ASHLAND COMMUNITY HEALTH SERVICES: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- ASHLAND COMMUNITY HEALTH SERVICES (EIN 93-1213059)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-08-13
- IRS object ID
- 201532259349303648
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-08-13T18:39:25-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 930623286 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AKT LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5665 SW MEADOWS RD SUITE 200 | AddressLine1 |
| City | LAKE OSWEGO | City |
| State | OR | State |
| ZIP Code | 97035 | 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 | 931213059 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHLAND COMMUNITY HEALTHCARE SERVICES | BusinessNameLine1 |
| Business Name Line2 | DBA ASHLAND COMMUNITY HOSPITAL | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ASHL | BusinessNameControlTxt |
| Phone | 5417894549 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2650 SISKIYOU BLVD | AddressLine1 |
| City | MEDFORD | City |
| State | OR | State |
| ZIP Code | 97504 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PATRICK HOCKING | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5417894549 | PhoneNum |
| Signature | 2015-08-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOYLYN M ANKENEY CPA | PreparerPersonNm |
| PTIN | P00366587 | PTIN |
| Phone | 5036204489 | PhoneNum |
| Preparation | 2015-08-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PATRICK HOCKING | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2650 SISKIYOU BLVD | AddressLine1 |
| City | MEDFORD | City |
| State | OR | State |
| ZIP Code | 97504 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $47,158,341 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ASANTE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | ASANTE ASHLAND COMMUNITY HOSPITAL EXISTS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE MANNER, VALUED BY THE COMMUNITIES IT SERVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 268 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $35,682 | PYContributionsGrantsAmt |
| CY Contributions Grants | $19,304 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,323,735 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $46,634,149 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,224 | PYInvestmentIncomeAmt |
| CY Investment Income | $11,418 | CYInvestmentIncomeAmt |
| PY Other Revenue | $456,906 | PYOtherRevenueAmt |
| CY Other Revenue | $493,470 | CYOtherRevenueAmt |
| PY Total Revenue | $7,820,547 | PYTotalRevenueAmt |
| CY Total Revenue | $47,158,341 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,031,751 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $27,924,295 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,484,077 | PYOtherExpensesAmt |
| CY Other Expenses | $24,821,076 | CYOtherExpensesAmt |
| PY Total Expenses | $7,515,828 | PYTotalExpensesAmt |
| CY Total Expenses | $52,745,371 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $304,719 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$5,587,030 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $39,228,423 | TotalAssetsBOYAmt |
| Total Assets EOY | $34,992,173 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $38,533,237 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $36,015,030 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $695,186 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,022,857 | NetAssetsOrFundBalancesEOYAmt |
| Mission | ASANTE ASHLAND COMMUNITY HOSPITAL EXISTS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE MANNER, VALUED BY THE COMMUNITIES IT SERVES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $45,179,618 | ExpenseAmt |
| Revenue | $46,644,051 | RevenueAmt |
| Desc | ASHLAND COMMUNITY HEALTHCARE SERVICES GREATEST PROGRAM SERVICE ACCOMPLISHMENT IS THE OPERATION OF ASANTE ASHLAND COMMUNITY HOSPITAL(AACH), A 49 LICENSED BED NOT-FOR-PROFIT HOSPITAL LOCATED IN ASHLAND, OREGON. DURING THE SHORT YEAR PERIOD OF OCTOBER 1 2013 TO SEPTEMBER 30, 2014, AACH ADMITTED 1,707 INPATIENTS FOR A TOTAL OF 4,967 PATIENT DAYS. IT ALSO HAD 554 INPATIENT SURGERIES AND DELIVERED 304 BABIES. THE OUTPATIENT DEPARTMENTS ALSO PERFORMED 1,753 OUTPATIENT SURGERIES, 7,790 HOME HEALTH VISITS, AND 7,166 DAYS OF CARE AT IT'S HOSPICE DEPARTMENT. ADDITIONALLY, THERE WERE 8,861 EMERGENCY ROOM VISITS, 22,861 RADIOLOGY STUDIES, 4,903 PHYSICAL THERAPY SESSIONS, AND 3,878 WOUND CLINIC TREATMENTS. | Desc |
| Total Program Service Expenses | $45,179,618 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 268 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATRICK HOCKING | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5417894549 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2650 SISKIYOU BLVD | AddressLine1 |
| City | MEDFORD | City |
| State | OR | State |
| ZIP Code | 97504 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| WILLIAM THORNDIKE | ||||||||
| PAST CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ALAN BINETTE MD | ||||||||
| CURRENT CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| DOUG GENTRY | ||||||||
| PAST CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS R MCGILLOWAY | ||||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| RAY A COX | ||||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| GAYLE BYRNE | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KENT W DAUTERMAN MD | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ANNE GOLDEN | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| RONALD JONES MD | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| STEPHEN D ROE | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ALVIN SPEARS | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS M TUREY MD | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ROY G VINYARD | ||||||||
| ASANTE CEO | 2.00 | Yes (X) | $0 | $902,421 | $427,573 | Yes (X) | 40.00 | |
| JAMES M WRIGHT | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DOUG DIEHL MD | ||||||||
| PAST CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ALAN DEBOER | ||||||||
| PAST SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SHEILA CLOUGH | ||||||||
| ASHLAND CEO | 40.00 | $137,031 | $0 | $18,498 | Yes (X) | |||
| PATRICK HOCKING | ||||||||
| ASANTE CFO | 0.00 | $0 | $333,538 | $136,827 | Yes (X) | 40.00 | ||
| DAVID CANDELARIA | ||||||||
| MEDICAL DOCTOR | 40.00 | $118,673 | $0 | $12,484 | Yes (X) | |||
| AGNIESZKA DOBIECKA | ||||||||
| MEDICAL DOCTOR | 40.00 | $121,243 | $0 | $28,097 | Yes (X) | |||
| MOLLY GRAMLEY | ||||||||
| MEDICAL DOCTOR | 40.00 | $104,704 | $0 | $12,564 | Yes (X) | |||
| BETH LEONE | ||||||||
| MEDICAL DOCTOR | 40.00 | $105,332 | $0 | $6,773 | Yes (X) | |||
| PAMELA ATOR | ||||||||
| MEDICAL DOCTOR | 40.00 | $118,599 | $0 | $5,930 | 0.00 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $705,582 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,235,959 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $648,746 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ASHLAND ANESTHESIA ASSOCIATES | |||||
| 638 N MAIN STREET | ASHLAND | OR | 97520 | ANESTHESIA SERVICES | $577,233 |
| ASHLAND EMERGENCY ASSOCIATES PC | |||||
| 280 MAPLE STREET | ASHLAND | OR | 97520 | PHYSICIAN SUPPORT | $520,568 |
| DIVERSIFIED CLINICAL SERVICES INC | |||||
| PO BOX 551187 | JACKSONVILLE | FL | 32255 | WOUND CARE SERVICES | $462,242 |
| MAYO COLLABORATIVE SERVICES INC | |||||
| PO BOX 9146 | MINNEAPOLIS | MN | 55480 | LABORATORY SERVICES | $442,621 |
| HEALTH DATA SPECIALISTS | |||||
| 1720 SAND CREEK ROAD | POMONA | KS | 66076 | CONSULTANTS | $290,120 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $19,304 | AllOtherContributionsAmt |
| Total Contributions | $19,304 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HOSPITAL SERVICES | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $46,634,149 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $46,634,149 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $46,634,149 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,418 | TotalRevenueColumnAmt |
| Exclusion | $11,418 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| OTHER REVENUE | 900099 | $314,005 | $314,005 | |
| CAFETERIA | 722210 | $169,563 | $169,563 | |
| JOINT VENTURE INCOME | 621990 | $9,902 | $9,902 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $493,470 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,158,341 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $46,644,051 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $494,986 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,280 | TotalAmt |
| Program Services | $77,140 | ProgramServicesAmt |
| Management And General | $77,140 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,597,738 | TotalAmt |
| Program Services | $15,069,556 | ProgramServicesAmt |
| Management And General | $1,528,182 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,066,497 | TotalAmt |
| Program Services | $4,600,016 | ProgramServicesAmt |
| Management And General | $466,481 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,824,958 | TotalAmt |
| Program Services | $4,380,716 | ProgramServicesAmt |
| Management And General | $444,242 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,280,822 | TotalAmt |
| Program Services | $1,162,895 | ProgramServicesAmt |
| Management And General | $117,927 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,226 | TotalAmt |
| Management And General | $27,226 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,649,822 | TotalAmt |
| Program Services | $824,911 | ProgramServicesAmt |
| Management And General | $824,911 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $569 | TotalAmt |
| Management And General | $569 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,002,900 | TotalAmt |
| Program Services | $501,450 | ProgramServicesAmt |
| Management And General | $501,450 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $722,108 | TotalAmt |
| Program Services | $649,897 | ProgramServicesAmt |
| Management And General | $72,211 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,342 | TotalAmt |
| Program Services | $88,274 | ProgramServicesAmt |
| Management And General | $22,068 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,308 | TotalAmt |
| Program Services | $11,446 | ProgramServicesAmt |
| Management And General | $2,862 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $347,232 | TotalAmt |
| Program Services | $312,509 | ProgramServicesAmt |
| Management And General | $34,723 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,839,294 | TotalAmt |
| Program Services | $2,919,647 | ProgramServicesAmt |
| Management And General | $2,919,647 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,683,529 | TotalAmt |
| Program Services | $1,515,176 | ProgramServicesAmt |
| Management And General | $168,353 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $433,059 | TotalAmt |
| Program Services | $389,753 | ProgramServicesAmt |
| Management And General | $43,306 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PATIENT SUPPLIES | $7,295,808 | $7,295,808 | |
| BAD DEBT | $2,467,485 | $2,467,485 | |
| PURCHASED SERVIVES | $2,020,400 | $1,818,360 | $202,040 |
| REPAIRS AND MAINTENANCE | $935,674 | $842,107 | $93,567 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,320 | TotalAmt |
| Program Services | $252,472 | ProgramServicesAmt |
| Management And General | $18,848 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,745,371 | TotalAmt |
| Program Services | $45,179,618 | ProgramServicesAmt |
| Management And General | $7,565,753 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,877,790 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $940,593 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,662,003 | BOYAmt |
| EOY | $6,369,000 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $596,240 | BOYAmt |
| EOY | $469,092 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $295,513 | BOYAmt |
| EOY | $325,648 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $312,456 | BOYAmt |
| EOY | $228,951 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $28,705,396 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,000,553 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,284,195 | BOYAmt |
| EOY | $26,704,843 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,914,838 | BOYAmt |
| EOY | $743,380 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $224,795 | BOYAmt |
| EOY | $151,259 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,228,423 | BOYAmt |
| EOY | $34,992,173 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,544,709 | BOYAmt |
| EOY | $2,013,520 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,713,286 | BOYAmt |
| EOY | $7,503,486 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,275,242 | BOYAmt |
| EOY | $26,498,024 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,533,237 | BOYAmt |
| EOY | $36,015,030 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $304,720 | BOYAmt |
| EOY | -$1,172,034 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $390,466 | BOYAmt |
| EOY | $149,177 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $695,186 | BOYAmt |
| EOY | -$1,022,857 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,228,423 | BOYAmt |
| EOY | $34,992,173 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$5,587,030 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $3,868,987 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,161,560 | OtherCostOrOtherBasisAmt |
| Book Value | $5,161,560 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,991,806 | OtherCostOrOtherBasisAmt |
| Depreciation | $845,978 | DepreciationAmt |
| Book Value | $15,145,828 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,815,548 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,154,575 | DepreciationAmt |
| Book Value | $2,660,973 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,736,482 | OtherCostOrOtherBasisAmt |
| Book Value | $3,736,482 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $26,704,843 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)
| DescDesc | AmtAmt |
|---|---|
| BANK OVER DRAFT | $9,836 |
| DEFINED BENEFIT PLAN | $20,631,383 |
| OTHER LIABILITIES | $2,477,478 |
| ESTIMATED REIMBURSEMENT TO THIRD PARTIES | $940,000 |
| SELF INSURANCE RESERVE | $3,000 |
| ASBETOS ABATEMENT | $1,218,835 |
| CURRENT PORTION LTD | $392,954 |
| PAYROLL/BENEFITS PAYABLE | $824,538 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $26,498,024 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 668 | PersonsServedCnt |
| Total Community Benefit Expns | $529,304 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $529,304 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01060 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 396 | PersonsServedCnt |
| Total Community Benefit Expns | $518,936 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $329,554 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $189,382 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1064 | PersonsServedCnt |
| Total Community Benefit Expns | $1,048,240 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $329,554 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $718,686 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01440 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2482 | PersonsServedCnt |
| Total Community Benefit Expns | $405,218 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $405,218 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00540 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $298 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $298 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,835,648 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,539,764 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,295,884 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02460 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,032 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,032 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2482 | PersonsServedCnt |
| Total Community Benefit Expns | $5,252,196 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,539,764 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,712,432 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03020 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3546 | PersonsServedCnt |
| Total Community Benefit Expns | $6,300,436 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,869,318 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,431,118 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04460 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,467,485 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $11,149,059 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $12,451,559 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,302,500 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 SISKIYOU IMAGING | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | IMAGING SERVICES | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.33000 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.33000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | ASHLAND COMMUNITY HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 280 MAPLE STREET | AddressLine1 |
| City | ASHLAND | City |
| State | OR | State |
| ZIP Code | 97520 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.ASHLANDHOSPITAL.ORG | WebsiteAddressTxt |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASHLAND COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Lawsuit | Yes (X) | PermitLawsuitInd |
| Permit Lien On Residence | Yes (X) | PermitLienOnResidenceInd |
| Permit Other Actions | Yes (X) | PermitOtherActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ASHLAND COMMUNITY HOSPITAL | PART V, SECTION B, LINE 3: ACCOUNT INPUT FROM PERSON WHO REPRESENT THE COMMUNITY FACILITY:AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT'S REQUIREMENT TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS, ASANTE AND ASHLAND COMMUNITY HOSPITAL PARTNERED WITH PROFESSIONAL RESEARCH CONSULTANTS, INC. TO COMPLETE 600 COMMUNITY SURVEYS IN FISCAL YEAR 2013. THAT YEAR, WE ALSO HELD A FOCUS GROUP COMPRISED OF 7 KEY COMMUNITY LEADERS FROM JACKSON AND JOSEPHINE COUNTIES. THE FOCUS GROUP DISCUSSED THE INDIVIDUAL LEADERS' EXPERIENCES AND PERCEPTIONS OF THE TOP HEALTH CONCERNS IN OUR COMMUNITY. ALSO REQUIRED IS THE DEVELOPMENT AND EXECUTION OF AN IMPLEMENTATION STRATEGY TO ADDRESS THESE CONCERNS. |
| ASHLAND COMMUNITY HOSPITAL | PART V, SECTION B, LINE 4: ROGUE REGIONAL MEDICAL CENTER OF MEDFORD, OREGONTHREE RIVERS MEDICAL CENTER OF GRANTS PASS, OREGON |
| ASHLAND COMMUNITY HOSPITAL | PART V, SECTION B, LINE 14G: PARTIAL INFORMATION, BUT NOT THE ENTIRE POLICY, ABOUT APPLYING FOR FINANCIAL AID IS PRINTED ON THE PATIENT'S BILLING STATEMENT. THE ENTIRE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE ASANTE WEBSITE AT WWW.ASANTE.ORG. THE ENTIRE POLICY IS ALSO ON POSTERS IN THE PATIENT REGISTRATION DEPARTMENT. IF A PATIENT WISHES TO APPLY FOR FINANCIAL AID, THEY ARE DIRECTED TO CALL THE ASANTE BUSINESS OFFICE FOR A FINANCIAL ASSISTANCE APPLICATION. |
| ASHLAND COMMUNITY HOSPITAL | PART V, SECTION B, LINE 16E: ASHLAND COMMUNITY HOSPITAL'S "POLICY" IS TO ALLOW THIRD PARTIES TO PERFORM LAWSUITS, PLACE LIENS ON RESIDENCES AND GARNISH WAGES BUT ONLY AS A FINAL RESORT. HOWEVER, THE ASANTE BUSINESS OFFICE IS AUTHORIZED TO PLACE A VOLUNTARY LIEN ON A PATIENTS RESIDENCE ON CERTAIN RARE CIRCUMSTANCES. THE PATIENT MUST APPROVE THE VOLUNTARY LIEN FIRST. |
| ASHLAND COMMUNITY HOSPITAL | PART V, SECTION B, LINE 20D: THE DISCOUNT ASHLAND COMMUNITY HOSPITAL OFFERS IS SIMILAR TO THAT OF COMMERCIAL INSURANCE PLANS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| CENTER FOR INTERNAL MEDICINE | ||||
| 530 CATALINA STREET | ASHLAND | OR | 97520 | INTERNAL MEDCINE CLINIC |
| CENTER FOR FAMILY MEDICINE | ||||
| 628 N MAIN STREET | ASHLAND | OR | 97520 | FAMILY MEDICINE CLINIC |
| CENTER FOR FAMILY MEDICINE | ||||
| 49 TALENT AVE | TALENT | OR | 97540 | FAMILY MEDICINE CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | A COMMUNITY BENEFIT REPORT (CBR-1) WAS PREPARED AND FILED WITH THE STATE OF OREGON DURING THE PRIOR TAX YEAR. |
| PART III, LINE 2: | BAD DEBT EXPENSE IS REPORTED BASED ON A GROSS PATIENT CHARGES THAT HAVE BEEN WRITTEN OFF DUE TO NON-PAYMENT. |
| PART III, LINE 4: | BAD DEBTS RESULT WHEN A PATIENT WHO HAS BEEN DETERMINED TO HAVE THE FINANCIAL CAPACITY TO PAY FOR HEALTHCARE SERVICES IS UNWILLING TO SETTLE THE CLAIM OR DOES NOT PROVIDE FINANCIAL INFORMATION TO ACCESS CAPACITY. |
| PART III, LINE 8: | CERTAIN GOVERNMENT SPONSORED HEALTH INSURANCE COMPANIES, SUCH AS MEDICARE AND MEDICAID, PAY A SIGNIFICANTLY REDUCED AMOUNT FOR MEDICAL SERVICES RENDERED TO THEIR INSUREES. IN MOST CASES, THE AMOUNT PAID DOES NOT EVEN COVER THE EXPENSES OF RENDERING SERVICES. ASHLAND COMMUNITY HOSPITAL CONSIDERS THE DIFFERENCE BETWEEN THE EXPENSES OF RENDERING SERVICES TO MEDICARE AND MEDICAID PATIENTS AND THE AMOUNT OF NET REIMBURSEMENT FROM THESE GOVERNMENT SPONSORED INSURANCE COMPANIES A COMMNUITY BENEFIT. HOWEVER, DURING THE SHORT PERIOD, PAYMENTS AND ALLOWABLE COSTS PER THE MEDICARE COST REPORT WERE NOT AVAILABLE. CONSEQUENTLY, NO INFORMATION COULD BE ENTERED IN SECTION B: MEDICARE.CALCULATION: TOTAL MEDICARE PAYMENTS PER COST REPORT LESS TOTAL MEDICARE COSTS PER COST REPORT = UNRECOVERED MEDICARE COST PER COST REPORT. |
| PART III, LINE 9B: | IF THERE IS AN INDICATION THAT A PATIENT MAY BE UNABLE TO PAY THEIR BILL, A FINANCIAL QUESTIONNAIRE IS GIVEN OR SENT TO THE PATIENT. ON RECEIPT OF THE COMPLETED QUESTIONNAIRE, THE BUSINESS OFFICE WILL DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE AND NOTIFY THE PATIENT WITHIN 20 DAYS. ELIGIBILITY IS DETERMINED BASED UPON THE QUESTIONNAIRE AND ON FINANCIAL DOCUMENTS, SUCH AS TAX RETURNS, SSI STATEMENTS, PAYCHECK STUBS, AND FSA/HSA INFORMATION. THE PATIENT'S OTHER FINANCIAL OBLIGATIONS, NUMBER OF DEPENDENTS, ASSETS AND OTHER FINANCIAL CIRCUMSTANCES ARE CONSIDERED. OFTEN, A PATIENT WILL NOT PROVIDE A FINANCIAL QUESTIONNAIRE, SO THE BUSINESS OFFICE WILL USE SOFT CREDIT CHECKS AND ZIP CODES+4 TO HELP DETERMINE ELIGIBILITY. THE PERCENTAGE OF FINANCIAL ASSISTANCE PROVIDED IS BASED UPON A SLIDING SCALE TABLE THAT UTILIZES THE PATIENT FAMILY'S INCOME AS A PERCENTAGE OF THE FEDERAL POVERTY GUIDELINES. |
| PART III, SECTION B | UNREIMBURSED COSTS FROM THE MEDICARE PROGRAM (USING THE MEDICARE COST REPORT).NO MEDICARE COST REPORT WAS FILED DURING THE YEAR PERIOD OF JULY 1ST THROUGH SEPT 30, 2013. CONSEQUENTLY, WE WERE UNABLE TO DETERMINE THE MEDICARE SURPLUS (OR SHORTFALL) FOR SECTION B, LINES 5,6,AND 7 DURING THIS PERIOD. |
| PART V | DURING THE PERIOD OF OCTOBER 1, 2013 THROUGH SEPTEMBER 30, 2014, ASANTE ASHLAND COMMUNITY HOSPITAL WAS COMPRISED OF A FULL SERVICE ACUTE CARE HOSPITAL, AN INTERNAL MEDICINE CLINIC AND TWO FAMILY MEDICINE CLINICS. |
| PART VI, LINE 2: | ASHLAND COMMUNITY HOSPITAL'S PRIMARY SOURCES OF INPUT INCLUDE THE COMMUNITY LEADERS FORUM, FORMAL CONVERSATIONS WITH OUR COLLABORATORS, IDENTIFIED STRATEGIC PLAN GAPS, AND ENVIRONMENTAL AND COMMUNITY ASSESSMENT SURVEYS FROM MEMBERS OF THE COMMUNITY. |
| PART VI, LINE 3: | THE FINANCIAL ACCESS SPECIALISTS, CREDIT ANALYSTS, AND REGISTRATION PERSONNEL WORK WITH THE PATIENT EITHER AT THE TIME OF SCHEDULING, ARRIVAL AT THE HOSPITAL, OR DURING THE BILLING PROCESS. IF THE PATIENT DISCLOSES THEY WILL HAVE DIFFICULTY PAYING, WE ASSIST THEM APPLYING FOR THE OREGON HEALTH PLAN, FINANCIAL ASSISTANCE, OR A PAYMENT PLAN. BASED UPON INCOME AND EXPENSES, A PATIENT MAY BE ELIGIBLE FOR CHARITY CARE WRITE-OFF OF BETWEEN 10% AND 100% OF THEIR BILL. |
| PART VI, LINE 4: | THE POPULATION OF THE HOSPITAL'S PRIMARY SERVICE AREA IS PROJECTED TO INCREASE BY APPROXIMATELY 6.3% OVER THE FIVE YEAR PERIOD OF 2009-2014. SIMILARLY, THE POPULATION OF THE SECONDARY SERVICE AREA IS PROJECTED TO INCREASE BY 6.7% OVER THE SAME PERIOD. ALMOST 50% OF THE POPULATION GROWTH IN BOTH THE PRIMARY AND SECONDARY SERVICE AREAS IS PROJECTED TO OCCUR IN THE 65+ AGE COHORT. THE SIGNIFICANT INCREASE IN THE PORTION OF THE HOSPITAL'S TOTAL REVENUE DERIVED FROM THE MEDICARE PROGRAM INCREASED FROM APPROXIMATELY 40% OF GROSS REVENUE IN 2004 TO 54% IN 2014. |
| PART VI, LINE 5: | ALONG WITH PROVIDING QUALITY HEALTHCARE, ASANTE ASHLAND COMMUNITY HOSPITAL FURTHERS ITS EXEMPT PURPOSE AND FULFILLS ITS MISSION TO THE COMMUNITY BY PROVIDING OR SUBSIDIZING NUMEROUS CLASSES, SUPPORT GROUPS, HEALTH FAIRS, AND SELF-HELP PROGRAMS. THESE PROGRAMS ARE AT NO OR LOW COST TO THE PUBLIC. |
| PART VI, LINE 6: | FOUNDED IN 1996, ASANTE ASHLAND COMMUNITY HOSPITAL IS A COMMUNITY OWNED AND GOVERNED NOT-FOR-PROFIT ACUTE CARE HOSPITAL PROVIDING COMPREHENSIVE HEALTHCARE SERVICES TO MORE THAN 550,000 RESIDENTS IN NINE COUNTIES THROUGHOUT SOUTHERN OREGON AND NORTHERN CALIFORNIA. SINCE MERGING WITH ASANTE, THE HOSPITAL TODAY IS AFFILITATED WITH ROGUE REGIONAL MEDICAL CENTER (RRMC) IN MEDFORD, OREGON AND THREE RIVERS MEDICAL CENTER (TRMC) IN GRANTS PASS, OREGON. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | OR |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROY G VINYARD | ||||||||||||||
| ASANTE CEO | $0 | $618,863 | $0 | $191,735 | $0 | $91,823 | $0 | $383,691 | $0 | $43,882 | $0 | $1,329,994 | $0 | $0 |
| SHEILA CLOUGH | ||||||||||||||
| ASHLAND CEO | $61,208 | $0 | $70,000 | $0 | $5,823 | $0 | $13,051 | $0 | $5,447 | $0 | $155,529 | $0 | $0 | $0 |
| PATRICK HOCKING | ||||||||||||||
| ASANTE CFO | $0 | $267,853 | $0 | $10,720 | $0 | $54,965 | $0 | $94,077 | $0 | $42,750 | $0 | $470,365 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE SALARY RANGE OF THE CEO IS SET BY THE ASANTE COMPENSATION COMMITTEE AND IS APPROVED BY THE ASANTE BOARD OF DIRECTORS ON AN ANNUAL BASIS. THE ACTUAL SALARY IS SET BY THE ASANTE CEO. |
| PART I, LINE 4B | ASANTE, THE PARENT CORPORATION OF ASHLAND COMMUNITY HOSPITAL, HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR ROY VINYARD, THE ASANTE CEO. THIS PLAN STATES HE IS TO RECEIVE FIXED PAYMENTS AT PRE-DETERMINED INTERVAL FROM ASANTE IF HE IS EMPLOYED BY ASANTE AS CEO AT THE TIME OF VESTING. MR. VINYARD HAS THE AUTHORITY TO DIRECT HOW HIS PLAN ASSETS ARE TO BE INVESTED. IF MR. VINYARD IS NOT EMPLOYED AS CEO BY ASANTE FOR ANY REASON PRIOR TO VESTING, HE WILL NOT HAVE CLAIM TO THE FUNDS. FOR THE FISCAL YEAR ENDED SEPT 30, 2014, THERE WAS $260,199 CONTRIBUTED TO MR. VINYARD'S SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THIS AMOUNT IS INCLUDED IN DEFERRED COMPENSATION REPORTED IN PART II. ASANTE, THE PARENT CORPORATION OF ASHLAND COMMUNITY HOSPITAL, HAS AN EXECUTIVE RESTORATION PLAN WHICH INCLUDES ASANTE CFO PATRICK HOCKING AND ASANTE CEO ROY VINYARD. . THIS PLAN STATES FIXED PAYMENTS WILL BE RECEIVED AT PRE-DETERMINED INTERVALS FROM ASANTE IF STILL EMPLOYED BY ASANTE IN THEIR CURRENT ROLL AT THE TIME OF VESTING. IF EMPLOYMENT TERMINATES BY ASANTE FOR ANY REASON PRIOR TO VESTING,THEY WILL NOT HAVE CLAIM TO THE FUNDS. FOR THE FISCAL YEAR ENDED SEPT 30, 2014, THERE WAS $10,306 CONTRIBUTED FOR MR. HOCKING AND $95,807 CONTRIBUTED FOR MR. VINYARD. THESE AMOUNTS WERE INCLUDED IN DEFERRED COMPENSATION REPORTED IN PART II. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FEDERAL FORM 990 IS A FEDERALLY MANDATED LEGAL DOCUMENT THAT IS HIGHLY REGULATED. WITHIN ASHLAND COMMUNITY HEALTHCARE SERVICES, THEY ARE TO BE PREPARED BY PERSONNEL IN THE ASANTE ACCOUNTING DEPARTMENT. ASANTE IS THE PARENT CORPORATION OF ASHLAND COMMUNITY HEALTHCARE SERVICES. ADDITIONAL ASSISTANCE WILL BE PROVIDED BY PERSONNEL IN THE ASANTE MARKETING, COMPLIANCE, AND EXECUTIVE DEPARTMENTS. BEFORE FINAL SUBMISSION OF THE DOCUMENTS, THEY ARE TO HAVE ASHLAND COMMUNITY HEALTHCARE SERVICES BOARD REVIEW. POLICY DETAILS: 1. WHEN FINAL AUDITED FINANCIAL INFORMATION IS AVAILABLE, ACCOUNTING PERSONNEL WILL COMPILE THE NEEDED INFORMATION TO PREPARE THE APPROPRIATE RETURNS FOR THE PRIOR FISCAL YEAR. 2. AS NEEDED, ACCOUNTING WILL FILE ALL APPROPRIATE EXTENSIONS ON A TIMELY BASIS. HOWEVER, THE FINAL SUBMISSION CAN NEVER BE EXTENDED PAST AUGUST 15TH OF THE YEAR FOLLOWING THE FISCAL YEAR BEING FILED. 3. IN ADDITION TO NORMAL PREPARATION, ACCOUNTING PERSONNEL WILL COORDINATE WITH PERSONNEL IN MARKETING, COMPLIANCE, AND POSSIBLY THE EXECUTIVE DEPARTMENTS IN PREPARING THE VARIOUS SCHEDULES NEEDED TO COMPLETE THE RETURN. ALL WORK PAPERS ARE TO BE RETAINED IN A PERMANENT FILE. 4. WHEN ALL NECESSARY INFORMATION HAS BEEN COMPILED, IT IS TO BE LOADED INTO APPROPRIATE TAX SOFTWARE. 5. WHEN COMPLETED, A DRAFT RETURN WILL BE REVIEWED BY THE ASANTE CHIEF ADMINISTRATIVE AND FINANCE OFFICER. AFTER THE REVIEW, ACCOUNTING WILL CLEAR ALL REVIEW NOTES AND COMMENTS. 6. ONCE REVIEWED BY THE CAFO, AN ADDITIONAL REVIEW WILL BE PERFORMED BY AN OUTSIDE CPA FIRM. ACCOUNTING WILL AGAIN CLEAR ANY ADDITIONAL REVIEW NOTES AND COMMENTS SUBMITTED BY THE OUTSIDE CPA. 7. THE ACHS CHIEF EXECUTIVE OFFICER AND MEMBERS OF THE BOARD OF DIRECTORS WILL LOOK OVER THE FINAL SET OF RETURNS AND MAKE FURTHER COMMENTS AND CORRECTIONS, AS IS APPROPRIATE. 8. ONCE ALL REVIEWS AND CORRECTIONS ARE MADE, THE ASANTE CAFO WILL SIGN ALL APPROPRIATE RETURNS FOR FILING. 9. ALL RETURNS WILL THEN BE FILED EITHER ELECTRONICALLY OR PAPER COPY WITH THE APPROPRIATE GOVERNMENT AGENCY. A COPY OF EACH RETURN IS TO BE KEPT IN THE ACCOUNTING DEPARTMENT AND A COPY OF THE 990 WILL BE KEPT AT THE ASANTE CORPORATE HEADQUARTERS FOR PUBLIC DISPLAY AND COPYING, AS REQUESTED. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL ASHLAND COMMUNITY HOSPITAL MANAGERS, KEY EMPLOYEES, AND BOARD MEMBERS ARE REQUIRED TO FILE A CONFLICT OF INTEREST QUESTIONAIRE. THE PURPOSE OF THE QUESTIONAIRE IS THE PROTECT THE HOSPITAL'S INTERESTS WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THE MIGHT BENEFIT THE PRIVATE INTERESTS OF A BOARD MEMBER OR OFFICER OF THE COMPANY. IN ADDITION, ALL EMPLOYEES OF THE HOSPITAL HAVE AN OBLIGATION TO DISCLOSE CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS TO THEIR SUPERVISOR. THE ASANTE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR ADMINISTERING, MONITORING, AND INVESTIGATING ANY POSSIBLE CONFLICTS AND MAKE AN ANNUAL REPORT TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | DONATED CAPITAL 3,868,987. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| ASANTE | |||||||||
| 2650 SISKIYOU BLVD | MEDFORD | OR | 97504 | 930223960 | HOSPITAL/HEALTHCARE | OR | 501(C)(3) | LINE 10 | 0 |
| ASHLAND COMMUNITY HOSPITAL FOUNDATION | |||||||||
| 280 MAPLE STREET | ASHLAND | OR | 97520 | 930691238 | SUPPORT ASHLAND COMM HOSP | OR | 501(C)(3) | LINE 11B, II | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SISKIYOU IMAGING LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 278 MAPLE STREET | AddressLine1 |
| City | ASHLAND | City |
| State | OR | State |
| ZIP Code | 97520 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 753006992 | EIN |
| Primary Activities | IMAGING SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASANTE HEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $60,952 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $133,602 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (1) | GeneralOrManagingPartnerInd |
| Ownership | 0.33330 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ASANTE | ||
| E | $7,730,010 | CASH |
| ASANTE | ||
| O | $16,752,017 | CASH |
| ASHLAND COMMUNITY HOSPITAL FOUNDATION | ||
| C | $19,304 | CASH |