PETERSBURG MEDICAL CENTER: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- PETERSBURG MEDICAL CENTER (EIN 92-6001607)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-14
- IRS object ID
- 201401349349307275
- Schema version
- 2012v2.1
- 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 J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-14T16:29:43-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 135381590 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3601 C STREET SUITE 600 | AddressLine1 |
| City | ANCHORAGE | City |
| State | AK | State |
| ZIP Code | 99503 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 926001607 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PETERSBURG MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PETE | NameControl |
| Phone | 9077724291 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 589 | AddressLine1 |
| City | PETERSBURG | City |
| State | AK | State |
| ZIP Code | 99833 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ELIZABETH WOODYARD | Name |
| Title | CHIEF EXECUTIVE OFFICER | Title |
| Phone | 9077724291 | Phone |
| Date Signed | 2014-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KEY E GETTY CPA | Name |
| PTIN | P00121200 | PTIN |
| Phone | 9072788878 | Phone |
| Date Prepared | 2014-05-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ELIZABETH WOODYARD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 589 | AddressLine1 |
| City | PETERSBURG | City |
| State | AK | State |
| ZIP Code | 99833 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 15074272 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.PMC-HEALTH.COM | WebSite |
| Type Of Organization Other | X | TypeOfOrganizationOther |
| Type Of Org Other Description | COMPONENT UNIT OF PETERSBURG BOROUGH, AK | TypeOfOrgOtherDescription |
| Year Formation | 1993 | YearFormation |
| State Legal Domicile | AK | StateLegalDomicile |
| Activity Or Mission Description | OUR MISSION IS TO PROVIDE EXCELLENT HEALTHCARE AND TO PROMOTE WELLNESS IN OUR COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 138 | TotalNbrEmployees |
| Total Nbr Volunteers | 13 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 910405 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1098094 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 11439560 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 12948321 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 205447 | InvestmentIncomePriorYear |
| Investment Income Current Year | 97972 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 183536 | OtherRevenuePriorYear |
| Other Revenue Current Year | 130899 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 12738948 | TotalRevenuePriorYear |
| Total Revenue Current Year | 14275286 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 7105180 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8925363 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4812914 | OtherExpensePriorYear |
| Other Expenses Current Year | 4651493 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 11918094 | TotalExpensesPriorYear |
| Total Expenses Current Year | 13576856 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 820854 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 698430 | RevenuesLessExpensesCY |
| Total Assets BOY | 12282231 | TotalAssetsBOY |
| Total Assets EOY | 13725987 | TotalAssetsEOY |
| Total Liabilities BOY | 2323859 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2844115 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 9958372 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 10881872 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | OUR MISSION IS TO PROVIDE EXCELLENT HEALTHCARE AND TO PROMOTE WELLNESS IN OUR COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 2309185 | Expense |
| Revenue | 2549125 | Revenue |
| Description | NURSING SERVICES PROVIDED IN ACUTE CARE, INTENSIVE CARE, SWING BED, EMERGENCY ROOM, OPERATING ROOM AND HOME HEALTH SETTINGS. THESE SERVICES ARE PROVIDED IN A SEMI REMOTE RURAL AREA OF ALASKA. ACCESS TO THE AREA IS BY AIR OR WATER ONLY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2890045 | Expense |
| Revenue | 5368847 | Revenue |
| Description | OTHER HEALTHCARE SERVICES. THESE SERVICES ARE PROVIDED IN A SEMI-REMOTE AREA OF RURAL ALASKA. ACCESS TO THE AREA IS BY AIR OR WATER ONLY. THE SERVICES INCLUDE LABORATORY, IMAGING AND PHYSICAL THERAPY. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2097551 | Expense |
| Revenue | 1888958 | Revenue |
| Description | CLINIC. WE PROVIDE CLINIC SERVICES TO A SEMI REMOTE AREA OF RURAL ALASKA. ACCESS TO THE AREA IS BY AIR OR WATER ONLY. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1652242 | Expense |
| Revenue | 3141391 | Revenue |
| Description | NURSING HOME. WE PROVIDE NURSING HOME SERVICES IN A SEMI REMOTE AREA OF RURAL ALASKA. ACCESS TO THE AREA IS BY AIR OR WATER ONLY. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 1652242 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 3141391 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 8949023 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 53 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 138 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicy |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YING SCHWARTE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9077724291 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 589 | AddressLine1 |
| City | PETERSBURG | City |
| State | AK | State |
| ZIP Code | 99833 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| TOM ABBOTT | ||||||||
| PRESIDENT | 4.00 | X | X | 0 | 0 | 0 | ||
| JEANETTE NESS | ||||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | ||
| DARCY JUDY | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| TIM KOENEMAN | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| KRIS KISSINGER | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| DARLENE WHITETHORN | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| KRIS NOROSZ | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| KEN HILL | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| PHIL BEARDSLEY | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| ROCIO TEJERA | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| ELIZABETH WOODYARD | ||||||||
| CHIEF EXECUTIVE OFFICER EF | 40.00 | X | 175588 | 0 | 12235 | 1.00 | ||
| LEON WALSH | ||||||||
| CHIEF FINANCIAL OFFICER-IN | 40.00 | X | 122107 | 0 | 12533 | |||
| JENNIFER BRYNER | ||||||||
| DIRECTOR OF NURSING | 40.00 | X | 126370 | 0 | 42908 | |||
| YING SCHWARTE | ||||||||
| CHIEF FINANCIAL OFFICER EF | 40.00 | X | 35848 | 0 | 8628 | |||
| ALICE HULEBAK | ||||||||
| PHYSICIAN | 40.00 | 170979 | 0 | 23277 | X | |||
| JENNIFER HYER | ||||||||
| PHYSICIAN | 40.00 | 170838 | 0 | 28149 | X | |||
| MARK TUCILLO | ||||||||
| PHYSICIAN | 40.00 | 172223 | 0 | 42389 | X | |||
| ELIZABETH BACOM | ||||||||
| DIRECTOR OF LAB & IMAGING | 43.00 | 107121 | 0 | 30403 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1081074 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 200522 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| INNOVATIVE EMPLOYEE SOLUTIONS | |||||
| 9665 GRANITE RIDGE 420 | SAN DIEGO | CA | 92123 | TRAVELER NURSES | 297251 |
| DELTA HEALTHCARE PLACEMENT | |||||
| PO BOX 202940 | DALLAS | TX | 753202056 | RECRUITMENT | 273267 |
| COMP HEALTH | |||||
| PO BOX 972651 | DALLAS | TX | 753972651 | PHYSICIAN STAFFING | 131366 |
| CARDINAL HEALTH | |||||
| PO BOX 100316 | PASADENA | CA | 911890316 | ADMINISTRATIVE SERVICES | 109484 |
| QUEST DIAGNOSTICS | |||||
| FILE 91514 | LOS ANGELES | CA | 90074 | DIAGNOSTIC SERVICES | 106686 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Government Grants | 1097994 | GovernmentGrants |
| All Other Contributions | 100 | AllOtherContributions |
| Total Contributions | 1098094 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICES | Description |
| Business Code | 624100 | BusinessCode |
| Total Revenue Column | 12948321 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12948321 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 12948321 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 54769 | TotalRevenueColumn |
| Exclusion | $54,769 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 42279 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 42279 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 42279 | TotalRevenueColumn |
| Exclusion | $42,279 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 842189 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 798986 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 43203 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 43203 | TotalRevenueColumn |
| Exclusion | $43,203 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| OTHER OPERATING REVENUE | 900099 | 85485 | $85,485 |
| OTHER NON-OPERATING REVENUE | 900099 | 3135 | $3,135 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 88620 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14275286 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12948321 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $228,871 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 540436 | Total |
| Program Services | 172875 | ProgramServices |
| Management And General | 367561 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8384927 | Total |
| Program Services | 6297690 | ProgramServices |
| Management And General | 2087237 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18166 | Total |
| Management And General | 18166 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 643785 | Total |
| Management And General | 643785 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59555 | Total |
| Management And General | 59555 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| ADMINISTRATIVE AND FISC | 805760 | 805760 | |
| NURSING SERVICES | 720770 | 720770 | |
| OTHER EXPENSE | 661271 | 140529 | 520742 |
| MAINTENANCE | 505240 | 505240 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1236946 | Total |
| Program Services | 1236946 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13576856 | Total |
| Program Services | 8949023 | ProgramServices |
| Management And General | 4627833 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1072395 | BOY |
| EOY | 95032 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 204477 | BOY |
| EOY | 7268 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2161023 | BOY |
| EOY | 4720658 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147085 | BOY |
| EOY | 188835 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 127682 | BOY |
| EOY | 90790 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 17542643 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 13068588 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4964581 | BOY |
| EOY | 4474055 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3533877 | BOY |
| EOY | 4035851 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 71111 | BOY |
| EOY | 113498 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12282231 | BOY |
| EOY | 13725987 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 802750 | BOY |
| EOY | 1218060 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1218996 | BOY |
| EOY | 1398367 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 302113 | BOY |
| EOY | 227688 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2323859 | BOY |
| EOY | 2844115 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5414585 | BOY |
| EOY | 6691170 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4543787 | BOY |
| EOY | 4190702 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9958372 | BOY |
| EOY | 10881872 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12282231 | BOY |
| EOY | 13725987 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 698430 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 225070 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Governmental Unit170b1 Av | X | GovernmentalUnit170b1Av |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 347944 | OtherCostOrOtherBasis |
| Book Value | 347944 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12402414 | OtherCostOrOtherBasis |
| Depreciation | 9369883 | Depreciation |
| Book Value | 3032531 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 125327 | OtherCostOrOtherBasis |
| Depreciation | 105312 | Depreciation |
| Book Value | 20015 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4666958 | OtherCostOrOtherBasis |
| Depreciation | 3593393 | Depreciation |
| Book Value | 1073565 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4474055 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| PAYABLE TO FOUNDATION | $29,204 |
| CAPITAL LEASE | $198,484 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 227688 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 14482190 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 225070 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 225070 | RevenueNotRptdF990 |
| Revenue Subtotal | 14257120 | RevenueSubtotal |
| Other Revenues Not Included | 18166 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 18166 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 14275286 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 13558690 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 13558690 | ExpensesSubtotal |
| Other Expenses Not Included | 18166 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 18166 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 13576856 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | INVESTMENT FEES RECLASSIFIED AS EXPENSE 18,166. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | INVESTMENT FEES RECLASSIFIED AS EXPENSE 18,166. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 175.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 231493 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 231493 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01710 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 231493 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 231493 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01710 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 231493 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 231493 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01710 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $571,581 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 2051868 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 2026199 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 25669 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 NONE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PETERSBURG MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 103 FRAM ST | AddressLine1 |
| City | PETERSBURG | City |
| State | AK | State |
| ZIP Code | 99833 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | NURSING HOME, OUTPATIENT CLINIC | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PETERSBURG MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 0 | CHNAWidelyAvailable |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 175.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Other Factors | X | OtherFactors |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART I, LINE 7: THE PERCENT OF FINANCIAL ASSISTANCE IS THE AMOUNT OF FINANCIAL ASSISTANCE AT COST ($231,493) DIVIDED BY TOTAL EXPENSES OF 13,576,856. | |
| PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE IS THE NET DOLLAR AMOUNT OF PATIENT CHARGES TURNED OVER TO COLLECTION AGENCIES DURING THE YEAR. | |
| PART II: N/A | |
| PART III, LINE 4: THERE IS NO FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE. | |
| PART III, LINE 8: MEDICARE REVENUES EXCEED MEDICARE EXPENSES- THERE IS NO SHORTFALL. MEDICARE COSTS AND EXPENSES ARE FROM THE COST REPORT. | |
| PART III, LINE 9B: IF A PATIENT STATES OR IMPLIES HAVING A LIMITED MEANS TO PAY, BUSINESS OFFICE STAFF SPECIFICALLY NOTIFY THEM OF THE CHARITY POLICY. | |
| PART V, SECTION B, LINE 1J: THE ORGANIZATION'S BOARD MAINTAINS AN AWARENESS OF THE HEALTH CARE NEEDS OF TEH COMMUNITY AND ATTEMPTS TO PROVIDE FOR THOSE NEEDS WHILE REMAINING FINANCIALLY VIABLE. | PETERSBURG MEDICAL CENTER |
| PART V, SECTION B, LINE 12H: AN ADDITIONAL FACTOR USED TO DETERMINE AMOUNTS CHARGED TO PATIENTS UNDER THE FINANCIAL ASSISTANCE POLICY IS FAMILY SIZE. | PETERSBURG MEDICAL CENTER |
| PART V, SECTION B, LINE 20D: PATIENTS WHO DO NOT HAVE INSURANCE COVERING EMERGENCY OR MEDICALLY NECESSARY CARE ARE BILLED THE RATES ESTABLISHED IN THE CHARGEMASTER FOR THE SERVICES PROVIDED. | PETERSBURG MEDICAL CENTER |
| PART V, SECTION B, LINE 22: THE ORGANIZATION CHARGES ALL PATIENTS THE GROSS CHARGE ESTABLISHED IN THE CHARGE MASTER FOR THE SERVICES PROVIDED.IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UDNER THE FINANCIAL ASSISTANCE POLICY, THE CHARGES ARE REDUCED TO THE AMOUNTS PERMITTED BY THE POLICY. | PETERSBURG MEDICAL CENTER |
| PART VI, LINE 2: THE ORGANIZATION'S STAFF AND BOARD OF DIRECTORS MAINTAINS AN AWARENESS OF THE GENERAL HEALTHCARE NEEDS OF THE COMMUNITY AND ATTEMPTS TO PROVIDE FOR THOSE NEEDS WHILE REMAINING FINANCIALLY VIABLE. | |
| PART VI, LINE 3: THE ORGANIZATION'S BUSINESS OFFICE STAFF INFORMS AND EDUCATES PATIENTS ABOUT THEIR ELIGIBILITY FOR GOVERNMENT PROGRAMS AND THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM AS PART OF THE COLLECTION PROCESS. | |
| PART VI, LINE 4: PETERSBURG MEDICAL CENTER OPERATES ON MITKOF ISLAND IN THE GULF OF ALASKA. MITKOF ISLAND IS ACCESSABLE ONLY BY AIR OR BOAT. | |
| PART VI, LINE 5: PETERSBURG MEDICAL CENTER IS OVERSEEN BY AN UNPAID SEVEN MEMBER BOARD OF DIRECTORS. THE ENTITY TAKES SERIOUSLY ITS MISSION OF PROMOTING WELLNESS IN THE COMMUNITY. ONE PROGRAM IS A HEALTH FAIR HELD BIANNUALLY WHERE RESIDENTS ARE ABLE TO OBTAIN CORE LAB TESTS AT A REDUCED COST TO HELP THEM MONITOR THEIR HEALTH STATUS. THE ORGANIZATION ALSO PARTICIPATES IN AND PROMOTES AN ANNUAL PHYSICAL ACTIVITY CHALLENGE AMONG AREA ENTITIES TO PROMOTE MORE HEALTHY LIVING. | |
| PART VI, LINE 6: N/A |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | 1 | SubstantiationRequired |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ELIZABETH WOODYARD | ||||||||||||||
| CHIEF EXECUTIVE OFFICER EF | 175588 | 0 | 0 | 0 | 0 | 0 | 8779 | 0 | 3456 | 0 | 187823 | 0 | 0 | 0 |
| JENNIFER BRYNER | ||||||||||||||
| DIRECTOR OF NURSING | 126370 | 0 | 0 | 0 | 0 | 0 | 27801 | 0 | 15107 | 0 | 169278 | 0 | 0 | 0 |
| ALICE HULEBAK | ||||||||||||||
| PHYSICIAN | 170979 | 0 | 0 | 0 | 0 | 0 | 8548 | 0 | 14729 | 0 | 194256 | 0 | 0 | 0 |
| JENNIFER HYER | ||||||||||||||
| PHYSICIAN | 170838 | 0 | 0 | 0 | 0 | 0 | 8542 | 0 | 19607 | 0 | 198987 | 0 | 0 | 0 |
| MARK TUCILLO | ||||||||||||||
| PHYSICIAN | 172223 | 0 | 0 | 0 | 0 | 0 | 37889 | 0 | 4500 | 0 | 214612 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ELIZABETH HART | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | SPOUSE OF BOARD PRESIDENT | Relationship |
| Amount Of Transaction | 92257 | AmountOfTransaction |
| Description Of Transaction | WAGES | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE CHIEF FINANCIAL OFFICER AND THE CHIEF EXECUTIVE OFFICER WILL EACH REVIEW THE COMPLETED RETURN SEPARATELY AND THEN RESOLVE ANY ISSUES WHICH ARISE PRIOR TO FILING THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CHIEF EXECUTIVE OFFICER'S SALARY IS DETERMINED BY THE BOARD OF DIRECTORS AFTER REVIEWING SALARIES FOR SIMILAR POSITIONS IN COMPARABLE ORGANIZATIONS OF THE HEALTHCARE INDUSTRY. A SALARY HISTORY OF THE POSITION IS PART OF THE REVIEW. THE COMPENSATION REVIEW IS MADE IN CONJUNCTION WITH THE CEO'S ANNUAL EVALUATION. THE CHIEF EXECUTIVE OFFICER'S SALARY IS DETERMINED BY THE BOARD OF DIRECTORS AFTER REVIEWING SALARIES FOR SIMILAR POSITIONS IN COMPARABLE ORGANIZATIONS OF THE HEALTHCARE INDUSTRY. A SALARY HISTORY OF THE POSITION IS PART OF THE REVIEW. THE COMPENSATION REVIEW IS MADE IN CONJUNCTION WITH THE CEO'S ANNUAL EVALUATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | PETERSBURG MEDICAL CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990 PART XII LINE 2C | THERE HAS BEEN NO CHANGE IN THE AUDIT SELECTION OR OVERSIGHT PROCESS FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PETERSBURG MEDICAL CENTER FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 589 | AddressLine1 |
| City | PETERSBURG | City |
| State | AK | State |
| ZIP Code | 99833 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 920134279 | EIN |
| Primary Activities | CARRY OUT FUNDRAISING & CHARITABLE ACTIVITIES FOR PETERSBURG MEDICAL CENTER | PrimaryActivities |
| Legal Domicile State | AK | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 509(A)(3) | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PETERSBURG MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 1 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |