ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME (EIN 42-0733472)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-15
- IRS object ID
- 201721379349300432
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-15T00:00:00-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 South Sixth Street Suite 2800 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420733472 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Anthony Regional Hospital | BusinessNameLine1Txt |
| Business Name Line2 | and Nursing Home | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STAN | BusinessNameControlTxt |
| Phone | 7127945246 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 South Clark Street PO Box 628 | AddressLine1Txt |
| City | Carroll | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51401 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | John Munson | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7127945246 | PhoneNum |
| Signature | 2017-05-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kristina Rasmussen | PreparerPersonNm |
| PTIN | P00143920 | PTIN |
| Phone | 6123974000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Edward H Smith Jr | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 South Clark Street PO Box 628 | AddressLine1Txt |
| City | Carroll | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $94,658,784 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.stanthonyhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1905 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | Consistently providing high quality healthcare services to meet patient and community needs. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 791 | TotalEmployeeCnt |
| Total Volunteers | 515 | TotalVolunteersCnt |
| Total Gross UBI | $2,177 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $467,616 | PYContributionsGrantsAmt |
| CY Contributions Grants | $170,296 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $68,320,240 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $73,302,323 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,959,424 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,074,479 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$403,520 | PYOtherRevenueAmt |
| CY Other Revenue | -$489,405 | CYOtherRevenueAmt |
| PY Total Revenue | $73,343,760 | PYTotalRevenueAmt |
| CY Total Revenue | $74,057,693 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $6,500 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $34,097,214 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $36,193,177 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $31,962,469 | PYOtherExpensesAmt |
| CY Other Expenses | $34,959,121 | CYOtherExpensesAmt |
| PY Total Expenses | $66,059,683 | PYTotalExpensesAmt |
| CY Total Expenses | $71,158,798 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,284,077 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,898,895 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $145,455,995 | TotalAssetsBOYAmt |
| Total Assets EOY | $145,239,794 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $21,348,840 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $21,354,065 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $124,107,155 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $123,885,729 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | St. Anthony Regional Hospital is inspired by faith and committed to excellence. We are dedicated to improving the health of the people we serve. We will lead in providing high quality, high value healthcare services responsive to the needs of our patients and the region. We are committed to the health ministry of our sponsors, the Franciscan Sisters of Perpetual Adoration. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $64,314,514 | ExpenseAmt |
| Grant | $6,500 | GrantAmt |
| Revenue | $73,302,323 | RevenueAmt |
| Desc | St. Anthony Regional Hospital is a 99 bed acute care facility and St. Anthony Nursing Home has 79 beds in Carroll, IA. In the year ended June 30, 2016, St. Anthony Regional Hospital and Nursing Home provided health care services to approximately 2,543 inpatients, 80,718 outpatients, and 39,105 clinic visits. St. Anthony Regional Hospital provided services for 1,578 acute care inpatients, and provided psychiatric, swing bed, and nursing home services for the remainder of inpatients. Outpatient services were provided to patients through ancillary departments, emergency room, and clinics.See Schedule O.St. Anthony Hospital provides services of cardiac rehabilitation, dialysis, hospice care, laboratory, observation, chemotherapy, pathology, radiology, respiratory therapy, physical therapy, occupational therapy, speech therapy, diabetes and surgical services. St. Anthony's largest patient service area is laboratory. In the year ended June 30, 2016, St. Anthony serviced 17,527 patients in laboratory, 7,533 in emergency room, and 7,935 in radiology. The activities pursued by St. Anthony Regional Hospital and Nursing Home in the provision of health care services are consistent with its exempt purpose. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,732,845 | ExpenseAmt |
| Desc | As part of its mission, St. Anthony Regional Hospital provides medical care to individuals who are unable to pay for services, incurs costs in excess of reimbursement for services to medicaid beneficiaries, and carries out other activities and programs free of charge to support the community in which it operates. Community benefit projects include community health education, health care support services, behavioral health services, community health improvement advocacy, and other traditional charity care. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $67,047,359 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 132 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 791 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | IA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | John R Munson | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7127945115 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 South Clark St | AddressLine1Txt |
| City | Carroll | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 514010628 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 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 |
|---|---|---|---|---|---|---|---|---|
| Fred Dolezal | ||||||||
| Chairman | 0.30 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Tom Gronstal | ||||||||
| Vice-Chairman | 0.30 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Sr Ramona Klaubauf | ||||||||
| Secretary | 0.30 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Wayne Seaman | ||||||||
| Treasurer | 0.30 | 0.30 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Nick Badding | ||||||||
| Board Member | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Howard J Drees | ||||||||
| Board Member | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sr Theresa Keller | ||||||||
| Board Member | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sr Maris Kerwin | ||||||||
| Board Member | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Josh Smith | ||||||||
| Board Member (Start 7/15) | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sr Donna Venticher | ||||||||
| Board Member | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Peggy White | ||||||||
| Board Member | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Edward H Smith Jr | ||||||||
| CEO/President | 40.00 | 0.30 | Yes (X) | $355,462 | $0 | $35,258 | ||
| John Munson | ||||||||
| CFO/Vice President | 40.00 | 0.30 | Yes (X) | $165,547 | $0 | $18,412 | ||
| Richard C Sazama MD | ||||||||
| Physician | 40.00 | 0.00 | $428,889 | $0 | $10,254 | Yes (X) | ||
| Nelson H Lo MD | ||||||||
| Physician | 40.00 | 0.00 | $362,841 | $0 | $26,862 | Yes (X) | ||
| Jwong H Ling | ||||||||
| Physician | 40.00 | 0.00 | $343,274 | $0 | $0 | Yes (X) | ||
| Tina F Schechinger MD | ||||||||
| Physician | 40.00 | 0.00 | $260,976 | $0 | $20,689 | Yes (X) | ||
| David C Pederson | ||||||||
| Anesthesist | 40.00 | 0.00 | $253,181 | $0 | $17,548 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,170,170 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $129,023 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 31 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Medical Oncology | |||||
| 1221 Pleasant St | Des Moines | IA | 50309 | Oncology Services | $226,114 |
| Park Place International LLC | |||||
| 7227 Chagrin Rd | Chagrin Falls | OH | 44023 | Computer Services | $182,462 |
| Deloitte and Touche LLP | |||||
| PO Box 844708 | Dallas | TX | 752844708 | Accounting Services | $149,252 |
| Dorsey & Whitney LLP | |||||
| 801 Grand Ste 4100 | Des Moines | IA | 502098002 | Legal Services | $146,296 |
| Dr Jed Hagen | |||||
| 2313 Skyline Dr | Carroll | IA | 51401 | Pathology Services | $128,750 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $170,296 | RelatedOrganizationsAmt |
| Total Contributions | $170,296 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|---|
| Patient Svc Revenue | 621400 | $42,213,975 | $42,213,975 | ||
| Medicare/Medicaid Pmts | 621400 | $30,702,400 | $30,702,400 | ||
| Cafeteria Sales | 621400 | $383,771 | $383,771 | ||
| Inc. from Partnership | 900004 | $2,177 | $2,177 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $73,302,323 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,396,867 | TotalRevenueColumnAmt |
| Exclusion | $1,396,867 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,017,181 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,506,586 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$489,405 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$489,405 | TotalRevenueColumnAmt |
| Exclusion | -$489,405 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $18,736,037 | SecuritiesAmt |
| Other | $36,080 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $18,990,206 | SecuritiesAmt |
| Other | $104,299 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$254,169 | SecuritiesAmt |
| Other | -$68,219 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$322,388 | TotalRevenueColumnAmt |
| Exclusion | -$322,388 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $74,057,693 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $72,916,375 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,177 | UnrelatedBusinessRevenueAmt |
| Exclusion | $968,845 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,000 | TotalAmt |
| Program Services | $5,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,500 | TotalAmt |
| Program Services | $1,500 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $514,715 | TotalAmt |
| Management And General | $514,715 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,805,269 | TotalAmt |
| Program Services | $27,879,880 | ProgramServicesAmt |
| Management And General | $925,389 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $639,172 | TotalAmt |
| Program Services | $575,332 | ProgramServicesAmt |
| Management And General | $63,840 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,207,434 | TotalAmt |
| Program Services | $4,000,491 | ProgramServicesAmt |
| Management And General | $206,943 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,026,587 | TotalAmt |
| Program Services | $1,940,055 | ProgramServicesAmt |
| Management And General | $86,532 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,827 | TotalAmt |
| Management And General | $66,827 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,557 | TotalAmt |
| Management And General | $179,557 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $267,705 | TotalAmt |
| Management And General | $267,705 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,874,486 | TotalAmt |
| Program Services | $5,883,298 | ProgramServicesAmt |
| Management And General | $991,188 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $305,299 | TotalAmt |
| Program Services | $33,619 | ProgramServicesAmt |
| Management And General | $271,680 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,870,970 | TotalAmt |
| Program Services | $1,682,938 | ProgramServicesAmt |
| Management And General | $188,032 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $432,352 | TotalAmt |
| Program Services | $432,352 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,034,609 | TotalAmt |
| Program Services | $2,022,909 | ProgramServicesAmt |
| Management And General | $11,700 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $323,494 | TotalAmt |
| Program Services | $260,965 | ProgramServicesAmt |
| Management And General | $62,529 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $600,756 | TotalAmt |
| Program Services | $600,756 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,115,734 | TotalAmt |
| Program Services | $6,115,734 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $362,776 | TotalAmt |
| Program Services | $362,776 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $13,223,396 | $13,223,396 | |
| Repair and Maintenance | $1,620,482 | $1,505,229 | $115,253 |
| Joint Venture Expenses | $680,214 | $521,129 | $159,085 |
| Community Event Support | $464 | $464 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,158,798 | TotalAmt |
| Program Services | $67,047,359 | ProgramServicesAmt |
| Management And General | $4,111,439 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,420,467 | BOYAmt |
| EOY | $1,938,636 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,717,203 | BOYAmt |
| EOY | $12,048,209 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13 | BOYAmt |
| EOY | $17 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,007,239 | BOYAmt |
| EOY | $1,977,648 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $409,964 | BOYAmt |
| EOY | $429,459 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $132,322,552 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $69,260,562 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,078,620 | BOYAmt |
| EOY | $63,061,990 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,176,378 | BOYAmt |
| EOY | $51,580,897 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $413,817 | BOYAmt |
| EOY | $1,729,743 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,232,294 | BOYAmt |
| EOY | $12,473,195 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,455,995 | BOYAmt |
| EOY | $145,239,794 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,629,473 | BOYAmt |
| EOY | $5,986,067 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,391,000 | BOYAmt |
| EOY | $12,881,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,264,336 | BOYAmt |
| EOY | $1,418,800 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,064,031 | BOYAmt |
| EOY | $1,068,198 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,348,840 | BOYAmt |
| EOY | $21,354,065 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,540,473 | BOYAmt |
| EOY | $119,178,876 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,466,682 | BOYAmt |
| EOY | $4,606,853 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,000 | BOYAmt |
| EOY | $100,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,107,155 | BOYAmt |
| EOY | $123,885,729 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,455,995 | BOYAmt |
| EOY | $145,239,794 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,898,895 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,136,294 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,984,027 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $7,892 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,892 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | St. Anthony Hospital is a member of the Iowa Hospital Association. A percentage of the membership dues paid to IHA is related to lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,720,664 | BeginningYearBalanceAmt |
| Contributions | $357,317 | ContributionsAmt |
| Investment Earnings Or Losses | $138,893 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $9,500 | GrantsOrScholarshipsAmt |
| Other Expenditures | $33,467 | OtherExpendituresAmt |
| End Year Balance | $12,173,907 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,950,534 | BeginningYearBalanceAmt |
| Contributions | $1,706,686 | ContributionsAmt |
| Investment Earnings Or Losses | $510,919 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $3,500 | GrantsOrScholarshipsAmt |
| Other Expenditures | $443,975 | OtherExpendituresAmt |
| End Year Balance | $11,720,664 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,852,058 | BeginningYearBalanceAmt |
| Contributions | $1,626,938 | ContributionsAmt |
| Investment Earnings Or Losses | $1,547,970 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $4,000 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1,072,432 | OtherExpendituresAmt |
| End Year Balance | $9,950,534 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,622,373 | BeginningYearBalanceAmt |
| Contributions | $3,018,705 | ContributionsAmt |
| Investment Earnings Or Losses | $739,105 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $2,500 | GrantsOrScholarshipsAmt |
| Other Expenditures | $525,625 | OtherExpendituresAmt |
| End Year Balance | $7,852,058 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $995,357 | BeginningYearBalanceAmt |
| Contributions | $3,662,163 | ContributionsAmt |
| Investment Earnings Or Losses | -$30,442 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $3,500 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1,205 | OtherExpendituresAmt |
| End Year Balance | $4,622,373 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.54000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.46000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $632,934 | OtherCostOrOtherBasisAmt |
| Book Value | $632,934 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $86,476,104 | OtherCostOrOtherBasisAmt |
| Depreciation | $39,414,426 | DepreciationAmt |
| Book Value | $47,061,678 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,979,709 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,775,122 | DepreciationAmt |
| Book Value | $8,204,587 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,233,805 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,071,014 | DepreciationAmt |
| Book Value | $7,162,791 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $63,061,990 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Deferred Compensation Investments | $1,068,198 |
| Beneficial Interest in Net Assets of the Foundation | $11,206,853 |
| Other | $198,144 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $12,473,195 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Deferred Compensation | Desc |
| Amt | $1,068,198 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,068,198 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $74,366,493 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$1,136,294 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $140,171 | OtherRevenueAmt |
| Revenue Not Reported | -$996,123 | RevenueNotReportedAmt |
| Revenue Subtotal | $75,362,616 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $267,705 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | -$1,572,628 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$1,304,923 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $74,057,693 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $72,697,437 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $1,806,344 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $1,806,344 | ExpensesNotReportedAmt |
| Expenses Subtotal | $70,891,093 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $267,705 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $267,705 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $71,158,798 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | All restricted endowed funds held at St. Anthony Foundation are used for the benefit of St. Anthony Regional Hospital for pastoral care and scholarships. |
| Part X, Line 2: | The Internal Revenue Service has determined that the Hospital is an organization exempt from income tax under the Internal Revenue Code; and accordingly, no provision for income taxes is recorded in the consolidated statements of activities. Accounting for income taxes provides that a tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. The Hospital recorded no liabilities for unrecognized tax benefits as of June 30, 2016 and 2015. The Hospital is engaged in certain activities that result in unrelated business income recorded within other revenue in the consolidated statements of activities. |
| Part XI, Line 2d - Other Adjustments: | Change in beneficial interest of Net Assets of Foundation 140,171. |
| Part XI, Line 4b - Other Adjustments: | Rental Expenses -1,506,586. Realized Loss on Sale of Assets -68,219. Income from Partnerships 2,177. |
| Part XII, Line 2d - Other Adjustments: | Rental Expenses 1,506,586. Realized Loss on Sale of Assets 68,219. Transfer to Foundation - Reimbursed Expenses 231,539. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 399.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $481,355 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $481,355 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00680 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,494,250 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,763,266 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,730,984 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02430 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,975,605 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,763,266 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,212,339 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03110 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $213,238 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,395 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $181,843 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00260 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $254,705 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,750 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $252,955 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,581,652 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,603,754 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,977,898 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04180 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $195,056 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $63,301 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $131,755 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,244,651 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,700,200 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,544,451 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04990 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,220,256 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,463,466 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,756,790 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08100 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,005 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,005 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,346 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,221 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,125 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,351 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,221 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,130 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,221,594 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $20,117,579 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $25,278,359 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$5,160,780 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Anthony Regional Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 South Clark St PO Box 628 | AddressLine1Txt |
| City | Carroll | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 514010628 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.stanthonyhospital.org | WebsiteAddressTxt |
| State License | 14009OH | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Anthony Regional Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Section C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.stanthonyhospital.org/images/sarpdf/CHNA.13/CHNA16Final.pdf | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 399.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.stanthonyhospital.org/images/sarpdf/Financial_Assistance_Policy.pdf | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.stanthonyhospital.org/images/sarpdf/St_Anthony_CARES_Financial_Applicat | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.stanthonyhospital.org/images/sarpdf/Plain_Language_Summary | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| St. Anthony Regional Hospital | Part V, Section B, Line 5: In the year ended 6/30/16, St. Anthony Regional Hospital conducted a CHNA assessment. A total of 20 individuals were interviewed, including internal stakeholders - those affiliated or employed by St. Anthony Regional Hospital and Nursing Home - and external stakeholders from across the area. The interviews were conducted using a structured questionnaire with key stakeholders being asked to discuss community health needs and availability of services and recommendations for improving community health. All interviews were reviewed and comments analyzed to identify the most frequently mentioned community health issues. The interviews were conducted during the months of May and June 2016. |
| St. Anthony Regional Hospital | Part V, Section B, Line 6b: St. Anthony Regional Hospital and Nursing Home contracted with Community Health Advisors, LLC for assistance with the Community Health Needs Assessment. |
| St. Anthony Regional Hospital | Part V, Section B, Line 7d: www.stanthonyhospital.org/images/sarpdf/CHNA.13/CHNA13Final.pdf |
| St. Anthony Regional Hospital | Part V, Section B, Line 11: The following significant health needs were identified in the St. Anthony Regional Hospital and Nursing Home service area.- Access to Care Related to Cost and Use of Insurance- Cancer - Treatment and Prevention- Chronic Disease Management- Health Education- Mental Health Services- Nutrition and Exercise- Obesity and Diabetes- Substance Abuse - Tobacco and Alcohol- Transportation- VaccinationsSt. Anthony Regional Hospital and Nursing Home has worked to meet these identified heath needs this year in the following ways:Access to Care Related to Cost and Use of Insurance:- Distributed 750 annually copies of outreach and education materials on the St. Anthony Cares financial assistance program.- The four certified financial counselors helped people in the community sign up in health exchanges. - We distributed Spanish materials to help non-English speaking population.Cancer - Treatment and Prevention:- We continued public awareness campaigns aimed at cancer screening.- We provided 1500 mammograms.- The expanded and remodeled radiation oncology department procedures increased.Chronic Disease Management:- The Health Coach helped patients access information and treat chronic diseases.- The St. Anthony Care Clinic offered diabetes education, wound care and health coaching.- The Healthy Bodies exercise program continued to help at risk patients.Health Education:- We have provided community education by local physicians and professional staff to address community health education with the following programs:Managing Diabetes, Women's Heart Health, No Symptoms Required, Pain Management Anatomy of a Bicycle, Girls Night Out, Advanced Care Planning Conversations, My Heart is Fluttering is it Love or Should I See a Doctor, Making the Most of a Health Heart, Cancer the Emperor of All Maladies, Change for Life, Eat Well, Move More, Live Longer, Feeding Your Young Child, Healthy Active Children, Talking about Men's Health, Menopause Education, and Women's Incontinence. Mental Health:- We have contracted with mental health providers to provide coverage and continue to provide adult and adolescent care on and inpatient and outpatient basis. Inpatients days have increased 9.7% and outpatient visits have increased 7.3% from 2015 to 2016.- We have continued to support Carroll County Supervisors and area schools' efforts to increase access to mental health in area.Nutrition, Exercise, Obesity and Diabetes:- The Health Coach and Chronic Care Clinic provide services to manage diet, diabetes and weight loss.- The Chronic Care Clinic provides diabetes education and healthy bodies exercise program.- We continue to promote support groups for anyone affected by diabetes, along with family and any others in a supporting role.- We continue to work with local employers to promote wellness programs.Substance Abuse - Tobacco and Alcohol:- We have implemented routine screening for tobacco use for outpatient and clinic patients.- Referrals, as appropriated, made for assistance with tobacco cessation.- We have implemented routine screening for alcohol use for all patients admitted to the hospital.Vaccinations:- Collaborated with Public Health departments to promote and administer vaccines.- Designed a public education message on the importance of flu vaccine.Transportation:The objective was to address challenges related to public transportation for medical care in the service area. The Public Health Department is addressing the transportation needs by maintaining a list of available taxi services and raising funds to support taxi vouchers for elderly patients. However, given the challenge of enduring adequate transportation in a rural area, this need was not addressed by St. Anthony due to lack of infrastructure and expertise. |
| St. Anthony Regional Hospital | Part V, Section B, Line 13h: Additional eligibility criteria for financial assistance include Medicaid/Medicare coverage, and State regulations. |
| St. Anthony Regional Hospital | Part V, Section B, Line 22d: St. Anthony uses annual poverty guidelines to determine FAP eligibility. The maximum amount a FAP eligible patient would pay is 75% of gross charges. Individuals that earn 301-399% of federal poverty guidelines are eligible for a discout of 25%. All individuals that earn less than 200% of federal poverty guidelines pay 0% of gross charges. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - St Anthony Regional Hospice | ||||
| 311 South Clark St | Carroll | IA | 51401 | Hospice Services |
| 2 - St Anthony Regional Hospital | ||||
| 311 South Clark St | Carroll | IA | 51401 | Dialysis Services |
| 3 - St Anthony Regional Home Hlth Agency | ||||
| 311 South Clark St | Carroll | IA | 51401 | Home Health Services |
| 4 - St Anthony Regional Hospital | ||||
| 311 South Clark St | Carroll | IA | 51401 | Psychiatric Services |
| 5 - Wall Lake Medical Clinic | ||||
| 311 West First St | Wall Lake | IA | 51466 | Rural Health Clinic |
| 6 - St Anthony Nursing Home | ||||
| 311 South Clark St | Carroll | IA | 51401 | Nursing Home |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | In addition to FPG, the Hospital will consider the extent to which the patient's household has assets that could be used to meet his or her financial obligation. Assets may include, but are not limited to, cash, savings, and checking accounts, certificates of deposit, stocks, bonds, IRA accounts, trust funds, real estate, and motor vehicles. The hospital will also take into account any liabilities that are the responsibility of the patient's household. To relieve the stress related to financial burdens, families with a medical catastrophe with self- pay balances greater than 20% of their annual income in one calendar year may be eligible for substantial discounts. |
| Part I, Line 7: | The cost to charge ratio was used when calculating the amounts reported in Part 1, line 7, with the exception of line 7g, subsidized heath services. Subsidized heath services are reported using departmental cost from the 2016 cost report. |
| Part I, Line 7g: | St. Anthony Regional Hospital has eight physician clinics that are included in subsidized health services where cost exceeds the reimbursements. |
| Part II, Community Building Activities: | The Hospital CEO participates in the Carroll Area Development board that is active in workforce development. The hospital emergency room director attended regional meetings on disaster readiness. The CEO is a board member of the Iowa Hospital Association Board of Directors. There are managers of the Hospital that serve on local health advisory boards. |
| Part III, Line 2: | St. Anthony Regional Hospital reports bad debt in accordance with generally accepted accounting principles (GAAP). Bad debt at cost is calculated with the same cost to charge ratio used for the charity care at cost multiplied by the estimated debt charges.Part III, Line 3:St. Anthony Regional Hospital works with those qualifying for charity care along every step of the process including accepting applications for financial assistance after previous attempts to work with the patient fail. Every effort is made to work with the patient to provide financial assistance when appropriate. While there are people who do not cooperate with the Hospital regarding payment plans, financial assistance or with those trying to help them get on government programs. For individuals not providing necessary information it is impossible to know the reason for not cooperating and therefore know whether they will qualify for charity care. St. Anthony Regional Hospital is unable to reasonably determine whether any amount of bad debt could have been classified as charity care if individuals do not provide the necessary information to evaluate their situation to determine qualification with the charity care policy.Part III, Line 4: The financial statements for St. Anthony Regional Hospital do not include a footnote regarding bad debts; however, the bad debt expense from the financial statement is a percent of revenue that is an estimate of the historical bad debt written off. |
| Part III, Line 8: | The amount of Medicare short fall on line 7 should be included in the community benefit because Medicare pays less than the cost for rendering services. The Medicare allowable costs are taken from the Medicare cost report and determined based on the cost to charge ratio from the Medicare report. |
| Part III, Line 9b: | The policy states that St. Anthony Regional Hospital offers charity care to all patients who meet the criteria for financial aid and want assistance. Patients who do not have insurance may qualify for St. Anthony Cares based on annual income and family size. Patients with insurance may also qualify for St. Anthony Cares for bills not covered by insurance. Charity information is available upon admission and disclosed in monthly billing statements. An application is completed by the patient and based on the income and family size the amount of charity is determined based on the federal poverty guidelines. Patients receive statements and make payment arrangements with Preferred Medical Deposits (PMD). Accounts at PMD with no activity after 60 days are then turned over to our collection agency Avadyne Health. |
| Part VI, Line 2: | The Hospital and county performs a community needs assessment every three years to identify specific health concerns of the county. Meetings are held with community partners to identify needs from the daily work and with clients, students, educators, health care, volunteer services, case management, behavior medicine, and others in the county. A survey was developed to gather county residents identified needs. The primary data collection included a web based community survey. The survey was posted on the hospital website. Similar versions of the survey were distributed by the Carroll County Public Health Department and Manning Regional Health Care Center. There were over 250 people who participated in the survey.The needs assessment was completed and adopted by the St. Anthony Hospital Board of Directors. The implementation strategy was developed and implemented based on the assessment of the survey. The hospital intends to coordinate efforts with the Carroll County Public Health Department to ensure that community benefit resources address needs to improve the health of residents of the service area. |
| Part VI, Line 3: | The financial counselor from the organization informs and educates patients about eligibility of federal, state, and local government programs and charity care policies. The charity care policy is made available to patients in the admissions office and provided in the admission packets. If patients have questions they can stop in the business office and discuss them with a financial counselor. |
| Part VI, Line 4: | The Hospital is located in the city of Carroll in West Central Iowa, Carroll County with a population of 20,562. St. Anthony Hospital also serves portions of 6 surrounding counties with a radius of 50 miles. St. Anthony Hospital operates 5 satellite physician clinics in the service area, in addition to 3 physician clinics in the hospital. The six counties of Audubon, Carroll, Calhoun, Crawford, Green, and Sac comprise the hospital's primary service area. The estimated population of St. Anthony's six county area was 72,685 in 2014. The estimated 2014 median house hold income for all counties in the service area is less than the median Iowa household income of $52,716, as well as the national median income of $53,482. The majority of the population in the St. Anthony, six county service area is White/ Caucasian. Crawford County has a significant Hispanic population, with more than one-quarter of the population being Hispanic. The majority of the service area is comprised of English speaking residents. The exception is Crawford County were nearly one-quarter of the population speaks a language other than English in the home, nearly all of them being Spanish speaking. |
| Part VI, Line 5: | St. Anthony Regional Hospital has demonstrated a commitment to promoting health care to further its exempt purpose providing quality health care in the community and surrounding counties for one hundred and eleven years. The majority of the Hospital's board members are from local businesses and reside in the community. The Hospital's medical staff consists of 34 active staff, 8 associate staff in the community, and 69 courtesy staff from outside the community. St. Anthony Regional Hospital is a regional provider and is committed to providing quality care to the community. |
| Part VI, Line 7, Reports Filed With States | IA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Edward H Smith Jr | ||||||||||||||
| CEO/President | $278,355 | $0 | $55,000 | $0 | $22,107 | $0 | $20,088 | $0 | $15,170 | $0 | $390,720 | $0 | $0 | $0 |
| John Munson | ||||||||||||||
| CFO/Vice President | $152,167 | $0 | $12,057 | $0 | $1,323 | $0 | $5,042 | $0 | $13,370 | $0 | $183,959 | $0 | $0 | $0 |
| Richard C Sazama MD | ||||||||||||||
| Physician | $417,493 | $0 | $500 | $0 | $10,896 | $0 | $7,754 | $0 | $2,500 | $0 | $439,143 | $0 | $0 | $0 |
| Nelson H Lo MD | ||||||||||||||
| Physician | $359,036 | $0 | $1,000 | $0 | $2,805 | $0 | $10,992 | $0 | $15,870 | $0 | $389,703 | $0 | $0 | $0 |
| Jwong H Ling | ||||||||||||||
| Physician | $343,274 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $343,274 | $0 | $0 | $0 |
| Tina F Schechinger MD | ||||||||||||||
| Physician | $235,544 | $0 | $23,336 | $0 | $2,096 | $0 | $7,319 | $0 | $13,370 | $0 | $281,665 | $0 | $0 | $0 |
| David C Pederson | ||||||||||||||
| Anesthesist | $225,215 | $0 | $23,591 | $0 | $4,375 | $0 | $7,620 | $0 | $9,928 | $0 | $270,729 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 4b | St. Anthony Regional Hospital and Nursing Home has a non-qualified deferred compensation plan that complies with Section 457(f) of the Internal Revenue Code and the short-term deferral provisions of section 409A of the Code. The plan is to be an unfunded plan maintained primarily for the purpose of providing deferred compensation benefits for a select group of management or highly compensated employees. |
| Part I, Line 7 | In their roles as executives employed by St. Anthony Regional Hospital, the executives are eligible for incentive payouts. The incentive award will be a percentage of the base pay compensation for the CEO, CFO, and other executives. The ultimate payout includes a reduction/increase multiplier depending on whether the organization reached specified performance metrics identified by the Board of Directors. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| Carroll County IA | ||||||||
| A | 426004323 | 144813AB8 | 2006-11-22 | $6,672,573 | Construction of Hospital Addition | 0 | 0 | 0 |
| City of Carroll IA | ||||||||
| B | 426004322 | 145181CK7 | 2006-11-22 | $5,402,508 | Construction of Hospital Addition | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | RetiredRetiredAmt |
|---|---|---|---|---|---|---|---|---|---|
| A | $6,969,080 | $133,451 | $6,835,629 | 2009 | 0 | 0 | Yes (1) | Yes (1) | |
| B | $5,637,070 | $107,254 | $5,529,816 | 2009 | 0 | 0 | Yes (1) | Yes (1) | $2,835,000 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Term Of GICTermOfGICPct | Regulatory Safe Harbor StsfdRegulatorySafeHarborStsfdInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Citi Group | |||||||||||
| A | 0 | 0 | 0 | Yes (1) | 0 | 0 | Yes (1) | 1.900000000000 | Yes (1) | 0 | 0 |
| Citi Group | |||||||||||
| B | 0 | 0 | 0 | Yes (1) | 0 | 0 | Yes (1) | 1.900000000000 | Yes (1) | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule K, Supplemental Information: | FormAndLineReferenceDesc |
| Explanation | The two 2006 issues actually comprise a single issue for tax purposes, but are reported separately herein because the two series were issued by two different issuers (each of which files a form 8038) and were accounted for separately. Differences between the issue price (Part 1) and total proceeds (Part II, Line 3 ) are due to investment earning and (for column B) to a small excess amount (less than $1,000) that was used to pay principal on bonds. Part IV, Line 2c. The rebate computation was performed on 11/19/2012 for the 2006 bonds outstanding. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Sister Ramona Klaubauf, Sister Theresa Keller, Sister Maris Kerwin, and Sister Donna Venticher have a business relationship through their membership in The Franciscan Sisters of Perpetual Adoration. |
| Form 990, Part VI, Section A, line 6 | The members of the St. Anthony Regional Hospital are the sisters of the religious community known as the Congregation of the Sisters of the Third Order of St. Francis of Perpetual Adoration (FSPA). The members have the power to elect the board of directors, amend the articles of incorporation and bylaws of the organizations, and dissolve the organization. |
| Form 990, Part VI, Section A, line 7a | The Franciscan Sisters of Perpetual Adoration, as members of the St. Anthony Regional Hospital, elect and approve the board of directors for St. Anthony Regional Hospital. |
| Form 990, Part VI, Section A, line 7b | All decisions, including dissolution of the organization, made by the Board of Directors of St. Anthony Regional Hospital are subject to the approval of the Franciscan Sisters of Perpetual Adoration. |
| Form 990, Part VI, Section B, line 11 | St. Anthony Regional Hospital gathers the necessary information for the completion of the Form 990 within the finance department and with assistance from the human resources and operation departments. The form was prepared by an independent accounting firm. Drafts of the form were reviewed by the CFO and the Audit committee. After the internal reviews were complete, the final version of the form 990 was given to each member of the Board of Directors prior to filing the return. |
| Form 990, Part VI, Section B, line 12c | The Officers and Board Members annually disclose in writing, "any interest which would be inconsistent with the expeditious, proper, and impartial performance of duties." Defining disclosable conflict or duality of interest as any matter in which the corporations are "interested which affects the financial interest or employment of such member, a member of his/her family by blood or marriage, or any business enterprise in which he/she or such family member is employed or has a financial interest." Officers and Board Members are required to disclose the facts surrounding any possible conflict of interest throughout the year. If a conflict of interest is disclosed by an Officer or Board Member, during a board meeting the Officer or Board Member will not participate in any discussions or deliberations regarding the matter and would abstain from any voting decisions on this matter during the meeting. All conflict of interests that are disclosed will be reported in the minutes of the board meetings. |
| Form 990, Part VI, Section B, line 15 | At the direction of the Board of Directors the CEO gathers compensation information (salary and benefits) from various sources including Iowa Hospital Association and benefit consultants for like-sized organizations. The Executive Committee then determines the annual compensation for the CEO, other officers, and any key employees for the total board approval. |
| Form 990, Part VI, Section C, line 19 | St. Anthony Regional Hospital mails its consolidated audited financial statements to financial institutions, governmental institutions, board members, and the Iowa Hospital Association. The Form 990 is available at guidestar.org. St. Anthony Regional Hospital discloses financial statements to bondholders, the IHA, and the Iowa Attorney General's office. St. Anthony Regional Hospital's governing documents, conflict of interest policy, and financial statements are available to the public upon request. |
| Form 990, Part XI, line 9: | Transfer to Foundation - Reimbursed Expenses -231,539. Change in beneficial interest of Net Assets of Foundation 140,171. Income From Partnership -2,177. Consolidation Joint Venture -1,890,482. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| St Anthony Foundation | |||||||||||
| 311 South Clark St PO Box 628 | Carroll | IA | 51401 | 421419695 | Fundraising | IA | 501(c)(3) | 11a | St Anthony Regional Hospital and Nursing Home | Yes (1) | |
| Franciscan Sisters of Perpetual Adoration | |||||||||||
| 912 Market Street | La Crosse | WI | 546014782 | 390806386 | Religious Order | WI | 501(c)(3) | 1 | 0 | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| St Anthony Foundation | ||
| C | $170,296 | FMV |
| St Anthony Foundation | ||
| P | $231,539 | FMV |