DESOTO HOSPITAL ASSOCIATION: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- DESOTO HOSPITAL ASSOCIATION (EIN 72-0500565)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-05-06
- IRS object ID
- 202031279349300043
- Schema version
- 2018v3.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-05-06T09:44:34-07:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 720979212 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lester Miller & Wells | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3600 Bayou Rapides | AddressLine1Txt |
| City | Alexandria | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 71303 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 720500565 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Desoto Hospital Association Inc | BusinessNameLine1Txt |
| Business Name Line2 | DBA Desoto Regional Health System | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DESO | BusinessNameControlTxt |
| Phone | 3188724610 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 207 Jefferson Street | AddressLine1Txt |
| City | Mansfield | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 71052 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TODD EPPLER | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Signature | 2020-05-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Mary L Carroll | PreparerPersonNm |
| PTIN | P00564251 | PTIN |
| Phone | 3184871450 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 207 Jefferson Street | AddressLine1Txt |
| City | Mansfield | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 71052 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $25,742,880 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.desotoregional.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1949 | FormationYr |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Activity Or Mission | 34 BED HOSPITAL LOCATED IN A MEDICALLY UNDERSERVED PARISH IN NORTHWEST LOUISIANA DOING BUSINESS AS DESOTO REGIONAL HEALTH SYSTEM. INCLUDES THREE RURAL HEALTH CLINICS, WITH FOUR FULL-TIME PHYSICIANS AND ONE PART TIME PHYSICIAN, 24 HOUR EMERGENCY SERVICES, INTENSIVE OUTPATIENT PROGRAM, AND A WELLNESS AND THERAPY CENTER. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 270 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $7,253 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$3,724 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $119,195 | PYContributionsGrantsAmt |
| CY Contributions Grants | $403,980 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $24,300,780 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,658,745 | CYProgramServiceRevenueAmt |
| PY Investment Income | $50,029 | PYInvestmentIncomeAmt |
| CY Investment Income | -$13,944 | CYInvestmentIncomeAmt |
| PY Other Revenue | $697,105 | PYOtherRevenueAmt |
| CY Other Revenue | $670,142 | CYOtherRevenueAmt |
| PY Total Revenue | $25,167,109 | PYTotalRevenueAmt |
| CY Total Revenue | $25,718,923 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,662,516 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,485,023 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,198,960 | PYOtherExpensesAmt |
| CY Other Expenses | $13,894,689 | CYOtherExpensesAmt |
| PY Total Expenses | $23,861,476 | PYTotalExpensesAmt |
| CY Total Expenses | $25,379,712 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,305,633 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $339,211 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,436,357 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,554,547 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,041,028 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,820,007 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $15,395,329 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $15,734,540 | NetAssetsOrFundBalancesEOYAmt |
| Mission | 34 BED HOSPITAL LOCATED IN A MEDICALLY UNDERSERVED PARISH IN NORTHWEST LOUISIANA DOING BUSINESS AS DESOTO REGIONAL HEALTH SYSTEM. INCLUDES THREE RURAL HEALTH CLINICS, WITH FOUR FULL-TIME PHYSICIANS AND ONE PART TIME PHYSICIAN, 24 HOUR EMERGENCY SERVICES, INTENSIVE OUTPATIENT PROGRAM, AND A WELLNESS AND THERAPY CENTER. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $21,620,237 | ExpenseAmt |
| Revenue | $24,663,670 | RevenueAmt |
| Desc | DeSoto Hospital Association, INC. (DHA) is licensed to operate a 34 bed acute care hospital for medical, surgical, and diagnostic services. The hospital provided 1,317 inpatient days of care (Medicare 846 and Medicaid 170). DHA also is licensed to operate three rural health clinics, which provided total visits of 47,015 (Medicare 10,973 and Medicaid 17,657).At no charge, the following exempt organizations use the Hospitals conference room for meetings: Rotary Club, Crime Stoppers, Mayors Liaison Committee, ADAC, Alcoholics Anonymous, Gideons, Family Abuse Support, and cancer survivors.Without charge, various hospital employees were sent to educate the community through high school career days, science and health fairs, job shadowing, AHEC, and speaking at various festivals. | Desc |
| Total Program Service Expenses | $21,620,237 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | 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 |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| 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 | false | 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 | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 270 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| 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 |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | Yes (true) | IndoorTanningServicesInd |
