STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

SAN GORGONIO MEMORIAL HOSPITAL: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
SAN GORGONIO MEMORIAL HOSPITAL (EIN 33-0420041)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-05-10
IRS object ID
201641319349300049
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

FieldValueIRS element (for citing)
Return2016-05-10T07:32:48-07:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1JWT & Associates LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11111 East Herndon Avenue Suite 211AddressLine1Txt
CityFresnoCityNm
State AbbreviationCAStateAbbreviationCd
ZIP93720ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN330420041EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1San Gorgonio Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSANGBusinessNameControlTxt
Phone9517692103PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 North Highland Springs AveAddressLine1Txt
CityBanningCityNm
State AbbreviationCAStateAbbreviationCd
ZIP92220ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDavid RecuperoPersonNm
Person TitleCFOPersonTitleTxt
Signature2016-05-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonInger Sullenger CPAPreparerPersonNm
PTINP01464277PTIN
Phone5413636707PhoneNum
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDavid Recupero CFOPrincipalOfficerNm
Gross Receipts$70,614,912GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.sgmh.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1991FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionSan Gorgonio Memorial Hospital is a nonprofit public benefit corporation formed for the purpose of operating the San Gorgonio Acute Care Facility.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee742TotalEmployeeCnt
Total Volunteers75TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,433,204PYContributionsGrantsAmt
CY Contributions Grants$674,146CYContributionsGrantsAmt
PY Program Service Revenue$62,467,274PYProgramServiceRevenueAmt
CY Program Service Revenue$67,488,292CYProgramServiceRevenueAmt
PY Investment Income$446,917PYInvestmentIncomeAmt
CY Investment Income$19CYInvestmentIncomeAmt
PY Other Revenue$466,976PYOtherRevenueAmt
CY Other Revenue$2,452,455CYOtherRevenueAmt
PY Total Revenue$64,814,371PYTotalRevenueAmt
CY Total Revenue$70,614,912CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$34,088,626PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$38,630,310CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$118,166CYTotalFundraisingExpenseAmt
PY Other Expenses$29,793,466PYOtherExpensesAmt
CY Other Expenses$28,863,566CYOtherExpensesAmt
PY Total Expenses$63,882,092PYTotalExpensesAmt
CY Total Expenses$67,493,876CYTotalExpensesAmt
PY Revenues Less Expenses$932,279PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,121,036CYRevenuesLessExpensesAmt
Total Assets BOY$27,446,354TotalAssetsBOYAmt
Total Assets EOY$23,795,602TotalAssetsEOYAmt
Total Liabilities BOY$23,332,659TotalLiabilitiesBOYAmt
Total Liabilities EOY$16,560,871TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,113,695NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,234,731NetAssetsOrFundBalancesEOYAmt
MissionSan Gorgonio Memorial Hospital is a nonprofit public benefit corporation formed for the purpose of operating the San Gorgonio Acute Care Facility.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$54,937,030ExpenseAmt
Revenue$69,940,747RevenueAmt
DescThe Hospital is comprised of an acute care facility which provides healthcare services. The Hospital provided 15,601 days of inpatient services, 42,177 emergency room visits and delivered 470 babies during the fiscal year. The Hospital provides care to persons covered by governmental programs at an amount below cost, and provides care to individuals who are unable to pay. The unreimbursed value of providing charity and uncompensated care was $877,054. Unpaid Medi-Cal program charges were $9,656,439. Unpaid Medicare program charges for the fiscal year were $50,960,603. Thus, total quantifiable community benefits were $61,494,096.Desc
Total Program Service Expenses$54,937,030TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document55IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee742EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMargaret KammerPersonNm
Phone9517692118PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 North Highland Springs AveAddressLine1Txt
CityBanningCityNm
State AbbreviationCAStateAbbreviationCd
ZIP92220ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Jerilynn Kaibel DC
Chair10.000.00Yes (X)$4,800$0$0
Estelle Lewis
Vice Chair10.000.00Yes (X)$4,900$0$0
DeNae Reagins
Secretary10.000.00Yes (X)$3,500$0$0
Olivia Hershey
Treasurer10.000.00Yes (X)$4,500$0$0
Ludwig Cibelli MD
Director5.000.00Yes (X)$2,600$0$0
Lynn Baldi
Director5.000.00Yes (X)$3,900$0$0
Joe Dotan MD
Director5.000.00Yes (X)$3,700$0$0
Robert Ewert
Director5.000.00Yes (X)$3,000$0$0
Farzad Farrokhi MD
Director5.000.00Yes (X)$1,000$0$0
David Frisbie
Director5.000.00Yes (X)$800$0$0
Ron Rader
Director5.000.00Yes (X)$900$0$0
N Irwin Reeves
Director5.000.00Yes (X)$3,200$0$0
Brian Sylva
Director5.000.00Yes (X)$800$0$0
David Recupero
CFO45.000.00$256,155$0$61,516Yes (X)
Mark Turner
CEO45.000.00$450,531$0$69,183Yes (X)
Prince Nnah
Executive Director45.000.00$298,564$0$68,920Yes (X)
Lynn Gomez
Executive Director45.000.00$185,400$0$43,635Yes (X)
Patricia Brown
Chief of Nursing45.000.00$182,814$0$32,882Yes (X)
Lauron Lima
Registered Nurse45.000.00$150,116$0$34,527Yes (X)
Carrie Echols
Dir of OB/Lbr Dvry45.000.00$148,251$0$34,098Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,709,431TotalReportableCompFromOrgAmt
Total Other Compensation$344,761TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K34IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Desert Anesthesia Consulting
1540 Barton Rd Ste 434RedlandsCA92373Anesthesiology$946,175
DVA Renal Healthcare Inc
6090 W Ramsey StBanningCA92220Dialysis & Support$304,941
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$470,080GovernmentGrantsAmt
All Other Contributions$204,066AllOtherContributionsAmt
Total Contributions$674,146TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNet Patient Svc RevenueDesc
Business622110BusinessCd
Total Revenue Column$67,488,292TotalRevenueColumnAmt
Related Or Exempt Func Income$67,488,292RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$67,488,292TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$19TotalRevenueColumnAmt
Exclusion$19ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Cafeteria,Med Records,etc622110$1,587,864$1,587,864
EHR Incentive Program622110$864,591$864,591
FieldValueIRS element (for citing)
Other Revenue Total$2,452,455OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$70,614,912TotalRevenueColumnAmt
Related Or Exempt Func Income$69,940,747RelatedOrExemptFuncIncomeAmt
Exclusion$19ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$874,985TotalAmt
Management And General$874,985ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$30,487,880TotalAmt
Program Services$26,072,054ProgramServicesAmt
Management And General$4,349,065ManagementAndGeneralAmt
Fundraising$66,761FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$836,746TotalAmt
Program Services$724,777ProgramServicesAmt
Management And General$110,113ManagementAndGeneralAmt
Fundraising$1,856FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,963,645TotalAmt
Program Services$3,318,541ProgramServicesAmt
Management And General$636,606ManagementAndGeneralAmt
Fundraising$8,498FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,467,054TotalAmt
Program Services$2,042,989ProgramServicesAmt
Management And General$418,813ManagementAndGeneralAmt
Fundraising$5,252FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$609,983TotalAmt
Management And General$609,983ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$348,386TotalAmt
Management And General$348,386ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$53,640TotalAmt
Management And General$53,640ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,998,303TotalAmt
Program Services$1,920,608ProgramServicesAmt
Management And General$1,077,632ManagementAndGeneralAmt
Fundraising$63FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$126,517TotalAmt
Management And General$126,517ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$325,635TotalAmt
Program Services$225,422ProgramServicesAmt
Management And General$99,653ManagementAndGeneralAmt
Fundraising$560FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,510,194TotalAmt
Program Services$1,045,435ProgramServicesAmt
Management And General$462,162ManagementAndGeneralAmt
Fundraising$2,597FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,364,305TotalAmt
Program Services$1,140,496ProgramServicesAmt
Management And General$208,839ManagementAndGeneralAmt
Fundraising$14,970FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$58,978TotalAmt
Program Services$39,981ProgramServicesAmt
Management And General$17,911ManagementAndGeneralAmt
Fundraising$1,086FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$106,433TotalAmt
Program Services$29,682ProgramServicesAmt
Management And General$76,751ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$231,757TotalAmt
Management And General$231,757ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$792,633TotalAmt
Program Services$741,590ProgramServicesAmt
Management And General$51,043ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Medical Supplies & Drugs$8,904,911$8,904,911
Intergovernmental Fees$6,186,992$6,186,992
Other Purchased Services$3,450,905$2,210,529$1,240,303$73
Other Operating Expenses$1,793,994$333,023$1,444,521$16,450

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$67,493,876TotalAmt
Program Services$54,937,030ProgramServicesAmt
Management And General$12,438,680ManagementAndGeneralAmt
Fundraising$118,166FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,990,318BOYAmt
EOY$2,999,286EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$4,513EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$45,850BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,998,142BOYAmt
EOY$11,014,545EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,373,972BOYAmt
EOY$1,587,837EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$20,820BOYAmt
EOY$150,708EOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$169,194BOYAmt
EOY$207,448EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$13,848,058BOYAmt
EOY$7,831,265EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$27,446,354BOYAmt
EOY$23,795,602EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,672,659BOYAmt
EOY$11,015,407EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$17,660,000BOYAmt
EOY$5,545,464EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$23,332,659BOYAmt
EOY$16,560,871EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,113,695BOYAmt
EOY$7,234,731EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,113,695BOYAmt
EOY$7,234,731EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$27,446,354BOYAmt
EOY$23,795,602EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$3,121,036ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescJoint Venture Loma Linda Univ Med CtrDesc
Book Value$207,448BookValueAmt
Method ValuationCMethodValuationCd

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
Intergovernmental Receivable$5,076,499
Malpractice Insurance Recoveries
MCE Bed Fund Receivable$1,057,020
Other Receivables$303,470
Third-Party Settlements$1,394,276
FieldValueIRS element (for citing)
Total Book Value Other Assets$7,831,265TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Bank Line of Credit$5,500,000
Malpractive Claims Payable$45,464
FieldValueIRS element (for citing)
Total Liability$5,545,464TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X : FIN48 FootnoteFormAndLineReferenceDesc
ExplanationPart X - FIN 48 FootnoteThe Hospital is exempt from federal income tax. Accordingly, no provision for income tax is necessary. The Hospital evaluates uncertain tax positions whereby the effect of the uncertainty would be recorded if the outcome was considered probable and reasonably estimable. As of June 30, 2015 and 2014, the Hospital had no uncertain tax positions requiring accrual.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportfalseAnnualCommunityBnftReportInd
Report Publically AvailablefalseReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$877,054TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$877,054NetCommunityBenefitExpnsAmt
Total Expense0.01300TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,656,439TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,656,439NetCommunityBenefitExpnsAmt
Total Expense0.14310TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$50,960,603TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$50,960,603NetCommunityBenefitExpnsAmt
Total Expense0.75500TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$61,494,096TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$61,494,096NetCommunityBenefitExpnsAmt
Total Expense0.91110TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Persons Served117PersonsServedCnt
Total Community Benefit Expns$5,940TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,940NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Persons Served131PersonsServedCnt
Total Community Benefit Expns$55,640TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$55,640NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Persons Served248PersonsServedCnt
Total Community Benefit Expns$61,580TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$61,580NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served248PersonsServedCnt
Total Community Benefit Expns$61,555,676TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$61,555,676NetCommunityBenefitExpnsAmt
Total Expense0.91200TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Persons Served320PersonsServedCnt
Total Community Benefit Expns$3,228TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,228NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Persons Served320PersonsServedCnt
Total Community Benefit Expns$3,228TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,228NetCommunityBenefitExpnsAmt
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$6,233,373BadDebtExpenseAmt
Reimbursed By Medicare$28,542,218ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$39,401,299CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$10,859,081MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1San Gorgonio Memorial HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 North Highland Springs AveAddressLine1Txt
CityBanningCityNm
State AbbreviationCAStateAbbreviationCd
ZIP92220ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.sgmh.orgWebsiteAddressTxt
State License250000199StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1San Gorgonio Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Sch H, Pg 9, Part VI Need AssessOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSee Sch H, Pg 9, Part VI Need AssessStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care350.0000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care350.0000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit Other ActionsYes (X)PermitOtherActionsInd
Collection ActivitiesYes (true)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
Engaged Legal Judicial ProcessYes (X)EngagedLegalJudicialProcessInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Medicare RatesYes (X)MedicareRatesInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 5 - Account Input from Persons Who Represent the CommunityThe Hospital partnered with LLUMC Community Health Development Department and the Riverside County Department of Public Health Development Department and the Riverside County Department of Public Health looking ast both quantitative and qualitative data impacting the health of the community. The team conducting the assessment included public health professionals and the assessment included input from community members, community agencies.
Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs AssessmentThe assessment was conducted in collaboration with Loma Linda University, as well as, Riverside and San Bernardino County Public Health Departments.
Part V, Line 18d - Other Collection Actions Against a PatientThe hospital does not take any of these actions, it assigns delinquent accounts to a collections agency.

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part III, Line 2 - Methodology Used To Estimate Bad Debt ExpenseThe costing methodology used to determine the amounts reported includes the cost to charge ratio of patient care.
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community BenefitBad Debt expense attributable to charity care policy cannot be determined. The Hospital did not track the amount of bad debt expense that could reasonably be attributable to patients who likely would qualify for financial assistance under the Hospital's charity care policy, and furthermore sufficient information was not obtained from all patients that might be eligible to make this determination and calculation.
Part III, Line 4 - Bad Debt ExpenseThe Financial statements do not contain a footnote describing bad debt expense. However, there is a footnote (Note Q) that discusses charity care and community benefit expense.
Part III, Line 8 - Explanation Of Shortfall As Community BenefitAny shortfall is deemed a community benefit in its entirety.
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsThe Hospital's business office staff follow up on accounts 15 to 30 days after the accounts are billed. The staff contact the insurerss to verify claims have been received and to resend the claims if necessary. After verifying claims have veen received, the staff continue to contact the insurers every 30 days, as necessary, to follow up on the status of the claims. All claims not resolved within 60 days of billing are reviewed by a supervisor or manager for additional guidance and consideration. Accounts not resolved within 60 days of billing are considered delinquent. The supervisor or manager will determine whether the accounts should be written off as bad debt, further collection procedures should be attempted, and/or the state insurance commission office should be contacted.
Part VI - Needs AssessmentThe management team, hospital department staff and managers, and the Board of Directors are comprised of community members. They are able to gather and communicate the health care needs of the community the hospital serves and continually address them at staff and board meetings. The most recently adopted implementation strategy is publicly available on the internet at: http://www.sgmhf.org/docs/CHNA_Community_Needs_Assessment_11-14-13_SGMH_CHNA_(v2).pdf
Part VI - Patient Education of Eligibility for AssistanceIt is the Hospital's policy that when it becomes apparent that a patient may have difficulty in meeting his/her financial responsibility to the hospital, the patient will be requested to complete the application process for California Medi-Cal and/or other available programs. Hospital staff assist in the application process. Patients who do not qualify for Calfornia Medi-Cal or other assistance may apply for the Hospital's assistance program.
Part VI - Community InformationThe Hospital is a rural hospital located in the pass area of Riverside County. It primarily serves the cities of Banning, Beaumont, Cabazon, and Calimesa, California. The population served is high-risk due to poverty level incomes, low education levels, and high drug use. The county has an unemployment rate of 14.2%. The Hospital's payor mix includes approximately 23% Medi-Cal recipients and 11% uninsured.
Part VI - Community Building ActivitiesThe Hospital holds community education courses such as CPR certification, smoking cessation, childbirth preparation, disaster preparedness, cancer education, health fairs etc. The Hospital also has several contracts with various schools to provide teaching programs for nursing students. This training contributes to healthcare professional development of the students. Hospital staff volunteer in community support activities such as relay for life, toys for tots, and many others. The Hospital also provides usage of meeting rooms at no charge to various community groups.
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeThe hospital continues to strive to meet the health needs of its community as these needs evolve.
Part VI - Affilated Health Care System Roles and PromotionN/A
Part VI - States Where Community Benefit Report FiledCA
Part V - Explanation of Number of Facility TypeThere is one licensed general medical and surgical hospital that offers 24-hour emergency room services.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd
Rebuttable Presumption ProcfalseRebuttablePresumptionProcInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmt
Carrie Echols
Dir of OB/Lbr Dvry$148,251$34,098$182,349
David Recupero
CFO$187,108$58,916$317,671$69,047$2,600
Lauron Lima
Registered Nurse$150,116$34,527$184,643
Lynn Gomez
Executive Director$167,107$38,435$229,035$18,293$5,200
Mark Turner
CEO$285,996$65,779$519,714$164,535$3,404
Patricia Brown
Chief of Nursing$131,660$30,282$215,696$51,154$2,600
Prince Nnah
Executive Director$249,557$68,670$367,484$49,007$250

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart III, Additional InformationFormAndLineReferenceDesc
ExplanationCompensation of highest paid officers and other individuals is reviewed and approved by the Board of Directors each year during the budget process, and arrangements are solidified in written employment contracts. Sources utilized by the Board when reviewing fair market value in compensation include market surveys, salary ranges, and Form 990 information of comparable organizations. Bonus or incentive compensation was based on the individual's unique qualifications and succcessful achievement of different goals.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonFarzad FarrokhiPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionBoard MemberRelationshipDescriptionTxt
Transaction$518,244TransactionAmt
TransactionPhys Group PartnerTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule L, Part V Supplemental InformationFormAndLineReferenceDesc
ExplanationThe Hospital has a contract with Desert Anesthesia, of which Dr. Farrokhi (Hospital board Member) is a 50% partner. This transaction is reportable on Schedule L as a business transaction and Dr. Farrokhi is deemed to have lost independence in voting as a hospital Board member (Per Form 990 Instructions).ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 1a: Explanation of Delegated Broad Authority to CommitteeThe Board has delegated authority to a finance committee to oversee the audit, and other monthly financial matters.
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtThe Hospital has a contract with Desert Anesthesia, of which Dr. Farrokhi (Hospital board member) is a 50% partner. This transaction is reportable on Schedule L as a business transaction and Dr. Farrokhi is deemed to have lost independence in voting as a hospital Board member (Per Form 990 Instructions).
Form 990, Part VI, Line 3: Description of Delegated Duties to Management CompanyThe hospital contracts with Epic Management LP (EPIC) for management services. However, the Chief Executive Officer and Chief Financial Officer are employees of the Hospital. EPIC was paid $643,641 during the fiscal year. The management agreement with EPIC has since been terminated.
Form 990, Part VI, Line 11b: Form 990 Review ProcessThe Form 990 is provided to the Finance Committee and full Board at the monthly Board meeting.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsExecutive Assistant monitors and documents conflicts.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementThe Board of Directors Review and approve management wages each year during the budget process. Sources utilized by the Board when reviewing fair market value in compensation include market surveys and salary ranges provided by the management company.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe Board of Directors Review and approve management wages each year during the budget process. Sources utilized by the Board when reviewing fair market value in compensation include market surveys and salary ranges provided by the management company.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailablePublished on website www.sgmh.org or available by request from the CEO, CFO, or Controller.
Form 990, Part I, Line 6The Hospital volunteers help in the Gift Shop, Cafeteria, and Reception Booths, as well as Materials Management deliveries and mailings.
Form 990, Part V, Lines 7a & 7bThe Hospital did receive contributions from donors, although none of them were made partly for goods and for services. Donors just gave donations without the receipt of any goods or services, and the donor was properly notified of the deductible value of the donation they made. Thus questions 7a&b were marked "No," since no goods and services in combination were received by donors.
Schedule H, Part I, Table 7Financial Assistance and Means-Tested Government Programs: The Hospital has recorded its community benefit expense in the form of traditional charity care and other uncompensated care in row a-financial assistance at cost, unpaid Medi-Cal program charges in row b-Medicaid, and unpaid medicare program charges in row c-Costs of other means-tested government programs.Other Benefits: Community health improvement services expenses such as CPR & First Aid, Cancer education, etc. are recorded in row e-Community health improvement services and community benefit operations. Nursing education expense for education provided at area schools is recorded in row f-Health professions education.
Schedule H, Part IIExpenses for community support activities such as volunteering for Relay for Life, School events, and Toys for Tots are recorded on line 3-Community Support.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1San Gorgonio Health Care DistrictBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 N Highland Springs AveAddressLine1Txt
CityBanningCityNm
State AbbreviationCAStateAbbreviationCd
ZIP92220ZIPCd
FieldValueIRS element (for citing)
EIN956004149EIN
Primary ActivitiesHealthcarePrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd
Exempt Code Section501c3ExemptCodeSectionTxt
Public Charity Status3PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1San Gorgonio Health Care DistrictBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypekTransactionTypeTxt
Involved$784,157InvolvedAmt
Method Of Amount DeterminationCash ValueMethodOfAmountDeterminationTxt