STRATEGY STUDIO / PUBLIC DATA EXPLORER

GRACE HOSPITAL: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
GRACE HOSPITAL (EIN 34-0714479)
Tax period
2017-07-01 to 2018-06-30
Filed
2019-05-15
IRS object ID
201901359349303415
Schema version
2017v2.3
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

FieldValueIRS element (for citing)
Return2019-05-15T09:49:02-05:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14505 STEPHEN CIRCLE NW STE 200AddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44718ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN340714479EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GRACE HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlGRACBusinessNameControlTxt
Phone4402043500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12307 W 14TH STREET NO 2AddressLine1Txt
CityCLEVELANDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP441133698ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRAJIVE KHANNAPersonNm
Person TitlePRESIDENT AND CEOPersonTitleTxt
Phone2164563880PhoneNum
Signature2019-05-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLISA HILLINGPreparerPersonNm
PTINP01624111PTIN
Phone3304972000PhoneNum
Preparation2019-05-10PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-05-15IPDt
IP Tm08:46:27IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdA35E03A7B2C0C94883AC3ED31AE0DD614A300C60AtSubmissionCreationDeviceId
At Submission Filing Device Id1CC97E19E024F450F17B6EFDB094B1F77DAAE223AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRAJIVE KHANNAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12307 W 14TH STREET NO 2AddressLine1Txt
CityCLEVELANDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP441133698ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$11,378,093GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GRACEHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1910FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTO PROVIDE SPECIALIZED HEALTH CARE SERVICES FOR THOSE COPING WITH CATASTROPHIC ILLNESS AND INJURY.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee132TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$404,947PYContributionsGrantsAmt
CY Contributions Grants$447,225CYContributionsGrantsAmt
PY Program Service Revenue$11,792,667PYProgramServiceRevenueAmt
CY Program Service Revenue$10,909,149CYProgramServiceRevenueAmt
PY Investment Income$7,467PYInvestmentIncomeAmt
CY Investment Income-$15,785CYInvestmentIncomeAmt
PY Other Revenue$43,134PYOtherRevenueAmt
CY Other Revenue$17,115CYOtherRevenueAmt
PY Total Revenue$12,248,215PYTotalRevenueAmt
CY Total Revenue$11,357,704CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,680,109PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,208,040CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,466,109PYOtherExpensesAmt
CY Other Expenses$6,604,113CYOtherExpensesAmt
PY Total Expenses$12,146,218PYTotalExpensesAmt
CY Total Expenses$11,812,153CYTotalExpensesAmt
PY Revenues Less Expenses$101,997PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$454,449CYRevenuesLessExpensesAmt
Total Assets BOY$16,561,783TotalAssetsBOYAmt
Total Assets EOY$16,469,494TotalAssetsEOYAmt
Total Liabilities BOY$3,254,446TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,181,759TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$13,307,337NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$13,287,735NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO SERVE AS A CENTER FOR EXCELLENCE IN THE PROVISION OF SPECIALIZED HEALTH CARE SERVICES AND COMFORT FOR PATIENTS AND FAMILIES COPING WITH CATASTROPHIC ILLNESS AND INJURY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$7,640,314ExpenseAmt
Grant$0GrantAmt
Revenue$10,909,149RevenueAmt
DescGRACE HOSPITAL IS A NOT-FOR-PROFIT, LONG-TERM ACUTE CARE HOSPITAL (LTACH) LOCATED IN CLEVELAND, OHIO DEDICATED TO PROVIDING PERSONALIZED CARE TO MEET THE NEEDS OF PATIENTS COPING WITH CATASTROPHIC OR CHRONIC INJURY OR ILLNESS REQUIRING EXTENDED HOSPITALIZATION. THE HOSPITAL WAS FOUNDED IN 1910 BY A GROUP OF PHYSICIANS WHO WERE COMMITTED TO MEETING THE HEALTHCARE NEEDS OF THE COMMUNITY. GRACE HOSPITAL HAS CONTINUOUSLY PROVIDED SERVICES FOR ITS PATIENTS. IN 1995, GRACE HOSPITAL EARNED APPROVAL TO BECOME THE FIRST CERTIFIED LONG-TERM ACUTE CARE HOSPITAL IN BOTH THE CITY OF CLEVELAND AND CUYAHOGA COUNTY. THE HOSPITAL PRESENTLY SPONSORS SEVERAL INPATIENT SERVICES INCLUDING COMPLEX MEDICAL, PULMONARY, REHABILITATION, VENTILATOR WEANING, LEFT VENTRICLE ASSIST DEVICE, TRANSPLANT SUPPORT, WOUND CARE, AND NEUROLOGICAL REHABILITATION PROGRAMS. THESE SERVICES ARE PROVIDED AT INPATIENT SATELLITES LOCATED WITHIN SOUTH POINTE AND BEDFORD HOSPITALS. GRACE HOSPITAL IS COMMITTED TO PROVIDING PERSONALIZED HEALTHCARE CHARACTERIZED BY QUALITY, ACCESSIBILITY, EFFICIENCY, AND COST EFFECTIVENESS. THE HOSPITAL IS SENSITIVE TO AGE, CULTURAL, AND ECONOMIC VARIATIONS, AND IS CONTINUOUSLY ASSESSED AND IMPROVED THROUGH A QUALITY MANAGEMENT PROGRAM. GRACE VOLUNTARILY MAINTAINS A CHARITY CARE POLICY THAT PROVIDES CARE TO INDIVIDUALS REGARDLESS OF ABILITY TO PAY. THE HOSPITAL IS ALSO COMMITTED TO EMPLOYING INDIVIDUALS TO MATCH CULTURAL DIVERSITY OF ITS PATIENT POPULATION. GRACE HOSPITAL IS INVOLVED IN MANY COMMUNITY ACTIVITIES, INCLUDING SPECIAL HEALTH-RELATED PRESENTATIONS AND EMPLOYEES WHO SERVE ON THE BOARDS OF OTHER HEALTHCARE AGENCIES. THE BOARD OF DIRECTORS, MEDICAL STAFF, AND MANAGEMENT OF GRACE HOSPITAL ARE COMMITTED TO THE PROVISION OF QUALITY SPECIALTY HEALTHCARE SERVICES AS A LONG-TERM HOSPITAL, AND FULFILLING A LEADERSHIP ROLE IN THE COMMUNITY. DESPITE CHALLENGING ECONOMIC TIMES, GRACE HOSPITAL HAS SUCCESSFULLY CONTINUED ITS ROLE OF COMMUNITY SERVICE AS ORIGINALLY ENVISIONED BY ITS FOUNDERS.Desc
Total Program Service Expenses$7,640,314TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document35IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee132EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MICHELLE HENNISBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2164563880PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12307 W 14TH STREET NO2AddressLine1Txt
CityCLEVELANDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44111ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
WILLARD E BARTEL
CHAIRPERSON1.001.00Yes (X)Yes (X)$0$0$0
ROBERT A GREVEY
VICE CHAIRPERSON1.001.00Yes (X)Yes (X)$0$0$0
JEFFREY L CLOSE
TREASURER1.001.00Yes (X)Yes (X)$0$0$0
REV JOSEPH D MCNULTY
SECRETARY1.001.00Yes (X)Yes (X)$0$0$0
GERALD L JEPPE
DIRECTOR1.001.00Yes (X)$0$0$0
NIZAR Z NADER MD
DIRECTOR4.001.00Yes (X)$48,200$0$0
M P PATEL MD
DIRECTOR1.001.00Yes (X)$0$0$0
DEEPAK RAHEJA MD
DIRECTOR5.001.00Yes (X)$35,400$0$0
RICHARD J RYMOND
DIRECTOR1.001.00Yes (X)$0$0$0
PAUL C VENIZELOS MD
DIRECTOR1.001.00Yes (X)$0$0$0
RAJIVE KHANNA
PRESIDENT AND CEO - GRACE HOSPITAL40.001.00Yes (X)$202,201$0$8,236
MICHELLE HENNIS
DIRECTOR OF FINANCE40.001.00Yes (X)$128,728$0$25,058
FieldValueIRS element (for citing)
Total Reportable Comp From Org$414,529TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$33,294TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
FRESENIUS KABI USA LLC
THREE CORPORATE DRIVELAKE ZURICHIL60047DIALYSIS$150,185
MAXIM STAFFING SOLUTIONS
12558 COLLECTIONS CENTER DRIVECHICAGOIL60693TEMPORARY STAFFING$113,484
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
All Other Contributions$447,225AllOtherContributionsAmt
Total Contributions$447,225TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE624100$10,125,733$10,125,733
SPECIALTY HOSPITAL OF LORAIN SERV624100$608,440$608,440
OTHER PROGRAM SERVICE REVENUE624100$107,992$107,992
GRACE FOUNDATION MANAGEMENT FEE624100$66,984$66,984
FieldValueIRS element (for citing)
Total Program Service Revenue$10,909,149TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,604TotalRevenueColumnAmt
Exclusion$4,604ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$17,115RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$17,115RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,115TotalRevenueColumnAmt
Exclusion$17,115ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$20,389OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$20,389OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$20,389TotalRevenueColumnAmt
Exclusion-$20,389ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,357,704TotalRevenueColumnAmt
Related Or Exempt Func Income$10,909,149RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,330ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$447,826TotalAmt
Program Services$83,600ProgramServicesAmt
Management And General$364,226ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,943,331TotalAmt
Program Services$3,552,200ProgramServicesAmt
Management And General$391,131ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$547,324TotalAmt
Program Services$453,175ProgramServicesAmt
Management And General$94,149ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$269,559TotalAmt
Program Services$223,190ProgramServicesAmt
Management And General$46,369ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$45,245TotalAmt
Management And General$45,245ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$26,535TotalAmt
Management And General$26,535ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,048,066TotalAmt
Program Services$1,687,818ProgramServicesAmt
Management And General$1,360,248ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,400TotalAmt
Management And General$5,400ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,108,097TotalAmt
Program Services$7,173ProgramServicesAmt
Management And General$1,100,924ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$24,702TotalAmt
Program Services$17,550ProgramServicesAmt
Management And General$7,152ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$73,698TotalAmt
Program Services$73,698ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$338,476TotalAmt
Program Services$2,191ProgramServicesAmt
Management And General$336,285ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$193,195TotalAmt
Management And General$193,195ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES-MEDICAL$1,073,625$1,073,625
EQUIP RENTAL & MAINT$283,712$218,086$65,626
BAD DEBT EXPENSE$220,950$220,950
MISCELLANEOUS$120,501$6,088$114,413

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$41,911TotalAmt
Program Services$20,970ProgramServicesAmt
Management And General$20,941ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$11,812,153TotalAmt
Program Services$7,640,314ProgramServicesAmt
Management And General$4,171,839ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$947,812BOYAmt
EOY$367,303EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$692,937BOYAmt
EOY$569,156EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,517,446BOYAmt
EOY$1,220,207EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$188,356BOYAmt
EOY$189,111EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$153,157BOYAmt
EOY$132,979EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$12,208,677LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$9,758,602LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,283,803BOYAmt
EOY$2,450,075EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$307,181BOYAmt
EOY$312,581EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$9,418,320BOYAmt
EOY$9,853,167EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,052,771BOYAmt
EOY$1,374,915EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$16,561,783BOYAmt
EOY$16,469,494EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,588,909BOYAmt
EOY$1,695,347EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,223,066BOYAmt
EOY$1,202,559EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$442,471BOYAmt
EOY$283,853EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,254,446BOYAmt
EOY$3,181,759EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,889,017BOYAmt
EOY$3,434,568EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,418,320BOYAmt
EOY$9,853,167EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,307,337BOYAmt
EOY$13,287,735EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,561,783BOYAmt
EOY$16,469,494EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$454,449ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$434,847NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$32,151OtherCostOrOtherBasisAmt
Book Value$32,151BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,243,187OtherCostOrOtherBasisAmt
Depreciation$4,311,279DepreciationAmt
Book Value$1,931,908BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$145,197OtherCostOrOtherBasisAmt
Depreciation$144,586DepreciationAmt
Book Value$611BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,788,142OtherCostOrOtherBasisAmt
Depreciation$5,302,737DepreciationAmt
Book Value$485,405BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,450,075TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescBENEFICIAL INTEREST IN PERPETUAL TRUSTSDesc
Book Value$9,853,167BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$9,853,167TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM RELATED ORGANIZATIONSDesc
Book Value$1,374,915BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,374,915TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescEST SETTLEMENTS TO THIRD PARTIESDesc
Amt$283,853Amt
FieldValueIRS element (for citing)
Total Liability$283,853TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE HOSPITAL IS A NONPROFIT CORPORATION AND IS RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEREFORE, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES ON THE ACCOMPANYING FINANCIAL STATEMENTS. WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. IN ACCORDANCE WITH THE INCOME TAXES TOPIC OF THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION, THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS RECORDED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,388,845TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,284,564DirectOffsettingRevenueAmt
Net Community Benefit Expns$104,281NetCommunityBenefitExpnsAmt
Total Expense0.00900TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,388,845TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,284,564DirectOffsettingRevenueAmt
Net Community Benefit Expns$104,281NetCommunityBenefitExpnsAmt
Total Expense0.00900TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,388,845TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,284,564DirectOffsettingRevenueAmt
Net Community Benefit Expns$104,281NetCommunityBenefitExpnsAmt
Total Expense0.00900TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$220,950BadDebtExpenseAmt
Bad Debt Expense Attributable$220,950BadDebtExpenseAttributableAmt
Reimbursed By Medicare$5,480,486ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$5,410,552CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$69,934MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GRACE HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line120000 HARVARD AVEAddressLine1Txt
CityCLEVELANDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44122ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.GRACEHOSPITAL.ORGWebsiteAddressTxt
State License1147StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
OtherLONG TERM ACUTE CAREOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1GRACE HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted17CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.GRACEHOSPITAL.ORGOwnWebsiteURLTxt
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt17ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.GRACEHOSPITAL.ORGStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.GRACEHOSPITAL.ORG/BILLING.HTMLFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.GRACEHOSPITAL.ORG/BILLING.HTMLFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.GRACEHOSPITAL.ORG/BILLING.HTMLFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care Policy0NondisEmergencyCarePolicyInd
No Emergency CareYes (X)NoEmergencyCareInd
Other ReasonYes (X)OtherReasonInd
Look Back MedicareYes (X)LookBackMedicareInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, SECTION A:GRACE HOSPITAL HAD TWO LOCATIONS DURING THE FISCAL YEAR, AS FOLLOWS:GRACE SOUTH POINTE - 20000 HARVARD AVENUE, CLEVELAND, OH 44122GRACE BEDFORD - 44 BLAINE AVENUE, BEDFORD, OH 44146
GRACE HOSPITALPART V, SECTION B, LINE 5: SURVEYS WERE SENT TO 2,000 ADULTS IN OUR COMMUNITY. 1,465 COMPLETED SURVEYS WERE RETURNED. IN ADDITION, OPINIONS WERE SOLICITED FROM HEALTH EXPERTS, COMMUNITY LEADERS, STAFF CAREGIVERS, AND PATIENTS WITHIN THE COMMUNITY.
GRACE HOSPITALPART V, SECTION B, LINE 11: THE CHNA IDENTIFIED THE FOLLOWING SIGNIFICANT NEEDS: 1. DIABETES-RELATED EDUCATION AND SUPPORT; 2. VENTILATOR WEANING AND RESULTS; 3. PALLIATIVE CARE AND ADVANCED DIRECTIVES1. PALLIATIVE CARE AND ADVANCED DIRECTIVES:- THE FIRST ACTION STEP - PHYSICIAN COMING ON BOARD- A PALLIATIVE CARE STRATEGIC PLAN IS IN DEVELOPMENT; ACTION STEPS WILL SUPPORT THE DIRECTION OF THIS PLAN- CONTINUE COMMUNITY-BASED EDUCATION EVENTS CONCERNING ADVANCE DIRECTIVES- TRANSPORTABLE PHYSICIAN ORDERS FOR PATIENT PREFERENCES- INITIATE EDUCATION (MC STRATEGY) CONCERNING INPATIENT PALLIATIVE CARE- CONTINUE NURSING EDUCATION CONSORTIUM ON END-OF-LIFE CARE- INITIATE END-OF-LIFE CARE EDUCATION FOR PHYSICIANS- COMMUNITY ACTION STEPS WITH PHYSICIANS THROUGH: - QUARTERLY PROVIDER MEETINGS - BOARD OF GOVERNORS - NEED TO KNOW EMAILS2. DIABETES-RELATED EDUCATION AND SUPPORT- CONTINUE DIABETES MANAGEMENT CLASSES THROUGH THE DIABETES CENTER- CONTINUE TO PROVIDE EDUCATION AND SELF-ASSESSMENT TOOL THROUGH THE WEBSITE3. VENTILATOR WEANING AND RESULTS- PROVIDE FAMILY WITH TRAINING AND ONGOING NEED OF PERSONS WITH PULMONARY DISEASE- VENTILATOR EDUCATION AND TRAINING FOR VENT DEPENDENT PATIENTS- TRAINING AND EDUCATION FOR "TRACH CARE AND SUCTIONING TO CARE GIVERS AND PATIENTS- VENTILATOR SUPPORT GROUPS LED BY PULMONOLOGIST AND CLINICAL PSYCHOLOGY- ONGOING SUPPORT AND EDUCATION THROUGH BETTER BREATHER CLUB
GRACE HOSPITALPART V, SECTION B, LINE 13H: THE FOLLOWING STRUCTURE WILL BE UTILIZED TO DETERMINE THE AMOUNT OF FREE CARE TO BE PROVIDED: HOUSEHOLD INCOME AND THE NUMBER OF PEOPLE LIVING IN THE HOUSEHOLD WILL BE THE TWO MAJOR CRITERIA USED TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FREE CARE. EXTENUATING CIRCUMSTANCES SHOULD BE NOTED AND MAY INCLUDE INFORMATION SUPPLIED TO SUPPORT EXCEPTIONAL SCENARIOS INCLUDING A TERMINAL ILLNESS, DEATH OF A SPOUSE, OR CATASTROPHIC PROBLEMS.
GRACE HOSPITALPART V, SECTION B, LINE 16J: THE POLICY IS ATTACHED TO BILLING INVOICES.
GRACE HOSPITALPART V, SECTION B, LINE 21D: GRACE HOSPITAL OPERATES LONG TERM ACUTE CARE (LTAC) FACILITIES LOCATED ON A FLOOR OF TWO CLEVELAND CLINIC HOSPITALS. DUE TO THE TYPE OF SERVICES PROVIDED, GRACE HOSPITAL DOES NOT PROVIDE CARE FOR EMERGENCY MEDICAL CONDITIONS. IF FULL-SERVICE EMERGENCY ROOM CARE IS NEEDED, THE FACILITIES OF THE CLEVELAND CLINIC ARE AVAILABLE.

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:THE FOLLOWING STRUCTURE WILL BE UTILIZED TO DETERMINE THE AMOUNT OF FREE CARE TO BE PROVIDED: HOUSEHOLD INCOME AND THE NUMBER OF PEOPLE LIVING IN THE HOUSEHOLD WILL BE THE TWO MAJOR CRITERIA USED TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FREE CARE. EXTENUATING CIRCUMSTANCES SHOULD BE NOTED AND MAY INCLUDE INFORMATION SUPPLIED TO SUPPORT EXCEPTIONAL SCENARIOS INCLUDING A TERMINAL ILLNESS, DEATH OF A SPOUSE, OR CATASTROPHIC PROBLEMS.
PART I, LINE 6A:N/A
PART I, LINE 7:THE AMOUNTS REPORTED ON LINE B WERE GENERATED FROM THE MEDICAID COST REPORT FILED FOR FISCAL YEAR 2018 AND THE HOSPITAL'S ACCOUNTING SYSTEM. THE AMOUNTS REPORTED INCLUDE GRACE HOSPITAL'S PROPORTIONATE SHARE FROM SPECIALTY HOSPITAL OF LORAIN. ACUTE CARE HOSPITAL SERVICES RENDERED TO MEDICAID PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC AND OTHER FACTORS. CAPITAL COSTS FOR MEDICAID INPATIENT SERVICES ARE REIMBURSED BASED ON A COST REIMBURSEMENT METHODOLOGY. THE HOSPITAL IS REIMBURSED FOR COST REIMBURSABLE ITEMS AT A TENTATIVE RATE WITH FINAL SETTLEMENT DETERMINED AFTER SUBMISSION OF ANNUAL COST REPORTS AND AUDITS THEREOF BY THE FISCAL INTERMEDIARY.
PART I, LINE 7G:N/A
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 220,950.
PART II, COMMUNITY BUILDING ACTIVITIES:N/A
PART III, LINE 2:THE AMOUNT REPORTED ON LINE 2 REPRESENTS THE PROVISION FOR DOUBTFUL ACCOUNTS REPORTED ON THE 2018 AUDITED FINANCIAL STATEMENTS, PLUS BAD DEBT RECOVERIES, WHICH WERE NETTED AGAINST BAD DEBT EXPENSE AS STATED IN NOTE 2 TO THE AUDITED FINANCIAL STATEMENTS.
PART III, LINE 3:THE AMOUNT REPORTED ON LINE 3 REPRESENTS CHARGES WRITTEN OFF FOR SELF-PAY INDIVIDUALS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY BUT FOR WHOM INSUFFICIENT INFORMATION WAS OBTAINED TO DETERMINE THEIR ELIGIBILITY. THIS AMOUNT WAS DETERMINED BASED ON REVIEW OF BAD DEBT WRITE-OFFS DURING THE YEAR.
PART III, LINE 4:SEE NOTE 2 ON PAGES 13-14 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR INFORMATION ABOUT THE ORGANIZATION'S BAD DEBT EXPENSE.
PART III, LINE 8:MEDICARE SHORTFALL IS NOT TREATED AS COMMUNITY BENEFIT. THE AMOUNTS REPORTED WERE GENERATED FROM THE MEDICARE COST REPORT FILED FOR FISCAL YEAR 2018. INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES PER DISCHARGE. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. INPATIENT NONACUTE CARE SERVICES RELATED TO MEDICARE BENEFICIARIES ARE PAID BASED ON A COST REIMBURSEMENT METHODOLOGY. THE HOSPITAL IS REIMBURSED FOR COST REIMBURSABLE ITEMS AT TENTATIVE RATES WITH FINAL SETTLEMENT AFTER SUBMISSION OF ANNUAL COST REPORTS AND AUDITS THEREOF BY THE MEDICARE FISCAL INTERMEDIARY.
PART III, LINE 9B:FREE CARE WILL BE EXTENDED TO THOSE WHO QUALIFY FOR THESE REASONS: THE PATIENT IS UNINSURED, THE PATIENT IS NOT ELIGIBLE FOR MEDICAID OR PENDING MEDICAID APPROVAL, THE PATIENT IS DETERMINED TO BE UNABLE TO PAY FOR SERVICES PROVIDED, THE PATIENT IS UNABLE TO ACCEPT AN INSTALLMENT PAYMENT ARRANGEMENT, THE PATIENT IS BELOW 200% OF THE FEDERAL POVERTY GUIDELINES, AND THE PATIENT IS A HARDSHIP CASE AS DESIGNATED BY THE PHYSICIAN AND GRACE HOSPITAL. THE PATIENT WILL NEED TO COMPLETE A CHARITY CARE FORM AND RETURN TO GRACE HOSPITAL FOR DETERMINATION OF FREE CARE. GRACE HOSPITAL STAFF OR ITS BILLING REPRESENTATIVES WILL HELP THE PATIENT COMPLETE THE FORM ON REQUEST. ULTIMATELY, IT IS THE PATIENT'S RESPONSIBILITY TO COMPLETE THE FORM. HE/SHE WILL CONTINUE TO BE FULLY RESPONSIBLE FOR THE BILL UNTIL A DETERMINATION IS MADE. DOCUMENTED PROOF OF INCOME IS REQUIRED.
PART VI, LINE 2:THE HOSPITAL PRESENTLY SPONSORS SEVERAL INPATIENT SERVICES INCLUDING COMPLEX MEDICAL, PULMONARY, REHABILITATION, VENTILATOR WEANING, LEFT VENTRICLE ASSIST DEVICE, TRANSPLANT SUPPORT, WOUND CARE, AND NEUROLOGICAL REHABILITATION PROGRAMS. THESE SERVICES ARE PROVIDED AT INPATIENT SATELLITES LOCATED WITHIN BEDFORD AND SOUTH POINTE HOSPITALS. GRACE HOSPITAL IS COMMITTED TO PROVIDING PERSONALIZED HEALTHCARE CHARACTERIZED BY QUALITY, ACCESSIBILITY, EFFICIENCY, AND COST EFFECTIVENESS. THE HOSPITAL IS SENSITIVE TO AGE, CULTURAL, AND ECONOMIC VARIATIONS, AND IS CONTINUOUSLY ASSESSED AND IMPROVED THROUGH A QUALITY MANAGEMENT PROGRAM. GRACE VOLUNTARILY MAINTAINS A CHARITY CARE POLICY THAT PROVIDES CARE TO INDIVIDUALS REGARDLESS OF ABILITY TO PAY. THE HOSPITAL IS ALSO COMMITTED TO EMPLOYING INDIVIDUALS TO MATCH CULTURAL DIVERSITY OF ITS PATIENT POPULATION. GRACE HOSPITAL IS INVOLVED IN MANY COMMUNITY ACTIVITIES, INCLUDING SPECIAL HEALTH-RELATED PRESENTATIONS AND EMPLOYEES WHO SERVE ON THE BOARDS OF OTHER HEALTHCARE AGENCIES. THE BOARD OF DIRECTORS, MEDICAL STAFF, AND MANAGEMENT OF GRACE HOSPITAL ARE COMMITTED TO THE PROVISION OF QUALITY SPECIALTY HEALTHCARE SERVICES AS A LONG-TERM HOSPITAL, AND FULFILLING A LEADERSHIP ROLE IN THE COMMUNITY. DESPITE CHALLENGING ECONOMIC TIMES, GRACE HOSPITAL HAS SUCCESSFULLY CONTINUED ITS ROLE OF COMMUNITY SERVICE AS ORIGINALLY ENVISIONED BY ITS FOUNDERS.
PART VI, LINE 3:INFORMATION ABOUT ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS IS DESCRIBED ON THE PATIENT'S BILL. THE PATIENT WILL NEED TO COMPLETE A CHARITY CARE FORM AND RETURN TO GRACE FOR DETERMINATION OF FREE CARE. GRACE STAFF OR ITS BILLING REPRESENTATIVES WILL HELP THE PATIENT COMPLETE THE FORM ON REQUEST.
PART VI, LINE 4:GRACE HOSPITAL IS A LONG-TERM ACUTE CARE HOSPITAL (LTACH) DEDICATED TO PROVIDING HIGH QUALITY PRIMARY AND SECONDARY HEALTH CARE SERVICES TO MEET THE NEEDS OF LOCAL COMMUNITIES IN NORTHEAST OHIO.
PART VI, LINE 5:GRACE HOSPITAL PROMOTES HEALTH, WELLNESS AND ECONOMIC DEVELOPMENT IN THE TREMONT, OHIO AREA. THIS IS THE GEOGRAPHIC AREA THE HOSPITAL HAS HISTORICALLY SERVED. THE FACILITY ON WEST 14TH STREET INCLUDES OUTPATIENT, INPATIENT, AND DIAGNOSTIC AND REHABILITATIVE CARE PROGRAMS DIRECTED TOWARD THE HEALTH AND WELLNESS NEEDS OF THE ADULT POPULATION.
PART VI, LINE 6:N/A
PART VI, LINE 7N/A

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RAJIVE KHANNA
PRESIDENT AND CEO - GRACE HOSPITAL$202,201$0$0$0$0$0$0$0$8,236$0$210,437$0$0$0
MICHELLE HENNIS
DIRECTOR OF FINANCE$128,728$0$0$0$0$0$0$0$25,058$0$153,786$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF GRACE HOSPITAL IS THE GRACE FOUNDATION FOR HEALTH, WELLNESS & EDUCATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD OF DIRECTORS OF GRACE HOSPITAL CONSISTS OF THE INDIVIDUALS ELECTED TO THE BOARD OF DIRECTORS OF THE GRACE FOUNDATION FOR HEALTH, WELLNESS & EDUCATION, THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING ACTIONS REQUIRE APPROVAL OF THE SOLE MEMBER: (A) AMENDMENT OR RESTATEMENT OF THE ARTICLES OR CODE OF REGULATIONS; (B) MERGER, CONSOLIDATION, REORGANIZATION OR DISSOLUTION; (C) SALE, LEASE, DISPOSITION, PLEDGE, GIFT OR ENCUMBRANCE OF ANY INTEREST IN REAL OR PERSONAL PROPERTY, EXCEPT IN ACCORDANCE WITH THE ESTABLISHED POLICIES FOR SUCH MATTERS APPROVED FROM TIME TO TIME IN ADVANCE BY THE MEMBER; (D) AGGREGATE BORROWING FOR ANY ONE YEAR PERIOD IN EXCESS OF $250,000; (E) THE FORMULATION OF AN INITIAL OR ANY CHANGE IN ANY SUBSEQUENT, FORMAL OR INFORMAL STATEMENT OF GRACE HOSPITAL'S PURPOSES OR OBJECTIVES; (F) THE APPROVAL OR ADOPTION OF THE ANNUAL AND ANY SPECIAL OPERATING AND CAPITAL BUDGETS; (G) ANY EXPENDITURE OF A NATURE THAT WAS NOT ANTICIPATED OR REFLECTED IN A BUDGET APPROVED IN ADVANCE OF SUCH EXPENDITURE BY THE MEMBER AND ANY EXPENDITURE THAT EITHER SINGLY OR WHEN AGGREGATED WITH ALL OTHER SIMILAR AMOUNTS THROUGHOUT THE FISCAL YEAR EXCEEDS 10 PERCENT OF THE AMOUNT BUDGETED FOR SUCH EXPENDITURE OR CLASS OF EXPENDITURES PURSUANT TO A BUDGET APPROVED IN ADVANCE OF SUCH EXPENDITURE BY THE MEMBER; (H) ANY EXPENDITURE OF THE PRINCIPAL OF OR INCOME FROM ANY FUND OR FUNDS IN ANY MANNER THAT IS INCONSISTENT WITH ANY RESTRICTIONS IMPOSED ON SUCH FUND OR FUNDS BY DONORS, BY THE MEMBER, OR BY THE BOARD OF DIRECTORS; (I) ANY ARRANGEMENT OR THE TERMINATION OF ANY SUCH ARRANGEMENT WITH ANY BANK, TRUST COMPANY, BROKERAGE FIRM, INVESTMENT ADVISOR OR SIMILAR INSTITUTION TO MANAGE THE ASSETS AND INVESTMENT OF THE ASSETS OF GRACE HOSPITAL; AND (J) THE APPOINTMENT OF AN INDEPENDENT AUDITOR.
FORM 990, PART VI, SECTION B, LINE 11BTHE HOSPITAL CONTRACTED WITH AN OUTSIDE ACCOUNTING FIRM FOR THE PREPARATION OF THE FORM 990. THE HOSPITAL PROVIDED MATERIAL BASED ON REQUESTS FROM THE ACCOUNTING FIRM. MOST OF THE INFORMATION WAS PROVIDED BY THE DIRECTOR OF FINANCE. THE FINAL FORM WAS REVIEWED BY THE DIRECTOR OF FINANCE AND THE CEO. A COPY OF THE FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLICES TO DIRECTORS, OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS, AND ANY MEDICAL STAFF MEMBERS WITH ADMINISTRATIVE RESPONSIBILITIES. ANY INDIVIDUAL WHO HAS AN INTEREST, DIRECT OR INDIRECT, IN A CONTRACT OR OTHER TRANSACTION THAT IS PRESENTED TO THE BOARD OF DIRECTORS OR A COMMITTEE THEREOF, IS REQUIRED TO GIVE PROMPT, FULL AND FRANK DISCLOSURE OF THEIR INTEREST PRIOR TO THE BODY'S ACTING ON SUCH CONTRACT OR TRANSACTION. THE CONTRACT OR TRANSACTION WILL BE AUTHORIZED, APPROVED OR RATIFIED ONLY UPON A FAVORABLE VOTE OF AT LEAST TWO-THIRDS OF DIRECTORS PRESENT. THE INTERESTED PERSON MAY NOT VOTE ON, USE THEIR PERSONAL INFLUENCE ON, NOR PARTICIPATE (OTHER THAN TO PRESENT FACTUAL INFORMATION OR TO RESPOND TO QUESTIONS) IN THE DISCUSSIONS REGARDING THE CONTRACT OR TRANSACTION. THE BOARD MEMBERS COMPLETED CONFLICT OF INTEREST STATEMENTS IN OCTOBER 2017.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION OF THE ORGANIZATION'S CEO IS DETERMINED BY THE BOARD OF DIRECTORS. THE CEO RECEIVES SALARY COMPARABILITY INFORMATION FROM MODERN HEALTHCARE AND CLEVELAND MAGAZINE. SINCE GRACE IS A SMALL HOSPITAL, THE SALARIES IN EFFECT AT GRACE ARE ALWAYS BELOW THE OTHER HOSPITALS IN THE AREA. SALARY ADJUSTMENTS ARE RECEIVED WHEN THE HOSPITAL PROVIDES A COST OF LIVING ADJUSTMENT TO ALL STAFF OR WHEN THERE IS A CHANGE IN THE EMPLOYEE'S RESPONSIBILITIES.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER FEES: PROGRAM SERVICE EXPENSES 1,687,818. MANAGEMENT AND GENERAL EXPENSES 1,360,248. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,048,066.
FORM 990, PART XII, LINE 2CTHE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT OR THE SELECTION PROCESS DURING THE TAX YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
THE GRACE FOUNDATION FOR HEALTH WELLNESS & EDUCATION
2307 WEST 14TH STREETCLEVELANDOH44114273418360SUPPORTING ORGANIZATIONOH501(C)(3)LINE 12C, III-FIN/A0
SPECIALTY HOSPITAL OF LORAIN
254 CLEVELAND AVENUEAMHERSTOH44001341902731HOSPITALOH501(C)(3)LINE 3N/A0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1THE GRACE CENTER PROPERTY LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12307 WEST 14TH STREETAddressLine1Txt
CityCLEVELANDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44113ZIPCd
FieldValueIRS element (for citing)
EIN473431477EIN
Primary ActivitiesREAL ESTATEPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1GRACE CENTER PROPERTY HOLDING LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12307 WEST 14TH STREETAddressLine1Txt
CityCLEVELANDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44113ZIPCd
FieldValueIRS element (for citing)
EIN473494723EIN
Primary ActivitiesHOLDING COMPANYPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd