SALEM COMMUNITY HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- SALEM COMMUNITY HOSPITAL (EIN 34-1041385)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-04-21
- IRS object ID
- 201441119349300214
- Schema version
- 2012v2.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-04-21T09:13:42-07:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341041385 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SALEM COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SALE | NameControl |
| Phone | 3303327214 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1995 East State Street | AddressLine1 |
| City | Salem | City |
| State | OH | State |
| ZIP Code | 44460 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Michael Giangardella | Name |
| Title | VP Finance/Administration | Title |
| Phone | 3303327214 | Phone |
| Date Signed | 2014-04-21 | DateSigned |
| 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 | Michael Giangardella | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1995 East State Street | AddressLine1 |
| City | Salem | City |
| State | OH | State |
| ZIP Code | 44460 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 102861286 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.salemhosp.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1913 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | Salem Community Hospital (SCH) is a 110-bed, not-for-profit rural facility, which provides a continuum of medical services to the residents of Columbiana and southern Mahoning counties, including inpatient and outpatient medical and surgical care, obstetrics, and gynecology, pediatrics, orthopedics, intensive care and a 15-bed skilled nursing facility. The Hospital also operates a full-time 24-hour Emergency Department, and treats all patients requiring medical care, irrespective of their financial means. The Hospital provides its services free of charge or on a sliding scale to uninsured/underinsured patients, regardless of race, creed, origin, handicap, age or ability to pay.; in support of its mission- "To Serve. To Care. To Heal.", adopted by the Board of Directors in March 2013. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 18 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 16 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1023 | TotalNbrEmployees |
| Total Nbr Volunteers | 195 | TotalNbrVolunteers |
| Total Gross UBI | 1990803 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 107383 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 527923 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 96568019 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 94712559 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 6579676 | InvestmentIncomePriorYear |
| Investment Income Current Year | 6547466 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 649381 | OtherRevenuePriorYear |
| Other Revenue Current Year | 749032 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 103904459 | TotalRevenuePriorYear |
| Total Revenue Current Year | 102536980 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 16655 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 34790 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 46973971 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 49394827 | 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 | 49293617 | OtherExpensePriorYear |
| Other Expenses Current Year | 49398640 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 96284243 | TotalExpensesPriorYear |
| Total Expenses Current Year | 98828257 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 7620216 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3708723 | RevenuesLessExpensesCY |
| Total Assets BOY | 200584570 | TotalAssetsBOY |
| Total Assets EOY | 234566857 | TotalAssetsEOY |
| Total Liabilities BOY | 58055743 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 74532194 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 142528827 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 160034663 | NetAssetsOrFundBalancesEOY |
| Mission Description | "To Serve. To Care. To Heal," encompasses the Hospital's mission of providing high quality care on both an inpatient and outpatient basis; and addresses our patients' health care needs at each life stage, within our available resources. SCH seeks to provide a broad range of diagnostic, inpatient, outpatient and emergency services appropriate for a community-based hospital, while ensuring that sufficient, high-quality primary and specialty physician services are available and accessible to residents of our service area. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 69493260 | Expense |
| Revenue | 93372036 | Revenue |
| Description | The Hospital's mission and purpose is achieved by providing quality care to the sick and injured on both and inpatient and outpatient basis, while addressing our patients' healthcare needs at each life stage, within our available resources. SCH seeks to provide a broad range of diagnostic, inpatient, outpatient and emergency services appropriate for a community hospital, while ensuring that sufficient, high-quality primary and specialty physician services are available and accessible to residents of our service area. During fiscal year 2013, the Hospital provided comprehensive healthcare services including: 4,937 Admissions; 3,568 Surgeries; and 27,490 Emergency Department visits. In support of this commitment, the Hospital operates a full-time, 24-hour Emergency Department, and treats all patients requiring emergency medical care, irrespective of their financial means. The Hospital also accepts all patients covered by Medicare, Medicaid and General Assistance. Subsidized health services provided by the Hospital that are not self-sustaining include obstetric and behavioral health services, and the Hospital's costs for supporting these services is $1,346,059. If these programs were closed or not available to the community, the cost to the government or to another tax-exempt organization would increase. The Hospital also accepts all patients covered by Medicare, Medicaid and General Assistance. For fiscal year 2013, costs incurred by the Hospital for net charity care provided were $1,971,965, with unpaid costs of Medicaid representing $1,126,392 , and unreimbursed costs from other governmental programs representing $3,342,465. These community benefits, arising from patient care provided by the Hospital are documented to help to relieve a governmental financial and programmatic burden as evidenced through the Hospital's charitable purpose. Community investment grants provided by the Hospital totaled $6,000 during FY 2013, and included financial support of a medication assistance program to the elderly or disadvantaged. | Description |
| Total Of Other Program Service Exp | 0 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 0 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 69493260 | 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 | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | 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 | 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 | 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 | 81 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1023 | 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 |
| 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 | 18 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 16 | 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 | 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 | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Michael Giangardella | NamePerson |
| Telephone Number | 3303327214 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1995 East State Street | AddressLine1 |
| City | Salem | City |
| State | OH | State |
| ZIP Code | 44460 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Institutional TrusteeInstitutionalTrustee | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Catherine Hubbs | |||||||||||
| Chair | 1 | 0 | X | 0 | 0 | 0 | |||||
| Derek Hiscox | |||||||||||
| Vice-chair | 1 | 0 | X | 0 | 0 | 0 | |||||
| Matt Bender | |||||||||||
| Treasurer | 1 | 0 | X | 0 | 0 | 0 | |||||
| Dick Wilk | |||||||||||
| secretary | 1 | 0 | X | 0 | 0 | 0 | |||||
| John Haller | |||||||||||
| Director | 1 | 0 | X | 0 | 0 | 0 | |||||
| Greg Bestic | |||||||||||
| Director | 1 | 0 | X | 0 | 0 | 0 | |||||
| Peter Apicella MD | |||||||||||
| Director | 1 | X | 34703 | 0 | 0 | ||||||
| Jon Rettig Sr | |||||||||||
| Director | 1 | 0 | X | 0 | 0 | 0 | |||||
| Dave Mollenkopf | |||||||||||
| Director | 1 | 1 | X | 0 | 0 | 0 | |||||
| Dave Gano | |||||||||||
| Director | 1 | 0 | X | 0 | 0 | 0 | |||||
| Jeffrey Cohen MD | |||||||||||
| Director | 1 | 0 | X | 0 | 0 | 0 | |||||
| John Biastro | |||||||||||
| Director | 1 | 0 | X | 0 | 0 | 0 | |||||
| Todd Olson | |||||||||||
| Director | 1 | 0 | X | 0 | 0 | 0 | |||||
| Jon Vollnogle | |||||||||||
| Director | 1 | X | 2850 | 0 | 0 | ||||||
| Vicki Hall | |||||||||||
| Director | 1 | 0 | X | 0 | 0 | 0 | |||||
| Bart Brine MD | |||||||||||
| Director | 1 | 0 | X | 0 | 0 | 0 | |||||
| John Dawson MD | |||||||||||
| Director | 1 | 1 | 20000 | 0 | 0 | X | |||||
| Steven Ruwoldt | |||||||||||
| President/CEO | 40 | 0 | 185272 | 0 | 11066 | X | |||||
| Mike Giangardella | |||||||||||
| VP Finance/Administration | 40 | 0 | 191079 | 0 | 19427 | X | |||||
| Anita Hackstedde | |||||||||||
| VP Medical Affairs | 40 | 1 | 236751 | 0 | 19855 | X | |||||
| Barbara Hirst | |||||||||||
| VP Nursing/Human Resources | 40 | 0 | 164696 | 0 | 22580 | X | |||||
| Keith Meredith | |||||||||||
| Director Pharmacy | 40 | 0 | 137805 | 0 | 14661 | X | |||||
| Mark LItalien | |||||||||||
| Director Information Services | 40 | 0 | 124219 | 0 | 29919 | X | |||||
| Stephen Ferenchak | |||||||||||
| Pharmacist | 40 | 0 | 113925 | 0 | 29913 | X | |||||
| Doreen Sheck | |||||||||||
| Pharmacist | 40 | 0 | 113065 | 0 | 24275 | X | |||||
| Beverly Proverbs | |||||||||||
| Registered Nurse | 52 | 0 | 112034 | 0 | 0 | X | |||||
| Howard Rohleder | |||||||||||
| President/CEO--retired | 0 | 0 | 230849 | 0 | 5655 | X | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1667248 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 177351 | TotalOtherCompensation |
| Number Individuals GT100 K | 16 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 | Address Line2AddressOfContractor/AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|
| Associates in Anesthesiology Inc | ||||||
| PO Box 2190 | Youngstown | OH | 44504 | Medical Services | 1261055 | |
| Wilmot Sanz | ||||||
| 18310 Montgomery Village Avenue | Gaithersburg | MD | 20879 | Architectural services | 1008781 | Suite 300 |
| Inpatient Medical Services Inc | ||||||
| 822 Kumho Drive | Fairlawn | OH | 44333 | Medical Services | 874974 | Suite 202 |
| Laboratory Corporation of America | ||||||
| PO box 12140 | Burlington | NC | 27216 | Laboratory services | 629905 | |
| Alliance Healthcare Services | ||||||
| PO Box 96485 | Chicago | IL | 60693 | Healthcare Services | 360025 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 12 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 0 | MembershipDues |
| Fundraising Events | 35855 | FundraisingEvents |
| Related Organizations | 0 | RelatedOrganizations |
| Government Grants | 359527 | GovernmentGrants |
| All Other Contributions | 132541 | AllOtherContributions |
| Noncash Contributions | 0 | NoncashContributions |
| Total Contributions | 527923 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Patient Service Revenue | 622000 | 92721756 | 92721756 | 0 | $0 |
| Patient Service Revenue | 621500 | 871920 | 0 | 871920 | $0 |
| Patient Service Revenue | 621610 | 1118883 | 0 | 1118883 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 94712559 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6546266 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $6,546,266 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 411963 | Real |
| Personal | 0 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 294698 | Real |
| Personal | 0 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 117265 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 117265 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $117,265 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 1200 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 1200 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1200 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,200 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 11095 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 35855 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 29608 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -18513 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$18,513 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Dietary Income | 900099 | 548146 | 548146 | 0 | $0 |
| Chart Fees/Medical Records | 900099 | 25302 | 25302 | 0 | $0 |
| Gift Shop Income | 900099 | 15976 | 15976 | 0 | $0 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 60856 | TotalRevenueColumn |
| Related Or Exempt Function Income | 60856 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 650280 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 102536980 | TotalRevenueColumn |
| Related Or Exempt Function Income | 93372036 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1990803 | UnrelatedBusinessRevenue |
| Exclusion | $6,646,218 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34790 | Total |
| Program Services | 34790 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1113808 | Total |
| Management And General | 1113808 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36465154 | Total |
| Program Services | 27249200 | ProgramServices |
| Management And General | 9215954 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2675721 | Total |
| Program Services | 1856406 | ProgramServices |
| Management And General | 819315 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6377969 | Total |
| Program Services | 4338122 | ProgramServices |
| Management And General | 2039847 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2762175 | Total |
| Program Services | 2029743 | ProgramServices |
| Management And General | 732432 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 77707 | Total |
| Management And General | 77707 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 83703 | Total |
| Management And General | 83703 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8273407 | Total |
| Program Services | 5278928 | ProgramServices |
| Management And General | 2994479 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 470982 | Total |
| Management And General | 470982 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17511163 | Total |
| Program Services | 14984966 | ProgramServices |
| Management And General | 2526197 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3001947 | Total |
| Management And General | 3001947 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4317427 | Total |
| Program Services | 2954686 | ProgramServices |
| Management And General | 1362741 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 150710 | Total |
| Program Services | 15525 | ProgramServices |
| Management And General | 135185 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 503925 | Total |
| Management And General | 503925 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8324825 | Total |
| Program Services | 5505466 | ProgramServices |
| Management And General | 2819359 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 458625 | Total |
| Program Services | 421579 | ProgramServices |
| Management And General | 37046 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Bad Debts | 4823849 | 4823849 | 0 | 0 |
| State Franchise Fee | 1400370 | 0 | 1400370 | 0 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 98828257 | Total |
| Program Services | 69493260 | ProgramServices |
| Management And General | 29334997 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3814525 | BOY |
| EOY | 2943548 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7190157 | BOY |
| EOY | 8975895 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1632 | BOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 655430 | BOY |
| EOY | 763142 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3754447 | BOY |
| EOY | 3790521 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 185569344 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 102290835 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66054777 | BOY |
| EOY | 83278509 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 118933147 | BOY |
| EOY | 134649303 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 180455 | BOY |
| EOY | 165939 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 200584570 | BOY |
| EOY | 234566857 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10522085 | BOY |
| EOY | 14445674 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30850000 | BOY |
| EOY | 52000000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 922282 | BOY |
| EOY | 448098 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15761376 | BOY |
| EOY | 7638422 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58055743 | BOY |
| EOY | 74532194 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 142408827 | BOY |
| EOY | 159914663 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120000 | BOY |
| EOY | 120000 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 142528827 | BOY |
| EOY | 160034663 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 200584570 | BOY |
| EOY | 234566857 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 3708723 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 6879294 | ReconciliationUnrealizedInvest |
| Reconcilation Donated Services | 0 | ReconcilationDonatedServices |
| Reconcilation Invest Expenses | 0 | ReconcilationInvestExpenses |
| Reconcilation Prior Adjustment | 0 | ReconcilationPriorAdjustment |
| Reconcilation Other Changes | 6917819 | 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 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) |
|---|---|---|
| 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 D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1908632 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Book Value | 1908632 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 91357327 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 48661137 | Depreciation |
| Book Value | 42696190 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1483812 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 1174792 | Depreciation |
| Book Value | 309020 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 71719344 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 52454906 | Depreciation |
| Book Value | 19264438 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 19100229 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 19100229 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 83278509 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Deferred Liability | $270,000 |
| Pension Liability | $7,368,422 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 7638422 | TotalOfAmounts |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Dinner Party | NameOfEvent1 |
| Gross Receipts Event1 | 46950 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 35855 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 11095 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 0 | CashPrizesEvent1 |
| Non Cash Prizes Event1 | 0 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 0 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 9770 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 1325 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 18513 | OtherDirectExpensesEvent1 |
| Food And Beverage Other Events | 0 | FoodAndBeverageOtherEvents |
| Entertainment Other Events | 0 | EntertainmentOtherEvents |
| Gross Receipts Total | 46950 | GrossReceiptsTotal |
| Charitable Contributions Total | 35855 | CharitableContributionsTotal |
| Gross Revenue Total Events | 11095 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 0 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 0 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 0 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 9770 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 1325 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 18513 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 29608 | DirectExpenseSummaryEvents |
| Net Income Summary | -18513 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent350 | X | Pcent350 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| 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 | 3416177 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1444212 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1971965 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3888578 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2762186 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1126392 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0114 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8961917 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5718452 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3243465 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0328 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 16266672 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9924850 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6341822 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0642 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 186 | NumberOfActivitiesOrPrograms |
| Persons Served | 38233 | PersonsServed |
| Total Community Benefit Expense | 194390 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 18805 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 175585 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00177 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 199 | PersonsServed |
| Total Community Benefit Expense | 1406310 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1406310 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01422 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3649644 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2303585 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1346059 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01362 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 23 | NumberOfActivitiesOrPrograms |
| Persons Served | 4663 | PersonsServed |
| Total Community Benefit Expense | 78524 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 588 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 77936 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00079 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 217 | NumberOfActivitiesOrPrograms |
| Persons Served | 43095 | PersonsServed |
| Total Community Benefit Expense | 5328868 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2322978 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3005890 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03040 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 217 | NumberOfActivitiesOrPrograms |
| Persons Served | 43095 | PersonsServed |
| Total Community Benefit Expense | 21595540 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12247828 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9347712 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09460 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Persons Served | 27 | PersonsServed |
| Total Community Building Expense | 2190 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2190 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00002 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 15 | NumberOfActivitiesOrPrograms |
| Persons Served | 815 | PersonsServed |
| Total Community Building Expense | 8150 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 8150 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00008 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 754 | PersonsServed |
| Total Community Building Expense | 14892 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 14892 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00015 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 450 | PersonsServed |
| Total Community Building Expense | 2952 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2952 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00002 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 10 | NumberOfActivitiesOrPrograms |
| Persons Served | 247 | PersonsServed |
| Total Community Building Expense | 6273 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6273 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00006 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 25 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 9892 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 9892 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.0001 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 3600 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3600 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00004 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 215 | PersonsServed |
| Total Community Building Expense | 15640 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 15640 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00016 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 68 | NumberOfActivitiesOrPrograms |
| Persons Served | 2508 | PersonsServed |
| Total Community Building Expense | 63589 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 63589 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00063 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $2,165,725 | BadDebtExpenseAmount |
| Amount Attributable To | 206021 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 21801983 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 29904510 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -8102527 | 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 | 0 | 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 | Salem Community Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1995 East State Street | AddressLine1 |
| City | Salem | City |
| State | OH | State |
| ZIP Code | 44460 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Other | 15 bed skilled nursing facility | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Salem Community 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 | 13 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| 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 |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 150 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 350 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| 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 | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 0 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Salem Community Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1995 East State Street | AddressLine1 |
| City | Salem | City |
| State | OH | State |
| ZIP Code | 44460 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | 15 bed skilled nursing facility | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchH_P01_S00_L06a | Schedule H, Part I, Line 6a | Salem Community Hospital prepares an Annual Report that is distributed to the community in paper format as well as being posted on the Hospital's website at www.salemhosp.com. The Annual Report includes a summary of the Hospital's statement of expenses and uncompensated care, along with highlighting the Hospital's major community benefit initiatives. This community benefit information is provided in an effort to document its tax exempt purpose and demonstrate the benefits provided for the broader community as determined by community need. |
| SchH_P01_S00_L07 | Schedule H, Part I, Line 7 | Costs are determined by applying the ratio of cost to charges to gross charges and utilizing the format as outlined in the Schedule H worksheets. |
| SchH_P01_S00_L07g | Schedule H, Part I, Line 7g | Costs for subsidized health services include those attributable to providing women's obstetric services and outpatient behavioral health services. There are no health services attributable to a physician clinic |
| SchH_P02_S00_L00 | Schedule H, Part II | During the taxable year, the Hospital participated in 68 different community building activities in an effort to provide programs and activities that respond to demonstrated, unmet community needs and meet community benefit objectives by improving access to health services and/or enhancing population health and knowledge. The Hospital participated in the Salem Area Industrial and Development Council and several area Chambers of Commerce activities; provided community support related to youth asset development through the Coordinated Action for School Health (CASH) Coalition and was a leading collaborative partner in disaster readiness; assisted in environmental improvements related to community medications disposals; offered leadership development and training related to cultural skills and language skills training for those with limited English proficiency; represented the Hospital on diverse community coalitions related to improving community health; advocated for community health improvements on the local and state levels on behalf of improving access to health care; and assisted with workforce development related to participation in community workforce boards, partnerships with area universities to address the health care work force shortage, and providing many school-based programs on health care careers, including offering teen and college student mentoring opportunities. The Hospital continues to serve as a community resource and partner for regional non-profit organizations, by providing collaborative programming with agencies such as the American Cancer Society, American Diabetes Association, American Heart Association, American Red Cross, Columbiana County Community Action Agency, Columbiana County and Salem City Departments of Health, Coordinated Action for School Health, Hospice of the Valley, Kent State University- Salem Campus, Northeast Ohio Workforce Development, Northeast Ohio Medical University, Retried Senior Volunteer Program-Medication Assistance, Salem Area Visiting Nurses Association, and the Salem Community Center. In addition, the Hospital makes financial and in-kind contributions to many of these not-for-profit organizations through event sponsorships, less the cost of benefits received; and meeting space. |
| SchH_P03_S0A_L04 | Schedule H, Part III, Section A, Line 4 | Excerpt from footnote:Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provisions for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exits for part of the bill), the Hospital records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts." The cost of bad debts was determined by applying the Hospital's cost to charge ratio to the charges that were written off to bad debt. The Hospital believes that this cost is a community benefit because patients ,who would likely qualify for assistance under the Hospital's charity Care policy,do not or are unwilling to provide documentation of their eligibility for charity care and are therefore classified as bad debt. The Hospital is very willing to work out payment arrangements and discounted fees;however those patients who do not respond to repeated offers of assistance are categorized as bad debt expense. Had information been made available to make a determination of their eligibility ,the Hospital believes that many of the patients classified as bad debt would qualify for charity care. This judgement is based on the economic conditions of the area and the specific knowledge of the patients involved. |
| SchH_P03_S0B_L08 | Schedule H, Part III, Section B, Line 8 | The costs were obtained from the Hospital's Medicare cost Report. The Hospital incurred costs in excess of $29.9 million to care for and treat Mediciare beneficiaries,while receiving reimbursement of approximately $21.8 million,leaving a shortfall of $8.1 million. This was a direct health care benefit provided by the Hospital to local Medicare beneficiaries who live in the surrounding communities. |
| SchH_P03_S0C_L09b | Schedule H, Part III, Section C, Line 9b | Per the Hospital's charity Care policy,the Hospital will not pursue collection for non-payment of bills against individuals who demonstrate that they have neither sufficient income nor assets to meet their financial obligations. |
| SchH_P05_S0B_L03 | Schedule H, Part V, Section B, Line 3 | To take into account input from persons representing the community served, the CHNA primary data collection process included 2 focus groups that were conducted with a total of 37 adult participants, along with 11 individual interviews conducted with key stakeholders in the community to gather additional insight into the health of a community from diverse community groups and underrepresented populations. In addition, an internet and paper-based Community Needs Survey was conducted with 1,091 completed surveys obtained. |
| SchH_P05_S0B_L04 | Schedule H, Part V, Section B, Line 4 | Along with Salem Community Hospital, East Liverpool City Hospital also provided financial support for the CHNA process. |
| SchH_P05_S0B_L05 | Schedule H, Part V, Section B, Line 5 | : With financial support from East Liverpool City Hospital and Salem Community Hospital, as well as in-kind support provided by the Community Action Agency of Columbiana County, the Community Health Needs Assessment process not only brought forth the CHNA report, but also included investment in a web-based community health data platform developed by the Healthy Communities Institute. The system is hosted on Salem Community Hospital's website and can be accessed through: http://salemhosp.com. The system includes a comprehensive dashboard of approximately 100 community indicators from over 12 sources, covering over 20 topics in the areas of health, determinants of health, and quality of life. |
| SchH_P05_S0B_L07 | Schedule H, Part V, Section B, Line 7 | The Columbiana County Needs Assessment identified a high percentage of poverty among children, families, and the general population, as compared to other U.S. counties; along with a high unemployment rate and low proportion of adults with a college degree compared to other U.S. counties. The top environmental needs identified in the Community Survey portion of the CHNA included not enough money, lack of access to employment/better jobs and safe water/clean air. In addition, focus group participants and stakeholders identified multi-faceted and intertwined demographic and socio-economic issues related to income, the poor economy, drug abuse, lack of education, and unemployment as key environmental drivers of the health status of the community. Each of these needs is important and should be addressed by various county-wide organizations and/or community partners of the Hospital. However, due to their societal magnitude and the Hospital's limited resources and capacity to meaningfully impact the economic foundation of the county, the Hospital has chosen to allocate significant internal resources to the priority health needs which yield the greatest opportunities to affect a positive change, as outlined in the Implementation Plan; and will focus on the priorities of chronic disease; physical activity and nutrition; healthy mothers, babies and children; infectious disease; and access to medical care. The Implementation Plan was presented and approved by the Hospital's Board in June 2013. |
| SchH_P05_S0B_L14 | Schedule H, Part V, Section B, Line 14 | The availability of free or discounted care is provided on billing statements sent to patients. |
| SchH_P05_S0B_L20 | Schedule H, Part V, Section B, Line 20 | The Hospital's uninsured/underinsured polocy provides discounts to patients based on the patient's income( up to 350% of the federal poverty level). The amount of the discount is based on the gross charges ,with the discount level increasing as charges increase. |
| SchH_P06_S00_L02 | Schedule H, Part VI, Line 2 | SCH formally assesses the healthcare needs of the communities that it serves on a minimum of a triennial basis, and does so in collaboration with other community health providers. The most recent comprehensive, county-wide needs assessment was published in May 2013, and included the formation of a collaborative Columbiana County Health Coalition including Salem Community Hospital; East Liverpool City Hospital; the Columbiana County, East Liverpool and Salem City Health Departments; Community Action Agency of Columbiana County; Columbiana County Job and Family Services, the Coordination Action for School Health (CASH) Coalition; Kent State University; and the Columbiana County Mental Health Services and Recovery Board. The CHNA process began in July 2011, when the Columbiana County Health Coalition convened to outline the approach for following the 6-step Community Health Improvement model outlined by the Association for Community Health Improvement. The coalition initially requested assistance from Kent State University to facilitate the process and to direct the primary and secondary data collection efforts. When the process was not completed by September 2012, the coalition decided to invest in a web-based dashboard system developed by Healthy Communities Institute, which allows data to be easily accessed by its users. In addition, Strategy Solutions, Inc. was retained to facilitate the remainder of the process and provide primary data analysis and prioritization support. The geographic area of the needs assessment encompassed Ohio's Columbiana County, most of which is within Salem Community Hospital's Service Area, and prioritized the public, primary and specialty health care needs of community members from birth through end-of-life care. The CHNA action plan and report development were presented to and approved by the SCH Board in May 2013, and distributed to all participating coalition organizations. The SCH Implementation Plan was then approved by the Board in June 2013, and both documents are posted on the Hospital's website at http://www.salemhosp.com/getpage.php?name=Community_Dashboard&sub=About+Us. The Hospital has carried forward its implementation strategies by including them in its annual Organizational Goals In addition, the Hospital is a collaborative partner in other types of needs assessments, such as the school health asset study, through the Search Institute, conducted on an annual basis with area school districts. During this past fiscal year, Salem Community Hospital also participated in a tri-county health needs assessment and development of an implementation plan for Mahoning, Columbiana and Trumbull Counties, the hospital partners of which included Humility of Mary Health Partners, Akron Children's Hospital and Salem Community Hospital, along with the Mahoning County, Columbiana County, East Liverpool City and Salem City Health Departments. Because the scope of the tri-county needs assessment was so broad, Salem Community Hospital used the preliminary findings from this needs assessment to launch its county-wide needs assessment process, targeted toward the specific needs of Columbiana County residents |
| SchH_P06_S00_L03 | Schedule H, Part VI, Line 3 | The hospital includes on all billing statements information regarding the availability of free care programs and the required income guidelines. This information is also posted on the Hospital's website,along with the charity care policies. |
| SchH_P06_S00_L04 | Schedule H, Part VI, Line 4 | The hospital's rural service area is officially designated as part of the Appalachian region and includes Columbiana County, excluding Yellow Creek and East Liverpool Townships; and the five lower townships of Mahoning County. Portions of Columbiana County are also designated as Medically Underserved (MUP), and as a dental and mental health care Health Professional Shortage Areas (HPSA). Columbiana County residents are older than their state and national counterparts, and the Service Area is characterized by a declining social and economic base, which impacts the area's health status problems and health service utilization. The age distribution of Columbiana County is more elderly, with 16.7% of Columbiana County residents 65 years and over compared to 14.3% of Ohio residents and 13.3% of U.S residents... In addition, according to the 2010 Census, Columbiana County has a significant older adult population (36.5%), aged 40-65 years, nearing retirement age. Columbiana County has a large percentage of adults who are unable to afford to see a doctor compared to other US counties, and the county is not meeting the Healthy People 2020 goals for health insurance coverage for children and adults. Poverty is also a factor with almost one-half of the county's population at or below 200% of the federal poverty level. Area residents experience higher death rates for chronic diseases, such as heart disease, cerebrovascular disease, diabetes and chronic obstructive pulmonary disease. The overall cancer mortality rate in Columbiana County is significantly higher than surrounding counties and the state of Ohio, especially related to colorectal, kidney, leukemia, liver and lung cancers, and lymphoma; and county rates of death attributable to chronic diseases like diabetes mellitus are higher than the state's average. The county has a high percentage of obesity and sedentary behavior compared to other Ohio counties, and only small percentages of residents engage in health habits related to physical activity and nutrition. The area also has a low educational attainment rate, with 15.5% of adults over age 25 having no high school diploma, and less than 12% of adults having a Bachelor's or Master's degree. |
| SchH_P06_S00_L05 | Schedule H, Part VI, Line 5 | The Hospital seeks to provide a broad range of diagnostic, inpatient, outpatient and emergency services appropriate for a community hospital, while ensuring that sufficient, high-quality primary and specialty physician services are available and accessible to residents of our service area. Medical staff privileges are extended to qualified physicians in the Hospital's Service Area, based on documented community need for the medical service and the Hospital's resources to provide the service. During fiscal year 2013, the Hospital provided comprehensive healthcare services including: 4,937 Admissions; 3,568 Surgeries; and 27,490 Emergency Department visits. In support of this commitment, the Hospital operates a full-time, 24-hour Emergency Department, and treats all patients requiring emergency medical care, irrespective of their financial means. The Hospital also accepts all patients covered by Medicare, Medicaid and General Assistance. Subsidized health services provided by the Hospital that are not self-sustaining include obstetric and behavioral health services, and the Hospital's costs for supporting these services is $1,346.059. If these programs were closed or not available to the community, the cost to the government or to another tax-exempt organization would increase. The Hospital also accepts all patients covered by Medicare, Medicaid and General Assistance. For fiscal year 2013, costs incurred by the Hospital for net charity care provided were $1,971,965, with unpaid costs of Medicaid representing $1,126,392 MG, and unreimbursed costs from other governmental programs representing 3,342,465. These community benefits, arising from patient care provided by the Hospital are documented to help to relieve a governmental financial and programmatic burden as evidenced through the Hospital's charitable purpose. In order to provide services efficiently and cost-effectively, the Hospital also utilizes an active volunteer base, with 180 community members donating over 16,730 hours of volunteer service annually. In addition, the Hospital's Board of Directors is comprised of 15 community volunteers from the Hospital's Service Area, who perform fiduciary responsibilities through monthly committee and Board activities. The Hospital actively seeks opportunities to further its tax exempt purpose through community health improvement and community benefit operations that provide treatment and/or promote health in response to identified community needs. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Retired Senior Volunteer Program | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 966 1/2 North Market Street | AddressLine1 |
| Address Line2 | PO Box 355 | AddressLine2 |
| City | Lisbon | City |
| State | OH | State |
| ZIP Code | 44432 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 341902451 | EINOfRecipient |
| IRC Section | 501(c)(3) | IRCSection |
| Amount Of Cash Grant | 6000 | AmountOfCashGrant |
| Purpose Of Grant | Medication Assistance Program | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchI_P01_S00_L02 | Identifier |
| Return Reference | Schedule I, Part I, Line 2 | ReturnReference |
| Explanation | The allocation and utilization of grant funds are monitored through the required tracking and reporting of specific outcomes by each grantee,along with site visits to the respective grantee organization. Grantee organizations are also required to submit either itemized invoices for subcontracted services and/or a detailed outcome report listing the number and types of services provided and the number of clients served. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| 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 | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Steven Ruwoldt | ||||||||||||
| President/CEO | 185272 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 11066 | 0 | 196338 | 0 |
| Anita Hackstedde | ||||||||||||
| VP Medical Affairs | 236751 | 0 | 0 | 0 | 0 | 0 | 9226 | 0 | 10629 | 0 | 256606 | 0 |
| Mike Giangardella | ||||||||||||
| VP Finance/Administration | 191079 | 0 | 0 | 0 | 0 | 0 | 8207 | 0 | 11220 | 0 | 210506 | 0 |
| Barbara Hirst | ||||||||||||
| VP Nursing/Human Resources | 164696 | 0 | 0 | 0 | 0 | 0 | 16674 | 0 | 5906 | 0 | 187276 | 0 |
| Keith Meredith | ||||||||||||
| Director Pharmacy | 137805 | 0 | 0 | 0 | 0 | 0 | 8755 | 0 | 5906 | 0 | 152466 | 0 |
| Mark LItalien | ||||||||||||
| Director Information Services | 124219 | 0 | 0 | 0 | 0 | 0 | 10718 | 0 | 19201 | 0 | 154138 | 0 |
| Howard Rohleder | ||||||||||||
| President/CEO--retired | 230849 | 0 | 0 | 0 | 0 | 0 | -251 | 0 | 5906 | 0 | 236504 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchJ_P01_S00_L03 | Schedule J, Part I, Line 3 | The President's compensation is determined by the Board of Directors.,based upon the recommendation of the Board's Executive Committee. The Committee evaluates market data through statewide salary surveys as well as targeted regional survey data. Their decision is documented in their minutes. This process was last completed during the fiscal year ending June 30,2012. |
| SchJ_P01_S00_L04 | Schedule J, Part I, Line 4 | A non-qualified compensation plan exists for a former CEO. There were no employer contributions to the plan during the fiscal year. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | City Of Salem Ohio | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 346002560 | IssuerEIN |
| Date Issued | 2013-04-04 | DateIssued |
| Issue Price | 52000000 | IssuePrice |
| Description Of Purpose | Hospital Facility Construction | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 1 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 29600292 | AmountRetired |
| Amount Bond Defeased | 0 | AmountBondDefeased |
| Total Proceeds | 52000000 | TotalProceeds |
| Amount In Reserve Fund | 0 | AmountInReserveFund |
| Capitalized Interest | 112550 | CapitalizedInterest |
| Refunding Escrow | 0 | RefundingEscrow |
| Issuance Costs From Proceeds | 168913 | IssuanceCostsFromProceeds |
| Credit Enhancement | 0 | CreditEnhancement |
| Capital Expenditures | 16460628 | CapitalExpenditures |
| Other Spent Proceeds | 3727 | OtherSpentProceeds |
| Amount Unspent | 5661344 | AmountUnspent |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 1 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 1 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.0112 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.0112 | TotalPrivateBusinessUse |
| Bond Iss Meet Prvt Security Pay Test | 1 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 1 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 1 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 1 | WrittenProcToMonitorReqs |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | 1 | ProcToUndertkCorrectiveAction |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P06_S0B_L11b | Form 990, Part VI, Section B, Line 11b | The final 990 is available for review by the governing body ,prior to review. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | On an annual basis,Directors and key employees disclose potential busienss or professional relationships they may have with the organization and/or other Directors/key employees. In situations when a Director has a conflict ,they may participate in the discussion ,but leave the room prior to final discussion and vote. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | The President's compensation is determined by the Board of directors, based upon the recommendation of the Board's Executive Committee. The Committee evaluates market data through statewide salary surveys ,as well as targeted regional survey data. Their decision is documented in their minutes. The process was last completed during the fiscal year ended June 30,2012. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | As a private not-for-profit organization,Salem Community Hospital does not mahke its governing documents or financial statements generally available to the public,although the Federal Form 990 is available for review upon request. |
| F990_P09_S00_L11g | Form 990, Part IX, Line 11g | Professional Fees and Purchased Services |
| F990_P11_S00_L09 | Form 990, Part XI, Line 9 | Change in defined benefit plan net gains of $8,538,029 and fund balance transfer to related organization of $1,620,210 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCH Professional Corporation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1995 East State Street | AddressLine1 |
| City | Salem | City |
| State | OH | State |
| ZIP Code | 44460 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341764515 | EIN |
| Primary Activities | Physician Offices | PrimaryActivities |
| Legal Domicile State | OH | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | 11 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Salem Medical Arts & Development Corporation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2020 East State Street | AddressLine1 |
| City | Salem | City |
| State | OH | State |
| ZIP Code | 44460 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341049534 | EIN |
| Primary Activity | Office Rent | PrimaryActivity |
| Legal Domicile State | OH | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Percentage Ownership | 1 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | 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 | 1 | 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 |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| SCH Professional Corporation | ||
| n | 93829 | % of time spent |
| SCH Professional Corporation | ||
| b | 1541956 | actual expenditures |
| SCH Professional Corporation | ||
| i | 100635 | Actual expenditures |
| Salem Medical Arts & Development Corporation | ||
| k | 10400 | Actual expenditures |