GIBSON GENERAL HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- GIBSON GENERAL HOSPITAL INC (EIN 35-0877575)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-08-17
- IRS object ID
- 201502299349302590
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-08-17T12:06:09-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 N Illinois Street | AddressLine1 |
| City | Indianapolis | City |
| State | IN | State |
| ZIP Code | 46204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350877575 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gibson General Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % GIBSON GENERAL HOSPITAL | InCareOfNm |
| Business Name Control | GIBS | BusinessNameControlTxt |
| Phone | 8123853401 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | PRINCETON | City |
| State | IN | State |
| ZIP Code | 47670 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RON HARRINGTON | PersonNm |
| Person Title | VP & CFO | PersonTitleTxt |
| Phone | 8123853401 | PhoneNum |
| Signature | 2015-08-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AARON D HERSHBERGER | PreparerPersonNm |
| PTIN | P00961884 | PTIN |
| Phone | 8123853401 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | EMMETT C SCHUSTER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1 |
| City | PRINCETON | City |
| State | IN | State |
| ZIP Code | 47670 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $57,156,442 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GIBSONGENERAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1947 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF GIBSON GENERAL HOSPITAL AND THE SKILLED NURSING FACILITY IS TO PROVIDE HIGH QUALITY, PATIENT- CENTERED, COST-EFFECTIVE CARE FOR THE PEOPLE IN OUR COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 461 | TotalEmployeeCnt |
| Total Volunteers | 60 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $51,015 | PYContributionsGrantsAmt |
| CY Contributions Grants | $25,549 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $56,737,922 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $56,543,924 | CYProgramServiceRevenueAmt |
| PY Investment Income | $161,754 | PYInvestmentIncomeAmt |
| CY Investment Income | $188,924 | CYInvestmentIncomeAmt |
| PY Other Revenue | $191,294 | PYOtherRevenueAmt |
| CY Other Revenue | $398,045 | CYOtherRevenueAmt |
| PY Total Revenue | $57,141,985 | PYTotalRevenueAmt |
| CY Total Revenue | $57,156,442 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $49,871 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $46,674 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,135,169 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,367,729 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $39,090,076 | PYOtherExpensesAmt |
| CY Other Expenses | $39,974,582 | CYOtherExpensesAmt |
| PY Total Expenses | $57,275,116 | PYTotalExpensesAmt |
| CY Total Expenses | $58,388,985 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$133,131 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,232,543 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $24,741,986 | TotalAssetsBOYAmt |
| Total Assets EOY | $23,111,653 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $13,280,039 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $12,500,956 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,461,947 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,610,697 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF GIBSON GENERAL HOSPITAL AND THE SKILLED NURSING FACILITY IS TO PROVIDE HIGH QUALITY, PATIENT-CENTERED, COST-EFFECTIVE CARE FOR THE PEOPLE IN OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $53,231,341 | ExpenseAmt |
| Grant | $46,674 | GrantAmt |
| Revenue | $56,543,924 | RevenueAmt |
| Desc | THE HOSPITAL'S MISSION IS TO PROVIDE HIGH QUALITY COST EFFECTIVE HEALTHCARE, WHICH INCLUDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO THE RESIDENTS OF THE SURROUNDING TRI-STATE AREA. ALL EXPENSES RELATE TO COSTS ASSOCIATED WITH PROVIDING THESE SERVICES, AND MAINLY INCLUDE SALARIES AND WAGES TO STAFF AND SUPPLY COSTS. DURING THE YEAR THE HOSPITAL HAD 472 ADMISSIONS AND 45,456 OP VISITS INCLUDING ER VISITS. | Desc |
| Total Program Service Expenses | $53,231,341 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 60 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 461 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GIBSON GENERAL HOSPITAL | PersonNm |
| Phone | 8123853401 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1 |
| City | PRINCETON | City |
| State | IN | State |
| ZIP Code | 47670 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 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 |
|---|---|---|---|---|---|---|---|---|
| DR MICHAEL GREEN | ||||||||
| CHAIRMAN | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBERT GIBSON JR | ||||||||
| FIRST VICE CHAIRMAN | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARION JOCHIM | ||||||||
| SECOND VICE CHAIRMAN | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DON HAUKE | ||||||||
| SECRETARY | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MIKE WOOD | ||||||||
| TREASURER | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BRUCE BRINK JR DO | ||||||||
| CHIEF OF STAFF | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GEORGE ANKENBRAND | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT HURST | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| PHIL YOUNG | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| STANLEY MADISON | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| LARRY JOHNSON | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT KINKLE | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DR KRISHNA | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN LANKFORD | ||||||||
| BOARD MEMBER - (JAN-SEP) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JERRY RICHARDSON - JAN-SEP | ||||||||
| BOARD MEMBER - FND. PRES. | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| SHERRI SMITH | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| EMMETT SCHUSTER | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.0 | 1.0 | Yes (X) | $227,005 | $0 | $22,982 | ||
| LORI PHILLIPS | ||||||||
| CHIEF NURSING OFFICER | 40.0 | 0.0 | Yes (X) | $147,819 | $0 | $4,195 | ||
| RON HARRINGTON | ||||||||
| CHIEF FINANCIAL OFFICER | 40.0 | 0.0 | Yes (X) | $134,962 | $0 | $27,391 | ||
| COREY POTTS | ||||||||
| CRNA | 40.0 | 0.0 | $235,200 | $0 | $29,900 | Yes (X) | ||
| MARK CARPENTER | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $350,015 | $0 | $20,469 | Yes (X) | ||
| MICHELLE SNYDER | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $180,892 | $0 | $17,175 | Yes (X) | ||
| RICHARD CLARK | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $203,160 | $0 | $27,920 | Yes (X) | ||
| STEPHEN SHOEMAKER | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $227,745 | $0 | $21,217 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,706,798 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $171,249 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ST MARY'S MEDICAL CENTER | |||||
| 3700 WASHINGTON AVENUE | EVANSVILLE | IN | 47750 | HEALTHCARE | $795,327 |
| BLAKE TITZER DO PC | |||||
| PO BOX 130 | INGLEFIELD | IN | 47618 | HEALTHCARE | $401,616 |
| PHILOMINA THURUTHUMALY | |||||
| 1707 BRENTWOOD DRIVE | PRINCETON | IN | 47670 | ANESTHESIOLOGY | $325,000 |
| ROCHE DIAGNOSTICS CORP | |||||
| PO BOX 660367 | DALLAS | TX | 75266 | HEALTHCARE | $232,517 |
| GOOD SAMARITIAN HOSPITAL | |||||
| 520 SOUTH SEVENTH STREET | VINCENNES | IN | 47591 | HEALTHCARE | $132,955 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,203 | RelatedOrganizationsAmt |
| All Other Contributions | $24,346 | AllOtherContributionsAmt |
| Total Contributions | $25,549 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICES | 621110 | $56,189,023 | $56,189,023 |
| CAFETERIA SALES | 722210 | $169,110 | $169,110 |
| MANAGEMENT FEES | 541610 | $80,288 | $80,288 |
| INCENTIVE INCOME | 900099 | $45,350 | $45,350 |
| CAPITAL MAINTENANCE INCOME | 811000 | $23,100 | $23,100 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,053 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $37,053 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $56,543,924 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $188,924 | TotalRevenueColumnAmt |
| Exclusion | $188,924 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,332 | TotalRevenueColumnAmt |
| Exclusion | $44,332 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $353,713 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $353,713 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $353,713 | TotalRevenueColumnAmt |
| Exclusion | $353,713 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $57,156,442 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $56,543,924 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $586,969 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,674 | TotalAmt |
| Program Services | $46,674 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $564,354 | TotalAmt |
| Program Services | $508,585 | ProgramServicesAmt |
| Management And General | $55,769 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,089,395 | TotalAmt |
| Program Services | $12,697,133 | ProgramServicesAmt |
| Management And General | $1,392,262 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $233,438 | TotalAmt |
| Program Services | $156,787 | ProgramServicesAmt |
| Management And General | $76,651 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,468,152 | TotalAmt |
| Program Services | $1,931,098 | ProgramServicesAmt |
| Management And General | $537,054 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,012,390 | TotalAmt |
| Program Services | $911,494 | ProgramServicesAmt |
| Management And General | $100,896 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,907 | TotalAmt |
| Program Services | $1,800 | ProgramServicesAmt |
| Management And General | $145,107 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,450 | TotalAmt |
| Management And General | $58,450 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,491 | TotalAmt |
| Management And General | $19,491 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,698,936 | TotalAmt |
| Program Services | $3,235,821 | ProgramServicesAmt |
| Management And General | $1,463,115 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,511 | TotalAmt |
| Management And General | $261,511 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,748,687 | TotalAmt |
| Program Services | $2,704,975 | ProgramServicesAmt |
| Management And General | $43,712 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,112,162 | TotalAmt |
| Program Services | $1,741,317 | ProgramServicesAmt |
| Management And General | $370,845 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,949 | TotalAmt |
| Program Services | $253,602 | ProgramServicesAmt |
| Management And General | $13,347 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,229,725 | TotalAmt |
| Program Services | $1,168,239 | ProgramServicesAmt |
| Management And General | $61,486 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $477,675 | TotalAmt |
| Program Services | $272,832 | ProgramServicesAmt |
| Management And General | $204,843 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| CONTRACTUAL DISC. & ALLOW. | $22,333,809 | $22,333,809 |
| UNCOLLECTIBLE ACCOUNTS | $3,716,513 | $3,716,513 |
| PROVIDER TAX | $1,015,702 | $1,015,702 |
| COLLECTION EXPENSE | $128,455 | $128,455 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $759,610 | TotalAmt |
| Program Services | $406,505 | ProgramServicesAmt |
| Management And General | $353,105 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,388,985 | TotalAmt |
| Program Services | $53,231,341 | ProgramServicesAmt |
| Management And General | $5,157,644 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,775 | BOYAmt |
| EOY | $1,775 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,421,753 | BOYAmt |
| EOY | $1,004,463 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,263,137 | BOYAmt |
| EOY | $3,252,311 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $529,179 | BOYAmt |
| EOY | $337,281 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $709,189 | BOYAmt |
| EOY | $667,977 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $247,314 | BOYAmt |
| EOY | $459,983 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $33,723,476 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $21,041,791 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,802,315 | BOYAmt |
| EOY | $12,681,685 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,674,238 | BOYAmt |
| EOY | $4,613,415 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,086 | BOYAmt |
| EOY | $92,763 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,741,986 | BOYAmt |
| EOY | $23,111,653 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,361,219 | BOYAmt |
| EOY | $2,307,439 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,523,018 | BOYAmt |
| EOY | $9,656,022 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,629 | BOYAmt |
| EOY | $37,567 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $310,173 | BOYAmt |
| EOY | $499,928 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,280,039 | BOYAmt |
| EOY | $12,500,956 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,413,547 | BOYAmt |
| EOY | $10,558,766 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,400 | BOYAmt |
| EOY | $51,931 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,461,947 | BOYAmt |
| EOY | $10,610,697 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,741,986 | BOYAmt |
| EOY | $23,111,653 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,232,543 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $381,293 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $421,244 | OtherCostOrOtherBasisAmt |
| Book Value | $421,244 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,332,051 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,141,398 | DepreciationAmt |
| Book Value | $9,190,653 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,532,478 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,744,734 | DepreciationAmt |
| Book Value | $2,787,744 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $437,703 | OtherCostOrOtherBasisAmt |
| Depreciation | $155,659 | DepreciationAmt |
| Book Value | $282,044 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,681,685 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO MEDICARE | Desc |
| Amt | $499,928 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $499,928 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $35,203,926 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $381,293 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $381,293 | RevenueNotReportedAmt |
| Revenue Subtotal | $34,822,633 | RevenueSubtotalAmt |
| Other Revenues Not Included | $22,333,809 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $22,333,809 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $57,156,442 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $36,055,176 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $36,055,176 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $22,333,809 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $22,333,809 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $58,388,985 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART X | FIN 48 DISCLOSURE: Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. |
| SCHEDULE D, PART XI, LINE 4B | RECONCILIATION OF REVENUE: CONTRACTUAL DISCOUNTS & ALLOWANCES = $22,333,809 |
| SCHEDULE D, PART XII, LINE 4B | RECONCILIATION OF EXPENSES: CONTRACTUAL DISCOUNTS & ALLOWANCES = $22,333,809 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 100 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,522,121 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,522,121 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02780 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,558,127 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,024,007 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $534,120 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00980 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,080,248 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,024,007 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,056,241 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03760 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,518 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,755 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,763 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,518 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,755 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,763 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,094,766 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,029,762 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,065,004 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03780 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,716,513 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,096,620 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $5,965,736 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,311,304 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $654,432 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMA DRIVE | AddressLine1 |
| City | PRINCETON | City |
| State | IN | State |
| ZIP Code | 47670 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.GIBSONGENERAL.COM | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 100 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 100 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Lawsuit | Yes (X) | PermitLawsuitInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Lawsuit | Yes (X) | LawsuitInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 3 | INPUT FROM PERSONS WHO REPRESEMT THE COMMUNITY: THE HOSPITAL HAD ON-LINE SURVEYS, COMMUNITY FORUMS, AND DIRECT MAILINGS TO PEOPLE IN THE COMMUNITY FOR INPUT, FEEDBACK, AND SUGGESTIONS. THE HOSPITAL RECEIVED INPUT FROM THE FOLLOWING INDIVIDUALS DURING COMMUNITY FORUMS: LORI PHILLIPS, MARION JOCHIM, MICHAEL GREEN, PHD, MRS. NORA NIXON, TODD BRYANT, RON HARRINGTON, SHERRI STOKES, STANLEY MADISON, JANICE UTLEY, RANDY WILLIS, SHELLY SNYDER, SHANE MATTHEWS, PEGGY H SLAYPYN, JASON BRADSHAW, DR. JIM SPILLER, KERRY RYAN, ANGELA BRYANT, RACHEL MATTHEWS, JERRY TILE, DOUG MEINING, DEENA DODD, ALLISON ORWIG, LAURA CARLSON. |
| SCHEDULE H, PART V, SECTION B, LINE 7 | NEEDS IDENTIFIED: AFTER REVIEW OF THE SURVEY GIVEN, THE HOSPITAL IS PRIORITIZING THE ITEMS FROM THE COMMUNITY INPUT AND EVALUATING THE RESOURCES NEEDED TO ADDRESS THE TOP COMMUNITY NEEDS. OBESITY AND ASSISTED LIVING ARE TWO AREAS THAT THE HOSPITAL DOES NOT HAVE THE RESOURCES CURRENTLY TO MEET THE COMMUNITY CONCERNS AND NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| STAR ONE REHAB | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | PHYSICAL THERAPY OCCUPATIONAL THERAPY SPEECH THERAPY |
| PHYSICIAN OUTPATIENT CLINICS | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | SUBSIDIZED CARE PHYSICIAN PRACTICES |
| HOPE HOUSE | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | GERIATRIC CONSULTING MEDICATION MANAGEMENT |
| LIFESTYLES DIABETES CENTER | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | DIABETES EDUCATION COUNSELING |
| GGH - SKILLED NURSING FACILITY | ||||
| 1808 SHERMAN DRIVE | PRINCETON | IN | 47670 | SKILLED NURSING REHAB CENTER |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7, COLUMN F | PERCENT OF TOTAL EXPENSE: $3,716,513 OF BAD DEBT EXPENSE IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN A (TOTAL FUNCTIONAL EXPENSES), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. SCHEDULE H, PART III, SECTION A, LINE 2 METHODOLOGY USED TO ESTIMATE BAD DEBTS: ACCOUNTS ARE BILLED TO THE APPROPRIATE INSURANCE AND ONCE PAYMENT IS RECEIVED AND THE BALANCE AMOUNT IS THE PATIENT'S RESPONSIBILITY, THE ACCOUNTS ARE SENT LETTERS FOR THE BALANCE DUE. IF NOT PAID WITHIN 30 DAYS, ACCOUNTS ARE SENT TO COLLECTIONS TO WORK BASED ON LAST NAME ON THE ACCOUNT. IF THE ACCOUNT IS NOT PAID WITHIN 150 DAYS, THE ACCOUNT IS SENT BACK TO HOSPITAL AND THEN THE ACCOUNT IS WRITTEN OFF AS UNCOLLECTIBLE. |
| SCHEDULE H, PART III, SECTION A, LINE 3 AND 4 | DESCRIPTION OF BAD DEBT EXPENSE AND METHODOLOGY: THE HOSPITAL DOES NOT PURSUE COLLECTION AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS NET PATIENT REVENUE. CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. THE COST OF CHARITY CARE IS ESTIMATED BY APPLYING THE RATIO OF COST TO GROSS CHARGES TO THE GROSS UNCOMPENSATED CHARGES. Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectibility of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides a contractual allowance, an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers 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 copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Hospitals allowance for doubtful accounts for self-pay patients was approximately 77% and 80% of self-pay accounts receivable at September 30, 2014 and 2013, respectively. This slight decrease was the result of improvement experienced in the collection of amounts from self-pay patients in fiscal year 2014 and 2013. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | TREATMENT OF MEDICARE SHORTFALL AS COMMUNITY BENEFIT: THE GIBSON GENERAL HOSPITAL IS A CAH AND IS REIMBURSED 101% OF MEDICARE ALLOWABLE COSTS FOR INPATIENT SERVICES, SWING BED, AND OUTPATIENT PART B SERVICES. THE REVENUE SHORTFALL ABOVE IS THE DIFFERENCE BETWEEN THE ALLOWABLE COST FOR THE SKILLED NURSING FACILITY AND THE PPS REIMBURSEMENT ALLOWED FOR THAT SKILLED NURSING FACILITY. |
| SCHEDULE H, PART III, SECTION B, LINE 9B | ORGANIZATION COLLECTION POLICY: COLLECTION PRACTICES ARE APPLIED TO ALL PATIENTS AT GIBSON GENERAL HOSPITAL. PRIORITIZING THE ITEMS FROM THE COMMUNITY INPUT AND EVALUATING THE RESOURCES NEEDED TO ADDRESS THE TOP COMMUNITY NEEDS. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT: ON-LINE SURVEYS, COMMUNITY MEETINGS AND MAILING OF SURVEY INFORMATION. THE HOSPITAL USES THIS INFORMATION TO PREPARE THE CHNA. CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. THE COST OF CHARITY CARE IS ESTIMATED BY APPLYING THE RATIO OF COST TO GROSS CHARGES TO THE GROSS UNCOMPENSATED CHARGES. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL HAS POSTERS IN THE CENTRAL REGISTRATION AND ER WAITING AREA INFORMING PATIENTS THAT WE SEE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND ALSO PROVIDE FINANCIAL ASSISTANCE TO UNINSURED AND UNDERINSURED. IN COMPLIANCE WITH EMTALA ALL ER PATIENTS ARE SEEN BY A PRACTITIONER PRIOR TO SOLICIATION OF FINANCIAL ASSISTANCE OR INSURANCE INFORMATION. ALL PATIENTS WHO DO NOT HAVE INSURANCE AND PATIENTS WHO HAVE BALANCES AFTER INSURANCE ARE CONTACTED BY OUR PATIENT FINANCIAL COUNSELOR BY MAIL WITH A FINANCIAL ASSISTANCE APPLICATION. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION: THE HOSPITAL'S PRIMARY SERVICE AREA ENCOMPASSES GIBSON COUNTY, INDIANA, SW PIKE COUNTY AND POSEY COUNTY, INDIANA. GIBSON COUNTY HAS A POPULATION DENSITY OF 66/SQ. MILE. SW PIKE COUNTY HAS A POPULATION DENSITY OF 38/SQ. MILE. GIBSON GENERAL HOSPITAL HAS TWO LARGE COMPETING HEALTHCARE SYSTEMS 35 MILES TO THE SOUTH. TRADITIONALLY, GGH HAS BEEN RELIED UPON AS A SAFETY NET HOSPITAL FOR OLDER PATIENTS, LOW-INCOME PATIENTS AND PATIENTS WITH LIMITED MEANS TO TRAVEL TO THE LARGER CITY OF EVANSVILLE,INDIANA. MUCH OF GIBSON COUNTY IS RURAL WITH AGRICULTURE AND COAL MINING AS PRIMARY INDUSTRIES. GIBSON COUNTY DOES ENJOY SOME ECONOMIC BENEFIT FROM TOYOTA MANUFACTURING OF INDIANA. IN ADDITION, APPROX. 75 - 80% OF GGH'S PATIENT POPULATION IS FUNDED BY MEDICARE, MEDICAID AND OR OTHER GOVT. SUBSIDIZED PLANS. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH: THE HOSPITAL PARTICIPATES IN MANY ORGANIZATIONS AND ACTIVITIES DESIGNED TO IMPROVE THE HEALTH AND WELFARE OF THE SURROUNDING COMMUNITY. IN ADDITION TO PARTICIPATION ON VARIOUS BOARDS AND CIVIC ORGANIZATIONS FOCUSED ON ECONOMIC DEVELOPMENT, GGH LEADERSHIP PARTICIPATES IN THE INDIANA PATIENT SAFETY COALITION, THE DEPARTMENT OF HOMELAND SECURITY DISTRICT 10 EMERGENCY PREPAREDNESS AND NATIONAL INCIDENT MANAGEMENT SAFETY PROGRAMS. AS MEMBERS OF THE INDIANA RURAL HEALTH ASSOCIATION AND THE INDIANA STATE RURAL HEALTH NETWORK, GGH PARTICIPATES IN PROGRAMS DESIGNED TO ASSIST RURAL HEALTHCARE ORGANIZATIONS STATEWIDE AND HAS ASSISTED IN OBTAINING AND IMPLEMENTING COMMUNICATION, INFORMATION SHARING AND OTHER ACTIVITIES TO IMPROVE ACCESS TO HEALTHCARE IN GIBSON COUNTY AND THE SURROUNDING AREAS. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM: GIBSON GENERAL HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. THE HOSPITAL DOES PARTICIPATE IN SEVERAL COALITIONS AND COOPERATIVES WITH OTHER PROVIDERS AND OFTEN COLLABORATES WITH THE LARGER SYSTEMS IN THE EVANSVILLE AREA TO PROVIDE ACCESS TO SERVICES THE HOSPITAL CANNOT PROVIDE SUCH AS CARDIAC AND NEUROLOGICAL SURGERY. |
| SCHEDULE H, PART VI, LINE 7 | STATE FILING OF COMMUNITY BENEFIT REPORT: INDIANA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HEALTH FOUNDATION INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1 |
| City | PRINCETON | City |
| State | IN | State |
| ZIP Code | 47670 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 350950175 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $46,674 | CashGrantAmt |
| Purpose Of Grant | SUPPORT MISSION & ASSIST WITH PAYMENT OF EXPENSES | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | MONITORING USE OF FUNDS: THE HOSPITAL MONITORS THE USE OF THE FUNDS PROVIDED TO THE FOUNDATION BY HAVING THE FOUNDATION SUBMIT INVOICES FOR APPROVAL. THE HOSPITAL THEN PAYS THE INVOICES ON THE FOUNDATION'S BEHALF AND PROVIDES THE FOUNDATION WITH COPIES OF THESE PAYMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COREY POTTS | ||||||||||||||
| CRNA | $235,200 | $0 | $0 | $0 | $0 | $0 | $3,397 | $0 | $26,503 | $0 | $265,100 | $0 | $0 | $0 |
| MARK CARPENTER | ||||||||||||||
| PHYSICIAN | $350,015 | $0 | $0 | $0 | $0 | $0 | $5,100 | $0 | $15,369 | $0 | $370,484 | $0 | $0 | $0 |
| MICHELLE SNYDER | ||||||||||||||
| PHYSICIAN | $180,892 | $0 | $0 | $0 | $0 | $0 | $3,640 | $0 | $13,535 | $0 | $198,067 | $0 | $0 | $0 |
| RICHARD CLARK | ||||||||||||||
| PHYSICIAN | $203,160 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $27,920 | $0 | $231,080 | $0 | $0 | $0 |
| STEPHEN SHOEMAKER | ||||||||||||||
| PHYSICIAN | $227,745 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $21,217 | $0 | $248,962 | $0 | $0 | $0 |
| EMMETT SCHUSTER | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $227,005 | $0 | $0 | $0 | $0 | $0 | $3,519 | $0 | $19,463 | $0 | $249,987 | $0 | $0 | $0 |
| LORI PHILLIPS | ||||||||||||||
| CHIEF NURSING OFFICER | $147,819 | $0 | $0 | $0 | $0 | $0 | $2,986 | $0 | $1,209 | $0 | $152,014 | $0 | $0 | $0 |
| RON HARRINGTON | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $134,962 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $27,391 | $0 | $162,353 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| CITY OF PRINCETON | |||||||
| A | 356001169 | 2008-12-01 | $2,500,000 | RENOVATIONS - ER DEPARTMENT | false | false | false |
| CITY OF PRINCETON | |||||||
| B | 356001169 | 2007-10-01 | $2,096,000 | ENERGY CONSERVATION PROJECT | false | false | false |
| CITY OF PRINCETON | |||||||
| C | 356001169 | 2005-06-01 | $7,100,000 | CAPITAL IMPROVEMENTS | false | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $0 | $0 | $2,500,000 | $0 | $0 | $0 | $31,500 | $0 | $0 | $2,500,000 | $0 | $0 | 2009 | false | false | Yes (true) | Yes (true) |
| B | $0 | $0 | $2,096,000 | $0 | $0 | $0 | $0 | $0 | $0 | $2,002,380 | $0 | $0 | 2008 | false | false | Yes (true) | Yes (true) |
| C | $0 | $0 | $7,100,000 | $0 | $0 | $0 | $55,566 | $0 | $0 | $3,146,250 | $0 | $0 | 2009 | false | Yes (true) | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | 0 | false | false | false | false |
| B | false | false | false | false | 0 | false | false | false | false |
| C | false | false | false | false | 0 | false | false | false | false |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Exception To RebateExceptionToRebateInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/BusinessNameLine1 | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|
| 0 | ||||||||
| A | false | Yes (true) | Yes (true) | false | false | 0 | false | Yes (true) |
| 0 | ||||||||
| B | false | Yes (true) | Yes (true) | false | false | 0 | false | Yes (true) |
| 0 | ||||||||
| C | false | Yes (true) | Yes (true) | false | false | 0 | false | Yes (true) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
| C | Yes (true) |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LEANN COOPER | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SEE PART V | RelationshipDescriptionTxt |
| Transaction | $40,598 | TransactionAmt |
| Transaction | COMPENSATION PAID BY GGH | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART IV, LINE 1B | FormAndLineReferenceDesc |
| Explanation | RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: LEANN COOPER IS THE EXECUTIVE DIRECTOR OF GIBSON GENERAL HEALTH FOUNDATION AND IS THE DAUGHTER OF CHAIRMAN OF THE BOARD, DR. MICHAEL GREEN. THE HOSPITAL REIMBURSES THE GIBSON GENERAL HEALTH FOUNDATION FOR THE SALARY OF THE EXECUTIVE DIRECTOR. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS TO REVIEW THE FORM 990: THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES IS INFORMED OF THE NEED TO AND DUE DATE FOR FILING THE FORM 990 AND THAT IT IS AVAILABLE FOR INSPECTION AND REVIEW AT ANY TIME BY CONTACTING THE CFO OR THE CEO. THE CFO AND CEO DO A DETAIL OF THE RETURN BEFORE IT IS FILED. THE FORM 990 IS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. |
| FORM 990, PART VI, SECTION B, LINE 12C | PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE CEO OR A COMPLIANCE OFFICER REVIEWS THE SIGNED STATEMENTS. ANY BOARD MEMBER WHO HAS A CONFLICT OF INTEREST RECUSES HIMSELF OR HERSELF FROM VOTING ON THE RELATED ISSUE. |
| FORM 990, PART VI, SECTION B, LINE 15A | REVIEW OF CEO OR TOP MGMT OFFICIAL COMPENSATION: THE CEO'S COMPENSATION IS REVIEWED ANNUALLY AND APPROVED BY THE BOARD OF TRUSTEES COMPENSATION COMMITTEE. THE COMMITTEE USES A COMPENSATION CONSULTANT, COMPENSATION SURVEY, AND COMPARATIVE DATA FROM SIMILAR ORGANIZATIONS TO DETERMINE THE CEO'S COMPENSATION. THE LAST REVIEW WAS COMPLETED IN 2014. |
| FORM 990, PART VI, QUESTION 15B | REVIEW OF OTHER OFFICER OR KEY EMPLOYEES COMPENSATION: OFFICER COMPENSATION IS REVIEWED ANNUALLY BY THE CEO. COMPENSATION SURVEYS ARE USED IN DETERMINING OFFICER COMPENSATION. THE LAST REVIEWS WERE CONDUCTED IN 2014. |
| FORM 990, PART IV, QUESTION 19 | AVAILABILITY OF GOVERNING DOCUMENTS, C.O.I. POLICY, AND F/S: GIBSON GENERAL HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE ALSO AVAILABLE ON THE INDIANA STATE DEPARTMENT OF HEALTH WEBSITE. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GIBSON GENERAL HEALTH FOUNDATION INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1808 SHERMAN DRIVE | AddressLine1 |
| City | PRINCETON | City |
| State | IN | State |
| ZIP Code | 47670 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350950175 | EIN |
| Primary Activities | SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Exempt Code Section | 501 (C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 11-TYPE III | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |