PIKE HEALTH SERVICES INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- PIKE HEALTH SERVICES INC (EIN 31-1072406)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-14
- IRS object ID
- 201143189349303769
- 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 J
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-14T12:12:33-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 65 EAST STATE ST STE 600 | AddressLine1 |
| City | COLUMBUS | City |
| State | OH | State |
| ZIP Code | 43215 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311072406 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PIKE HEALTH SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PIKE | NameControl |
| Phone | 7409476306 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DAWN LANE | AddressLine1 |
| City | WAVERLY | City |
| State | OH | State |
| ZIP Code | 45690 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CRAIG SOLLE | Name |
| Title | PRESIDENT & CEO | Title |
| Phone | 7409476306 | Phone |
| Date Signed | 2011-11-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BERNIE OSTROWSKI | Name |
| Phone | 6148493000 | Phone |
| 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 | SEE SCHEDULE O | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CRAIG E SOLLE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DAWN LANE | AddressLine1 |
| City | WAVERLY | City |
| State | OH | State |
| ZIP Code | 45690 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 23471407 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.PIKECOMMUNITYHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1983 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | PIKE HEALTH SERVICES IS A 25-BED CRITICAL ACCESS HOSPITAL AND CLINIC LOCATED IN THE STATE OF OHIO IN PIKE COUNTY. INCLUDED IN THE BED COUNT ARE 21 ACUTE BEDS AND 4 INTENSIVE CARE BEDS WITH AUTHORIZATION FOR SWING BEDS ON AN AS NEEDED BASIS. PIKE HEALTH SERVICES HAD 727 INPATIENT ADMISSIONS, 501 SURGERY CASES ( INCLUDING AMBULATORY); 16,342 VISITS TO THE EMERGENCY DEPARTMENT. PIKE HEALTH SERVICES PROVIDED CHARITY CARE TO THE COMMUNITY IN THE AMOUNT OF $1,731,367 IN CHARGES FORGONE, BASED ON ESTABLISHED RATES, WITH 11.90% SELF PAY PATIENTS, WHO HAVE NO INSURANCE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 378 | TotalNbrEmployees |
| Total Nbr Volunteers | 42 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 70597 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 290543 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 22812846 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 22084750 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3642 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4041 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1055509 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1049170 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 23942594 | TotalRevenuePriorYear |
| Total Revenue Current Year | 23428504 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 236 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 161 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 11951001 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 11541000 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 3104 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 12992012 | OtherExpensePriorYear |
| Other Expenses Current Year | 11579102 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 24943249 | TotalExpensesPriorYear |
| Total Expenses Current Year | 23120263 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1000655 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 308241 | RevenuesLessExpensesCY |
| Total Assets BOY | 13217652 | TotalAssetsBOY |
| Total Assets EOY | 13573166 | TotalAssetsEOY |
| Total Liabilities BOY | 10411417 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 10456285 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2806235 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3116881 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | PIKE HEALTH SERVICES IS HIGH QUALITY; COMPASSIONATE HEALTHCARE; ACCESSIBLE TO THE COMMUNITY; COMMITTED TO EXCELLENCE; RESPECTFUL OF EACH INDIVIDUAL; AND FOUNDED ON SERVICE TO OTHERS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 20034735 | Expense |
| Grants | 161 | Grants |
| Revenue | 22084750 | Revenue |
| Description | SEE SCHEDULE OPIKE HEALTH SERVICES IS A 25-BED CRITICAL ACCESS HOSPITAL AND PHYSICIAN PRACTICE LOCATED IN THE STATE OF OHIO IN PIKE COUNTY. INCLUDED IN THE BED COUNT ARE 21 ACUTE BEDS AND 4 INTENSIVE CARE BEDS WITH AUTHORIZATION FOR SWING BEDS ON AN AS NEEDED BASIS. IN 2010, PIKE HEALTH SERVICES HAD 727 INPATIENT ADMISSIONS, 501 SURGERY CASES (INCLUDING AMBULATORY); AND 16,342 VISITS TO THE EMERGENCY DEPARTMENT. PIKE HEALTH SERVICES PROVIDED CHARITY CARE TO THE COMMUNITY IN THE AMOUNT OF $3,066,052, INCLUDING 11.90% SELF PAY PATIENTS, WHO HAVE NO INSURANCE.PIKE HEALTH SERVICE'S COMMUNITY OUTREACH ACTIVITY HAS SERVED 1,714 CITIZENS IN VARIOUS PROGRAMS THROUGHOUT PIKE COUNTY. DURING THE YEAR, THEY PARTICIPATED IN 4 HEALTH FAIRS AND 25 SCREENING AND EDUCATIONAL CLINICS FOR DIABETES, CHOLESTEROL AND ARTHRITIS. ADDITIONALLY THEY SUPPORT THE YOUNG RESIDENTS OF THE COUNTY IN VARIOUS PROGRAMS INCLUDING HEAD START AND CHILD SAFETY PRESENTATIONS. | Description |
| Total Program Service Expense | 20034735 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 0 | 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 | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | 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 | 35 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 378 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OH | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRAIG SOLLE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7409476310 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DAWN LANE | AddressLine1 |
| City | WAVERLY | City |
| State | OH | State |
| ZIP Code | 45690 | 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 | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| CATHERINE FARINET | |||||||
| CHIEF OF MEDICAL STAFF | 37.50 | X | 194338 | 0 | 14259 | ||
| TONY FISH | |||||||
| CHAIRMAN | 0.10 | X | 0 | 0 | 0 | X | |
| VAL FRANCIS | |||||||
| VICE CHAIRMAN | 0.10 | X | 0 | 0 | 0 | X | |
| LINDA B SHOEMAKER | |||||||
| SECRETARY | 0.10 | X | 0 | 0 | 0 | X | |
| MELBY WILLIAMS | |||||||
| TREASURER | 0.10 | X | 0 | 0 | 0 | X | |
| TOD BURKITT | |||||||
| TRUSTEE | 0.10 | X | 0 | 0 | 0 | ||
| DENNIS MILLER | |||||||
| TRUSTEE | 0.10 | X | 0 | 0 | 0 | ||
| MARGARET FOILL | |||||||
| TRUSTEE | 0.10 | X | 0 | 0 | 0 | ||
| REV RONALD HINES | |||||||
| TRUSTEE | 0.10 | X | 0 | 0 | 0 | ||
| CRAIG E SOLLE | |||||||
| PRESIDENT AND CEO | 37.50 | 113918 | 0 | 19081 | X | ||
| LINDA JAMES | |||||||
| VP PATIENT CARE | 37.50 | 74129 | 0 | 10713 | X | ||
| SHARON NOVAK | |||||||
| VP FINANCE/CFO | 37.50 | 78329 | 0 | 10830 | X | ||
| TINA PERKO | |||||||
| VP OPERATIONS | 37.50 | 67269 | 0 | 10529 | X | ||
| CINDY INGRAM | |||||||
| CRNA | 37.50 | 213071 | 0 | 25308 | X | ||
| DAVID KESSLER | |||||||
| PHYSICIAN | 37.50 | 215191 | 0 | 6161 | X | ||
| ERIC CRAWFORD | |||||||
| PHYSICIAN | 37.50 | 160748 | 0 | 22075 | X | ||
| ELLIS FRAZIER | |||||||
| PHYSICIAN | 37.50 | 175798 | 0 | 9702 | X | ||
| CHERYL SMITH | |||||||
| PHYSICIAN | 37.50 | 102532 | 0 | 3339 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1395323 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 131997 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| PREMIER HEALTHCARE | |||||
| PO BOX 631606 | CINCINNATI | OH | 452631606 | ED PHYSICIAN COVERAGE | 699400 |
| INNER OFFICE | |||||
| 80 ERIE STREET | CORTLAND | OH | 44410 | MEDICAL TRANSCRIPTION | 224446 |
| QUEST DIAGNOSTICS | |||||
| 2249 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | LAB TESTING | 203826 |
| PHILLIPS MEDICAL | |||||
| PO BOX 100355 | ATLANTA | GA | 303840355 | MAINTENANCE | 158760 |
| SIEMENS MEDICAL SOLUTIONS | |||||
| DEPT AT 40065 | ATLANTA | GA | 31192 | MAINTENANCE | 153048 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Government Grants | 242447 | GovernmentGrants |
| All Other Contributions | 48096 | AllOtherContributions |
| Total Contributions | 290543 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PROGRAM SERVICES | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 22084750 | TotalRevenueColumn |
| Related Or Exempt Function Income | 22084750 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 22084750 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1041 | TotalRevenueColumn |
| Exclusion | $1,041 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 12450 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 42903 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -30453 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -30453 | TotalRevenueColumn |
| Exclusion | -$30,453 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3000 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3000 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3000 | TotalRevenueColumn |
| Exclusion | $3,000 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| COUNTY TAX LEVY | 900099 | 1008339 | $1,008,339 |
| CAFETERIA REVENUE | 900099 | 71284 | $71,284 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1079623 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 23428504 | TotalRevenueColumn |
| Related Or Exempt Function Income | 22084750 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,053,211 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 161 | Total |
| Program Services | 161 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 717912 | Total |
| Management And General | 717912 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8237463 | Total |
| Program Services | 7355917 | ProgramServices |
| Management And General | 880214 | ManagementAndGeneral |
| Fundraising | 1332 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1525409 | Total |
| Program Services | 1385940 | ProgramServices |
| Management And General | 139469 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 442166 | Total |
| Program Services | 430235 | ProgramServices |
| Management And General | 11931 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 618050 | Total |
| Program Services | 509136 | ProgramServices |
| Management And General | 108914 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36412 | Total |
| Management And General | 36412 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 79515 | Total |
| Management And General | 79515 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3118416 | Total |
| Program Services | 2650471 | ProgramServices |
| Management And General | 466871 | ManagementAndGeneral |
| Fundraising | 1074 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17738 | Total |
| Management And General | 17738 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2298204 | Total |
| Program Services | 1946048 | ProgramServices |
| Management And General | 351508 | ManagementAndGeneral |
| Fundraising | 648 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4288 | Total |
| Management And General | 4288 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 392742 | Total |
| Program Services | 353468 | ProgramServices |
| Management And General | 39274 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17636 | Total |
| Program Services | 10427 | ProgramServices |
| Management And General | 7209 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 511698 | Total |
| Program Services | 460528 | ProgramServices |
| Management And General | 51170 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1142031 | Total |
| Program Services | 1027462 | ProgramServices |
| Management And General | 114569 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 173220 | Total |
| Program Services | 173220 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 3663690 | 3663690 | |
| DUES & SUBSCRIPTIONS | 58608 | 14886 | 43722 |
| BILLING EXPENSE | 20883 | 20883 | |
| CONTINUING EDUCATION | 19911 | 16653 | 3258 |
| LAB EXPENSE | 7814 | 7814 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16296 | Total |
| Program Services | 7796 | ProgramServices |
| Management And General | 8450 | ManagementAndGeneral |
| Fundraising | 50 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23120263 | Total |
| Program Services | 20034735 | ProgramServices |
| Management And General | 3082424 | ManagementAndGeneral |
| Fundraising | 3104 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 160011 | BOY |
| EOY | 109731 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 236630 | BOY |
| EOY | 14378 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2066889 | BOY |
| EOY | 1756848 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45210 | BOY |
| EOY | 31710 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 227193 | BOY |
| EOY | 245475 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 131702 | BOY |
| EOY | 207346 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 25196973 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 16918282 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8795795 | BOY |
| EOY | 8278691 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1254786 | BOY |
| EOY | 1255047 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85164 | BOY |
| EOY | 95975 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 214272 | BOY |
| EOY | 1577965 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13217652 | BOY |
| EOY | 13573166 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2689011 | BOY |
| EOY | 3007420 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5715000 | BOY |
| EOY | 5270000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 480370 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1527036 | BOY |
| EOY | 2178865 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10411417 | BOY |
| EOY | 10456285 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2806235 | BOY |
| EOY | 3116881 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2806235 | BOY |
| EOY | 3116881 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13217652 | BOY |
| EOY | 13573166 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 308241 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 2405 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amt Of4955 Tax | 0 | AmtOf4955Tax |
| Amt Of4955 Tax On Managers | 0 | AmtOf4955TaxOnManagers |
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $737 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 737 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | OHIO HOSPITAL ASSOCIATION STRATEGIC ISSUES AND ENERGY LITIGATION ASSESSMENT. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 244450 | OtherCostOrOtherBasis |
| Book Value | 244450 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13218083 | OtherCostOrOtherBasis |
| Depreciation | 7183991 | Depreciation |
| Book Value | 6034092 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 18000 | OtherCostOrOtherBasis |
| Depreciation | 5900 | Depreciation |
| Book Value | 12100 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10894524 | OtherCostOrOtherBasis |
| Depreciation | 9467706 | Depreciation |
| Book Value | 1426818 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 821916 | OtherCostOrOtherBasis |
| Depreciation | 260685 | Depreciation |
| Book Value | 561231 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8278691 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER RECEIVABLES | 1422071 |
| DEFERRED FINANCING COSTS | 155894 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1577965 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CAPITAL LEASE OBLIGATION | $995,380 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $407,794 |
| LINE OF CREDIT | $725,075 |
| OTHER NOTES PAYABLE | $50,616 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2178865 | TotalOfAmounts |
| Total Revenue | 23428504 | TotalRevenue |
| Total Expenses | 23120263 | TotalExpenses |
| Excess Or Deficit For Year | 308241 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 2405 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 2405 | TotalAdjustments |
| Excess Or Deficit Per FS | 310646 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 23412121 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 2405 | NetUnrealizedGainsInvestments |
| Other Revenues | -61691 | OtherRevenues |
| Revenue Not Rptd F990 | -59286 | RevenueNotRptdF990 |
| Revenue Subtotal | 23471407 | RevenueSubtotal |
| Other Revenues Not Included | -42903 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -42903 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 23428504 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 23101475 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 42903 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 42903 | ExpensesNotRptdF990 |
| Expenses Subtotal | 23058572 | ExpensesSubtotal |
| Other Expenses Not Included | 61691 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 61691 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 23120263 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | CHARITY CARE & BAD DEBT EXPENSES -61,691. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | RECLASS RENTAL EXPENSES -42,903. |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | RECLASS RENTAL EXPENSES 42,903. |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | CHARITY CARE & BAD DEBT EXPENSES 61,691. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2100158 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1506783 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 593375 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03050 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5090719 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2705884 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2384835 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12260 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7190877 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4212667 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2978210 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.15310 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7190877 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4212667 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2978210 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.15310 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Persons Served | 1714 | PersonsServed |
| Total Community Building Expense | 20412 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 1500 | DirectOffsettingRevenue |
| Net Community Building Expense | 18912 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Persons Served | 1714 | PersonsServed |
| Total Community Building Expense | 20412 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 1500 | DirectOffsettingRevenue |
| Net Community Building Expense | 18912 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,731,737 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 6781375 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6717912 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 63463 | 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 | PIKE COMMUNITY HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DAWN LANE | AddressLine1 |
| City | WAVERLY | City |
| State | OH | State |
| ZIP Code | 45690 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NOT APPLICABLE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PIKE MEDICAL & PROFESSIONAL ASSOCIATES | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DAWN LANE | AddressLine1 |
| City | WAVERLY | City |
| State | OH | State |
| ZIP Code | 45690 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | PRACTICES OWNED BY PHS | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: N/A | ||
| PART I, LINE 7: TOTAL COMMUNITY BENEFIT EXPENSE RELATED TO CHARITY CARE WAS CALCULATED USING A COST-TO-CHARGE RATIO AS CALCULATED USING SCHEDULE H WORKSHEET 2. TOTAL COMMUNITY BENEFIT RELATED TO MEDICAID WAS CALCULATED FROM THE MEDICAID COST REPORT.PART I, LINE 7, COLUMN (F): THE PERCENTAGE OF TOTAL EXPENSES WAS CALCULATED BASED ON TOTAL EXPENSES LESS BAD DEBT AS REPORTED ON FORM 990, PART IX. | ||
| PART I, L7 COL(F): CHARITY CARE AND OTHER COMMUNITY BENEFITS AS A PERCENTAGE OF EXPENSES IS CALCULATED USING TOTAL EXPENSES FROM FORM 990, PART IX LESS BAD DEBT EXPENSE OF $3,663,690 FROM PART IX. | ||
| PART II: THE HEALTH OF THE COMMUNITY IS PROMOTED THROUGH NUMEROUS SCREENING AND EDUCATION ACTIVIES FOR DIABETES, CHOLESTEROL AND OTHER CIRCULATORY DISEASES. THE EDUCATION IS PROVIDED BY THE HOSPITAL AND OTHER HEALTH PROMOTING GROUPS IN THE COMMUNITY. ADDITIONALLY, THE HOSPITAL PARTICIPATES IN HEALTH FAIRS AND CLINICS FOR SENIOR GROUPS AND LOCAL BUSINESSES. | ||
| PART III, LINE 4: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.BAD DEBT AT COST WAS CALCULATED USING A COST-TO-CHARGE RATIO. GROSS CHARGES WERE BASED ON STANDARD RATES LESS AMOUNTS COLLECTED. WE DO NOT BELIEVE BAD DEBT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. NONE OF THE BAD DEBT AT COST COULD BE ATTRIBUTED TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. ON A REGULAR BASIS, AMOUNTS INCLUDED IN BAD DEBT THAT COULD QUALIFY FOR FINANCIAL ASSISTANCE ARE RECLASSED OUT OF BAD DEBT TO HCAP OR CHARITY CARE. | ||
| PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE CALCULATED FROM THE MEDICARE COST REPORT. WE DO NOT BELIEVE THE COST OF MEDICARE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. MEDICARE ALLOWABLE COSTS REPORTED ON THE COST REPORT WERE DETERMINED USING A COST-TO-CHARGE RATIO IN ACCORDANCE WITH MEDICARE REQUIREMENTS. | ||
| PART III, LINE 9B: IN-HOUSE FINANCIAL COUNSELORS WILL BEGIN FOLLOW-UP ON ALL SELF-PAY ACCOUNTS DUE TO THE HOSPITAL WITHIN 30 DAYS OF BILLING. THEY WILL UTILIZE ALL REASONABLE EFFORTS TO OBTAIN PAYMENT. AFTER 60 DAYS OF COLLECTION EFFORTS, THE FINANCIAL COUNSELOR WILL REVIEW THE ACCOUNT AND RECOMMEND FURTHER COLLECTION EFFORTS. THE MANAGER OF PATIENT ACCOUNTS WILL REVIEW ALL ACCOUNTS FOR APPROVAL TO OUTSIDE COLLECTION AND BAD DEBT WRITE-OFF. THE MANAGER OF PATIENT ACCOUNTS IS AUTHORIZED TO WRITE OFF ACCOUNTS UNDER $500. ACCOUNT BALANCES OF $500 TO $5,000 MUST BE AUTHORIZED BY THE VICE PRESIDENT OF FINANCE, AND BALANCES OVER $5,000 REQUIRE THE AUTHORIZATION OF THE CEO. | ||
| PART VI, LINE 2: PIKE PROVIDES SCREENING ACTIVITIES THROUGHOUT THE COMMUNITY. THERE IS A LARGE POPULATION OF SENIORS AND MEDICARE RECIPIENTS WHO BENEFIT. PIKE ALSO PARTNERS WITH THE YMCA TO PROVIDE DIABETES SCREENINGS. THERE IS NO FORMAL NEEDS ASSESSMENT HOWEVER FOR THE FUTURE THE HOSPITAL IS IN THE PROCESS OF DEVELOPING A MORE COMPREHENSIVE ASSESSMENT BASED ON SURVEYS TO MEMBERS OF THE COMMUNITY. | ||
| PART VI, LINE 3: ELIGIBILITY FOR ASSISTANCE SIGNAGE IS POSTED THROUGHOUT THE HOSPITAL. ALL PATIENTS WITHOUT THIRD PARTY COVERAGE ARE GIVEN CHARITY APPLICATIONS AT THE TIME OF REGISTRATION. | ||
| PART VI, LINE 4: PIKE COMMUNITY HOSPITAL SERVES A POPULATION OF 28,000 PEOPLE IN PIKE COUNTY, OHIO. THE UNEMPLOYMENT RATE IN PIKE COUNTY IS 15.6% AND THE PER CAPITA INCOME IS $24,300. 22.9% OF THE POPULATION FALL BELOW THE FEDERAL POVERTY LEVEL. FINANCIAL UTILIZATION AT THE HOSPITAL IS 44% MEDICARE, 25% MEDICAID, 16% COMMERCIAL AND 15% SELF PAY. | ||
| PART VI, LINE 6: PIKE HEALTH SERVICES, INC. STRIVES TO MEET THE HEALTHCARE NEEDS OF ITS COMMUNITY. PIKE HEALTH SERVICE'S COMMUNITY OUTREACH ACTIVITY INCLUDES PARTICIPATION IN HEALTH FAIRS, SCREENINGS, AND EDUCATIONAL CLINICS FOR DIABETES, CHOLESTEROL AND ARTHRITIS. ADDITIONALLY, THEY SUPPORT THE YOUNG RESIDENTS OF THE COUNTY IN VARIOUS PROGRAMS INCLUDING HEAD START AND CHILD SAFETY PRESENTATIONS. | ||
| PART VI, LINE 7: N/A | ||
| OH | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CATHERINE FARINET | |||||||||||||
| 194338 | 0 | 0 | 0 | 0 | 0 | 5722 | 0 | 8537 | 0 | 208597 | 0 | 0 | 0 |
| CINDY INGRAM | |||||||||||||
| 213071 | 0 | 0 | 0 | 0 | 0 | 6000 | 0 | 19308 | 0 | 238379 | 0 | 0 | 0 |
| DAVID KESSLER | |||||||||||||
| 215191 | 0 | 0 | 0 | 0 | 0 | 6000 | 0 | 161 | 0 | 221352 | 0 | 0 | 0 |
| ERIC CRAWFORD | |||||||||||||
| 160748 | 0 | 0 | 0 | 0 | 0 | 2807 | 0 | 19268 | 0 | 182823 | 0 | 0 | 0 |
| ELLIS FRAZIER | |||||||||||||
| 175798 | 0 | 0 | 0 | 0 | 0 | 1171 | 0 | 8531 | 0 | 185500 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Loan Table LoanTable (2 entries)
| Purpose Of LoanPurposeOfLoan | Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|---|
| CINDY INGRAM-TU | ||||||
| TUITION ASSISTANCE, TO BE FORGIVEN WITH HOURS WORKED OVER 7 YEARS. | X | $127,960 | 31710 | 0 | 1 | 1 |
| CATHERINE FARINET | ||||||
| START-UP EXPENSES, TO BE FORGIVEN WITH HOURS WORKED | X | $12,000 | 0 | 1 | 1 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 31710 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE CEO REVIEWS FORM 990 AND THE BOARD WILL BE PRESENTED WITH A COPY OF FORM 990 PRIOR TO FILING. | |
| OFFICERS, BOARD MEMBERS, AND KEY EMPLOYEES ARE REQUIRED TO REVIEW AND DISCLOSE CONFLICTS OF INTEREST BY AN ANNUAL FORM SIGN-OFF. THROUGHOUT THE YEAR, BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY CONFLICT OF INTERESTS THAT ARISE AND MUST REFRAIN FROM VOTING ON ANY ISSUES IN WHICH A CONFLICT OF INTEREST IS PRESENT. | FORM 990, PART VI, SECTION B, LINE 12C | |
| INDIVIDUAL BOARD MEMBERS EVALUATE THE CEO ANNUALLY, AND THEN COME TOGETHER FOR RECOMMENDATIONS AS TO THE CEO'S COMPENSATION. OTHER OFFICERS' COMPENSATION IS REVIEWED ANNUALLY BY THE CEO. THE ORGANIZATION USES A WRITTEN EMPLOYEE CONTRACT AND UTILIZES THE OHIO HOSPITAL ASSOCIATION'S COMPENSATION STUDIES TO DETERMINE COMPENSATION LEVELS. | FORM 990, PART VI, SECTION B, LINE 15A | |
| THE ORGANIZATION'S FORM 1023 AND FORM 990 ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 18 | |
| THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED GAINS ON INVESTMENTS: 2,405. | FORM 990, PART XI, LINE 5: |
| FORM 990, PART XI, LINE 2C: THE BOARD OF DIRECTORS OVERSEES THE AUDIT PROCESS AND APPROVES THE INDEPENDENT AUDIT FIRM. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. | ||
| DOING BUSINESS AS: | PIKE COMMUNITY HOSPITAL; PIKE MEDICAL & SURGICAL ASSOCIATES | FORM 990, PAGE 1, LINE C |