OLD JMH INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- OLD JMH INC (EIN 06-0646696)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-13
- IRS object ID
- 201232269349301593
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-13T09:00:15-07:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 060646696 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHNSON MEMORIAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | JOHN | NameControl |
| Phone | 8606844251 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 Chestnut Hill Road | AddressLine1 |
| City | Stafford Springs | City |
| State | CT | State |
| ZIP Code | 060760860 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | John Grish | Name |
| Title | Chief Financial Officer | Title |
| Phone | 8606848150 | Phone |
| Date Signed | 2012-08-13 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | David Morgan | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 Pleasantview Drive | AddressLine1 |
| City | Somers | City |
| State | CT | State |
| ZIP Code | 06071 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 61508343 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.jmmc.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1912 | YearFormation |
| State Legal Domicile | CT | StateLegalDomicile |
| Activity Or Mission Description | Johnson Memorial Hospital provides needed medical care to the community regardless of any individuals ability to pay. Services include inpatient routine, inpatient ancilliary, and outpatient care in support of the hospitals healthcare mission. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 724 | TotalNbrEmployees |
| Total Nbr Volunteers | 122 | TotalNbrVolunteers |
| Total Gross UBI | -19959 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 252845 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 26249 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 61336091 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 59092708 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 134029 | InvestmentIncomePriorYear |
| Investment Income Current Year | 123908 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 34824592 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2265478 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 96547557 | TotalRevenuePriorYear |
| Total Revenue Current Year | 61508343 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 34409728 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 32505138 | 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 | 34763840 | OtherExpensePriorYear |
| Other Expenses Current Year | 29359136 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 69173568 | TotalExpensesPriorYear |
| Total Expenses Current Year | 61864274 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 27373989 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -355931 | RevenuesLessExpensesCY |
| Total Assets BOY | 46957303 | TotalAssetsBOY |
| Total Assets EOY | 41290011 | TotalAssetsEOY |
| Total Liabilities BOY | 38223343 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 32673891 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8733960 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8616120 | NetAssetsOrFundBalancesEOY |
| Mission Description | Johnson Memorial Hospital provides needed medical care to the community regardless of any individuals ability to pay. Services include inpatient routine, inpatient ancilliary, and outpatient care in support of the hospitals healthcare mission. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 55880089 | Expense |
| Grants | 14192 | Grants |
| Revenue | 59112667 | Revenue |
| Description | Inpatient and Outpatient Care: Expenses related to services performed for patients of Johnson Memorial Hospital contribute importantly to it's expempt purpose because the expenses are incurred in the diagnosis, cure, mitigation, treatment and prevention of disease and for medical purposes affecting the structure or function of the human body. (80,067 Outpatient visits and 15,614 Inpatient days) | 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 | 55880089 | 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 | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | 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 | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 116 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 724 | 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 |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | 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 | 1 | 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 | Thomas Blazejowski | NamePerson |
| Telephone Number | 8606848133 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 Chestnut Hill Road | AddressLine1 |
| City | Stafford Springs | City |
| State | CT | State |
| ZIP Code | 060760860 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Gary J Roman | ||||||||
| Chairman | 2 | X | 0 | 0 | 0 | |||
| James A Baum | ||||||||
| Director | 2 | X | 0 | 0 | 0 | |||
| Evelyne A Parizek | ||||||||
| Secretary | 2 | X | 0 | 0 | 0 | |||
| Richard P Dobson SR | ||||||||
| Director | 2 | X | 0 | 0 | 0 | |||
| John Larabee | ||||||||
| Director | 2 | X | 0 | 0 | 0 | |||
| Patrick Mahon | ||||||||
| Vice Chairman | 2 | X | 0 | 0 | 0 | |||
| James Makuch | ||||||||
| Treasurer | 2 | X | 0 | 0 | 0 | |||
| Joan C Smith | ||||||||
| Drector | 2 | X | 0 | 0 | 0 | |||
| Peter J Betts | ||||||||
| President/CEO | 50 | 0 | 0 | 471897 | X | |||
| David Morgan | ||||||||
| Interim President/CEO | 50 | 338553 | 0 | 23364 | X | |||
| John Grish | ||||||||
| Chief Financial Officer | 50 | 294915 | 0 | 21971 | X | |||
| Dr Michael S Woods | ||||||||
| Vice President Medical Affairs | 50 | 276724 | 0 | 21390 | X | |||
| Michelle Urban | ||||||||
| Vice President, Patient Care Services | 50 | 145997 | 0 | 17216 | X | |||
| Dianne Malsbury | ||||||||
| RN | 40 | 116768 | 0 | 16279 | X | |||
| James Clyburn | ||||||||
| Director of Perioperative Care | 40 | 114316 | 0 | 16200 | X | |||
| Andrew McFarlin | ||||||||
| Director Information Technology Services | 40 | 113580 | 0 | 16177 | X | |||
| Brian Nyberg | ||||||||
| Director of Physical Therapy and Rehab Services | 40 | 113547 | 0 | 16176 | X | |||
| Maria Ayson | ||||||||
| RN | 40 | 109344 | 0 | 16042 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1623744 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 636712 | TotalOtherCompensation |
| Number Individuals GT100 K | 28 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | Address Line2AddressOfContractor/AddressUS/AddressLine2 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|---|
| Somers Anesthesiology Associates inc | ||||||
| C/O IPMS | 99 East River Drive 5th Floor | East Hartford | CT | 06108 | Professional Services | 421491 |
| CRG Partners Group LLC | ||||||
| 2 Atlantic Avenue | Boston | MA | 02110 | Financial Consulting | 384824 | |
| Marcum LLP | ||||||
| 555 Long Wharf Drive | 12th Floor | New Haven | CT | 06511 | Audit Services | 222115 |
| Murphy Security Service LLC | ||||||
| PO Box 356 | New Britain | CT | 06050 | Security | 167814 | |
| AMF Property Management Corporation | ||||||
| 855 Sullivan Avenue | South Windsor | CT | 06074 | Real Estate Rentals | 142790 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 0 | MembershipDues |
| Fundraising Events | 0 | FundraisingEvents |
| Related Organizations | 0 | RelatedOrganizations |
| Government Grants | 14192 | GovernmentGrants |
| All Other Contributions | 12057 | AllOtherContributions |
| Noncash Contributions | 0 | NoncashContributions |
| Total Contributions | 26249 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Inpatient and Outpatient Revenues | Description |
| Business Code | 622000 | BusinessCode |
| Total Revenue Column | 59092708 | TotalRevenueColumn |
| Related Or Exempt Function Income | 59112667 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | -19959 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 59092708 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 123908 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $123,908 | 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 |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrbtns Rprtd Fundraising Events | 0 | CntrbtnsRprtdFundraisingEvents |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Equity Investment in Joint Venture | 900099 | -12760 | 0 | 0 | -$12,760 |
| Prior Period Adjustment | 900099 | 1094678 | 0 | 0 | $1,094,678 |
| Disportionate Share Payments | 900099 | 619650 | 619650 | 0 | $0 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 563910 | TotalRevenueColumn |
| Related Or Exempt Function Income | 563910 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2265478 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 61508343 | TotalRevenueColumn |
| Related Or Exempt Function Income | 60296227 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | -19959 | UnrelatedBusinessRevenue |
| Exclusion | $1,205,826 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1140130 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 1140130 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25152915 | Total |
| Program Services | 23276488 | ProgramServices |
| Management And General | 1876427 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 431137 | Total |
| Program Services | 380022 | ProgramServices |
| Management And General | 51115 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3808308 | Total |
| Program Services | 3509138 | ProgramServices |
| Management And General | 299170 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1972648 | Total |
| Program Services | 1795843 | ProgramServices |
| Management And General | 176805 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1856097 | Total |
| Program Services | 1384200 | ProgramServices |
| Management And General | 471897 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 338736 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 338736 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97397 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 97397 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Fundraising | 0 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4865877 | Total |
| Program Services | 4865877 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1060532 | Total |
| Program Services | 1060532 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4201851 | Total |
| Program Services | 4201851 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1554584 | Total |
| Program Services | 1554584 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3243262 | Total |
| Program Services | 3243262 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1390635 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 1390635 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Patient Supplies | 6946973 | 6946973 | 0 | 0 |
| Bad Debt | 2141072 | 2141072 | 0 | 0 |
| Misc other expenses | 1662120 | 1520247 | 141873 | 0 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61864274 | Total |
| Program Services | 55880089 | ProgramServices |
| Management And General | 5984185 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4142245 | BOY |
| EOY | 884889 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8177399 | BOY |
| EOY | 8443038 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1154583 | BOY |
| EOY | 1216494 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1147109 | BOY |
| EOY | 901400 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 58139738 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 37256964 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23070812 | BOY |
| EOY | 20882774 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4124507 | BOY |
| EOY | 4009963 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2868975 | BOY |
| EOY | 2856650 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2271673 | BOY |
| EOY | 2094803 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46957303 | BOY |
| EOY | 41290011 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21585647 | BOY |
| EOY | 17096845 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14132699 | BOY |
| EOY | 13072582 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2504997 | BOY |
| EOY | 2504464 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38223343 | BOY |
| EOY | 32673891 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4607130 | BOY |
| EOY | 4285194 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 321617 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4126830 | BOY |
| EOY | 4009309 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8733960 | BOY |
| EOY | 8616120 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46957303 | BOY |
| EOY | 41290011 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -355931 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 238091 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| 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
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 841760 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | 0 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 0 | AdministrativeExpenses |
| End Of Year Balance | 841760 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 841760 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | 0 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 0 | AdministrativeExpenses |
| End Of Year Balance | 841760 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 841760 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | 0 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 0 | AdministrativeExpenses |
| End Of Year Balance | 841760 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 1 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 406997 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Book Value | 406997 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 23615088 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 11992695 | Depreciation |
| Book Value | 11622393 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1276173 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 1009263 | Depreciation |
| Book Value | 266910 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 32312419 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 24109978 | Depreciation |
| Book Value | 8202441 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 529061 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 145028 | Depreciation |
| Book Value | 384033 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 20882774 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Investment in Joint Venture | Description |
| Book Value | 2856650 | BookValue |
| Method Of Valuation | C | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 2856650 | TotalOfBookValueProgramRelated |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Property under Capital Leases | 410496 |
| Deferred Financing, other | 1057581 |
| Due from Affiliates | 626726 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2094803 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Self-Insurance Liability | $1,269,265 |
| Due to Third Parties | $542,256 |
| Other Long Term Liabilities | $307,910 |
| Pension Obligation | $385,033 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2504464 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchD_P05_S00_L04 | Identifier |
| Return Reference | Schedule D, Part V, Line 4 | ReturnReference |
| Explanation | Principal is permanently restricted by donors and income is available for operations. The income related to this principal is recorded on Part VIII line 3 | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 491 | PersonsServed |
| Total Community Benefit Expense | 191306 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 191306 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.003 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 10773 | PersonsServed |
| Total Community Benefit Expense | 8011006 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3988567 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4022439 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.065 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 11264 | PersonsServed |
| Total Community Benefit Expense | 8202312 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3988567 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4213745 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.068 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 12 | NumberOfActivitiesOrPrograms |
| Persons Served | 3335 | PersonsServed |
| Total Community Benefit Expense | 145385 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 145385 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.002 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 115 | PersonsServed |
| Total Community Benefit Expense | 69577 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 170 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 69407 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.001 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 46 | PersonsServed |
| Total Community Benefit Expense | 9949 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9949 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0001 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 19 | NumberOfActivitiesOrPrograms |
| Persons Served | 3496 | PersonsServed |
| Total Community Benefit Expense | 224911 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 170 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 224741 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0031 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 19 | NumberOfActivitiesOrPrograms |
| Persons Served | 14760 | PersonsServed |
| Total Community Benefit Expense | 8427223 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3988737 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4438486 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0711 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 275 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 138 | DirectOffsettingRevenue |
| Net Community Building Expense | 137 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 132 | PersonsServed |
| Total Community Building Expense | 101 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 101 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 274 | PersonsServed |
| Total Community Building Expense | 2487 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 2487 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00001 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 349 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 349 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 406 | PersonsServed |
| Total Community Building Expense | 3212 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 138 | DirectOffsettingRevenue |
| Net Community Building Expense | 3074 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00001 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $889,187 | BadDebtExpenseAmount |
| Amount Attributable To | 62245 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 16754590 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 19817679 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3063089 | 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 | Johnson Memorial Hospital Inc | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 Chestnut Hill Road | AddressLine1 |
| City | Stafford Springs CT | City |
| State | CT | State |
| ZIP Code | 06076 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Johnson Memorial Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 10890 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 43560 | 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 |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| 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 |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| 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 | 5 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (5 entries)
| Business Name Line2Name/BusinessNameLine2 | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|---|
| Johnson Memorial Hospital | |||||
| DBA Johnson Surgery Center | 148 Hazard Avenue | Enfield | CT | 06083 | Outpatient Surgery Center and Diagnostic Imaging Center with Lab draw stations and Cardio Pumonary |
| Johnson Memorial Hospital | |||||
| 151 Hazard Avenue | Enfield | CT | 06083 | Physical Therapy Services | |
| Johnson Memorial Hospital | |||||
| 7 Elm Street | Enfield | CT | 06083 | Cardiac Rehab Services | |
| Johsnon Memorial Hospital | |||||
| DBA Tolland Medical Specialists | 384L Merrow Road | Tolland | CT | 06084 | Physician Session Space with Lab and Xray services |
| Johnson Memorial Hospital | |||||
| 15 Palomba Drive | Enfield | CT | 06086 | Lab Draw Station | |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchH_P01_S00_L07 | Schedule H, Part I, Line 7 | Ratio of Cost to Charges was utilized. Also actual accumualted costs with overhead allocations based on recent Medicare Cost studies. |
| SchH_P02_S00_L00 | Schedule H, Part II | Johnson Memorial Hospital helps promote the health of the communities it serves through community building activities by addressing the socioeconomic indicators of health including local economic development, workforce development, youth education, and collaborative partnerships to address public health. Specifically in FY11 JMH participated in activities including volunteering at local schools during American Education Week to encourage literacy, presenting at local schools and to the unemployed about careers in health care, participating in local community coalitions aimed at promoting heart health and excercise and nutrition, and supporting local nonprofits in their effort to promote local business. |
| SchH_P03_S0A_L04 | Schedule H, Part III, Section A, Line 4 | There is no footnote in the Audited Financial Statements pertaining to Bad Debts. Gross charges written to bad debt were reduced to cost by applying applicable (updated quarterly) ratio of Cost to Charges. The Director of Patient Accounts reviewed detailed reports and estimated that 7% of self pay may have been Charity Care. |
| SchH_P03_S0B_L08 | Schedule H, Part III, Section B, Line 8 | Line 6 was computed from the 2011 Medicare Cost Study (D) worksheets. The shortfall from Medicare contributes importantly to the welfare and and benefit of our community by providing high quality healthcare at affordable prices. |
| SchH_P03_S0C_L09b | Schedule H, Part III, Section C, Line 9b | Patients who can demonstrate that payment of their outstanding hospital bill would be a hardship for them may apply for financial assistance. |
| SchH_P05_S0B_L19 | Schedule H, Part V, Section B, Line 19 | Patients apply for financial assistance in accordance with Financial Assistance Policy |
| SchH_P06_S00_L02 | Schedule H, Part VI, Line 2 | JMH is expected to finish it's first community health needs assesment (CHNA) in Spring 2013. Once the organization completes its community health needs assessment, programs to address identified needs and target populations will be created. The assessment will also allow Johnson Memorial Hospital to formally evaluate its community benefits program. |
| SchH_P06_S00_L03 | Schedule H, Part VI, Line 3 | The Johnson Memorial Hospital has a position dedicated to informing and educating patients for assistance. This position is the "Entitlement Coordinator". The position functions as a resource to both the patient and hospital to evaluate, faciltate, and track Medicaid applications for the self pay patients that present. If a patient is not seen during their stay the Coordinator contacts them to see if they qualify for Medicaid or any of our assistance programs. |
| SchH_P06_S00_L04 | Schedule H, Part VI, Line 4 | The Johnson Memorial Hospital (JMH) is an acute-care hospital which primarily serves the communities in North Central Connecticut. The towns in JMH's service are are part of either Tolland or Hartford County, which are included in the Hartford-West Hartford-East Hartford, CT Metropolitan Statistical Area. The service area has a population of about 150,000 and is suburban to the city of Hartford. The average household income is in the $80,000 range. Approx. 11% of residents under 65 for all income levels are uninsured. JMH provided Charity Care in the amount of $465,816 in Fy2011. Eastern Connecticut Health Network, Saint Francis Hospital and Medical Center also provide services in JMH's service area. Baystate Medical Center, located in Massachusetts, also provides services to this area. |
| SchH_P06_S00_L07 | Schedule H, Part VI, Line 7 | CT |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Peter J Betts | |||||||||||||
| 471897 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 471897 | 0 | 0 | |
| David Morgan | |||||||||||||
| 338553 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 23364 | 0 | 361917 | 0 | 0 | 0 |
| John Grish | |||||||||||||
| 294915 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 21971 | 0 | 316886 | 0 | 0 | 0 |
| Dr Michael S Woods | |||||||||||||
| 276724 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 21390 | 0 | 298114 | 0 | 0 | 0 |
| Michelle Urban | |||||||||||||
| 145997 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 17216 | 0 | 163213 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchJ_P01_S00_L04 | Identifier |
| Return Reference | Schedule J, Part I, Line 4 | ReturnReference |
| Explanation | Peter Betts received a severence package in the amount of $188,998 which is included in the $471,894 on Part ll line 1e of Schedule J. These amounts were paid by Johnson Memorial Hospital to Peter J. Betts, Inc. The severence period was 3 months and David Morgan, previously COO, succeeded Peter Betts as Interim President/CEO on April 22, 2011. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Patrick Mahon | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Vice Chairman of Board | Relationship |
| Amount Of Transaction | 103893 | AmountOfTransaction |
| Description Of Transaction | Insurance coverage | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P06_S0A_L04 | Form 990, Part VI, Section A, Line 4 | The Parent Corporation changed it's name effective Oct.4, 2010 (formerly The Johnson Memorial Corporation). As part of this change the new "Johnson Memorial Medical Center" and the Johnson Memorial Hospital Inc.'s Bylaws were Ammended and Restated on January 17, 2011. |
| F990_P06_S0A_L06 | Form 990, Part VI, Section A, Line 6 | Article 3of the Johnson Memorial Medical Center Bylaws stipulates that there will be not less than 30 nor more than 60 members |
| F990_P06_S0A_L07a | Form 990, Part VI, Section A, Line 7a | Members are elected by the Board as recommended by the Governance and Nominationg Committee. |
| F990_P06_S0B_L11b | Form 990, Part VI, Section B, Line 11b | Board policy provides that Members of the Finance Committee are provided the opportunity to review and comment to Executive leadership before the 990 is filed. All members of the Board have access to any copy of the Form 990 and the Chief Financial Officer provides a summary of the 990 at the Board meeting following the filing of Form 990. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | An annual disclosure statement is required. Executives, Managers, and Board members are required on an ongoing basis to disclose interests that may give rise to conflict of interests. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | A Board Committee reviews compensation annually for the Executive team and recommends compensation for Board approval. Comparability data is reviewed and may include industry surveys, documented compensation of similiar positions in similiar organizations, and expert compensation schedules. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | The Johnson Memorial Medical Center maintains these documents in Administration and are available for viewing upon request during normal business hours. This is inlcudes the Johnson Memorial Hospital. |
| F990_P11_S00_L05 | Form 990, Part XI, Line 5 | Changes in Temp. Restricted Assets (for Capital) -321617, Unrealized Gains or Losses 80376, Fund Balance Trasfers Misc 3150 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Business Name Line2NameOfDisregardedEntity/BusinessNameLine2 |
|---|---|---|---|---|---|---|---|---|---|---|
| Johnson Memorial Medical Center | ||||||||||
| 201 Chestnut Hill Road | Stafford Springs | CT | 06076 | 222541974 | Parent Corporation | CT | 501 (c) (3) | 11 | N/A | |
| Johnson Evergreen Corporation | ||||||||||
| 205 Chestnut Hill Road | Stafford Springs | CT | 06076 | 223012385 | Nursing Home | CT | 501 (c) (3) | 3 | N/A | dba Evergreen Health Care Center |
| Johnson Development Fund | ||||||||||
| 201 Chestnut Hill Road | Stafford Springs | CT | 06076 | 222541977 | Fund Raising | CT | 501 (c) (3) | 11 | N/A | |
| Home and Community Health Services | ||||||||||
| 101 Phoenix Avenue | Enfield | CT | 06083 | 060646620 | Visiting Nurse Association | CT | 501 (c) (3) | 9 | N/A | |
| Johnson Health Care Inc | ||||||||||
| 201 Chestnut Hill Road | Stafford Springs | CT | 06076 | 222541981 | Occupational Medicine | CT | 501 (c) (3) | 9 | N/A | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wellcare Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 Chestnut Hill Road | AddressLine1 |
| City | Stafford Springs | City |
| State | CT | State |
| ZIP Code | 06076 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222541983 | EIN |
| Primary Activity | Inactive | PrimaryActivity |
| Legal Domicile State | CT | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Percentage Ownership | 0 | PercentageOwnership |
| 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 | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| 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 | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Business Name Line2NameOfOtherOrganization/BusinessNameLine2 | Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|---|
| Johnson Evergreen Corporation | |||
| dba Evergreen Health Care Center | j | 180000 | reasonable cost |
| Johnson Evergreen Corporation | |||
| dba Evergreen Health Care Center | p | 693475 | Reasonable allocation |
| Johnson Memorial Medical Center | |||
| j | 494992 | Reaonable cost | |
| Johnson Health Care Inc | |||
| p | 53088 | Resonable allocation | |
| Home and Community Health Services | |||
| p | 384600 | Reasonable allocation | |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Not Applicable | Explanation |