CENTRAL PENINSULA GENERAL HOSPITAL INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: CENTRAL PENINSULA GENERAL HOSPITAL INC (EIN 92-0077523)
Tax period: 2010-07-01 to 2011-06-30
Filed: 2012-03-01
IRS object ID: 201240679349300544
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 C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R
Reasonable Cause Explanation

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-03-01T19:14:08-07:00	Timestamp
Tax Period End Date	2011-06-30	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2010-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	920077523	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CENTRAL PENINSULA GENERAL HOSPITAL INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	CENT	NameControl
Phone	9077144404	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	250 Hospital Place	AddressLine1
City	Soldotna	City
State	AK	State
ZIP Code	99669	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Loren Weimer	Name
Title	Board President	Title
Phone	9077144404	Phone
Date Signed	2012-03-01	DateSigned

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

Field	Value	IRS element (for citing)
Business Name Line1	Central Peninsula Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Richard Davis	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	250 Hospital Place	AddressLine1
City	Soldotna	City
State	AK	State
ZIP Code	99669	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	163036521	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.cpgh.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1994	YearFormation
State Legal Domicile	AK	StateLegalDomicile
Activity Or Mission Description	We are a community initiated and community nurtured organization dedicated to promoting wellness and providing high quality health care that ensures the confidence and loyalty of our patients. We strive to improve individual and community health and achieve national standards of excellence.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	826	TotalNbrEmployees
Total Nbr Volunteers	234	TotalNbrVolunteers
Total Gross UBI	34703	TotalGrossUBI
Net Unrelated Business Txbl Income	40110	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	1086302	ContributionsGrantsPriorYear
Contributions Grants Current Year	1164424	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	139479810	ProgramServiceRevenuePriorYear
Program Service Revenue CY	160821053	ProgramServiceRevenueCY
Investment Income Prior Year	349551	InvestmentIncomePriorYear
Investment Income Current Year	280501	InvestmentIncomeCurrentYear
Other Revenue Prior Year	2458737	OtherRevenuePriorYear
Other Revenue Current Year	671090	OtherRevenueCurrentYear
Total Revenue Prior Year	143374400	TotalRevenuePriorYear
Total Revenue Current Year	162937068	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	122672	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	139192	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	52650261	SalariesEtcPriorYear
Salaries Etc Current Year	59648477	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	109110	TotalFundrsngExpCurrentYear
Other Expense Prior Year	87918395	OtherExpensePriorYear
Other Expenses Current Year	97675498	OtherExpensesCurrentYear
Total Expenses Prior Year	140691328	TotalExpensesPriorYear
Total Expenses Current Year	157463167	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	2683072	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	5473901	RevenuesLessExpensesCY
Total Assets BOY	121468958	TotalAssetsBOY
Total Assets EOY	121920884	TotalAssetsEOY
Total Liabilities BOY	51977585	TotalLiabilitiesBOY
Total Liabilities EOY	46955610	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	69491373	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	74965274	NetAssetsOrFundBalancesEOY
Mission Description	We are a community initiated and community nurtured organization dedicated to promoting wellness and providing high quality health care that ensures the confidence and loyalty of our patients. We strive to improve individual and community health and achieve national standards of excellence.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	138842498	Expense
Revenue	140718083	Revenue
Description	Our 49 bed hospital provided patient and ancillary services for 2,253 inpatients and 76,474 outpatients during the 2010 tax year. The hospital provides emergency medical services regardless of ability to pay. Emergency medical services were provided to 16134 individuals, while 1,471 were admitted to the hospital. The surgery department performed over 3,400 surgical cases. The imaging department performed 35,981 procedures. Over 41,000 physical therapy procedures were performed. Over $6 million in gross charges were written off for patients that received charity care.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	9763261	Expense
Revenue	10067520	Revenue
Description	Skilled nursing and longterm care services were provided by our 60 bed skilled nursing facility, Heritage Place. Heritage Place provides healing and compassionate residential care in a home like setting. Total admissions for the 2010 tax year were 62 while total resident days of care were 19,536. An average of 54 residents per day were provided longterm care and nursing. Ancillary services for residents included 7,813 physical therapy treatments.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	6170179	Expense
Revenue	8802233	Revenue
Description	Family and specialty physician clinics were added to the array of healthcare services provided by the Hospital during tax year 2009. A community healthcare need existed for general and specialty physicians that provide medical services to patients who are financially indigent. During the tax year 2010, the hospital added one family practice physician and one surgeon. A total of 24,378 patients were provided care at the various medical clinics during the year.	Description

Field	Value	IRS element (for citing)
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	154775938	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	1	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	1	ReportOtherAssets
Report Other Liabilities	0	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	1	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	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	1	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	1	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
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	128	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	826	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
Form8899 Filed	0	Form8899Filed
Form1098 C Filed	0	Form1098CFiled
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	11	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	1	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
Own Website	X	OwnWebsite
Other Website	X	OtherWebsite

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	Central Peninsula Hospital	BusinessNameLine1
Business Name Line2	Finance Department	BusinessNameLine2

Field	Value	IRS element (for citing)
Telephone Number	9077144525	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	250 Hospital Place	AddressLine1
City	Soldotna	City
State	AK	State
ZIP Code	99669	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
John Bramante
Board Member	4	X	4050	0	0
Thomas Boedeker
Board President	17	X	15100	0	0
Henry Krull
Board Member	4	X	0	0	0
Michael Navarre
Board Member	6.00	X	0	0	0
John Hoyt
Board Member	9.00	X	5500	0	0
Silverio Mattero
Board Member	4	X	3350	0	0
Russell Peterson
Board Member	7.00	X	0	0	0
Richard Ross
Board Member	8.00	X	4900	0	0
Judith Salo
Board Member	7.00	X	6200	0	0
Alyson Stogsdill
Secretary/Treasurer	7.00	X	6100	0	0
Trena Richardson
Board Member	8.5	X	5350	0	0
John Torgerson
Board Member	1.85	X	4700	0	0
Loren Wiemer
Vice President/Board President	15.0	X	6700	0	0
Ryan K Smith
CEO	40		466558	0	38781	X
Jason D Paret
CFO	40		199041	0	36564	X
Andrea D Posey
CNO	40		176140	0	36191	X
Johnny L Dodd
VP of Human Resources	40		106694	0	11707	X
Matthew Dammeyer
Assistant Administrator	40		185646	0	36275	X
Peter Brennan
Philanthropy Officer	40		93829	0	31195	X
Gregg Motonaga
Anesthesia PhD	40.00		594435	0	37247		X
Charles C Mickelson
Emergency PhD	33		489552	0	32619		X
David S Innes
Orthopedic Surgeon	40		789489	0	14130		X
Angus Warren
Emergency PhD	35		448479	0	14252		X
Cynthia Kahn
Pain Management Physician	40		463025	0	4636		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	4074838	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	293597	TotalOtherCompensation
Number Individuals GT100 K	63	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
McDermott Will & Emery LLP
PO Box 6043	Chicago	IL	606806043	Attorney Services	276087
Molloy Schmidt LLC
110 South Willow St Suite 101	Kenai	AK	99611	Attorney Services	428330
Sound Physicians
1123 Pacific Avenue	Tacoma	WA	98402	Physician Services	380761
Staff Care Inc
PO Box 281923	Atlanta	GA	303841923	Medical Services	151296
Juniper Advisory LLC
2727 Allen Parkway Suite 1350	Houston	TX	77019	Managment Consulting Services	173544

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	8	NumberOfContractorsGT100K
Federated Campaigns	0	FederatedCampaigns
Membership Dues	0	MembershipDues
Fundraising Events	0	FundraisingEvents
Related Organizations	211947	RelatedOrganizations
Government Grants	932477	GovernmentGrants
All Other Contributions	20000	AllOtherContributions
Noncash Contributions	792	NoncashContributions
Total Contributions	1164424	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount
Hospital Service Revenue	622000	140718083	140718083	$0
Nursing Home Revenue	623000	10067520	10067520	$0
Physician Clinic Revenue	621110	8802233	8802233	$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	1233217	TotalRevenueColumn
Related Or Exempt Function Income	1233217	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	160821053	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	277766	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$277,766	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	51	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$51	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	76733	Real
Personal	0	Personal

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	42030	Real
Personal	0	Personal

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	34703	Real
Personal	0	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	34703	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	34703	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	0	Securities
Other	2684	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	2684	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	2684	TotalRevenueColumn
Related Or Exempt Function Income	2684	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Cntrbtns Rprtd Fundraising Events	0	CntrbtnsRprtdFundraisingEvents
Gross Sales Of Inventory	209370	GrossSalesOfInventory
Cost Of Goods Sold	57423	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	151947	TotalRevenueColumn
Related Or Exempt Function Income	151947	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
Property tax revenue	900099	127125	127125	0	$0
USAC telephone service revenue	900099	357315	357315	0	$0

Miscellaneous Revenue MiscellaneousRevenue

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 Other Revenue	484440	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	162937068	TotalRevenueColumn
Related Or Exempt Function Income	161460124	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	34703	UnrelatedBusinessRevenue
Exclusion	$277,817	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	139192	Total
Program Services	139192	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	5401937	Total
Program Services	3563022	ProgramServices
Management And General	1729805	ManagementAndGeneral
Fundraising	109110	Fundraising

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	38081788	Total
Program Services	38081788	ProgramServices

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	1285966	Total
Program Services	1285966	ProgramServices

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	11996737	Total
Program Services	11996737	ProgramServices

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	2882049	Total
Program Services	2882049	ProgramServices

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	783347	Total
Management And General	783347	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	54128	Total
Management And General	54128	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	10839	Total
Management And General	10839	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	2456470	Total
Program Services	2456470	ProgramServices

Advertising Advertising

Field	Value	IRS element (for citing)
Total	212806	Total
Program Services	212806	ProgramServices

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	12618240	Total
Program Services	12618240	ProgramServices

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	2466060	Total
Program Services	2466060	ProgramServices

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2076827	Total
Program Services	2076827	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	369895	Total
Program Services	369895	ProgramServices

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	340703	Total
Program Services	340703	ProgramServices

Interest Interest

Field	Value	IRS element (for citing)
Total	1696960	Total
Program Services	1696960	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	8036307	Total
Program Services	8036307	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	879612	Total
Program Services	879612	ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
Medicare Patient Deductions	25560536	25560536
Medicaid Patient Deductions	13916915	13916915
Charity Care Patient Deductions	6114450	6114450
Commercial, Government, other Patient Deductions	9147431	9147431
Bad Debt Expense	6331500	6331500

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	4602472	Total
Program Services	4602472	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	157463167	Total
Program Services	154775938	ProgramServices
Management And General	2578119	ManagementAndGeneral
Fundraising	109110	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	23245962	BOY
EOY	21281704	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	114102	BOY
EOY	200722	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	14831114	BOY
EOY	15114899	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	2699469	BOY
EOY	3133692	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	486090	BOY
EOY	715429	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	112805991	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	44970418	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	68357506	BOY
EOY	67835573	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	501471	BOY
EOY	500000	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	11233244	BOY
EOY	13138865	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	121468958	BOY
EOY	121920884	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	11982197	BOY
EOY	8708436	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	12642	BOY
EOY	12136	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	39982746	BOY
EOY	38235038	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
EOY	0	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	51977585	BOY
EOY	46955610	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	68991373	BOY
EOY	74465274	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	500000	BOY
EOY	500000	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	69491373	BOY
EOY	74965274	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	121468958	BOY
EOY	121920884	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	5473901	ReconcilationRevenueExpenses
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	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	1	DirectContactLegislators
Direct Contact Legislators	$963	DirectContactLegislatorsAmount
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$9,876	OtherActivitiesAmount
Total Lobbying Expenditures IIB	10839	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	SchC_P2B_S00_L01	Identifier
Return Reference	Schedule C, Part II-B, Line 1	ReturnReference
Explanation	The Hospital engages in very little lobbying on an ongoing basis. However, educational discussions with lawmakers and general support of healthcare legistlation do occur on occasion. Lobbying expenses for tax year 2010 consisted of one trip to the state capital to meet with legislators ($963) and the % of dues paid to the American Hospital Association and the Alaska State Hospital and Nursing Home Association which were reportedly used for lobbying expenses ($9,876).	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Preservation For Public Use	X	PreservationForPublicUse
Protection Of Natural Habitat	X	ProtectionOfNaturalHabitat
Total Number Of Easements	1	TotalNumberOfEasements
Total Acreage	40	TotalAcreage
Nmbr Hist Struct Easements	0	NmbrHistStructEasements
Nmbr Hist Struct Easements After	0	NmbrHistStructEasementsAfter
Nmbr Easements Modified	0	NmbrEasementsModified
Nmbr States In Which Easements Held	1	NmbrStatesInWhichEasementsHeld
Written Policy Monitoring	0	WrittenPolicyMonitoring
Staff Hours Spent On Enforcement	0	StaffHoursSpentOnEnforcement
Expenses Incurred For Enforcement	0	ExpensesIncurredForEnforcement
Sect170h Requirements Satisfied	0	Sect170hRequirementsSatisfied

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	1786117	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Book Value	1786117	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	70413745	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	29783738	Depreciation
Book Value	40630007	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	657495	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	177378	Depreciation
Book Value	480117	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	38008556	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	14510109	Depreciation
Book Value	23498447	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	1940078	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	499193	Depreciation
Book Value	1440885	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	67835573	TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescription	Book ValueBookValue
Plant Replacement Funds	10097241
Long Term Investments	3034960
Proceeds from 2004 Bond	6664

Field	Value	IRS element (for citing)
Total Book Value Other Assets	13138865	TotalBookValueOtherAssets
Total Revenue	162937068	TotalRevenue
Total Expenses	157463167	TotalExpenses
Excess Or Deficit For Year	5473901	ExcessOrDeficitForYear
Net Unrealized GL On Investments	0	NetUnrealizedGLOnInvestments
Donated Services And Facilities	0	DonatedServicesAndFacilities
Investment Expenses	0	InvestmentExpenses
Prior Period Adjustments	0	PriorPeriodAdjustments
Other	$85,480	OtherAmount
Total Adjustments	85480	TotalAdjustments
Excess Or Deficit Per FS	5559381	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	102084334	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	0	NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities	0	DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants	0	RecoveriesOfPriorYearGrants
Other Revenues	218097	OtherRevenues
Revenue Not Rptd F990	218097	RevenueNotRptdF990
Revenue Subtotal	101866237	RevenueSubtotal
Investment Expenses Not Included	0	InvestmentExpensesNotIncluded
Other Revenues Not Included	61070831	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	61070831	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	162937068	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	96524953	TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities	0	DonatedServicesUseOfFacilities
Prior Year Adjustments	0	PriorYearAdjustments
Losses Reported	0	LossesReported
Other Expenses Included	132617	OtherExpensesIncluded
Expenses Not Rptd F990	132617	ExpensesNotRptdF990
Expenses Subtotal	96392336	ExpensesSubtotal
Investment Expenses Not Included2	0	InvestmentExpensesNotIncluded2
Other Expenses Not Included	61070831	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	61070831	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	157463167	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchD_P02_S00_L09	Schedule D, Part II, Line 9	In 2008 the Hospital purchased a building which resides on 40 acres of land subject to a 'perpetual covenant' for the benefit of all Alaska residents, restricting the use of the land to agricultural purposes as defined in Alaska Statute 38.05.321. The building is used by the Hospital's chemical dependency department. There is no value placed on the easement itself and therefore it does not appear on the hospital financial statements or footnotes to those statements. However, the cost of the land and the building is recorded on the Hospital's balance sheet at their net book value.
SchD_P11_S00_L08	Schedule D, Part XI, Line 8	The Hospital's audited financial statements are consolidated with Central Peninsula Health Foundation, a related organization. This adjustment is the net income for the tax year 2010 of the Foundation. It must be added to the Change in Net Assets in order to balance to the attached audited financials. The Foundation is a separate legal entity however and files its own 990.
SchD_P12_S00_L02d	Schedule D, Part XII, Line 2d	Revenues included on line 1, and on the audited financial statements but not on line 12 of 990 Part VIII are $118,644 in revenue of Central Peninsula Health Foundation (a related organization which files its own 990), $42,030 in rental expenses, and $57,423 in Cost of inventory sold.
SchD_P12_S00_L04b	Schedule D, Part XII, Line 4b	Amounts reported on the line 1, and the Audited Financial Statements are reported 'net' of certain allowances and deductions from revenue. 990 Part VIII, line 12 revenue is reported 'gross' of allowances and deductions of $61,070,831. Deductions include writeoffs for third party payors such as Medicare and Medicaid, Bad debt expenses, and Charity care writeoffs.
SchD_P13_S00_L02d	Schedule D, Part XIII, Line 2d	Amounts reported on line 1 which are not included in Part IX, line 25 include $33,164 in expenses of Central Peninsula Health Foundation (a related organization which files its own 990), $42,030 in rent expenses reported in Part VIII, and $57,423 in Cost of Inventory reported in Part VIII.
SchD_P13_S00_L04b	Schedule D, Part XIII, Line 4b	Amounts not reported on line 1, which are reported in Part IX line 25 include certain allowances and deductions from revenue for third party payors, charity care write-offs, and bad debt write-offs.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
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)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	7705	PersonsServed
Total Community Benefit Expense	3473979	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	3473979	NetCommunityBenefitExpense
Percent Of Total Expense	0.0361	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	20392	PersonsServed
Total Community Benefit Expense	18463737	TotalCommunityBenefitExpense
Direct Offsetting Revenue	17113562	DirectOffsettingRevenue
Net Community Benefit Expense	1350175	NetCommunityBenefitExpense
Percent Of Total Expense	0.014	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	263	PersonsServed
Total Community Benefit Expense	44913	TotalCommunityBenefitExpense
Direct Offsetting Revenue	22698	DirectOffsettingRevenue
Net Community Benefit Expense	22215	NetCommunityBenefitExpense
Percent Of Total Expense	0.0002	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	3	NumberOfActivitiesOrPrograms
Persons Served	28360	PersonsServed
Total Community Benefit Expense	21982629	TotalCommunityBenefitExpense
Direct Offsetting Revenue	17136260	DirectOffsettingRevenue
Net Community Benefit Expense	4846369	NetCommunityBenefitExpense
Percent Of Total Expense	0.0503	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	403	NumberOfActivitiesOrPrograms
Persons Served	19019	PersonsServed
Total Community Benefit Expense	518559	TotalCommunityBenefitExpense
Direct Offsetting Revenue	100496	DirectOffsettingRevenue
Net Community Benefit Expense	418063	NetCommunityBenefitExpense
Percent Of Total Expense	0.0043	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	117	NumberOfActivitiesOrPrograms
Persons Served	643	PersonsServed
Total Community Benefit Expense	60222	TotalCommunityBenefitExpense
Direct Offsetting Revenue	25810	DirectOffsettingRevenue
Net Community Benefit Expense	34412	NetCommunityBenefitExpense
Percent Of Total Expense	0.0004	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	9	NumberOfActivitiesOrPrograms
Persons Served	13998	PersonsServed
Total Community Benefit Expense	2461874	TotalCommunityBenefitExpense
Direct Offsetting Revenue	770693	DirectOffsettingRevenue
Net Community Benefit Expense	1691180	NetCommunityBenefitExpense
Percent Of Total Expense	0.0176	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	549	NumberOfActivitiesOrPrograms
Persons Served	2539	PersonsServed
Total Community Benefit Expense	159192	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	159192	NetCommunityBenefitExpense
Percent Of Total Expense	0.0017	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1078	NumberOfActivitiesOrPrograms
Persons Served	36199	PersonsServed
Total Community Benefit Expense	3199847	TotalCommunityBenefitExpense
Direct Offsetting Revenue	896999	DirectOffsettingRevenue
Net Community Benefit Expense	2302847	NetCommunityBenefitExpense
Percent Of Total Expense	0.0240	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1081	NumberOfActivitiesOrPrograms
Persons Served	64559	PersonsServed
Total Community Benefit Expense	25182476	TotalCommunityBenefitExpense
Direct Offsetting Revenue	18033259	DirectOffsettingRevenue
Net Community Benefit Expense	7149216	NetCommunityBenefitExpense
Percent Of Total Expense	0.0743	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	20	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	5124	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	5124	NetCommunityBuildingExpense
Percent Of Total Expense	0.0001	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	20	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	5124	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	5124	NetCommunityBuildingExpense
Percent Of Total Expense	0.0001	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$3,645,785	BadDebtExpenseAmount
Amount Attributable To	2661423	AmountAttributableTo
Amount Reimbursed By Medicare	23304868	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	24184106	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-879238	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	Central Peninsula Hospital	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	250 Hospital Place	AddressLine1
City	Soldotna	City
State	AK	State
ZIP Code	99669	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	Central Peninsula 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	09	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	0	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Other Method	X	OtherMethod
Adopt Implement Strategy	X	AdoptImplementStrategy
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
Other Needs Addressed	X	OtherNeedsAddressed
All Needs Addressed	0	AllNeedsAddressed
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	400	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
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	1	ActionsOnNonpayment
Permit Report To Credit Agency	X	PermitReportToCreditAgency
Collection Activities	1	CollectionActivities
Report To Credit Agency	X	ReportToCreditAgency
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Other Actions Taken	X	OtherActionsTaken
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	15	NumberOfOtherFacilities

Other Facilities OtherFacilities (17 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType	Business Name Line2Name/BusinessNameLine2
Heritage Place
232 Rockwell Ave	Soldotna	AK	99669	Skilled nursing facility, long term care
Serenity House
47480 Kristina Way	Soldotna	AK	99669	Chemical dependency treatment center
Central Peninsula Pain Management
289 N Fireweed Unit B	Soldotna	AK	99669	Pain Management clinic.
Central Peninsula Neurology
198 West Corral	Soldotna	AK	99669	Neurology clinic
Central Peninsula Family Practice Kenai
506 Lake Street	Kenai	AK	99611	Family practice clinic
Kenai Physical Medicine
130 Willow Street Unit 1	Kenai	AK	99611	Physical therapy clinic
Soldotna Physical Medicine
35551 Kenai Spur Hwy	Soldotna	AK	99669	Physical Therapy clinic
Kenai Health Center
630 Barnacle Way	Kenai	AK	99611	Diagnostic Imaging, lab, and DV services
Central Peninsula Family Practice Kobuk
431 S Kobuk Suite B	Soldotna	AK	99669	Family practice clinic
Central Peninsula Surgical Services
245 N Binkley Street Suite 101	Soldotna	AK	99669	Surgical clinic
Central Peninsula Pediatrics
289 N Fireweed Unit C	Soldotna	AK	99669	Pediatric clinic
Central Peninsula Family Practice Fireweed
289 N Fireweed Unit D	Soldotna	AK	99669	Family practice clinic
Serenity House Intake Office
245 N Binkley St Suite 203	Soldotna	AK	99669	Chemical dependency intake, behavioral health
Peninsula Medical Center
265 N Binkley St	Soldotna	AK	99669	Owned medical office building
Central Peninsula Medical Center
245 N Binkley St	Soldotna	AK	99669	Owned Medical office building
Central Peninsula Hospital
158 W Corral	Soldotna	AK	99669	Vacant building for remodel	Residential building
Central Peninsula Hospital
166 W Corral	Soldotna	AK	99669	Vacant building for remodel	Residential Building

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchH_P01_S00_L07	Schedule H, Part I, Line 7	In activities where costs were reasonably able to be compiled, we used actual costs. For activities such as charity, and cost to provide patient care, we used the Cost to Charge ratio as calculated by actual Medicare cost report figures.
SchH_P01_S00_L072f	Schedule H, Part I, Line 7, Column f	Total bad debt (at gross charges) reported was $6,331,500. However using a cost to charge ratio of 57.58% we reduced bad debt to $3,645,785 to report the amount of 'cost' to the organization for unpaid accounts. Of this balance, approximately 72% is estimated to be attributable to patients who may be eligible to receive free or discounted care under the organizations charity care policy.
SchH_P02_S00_L00	Schedule H, Part II	Community building activities consisted of staff involvement in Local Emergency Planning Committee meetings, communications with the Borough medical reserve corps, Mass casualty blood availability meetings, and Emergency disaster planning. Each of these events help to build the medical infrastructure of our community and properly prepare for an emergency.
SchH_P03_S0A_L04	Schedule H, Part III, Section A, Line 4	Footnote Text: Bad debt provisions are made for the amount of revenue that will not be collected from patients to whom services were billed but not paid. The Hospital has determined these patients are neither medically nor financially indigent and do not qualify for the Hospital's charity care program. Bad debt provisions are determined by management's assessment with consideration of business and economic conditions, changes and trends in healthcare coverage, and other collection indicators. The adequacy of this provision is periodically reviewed and further modified based upon the accounts receivable payor composition and aging, and historical write-off experience by payor category. The amount reported on Line 1 is based on total gross charges written off to bad debt $6,331,500 x cost to charge ratio of 57.5% to arrive at Cost of services written off to bad debt. The amount reported on Line 2 is based on an estimated 72% of bad debts which may be attributable to patients that qualify for a discount or free care under our financial assistance policy. Because Bad Debts are primarily related to uninsured and underinsured patients to which services are provided despite the ability to pay, we believe that bad debts are also considered a community benefit.
SchH_P03_S0B_L08	Schedule H, Part III, Section B, Line 8	The cost to charge ratio has been calculated based on current charges and costs reported on our 2011 Draft Medicare Cost Report. The ratio is slightly lower than that reported due to the removal of community benefit expenses from the total 'costs' (for the purposes of the 990 Schedule H). It is the position of management that virtually all of the shortfall of medicare costs vs reimbursement are considered community benefit. The reason for this stance is that the Hospital is required to write off contractual allowances for medicare patients regardless of the shortfall created to provide services. The hospital may only collect the portion which is patient co-pay or deductible and may not engage in collection efforts for the remainder.
SchH_P03_S0C_L09b	Schedule H, Part III, Section C, Line 9b	The hospital's collection policy PFS-546 addresses the various classes of private pay patients and defines the individuals which may request financial assistance based on either financial or medical indigence. The collection policy refers the collector first to the Charity care policy for instruction on determining eligiblity. As noted in Part I, the charity care policy is based on FPG which is the basis for a sliding scale between 200% and 400% of those guidelines. Applicants on the upper end of the scale (400%) are eligible for partial write-off, while those on the lower end (200%) are eligible for free care.
SchH_P05_S0B_L05	Schedule H, Part V, Section B, Line 5	In addition to the above methods of disbursement, the Health Needs Assessment was also provided via email to Administrators, Hospital board members, and supervisory staff of Central Peninsula Hospital.
SchH_P05_S0B_L06	Schedule H, Part V, Section B, Line 6	Hospital Adminitrators and key personnel have not only prioritized the key findings of the health needs assessment, but are already working on meeting those needs. These management decisions have not been formally adopted by the board, however, programs are already in place which meet more than half of the findings. The remainder have long term solutions which must be developed.
SchH_P05_S0B_L07	Schedule H, Part V, Section B, Line 7	The health findings which require long term planning are as follows: 1. Smoking rates among Central Kenai Peninsula residents remains elevated. 2. Cancer risks on the Central Kenai Peninsula are elevated. 3. Barriers to oral health care exist due to cost for a large number of residents. These items require additional efforts to devise a strategy and implement solutions. Management is beginning to address item 2 by recruiting an Oncologist or Oncology group to provide services on the Kenai Peninsula from a Cancer Center which would be built on the hospital campus.
SchH_P05_S0B_L13	Schedule H, Part V, Section B, Line 13	The Hospital employs 2 full time Financial Counselors that meet personally with patients to review bills, set payment arrangements, explain the financial assistance policy, and assist patients with the application process for receiving free or discounted care.
SchH_P05_S0B_L17	Schedule H, Part V, Section B, Line 17	Our Financial Counselors attempt to contact all patients with suspected financial need to communicate the various options for payment arrangements or charity assistance prior to sending an account to collections.
SchH_P05_S0B_L19	Schedule H, Part V, Section B, Line 19	The Hospital offers all self pay patients a prompt pay discount of 25% on hospital charges. This discount is greater than commercial payer discounts. Additionally, those patients which are uninsured, underinsured, or medically indigent may qualify for either free or discounted care.
SchH_P06_S00_L02	Schedule H, Part VI, Line 2	In addition to the Health Needs Assessment report, the Hospital also determines health needs of the community through a variety of ways. A Patient Advisory committee comprised of area residents and hospital representavies assists in determining the adequacy of facilities and services to meet the health needs of the community. The Hospital periodically employs consultants to determine the physician and specialty physician needs of the community to direct physician recruiting and strategic planning.
SchH_P06_S00_L03	Schedule H, Part VI, Line 3	The Hospital attempts to provide a Financial Assistance Program Brochure to every patient during discharge. The brochure is also available on our website under Patient Financial Services. Additionally, the hospital has two full time Financial counselors who personally contact patients and explain the financial assistance policy, assist with the completion of the application, and set up payment plans if necessary.
SchH_P06_S00_L04	Schedule H, Part VI, Line 4	The area served by Central Peninsula Hospital is comprised of 13 Census Designated Places or towns, and has a total population of nearly 35,000 residents according to the 2008 census estimates. The Geographic region is in the Central Kenai Peninsula of the State of Alaska. Based on the 2000 Census , approximately 7 percent of the population is age 65 or older, 25 percent are between 45 and 64, while 37 percent are between age 18 and 44. Basic social and economic characteristics of the region indicate high unemployement and uninsured rates, nearly 3 percent higher than the US average and 2 percent higher than the State average.
SchH_P06_S00_L05	Schedule H, Part VI, Line 5	The Hospital engages in numerous community efforts to improve the health of the region served. Monetary and personnel support of local non-profits, public service announcements, healthy choice advertising campaigns, child safety programs, low cost health fairs, physician speakers bureau, community health newsletters, and many other programs.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (10 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant	Address Line2AddressUS/AddressLine2	Business Name Line2RecipientNameBusiness/BusinessNameLine2
Kenai Watershed Forum
PO BOX 2937	Soldotna	AK	99669	911829284	501 c 3	7500	$5,000 Capital campaign donation $2,500 Run for the River sponsorship donation. Cash contributions support the mission of the Forum, to provide for healthy watersheds on the Kenai Peninsula.
Kenai Peninsula United Way
11355 Frontage Road	Kenai	AK	99611	920111698	501 c 3	10500	$10,000 2010/2011 Match for Employee giving campaign $500 program donation. The United Way on the Kenai peninsula provides support to financial indigent area residents as well as support to other local non-profits.	Benco Building Suite 101
Kenai Peninsula Youth Foundation
PO Box 2605	Soldotna	AK	99669	262580744	501 c 3	7500	2010/11 Season Sponsorship -- Peninsula Youth Foundation The Kenai Peninsula Youth Foundation is an organization dedicated to providing developmental programs for aspiring student athletes. This cash contribution was made to the foundation owned Kenai River Brown Bears to support a Breast Cancer Awareness sporting event. All proceeds from the event were donated to the Breast Cancer fund of Central Peninsula Health Foundation, a related organization.		Kenai River Brown Bears
Boys and Girls club of the Kenai Peninsula
705 Frontage Road	Kenai	AK	99611	943067142	501 c 3	13800	$2,500 Annual 2010 auction sponsorship $500 Adult basketball season sponsorship $300 Are you Smarter than our kids sponsorship $500 Kids soccer sponsorship $10,000 Golf classic sponsorship 2011. Cash contributions are used to support the provision of safe after-school programs and healthy activities and events for Peninsula children.	Suite B
Kenai River Sportfishing Association
224 Kenai Ave	Soldotna	AK	99669	920142688	501 c 3	11500	$10,000 Kenai River Women's Classic 2010 sponsorship $1,500 Annual Fundraiser sponsorship. Cash contributions to KRSA fundraisers help to ensure the sustainability of the Kenai River through programs focused on habitat, fishing management, research and education.	Suite 102
Kenai River Professional Guide Association
PO box 3674	Soldotna	AK	99669	920162358	501 c 3	10000	Wounded warrior program sponsor 2010
Kenai Peninsula Food Bank Inc
33955 Community College Drive	Soldotna	AK	99669	943112445	501 c 3	26000	$25,000 Building fund donation $1,000 Soup Supper sponsorship
Southcentral Foundation
4501 Diplomacy Drive	Anchorage	AK	99508	920086076	501 c 3	5500	All Alaska Pediatric Partnership sponsor
Soldotna Chamber of Commerce
44790 Sterling Highway	Soldotna	AK	99669	920061612	501 c 6	5400	$400 Alaska chamber awards banquet $5,000 Community partner sponsorship. Cash contributions to the Chamber of commerce help support scholarships for local teens, foster community partnerships, and support the Toys for tots program.
Friends of Kenai Community Library
PO Box 656	Kenai	AK	99611	920133770	501 c 3	10000	Support for construction of new Kenai Community library.

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	9	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	1	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 hospital does not provide 'grants' but cash contributions to local organizations which support community initiatives and healthy living on the Kenai Peninsula. The Hospital provides funding to organizations of good community standing. Hospital officers are responsible for approving all assistance payments to organizations, and do so with discretion.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Payments	X	IdemnificationGrossUpPayments
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	0	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	1	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	1	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 (10 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
Gregg Motonaga
543177	0	52310	0	1004	0	21983	0	20556	0	639030	0	0
Charles C Mickelson
491615	0	30	0	944	0	5283	0	30374	0	528246	0	0
David S Innes
547815	0	210267	0	32977	0	0	0	15700	0	806759	0	0	0
Angus Warren
448927	0	30	0	519	0	5283	0	9966	0	464725	0	0	0
Ryan K Smith
257764	0	161319	0	50512	0	14575	0	30374	0	514544	0	0	0
Jason D Paret
153497	0	28634	0	19948	0	9228	0	30374	0	241681	0	0	0
Andrea D Posey
134778	0	26313	0	18086	0	8855	0	30374	0	218406	0	0	0
Johnny L Dodd
84081	0	20223	0	3453	0	2144	0	10625	0	120526	0	0	0
Cynthia Kahn
429335	0	30	0	34175	0	0	0	5151	0	468691	0	0	0
Matthew Dammeyer
139774	0	26931	0	21978	0	8939	0	30374	0	227996	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchJ_P01_S00_L01a	Schedule J, Part I, Line 1a	Gross up payments are made for certain fringe benefits and for the value of life insurance over $50,000. A year end wage adjustment is made for all affected employees to include the gross up for fringe benefits and excess life insurance benefits. The Hospital has historically paid all social security and medicare taxes on such benefits. The employee is responsible for federal income taxes. Among the fringe benefits offered to the employees are health club discounts. The hospital pays for one-half of gym membership fees.
SchJ_P01_S00_L01b	Schedule J, Part I, Line 1b	The year end gross up adjustment for fringe benefits and life insurance over $50,000 is based on historical practice of the hospital and is not governed by a hospital policy. The hospital maintains that at some future date, employees may be required to pay their own FICA taxes on fringe benefits. Similarly, payment of one-half of health club memberships is also not a written policy. Although the hospital currently extends this benefit to its employees, it may not always choose to do so.
SchJ_P01_S00_L03	Schedule J, Part I, Line 3	The hospital contracts with an independent consultant to perform a review of CEO wages and benefits using comparable data. The resulting report is provided to the Board of Directors for review. The Board then sets the compensation for the CEO. The CEO has a written employment contract with the organization.
SchJ_P01_S00_L04	Schedule J, Part I, Line 4	The hospital provides a 457 Top Hat plan to certain key employees and management. The following individuals on Schedule J participated in the 457 plan and either deferred their own compensation or received hospital contribution into the plan during the tax year: Gregg Motonaga $15,865, Ryan Smith $8,970, Jason Paret $3,993, Andrea Posey $3,500, Johnny Dodd $2,606, Matthew Dammeyer $3,582, and Peter Brennan $1,680.
SchJ_P01_S00_L05	Schedule J, Part I, Line 5	In accordance with their employment contract, Emergency Room Physicians receive a percentage of their physician fees billed. However, physician compensation is not based on the entity's overall performance of revenues.
SchJ_P01_S00_L06	Schedule J, Part I, Line 6	The Hospital pays an annual incentive plan bonus to all employees, supervisors, and officers based on a series of 4 operational quality measures. One of these 4 measures is based on the hospital meeting its net earnings budget. This element comprises only one-fourth of the potential incentive plan bonus payment. The remaining measures are 1) patient satisfaction 2) quality measures, and 3) utilization.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	Kenai Peninsula Borough	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	920030894	IssuerEIN
CUSIP Number	488530NF9	CUSIPNumber
Date Issued	2003-12-18	DateIssued
Issue Price	47985000	IssuePrice
Description Of Purpose	Hospital expansion project	DescriptionOfPurpose
Defeased	0	Defeased
On Behalf Of Issuer	0	OnBehalfOfIssuer
Pool Financing	0	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Amount Retired	0	AmountRetired
Amount Bond Defeased	0	AmountBondDefeased
Total Proceeds	53952406	TotalProceeds
Amount In Reserve Fund	518266	AmountInReserveFund
Capitalized Interest	0	CapitalizedInterest
Refunding Escrow	0	RefundingEscrow
Issuance Costs From Proceeds	544896	IssuanceCostsFromProceeds
Credit Enhancement	0	CreditEnhancement
Capital Expenditures	53587225	CapitalExpenditures
Other Spent Proceeds	0	OtherSpentProceeds
Amount Unspent	6664	AmountUnspent
Year Of Subst Completion	2008	YearOfSubstCompletion
Current Refunding	0	CurrentRefunding
Advance Refunding	0	AdvanceRefunding
Final Allocation Made	1	FinalAllocationMade
Adequate Books And Recds Maintaind	1	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Owning Bond Financed Property	0	OwningBondFinancedProperty
Any Lease Arrangements	0	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	0	MngmentCntrctBondFinancdPrprty
Any Research Agreements	0	AnyResearchAgreements
Bond Counsel Routinely Engaged	0	BondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others	0	PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI	0	PercentageOfPrvtBusinessReUBI
Total Private Business Use	0	TotalPrivateBusinessUse
Post Issuance Compliance Procdrs	0	PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Form8038 T Filed	1	Form8038TFiled
Variable Rate Issue	1	VariableRateIssue
Hedge Identified In Books And Recds	0	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGIC
Gross Proceeds Invested	1	GrossProceedsInvested
Exception To Rebate	0	ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
John Bramante
Dr. Bramante is employed by Peninsula Internal Medicine and on the active medical staff of Hospital	85976	Payments from Hospital to Peninsula Internal Medicine	0
Charles Weimer
Mr. Weimer is the husband of CPGH Board President Loren Weimer	10000	Fair market value for rental of residential real estate to house LifeMed crew	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
F990_P06_S0A_L07b	Form 990, Part VI, Section A, Line 7b	Central Peninsula General Hospital Inc manages the hospital through a Lease and Operating Agreement with the Kenai Peninsula Borough. CPGH Inc Board's decisions regarding the purchase of significant capital assets and plant expansion are subject to approval by the Borough Assembly. Bonds, loans, and capital expenditures not funded through the Hospital's plant replacement funds must be approved by a vote of Borough constituents if greater than $1.0 million.
F990_P06_S0A_L09	Form 990, Part VI, Section A, Line 9	Jason Paret: 651229A Opelo Rd Kamuela, HI 96743
F990_P06_S0B_L11a	Form 990, Part VI, Section B, Line 11a	The 990 is prepared by the Finance Department and submitted to management for review. Management submits edits to the Finance Dept. The 2nd Draft and all schedules and statements are then submitted to each Board Member for review and comment. Final edits are made to the 990 prior to electronic submission by the CFO or Board President.
F990_P06_S0B_L12c	Form 990, Part VI, Section B, Line 12c	After completion of the conflict of interest questionnaire, the board reviews and discusses any conflicts which may arise and appropriate action which should be taken.
F990_P06_S0B_L15	Form 990, Part VI, Section B, Line 15	An independent professional Executive remuneration study was performed for 2011 by the HayGroup, project manager Ronald Keimach. Remuneration reports are submitted to the Board for review and used to set wage scales for the CEO, CFO, CNO, and COO. Contemporaneous documentation exists for this study.
F990_P06_S0C_L19	Form 990, Part VI, Section C, Line 19	The Hospital publishes its 3 most recent 990s on its website at www.cpgh.org. The 990 is also available at Guidestar.com. The Hospital provides its governing documents, conflict of interest policy, and audited financial statements, in electronic format upon request.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg
Central Peninsula Health Foundation
250 Hospital Place	Soldotna	AK	99669	202778670	To support quality healthcare activities	AK	501(c)3	Public Charity	N/A	0
Kenai Peninsula Borough
144 N Binkley Street	Soldotna	AK	99669	920030894	Local Government which owns the hospital assets.	AK	115		N/A	0

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
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	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
Central Peninsula Health Foundation
c	211947	Actual cash value of contributions or payments received from Central Peninsula Health Foundation.
Kenai Peninsula Borough
j	1	Central Peninsula General Hospital Inc operates the Hospital through a lease and operating agreement with the Kenai Peninsula Borough. Ultimately, the Borough owns the hospital facility and all related assets under the agreement and leases them to CPGH Inc to operate on its behalf. The amount stated in that lease and operating agreement is $1 per annum.
Central Peninsula Health Foundation
m	15331	Central Peninsula Hospital provides office space to Central Peninsula Health Foundation. The value of that space is determined based on our most recently filed Medicare Cost Report (2010) facility, administrative, and support service values allocated per square foot.
Central Peninsula Health Foundation
n	93206	Actual cost of wages, payroll taxes, pension contribution, and health insurance for shared employees.
Central Peninsula Health Foundation
p	61498	Actual dollar value of services and operating expenses purchased by the Hospital and reimbursed by the Foundation.
Kenai Peninsula Borough
q	5723773	Per the Lease and Operating agreement all cash on hand >90 days must be transferred to an account held by the Kenai Peninsula Borough. This is the total amount of cash transferred to that account during FY11.

Reasonable Cause Explanation ReasonableCauseExplanation

Field	Value	IRS element (for citing)
Explanation	N/A - Form 8868 Request for Extension was timely filed and accepted by the IRS.	Explanation