THE CITY HOSPITAL ASSOCIATION: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- THE CITY HOSPITAL ASSOCIATION (EIN 34-0714583)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2019-04-30
- IRS object ID
- 201941209349301909
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-04-30T19:04:37-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLTHOUSE CARLIN & VAN TRIGT LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3011 TOWNSGATE ROAD SUITE 400 | AddressLine1Txt |
| City | WESTLAKE VILLAGE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91361 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 340714583 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MELISSA BRACONE | InCareOfNm |
| Business Name Control | CITY | BusinessNameControlTxt |
| Phone | 3303857200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 425 WEST FIFTH STREET | AddressLine1Txt |
| City | EAST LIVERPOOL | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43920 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MIKE HEATHER | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3303857200 | PhoneNum |
| Signature | 2019-04-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Stephanie Wilkinson | PreparerPersonNm |
| PTIN | P01231617 | PTIN |
| Phone | 8053748555 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 174.46.231.234 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 95206420191205000008 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-04-30 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 3DE82CF03C4C669F244574ECA69CF31BB07201F8 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 3DE82CF03C4C669F244574ECA69CF31BB07201F8 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EAST LIVERPOOL CITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEITH RICHARDSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 425 WEST FIFTH STREET | AddressLine1Txt |
| City | EAST LIVERPOOL | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43920 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $83,303,668 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.elch.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1905 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION IS ORGANIZED AND OPERATED TO PROVIDE THE PEOPLE OF THE TRI-STATE AREA HIGH QUALITY HEALTH SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 646 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | $217,900 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $11,760 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $17,560 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $76,234,832 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $82,891,296 | CYProgramServiceRevenueAmt |
| PY Investment Income | $450,393 | PYInvestmentIncomeAmt |
| CY Investment Income | $196,093 | CYInvestmentIncomeAmt |
| PY Other Revenue | $18,661,428 | PYOtherRevenueAmt |
| CY Other Revenue | $107,858 | CYOtherRevenueAmt |
| PY Total Revenue | $95,346,653 | PYTotalRevenueAmt |
| CY Total Revenue | $83,212,807 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,500 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $27,676,390 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $30,059,386 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $37,463,607 | PYOtherExpensesAmt |
| CY Other Expenses | $41,153,438 | CYOtherExpensesAmt |
| PY Total Expenses | $65,139,997 | PYTotalExpensesAmt |
| CY Total Expenses | $71,215,324 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $30,206,656 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $11,997,483 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $34,457,288 | TotalAssetsBOYAmt |
| Total Assets EOY | $56,691,528 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,250,632 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $13,492,661 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $30,206,656 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $43,198,867 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION PROVIDES HIGH QUALITY, COMPASSIONATE HEALTH CARE SERVICES WITHIN THE AVAILABLE RESOURCES. HEALTHCARE SERVICES WILL BE PROVIDED TO PREVENT ILLNESS, RELIEVE SUFFERING, AID IN HEALTH RESTORATION AND TO PROMOTE WELLNESS. THE ORGANIZATION PROVIDES SERVICES TO ANY PERSON, WITHOUT DISCRIMINATION. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $54,366,387 | ExpenseAmt |
| Grant | $2,500 | GrantAmt |
| Revenue | $82,777,586 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE ORGANIZATION, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO AFFORD ESSENTIAL MEDICAL SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING WITH THE ORGANIZATION'S COMMITMENT TO SERVE ALL MEMBERS OF THE ORGANIZATION'S COMMUNITY WITH FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COSTS, AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY HAVE BEEN CONSIDERED WHERE THE NEED AND AN INDIVIDUAL'S INABILITY TO PAY EXIST. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. THE ORGANIZATION PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, THE ORGANIZATION CONSIDERS THESE AMOUNTS AS UNCOMPENSATED CARE IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY. THE ORGANIZATION IS LOCATED IN EAST LIVERPOOL, OHIO AND SERVICES THE SURROUNDING COMMUNITIES; STAFFING 152 BEDS FOR ACUTE CARE, INTENSIVE CARE, NURSERY, AND SKILLED NURSING IN THIS MEDICALLY UNDERSERVED AREA. DURING 2017, THE ORGANIZATION PROVIDED NUMEROUS BENEFITS TO THE SURROUNDING COMMUNITY, INCLUDING FINANCIAL SUPPORT THROUGH THE COMMUNITY BENEFIT INITIATIVE PROGRAM. COMMUNITY EDUCATION AND WELLNESS PROGRAMS - THE ORGANIZATION OFFERED THE FOLLOWING TO THE COMMUNITY FREE OR AT A NOMINAL CHARGE: HEALTH FAIRS CPR CLASSES CHILDBIRTH CLASSES GARFIELD ELEMENTARY WELLNESS PROGRAM COVER THE UNINSURED PROGRAM HEARTSAVER FIRST AID CLASSES ADVANCE CARDIAC LIFE SUPPORT HEALTHCARE PROVIDE RECERTIFICATION BREAST FEEDING SUPPORT PASTORAL OUTREACH PROGRAMS DIABETES EDUCATION ARTHRITIS AQUATICS CLASSES SMOKING CESSATION CLASSES BASICS IN BABYSITTING CLASSES AUTISM SUPPORT GROUP CONDUCTED HOSPITAL TOURS FOR AREA SCHOOLS AND COMMUNITY GROUPS SERVED AS AN OBSERVATION SITE FOR THE HIGH SCHOOL FOR HEALTH PROFESSIONS DEVELOPED BY THE PUBLIC SCHOOLS HOSTED SEVERAL SHADOW STUDENTS FROM AREA SCHOOLS SERVED AS HOST SITE FOR OHIO HIGHER EDUCATION TELECOMMUNICATION SYSTEM OPERATED A PHYSICIAN REFERRAL LINE FREE TO THE COMMUNITY HOSTED PROGRAMS FOR STUDENT NURSES AND RADIOLOGY TECHNICIANS IN TRAINING PROVIDED FOOD TO NEEDY FAMILIES FOR THANKSGIVING, AND GIFTS TO NEEDY CHILDREN FOR CHRISTMAS TO THE SALVATION ARMY DAY OF CARING, DAY OF GIVING PROGRAM - MONEY AND FOOD DRIVE | Desc |
| Total Program Service Expenses | $54,366,387 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| 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 | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | 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 | 71 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 646 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MELISSA BRACONE | PersonNm |
| Phone | 3303862633 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 425 WEST FIFTH STREET | AddressLine1Txt |
| City | EAST LIVERPOOL | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43920 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| KEITH RICHARDSON | ||||||||
| CEO/DIRECTOR | 40.0 | 0.3 | Yes (X) | Yes (X) | $322,960 | $0 | $1,140 | |
| JOSEPH LUDOVICI | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| PETE WICKS | ||||||||
| PRESIDENT (UNTIL 10/17) | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBERT O'HARA | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| TAMMIE MCINTOSH | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH SHEMASEK | ||||||||
| CHAIRMAN | 1.0 | 0.3 | Yes (X) | $0 | $0 | $0 | ||
| DAVID HAMILTON | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| GRETCHEN NICKELL DO | ||||||||
| DIRECTOR | 1.0 | 40.0 | Yes (X) | $0 | $372,204 | $18,700 | ||
| MARK MANGANO | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| TARUN GHOSH | ||||||||
| CFO (UNTIL 08/17) | 40.0 | 0.3 | Yes (X) | $144,727 | $0 | $0 | ||
| MIKE SARIAN | ||||||||
| CHAIR/PRESIDENT | 0.0 | 10.0 | Yes (X) | $0 | $0 | $0 | ||
| MIKE HEATHER | ||||||||
| CFO | 0.0 | 10.0 | Yes (X) | $0 | $0 | $0 | ||
| DONALD THOMPSON | ||||||||
| SECRETARY/GENERAL COUNSEL | 0.0 | 5.0 | Yes (X) | $0 | $0 | $0 | ||
| MADAN REDDY | ||||||||
| TREASURER | 0.0 | 5.0 | Yes (X) | $0 | $0 | $0 | ||
| TROY SCHELL | ||||||||
| SEC./GEN.COUNSEL (until 8/17) | 0.0 | 5.0 | Yes (X) | $0 | $0 | $0 | ||
| JAYNE ROSE | ||||||||
| CNO | 40.0 | 0.0 | $153,030 | $0 | $100 | Yes (X) | ||
| NICHOLAS PETRUSKA | ||||||||
| PHARMACIST | 40.0 | 0.0 | $122,110 | $0 | $1,698 | Yes (X) | ||
| WILLIAM SMITH | ||||||||
| DIRECTOR OF PHARMACY | 40.0 | 0.0 | $136,301 | $0 | $3,356 | Yes (X) | ||
| FRANK MADER | ||||||||
| DIRECTOR OF INFO. SERVICES | 40.0 | 0.0 | $110,433 | $0 | $158 | Yes (X) | ||
| TODD MORANDO | ||||||||
| DIRECTOR OF EMERGENCY DEPT | 40.0 | 0.0 | $110,519 | $0 | $314 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,100,080 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $372,204 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $25,466 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MORRISON HEALTHCARE | |||||
| PO BOX 102289 | ATLANTA | GA | 303682289 | DIETARY SERVICES | $1,309,277 |
| OHIO VALLEY Anesthetists LLC | |||||
| 425 WEST 5TH STREET | EAST LIVERPOOL | OH | 43920 | ANESTHESIA | $1,112,583 |
| CROTHALL HEALTHCARE | |||||
| 13028 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | HOUSEKEEPING | $959,525 |
| HOSPITAL BUSINESS SERVICES INC | |||||
| 3300 E GUASTI ROAD 3RD FLOOR | ONTARIO | CA | 91761 | BUSINESS OFFICE SERV | $1,462,764 |
| PRIME HEALTHCARE MANAGEMENT II INC | |||||
| 3300 E GUASTI ROAD 3RD FLOOR | ONTARIO | CA | 91761 | MANAGEMENT | $5,359,150 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 42 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| All Other Contributions | $17,560 | AllOtherContributionsAmt |
| Total Contributions | $17,560 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REVENUE | 621500 | $82,673,396 | $82,673,396 | |
| LAB SERVICES | 621500 | $210,874 | $210,874 | |
| THERAPY SERVICES | 621500 | $7,026 | $7,026 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $82,891,296 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $185,921 | TotalRevenueColumnAmt |
| Exclusion | $185,921 | 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 |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $101,033 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $90,861 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $10,172 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,172 | TotalRevenueColumnAmt |
| Exclusion | $10,172 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
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 | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAFETERIA/VENDING | 900099 | $57,215 | $57,215 |
| PURCHASE DISCOUNTS | 900099 | $16,494 | $16,494 |
| OTHER OPERATING INCOME | 900099 | $17,713 | $17,713 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,436 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,768 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $3,668 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $107,858 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $83,212,807 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $82,777,586 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $217,900 | UnrelatedBusinessRevenueAmt |
| Exclusion | $199,761 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,500 | TotalAmt |
| Program Services | $2,500 | ProgramServicesAmt |
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 | $467,687 | TotalAmt |
| Program Services | $280,612 | ProgramServicesAmt |
| Management And General | $187,075 | ManagementAndGeneralAmt |
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 | $22,528,458 | TotalAmt |
| Program Services | $13,517,075 | ProgramServicesAmt |
| Management And General | $9,011,383 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,519 | TotalAmt |
| Program Services | $183,519 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,220,816 | TotalAmt |
| Program Services | $5,220,816 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,658,906 | TotalAmt |
| Program Services | $1,211,001 | ProgramServicesAmt |
| Management And General | $447,905 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,280,087 | TotalAmt |
| Management And General | $4,280,087 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,078 | TotalAmt |
| Management And General | $3,078 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181,262 | TotalAmt |
| Management And General | $181,262 | 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 | $10,842,896 | TotalAmt |
| Program Services | $10,282,197 | ProgramServicesAmt |
| Management And General | $560,699 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,900 | TotalAmt |
| Program Services | $120,314 | ProgramServicesAmt |
| Management And General | $19,586 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,929 | TotalAmt |
| Program Services | $111,747 | ProgramServicesAmt |
| Management And General | $53,182 | ManagementAndGeneralAmt |
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 | $1,214,866 | TotalAmt |
| Program Services | $728,920 | ProgramServicesAmt |
| Management And General | $485,946 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,137 | TotalAmt |
| Program Services | $62,038 | ProgramServicesAmt |
| Management And General | $10,099 | 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 | $426,608 | TotalAmt |
| Program Services | $426,608 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,528,459 | TotalAmt |
| Program Services | $2,528,459 | ProgramServicesAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $985,258 | TotalAmt |
| Program Services | $985,258 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $8,145,688 | $8,145,688 | |
| MEDICAL SUPPLIES | $5,592,043 | $5,032,839 | $559,204 |
| TAXES AND LICENSES | $2,598,103 | $2,598,103 | |
| REPAIRS AND MAINTENANCE | $1,744,556 | $1,046,734 | $697,822 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,233,568 | TotalAmt |
| Program Services | $1,881,959 | ProgramServicesAmt |
| Management And General | $351,609 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,215,324 | TotalAmt |
| Program Services | $54,366,387 | ProgramServicesAmt |
| Management And General | $16,848,937 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,540,247 | BOYAmt |
| EOY | $6,787,360 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,021,131 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,071,657 | BOYAmt |
| EOY | $11,289,141 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $409,414 | BOYAmt |
| EOY | $477,259 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $316,257 | BOYAmt |
| EOY | $272,412 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,042,623 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,318,781 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,522,207 | BOYAmt |
| EOY | $8,723,842 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,151,617 | BOYAmt |
| EOY | $145,005 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,445,889 | BOYAmt |
| EOY | $1,343,222 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $25,632,156 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,457,288 | BOYAmt |
| EOY | $56,691,528 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $775,961 | BOYAmt |
| EOY | $5,195,252 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $213,091 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,474,671 | BOYAmt |
| EOY | $8,084,318 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,250,632 | BOYAmt |
| EOY | $13,492,661 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,206,656 | BOYAmt |
| EOY | $43,198,867 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,206,656 | BOYAmt |
| EOY | $43,198,867 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,457,288 | BOYAmt |
| EOY | $56,691,528 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $11,997,483 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $994,728 | PriorPeriodAdjustmentsAmt |
| 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
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (true) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $1,181 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $1,181 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1F | FormAndLineReferenceDesc |
| Explanation | AMOUNT REPORTED IN PART II-B, LINE 1F REPRESENTS PORTION OF DUES PAID TO TRADE ASSOCIATIONS THAT IS ATTRIBUTABLE TO LOBBYING ACTIVITES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $918,703 | OtherCostOrOtherBasisAmt |
| Book Value | $918,703 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,707,632 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,595,686 | DepreciationAmt |
| Book Value | $3,111,946 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $253,305 | OtherCostOrOtherBasisAmt |
| Depreciation | $75,000 | DepreciationAmt |
| Book Value | $178,305 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,968,306 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,559,217 | DepreciationAmt |
| Book Value | $4,409,089 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $194,677 | OtherCostOrOtherBasisAmt |
| Depreciation | $88,878 | DepreciationAmt |
| Book Value | $105,799 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,723,842 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM PRIME HEALTHCARE FDN | $23,133,368 |
| DUE FROM OHIO VALLEY HOME | $1,344,641 |
| DUE FROM MEDICARE | $1,154,147 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $25,632,156 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| CAPITAL LEASES | $2,162,465 |
| REVOLVING CREDIT FACILITY | $2,592,780 |
| DUE TO AFFILIATES | $2,560,849 |
| IBNR | $768,224 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $8,084,318 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | THE LITERATURE RELATED TO UNCERTAIN TAX POSITIONS PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR ACCOUNTING FOR UNCERTAIN TAX POSITIONS AND ALSO PROVIDES GUIDANCE ON VARIOUS RELATED MATTERS SUCH AS DE-RECOGNITION, INTEREST, PENALTIES AND DISCLOSURES REQUIRED. THE COMPANY DOES NOT HAVE ANY ENTITY-LEVEL UNCERTAIN TAX POSITIONS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,372,426 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $947,407 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $425,019 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00670 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $102,100,535 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $87,736,040 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,364,495 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.22780 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,347 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,876 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $471 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $103,476,308 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $88,686,323 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,789,985 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.23450 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $103,476,308 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $88,686,323 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,789,985 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.23450 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $8,145,688 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $3,502,627 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $19,385,267 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $19,364,396 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $20,871 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EAST LIVERPOOL CITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 425 WEST FIFTH STREET | AddressLine1Txt |
| City | EAST LIVERPOOL | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43920 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.elch.org | WebsiteAddressTxt |
| State License | 11418 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EAST LIVERPOOL CITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINES 6A & 6B | PARTICIPANTS IN THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDE: COLUMBIANA COUNTY EDUCATIONAl SERVICE CENTER, COLUMBIANA COUNTY GENERAL HEALTH DISTRICT, COLUMBIANA COUNTY MENTAL HEALTH AND RECOVERY SERVICES BOARD, COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY, EAST LIVERPOOL CITY HEALTH DEPARTMENT, EAST LIVERPOOL CITY HOSPITAL, RIVER VALLEY PHYSICIANS, SALEM CITY HEALTH DEPARTMENT, AND SALEM REGIONAL MEDICAL CENTER. |
| SCHEDULE H, PART V, SECTION B, LINE 16A | FINANCIAL ASSISTANCE POLICY AVAILABLE ON THE HOSPITAL FACILITY'S WEBSITE: http://www.elch.org/documents/ELCH-financial-assistance-full-policy-new.pd f |
| SCHEDULE H, PART V, SECTION B, LINE 5 | Primary qualitative data to reflect input from the broad community and vulnerable populations was collected specifically for this assessment and included a total of seventeen in-depth stakeholder interviews, four focus groups reflecting 49 participants, and 417 surveys completed by individuals representing diverse constituent groups. In addition to gathering input from focus groups and stakeholder interviews, input and guidance also came from the community representatives, who served on the Columbiana County Health Partners Steering Committee. Seventeen stakeholder interviews were conducted from January 21- April 16, 2016 by members of the Steering Committee. Stakeholders interviewed included individuals with expertise in the following disciplines and/or organizational affiliations. Stakeholders Interviewed: - School Districts - Case Management at each hospital - Catholic Charities - Juvenile Justice System - Local Government/ County Commissioners - Community Resource Center - Health and Human Service Providers - Food Pantry - Mental Health and Recovery - Youth Services - Visiting Nurses Association - Faith-Based Organizations Providing Assistance - Hispanic Community |
| SCHEDULE H, PART V, SECTION B, LINE 11 | East Liverpool City Hospital, Salem Regional Center and the Columbiana County General Health Districts have been collaborating on their county-wide CHNA planning efforts since 2013, and have addressed at least two of Ohios health priorities in each planning cycle. In addition, the local health departments and hospitals have aligned with a three-year timeline for conducting assessments and planning, beginning in 2013 and continuing into the 2016 CHNA planning cycle. Columbiana Countys existing population health planning infrastructure will continue to collaborate on the development of future strategies to be determined by the Columbiana County Health Partners as a result of this CHNA, including identifying enhanced opportunities to: - Determine priorities, objectives, implementation strategies, ongoing evaluation and a communication plan - Standardize assessment timelines and provide an integrated definition of community - Efficiently collect and share population-level and clinical data - Pursue collaborative partnerships for implementing evidence-based, community health improvement activities - Define standards for tracking progress and evaluating the impact of implemented activities During the May 2, 2016 Columbiana County Health Partners CHNA Work Group meeting, the participants agreed that the 2016 CHNA initiatives should focus on three major priority categories as selected from the Prioritization Surveys 52 options. these were sorted and ranked by the prioritization criteria of Magnitude and Impact. The three major priority categories selected include: Obesity, Mental Health/Substance Abuse, and Tobacco Use/Cancer Prevention. |
| SCHEDULE H, PART V, SECTION B, LINE 7A | CHNA REPORT AVAILABLE ON THE HOSPITAL FACILITY'S WEBSITE: http://www.elch.org/documents/ColumbianaCountyCHNAFinalFullReport_2016-edi t9-15.pdf |
| SCHEDULE H, PART V, SECTION B, LINE 10A | IMPLEMENTATION PLAN AVAILABLE ON THE HOSPITAL FACILITY'S WEBSITE: http://www.elch.org/documents/IMPLEMENTATIONPLAN2016-East-Liverpool-City-H ospital.pdf |
| SCHEDULE H, PART V, SECTION B, LINE 16C | PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL): http://www.elch.org/Patients-Visitors/Insurance-Financial-Info.aspx |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART III, SECTION A, LINE 2 | THE AMOUNT REPORTED ON LINE 2 IS BASED ON BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | THE HOSPITAL CONTENDS THAT THE ENTIRE AMOUNT OF THE MEDICARE SURPLUS SHOULD ALSO BE CONSIDERED AS A COMMUNITY BENEFIT. THE REASON FOR THIS IS THAT THE MEDICARE RATES ARE SET UNILATERALLY BY THE FEDERAL GOVERNMENT AND THE HOSPITAL AGREES TO SERVICE THESE PATIENTS AT THESE RATES AS PART OF OUR MISSION AND SERVICE TO THE COMMUNITY. THE COST INCLUDED ON LINE 6 COMES FROM THE MEDICARE COST REPORT WHICH THE FEDERAL GOVERNMENT HAS SET UP AS THEIR WAY TO CAPTURE AND SEGREGATE THE COSTS OF SERVICES PROVIDED TO MEDICARE PATIENTS. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | THE HOSPITAL PRACTICE IS THAT UPON VERIFICATION THAT A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, THE HOSPITAL DISCONTINUES COLLECTION EFFORTS AND MAKES THE APPROPRIATE ADJUSTMENT TO THE PATIENT'S ACCOUNT BASED UPON THE PATIENT'S INDIVIDUAL CIRCUMSTANCES. |
| SCHEDULE H, PART VI, LINE 2 | ONGOING EFFORTS AND EVALUATION OF MANAGEMENT, STAFF, PHYSICIANS WITH FEEDBACK FROM PATIENTS AND COMMUNITY. DEMOGRAPHIC RESEARCH AND STUDIES ALSO UTILIZED TO DETERMINE TYPE AND QUANTITY OF SERVICES NEEDED BY SPECIALTY TO BEST SERVE OUR COMMUNITY. |
| SCHEDULE H, PART VI, LINE 3 | INFORMATION REGARDING FINANCIAL ASSISTANCE AND CHARITY CARE IS MADE AVAILABLE AT TIME OF REGISTRATION, ON THE HOSPITAL'S WEBSITE, AND ON PATIENT STATEMENTS. APPLICATIONS ARE ALSO MADE AVAILABLE TO PATIENTS AT TIME OF REGISTRATION IF APPROPRIATE. In order to ensure that patients are aware of the existence of the Financial Assistance Policy, the Hospital widely disseminates the existence and terms of this Policy throughout its service area. In addition to other appropriate efforts to inform the community about the Policy in a way targeted to reach community members most likely to need financial assistance, the following actions ARE taken: A. WRITTEN NOTICE TO ALL PATIENTS Each patient who is seen, whether admitted or not, shall receive the Plain Language Summary. The notice shall be provided in non-English languages spoken by a substantial number of the patients served by the Hospital. B. POSTING OF NOTICES The financial assistance policy shall be clearly and conspicuously posted in locations that are visible to the patients in the following areas: (1) Emergency Department; (2) Billing Office; (3) Admissions Office; and (4) other outpatient settings. The notice shall be provided in non-English languages spoken by a substantial number of the patients served by the Hospital. C. Notice to Accompany Billing statements Every post-discharge statement shall include a copy of the notice. Each bill that is sent to a patient who has not provided proof of coverage by a third party at the time care is provided or upon discharge must include a statement of charges for services rendered by the Hospital. These notices shall be provided in non-English languages spoken by a substantial number of the patients served by the Hospital. D. AVAILABILITY OF FINANCIAL ASSISTANCE DOCUMENTS The Hospital shall post a copy of this Policy, the Plain Language Summary and the financial assistance application on its website and make all such documents available for free download. Such documents shall be available in the emergency room and admissions office and by mail upon request. The documents shall be provided in non-English languages spoken by a substantial number of the patients served by the Hospital. E. ACCESSIBILITY TO LIMITED ENGLIGH PROFICIENT INDIVIDUALS The Hospital shall make translations of this Policy, the Plain Language Summary, and the financial assistance application available in any language that is the primary language of the lesser of one thousand (1,000) individuals or five percent (5%) of the population of the communities served by the Hospital. |
| SCHEDULE H, PART VI, LINE 4 | Columbiana County, Ohio Columbiana County is located in northeastern Ohio and is one of Ohio's 32 Appalachian counties. It is bordered on the north by Mahoning County; on the east by Pennsylvania; on the south by the Ohio River and West Virginia; and on the west by Jefferson, Carroll and Stark Counties. Over half of the county's total population of 105,686 lives in unincorporated rural areas, with villages and towns some distance apart. The county has two major geographic concentrations of development and population. The northern corridor between the cities of Salem and East Palestine, (including the villages of Washingtonville, Leetonia, Columbiana and New Waterford and the four townships of Perry, Salem, Fairfield and Unity); extend along a 20-mile distance bordering Mahoning County to the north, and contain almost 48% of the county's population. The southern corridor extends for about 10 miles from the Village of Wellsville to East Liverpool, (including St. Clair Township) and contains 11% of the county's total population. EAST LIVERPOOL CITY HOSPITAL IS THE ONLY HOSPITAL WITHIN 20 MILES OF THE CITY. THE HOSPITAL SERVES PATIENTS WITHIN A 10-15 MILE RADIUS INCLUDING PATIENTS FROM NEIGHBORING PENNSYLVANIA AND WEST VIRGINIA. MOST RESIDENTS HAVE LIVED HERE ALL THEIR LIVES AND THE COMMUNITY SERVED IS COMPRISED OF A SIGNIFICANT BIAS OF SENIOR CITIZENS.A SIGNIFICANT BIAS OF SENIOR CITIZENS. |
| SCHEDULE H, PART VI, LINE 5 | EAST LIVERPOOL CITY HOSPITAL HAS AN OPEN MEDICAL STAFF, A COMMUNITY BOARD OF TRUSTEES AND IS EXTREMELY GENEROUS WITH FUNDING COMMUNITY CHARITIES AND DONATING EMPLOYEE TIME TO SERVE THE GENERAL POPULATION OF THE AREA SERVED. THIS INCLUDES PARTICIPATING IN COMMUNITY HEALTH FAIRS, SCHOOL PROGRAMS, AND FREE PUBLIC SPEAKING REGARDING TOPICS RECOGNIZED AS IMPLEMENTATION PRIORITIES IN THE 2016 CHNA. ELCH OFFERS FREE SMOKING CESSATION, DIABETES EDUCATION, AND HEALTH NUTRITION TO ALL COMMUNITY MEMBERS. |
| PERCENT OF TOTAL EXPENSE | BAD DEBT EXPENSE OF $8,145,688 WAS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FROM TOTAL EXPENSE FOR THE CALCULATION OF "PERCENT OF TOTAL EXPENSE" IN THIS COLUMN. |
| Disclosure pursuant to Revenue Procedure 2015-21: | Professional advisors to Prime Healthcare Foundation, Inc., the indirect sole member of the hospital, identified that the hospitals financial assistance policy (FAP) did not contain every provision required under Treasury Regulations Section 1.501(r)-4 and may not have been consistently available on the hospitals website. These issues were identified by auditors on July 21, 2017 and by legal counsel on August 4, 2017. ALL IDENTIFIED ISSUES WERE CORRECTED DURING late 2017 AND EARLY 2018 AND THE UPDATED FAP WAS ADOPTED BY THE BOARD ON MAY 24, 2018. THE FAP, FAP PLAIN LANGUAGE SUMMARY, AND FINANCIAL ASSISTANCE APPLICATION (INCLUDING TRANSLATIONS THEREOF, AS APPLICABLE) HAVE BEEN POSTED ON THE HOSPITAL WEBSITE. IN OTHER WORDS, EFFECTIVE AS OF SUCH 2018 DATE, THE HOSPITAL CAN CHECK ALL OF THE BOXES IN PART V, LINE 16(A) THROUGH AND INCLUDING LINE 16(I). A revised FAP was prepared that meets the requirements of the final regulations. This revised FAP was reviewed and approved by the board of directors of the hospital. The updated FAP is widely publicized, including on the hospitals website, in paper form by mail and in key hospital areas such as admissions and emergency room, through inclusion of information in billing statements, and conspicuous signage at the facility. It was also brought to the attention of management that the FAP, Plain Language Summary, and/or application form have at times inadvertently not been posted on the hospitals website. The dates during which this problem existed are not clear. Safeguards have been put in place to communicate with responsible personnel and highlight the importance of web access, and the newly-revised FAP contains an explicit procedural requirement that the policy be posted on the hospitals website. Despite these inadvertent failures, the hospital has at all times had a financial assistance program in effect that is consistent with the intent of Code Section 501(r) and has publicized the availability of charity care and discounted care through a written summary notice provided to all patients, conspicuous notices posted in the emergency department and admissions office, and notices included in billing statements to patients who have not provided proof of insurance. Therefore the hospital does not believe there have been qualifying individuals who were unaware of the program. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | The amount of bad debt attributable to patients eligible under the organization's financial assistance policy is from the 2017 Medicare Cost Report. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM City Hospital Association is a subsidiary of Prime Healthcare Foundation, Inc. (PHF). PHF and its subsidiaries are their own health system managed by Prime Healthcare Management II, Inc. |
| SCHEDULE H, PART VI, LINE 7 | STATE FILING OF COMMUNITY BENEFIT REPORT THIS IS NOT APPLICABLE TO CITY HOSPITAL ASSOCIATION. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | The Companys patient accounts receivable are reduced by allowances for contractual adjustments and doubtful accounts. In evaluating the collectability of patient accounts receivable, the Company analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowances for both contractual adjustments and doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of these allowances. For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and co-payment balances due for which third-party coverage exists for part of the bill), the Company records a provision for doubtful accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the expected rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEITH RICHARDSON | ||||||||||||||
| CEO/DIRECTOR | $288,960 | $0 | $34,000 | $0 | $0 | $0 | $0 | $0 | $1,140 | $0 | $324,100 | $0 | $0 | $0 |
| GRETCHEN NICKELL DO | ||||||||||||||
| DIRECTOR | $0 | $225,525 | $0 | $143,929 | $0 | $2,750 | $0 | $1,200 | $0 | $17,500 | $0 | $390,904 | $0 | $0 |
| JAYNE ROSE | ||||||||||||||
| CNO | $145,030 | $0 | $8,000 | $0 | $0 | $0 | $0 | $0 | $100 | $0 | $153,130 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A: | CITY HOSPITAL ASSOCIATION ALLOWS COMPANION TRAVEL BY EXECUTIVES ONLY WHEN IT SERVES A JUSTIFIED BUSINESS PURPOSE. IF IT IS LATER DETERMINED THAT THERE WAS NOT A JUSTIFIED BUSINESS PURPOSE, THIS WILL RESULT IN TAXABLE COMPENSATION TO THE EXECUTIVE IN QUESTION. CITY HOSPITAL ASSOCIATION PROVIDES A MEMBERSHIP TO AN AREA SOCIAL CLUB IN ORDER FOR EXECUTIVES TO CONDUCT HOSPITAL BUSINESS. ANY PERSONAL USE BY THE EXECUTIVES IS INCLUDED IN THAT EXECUTIVE'S TAXABLE WAGES. |
| METHODS TO ESTABLISH COMPENSATION OF CEO/EXECUTIVE DIRECTOR | PART 1, LINE 3 A RELATED ORGANIZATION USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION: WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY OFFICER COMPENSATION IS ESTABLISHED BY PRIME HEALTHCARE MANAGEMENT II, INC. IN ACCORDANCE WITH A MANAGEMENT AGREEMENT. WRITTEN EMPLOYMENT CONTRACTS ARE FORWARDED TO THE FACILITY ONCE EXECUTED. COMPENSATION SURVEY OR STUDIES ARE UTILIZED. |
Schedule L IRS990ScheduleL
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $0 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| PRIME HEALTHCARE MANAGEMENT IIINC | |||
| SEE PART V | $5,359,150 | MANAGEMENT FEES | Yes (true) |
| Hospital Business Services Inc | |||
| SEE PART V | $1,462,764 | BUSINESS OFFICE SERVICES | Yes (true) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, LINEs (1) AND (2), COLUMN (B) | FormAndLineReferenceDesc |
| Explanation | ENTITY IS INDIRECTLY, CONSTRUCTIVELY OWNED MORE THAN 35% BY AN OFFICER OF THE ORGANIZATION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (26 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B: | Information is compiled by the finance department and the Form 990 is prepared by an outside accounting firm. Once prepared, the forms are reviewed by outside counsel prior to filing and then the returns are provided to the board for their review contemporaneously with their filing. |
| FORM 990, PART VI, SECTION B, LINE 12C: | ALL DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST, ON THE PART OF ANY MEMBERS OF THE BOARD OF TRUSTEES, ON ANY ISSUE, SHOULD BE DISCLOSED TO THE OTHER MEMBERS OF THE BOARD OF TRUSTEES AND MADE A MATTER OF RECORD. ANY MEMBER OF THE BOARD OF TRUSTEES HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST, ON ANY MATTER SHOULD NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER. THE MINUTES OF THE MEETING SHOULD REFLECT THAT A DISCLOSURE WAS MADE AND THE ABSTENTION FROM VOTING. |
| FORM 990, PART VI, SECTION B, LINES 15A AND 15B: | A RELATED ORGANIZATION USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION: WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY OFFICER COMPENSATION IS ESTABLISHED BY PRIME HEALTHCARE MANAGEMENT II, INC. IN ACCORDANCE WITH A MANAGEMENT AGREEMENT. WRITTEN EMPLOYMENT CONTRACTS ARE FORWARDED TO THE FACILITY ONCE EXECUTED. COMPENSATION SURVEY OR STUDIES ARE UTILIZED. |
| FORM 990, PART VI, SECTION C, LINE 19: | THE DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION A, LINE 3: | THE ORGANIZATION IS BEING MANAGED BY PRIME HEALTHCARE MANAGEMENT II,INC., AN AFFILIATE OF PRIME HEALTHCARE FOUNDATION,INC. |
| WILDFIRE DISASTER RELIEF EXTENSION DISCLOSURE | On November 13, 2018, the Internal Revenue Service announced in CA-2018-13 that victims of wildfires that took place beginning on November 8, 2018 in California may qualify for tax relief. The relief applies to affected taxpayers in certain counties of California. The announcement indicates that it is applicable to tax-exempt organizations that operate on a calendar-year basis and had previously been granted an automatic extension to file until November 15, 2018. Since the organization engages a tax preparer in the covered disaster area (Ventura county) to prepare its Federal Form 990, Return of Organization Exempt from Income Tax, and the records necessary to file the calendar-year 2017 Federal Form 990 are located in the covered disaster area, the postponed due date for the Federal Form 990 is now April 30, 2019. The organization respectfully requests relief from any late filing penalty or interest. |
| FORM 990, PART VI, SECTION A, LINE 4: | THE ORGANIZATION'S BYLAWS WERE AMENDED AND RESTATED ON FEBRUARY 1, 2016. THE SIGNIFICANT CHANGES TO THE BYLAWS ARE AS FOLLOW: - THE ORGANIZATION'S DIRECT CONTROLLING ENTITY AND SOLE MEMBER IS PRIME HEALTHCARE FOUNDATION - EAST LIVERPOOL, LLC. PRIME HEALTHCARE FOUNDATION, INC. ("PHF"), A DELAWARE NONPROFIT, NON-STOCK CORPORATION EXEMPT FROM TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE IS THE SOLE MEMBER OF PRIME HEALTHCARE FOUNDATION - EAST LIVERPOOL, LLC. - THE GOVERNING BOARD MAY NOMINATE QUALIFIED INDIVIDUALS BUT THE SOLE MEMBER HAS THE AUTHORITY TO SELECT THE CEO. THE CEO IS APPOINTED BY THE MEMBER TO MANAGE THE DAY-TO-DAY BUSINESS AFFAIRS AND ADMINISTRATION. THE CEO REPORTS TO THE GOVERNING BOARD, WHILE MAINTAINING CONTINUING COMMUNICATION WITH THE MEMBER AND STAFF. - The Governing Board has delegated to the CEO broad authority and responsibility, including but not limited to the following: (a) carrying out the directives of the Governing Board; (b) providing orientation for new Governing Board Members and continuing education for all Governing Board Members and reviewing their performance. Continuing education shall include, but not be limited to, education related to (i) the organization's Mission, Vision and Values (ii) the organization's safety and quality goals, (iii) the organization's organizational structure and decision making process, (iv) the development of a budget for the organization and the interpretation of the organization's financial statements, (v) the patient population served by the organization and any issues related to such population, (vi) the individual and interdependent responsibilities and accountability of the Governing Board, the organization's senior management, and the Medical Staff leadership as they relate to supporting the organization's mission of providing safe and quality care, and (vii) applicable laws and regulations; (c) identifying a nurse leader to serve as the Chief Nursing Officer/Director of Nursing who will, among other things, participate in decision making at the executive level; (d) identifying a qualified individual to serve as the Chief Financial Officer of the organization, who will, among other things, participate in financial planning, reporting and management; (e) establishing and managing such non-Medical Staff departments of the organization as he deems necessary; (f) serving as the liaison among the organization's Member, health care delivery organizations corporately and functionally related to the organization, the Governing Board, the Medical Staff, the AHP Staff, and organization employees; (g) supporting the organization's performance improvement programs and its initiatives and the organization's patient safety program; (h) negotiating, entering into, administering, modifying, and terminating such contracts (including contracts with Practitioners for the rendering of services at or to the organization) for the organization as he may deem necessary; (i) performing or delegating the performance of all personnel, financial, strategic planning, and other management functions within the organization, except to the extent that such functions are explicitly and exclusively reserved to the Governing Board or to the Medical Staff pursuant to these Bylaws; (j) Perfecting and submitting to the Governing Board for approval a plan of organization of the personnel and others concerned with the operation of the organization. This plan of organization shall clearly outline the chain of administrative command and accountability, which shall be operational in the absence of the CEO (or similarly appointed officer). The CEO shall further provide a liaison between the general and professional staff of the organization and the Governing Board; (k) Preparing an annual budget showing the expected receipts and expenditures of the organization as required by the Governing Board; (l) Assuring that all physical properties and fixed and movable equipment are kept in good state of repair and operating condition; (m) Supervising all business such as the collection of accounts, purchases and issuance of supplies, and making all proper efforts to collect the funds due so as to maintain the financial solvency of the organization; (n) Developing criteria to select, employ, evaluate, control and discharge all employees as authorized by the Governing Board; (o) Providing for such personnel policies as are necessary to foster and maintain a work environment responsive to changing business conditions, regulatory requirements, and fairness to the employees of the organization. Criteria utilized in establishing job performance expectations and evaluation indicators will apply to contracted and payroll staff. The criteria for clinical providers shall reflect the skills needed to accomplish age appropriate assessments and treatment plans; such age appropriate assessment and treatment planning criteria shall also be developed with the collaboration of the Medical Staff for their utilization in recommendations concerning reappointment and Clinical Privileges; (p) Cooperating with the Medical Staff and securing like cooperation on the part of those concerned with the rendering of high quality professional services to all patients. Providing the necessary administrative, fiscal and personnel resources to assist the Medical Staff and departmental/service staff in implementing the organization's performance improvement, risk management and safety programs; (q) Attending all meetings of the Governing Board and its committees when requested to do so; (r) Submitting regularly to the Governing Board and to the Member periodic reports showing the professional services and financial activities of the organization, and preparing and submitting such other special reports as may be required by the Governing Board or the Member, including those reports attesting to there being one level of care for patients with the same health problem regardless of payer source or other non-medical factor; and facilitating the reporting by the general staff of the organization to the Governing Board quality assessment results and findings; (s) Performing any other duties as directed by the Governing Board that are in the best interests of the organization; (t) Serving as liaison officer and channel of communications for official communications between the Governing Board, organization administration, and the Medical Staff; (u) Continually providing and updating the capital expenditures plan as required by applicable laws and regulations and as directed by the Governing Board; (v) Preparing a strategic plan for the organization (a "Strategic Plan") and submitting the plan to the Governing Board for approval. Such submission for approval shall be at least once every five years with annual updates to each Governing Board as to the progress of the completion of the activities called for in the Strategic Plan; (W) Assuring that the implementation of the organization's programs and services is cost effective; (x) Reviewing and acting promptly upon reports of authorized planning, regulatory and accrediting agencies. The CEO shall undertake corrective action for any deficiencies reported by such agencies, and shall prepare documentation of such corrective action when necessary, to be made available to licensing, accrediting, or any governmental agency for the organization's accreditation or plan of correction survey; (y) Receiving, as authorized agent of the organization, the service of any documents, including reports of inspections and consultations and civil and administrative process; and (z) Subject to the approval of the Member, appointing a qualified individual to act in the CEO's temporary absence. individual to act in the CEO's temporary absence. |
| FORM 990, PART VI, SECTION A, LINE 4: | THE ORGANIZATION'S BYLAWS WERE AMENDED AND RESTATED ON FEBRUARY 1, 2016. THE SIGNIFICANT CHANGES TO THE BYLAWS ARE CONTINUED AS FOLLOWS: - The Medical Staff shall be established by and accountable to the Governing Board and shall operate as a part of the ORGANIZATION. Only the Medical Staff Bylaws, rules, and regulations as are recommended by the Medical Staff and adopted and approved by the Governing Board shall be effective. - The Governing Board retains the right to recommend amendments to the Medical Staff Bylaws as necessary for the operation of the organization and as necessary for compliance with applicable laws, the requirements of the Joint Commission, the Healthcare Facilities Accreditation Program, or other similar deemed status accrediting agency, whichever is applicable, other accrediting bodies, and the requirements of the organization. - The Medical Staff Bylaws shall include a mechanism whereby the Medical Executive Committee makes recommendations to the Governing Board regarding certain matters. - In order for any licensed Practitioner to practice in the organization, such individual must first be appointed to either the Medical Staff or the AHP Staff and be granted specific Clinical Privileges. - From time to time, the organization may engage one or more physicians as a medico-administrative officer under such terms and conditions as are specified in an engagement contract. - The Governing Board will cooperate with auxiliary and associate organizations to assist in the fulfillment of the purposes of the organization. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MEDICAL PURCHASED SERVICES TOTAL FEES:850383 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:RECRUITING TOTAL FEES:62013 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LABORATORY SERVICE CONTRACTS TOTAL FEES:176547 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:ADMINISTRATIVE SERVICE CONTRAC TOTAL FEES:42098 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BUSINESS OFFICE SERVICES TOTAL FEES:1462764 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:15611 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:INFORMATION SERVICE CONTRACTS TOTAL FEES:358229 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OPERATION SERVICE CONTRACTS TOTAL FEES:303118 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BIOMED SERVICE CONTRACTS TOTAL FEES:524991 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:COLLECTION FEES TOTAL FEES:146929 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PROFESSIONAL FEES TOTAL FEES:1081140 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LABORATORY FEES TOTAL FEES:126507 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:WOUND CARE CLINIC FEES TOTAL FEES:589134 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LINEN CARE PROFEESIONAL FEES TOTAL FEES:277837 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:ADMINISTRATION PROF FEES TOTAL FEES:3214631 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:ANESTHESIA PROFESSIONAL FEES TOTAL FEES:900488 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MEDICAL PROFESSIONAL FEES TOTAL FEES:528640 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BEHAVORIAL HEALTH PROF FEES TOTAL FEES:181836 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PRIME HEALTHCARE FOUNDATION INC | ||||||||||
| 3300 E GUASTI ROAD SUITE 300 | ONTARIO | CA | 91761 | 208065139 | HOSPITAL/MGMT | DE | 501(C)(3) | 3 | NA | false |
| OHIO VALLEY HOME HEALTH SERVICES | ||||||||||
| 425 WEST FIFTH STREET | EAST LIVERPOOL | OH | 43920 | 341014198 | HEALTHCARE | OH | 501(c)(3) | 10 | PHF-EAST LIV | false |
| KNAPP MEDICAL CENTER | ||||||||||
| 1401 E 8TH STREET-PO BOX 1110 | WESLACO | TX | 78596 | 741393060 | HOSPITAL | TX | 501(C)(3) | 3 | PHF | false |
| MID-VALLEY PHYSICIANS ASSOCIATION | ||||||||||
| 1401 E 8TH STREET | WESLACO | TX | 78596 | 742755150 | SUPPORT | TX | 501(C)(3) | 11A | KMC | false |
| KNAPP MEDICAL GROUP | ||||||||||
| 1402 E 8TH STREET | WESLACO | TX | 78596 | 271619835 | HEALTHCARE | TX | 501(C)(3) | 3 | KMC | false |
| CALIFORNIA UNIVERSITY OF SCIENCE AND MED | ||||||||||
| 3300 E GUASTI ROAD SUITE 300 | ONTARIO | CA | 91761 | 464141445 | EDUCATION | CA | 501(C)(3) | 2 | PHF | false |
| MISSION HOSPITAL INC | ||||||||||
| 900 SOUTH BRYAN ROAD | MISSION | TX | 78572 | 742206635 | HOSPITAL | TX | 501(C)(3) | 3 | PHF-MISSION | false |
| MISSION HOSPITAL FOUNDATION | ||||||||||
| 900 SOUTH BRYAN ROAD | MISSION | TX | 78572 | 542076455 | SUPPORT | TX | 501(C)(3) | 11A | MISSION HOSP | false |
| MISSION DOCTORS GROUP | ||||||||||
| 906 SOUTH BRYAN ROADSUITE 209 | MISSION | TX | 78572 | 742798500 | HEALTHCARE | TX | 501(C)(3) | 3 | MISSION HOSP | false |
| 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 | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |