ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME (EIN 42-0733472)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-09
- IRS object ID
- 201411299349302346
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-09T16:17:19-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 South Sixth Street Suite 2800 | AddressLine1 |
| City | Minneapolis | City |
| State | MN | State |
| ZIP Code | 55402 | 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 | 420733472 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Anthony Regional Hospital and Nursing Home | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STAN | NameControl |
| Phone | 7127945246 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 South Clark Street PO Box 628 | AddressLine1 |
| City | Carroll | City |
| State | IA | State |
| ZIP Code | 51401 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | John Munson | Name |
| Title | Vice President/CFO | Title |
| Phone | 7127945246 | Phone |
| Date Signed | 2014-05-07 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kristina Rasmussen | Name |
| PTIN | P00143920 | PTIN |
| Phone | 6123974000 | Phone |
| 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 | Edward H Smith Jr | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 South Clark Street PO Box 628 | AddressLine1 |
| City | Carroll | City |
| State | IA | State |
| ZIP Code | 51401 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 83193962 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.stanthonyhospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1905 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | Consistently providing high quality healthcare services to meet patient and community needs. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 757 | TotalNbrEmployees |
| Total Nbr Volunteers | 444 | TotalNbrVolunteers |
| Total Gross UBI | 2023 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 149934 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 158567 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 64337847 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 59012017 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2835658 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2694001 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -423758 | OtherRevenuePriorYear |
| Other Revenue Current Year | -564197 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 66899681 | TotalRevenuePriorYear |
| Total Revenue Current Year | 61300388 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 3000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 5000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 30026394 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 31241575 | 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 | 30280643 | OtherExpensePriorYear |
| Other Expenses Current Year | 28379234 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 60310037 | TotalExpensesPriorYear |
| Total Expenses Current Year | 59625809 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 6589644 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1674579 | RevenuesLessExpensesCY |
| Total Assets BOY | 126551178 | TotalAssetsBOY |
| Total Assets EOY | 132472507 | TotalAssetsEOY |
| Total Liabilities BOY | 23117178 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 21650597 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 103434000 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 110821910 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | St. Anthony Regional Hospital is a catholic healthcare organization sponsored by the Franciscan Sisters of Perpetual Adoration and a regional leader in providing consistently high quality healthcare services responsive to patient and community needs. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 53881995 | Expense |
| Grants | 5000 | Grants |
| Revenue | 58653462 | Revenue |
| Description | St. Anthony Regional Hospital is a 99 bed acute care facility and St. Anthony Nursing Home has 79 beds in Carroll, IA. In the year ended June 30, 2013, St. Anthony Regional Hospital and Nursing Home provided heath care services to approximately 2,556 inpatients, 69,552 outpatients, and 27,820 clinic visits. St. Anthony Regional Hospital provided services for 1,788 acute care inpatients, and provided psychiatric, swing bed, and nursing home services for the remainder of the inpatients. Outpatient services were provided to patients through ancillary departments, emergency room, and clinics. See Schedule O.St. Anthony Hospital provides services of cardiac rehabilitation, dialysis, hospice care, laboratory, observation, chemotherapy, pathology, radiology, respiratory therapy, phyiscial therapy, occupational therapy, speech therapy, diabetes and surgical services. St. Anthony's largest patient service area is physical therapy. In the year ended June 30, 2013, St. Anthony serviced 10,012 in physical therapy, 7,083 in laboratory, and 7,918 in radiology. The activities pursued by St. Anthony Regional Hospital and Nursing Home in the provision of health care services are consistent with its exempt purpose. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2238651 | Expense |
| Description | As part of its mission, St. Anthony Regional Hospital provides medical care to individuals who are unable to pay for services, incurs costs in excess of reimbursement for services to medicaid beneficiaries, and carries out other activities and programs free of charge to support the community in which it operates. Community benefit projects include community health education, health care support services, behavioral health services, community health improvement advocacy, and other traditional charity care. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 56120646 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | 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 | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | 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 | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 102 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 757 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| 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 | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | 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 | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | 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 | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | IA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | John R Munson | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7127945115 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 South Clark St | AddressLine1 |
| City | Carroll | City |
| State | IA | State |
| ZIP Code | 51401 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Gary McMinimee | ||||||||
| Chairman | 0.30 | 0.00 | X | X | 0 | 0 | 0 | |
| Fred Dolezal | ||||||||
| Vice-Chairman | 0.30 | 0.30 | X | X | 0 | 0 | 0 | |
| Sr Helen Elsbernd | ||||||||
| Secretary | 0.30 | 0.30 | X | X | 0 | 0 | 0 | |
| Tom Gronstal | ||||||||
| Treasurer | 0.30 | 0.00 | X | X | 0 | 0 | 0 | |
| Urban Knobbe | ||||||||
| Board Member | 0.30 | 0.30 | X | 0 | 0 | 0 | ||
| Wayne Seaman | ||||||||
| Board Member | 0.30 | 0.30 | X | 0 | 0 | 0 | ||
| Sr Rita Heires | ||||||||
| Board Member | 0.30 | 0.00 | X | 0 | 0 | 0 | ||
| Sr Romana Klaubauf | ||||||||
| Board Member | 0.30 | 0.00 | X | 0 | 0 | 0 | ||
| Art Neu | ||||||||
| Board Member | 0.30 | 0.00 | X | 0 | 0 | 0 | ||
| Sr Theresa Keller | ||||||||
| Board Member | 0.30 | 0.00 | X | 0 | 0 | 0 | ||
| Gary P Reidmann End 012013 | ||||||||
| CEO/President | 20.00 | 0.30 | X | 1066189 | 0 | 46133 | ||
| Edward H Smith Jr | ||||||||
| CEO/President | 40.00 | 0.30 | X | 233761 | 0 | 23435 | ||
| John Munson | ||||||||
| Vice President/CFO | 40.00 | 0.30 | X | 145956 | 0 | 11460 | ||
| Nelson H Lo MD | ||||||||
| Physician | 40.00 | 0.00 | 344763 | 0 | 21686 | X | ||
| Robert J Langenfeld MD | ||||||||
| Physician | 40.00 | 0.00 | 219201 | 0 | 16055 | X | ||
| Tina F Schechinger MD | ||||||||
| Physician | 40.00 | 0.00 | 225226 | 0 | 8595 | X | ||
| Dominick C Ervelli MD | ||||||||
| Physician | 40.00 | 0.00 | 202693 | 0 | 21772 | X | ||
| Brian L Pratt MD | ||||||||
| Physician | 40.00 | 0.00 | 199641 | 0 | 16982 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2637430 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 166118 | TotalOtherCompensation |
| Number Individuals GT100 K | 25 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Dell Marketing LP | |||||
| PO Box 677654 | Dallas | TX | 752676021 | Computer Consulting Services | 690683 |
| Deloitte & Touche LLP | |||||
| PO Box 7247-6446 | Philadelphia | PA | 191706446 | Accounting Services | 240113 |
| Dr Jedd Hagen | |||||
| 2313 Skyline Dr | Carroll | IA | 51401 | Pathology Services | 129000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| Related Organizations | 157993 | RelatedOrganizations |
| All Other Contributions | 574 | AllOtherContributions |
| Total Contributions | 158567 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|---|
| Patient Svc Revenue | 621400 | 33584732 | 33584732 | ||
| Medicare/Medicaid Pmts | 621400 | 24940480 | 24940480 | ||
| Cafeteria Sales | 621400 | 356532 | $356,532 | ||
| Radiation Oncology Svc | 621400 | 128250 | 128250 | ||
| Inc. from Partnership | 900004 | 2023 | 2023 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 59012017 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 923593 | TotalRevenueColumn |
| Exclusion | $923,593 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1226922 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1791119 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -564197 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -564197 | TotalRevenueColumn |
| Exclusion | -$564,197 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 21821833 | Securities |
| Other | 51030 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 19987994 | Securities |
| Other | 114461 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1833839 | Securities |
| Other | -63431 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1770408 | TotalRevenueColumn |
| Exclusion | $1,770,408 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 61300388 | TotalRevenueColumn |
| Related Or Exempt Function Income | 58653462 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 2023 | UnrelatedBusinessRevenue |
| Exclusion | $2,486,336 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5000 | Total |
| Program Services | 5000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 695887 | Total |
| Management And General | 695887 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24933292 | Total |
| Program Services | 23929285 | ProgramServices |
| Management And General | 1004007 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 257957 | Total |
| Program Services | 226113 | ProgramServices |
| Management And General | 31844 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3529127 | Total |
| Program Services | 3334802 | ProgramServices |
| Management And General | 194325 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1825312 | Total |
| Program Services | 1733319 | ProgramServices |
| Management And General | 91993 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43176 | Total |
| Management And General | 43176 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 253814 | Total |
| Management And General | 253814 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3770932 | Total |
| Program Services | 3106425 | ProgramServices |
| Management And General | 664507 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 240448 | Total |
| Program Services | 52688 | ProgramServices |
| Management And General | 187760 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1796273 | Total |
| Program Services | 1605571 | ProgramServices |
| Management And General | 190702 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 296184 | Total |
| Program Services | 296184 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1915363 | Total |
| Program Services | 1915043 | ProgramServices |
| Management And General | 320 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 295655 | Total |
| Program Services | 249759 | ProgramServices |
| Management And General | 45896 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 783628 | Total |
| Program Services | 783628 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6448994 | Total |
| Program Services | 6448994 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 323893 | Total |
| Program Services | 281255 | ProgramServices |
| Management And General | 42638 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Medical Supplies | 10863847 | 10863847 | 0 | 0 |
| Repair and Maintenance | 1346264 | 1288270 | 57994 | 0 |
| Miscellaneous expenses | 763 | 463 | 300 | 0 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59625809 | Total |
| Program Services | 56120646 | ProgramServices |
| Management And General | 3505163 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1129952 | BOY |
| EOY | 585093 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12434526 | BOY |
| EOY | 10543350 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3 | BOY |
| EOY | 108830 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1509025 | BOY |
| EOY | 1467853 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 330280 | BOY |
| EOY | 232605 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 114514199 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 50869700 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65242669 | BOY |
| EOY | 63644499 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37152099 | BOY |
| EOY | 44042782 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1149432 | BOY |
| EOY | 384432 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7603192 | BOY |
| EOY | 11463063 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 126551178 | BOY |
| EOY | 132472507 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5275477 | BOY |
| EOY | 5089358 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17160848 | BOY |
| EOY | 15657317 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42309 | BOY |
| EOY | 30102 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 638544 | BOY |
| EOY | 873820 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23117178 | BOY |
| EOY | 21650597 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 101551358 | BOY |
| EOY | 107088750 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1782642 | BOY |
| EOY | 3633160 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100000 | BOY |
| EOY | 100000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 103434000 | BOY |
| EOY | 110821910 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 126551178 | BOY |
| EOY | 132472507 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1674579 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 4088350 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 1624981 | ReconcilationOtherChanges |
| 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 Separate | X | FinancialStatementSeparate |
| 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) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $8,144 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 8144 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1: | ReturnReference |
| Explanation | St. Anthony Hospital is a member of Iowa Hospital Association. A percentage of the membership dues paid to IHA is related to lobbying activities. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4622373 | BeginningOfYearBalance |
| Contributions | 3018705 | Contributions |
| Investment Earnings Or Losses | 739105 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2500 | GrantsOrScholarships |
| Other Expenditures | 6612 | OtherExpenditures |
| End Of Year Balance | 8371071 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 995357 | BeginningOfYearBalance |
| Contributions | 3662163 | Contributions |
| Investment Earnings Or Losses | -30442 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 3500 | GrantsOrScholarships |
| Other Expenditures | 1205 | OtherExpenditures |
| End Of Year Balance | 4622373 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 680736 | BeginningOfYearBalance |
| Contributions | 190774 | Contributions |
| Investment Earnings Or Losses | 129468 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 3500 | GrantsOrScholarships |
| Other Expenditures | 2121 | OtherExpenditures |
| End Of Year Balance | 995357 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 362632 | BeginningOfYearBalance |
| Contributions | 265297 | Contributions |
| Investment Earnings Or Losses | 55307 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2500 | GrantsOrScholarships |
| End Of Year Balance | 680736 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 207355 | BeginningOfYearBalance |
| Contributions | 196019 | Contributions |
| Investment Earnings Or Losses | -33742 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 7000 | GrantsOrScholarships |
| End Of Year Balance | 362632 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.53000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.47000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 632934 | OtherCostOrOtherBasis |
| Book Value | 632934 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 80205902 | OtherCostOrOtherBasis |
| Depreciation | 29420477 | Depreciation |
| Book Value | 50785425 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 30357914 | OtherCostOrOtherBasis |
| Depreciation | 19716385 | Depreciation |
| Book Value | 10641529 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3317449 | OtherCostOrOtherBasis |
| Depreciation | 1732838 | Depreciation |
| Book Value | 1584611 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 63644499 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Deferred Compensation Investments | 873820 |
| Beneficial interest in Net Assets of the Foundation | 8233160 |
| Investment in Joint Venture | 2162323 |
| Other | 193760 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 11463063 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Deferred Compensation | Description |
| Amount | $873,820 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 873820 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 69091782 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 4088350 | NetUnrealizedGainsInvestments |
| Other Revenues | 3703044 | OtherRevenues |
| Revenue Not Rptd F990 | 7791394 | RevenueNotRptdF990 |
| Revenue Subtotal | 61300388 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 61300388 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 61703872 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 61703872 | ExpensesSubtotal |
| Other Expenses Not Included | -2078063 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | -2078063 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 59625809 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Intended Use of Endowment Funds: | Part V, Line 4: | All restricted endowed funds held at St. Anthony Foundation are used for the benefit of St. Anthony Regional Hospital for pastoral care and scholarships. |
| Description of Uncertain Tax Positions Under FIN 48: | Part X, Line 2: | Accounting for income taxes provides that a tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. The Hospital recorded no liabilities for unrecognized tax benefits as of June 30, 2013 and 2012. The Hospital is engaged in certain activities that result in unrelated business income. |
| Part XI, Line 2d - Other Adjustments: | Rental expenses 1,791,118. Realized gain on sale of assets 63,431. Change in beneficial interest of net assets of Foundation 1,850,518. Income from Partnerships -2,023. | |
| Part XII, Line 4b - Other Adjustments: | Rental expenses -1,791,118. Transfer to St. Anthony Foundation for Op. Cash Requirements -223,514. Realized gain on sale of assets -63,431. |
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 |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| 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 | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 916288 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 916288 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01540 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4128034 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2200612 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1927422 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03230 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5044322 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2200612 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2843710 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04770 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 188654 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 45694 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 142960 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 306150 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5500 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 300650 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00500 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6534970 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3666223 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2868747 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04810 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 229118 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 89059 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 140059 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00230 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7258892 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3806476 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3452416 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05780 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12303214 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6007088 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6296126 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10550 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 8810 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 8810 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 27276 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 24730 | DirectOffsettingRevenue |
| Net Community Building Expense | 2546 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 4368 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4368 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 40454 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 24730 | DirectOffsettingRevenue |
| Net Community Building Expense | 15724 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,092,167 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 17135724 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 21607799 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -4472075 | 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 |
| 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 | St Anthony Regional Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 South Clark St Box 628 | AddressLine1 |
| City | Carroll | City |
| State | IA | State |
| ZIP Code | 51401 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.stanthonyhospital.org | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Anthony Regional Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| 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 |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| Other Needs Addressed | X | OtherNeedsAddressed |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 399.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 5 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (5 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| St Anthony Regional Hospice | ||||
| 311 South Clark St | Carroll | IA | 51401 | Hospice services |
| St Anthony Regional Hospital | ||||
| 311 South Clark St | Carroll | IA | 51401 | Dialysis Services |
| St Anthony Regional Home Health Agency | ||||
| 311 South Clark St | Carroll | IA | 51401 | Home Health Services |
| St Anthony Regional Hospital | ||||
| 311 South Clark St | Carroll | IA | 51401 | Psychiatric Services |
| Wall Lake Medical Cllinic | ||||
| 311 First St | Wall Lake | IA | 51466 | Rural Health Clinic |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 3c: The family or household income must be less than or equal to 200% of the FPG to qualify for free care. For discounted care, the family or household income must be equal to the FPG as follows: 201% - 250% of FPG for a 75% discount, 251% - 300% of FCG for a 50% discount, and 301% - 399% of FPG for a 25% discount. | ||
| Part I, Line 7: The cost to charge ratio was used when calculating the amounts reported in Part I, line 7, with the exception of line 7g, subsidized heath services. Subsidized heath services are reported using departmental cost from the 2013 cost report. | ||
| Part I, Line 7g: St. Anthony Regional Hospital has eight physician clinics that are included in subsidized health services where cost exceeds the reimbursements. Included is a list of services and costs by clinics included in the subsidized health services calculation:OP Mental Health - $638,338Home Health Services - $525,614OP Diabetic Clinic - $449,403Medical Clinics - $4,433,258Public Health Services - $319,700Cardiac Rehabilitation Services - $168,657 | ||
| Part I, L7 Col(f): Bad debt expense of $1,563,718 was subtracted for purposes of calculating the percentage in Schedule H, Part I, Line 7, Column f. | ||
| Part II: The hospital CEO and VP participate in the Carroll Area Development board that is active in workforce development. The hospital emergency room director attended regional meetings on disaster readiness. The CEO is a board member of the Iowa Hospital Association board of directors. There are managers of the hospital that serve on local health advisory boards. | ||
| Part III, Line 2: St. Anthony Regional Hospital reports bad debt in accordance with generally accepted accounting principles (GAAP). Bad debt at cost is calculated with the same cost to charge ratio used for the charity care at cost multiplied by the estimated debt charges.Part III, Line 3: St. Anthony Regional Hospital works with those qualifying for charity care along every step of the process including accepting applications for financial assistance after previous attempts to work with the patient fail. Every effort is made to work with the patient to provide financial assistance when appropriate. While there are people who do not cooperate with the Hospital regarding payment plans, financial assistance or with those trying to help them get on government programs. For individuals not providing necessary information it is impossible to know the reason for not cooperating and therefore know whether they will qualify for charity care. St. Anthony Regional Hospital is unable to reasonably determine whether any amount of bad debt could have been classified as charity care if individuals do not provide the necessary information to evaluate their situation to determine qualification with the charity care policy.Part III, Line 4: The financial statements for St. Anthony Regional Hospital do not include a footnote regarding bad debts: however, the bad debt expense from the financial statement is a percent of revenue that is an estimate of the historical bad debt written off.Part III, Line 8: The amount of Medicare short fall on line 7 should be included in the community benefit because Medicare pays less than the cost for rendering services. The medicare allowable costs are taken from the medicare cost report and determined based on the cost to charge ratios from the Medicare report.Part III, Line 9: The policy states that St. Anthony Regional Hospital offers charity care to all patients who meet the criteria for financial aid and want assistance. Patients who do not have insurance may qualify for St. Anthony Cares based on annual income and family size. Patients with insurance may also qualify for St. Anthony Cares for bills not covered by insurance. Charity information is available upon admission and disclosed in monthly billing statements. An application is completed by the patient and based on the income and family size the amount of charity is determined based on the federal poverty guidelines. Patients receive statements and make payment arrangements with Preferred Medical Deposits (PMD). Accounts at PMD with no activity after 60 days are then turned over to our collection agency Avadyne Health. | ||
| Part V, Section B, Line 3: In 2012, St. Anthony Regional Hospital conducted a CHNA assessment. A total of 24 individuals were interviewed, including internal stakeholders - those affiliated or employed by St. Anthony Regional Hospital and Nursing Home - and external stakeholders from across the area. The interviews were conducted using a structured questionnaire with key stakeholders being asked to discuss community health issues, as well as the social determinants of health. Interviewees were asked about issues related to access to particular health services, prevalence and treatment of chronic health conditions, compliance with care treatment plans, health disparities, and other issues. All interviews were reviewed and comments analyzed to identify the most frequently mentioned community health issues. The interviews were conducted during the months of March through May 2013. | St. Anthony Regional Hospital | |
| Part V, Section B, Line 6i: The CHNA and Implementation Strategy are available at www.stanthonyhospital.org. Both of these documents were approved by the Board of Directors during the fiscal year ended June 30, 2013. | St. Anthony Regional Hospital | |
| Part V, Section B, Line 7: The hospital facility did not address all the significant needs identified in its most recently conducted CHNA. Alcohol Use:The objective to reduce alcohol use among residents is not being addressed because New Opportunities, a non-profit agency in Carroll, Iowa, is addressing the use of alcohol among residents.Unintentional Injury and Motor Vehicle Accident Deaths:The objective to reduce the number of accidental injuries and motor vehicle deaths among area residents is not being addressed because local law enforcement agencies are addressing this issue among area residents. | St. Anthony Regional Hospital | |
| Part V, Section B, Line 20d: St. Anthony uses annual poverty guidelines to determine FAP eligibility. The maximum amount a FAP eligible patient would pay is 75% of gross charges. Individuals that earn 301-399% of the federal poverty guidelines are eligible for a discount of 25%. All individuals that earn less 200% of the federal poverty guidelines pay 0% of gross charges. | St. Anthony Regional Hospital | |
| Part VI, Line 2: In addition to the Community Health Needs Assessment that was conducted in 2012, other area assessments were taken into account. The Hospital and county are involved in other coalitions that periodically assess community needs. Meetings were held with community partners to identify needs from their daily work and with clients, students, educators, health care, volunteer services, case management, behavior medicine, and others in the county. Surveys were developed and placed on the county website and hard copies were placed in the courthouse and public library. Survey data results were reviewed and areas of concern were identified for the county. Needs identified are assigned to committees and assessed over a three year period as action plans are developed and executed. Reports are sent to the state to monitor progress and action. | ||
| Part VI, Line 3: The financial counselor from the organization informs and educates patients about eligibility of federal, state, and local government programs and charity care policies. The charity care policy is made available to patients in the admissions office and provided in the admission packets. If patients have questions they can stop in the business office and discuss them with a financial counselor. | ||
| Part VI, Line 4: The hospital is located in the city of Carroll in West Central Iowa with a county population of 25,000. St. Anthony Hospital also serves portions of 6 surrounding counties within a radius of 50 miles. St. Anthony Hospital operates 5 satellite physician clinics in the service area, in addition to 3 physician clinics in the hospital. | ||
| Part VI, Line 5: St. Anthony Regional Hospital has demonstrated a commitment to promoting health care to further its exempt purpose providing quality health care in the community and surrounding counties for one hundred and seven years. The majority of the hospital's board members are from local business and reside in the community. The hospital's medical staff consists of 30 active staff, 8 associate staff in the community, and 115 courtesy staff from outside the community. St. Anthony Regional Hospital is a regional provider and is committed to providing quality health care to the community. | ||
| IA | Reports Filed With States | Part VI, Line 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | 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 | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Gary P Reidmann End 012013 | ||||||||||||||
| CEO/President | 132025 | 0 | 23888 | 0 | 910276 | 0 | 45133 | 0 | 1000 | 0 | 1112322 | 0 | 907625 | 0 |
| Edward H Smith Jr | ||||||||||||||
| CEO/President | 219260 | 0 | 10779 | 0 | 3722 | 0 | 10025 | 0 | 13410 | 0 | 257196 | 0 | 0 | 0 |
| John Munson | ||||||||||||||
| Vice President/CFO | 137706 | 0 | 7081 | 0 | 1169 | 0 | 0 | 0 | 11460 | 0 | 157416 | 0 | 0 | 0 |
| Nelson H Lo MD | ||||||||||||||
| Physician | 341128 | 0 | 1109 | 0 | 2526 | 0 | 6976 | 0 | 14710 | 0 | 366449 | 0 | 0 | 0 |
| Robert J Langenfeld MD | ||||||||||||||
| Physician | 213285 | 0 | 0 | 0 | 5916 | 0 | 4350 | 0 | 11705 | 0 | 235256 | 0 | 0 | 0 |
| Tina F Schechinger MD | ||||||||||||||
| Physician | 204321 | 0 | 600 | 0 | 20305 | 0 | 0 | 0 | 8595 | 0 | 233821 | 0 | 0 | 0 |
| Dominick C Ervelli MD | ||||||||||||||
| Physician | 199920 | 0 | 1270 | 0 | 1503 | 0 | 4212 | 0 | 17560 | 0 | 224465 | 0 | 0 | 0 |
| Brian L Pratt MD | ||||||||||||||
| Physician | 181525 | 0 | 1444 | 0 | 16672 | 0 | 3810 | 0 | 13172 | 0 | 216623 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 4b | St. Anthony Hospital and Nursing Home has an IRC Section 457F Deferred Compensation Plan. The following participant of the plan received a payment during the year, which was related to plan contributions accumulated over 20 years: Gary P. Reidmann: $907,625 |
| Part I, Line 7 | In their roles as executives employed by St. Anthony Regional Hospital, the executives are eligible for incentive payouts. The incentive award will be a percentage of the base pay compensation for the CEO, CFO, and other executives. The ultimate payout includes a reduction/increase multiplier depending on whether the organization reached specified performance metrics identified by the Board of Directors. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)
| Bond ReferenceBondReferenceCd | Issuer EINIssuerEIN | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing | CUSIP NumberCUSIPNumber |
|---|---|---|---|---|---|---|---|---|
| Carroll County Iowa | ||||||||
| A | 426004323 | 2003-09-29 | 10000000 | Construction of Hospital Addition | 0 | 0 | 0 | |
| Carroll County Iowa | ||||||||
| B | 426004323 | 2006-11-22 | 6672573 | Construction of Hospital Addition | 0 | 0 | 0 | 144813AB8 |
| City of Carroll Iowa | ||||||||
| C | 426004322 | 2006-11-22 | 5402508 | Construction of Hospital Addition | 0 | 0 | 0 | 145181CK7 |
Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)
| Bond ReferenceBondReferenceCd | Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|
| A | 9392683 | 10445730 | 35220 | 10410510 | 2006 | 0 | 0 | 1 | 1 |
| B | 6969080 | 133451 | 6835629 | 2009 | 0 | 0 | 1 | 1 | |
| C | 1770000 | 5637070 | 107254 | 5529816 | 2009 | 0 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 0 |
| C | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Term Of GICTermOfGIC | Regulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Citi Group | |||||||||||
| B | 0 | 0 | 0 | 1 | 0 | 0 | 1 | 1.900000000000 | 1 | 0 | 0 |
| Citi Group | |||||||||||
| C | 0 | 0 | 0 | 1 | 0 | 0 | 1 | 1.900000000000 | 1 | 0 | 0 |
Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)
| Bond ReferenceBondReferenceCd | Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction |
|---|---|
| A | 0 |
| B | 0 |
| C | 0 |
Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Schedule K Supplental Information | The two 2006 issues actually comprise a single issue for tax purposes, but are reported separately herein because the two series were issued by two different issuers (each of which filed a Form 8038) and were accounted for separately. Differences between the issue price (Part 1) and total proceeds (Part II, line 3) are due to investment earnings and (for column C) to a small excess amount (less than $1,000) that was used to pay principal on the bonds. |
| Part IV, column A, lines 2b and 2c: Shortly before this return was due to be filed, it came to St. Anthony's attention that a misinterpretation of documents associated with the Series 2003 bonds led to a failure to prepare a timely rebate analysis with respect to these bonds. That oversight is being rectified, but had not been finalized at the time this return was filed. At this date, St. Anthony does not know whether any rebate payment was due on the 2003 bonds. Part IV, Line 2c: The rebate computation was performed on 11/19/2012 for the 2006 bonds outstanding. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mid Iowa Insurance | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Fred Dolezal - VP | Relationship |
| Amount Of Transaction | 313321 | AmountOfTransaction |
| Description Of Transaction | Insurance | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Mid Iowa Insurance: Fred Dolezal Vice President, Insurance services for St. Anthony Regional Hospital and Nursing Home. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | The members of the St. Anthony Regional Hospital are the Sisters of the religious community known as the Congregation of the Sisters of the Third Order of St. Francis of Perpetual Adoration (FSPA). The members have the power to elect the board of directors, amend the articles of incorporation and bylaws of the organizations, and dissolve the organization. | |
| Form 990, Part VI, Section A, line 7a | The Franciscan Sisters of Perpetual Adoration, as members of the St. Anthony Regional Hospital, elect and approve the board of directors for St. Anthony Regional Hospital. | |
| Form 990, Part VI, Section A, line 7b | All decisions, including dissolution of the organization, made by the board of directors of St. Anthony Regional Hospital are subject to the approval of the Franciscan Sisters of Perpetual Adoration. | |
| Form 990, Part VI, Section B, line 11 | St. Anthony Regional Hospital gathers the necessary information for the completion of the Form 990 within the finance department and with assistance from the human resources and operations. The form was prepared by the St. Anthony Regional Hospital's accounting firm. Drafts of the form were reviewed by the CFO and the Audit committee. After the internal reviews were complete, the final version of the form 990 was given to each member of the board of directors prior to filing the return. | |
| Form 990, Part VI, Section B, line 12c | The board members annually disclose in writing, "any interest which would be inconsistent with the expeditious, proper, and impartial performance of duties." Defining disclosable conflict or duality of interest as any matter in which the corporations are "interested which affects the financial interest or employment of such member, a member of his/her family by blood or marriage, or any business enterprise in which he/she or such family member is employed or has a financial interest." Board members are required to disclose the facts surrounding any possible conflict of interest throughout the year. | |
| Form 990, Part VI, Section B, line 15 | At the direction of the board of directors the CEO gathers compensation information (salary and benefits) from various sources including Iowa Hospital Association and benefit consultants for like size organizations. The Executive Committee then determines the annual compensation for the CEO, other officers, and any key employees for the total board approval. | |
| Form 990, Part VI, Section C, line 19 | St. Anthony Regional Hospital mails its consolidated audited financial statements to financial institutions, governmental institutions, board members, and the Iowa Hospital Association. The Form 990 is available at guidestar.org. St. Anthony Regional Hospital discloses financial statements to bondholders, the IHA, and the Iowa Attorney General's office. St. Anthony Regional Hospital's governing documents, conflict of interest policy, and financial statements are available to the public upon request. | |
| Form 990, Part XI, line 9: | Transfer to St. Anthony Foundation for Op. cash requirements -223,514. Change in beneficial interest of net assets of Foundation 1,850,518. Income from Partnership -2,023. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| St Anthony Foundation | |||||||||||
| 311 South Clark Street PO Box 628 | Carroll | IA | 51401 | 421419695 | Fundraising | IA | 501(c)(3) | Line 11, Type I: 509 | St Anthony Regional Hospital | 1 | |
| Franciscan Sisters of Perpetual Adoration | |||||||||||
| 912 Market Street | La Crosse | WI | 546014782 | 390806386 | Religious Order | WI | 501(c)(3) | Line 1: 170(b)(1)(a) | 0 | N/A | |
| 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 | 0 | 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 | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| St Anthony Foundation | ||
| C | 157993 | FMV |
| St Anthony Foundation | ||
| P | 223514 | FMV |
| St Anthony Foundation | ||
| R | 2000000 | FMV |