| Form720 Filed | Yes (true) | Form720FiledInd |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | 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 | false | 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 | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Sandra Anderson | PersonNm |
| Phone | 3188713102 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 207 Jefferson Street | AddressLine1Txt |
| City | Mansfield | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 71052 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| John Russell | ||||||||
| Vice Chairman | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Tyler Rambin | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Johnny May | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| John L Freeman | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Deborah Eckles | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Jill Heard | ||||||||
| Secretary | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Deborah D Dees | ||||||||
| Chairman | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Richard Wilkinson | ||||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Stephen Flanders | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Doug Sawyer | ||||||||
| Cheif of Staff | 24.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Eric Cripps | ||||||||
| CFO | 0.00 | 20.00 | $0 | $60,000 | $0 | Yes (X) | ||
| Todd Eppler | ||||||||
| CEO | 0.00 | 40.00 | $0 | $265,730 | $28,471 | Yes (X) | ||
| Shane Goodman | ||||||||
| CNO | 40.00 | 0.00 | $114,778 | $0 | $29,607 | Yes (X) | ||
| Denis Kamberov | ||||||||
| Physician | 40.00 | 0.00 | $424,261 | $0 | $43,432 | Yes (X) | ||
| Benjamin Leggio | ||||||||
| Physician | 40.00 | 0.00 | $449,540 | $0 | $22,683 | Yes (X) | ||
| JEFFREY EVANS | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $145,681 | $0 | $20,668 | Yes (X) | ||
| Chi-Tai Lau | ||||||||
| Physician | 40.00 | 0.00 | $299,694 | $0 | $38,756 | Yes (X) | ||
| Douglas Sawyer | ||||||||
| PHYSICIAN | 24.00 | 0.00 | $209,992 | $0 | $15,941 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,643,946 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $325,730 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $199,558 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (true) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| IMPACT HEALTHCARE | |||||
| 1813 NORTHPOINTE LN | RUSTON | LA | 71270 | BILLING | $767,451 |
| EMERGENCY STAFFING SOLUTIONS | |||||
| 17304 PRESTON RD SUITE 1400 | DALLAS | TX | 75252 | ER PHYSICIANS | $749,050 |
| THERA TEAM PHYSICAL THERAPY | |||||
| 101 ISADORE STREET | NATCHITOCHES | LA | 71457 | THERAPY | $632,050 |
| FISHER HEALTHCARE | |||||
| 300 INDUSTRY DRIVE | PITTSBURGH | PA | 15275 | LABORATORY | $424,292 |
| CPSI | |||||
| PO BOX 850309 | MOBILE | AL | 36685 | INFORMATION SYSTEMS | $421,836 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $403,980 | AllOtherContributionsAmt |
| Total Contributions | $403,980 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Fitness First | 900099 | $104,827 | $104,827 |
| MAIL ORDER DRUG SALES | 900099 | $1,221,520 | $1,221,520 |
| Oncology | 900099 | $86,603 | $86,603 |
| Patient Service Revenue | 900099 | $23,245,795 | $23,245,795 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,658,745 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,013 | TotalRevenueColumnAmt |
| Exclusion | $10,013 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $28,882 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $28,882 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,882 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $28,882 | RelatedOrExemptFuncIncomeAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $23,957 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$23,957 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$23,957 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$23,957 | RelatedOrExemptFuncIncomeAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Cafeteria Income | 722210 | $293,190 | $293,190 |
| HH JOINT VENTURE | 621610 | $229,540 | $229,540 |
| Miscellaneous Income | 900099 | $92,507 | $92,507 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,023 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $7,253 | UnrelatedBusinessRevenueAmt |
| Exclusion | $18,770 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $641,260 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,718,923 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,663,670 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $7,253 | UnrelatedBusinessRevenueAmt |
| Exclusion | $644,020 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,778 | TotalAmt |
| Program Services | $114,778 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,777,530 | TotalAmt |
| Program Services | $9,090,895 | ProgramServicesAmt |
| Management And General | $686,635 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,089 | TotalAmt |
| Program Services | $88,089 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $804,559 | TotalAmt |
| Program Services | $804,559 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $700,067 | TotalAmt |
| Program Services | $700,067 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,493 | TotalAmt |
| Management And General | $7,493 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,716 | TotalAmt |
| Management And General | $69,716 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,812 | TotalAmt |
| Program Services | $47,812 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $382,794 | TotalAmt |
| Management And General | $382,794 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,146 | TotalAmt |
| Program Services | $69,941 | ProgramServicesAmt |
| Management And General | $25,205 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,386 | TotalAmt |
| Program Services | $4,386 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,078,203 | TotalAmt |
| Program Services | $1,078,203 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,349 | TotalAmt |
| Program Services | $161,631 | ProgramServicesAmt |
| Management And General | $102,718 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROFESSIONAL FEES | $4,409,850 | $3,082,112 | $1,327,738 |
| SUPPLIES | $3,582,822 | $3,034,644 | $548,178 |
| BAD DEBT EXPENSE | $2,877,406 | $2,877,406 | |
| EQUIPMENT MAINT-RENTAL | $730,403 | $338,138 | $392,265 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $344,309 | TotalAmt |
| Program Services | $127,576 | ProgramServicesAmt |
| Management And General | $216,733 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,379,712 | TotalAmt |
| Program Services | $21,620,237 | ProgramServicesAmt |
| Management And General | $3,759,475 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,268,918 | BOYAmt |
| EOY | $2,286,462 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,979,234 | BOYAmt |
| EOY | $1,923,783 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,943,648 | BOYAmt |
| EOY | $5,064,244 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $394,359 | BOYAmt |
| EOY | $427,047 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $230,476 | BOYAmt |
| EOY | $210,391 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $30,070,173 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $21,427,554 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,619,720 | BOYAmt |
| EOY | $8,642,619 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2 | BOYAmt |
| EOY | $1 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,436,357 | BOYAmt |
| EOY | $18,554,547 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,924,352 | BOYAmt |
| EOY | $2,606,509 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,676 | BOYAmt |
| EOY | $213,498 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,041,028 | BOYAmt |
| EOY | $2,820,007 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,395,329 | BOYAmt |
| EOY | $15,734,540 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,395,329 | BOYAmt |
| EOY | $15,734,540 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,436,357 | BOYAmt |
| EOY | $18,554,547 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $339,211 | ReconcilationRevenueExpnssAmt |
| 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 | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $707,181 | InvestmentCostOrOtherBasisAmt |
| Book Value | $707,181 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $13,048,342 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $8,270,471 | DepreciationAmt |
| Book Value | $4,777,871 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $666,846 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $491,973 | DepreciationAmt |
| Book Value | $174,873 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $15,055,438 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $12,665,110 | DepreciationAmt |
| Book Value | $2,390,328 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $592,366 | InvestmentCostOrOtherBasisAmt |
| Book Value | $592,366 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,642,619 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $22,878,362 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$2,840,561 | OtherRevenueAmt |
| Revenue Not Reported | -$2,840,561 | RevenueNotReportedAmt |
| Revenue Subtotal | $25,718,923 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $25,718,923 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $22,525,330 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $23,181 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $23,181 | ExpensesNotReportedAmt |
| Expenses Subtotal | $22,502,149 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,877,563 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,877,563 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $25,379,712 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X : FIN48 Footnote | NOTE 23 - INCOME TAXESAccounting principles generally accepted in the United States of America require management to evaluate tax positions taken by the Hospital and recognize a tax liability if the organization has taken an uncertain position that more likely than not would be sustained upon examination by the Internal Revenue Service. Management has concluded that there are no uncertain tax positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the financial statements. The Hospital is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. Hospital management believes it is no longer subject to income tax examinations for periods ending prior to October 1, 2015. |
| Part XII, Line 2d: Other expenses and losses per audited F/S | FOUNDATION EXPENSES $57124 CONSOLIDATION ELIMINATION $-33943 |
| Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S | PROVISION FOR BAD DEBT $2877563 |
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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
| Report Publically Available | false | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,524 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,524 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,716,233 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,630,399 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $85,834 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,718,757 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,630,399 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $88,358 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,718,757 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,630,399 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $88,358 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,587,675 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $319 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,432,526 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,130,092 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $302,434 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | false | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct |
|---|---|
| Louisiana Homecare | |
| Home Health-Profit Sharing | 0.33000 |
| Louisiana Homecare | |
| Home Health-Voting % | 0.51000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Desoto Regional Health System | BusinessNameLine1Txt |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.desotoregional.com | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.desotoregional.com | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| 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 | 125.0000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.0000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.desotoregional.com | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.desotoregional.com | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.desotoregional.com | 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 Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Selling Debt | Yes (X) | PermitSellingDebtInd |
| Permit Legal Judicial Process | Yes (X) | PermitLegalJudicialProcessInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Engaged Selling Debt | Yes (X) | EngagedSellingDebtInd |
| Engaged Legal Judicial Process | Yes (X) | EngagedLegalJudicialProcessInd |
| 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 (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | Yes (true) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Facility: - Part V, Section B, Line 5 | THE HOSPITAL FORMED A COMMITTEE CONSISTING OF THE HOSPITAL'S CEO AND CNO AS WELL AS THE CEOS OF TWO OTHER HEALTHCARE CLINICS IN THE AREA, THE LOCAL EMS DIRECTOR, TWO PHARMACISTS IN MANSFIELD, THE DIRECTOR OF THE COUNCIL ON AGING, LEADERS FROM THE VOCATIONAL TECHNICAL COLLEGE IN THE AREA, DESOTO PARISH HEALTH UNIT LEADERS, A LOCAL HOME HEALTH DIRECTOR, AND SEVERAL SMALL BUSINESS OWNERS. EACH COMMITEE MEMBER HAD SURVEYS FILLED OUT BY VARIOUS PEOPLE IN THE AREA THAT THEY WERE IN CONTACT WITH. THE INFORMATION WAS COMPILED AND DISCUSSED BY THE COMMITTEE AS A STARTING POINT FOR THE VARIOUS NEEDS OF THE COMMUNITY. |
| Facility: - Part V, Section B, Line 22d | ALL PATIENTS ARE BILLED THE SAME RATE FOR A PARTICULAR SERVICE. PAYMENT FOR THE SERVICE WILL VARY BASED ON WHETHER PATIENTS HAVE INSURANCE, MEDICARE, MEDICAID, OR SELFPAY (UNINSURED). CONTRACTS ARE IN PLACE WITH THE INSURANCE COMPANIES, MEDICARE, AND MEDICAID FOR REIMBURSEMENT. SELFPAY FALLS UNDER THE POLICY FOR CONSIDERATION. |
| Facility: - Part V, Section B, Line 24 | SOMETIMES HOSPITAL PATIENTS WHO MAY QUALIFY FOR CHARITY CARE DO NOT PROVIDE ADEQUATE DOCUMENTATION FOR CHARITY CARE ADJUSTMENTS. |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Desoto Reg Family Medicine | ||||
| 130 Jefferson St | Mansfield | LA | 71052 | Rural Health Clinic |
| Desoto Reg Family Medicine Logansport | ||||
| 110 Main St | Logansport | LA | 71049 | Rural Health Clinic |
| Industrial Medical Clinic | ||||
| 119 Jefferson St | Mansfield | LA | 71092 | Outpatient Physician Clinic |
| Desoto Reg Hlth System Zwolle Clinic | ||||
| 2306 Obrie St | Zwolle | LA | 71486 | Rural Health Clinic |
| Desoto Reg Wellness Clinic | ||||
| 305 Texas St | Mansfield | LA | 71092 | Fitness Center and Physical Therapy |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense | NOTE 2 - CONCENTRATION OF CREDIT RISK: THE HOSPITAL'S ESTIMATE OF COLLECTIBILITY IS BASED ON AN ANALYSIS OF AGED ACCOUNTS RECEIVABLE TO ESTABLISH AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS BASED UPON AGREEMENTS BETWEEN THE HOSPITAL AND THIRD PARTY PAYORS. |
| Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit | NOTE 5 ACCOUNTS RECEIVABLE: ESTIMATED ALLOWANCES FOR UNCOLLECTIBLES WERE $2,603,834 AND $2,095,328 AT SEPTEMBER 30, 2019 AND 2018, RESPECTIVELY. LIMITED PATIENT COOPERATION IN PROVIDING PERSONAL FINANCIAL INFORMATION RESULTS IN UNDER REPORTING OF INDIGENT CARE AND OVERSTATEMENT OF BAD DEBT EXPENSE. |
| Part III, Line 4 - Bad Debt Expense | NOTE 5: FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS AND FOR AGED THIRD-PARTY PAYORS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE AND ON THE AGE OF THE RECEIVABLES BALANCE. |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | THE HOSPITAL CONTENDS THAT THE MAJORITY, IF NOT ALL, OF THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE HOSPITAL OFFERS QUALITY HEALTHCARE TO ALL PATIENTS REGARDLESS OF PAYMENT OR REIMBURSEMENT EXPECTATION. RESOURCES FOR MEDICARE PATIENTS VERSUS ALL OTHER PATIENTS ARE IDENTICAL BASED ON TREATMENT. |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | THE HOSPITAL'S CHARITY CARE CRITERIA IS BASED ON FEDERAL POVERTY GUIDELINES. PATIENTS ARE CONSIDERED INDIGENT WHEN THEIR FAMILY INCOME LEVEL IS LESS THAN 125% OF THE FEDERAL POVERTY GUIDELINES, THEY HAVE NO INSURANCE, THEIR MEDICAID SERVICES WILL NOT BE PAID DUE TO LACK OF BENEFITS, AND THEY HAVE NO ASSETS.A PARTIAL INDIGENT/CHARITY WRITE OFF MAY BE OBTAINED WHEN THE PATIENT'S FAMILY INCOME LEVEL IS BETWEEN 125% AND 200% OF THE FEDERAL POVERTY GUIDELINES. LIMITED PATIENT COOPERATION IN PROVIDING PERSONAL FINANCIAL INFORMATION RESULTS IN UNDER REPORTING OF INDIGENT CARE AND OVERSTATEMENT OF BAD DEBT EXPENSE.WHEN THE NEED FOR FINANCIAL ASSISTANCE IS IDENTIFIED, EITHER DURING THE ADMISSIONS OR COLLECTION PROCESS, PATIENTS ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. THEY ARE REFERRED TO THE PATIENT FINANCIAL COUNSELOR WHO WILL INFORM THEM ABOUT THE PROCESS OF APPLYING FOR ASSISTANCE USING THE GUARANTOR FINANCIAL STATEMENT FORM AND WHAT DOCUMENTATION IS REQUIRED TO BE ELIGIBLE FOR ASSISTANCE AND/OR CHARITY CARE. |
| Part V - Explanation of Number of Facility Type | INPATIENT AND OUTPATIENT SERVICES, RURAL HEALTH CLINICS IN SMALL TOWNS WITH NO HOSPITALS, PHYSICIAN CLINIC, WELLNESS AND THERAPY CENTER, 24 HOUR EMERGENCY ROOM SERVICES |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| 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 | Yes (true) | 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 | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
| Rebuttable Presumption Proc | false | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|
| Benjamin Leggio | |||||||||
| Physician | $336,456 | $107,084 | $6,000 | $22,683 | $472,223 | ||||
| Chi-Tai Lau | |||||||||
| Physician | $248,478 | $33,216 | $18,000 | $32,762 | $338,450 | $5,994 | |||
| Denis Kamberov | |||||||||
| Physician | $327,116 | $70,185 | $26,960 | $34,947 | $467,693 | $8,485 | |||
| Douglas Sawyer | |||||||||
| PHYSICIAN | $177,764 | $14,728 | $17,500 | $11,741 | $225,933 | $4,200 | |||
| JEFFREY EVANS | |||||||||
| PHYSICIAN | $115,631 | $6,550 | $23,500 | $17,755 | $166,349 | $2,913 | |||
| Todd Eppler | |||||||||
| CEO | $265,730 | $28,471 | $294,201 | ||||||
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a: Relevant information in regards to selections on 1a. | |
| Part II, Compensation from Unrelated Organizations | HOSPITAL CEO IS AN EMPLOYEE OF WILLIS-KNIGHTON HEALTH SYSTEM. THE HOSPITAL PAYS WILLIS-KNIGHTON HEALTH SYSTEM A MANAGEMENT FEE FOR CEO SERVICES. |
| Part III, Additional Information | DRS KAMBEROV, LAU & SAWYER PARTICIPATE IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company | Desoto Regional Health System entered into a management contract with Willis-Knighton starting in July 2013 to provide a chief executive officer who oversees day to day operations. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | IRS Form 990 is submitted in draft form to the chairman of the finance committee for review and approval before submission to the IRS. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Written conflict of interest and disclosure policy is distributed to all appropriate persons. Once a year, each Board member, physician employee, contracted physician, and management employee reviews and signs the conflict of interest and disclosure of certain interest form. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | CEO is employee of management company, Willis-Knighton. Board approved contract with Willis-Knighton for services of CEO and other management areas. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | Compensation for CEO, CFO, and key employees is approved by the Board of Directors after recommendation of the compensation committee. The compensation committee reviews data from various sources, including industry benchmarks, consultants, and management company. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | According to availability of government returns policy, CFO is responsible for public access to the information returns. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Desoto Regional Health System Foundation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 207 Jefferson St | AddressLine1Txt |
| City | Mansfield | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 71052 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | Support healthcare at Desoto Regional | PrimaryActivitiesTxt |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Exempt Code Section | 501 C 3 | ExemptCodeSectionTxt |
| Public Charity Status | Yes | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Desoto Regional Health System | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | 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 | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |