GRACE HOSPITAL: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- GRACE HOSPITAL (EIN 34-0714479)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-16
- IRS object ID
- 201621379349301967
- Schema version
- 2014v6.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-16T09:25:18-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 340641962 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRUNER COX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 388 S MAIN STREET SUITE 403 | AddressLine1Txt |
| City | AKRON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44311 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 340714479 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRACE HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GRAC | BusinessNameControlTxt |
| Phone | 4402043500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17730 LORAIN AVE NO 2 | AddressLine1Txt |
| City | CLEVELAND | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44111 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RAJIVE KHANNA | PersonNm |
| Person Title | PRESIDENT AND CEO | PersonTitleTxt |
| Phone | 2164563880 | PhoneNum |
| Signature | 2016-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LISA M HILLING | PreparerPersonNm |
| PTIN | P01624111 | PTIN |
| Phone | 3303760100 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RAJIVE KHANNA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17730 LORAIN AVE NO 2 | AddressLine1Txt |
| City | CLEVELAND | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44111 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $24,382,818 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GRACEHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1910 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO SERVE AS A CENTER FOR EXCELLENCE IN THE PROVISION OF SPECIALIZED HEALTH CARE SERVICES AND COMFORT FOR PATIENTS AND FAMILIES COPING WITH CATASTROPHIC ILLNESS AND INJURY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 256 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $398,910 | PYContributionsGrantsAmt |
| CY Contributions Grants | $419,422 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $27,791,525 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $23,683,924 | CYProgramServiceRevenueAmt |
| PY Investment Income | $128,130 | PYInvestmentIncomeAmt |
| CY Investment Income | $242,747 | CYInvestmentIncomeAmt |
| PY Other Revenue | $29,266 | PYOtherRevenueAmt |
| CY Other Revenue | $36,725 | CYOtherRevenueAmt |
| PY Total Revenue | $28,347,831 | PYTotalRevenueAmt |
| CY Total Revenue | $24,382,818 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,085,246 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,635,470 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,776,672 | PYOtherExpensesAmt |
| CY Other Expenses | $12,409,010 | CYOtherExpensesAmt |
| PY Total Expenses | $25,861,918 | PYTotalExpensesAmt |
| CY Total Expenses | $24,044,480 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,485,913 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $338,338 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $19,883,631 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,284,122 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,367,590 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,085,633 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $14,516,041 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,198,489 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SERVE AS A CENTER FOR EXCELLENCE IN THE PROVISION OF SPECIALIZED HEALTH CARE SERVICES AND COMFORT FOR PATIENTS AND FAMILIES COPING WITH CATASTROPHIC ILLNESS AND INJURY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $20,316,644 | ExpenseAmt |
| Revenue | $23,925,614 | RevenueAmt |
| Desc | GRACE HOSPITAL IS A NON-FOR-PROFIT, LONG-TERM ACUTE CARE HOSPITAL LOCATED IN CLEVELAND, OHIO DEDICATED TO PROVIDING PERSONALIZED CARE TO MEET THE NEEDS OF PATIENTS COPING WITH CATASTROPHIC OR CHRONIC INJURY OR ILLNESS REQUIRING EXTENDED HOSPITALIZATION. THE HOSPITAL WAS FOUNDED IN 1910 BY A GROUP OF PHYSICIANS WHO WERE COMMITTED TO MEETING THE HEALTHCARE NEEDS OF THE COMMUNITY. GRACE HOSPITAL HAS CONTINUOUSLY PROVIDED SERVICES FOR ITS PATIENTS. IN 1995, GRACE HOSPITAL EARNED APPROVAL TO BECOME THE FIRST CERTIFIED LONG-TERM ACUTE CARE HOSPITAL IN BOTH THE CITY OF CLEVELAND AND CUYAHOGA COUNTY. THE HOSPITAL PRESENTLY SPONSORS SEVERAL INPATIENT SERVICES INCLUDING COMPLEX MEDICAL, PULMONARY, REHABILITATION, VENTILATOR WEANING, LEFT VENTRICAL ASSIST DEVICE, TRANSPLANT SUPPORT, WOUND CARE, AND NEUROLOGICAL REHABILITATION PROGRAMS. THESE SERVICES ARE PROVIDED AT INPATIENT SATELLITES LOCATED WITHIN FAIRVIEW, LAKEWOOD, SOUTH POINTE AND BEDFORD HOSPITALS. GRACE HOSPITAL IS COMMITTED TO PROVIDING PERSONALIZED HEALTHCARE CHARACTERIZED BY QUALITY, ACCESSIBILITY, EFFICIENCY, AND COST EFFECTIVENESS. THE HOSPITAL IS SENSITIVE TO AGE, CULTURAL, AND ECONOMIC VARIATIONS, AND IS CONTINUOUSLY ASSESSED AND IMPROVED THROUGH A QUALITY MANAGEMENT PROGRAM. GRACE VOLUNTARILY MAINTAINS A CHARITY CARE POLICY THAT PROVIDES CARE TO INDIVIDUALS REGARDLESS OF ABILITY TO PAY. THE HOSPITAL IS ALSO COMMITTED TO EMPLOYING INDIVIDUALS TO MATCH CULTURAL DIVERSITY OF ITS PATIENT POPULATION. SEVERAL JOB POSTINGS IN THE HOSPITAL REQUIRE EMPLOYEES TO BE BILINGUAL IN EITHER SPANISH OR VIETNAMESE. GRACE HOSPITAL IS INVOLVED IN MANY COMMUNITY ACTIVITIES, INCLUDING HEALTH FAIRS, SPECIAL HEALTH-RELATED PRESENTATIONS, AND SPONSORSHIPS IN HEALTHCARE EDUCATION. IN ADDITION, THE HOSPITAL SPONSORS MEETINGS FOR MANY NON-PROFIT COMMUNITY ORGANIZATIONS. THE BOARD OF DIRECTORS, MEDICAL STAFF, AND MANAGEMENT OF GRACE HOSPITAL ARE COMMITTED TO THE PROVISION OF QUALITY SPECIALTY HEALTHCARE SERVICES, AS A LONG-TERM HOSPITAL, AND FULFILLING A LEADERSHIP ROLE IN THE COMMUNITY. DESPITE CHALLENGING ECONOMIC TIMES, GRACE HOSPITAL HAS SUCCESSFULLY CONTINUED ITS ROLE OF COMMUNITY SERVICE AS ORIGINALLY ENVISIONED BY ITS FOUNDERS. | Desc |
| Total Program Service Expenses | $20,316,644 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | 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 | 0 | TaxExemptBondsInd |
| 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 55 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 256 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | 0 | 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 | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHELLE HENNIS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2164563880 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17730 LORAIN AVENUE | AddressLine1Txt |
| City | CLEVELAND | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44111 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 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 |
|---|---|---|---|---|---|---|---|---|
| WILLARD E BARTEL | ||||||||
| CHAIRPERSON | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBERT A GREVEY | ||||||||
| VICE CHAIRPERSON | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DONALD L LONG CPA | ||||||||
| TREASURER (RESIGNED JUNE 2015) | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RICHARD J RYMOND | ||||||||
| TREASURER | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| REV JOSEPH D MCNULTY | ||||||||
| SECRETARY | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MP PATEL MD | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GERALD L JEPPE | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN H NICKELS | ||||||||
| DIRECTOR OF MEDICAL STAFF | 10.00 | 1.00 | Yes (X) | $79,417 | $0 | $0 | ||
| JUDITH Z PETERS | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DEEPAK RAHEJA | ||||||||
| DIRECTOR OF NEUROLOGY | 5.00 | 1.00 | Yes (X) | $46,800 | $0 | $0 | ||
| PAUL C VENIZELOS | ||||||||
| MEDICAL DIRECTOR (LAKEWOOD UNIT) | 5.00 | 1.00 | Yes (X) | $19,175 | $0 | $0 | ||
| RAJIVE KHANNA | ||||||||
| PRESIDENT & CEO - GRACE HOSPITAL | 40.00 | 1.00 | Yes (X) | $196,006 | $0 | $3,453 | ||
| ROBERT P RANGE | ||||||||
| PRESIDENT & CEO - GRACE FOUNDATION | 20.00 | 20.00 | Yes (X) | $161,102 | $0 | $0 | ||
| MICHELLE HENNIS | ||||||||
| DIRECTOR OF FINANCE | 40.00 | 1.00 | Yes (X) | $112,410 | $0 | $27,765 | ||
| BARBARA J MORAN | ||||||||
| CNO/COO | 40.00 | 0.00 | $138,891 | $0 | $2,229 | Yes (X) | ||
| MARY CHENTNIK | ||||||||
| DIRECTOR OF HUMAN RESOURCES | 40.00 | 0.00 | $100,120 | $0 | $20,798 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $853,921 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $54,245 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | 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 |
|---|---|---|---|---|---|
| MAXIM HEALTHCARE SERVICES INC | |||||
| 13841 COLLECTIONS DR | CHICAGO | IL | 60693 | EMPLOYMENT AGENCY | $459,663 |
| FRESENIUS KABI USA LLC | |||||
| THREE CORPORATE DRIVE | LAKE ZURICH | IL | 60047 | MEDICAL DEVICES | $267,316 |
| ALLIANCE HEALTHCARE SOLUTIONS LLC | |||||
| 4500 ROCKSIDE ROAD SUITE 210 | INDEPENDENCE | OH | 44131 | EMPLOYMENT AGENCY | $181,011 |
| REVENUE ASSISTANCE CORPORATION | |||||
| 4780 HINCKLEY PARKWAY SUITE 200 | CLEVELAND | OH | 44109 | BILLING SERVICES | $173,121 |
| WESTLAKE REED LESKOSKY LTD | |||||
| 1422 EUCLID AVENUE | CLEVELAND | OH | 44115 | ARCHITECTURE | $119,618 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $419,422 | AllOtherContributionsAmt |
| Total Contributions | $419,422 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 624100 | $22,838,786 | $22,838,786 |
| SPECIALTY HOSPITAL OF LORAIN SERV | 624100 | $647,013 | $647,013 |
| OTHER PROGRAM SERVICE REVENUE | 624100 | $198,125 | $198,125 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $23,683,924 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $242,747 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $241,690 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,057 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $30,725 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $30,725 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,725 | TotalRevenueColumnAmt |
| Exclusion | $30,725 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PARKING FEES | Desc |
| Business | 812930 | BusinessCd |
| Total Revenue Column | $6,000 | TotalRevenueColumnAmt |
| Exclusion | $6,000 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $6,000 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,382,818 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,925,614 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $37,782 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $646,128 | TotalAmt |
| Program Services | $145,392 | ProgramServicesAmt |
| Management And General | $500,736 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,917,925 | TotalAmt |
| Program Services | $8,079,883 | ProgramServicesAmt |
| Management And General | $838,042 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,193,018 | TotalAmt |
| Program Services | $1,025,995 | ProgramServicesAmt |
| Management And General | $167,023 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $878,399 | TotalAmt |
| Program Services | $755,423 | ProgramServicesAmt |
| Management And General | $122,976 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,746 | TotalAmt |
| Management And General | $125,746 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,806 | TotalAmt |
| Management And General | $26,806 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,037,001 | TotalAmt |
| Management And General | $1,037,001 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,950 | TotalAmt |
| Management And General | $2,950 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,148 | TotalAmt |
| Management And General | $19,148 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,583,008 | TotalAmt |
| Program Services | $1,255,931 | ProgramServicesAmt |
| Management And General | $327,077 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,562 | TotalAmt |
| Program Services | $45,208 | ProgramServicesAmt |
| Management And General | $10,354 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,406 | TotalAmt |
| Program Services | $27,406 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,279 | TotalAmt |
| Program Services | $289,477 | ProgramServicesAmt |
| Management And General | $7,802 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $449,584 | TotalAmt |
| Program Services | $237,153 | ProgramServicesAmt |
| Management And General | $212,431 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASED SERVICES-PROF | $5,177,844 | $5,177,844 | |
| SUPPLIES - MEDICAL | $2,729,052 | $2,729,052 | |
| EQUIPMENT RENTAL AND MA | $497,561 | $455,167 | $42,394 |
| SUPPLIES - GENERAL | $142,863 | $91,026 | $51,837 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $237,200 | TotalAmt |
| Program Services | $1,687 | ProgramServicesAmt |
| Management And General | $235,513 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,044,480 | TotalAmt |
| Program Services | $20,316,644 | ProgramServicesAmt |
| Management And General | $3,727,836 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $601,763 | BOYAmt |
| EOY | $1,275,773 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,602,499 | BOYAmt |
| EOY | $2,103,952 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,984,071 | BOYAmt |
| EOY | $4,299,252 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $301,833 | BOYAmt |
| EOY | $321,534 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,844 | BOYAmt |
| EOY | $159,964 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,710,956 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,201,050 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,528,572 | BOYAmt |
| EOY | $1,509,906 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $301,166 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $552,915 | BOYAmt |
| EOY | $594,605 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,275,134 | BOYAmt |
| EOY | $8,717,970 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,883,631 | BOYAmt |
| EOY | $19,284,122 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,310,472 | BOYAmt |
| EOY | $3,471,185 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $485,396 | BOYAmt |
| EOY | $300,914 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,571,722 | BOYAmt |
| EOY | $1,313,534 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,367,590 | BOYAmt |
| EOY | $5,085,633 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,240,907 | BOYAmt |
| EOY | $5,480,519 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,275,134 | BOYAmt |
| EOY | $8,717,970 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,516,041 | BOYAmt |
| EOY | $14,198,489 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,883,631 | BOYAmt |
| EOY | $19,284,122 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $338,338 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$555,997 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$99,893 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,151 | OtherCostOrOtherBasisAmt |
| Book Value | $32,151 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,363,409 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,213,498 | DepreciationAmt |
| Book Value | $149,911 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $145,197 | OtherCostOrOtherBasisAmt |
| Depreciation | $136,306 | DepreciationAmt |
| Book Value | $8,891 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,738,068 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,851,246 | DepreciationAmt |
| Book Value | $886,822 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $432,131 | OtherCostOrOtherBasisAmt |
| Book Value | $432,131 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,509,906 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ASSETS HELD IN PERPETUAL TRUST | Desc |
| Book Value | $8,717,970 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $8,717,970 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CAPITAL LEASE OBLIGATIONS | $350,137 |
| EST SETTLEMENTS TO THIRD-PARTIES | $963,397 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,313,534 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FOUNDATION AND HOSPITAL ARE NOT-FOR-PROFIT CORPORATIONS AND ARE RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOLDING AND GRACE CENTER ARE INCORPORATED AS A LIMITED LIABILITY COMPANIES IN ACCORDANCE WITH CHAPTER 1705 OF THE OHIO REVISED CODE. THE HOLDING HAS FILED A 168(H) ELECTION. UNDER THESE PROVISIONS, THE TAXABLE INCOME FOR GRACE CENTER IS TAXED DIRECTLY TO THE HOLDING MEMBERS; THEREFORE, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES ON THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. IN ACCORDANCE WITH THE INCOME TAXES TOPIC OF THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION, THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS RECORDED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. | ExplanationTxt |
Schedule H IRS990ScheduleH
| 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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,816,927 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,260,278 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,556,649 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10630 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,796 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,796 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,841,723 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,260,278 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,581,445 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10730 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,841,723 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,260,278 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,581,445 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10730 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $972,338 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $232,450 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $13,139,271 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,077,214 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $62,057 | 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 |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 SPECIALTY HOSPITAL OF LORAIN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | NOT-FOR-PROFIT LONG-TERM ACUTE CARE HOSPITAL IN LORAIN, OHIO | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.33330 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.00000 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.00000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 5 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (5 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | Licensed HospitalLicensedHospitalInd | OtherOtherDesc | Facility Reporting GroupFacilityReportingGroupCd |
|---|---|---|---|---|---|---|---|---|
| GRACE FAIRVIEW | ||||||||
| 1 | 18101 LORAIN AVE | CLEVELAND | OH | 44111 | WWW.GRACEHOSPITAL.ORG | Yes (X) | LONG TERM ACUTE CARE | A |
| GRACE SOUTH POINTE | ||||||||
| 2 | 20000 HARVARD AVE | CLEVELAND | OH | 44122 | WWW.GRACEHOSPITAL.ORG | Yes (X) | LONG TERM ACUTE CARE | A |
| GRACE BEDFORD | ||||||||
| 3 | 44 BLAINE AVENUE | BEDFORD | OH | 44146 | WWW.GRACEHOSPITAL.ORG | Yes (X) | LONG TERM ACUTE CARE | A |
| GRACE LAKEWOOD | ||||||||
| 4 | 14519 DETROIT AVE | LAKEWOOD | OH | 44107 | WWW.GRACEHOSPITAL.ORG | Yes (X) | LONG TERM ACUTE CARE | A |
| SPECIALTY HOSPITAL OF LORAIN | ||||||||
| 5 | 254 CLEVELAND AVE | AMHERST | OH | 44001 | WWW.SPECIALTYHOSPITALOFLORAIN.ORG | Yes (X) | LONG TERM ACUTE CARE | |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)
| FacilityFacilityNum | First Licensed CY Or PYFirstLicensedCYOrPYInd | Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd | CHNA ConductedCHNAConductedInd | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct | Income Level CriteriaIncomeLevelCriteriaInd | Medical Indigency CriteriaMedicalIndigencyCriteriaInd | Insurance Status CriteriaInsuranceStatusCriteriaInd | Underinsurance Stat CriteriaUnderinsuranceStatCriteriaInd | Other CriteriaOtherCriteriaInd | Explained BasisExplainedBasisInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Described InfoDescribedInfoInd | Described Suprt DocDescribedSuprtDocInd | Provided Hospital ContactProvidedHospitalContactInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | Other PublicityOtherPublicityInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Permit No ActionsPermitNoActionsInd | Collection ActivitiesCollectionActivitiesInd | FAP Notified Upon AdmissionFAPNotifiedUponAdmissionInd | FAP Notified Before DischargeFAPNotifiedBeforeDischargeInd | FAP Notified All PatientsFAPNotifiedAllPatientsInd | Documented Elig DeterminationDocumentedEligDeterminationInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | No Emergency CareNoEmergencyCareInd | Other ReasonOtherReasonInd | Other Method UsedOtherMethodUsedInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SPECIALTY HOSPITAL OF LORAIN | |||||||||||||||||||||||||||||||||
| 5 | 0 | 0 | 0 | 0 | Yes (1) | Yes (X) | 100.000000000000 | 200.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | 0 | 0 |
| FACILITY REPORTING GROUP - A | |||||||||||||||||||||||||||||||||
| 0 | 0 | 0 | 0 | Yes (1) | Yes (X) | 100.000000000000 | 200.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | 0 | 0 | |
Supplemental Information SupplementalInformationGrp (24 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SPECIALTY HOSPITAL OF LORAIN | PART V, SECTION B, LINE 13H: THE FOLLOWING STRUCTURE WILL BE UTILIZED TO DETERMINE THE AMOUNT OF FREE CARE TO BE PROVIDED. HOUSEHOLD INCOME AND THE NUMBER OF PEOPLE LIVING IN HOUSEHOLD WILL BE THE TWO MAJOR CRITERIA USED TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FREE CARE. EXTENUATING CIRCUMSTANCES SHOULD BE NOTED AND MAY INCLUDE INFORMATION SUPPLIED TO SUPPORT EXCEPTIONAL SCENARIOS INCLUDING A TERMINAL ILLNESS, DEATH OF A SPOUSE, OR CATASTROPHIC PROBLEMS. |
| SPECIALTY HOSPITAL OF LORAIN | PART V, SECTION B, LINE 16I: THE POLICY IS ATTACHED TO BILLING INVOICES. |
| SPECIALTY HOSPITAL OF LORAIN | PART V, SECTION B, LINE 21D: SPECIALTY HOSPITAL OF LORAIN IS A LONG TERM ACUTE CARE (LTAC) FACILITY LOCATED ON A FLOOR OF AMHERST HOSPITAL. DUE TO THE TYPE OF SERVICES PROVIDED, SHL DOES NOT PROVIDE CARE FOR EMERGENCY MEDICAL CONDITIONS. IF FULL-SERVICE EMERGENCY ROOM CARE IS NEEDED, THE FACILITIES OF AMHERST HOSPITAL ARE AVAILABLE. |
| SPECIALTY HOSPITAL OF LORAIN | PART V, SECTION B, LINE 22D: A SLIDING SCALE FEE SCHEDULE IS USED TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS. |
| PART V, SECTION B | FACILITY REPORTING GROUP A |
| FACILITY REPORTING GROUP A CONSISTS OF: | - FACILITY 1: GRACE FAIRVIEW, - FACILITY 3: GRACE BEDFORD, - FACILITY 4: GRACE LAKEWOOD, - FACILITY 2: GRACE SOUTH POINTE |
| GROUP A-FACILITY 1 -- GRACE FAIRVIEW PART V, SECTION B, LINE 13H: | THE FOLLOWING STRUCTURE WILL BE UTILIZED TO DETERMINE THE AMOUNT OF FREE CARE TO BE PROVIDED. HOUSEHOLD INCOME AND THE NUMBER OF PEOPLE LIVING IN HOUSEHOLD WILL BE THE TWO MAJOR CRITERIA USED TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FREE CARE. EXTENUATING CIRCUMSTANCES SHOULD BE NOTED AND MAY INCLUDE INFORMATION SUPPLIED TO SUPPORT EXCEPTIONAL SCENARIOS INCLUDING A TERMINAL ILLNESS, DEATH OF A SPOUSE, OR CATASTROPHIC PROBLEMS. |
| GROUP A-FACILITY 1 -- GRACE FAIRVIEW PART V, SECTION B, LINE 16I: | THE POLICY IS ATTACHED TO BILLING INVOICES. |
| GROUP A-FACILITY 1 -- GRACE FAIRVIEW PART V, SECTION B, LINE 21D: | GRACE HOSPITAL IS A LONG TERM ACUTE CARE (LTAC) FACILITY LOCATED ON A FLOOR OF FAIRVIEW HOSPITAL, A CLEVELAND CLINIC HOSPITAL. DUE TO THE TYPE OF SERVICES PROVIDED, GRACE DOES NOT PROVIDE CARE FOR EMERGENCY MEDICAL CONDITIONS. IF FULL-SERVICE EMERGENCY ROOM CARE IS NEEDED, THE FACILITIES OF FAIRVIEW HOSPITAL ARE AVAILABLE. |
| GROUP A-FACILITY 1 -- GRACE FAIRVIEW PART V, SECTION B, LINE 22D: | A SLIDING SCALE FEE SCHEDULE IS USED TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS. |
| GROUP A-FACILITY 3 -- GRACE LAKEWOOD PART V, SECTION B, LINE 13H: | THE FOLLOWING STRUCTURE WILL BE UTILIZED TO DETERMINE THE AMOUNT OF FREE CARE TO BE PROVIDED. HOUSEHOLD INCOME AND THE NUMBER OF PEOPLE LIVING IN HOUSEHOLD WILL BE THE TWO MAJOR CRITERIA USED TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FREE CARE. EXTENUATING CIRCUMSTANCES SHOULD BE NOTED AND MAY INCLUDE INFORMATION SUPPLIED TO SUPPORT EXCEPTIONAL SCENARIOS INCLUDING A TERMINAL ILLNESS, DEATH OF A SPOUSE, OR CATASTROPHIC PROBLEMS. |
| GROUP A-FACILITY 3 -- GRACE LAKEWOOD PART V, SECTION B, LINE 16I: | THE POLICY IS ATTACHED TO BILLING INVOICES. |
| GROUP A-FACILITY 3 -- GRACE LAKEWOOD PART V, SECTION B, LINE 21D: | GRACE HOSPITAL IS A LONG TERM ACUTE CARE (LTAC) FACILITY LOCATED ON A FLOOR OF LAKEWOOD HOSPITAL, A CLEVELAND CLINIC HOSPITAL. DUE TO THE TYPE OF SERVICES PROVIDED, GRACE DOES NOT PROVIDE CARE FOR EMERGENCY MEDICAL CONDITIONS. IF FULL-SERVICE EMERGENCY ROOM CARE IS NEEDED, THE FACILITIES OF LAKEWOOD HOSPITAL ARE AVAILABLE. |
| GROUP A-FACILITY 3 -- GRACE LAKEWOOD PART V, SECTION B, LINE 22D: | A SLIDING SCALE FEE SCHEDULE IS USED TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS. |
| GROUP A-FACILITY 4 -- GRACE SOUTH POINTE PART V, SECTION B, LINE 13H: | THE FOLLOWING STRUCTURE WILL BE UTILIZED TO DETERMINE THE AMOUNT OF FREE CARE TO BE PROVIDED. HOUSEHOLD INCOME AND THE NUMBER OF PEOPLE LIVING IN HOUSEHOLD WILL BE THE TWO MAJOR CRITERIA USED TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FREE CARE. EXTENUATING CIRCUMSTANCES SHOULD BE NOTED AND MAY INCLUDE INFORMATION SUPPLIED TO SUPPORT EXCEPTIONAL SCENARIOS INCLUDING A TERMINAL ILLNESS, DEATH OF A SPOUSE, OR CATASTROPHIC PROBLEMS. |
| GROUP A-FACILITY 4 -- GRACE SOUTH POINTE PART V, SECTION B, LINE 16I: | THE POLICY IS ATTACHED TO BILLING INVOICES. |
| GROUP A-FACILITY 4 -- GRACE SOUTH POINTE PART V, SECTION B, LINE 21D: | GRACE HOSPITAL IS A LONG TERM ACUTE CARE (LTAC) FACILITY LOCATED ON A FLOOR OF SOUTH POINTE HOSPITAL, A CLEVELAND CLINIC HOSPITAL. DUE TO THE TYPE OF SERVICES PROVIDED, GRACE DOES NOT PROVIDE CARE FOR EMERGENCY MEDICAL CONDITIONS. IF FULL-SERVICE EMERGENCY ROOM CARE IS NEEDED, THE FACILITIES OF SOUTH POINTE HOSPITAL ARE AVAILABLE. |
| GROUP A-FACILITY 4 -- GRACE SOUTH POINTE PART V, SECTION B, LINE 22D: | A SLIDING SCALE FEE SCHEDULE IS USED TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS. |
| GROUP A-FACILITY 2 -- GRACE BEDFORD PART V, SECTION B, LINE 13H: | THE FOLLOWING STRUCTURE WILL BE UTILIZED TO DETERMINE THE AMOUNT OF FREE CARE TO BE PROVIDED. HOUSEHOLD INCOME AND THE NUMBER OF PEOPLE LIVING IN HOUSEHOLD WILL BE THE TWO MAJOR CRITERIA USED TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FREE CARE. EXTENUATING CIRCUMSTANCES SHOULD BE NOTED AND MAY INCLUDE INFORMATION SUPPLIED TO SUPPORT EXCEPTIONAL SCENARIOS INCLUDING A TERMINAL ILLNESS, DEATH OF A SPOUSE, OR CATASTROPHIC PROBLEMS. |
| GROUP A-FACILITY 2 -- GRACE BEDFORD PART V, SECTION B, LINE 16I: | THE POLICY IS ATTACHED TO BILLING INVOICES. |
| GROUP A-FACILITY 2 -- GRACE BEDFORD PART V, SECTION B, LINE 21D: | GRACE HOSPITAL IS A LONG TERM ACUTE CARE (LTAC) FACILITY LOCATED ON A FLOOR OF BEDFORD MEDICAL CENTER, A CAMPUS OF UNIVERSITY HOSPITALS REGIONAL HOSPITALS. DUE TO THE TYPE OF SERVICES PROVIDED, GRACE DOES NOT PROVIDE CARE FOR EMERGENCY MEDICAL CONDITIONS. IF FULL-SERVICE EMERGENCY ROOM CARE IS NEEDED, THE FACILITIES OF BEDFORD HOSPITAL ARE AVAILABLE. |
| GROUP A-FACILITY 2 -- GRACE BEDFORD PART V, SECTION B, LINE 22D: | A SLIDING SCALE FEE SCHEDULE IS USED TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS. |
| PART V, SECTION B, QUESTION #3 FAILURE TO CONDUCT CHNA - SHL | PURSUANT TO INTERNAL REVENUE BULLETIN 2015-5, IRS NOTICE 2014-3, AND REV. PROC. 2015-21, SPECIALTY HOSPITAL OF LORAIN (SHL) IS DISCLOSING FAILURE TO COMPLY WITH IRC SECTION 501(R)(3) WHICH REQUIRES A HOSPITAL ORGANIZATION TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). UNDER REG. 1.501(R)-2(C), "A HOSPITAL FACILITY'S FAILURE TO MEET ONE OR MORE OF THE REQUIREMENTS DESCRIBED IN 1.501(R)-3 THROUGH 1.501(R)-6 THAT IS NEITHER WILLFUL NOR EGREGIOUS SHALL BE EXCUSED FOR PURPOSES OF THIS SECTION IF THE HOSPITAL FACILITY CORRECTS AND MAKES DISCLOSURE IN ACCORDANCE WITH THE RULES SET FORTH IN THE GUIDANCE." SHL'S FAILURE TO COMPLY WITH THE REQUIREMENT TO CONDUCT A CHNA WAS NEITHER WILLFUL NOR EGREGIOUS. SHL IS A LONG-TERM ACUTE CARE HOSPITAL (LTAC) THAT OPERATES ON A FLOOR AT AMHERST HOSPITAL. DUE TO LIMITED RESOURCES, STAFF LIMITATIONS AND BASED ON THE SERVICES THAT SHL PROVIDES, SHL WAS NOT AWARE OF THE REQUIREMENT TO CONDUCT A CHNA AND DID NOT CONDUCT A CHNA FOR TAX YEAR 2014. UPON CONSULTATION FROM OUTSIDE CONSULTANTS, SHL WAS MADE AWARE OF THE REQUIREMENT. ONCE ADVISED ON REQUIREMENT TO CONDUCT A CHNA, SHL BEGAN THE PROCESS OF PREPARING AND ADOPTING A CHNA REPORT CONTAINING ALL OF THE REQUIRED ELEMENTS AND WILL MAKE THE CHNA REPORT WIDELY AVAILABLE ON A WEB SITE WITHIN THE MEANING OF 1.501(R)-1(C)(4) OF THE REGULATIONS.SUBSEQUENT TO TAX YEAR 2014 AND DURING TAX YEAR 2015, SHL COMPLETED THE CHNA AND PUBLISHED TO THE SHL WEBSITE. |
| PART V, SECTION B, QUESTION #3 FAILURE TO CONDUCT CHNA - GRACE | PURSUANT TO INTERNAL REVENUE BULLETIN 2015-5, IRS NOTICE 2014-3, AND REV. PROC. 2015-21, GRACE HOSPITAL (GRACE) IS DISCLOSING FAILURE TO COMPLY WITH IRC SECTION 501(R)(3) WHICH REQUIRES A HOSPITAL ORGANIZATION TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). UNDER REG 1.501(R)-2(C), "A HOSPITAL FACILITY'S FAILURE TO MEET ONE OR MORE OF THE REQUIREMENTS DESCRIBED IN 1.501(R)-3 THROUGH 1.501(R)-6 THAT IS NEITHER WILLFUL NOR EGREGIOUS SHALL BE EXCUSED FOR PURPOSES OF THIS SECTION IF THE HOSPITAL FACILITY CORRECTS AND MAKES DISCLOSURE IN ACCORDANCE WITH THE RULES SET FORTH IN THE GUIDANCE." GRACE'S FAILURE TO COMPLY WITH THE REQUIREMENT TO CONDUCT A CHNA WAS NEITHER WILLFUL NOR EGREGIOUS. GRACE IS A LONG-TERM ACUTE CARE HOSPITAL (LTAC) THAT OPERATES ON FLOORS WITHIN THREE CLEVELAND CLINIC HOSPITALS AND ONE UNIVERSITY HOSPITAL FACILITY. FOR EACH HOSPITAL FACILITY THAT GRACE OPERATES WITHIN, A CHNA WAS CONDUCTED BY THAT HOSPITAL SYSTEM. DUE TO LIMITED RESOURCES, STAFF LIMITATIONS AND BASED ON THE SERVICES THAT GRACE PROVIDES, GRACE DID NOT CONDUCT A CHNA FOR FISCAL YEAR 2015 (7/1/2014 - 6/30/2015). UPON CONSULTATION FROM OUTSIDE CONSULTANTS, GRACE WAS MADE AWARE OF THE REQUIREMENT. ONCE ADVISED ON REQUIREMENT TO CONDUCT A CHNA, GRACE HAS BEGUN THE PROCESS OF IMPLEMENTING A PLAN TO CONDUCT A CHNA AND WILL PREPARE AND ADOPT A CHNA REPORT CONTAINING ALL OF THE REQUIRED ELEMENTS AND WILL MAKE THE CHNA REPORT WIDELY AVAILABLE ON A WEB SITE WITHIN THE MEANING OF 1.501(R)-1(C)(4) OF THE REGULATIONS. GRACE IS CURRENTLY WORKING ON THE CHNA AND ANTICIPATES COMPLETING THE CHNA AND IMPLEMENTATION PLAN PRIOR TO THE END OF THE NEXT FISCAL YEAR (6/30/2016) FOR TAX YEAR 2015. |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | N/A |
| PART I, LINE 6A: | N/A |
| PART I, LINE 7: | THE AMOUNTS REPORTED ON LINE B WERE GENERATED FROM THE MEDICAID COST REPORT FILED FOR FY2015 AND THE HOSPITAL'S ACCOUNTING SYSTEM. THE AMOUNTS REPORTED INCLUDE GRACE HOSPITAL'S PROPORTIONATE SHARE FROM SPECIALTY HOSPITAL OF LORAIN. ACUTE CARE HOSPITAL SERVICES RENDERED TO MEDICAID PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC AND OTHER FACTORS. CAPITAL COSTS FOR MEDICAID INPATIENT SERVICES ARE REIMBURSED BASED ON A COST REIMBURSEMENT METHODOLOGY. THE HOSPITAL IS REIMBURSED FOR COST REIMBURSABLE ITEMS AT A TENTATIVE RATE WITH FINAL SETTLEMENT DETERMINED AFTER SUBMISSION OF ANNUAL COST REPORTS AND AUDITS THEREOF BY THE FISCAL INTERMEDIARY. |
| PART I, LINE 7G: | N/A |
| PART II, COMMUNITY BUILDING ACTIVITIES: | N/A |
| PART III, LINE 2: | THE AMOUNT REPORTED ON LINE 2 REPRESENTS THE PROVISION FOR DOUBTFUL ACCOUNTS REPORTED ON THE 2015 AUDITED FINANCIAL STATEMENTS. THE AMOUNTS REPORTED ALSO INCLUDE GRACE HOSPITAL'S PROPORTIONATE SHARE FROM SPECIALTY HOSPITAL OF LORAIN. |
| PART III, LINE 3: | THE AMOUNT REPORTED ON LINE 3 REPRESENTS CHARGES WRITTEN OFF FOR SELF-PAY INDIVIDUALS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY BUT FOR WHOM INSUFFICIENT INFORMATION WAS OBTAINED TO DETERMINE THEIR ELIGIBILITY. THIS AMOUNT WAS DETERMINED BASED ON REVIEW OF BAD DEBT WRITE-OFFS DURING THE YEAR. THE AMOUNTS REPORTED ALSO INCLUDE GRACE HOSPITAL'S PROPORTIONATE SHARE FROM SPECIALTY HOSPITAL OF LORAIN. |
| PART III, LINE 4: | IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR DOUBTFUL ACCOUNTS. IN ADDITION, MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE CONTRACTUAL ALLOWANCE. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND CO-PAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). 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 HOSPITAL IMMEDIATELY RESERVES THEIR BALANCES IN THE ALLOWANCE DOUBTFUL ACCOUNTS AND WRITES-OFF TO COLLECTION AFTER THE PATIENT IS BILLED FOUR TIMES, 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. |
| PART III, LINE 8: | MEDICARE SHORTHALL IS NOT TREATED AS COMMUNITY BENEFIT. THE AMOUNTS REPORTED WERE GENERATED FROM THE MEDICARE COST REPORT FILED FOR FY2015. INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES PER DISCHARGE. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. INPATIENT NONACUTE CARE SERVICES RELATED TO MEDICARE BENEFICIARIES ARE PAID BASED ON A COST REIMBURSEMENT METHODOLOGY. THE HOSPITAL IS REIMBURSED FOR COST REIMBURSABLE ITEMS AT TENTATIVE RATES WITH FINAL SETTLEMENT AFTER SUBMISSION OF ANNUAL COST REPORTS AND AUDITS THEREOF BY THE MEDICARE FISCAL INTERMEDIARY.THE AMOUNTS REPORTED ALSO INCLUDE GRACE HOSPITAL'S PROPORTIONATE SHARE FROM SPECIALTY HOSPITAL OF LORAIN. |
| PART III, LINE 9B: | FREE CARE WILL BE EXTENDED TO THOSE WHO QUALIFY FOR THESE REASONS: THE PATIENT IS UNINSURED, THE PATIENT IS NOT ELIGIBLE FOR MEDICAID OR PENDING MEDICAID APPROVAL,THE PATIENT IS DETERMINED TO BE UNABLE TO PAY FOR SERVICES PROVIDED, THE PATIENT IS UNABLE TO ACCEPT AN INSTALLMENT PAYMENT ARRANGEMENT, THE PATIENT IS BELOW 200% OF THE FEDERAL POVERTY GUIDELINES, AND THE PATIENT IS A HARDSHIP CASE AS DESIGNATED BY THE PHYSICIAN AND GRACE HOSPITAL. THE PATIENT WILL NEED TO COMPLETE A CHARITY CARE FORM AND RETURN TO GRACE HOSPITAL FOR DETERMINATION OF FREE CARE. GRACE HOSPITAL STAFF OR ITS BILLING REPRESENTATIVES WILL HELP THE PATIENT COMPLETE THE FORM ON REQUEST. ULTIMATELY, IT IS THE PATIENT'S RESPONSIBILITY TO COMPLETE THE FORM. HE/SHE WILL CONTINUE TO BE FULLY RESPONSIBLE FOR THE BILL UNTIL A DETERMINATION IS MADE. DOCUMENTED PROOF OF INCOME IS REQUIRED. |
| PART IV, JOINT VENTURES | IN FISCAL YEAR 2008, GRACE HOSPITAL ENTERED INTO A JOINT VENTURE WITH TWO OTHER HEALTHCARE PROVIDERS TO OPERATE SPECIALTY HOSPITAL OF LORAIN (SPECIALTY), A NOT-FOR-PROFIT LONG-TERM ACUTE CARE HOSPITAL IN LORAIN, OHIO. THE PARTIES TO THE JOINT VENTURE OPERATE AS MEMBER ORGANIZATIONS OF SPECIALTY, EACH WITH A 33-1/3% INTEREST. EACH MEMBER ORGANIZATION HAS ALSO AGREED TO SERVE AS CO-GUARANTORS WITH SEVERAL LIABILITIES ON A LINE OF CREDIT NOT TO EXCEED $1,000,000, WHICH IS SECURED BY SPECIALTY'S ASSETS. THE LINE OF CREDIT AGREEMENT EXPIRED ON FEBRUARY 28, 2013 AND THE OBLIGATION WAS PAID IN FULL.IN FISCAL YEAR 2008, GRACE HOSPITAL ENTERED INTO A MANAGERIAL, AS WELL AS, VARIOUS CLINICAL SERVICE AGREEMENTS WITH SPECIALTY. THE AGREEMENTS SPECIFY GRACE HOSPITAL IS TO PROVIDE MANAGERIAL AND CLINICAL SERVICES AT COST AND COST PLUS 3%, RESPECTIVELY. FOR THE YEARS ENDED JUNE 30, 2015 AND 2014, REVENUE RECOGNIZED AS A RESULT OF THESE AGREEMENTS IS REPORTED ON GRACE HOSPITAL'S STATEMENTS OF OPERATIONS TOTALING $647,013 AND $647,784, RESPECTIVELY. RECEIVABLES FOR THESE SERVICES, IN ADDITION TO OTHER REIMBURSEMENTS, ARE REPORTED ON GRACE HOSPITAL'S STATEMENTS OF FINANCIAL POSITION TOTALING $281,353 AND $422,151 AT JUNE 30, 2015 AND 2014, RESPECTIVELY.GRACE HOSPITAL'S INVESTMENT IN SPECIALTY IS CARRIED ON THE STATEMENT OF FINANCIAL POSITION AT JUNE 30, 2015 AND 2014. THESE ASSETS REPRESENT GRACE HOSPITAL'S PROPORTIONATE SHARE OF SPECIALTY'S NET ASSET BALANCES, WHICH ARE RECORDED ON THE EQUITY METHOD.ON JULY 1, 2015, THE MANAGERIAL AGREEMENT WAS AMENDED TO SPECIFY THE GRACE FOUNDATION FOR HEALTH, WELLNESS & EDUCATION AS THE ENTITY TO PROVIDE MANAGERIAL AND CLINICAL SERVICES AT COST PLUS 3% TO SPECIALTY AND THE FOUNDATION AS THE MEMBER OF SPECIALTY.GRACE HOSPITAL'S PROPORTIONATE SHARE OF SPECIALTY'S FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST AND BAD DEBTS HAVE BEEN INCLUDED IN SCHEDULE H. |
| PART VI, LINE 2: | THE HOSPITAL PRESENTLY SPONSORS SEVERAL INPATIENT SERVICES INCLUDING COMPLEX MEDICAL, PULMONARY, REHABILITATION, VENTILATOR WEANING, LEFT VENTRICAL ASSIST DEVICE, TRANSPLANT SUPPORT, WOUND CARE, AND NEUROLOGICAL REHABILITATION PROGRAMS. THESE SERVICES ARE PROVIDED AT INPATIENT SATELLITES LOCATED WITHIN AMHERST, FAIRVIEW, BEDFORD, LAKEWOOD, AND SOUTH POINTE HOSPITALS. GRACE HOSPITAL IS COMMITTED TO PROVIDING PERSONALIZED HEALTHCARE CHARACTERIZED BY QUALITY, ACCESSIBILITY, EFFICIENCY, AND COST EFFECTIVENESS. THE HOSPITAL IS SENSITIVE TO AGE, CULTURAL, AND ECONOMIC VARIATIONS, AND IS CONTINUOUSLY ASSESSED AND IMPROVED THROUGH A QUALITY MANAGEMENT PROGRAM. GRACE VOLUNTARILY MAINTAINS A CHARITY CARE POLICY THAT PROVIDES CARE TO INDIVIDUALS REGARDLESS OF ABILITY TO PAY. THE HOSPITAL IS ALSO COMMITTED TO EMPLOYING INDIVIDUALS TO MATCH CULTURAL DIVERSITY OF ITS PATIENT POPULATION. SEVERAL JOB POSTINGS IN THE HOSPITAL REQUIRE EMPLOYEES TO BE BILINGUAL IN EITHER SPANISH OR VIETNAMESE. GRACE HOSPITAL IS INVOLVED IN MANY COMMUNITY ACTIVITIES, INCLUDING HEALTH FAIRS, SPECIAL HEALTH-RELATED PRESENTATIONS, AND SPONSORSHIPS IN HEALTHCARE EDUCATION. IN ADDITION, THE HOSPITAL SPONSORS MEETINGS FOR MANY NON-PROFIT COMMUNITY ORGANIZATIONS. THE BOARD OF DIRECTORS, MEDICAL STAFF, AND MANAGEMENT OF GRACE HOSPITAL ARE COMMITTED TO THE PROVISION OF QUALITY SPECIALTY HEALTHCARE SERVICES, AS A LONG-TERM HOSPITAL, AND FULFILLING A LEADERSHIP ROLE IN THE COMMUNITY. DESPITE CHALLENGING ECONOMIC TIMES, GRACE HOSPITAL HAS SUCCESSFULLY CONTINUED ITS ROLE OF COMMUNITY SERVICE AS ORIGINALLY ENVISIONED BY ITS FOUNDERS. |
| PART VI, LINE 3: | INFORMATION ABOUT ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS IS DESCRIBED ON THE PATIENT'S BILL. THE PATIENT WILL NEED TO COMPLETE A CHARITY CARE FORM AND RETURN TO GRACE FOR DETERMINATION OF FREE CARE. GRACE STAFF OR ITS BILLING REPRESENTATIVES WILL HELP THE PATIENT COMPLETE THE FORM ON REQUEST. |
| PART VI, LINE 4: | GRACE HOSPITAL IS A LONG-TERM ACUTE CARE HOSPITAL (LTACH) DEDICATED TO PROVIDING HIGH QUALITY PRIMARY AND SECONDARY HEALTH CARE SERVICES TO MEET THE NEEDS OF LOCAL COMMUNITIES IN NORTHEAST OHIO. |
| PART VI, LINE 5: | GRACE HOSPITAL AND THE GRACE FOUNDATION FOR HEALTH, WELLNESS & EDUCATION PROMOTES HEALTH, WELLNESS AND ECONOMIC DEVELOPMENT IN THE TREMONT, OHIO AREA. THIS IS THE GEOGRAPHIC AREA THE HOSPITAL HAS HISTORICALLY SERVED. THE FACILITY ON WEST 14TH STREET INCLUDES OUTPATIENT, INPATIENT, AND DIAGNOSTIC AND REHABILITATIVE CARE PROGRAMS DIRECTED TOWARD THE HEALTH AND WELLNESS NEEDS OF THE ADULT POPULATION. THE FACILITY ALSO INCLUDES AN EDUCATION CENTER, FITNESS CENTER, THERAPEUTIC SPA AND COMPOUNDING PHARMACY. |
| PART VI, LINE 6: | N/A |
| PART VI, LINE 7 | N/A |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RAJIVE KHANNA | ||||||||||||||
| PRESIDENT & CEO - GRACE HOSPITAL | $196,006 | $0 | $0 | $0 | $0 | $0 | $3,260 | $0 | $193 | $0 | $199,459 | $0 | $0 | $0 |
| ROBERT P RANGE | ||||||||||||||
| PRESIDENT & CEO - GRACE FOUNDATION | $161,102 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $161,102 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE HOSPITAL CONTRACTS WITH AN OUTSIDE ACCOUNTING FIRM FOR THE PREPARATION OF THE FORM 990. THE HOSPITAL PROVIDES MATERIAL BASED ON REQUESTS FROM THE ACCOUNTING FIRM. MOST OF THE INFORMATION IS PROVIDED BY THE DIRECTOR OF FINANCE. THE FINAL FORM IS REVIEWED BY THE DIRECTOR OF FINANCE AND THE CEO. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE ORGANIZATION'S CEO IS DETERMINED BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | TRANSFER OF EQUITY FROM RESTRUCTURE -500,000. BOOK GAIN ON TRANSFER OF PROPERTY TO RELATED ENTITY 400,107. |
| FORM 990, PART XII, LINE 2C | THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT OR THE SELECTION PROCESS DURING THE TAX YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE GRACE FOUNDATION FOR HEALTH WELLNESS & EDUCATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2307 WEST 14TH STREET | AddressLine1Txt |
| City | CLEVELAND | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44114 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 273418360 | EIN |
| Primary Activities | SUPPORTING ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 11A, I | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE GRACE CENTER PROPERTY LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2307 WEST 14TH STREET | AddressLine1Txt |
| City | CLEVELAND | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44113 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 473431477 | EIN |
| Primary Activities | REAL ESTATE | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRACE CENTER PROPERTY HOLDING LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2307 WEST 14TH STREET | AddressLine1Txt |
| City | CLEVELAND | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44113 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 473494723 | EIN |
| Primary Activities | HOLDING COMPANY | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | 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 | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | 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 |
|---|---|---|
| THE GRACE FOUNDATION FOR HEALTH WELLNESS & EDUCATION | ||
| R | $500,000 | FMV PROPERTY TRANSFERRED |
| THE GRACE CENTER PROPERTY LLC | ||
| D | $2,500,000 | BALANCE ON LOAN GUARANTEE |