE | 681083889 | Laundry Services | $300,663 |
| Shared Medical Services Inc | |||||
| 209 Limestone Pass | Cottage Grove | WI | 53527 | Imaging Services | $283,049 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 18 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $3,018,297 | RelatedOrganizationsAmt |
| All Other Contributions | $19,159 | AllOtherContributionsAmt |
| Noncash Contributions | $19,159 | NoncashContributionsAmt |
| Total Contributions | $3,037,456 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Patient Svc Revenue | 621400 | $44,732,348 | $44,732,348 | |
| Medicare/Medicaid Pmts | 621400 | $33,700,658 | $33,700,658 | |
| Cafeteria Sales | 621400 | $372,322 | $372,322 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $78,805,328 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,547,023 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $937 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,546,086 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,038,125 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,252,402 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$214,277 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$214,277 | TotalRevenueColumnAmt |
| Exclusion | -$214,277 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $29,292,192 | SecuritiesAmt |
| Other | $66,365 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $28,451,555 | SecuritiesAmt |
| Other | $906 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $840,637 | SecuritiesAmt |
| Other | $65,459 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $906,096 | TotalRevenueColumnAmt |
| Exclusion | $906,096 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $84,081,626 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $78,433,006 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $937 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,610,227 | 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 | $7,500 | TotalAmt |
| Program Services | $7,500 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000 | TotalAmt |
| Program Services | $1,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $574,285 | TotalAmt |
| Management And General | $574,285 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,296,096 | TotalAmt |
| Program Services | $33,162,595 | ProgramServicesAmt |
| Management And General | $1,133,501 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $696,454 | TotalAmt |
| Program Services | $623,277 | ProgramServicesAmt |
| Management And General | $73,177 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,071,003 | TotalAmt |
| Program Services | $4,821,154 | ProgramServicesAmt |
| Management And General | $249,849 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,303,893 | TotalAmt |
| Program Services | $2,202,133 | ProgramServicesAmt |
| Management And General | $101,760 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,458 | TotalAmt |
| Management And General | $82,458 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $243,747 | TotalAmt |
| Management And General | $243,747 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,619 | TotalAmt |
| Management And General | $7,619 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $317,515 | TotalAmt |
| Management And General | $317,515 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,675,875 | TotalAmt |
| Program Services | $5,687,094 | ProgramServicesAmt |
| Management And General | $988,781 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $304,195 | TotalAmt |
| Program Services | $7,775 | ProgramServicesAmt |
| Management And General | $296,420 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,894,530 | TotalAmt |
| Program Services | $1,755,974 | ProgramServicesAmt |
| Management And General | $138,556 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $654,461 | TotalAmt |
| Program Services | $654,461 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,241,919 | TotalAmt |
| Program Services | $2,232,559 | ProgramServicesAmt |
| Management And General | $9,360 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $277,656 | TotalAmt |
| Program Services | $242,081 | ProgramServicesAmt |
| Management And General | $35,575 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $623,417 | TotalAmt |
| Program Services | $623,417 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,918,250 | TotalAmt |
| Program Services | $5,918,250 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,359 | TotalAmt |
| Program Services | $374,359 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $14,200,493 | $14,200,493 | |
| Repair and Maintenance | $2,154,185 | $1,998,039 | $156,146 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,920,910 | TotalAmt |
| Program Services | $74,512,161 | ProgramServicesAmt |
| Management And General | $4,408,749 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $311,617 | BOYAmt |
| EOY | $21,622,267 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,168,584 | BOYAmt |
| EOY | $8,832,710 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $245 | BOYAmt |
| EOY | $186 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,081,015 | BOYAmt |
| EOY | $2,302,761 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $558,737 | BOYAmt |
| EOY | $662,515 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $161,270,817 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $90,748,192 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,104,752 | BOYAmt |
| EOY | $70,522,625 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,570,964 | BOYAmt |
| EOY | $70,617,553 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,143,301 | BOYAmt |
| EOY | $5,046,493 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,748,770 | BOYAmt |
| EOY | $17,056,683 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,687,985 | BOYAmt |
| EOY | $196,663,793 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,426,554 | BOYAmt |
| EOY | $22,366,189 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,364,355 | BOYAmt |
| EOY | $26,459,921 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,119,176 | BOYAmt |
| EOY | $702,010 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,555,853 | BOYAmt |
| EOY | $1,687,671 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,465,938 | BOYAmt |
| EOY | $51,215,791 | 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 | $127,029,130 | BOYAmt |
| EOY | $134,059,831 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,192,917 | BOYAmt |
| EOY | $11,388,171 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $138,222,047 | BOYAmt |
| EOY | $145,448,002 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,687,985 | BOYAmt |
| EOY | $196,663,793 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,160,716 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,121,574 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$56,335 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $7,619 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,619 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | St. Anthony Regional Hospital and Nursing Home is a member of the Iowa Hospital Association and the Catholic Health Organization. A percentage of dues are paid for lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $18,596,647 | BeginningYearBalanceAmt |
| Contributions | $98,672 | ContributionsAmt |
| Investment Earnings Or Losses | $1,108,234 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $14,850 | GrantsOrScholarshipsAmt |
| Other Expenditures | $742,029 | OtherExpendituresAmt |
| End Year Balance | $19,046,674 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $14,742,656 | BeginningYearBalanceAmt |
| Contributions | $2,531,749 | ContributionsAmt |
| Investment Earnings Or Losses | $1,454,273 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $15,000 | GrantsOrScholarshipsAmt |
| Other Expenditures | $117,031 | OtherExpendituresAmt |
| End Year Balance | $18,596,647 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $13,393,000 | BeginningYearBalanceAmt |
| Contributions | $202,723 | ContributionsAmt |
| Investment Earnings Or Losses | $2,011,722 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $9,750 | GrantsOrScholarshipsAmt |
| Other Expenditures | $855,039 | OtherExpendituresAmt |
| End Year Balance | $14,742,656 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,173,907 | BeginningYearBalanceAmt |
| Contributions | $143,951 | ContributionsAmt |
| Investment Earnings Or Losses | $1,764,112 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $9,750 | GrantsOrScholarshipsAmt |
| Other Expenditures | $679,220 | OtherExpendituresAmt |
| End Year Balance | $13,393,000 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,720,664 | BeginningYearBalanceAmt |
| Contributions | $357,317 | ContributionsAmt |
| Investment Earnings Or Losses | $138,893 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $9,500 | GrantsOrScholarshipsAmt |
| Other Expenditures | $33,467 | OtherExpendituresAmt |
| End Year Balance | $12,173,907 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.40000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.60000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $693,934 | OtherCostOrOtherBasisAmt |
| Book Value | $693,934 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $106,472,564 | OtherCostOrOtherBasisAmt |
| Depreciation | $56,276,558 | DepreciationAmt |
| Book Value | $50,196,006 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,777,307 | OtherCostOrOtherBasisAmt |
| Depreciation | $34,471,634 | DepreciationAmt |
| Book Value | $8,305,673 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,327,012 | OtherCostOrOtherBasisAmt |
| Book Value | $11,327,012 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $70,522,625 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Deferred Compensation Investments | $1,687,671 |
| Beneficial Interest in Net Assets of the Foundation | $15,369,012 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $17,056,683 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Deferred Compensation | Desc |
| Amt | $1,687,671 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,687,671 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $89,248,723 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $2,121,574 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $176,095 | OtherRevenueAmt |
| Revenue Not Reported | $2,297,669 | RevenueNotReportedAmt |
| Revenue Subtotal | $86,951,054 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $317,515 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | -$3,186,943 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$2,869,428 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $84,081,626 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $82,022,768 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $3,419,373 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $3,419,373 | ExpensesNotReportedAmt |
| Expenses Subtotal | $78,603,395 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $317,515 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $317,515 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $78,920,910 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | All restricted endowed funds held at the St. Anthony Foundation are used for the benefit of St. Anthony Regional Hospital and Nursing Home and for scholarships. |
| Part X, Line 2: | The Internal Revenue Service has determined that the Hospital is an organization exempt from income tax under the Internal Revenue Code; and accordingly, no provision for income taxes is recorded in the consolidated statement of activities. Accounting for income taxes provides that a tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. The Hospital recorded no liabilities for unrecognized tax benefits as of June 30, 2020 and 2019. The Hospital is engaged in certain activities that result in unrelated business income recorded within other revenue in the consolidated statements of activities. |
| Part XI, Line 2d - Other Adjustments: | Change in beneficial interest of net assets of St. Anthony Foundation 176,095. |
| Part XI, Line 4b - Other Adjustments: | Rental Expenses -3,252,402. Realized Gain on Sale of Assets 65,459. |
| Part XII, Line 2d - Other Adjustments: | Rental Expenses 3,252,402. Realized Gain on Sale of Assets -65,459. Transfer to Foundation - Reimbursed Expenses 232,430. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 399.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $453,369 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $453,369 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00570 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,750,320 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,497,380 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,252,940 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02850 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,203,689 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,497,380 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,706,309 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03420 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $173,422 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,490 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $165,932 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $219,465 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $214,465 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,407,304 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,082,936 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,324,368 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06750 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $174,754 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $48,823 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $125,931 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,974,945 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,144,249 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,830,696 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07390 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,178,634 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,641,629 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,537,005 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10810 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,627 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,627 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,627 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,627 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,455,076 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $20,606,954 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $25,761,684 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$5,154,730 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Anthony Regional Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 South Clark St PO Box 628 | AddressLine1Txt |
| City | Carroll | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 514010628 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.stanthonyhospital.org | WebsiteAddressTxt |
| State License | 14009OH | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Anthony Regional Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Section C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Section C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 399.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, Page 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Page 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Page 8 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| St. Anthony Regional Hospital | Part V, Section B, Line 5: In the year ended 6/30/19, St. Anthony Regional Hospital conducted a CHNA assessment. A total of 8 individuals were interviewed. Primary data collection included key stakeholder interviews and a web based community survey. The interviews were conducted by Dory Escobar, PhD for Community Catalyst in May of 2019. Interviews were conducted with representatives from local hospitals and other health care providers with residents over a 6 county area. All interviews were reviewed and comments analyzed to identify the most frequently mentioned community health issues. The primary data collection included a web based online community survey in English and Spanish during February 2019. Community stakeholders participated in identifying key issued focused on health and well being through the life span. 260 people participated in the online survey. |
| St. Anthony Regional Hospital | Part V, Section B, Line 6b: St. Anthony Regional Hospital and Nursing Home contracted with Community Catalyst for assistance with the Community Health Needs Assessment. |
| St. Anthony Regional Hospital | Part V, Section B, Line 7d: https://www.stanthonyhospital.org/webres/File/legal/Community%20Health%20Needs%20Assessment%202019%20Final.pdfPart V, Section B, line 10a, Implementation Strategy Website:https://www.stanthonyhospital.org/webres/File/legal/St%20Anthony%20Implementation%20Strategy%202019.pdf |
| St. Anthony Regional Hospital | Part V, Section B, Line 11: The following significant health needs were identified in the St. Anthony Regional Hospital and Nursing Home service area.- Access to care and Health Education- Cancer - Treatment and Prevention- Chronic Disease Management- Mental Health Services- Nutrition and Exercise- Substance Abuse - Tobacco and Alcohol- Transportation- VaccinationsSt. Anthony Regional Hospital and Nursing Home has worked to meet these identified heath needs this year in the following ways:Access to Care and Health Education:- Developed updated list of service providers and other resources. - Organized community health fairs and events for vulnerable populations.- Promoted community service opportunities to address needs of target population. - Provided support groups for individuals with health issues.Cancer - Treatment and Prevention:- The development of a new cancer center and resources for the community.- Community runs for cancer to raise awareness and funds with partners Carroll Chamber and Carroll Cancer Crusaders. - Participation in Iowa Cancer Consortium on HPV.Chronic Disease Management:- Ongoing leadership and participation in activities and events in the community to promote health living and chronic disease prevention and management.Mental Health:- Community education on Adverse Childhood Experiences (ACES).- Provided parent education on child development and mental health.- Caregiver education on self care.- Mentoring programs.- Community and school based mental health promotion programs and events for middle school and high school students.- Bereavement support programs.Nutrition and Exercise:- Community gardens and gardening classes.- Community events promoting physical activity and education about healthy eating and drinking water.- Healthy eating education and health weight management programs.- Diabetes prevention and management programs.- Accredited diabetes education.- Participation in the Live Health Iowa initiative and Carroll County Wellness Coalition.- WIC clinics.- Fall prevention education and activities for older adults and providers.Substance Abuse - Tobacco and Alcohol:- Provider education.- Community and school based programs to prevent substance use amount adults, children and adolescents.- Responsible beverage service training.- Drivers education presentations regarding alcohol use.- Tobacco cessation "Quit Line".- Tobacco/nicotine free work policy with area work places and with area child care providers.- Collaboration with healthcare providers to implement 2A and R - Ask, Advise, Refer system.Vaccinations:- Community education about HPV and promotion of vaccination.- Radio and newspaper ads, social media posts to increase HPV and meningitis immunizations.- Community based immunizations clinics.Transportation:- Collaborate to increase transportation to healthcare services for vulnerable population, including older adults, people with disabilities and covered by Medicaid.- Community fundraiser to fund travel vouchers for low income individuals. |
| St. Anthony Regional Hospital | Part V, Section B, Line 13h: Additional eligibility criteria for financial assistance include Medicaid/Medicare coverage, and State regulations. |
| Part V, line 16a, FAP website: | https://www.stanthonyhospital.org/patients-visitors/patients/financial-assistance/ |
| Part V, line 16b, FAP Application website: | https://www.stanthonyhospital.org/patients-visitors/patients/financial-assistance/ |
| Part V, line 16c, FAP Plain Language Summary website: | https://www.stanthonyhospital.org/patients-visitors/patients/financial-assistance/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - St Anthony Regional Hospice | ||||
| 311 South Clark St | Carroll | IA | 51401 | Hospice Services |
| 2 - St Anthony Regional Hospital | ||||
| 311 South Clark St | Carroll | IA | 51401 | Dialysis Services |
| 3 - St Anthony Regional Home Hlth Agency | ||||
| 311 South Clark St | Carroll | IA | 51401 | Home Health Services |
| 4 - St Anthony Regional Hospital | ||||
| 311 South Clark St | Carroll | IA | 51401 | Psychiatric Services |
| 5 - Wall Lake Medical Clinic | ||||
| 311 West First St | Wall Lake | IA | 51466 | Rural Health Clinic |
| 6 - St Anthony Nursing Home | ||||
| 311 South Clark St | Carroll | IA | 51401 | Nursing Home |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | In addition to FPG, the Hospital will consider the extent to which the patient's household has assets that could be used to meet his or her financial obligation. Assets may include, but are not limited to, cash, savings and checking account, certificates of deposit, stocks and bonds, individual retirement accounts (IRAs), trust funds, real estate (excluding the patient's home) and motor vehicles. The hospital will take into account any liabilities that are the responsibility of the patient's household. To relieve stress related to financial burdens, families with a medical catastrophe with self-pay balances greater than 20 percent of their annual household income in one calendar year may be eligible for substantial discounts. |
| Part I, Line 7: | The cost to charge ratio was used when calculating the amounts reported in Part 1, line 7, with the exception of line 7g, subsidized health services. Subsidized health services are reported using departmental cost from the 2020 cost report. |
| Part I, Line 7g: | St. Anthony Regional Hospital has eight physician clinics that are included in subsidized health services where cost exceeds the reimbursements. |
| Part II, Community Building Activities: | The Hospital CEO participates in the Carroll Area Development board that is active in workforce development. The hospital emergency room director attended regional meetings on disaster readiness. The CEO is a board member of the Iowa Hospital Association Board of Directors. There are managers of the Hospital that serve on local health advisory boards. |
| Part III, Line 2: | St. Anthony Regional Hospital reports bad debt in accordance with generally accepted accounting principles (GAAP). Bad debt at cost is calculated with the same cost to charge ratio used for the charity care at cost multiplied by the estimated debt charges. |
| Part III, Line 3: | St. Anthony Regional Hospital works with those qualifying for charity care along every step of the process including accepting applications for financial assistance after previous attempts to work with the patient fail. Every effort is made to work with the patient to provide financial assistance when appropriate. While there are people who do not cooperate with the Hospital regarding payment plans, financial assistance or with those trying to help get on government programs. For individuals not providing necessary information it is impossible to know the reason for not cooperating and therefore know whether the will qualify for charity care. St. Anthony Regional Hospital is unable to reasonably determine whether any amount of bad debt could have been classified as charity care if individuals do not provide the necessary information to evaluate their situation to determine qualification with the charity care policy. |
| Part III, Line 4: | St. Anthony Regional Hospital's audited financial statements include a footnote for the provision for bad debts on Page 8 in the section entitled 'Net Patient Service Revenue'. |
| Part III, Line 8: | The amount of Medicare short fall on line 6 should be included in the community benefit because Medicare pays less than the cost for rendering services. The Medicare allowable costs are taken from the Medicare cost report and determined based on the cost to charge ratio from the Medicare report. |
| Part III, Line 9b: | The policy states that St. Anthony Regional Hospital offers charity care to all patients who meet criteria for financial aid and want assistance. Patients who do not have insurance may qualify for St. Anthony Cares based on annual income and family size. Patients with insurance may also qualify for St. Anthony Cares for bills not covered by insurance. Charity information is available upon admission an disclosed in monthly billing statements. An application is completed by the patient and based on income and family size the amount of charity is determined based on the federal poverty guidelines. Patients receive statements and make payment arrangements with Preferred Medical Deposits (PMD). Accounts at PMD with no activity after 60 days are turned over to a collection agency, Avadyne Health.Reasonable efforts will be extended to patients to make them aware of the Care. It includes the following action:- Providing written notice on their billing statement from the payment processor that financial assistant is available.- Making a determination regarding Financial Assistance eligibility if the patient submits a complete CARES application during the application period.- Notify the patient who submits an incomplete CARES application about how to complete it properly, and giving the patient a reasonable opportunity to do so.The Hospital must provide this notification in writing and must provide contact information for resources in assisting the patient with completing the CARES application. Providing a Plain Language Summary identifying the ECAs that the Hospital may take if needed, and stating a deadline after which ECAs may be initiated that is no earlier than 30 days after the date when the written notice is provided. |
| Part VI, Line 2: | The Hospital and county performs a community needs assessment every three years to identify specific health concerns of the county. Meetings are held with community partners to identify needs from the daily work and with clients, students, educators, health care, volunteer services, case management, behavior medicine, and others in the county. A survey was developed to gather county resident's identified needs. The primary data collection included a web based community survey. The survey was posted on the hospital website. There were 260 people who participated in the survey. The needs assessment was completed and adopted by the St. Anthony Hospital Board of Directors. The implementation strategy was developed and implemented based on the assessment of the survey. The hospital intends to coordinate efforts with the Carroll County Public Health Department to ensure that community benefit resources address needs to improve the health of residents of the service area. The Carroll County Public Health Department provides emergency preparedness, blood pressure clinics, care for your self program, disease management, health opportunities for parents, immunizations, senior health, assistant to obstetrics patients, and TB testing to the community. |
| Part VI, Line 3: | The financial counselor from the organization informs and educates patients about eligibility of federal, state and local government programs and charity policies. The charity care policy is made available to patients in the admissions office and provided in the admission packets. If patients have questions they can stop in the business office and discuss them with the financial counselor. |
| Part VI, Line 4: | The Hospital is located in the city of Carroll in West Central Iowa, Carroll County with a population of 20,320. St. Anthony Hospital also serves portions of 6 surrounding counties with a radius of 50 miles. St. Anthony Hospital operates 6 satellite physician clinics in the service area, in addition to 2 physician clinics in the hospital. The six countries of Audubon, Carroll, Calhoun, Crawford, Green, and Sac comprise the hospital's primary service area. The estimated population of St. Anthony's six county area was 71,498 in 2017. The estimated 2017 median house hold income for all counties in the service area is less than the median Iowa household income of $56,570. The majority of the population in the St. Anthony, six county service area is White/Caucasian. Crawford County has a significant Hispanic population, with more than 30% of the population being Hispanic. The majority of the service area is comprised of English speaking residents. The exception is Crawford County where 8 % of the population in not proficient in English, the majority of whom are Spanish speaking. |
| Part VI, Line 5: | St. Anthony Regional Hospital has demonstrated a commitment to promoting health care to further its exempt purpose of providing quality health care in the community and surrounding counties for one hundred and fourteen years. The majority of the Hospital's board members are from local businesses and reside in the community. The Hospital's medical staff consists of 31 active staff, 3 associate staff in the community, and 91 courtesy staff from outside the community. St. Anthony Regional Hospital is a regional provider and is committed to providing quality care to the community. |
| Part VI, Line 7, Reports Filed With States | IA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | American Cancer Society | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1717 Ingersol Ave Suite 111 | AddressLine1Txt |
| City | Des Moines | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 50309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 141788491 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $7,500 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | Support for Cancer Prevention | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | The organization will be funding and conducting research, sharing expert information, supporting patients and their caregiviers, advocating for policy, and spreading the word about prevention. While there is no specific procedure for monitoring the use of the grants, the St. Anthony Regional Hospital and Nursing Home provided the grant to the American Cancer Society and the funds are indicated for a specific purpose - the support of cancer prevention. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Randal O Hess MD | ||||||||||||||
| Physician | $447,773 | $0 | $1,455 | $0 | $17,144 | $0 | $13,700 | $0 | $24,789 | $0 | $504,861 | $0 | $0 | $0 |
| Patricia Teschke | ||||||||||||||
| Physician | $397,914 | $0 | $50,000 | $0 | $7,706 | $0 | $0 | $0 | $9,357 | $0 | $464,977 | $0 | $0 | $0 |
| Edward H Smith Jr | ||||||||||||||
| CEO/President | $310,386 | $0 | $35,161 | $0 | $30,807 | $0 | $26,175 | $0 | $26,389 | $0 | $428,918 | $0 | $0 | $0 |
| Richard C Sazama MD | ||||||||||||||
| Physician | $393,202 | $0 | $0 | $0 | $9,220 | $0 | $10,783 | $0 | $1,149 | $0 | $414,354 | $0 | $0 | $0 |
| Nelson H Lo MD | ||||||||||||||
| Physician | $355,714 | $0 | $200 | $0 | $0 | $0 | $10,918 | $0 | $25,291 | $0 | $392,123 | $0 | $0 | $0 |
| Nicholas Kuiper | ||||||||||||||
| Physician | $339,487 | $0 | $7,820 | $0 | $7,940 | $0 | $0 | $0 | $18,592 | $0 | $373,839 | $0 | $0 | $0 |
| John Munson | ||||||||||||||
| CFO/Vice President | $192,198 | $0 | $9,150 | $0 | $1,663 | $0 | $5,606 | $0 | $29,405 | $0 | $238,022 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 4b | St. Anthony Regional Hospital and Nursing Home has a non qualified deferred compensation plan that complies with section 457(f) of the Internal Revenue Code and the short-term deferral provisions of section 409A of the code. The plan is to be an unfunded plan maintained primarily for the purpose of providing deferred compensation benefits for a select group of management or highly compensated employees. No individuals received payments from the non qualified deferred compensation plan during calendar year 2019. |
| Part I, Line 7 | In their roles as executives employed by St. Anthony Regional Hospital and Nursing Home, the executives are eligible for incentive payouts. The incentive award will be a percentage of the base pay compensation for the CEO, CFO, and other executives. The ultimate payout includes a reduction/increase multiplier depending on whether the organization reached specified performance metrics identified by the Board of Directors. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | City of Carroll IA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 426004322 | BondIssuerEIN |
| CUSIP | 000000000 | CUSIPNum |
| Bond Issued | 2012-11-26 | BondIssuedDt |
| Issue Price | $4,820,000 | IssuePriceAmt |
| Purpose | Refund Bonds Issued 12/20/2001 | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $3,374,000 | RetiredAmt |
| Total Proceeds | $4,820,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $50,000 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $4,770,000 | OtherSpentProceedsAmt |
| Substantial Completion | 2009 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Drees Co | |||
| Entity more than 35% controlled by Howard J. Drees, Treasurer, and family. | $4,953,643 | Construction and Plumbing/Heating Services | 0 |
| Badding Construction | |||
| Entity more than 35% controlled by Nick Badding, board Chairman, and family | $1,370,557 | Construction Services | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Sister Romona Klaubauf, Sister Theresa Keller, Sister Maris Kerwin, and Sister Donna Venteicher have a business relationship through their membership in the Franciscan Sisters of Perpetual Adoration. |
| Form 990, Part VI, Section A, line 6 | The former members of the St. Anthony Regional Hospital and Nursing Home are the sisters of the religious community known as the Congregation of the Sisters of the Third Order of the St. Francis of Perpetual Adoration (FSPA). The FSPA has formed St. Anthony Ministries to assume canonical sponsorship and membership of St. Anthony Regional Hospital and Nursing Home, performed previously by the FSPA. St. Anthony Ministries has the power to elect the board of directors, amend the articles of incorporation and bylaws of the organizations and dissolve the organization. |
| Form 990, Part VI, Section A, line 7a | St. Anthony Ministries, as the sole member of St. Anthony Regional Hospital and Nursing Home, elects and approves the Board of Directors for St. Anthony Regional Hospital and Nursing Home. |
| Form 990, Part VI, Section A, line 7b | All decisions, including dissolution of the organization, made by the Board of Directors of St. Anthony Regional Hospital and Nursing Home are subject to the approval of St. Anthony Ministries. |
| Form 990, Part VI, Section B, line 11b | St. Anthony Regional Hospital and Nursing Home gathers the necessary information for the completion of the Form 990 within the finance department and with assistance form the human resources and operation departments. The form was prepared by an independent accounting firm. Drafts of the form were reviewed by the CFO and the Audit committee. After the internal reviews were complete, the final version of the form 990 was given to each member of the Board of Directors prior to filing the return. |
| Form 990, Part VI, Section B, line 12c | The Officers and Board Members annually disclose in writing, "any interest which would be inconsistent with the expeditious, proper, and impartial performance of duties." Defining disclosable conflict or duality of interest as any matter in which the corporations are "interested which affects the financial interest or employment of such member, a member of his/her family by blood or marriage, or any business enterprise in which he/she or such family member is employed or has a financial interest." Officers and Board members are required to disclose the facts surrounding any possible conflict of interest throughout the year. If a conflict of interest is disclosed by an Officer or Board Member, during a board meeting the Officer or Board Member will not participate in any discussions or deliberations regarding the matter and would abstain from any voting decisions on this matter during the meeting. All conflict of interests that are disclosed will be reported in the minutes of the board meetings. |
| Form 990, Part VI, Section B, line 15 | At the direction of the Board of Directors the CEO gathers compensation information (salary and benefits) from various sources including Iowa Hospital Association and benefit consultants for like-sized organizations. The Executive Committee then determines the annual compensation for the CEO, other officers, and any key employees for the total board approval. The compensation process for the CEO is completed in August annually. The other officers compensation is completed in March annually. |
| Form 990, Part VI, Section C, line 19 | The St. Anthony Regional Hospital and Nursing Home mails its audited financial statements to financial institutions, governmental institutions, board members, and the Iowa Hospital Association. The Form 990 is available at guidestar.org. St. Anthony Regional Hospital and Nursing Home discloses financial statements to bondholders, the IHA, and the Iowa Attorney General's office. St. Anthony Regional Hospital and Nursing Home's governing documents, conflict of interest policy, and financial statements are available to the public upon request. |
| Form 990, Part IX, line 11g | Physician Fees: Program service expenses 2,377,177. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,377,177. Patient Service Fees: Program service expenses 590,577. Management and general expenses 0. Fundraising expenses 0. Total expenses 590,577. Contract Labor: Program service expenses 1,669,033. Management and general expenses 9,980. Fundraising expenses 0. Total expenses 1,679,013. Laundry Fees: Program service expenses 282,546. Management and general expenses 0. Fundraising expenses 0. Total expenses 282,546. Consulting Fees: Program service expenses 20,594. Management and general expenses 54,676. Fundraising expenses 0. Total expenses 75,270. Professional Fees: Program service expenses 613,693. Management and general expenses 868,262. Fundraising expenses 0. Total expenses 1,481,955. Recruiting Fees: Program service expenses 133,474. Management and general expenses 55,863. Fundraising expenses 0. Total expenses 189,337. |
| Form 990, Part XI, line 9: | Transfer to Foundation - Reimbursed Expenses -232,430. Change in beneficial interest of net assets of St. Anthony Foundation 176,095. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| St Anthony Foundation | |||||||||||
| 311 South Clark St PO Box 628 | Carroll | IA | 51401 | 421419695 | Fundraising | IA | 501(c)(3) | 12a | St Anthony Regional Hospital and Nursing Home | Yes (1) | |
| St Anthony Ministries | |||||||||||
| 311 South Clark St PO Box 628 | Carroll | IA | 51401 | 000000000 | Religious Order | IA | 501(c)(3) | 1 | 0 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| St Anthony Foundation | ||
| C | $3,018,297 | FMV |
| St Anthony Foundation | ||
| P | $232,430 | FMV |