Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 93,930,998 | 95,049,002 | 106,824,492 | 109,003,392 | 138,138,221 | 542,946,105 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | 93,930,998 | 95,049,002 | 106,824,492 | 109,003,392 | 138,138,221 | 542,946,105 |
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | 542,946,105 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 93,930,998 | 95,049,002 | 106,824,492 | 109,003,392 | 138,138,221 | 542,946,105 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 1,106,685 | 1,595,089 | 1,759,375 | 2,052,493 | 2,173,363 | 8,687,005 |
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | 604,938 | 526,717 | 641,669 | 989,259 | 2,762,583 | |
| 11 | Total support. Add lines 7 through 10 | 554,395,693 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2022 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2023. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SUPPORTING SCHEDULE | ONE TIME CONTRIBUTION-GENERAL SUPPORT 10,000,000 |
| PART II, LINE 10 | LEGAL SETTLEMENT 641,669 DIETARY 1,131,655 |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4A | THE HOSPITAL DIVISION OF NORTON SOUND HEALTH CORPORATION (NSHC) INCLUDES A 18 BED ACUTE CARE HOSPITAL AND A 18 BED LONG-TERM CARE FACILITY THROUGH WHICH MEDICAL CARE IS PROVIDED TO THE RESIDENTS OF NOME AND 15 VILLAGES ON THE COAST AND ISLANDS OF THE BERING SEA. IN ADDITION TO INPATIENT/OUTPATIENT CARE, NSHC CONTINUES TO INCREASE ITS COMMITMENT TO PREVENTIVE HEALTH CARE BY SUPPORTING PROGRAMS THAT EMPHASIZE HEALTH AND FITNESS, INCLUDING OFFERING NUMEROUS SCREENING TESTS, DIET, EXERCISE AND FITNESS COUNSELING, AS WELL AS SCREENING PROCEDURES FOR COLON AND STOMACH CANCER, CARDIOVASCULAR AND DIABETES HEALTH RISKS. QUYANNA CARE CENTER - THE LONG TERM CARE FACILITY, CONTINUES TO MAXIMIZE THE QUALITY OF LIFE FOR ITS RESIDENTS. STAFF MEMBERS STRIVE TO MAINTAIN A VERY HIGH LEVEL OF CARE BY ENSURING THAT PATIENT SAFETY AND QUALITY OF CARE COME FIRST. A HOME- LIKE ENVIRONMENT IS PROMOTED AND EMBRACED AND THE NATIVE CULTURE IS WOVEN INTO EVERY ASPECT OF CARE. NATIVE FOODS ARE PREPARED OFTEN THROUGH FAMILY AND COMMUNITY DONATIONS. CELEBRATIONS AND FAMILY GATHERINGS ARE PART OF EVERYDAY LIFE IN THE FACILITY. KEY HOSPITAL STATISTICS FOR FY23 INCLUDE: ADMISSIONS ACUTE CARE: 752, LABOR & DELIVERY: 100, SWING BED 62 ER VISITS 5,534 OUTPATIENTS 11,703 DENTAL ENCOUNTERS 11,154 RADIOLOGY PROCEDURES SPECIALTY CLINIC 1,019 |
| FORM 990, PAGE 2, PART III, LINE 4B | NSHC'S REGIONAL HEALTH SERVICES PROVIDE A WIDE VARIETY OF HEALTH CARE, PROMOTION, SCREENING, AND PREVENTION PROGRAMS TO NOME AND 15 BERING SEA VILLAGES. SUCH PROGRAMS INCLUDE BUT ARE NOT LIMITED TO THE PROVISION OF HEALTH AIDES (CERTIFIED AND IN-TRAINING) AT EACH VILLAGE HEALTH CLINIC, A TRIBAL HEALER PROGRAM, INFANT LEARNING PROGRAMS, ENVIRONMENTAL HEALTH PROGRAM, HEALTHY STARTS AND OTHER SERVICES GEARED SPECIFICALLY TO WOMEN, INFANTS AND CHILDREN. KEY STATISTICS FOR FY23 INCLUDE: PATIENT VISITS IN VILLAGE CLINICS 25,908 WIC CLIENT ENCOUNTERS ENVIRONMENTAL HEALTH TECH ASSISTANCE ANIMAL BITES/RABIE INVESTIGATION WATER QUALTIY |
| FORM 990, PAGE 2, PART III, LINE 4C | NSHC'S BEHAVIORAL HEALTH SERVICES DIVISION PROVIDES OUTPATIENT INDIVIDUAL, COUPLE, FAMILY AND GROUP MENTAL HEALTH THERAPY, INTERACTIVE AND OBSERVATIONAL PLAY THERAPY AS WELL AS INDIVIDUAL, COUPLE, FAMILY AND GROUP SUBSTANCE ABUSE COUNSELING, SEXUAL ASSAULT RESPONSE SERVICES AND ALCOHOL AND DRUG INFORMATION SCHOOL. IT ALSO PROVIDES PSYCHOLOGICAL AND NEUROPSYCHOLOGICAL TESTING, PSYCHIATRIC SERVICES INCLUDING MEDICATION ASSESSMENT AND EVALUATION, CASE MANAGEMENT AND REFERRAL SERVICES AND 24/7 CRISIS INTERVENTION IN THE EMERGENCY ROOM AND INPATIENT UNITS. BEHAVIORAL HEALTH SERVICES ARE DELIVERED IN THE VILLAGES THROUGH THE VILLAGE BASED COUNSELORS (VBC'S). BHS IS THE ONLY RURAL LOCATION IN THE STATE ACCREDITED BY THE AMERICAN PSYCHOLOGICAL ASSOCIATION WITH A PR-DOCTORAL INTERNSHIP PROGRAM. KEY STATISTICS FOR FY23 INCLUDE: BEHAVIORAL HEALTH VISITS - 4,463 TELEHEALTH PRIMARY CARE - 618 |
| FORM 990, PAGE 2, PART III, LINE 4D | STATE & FEDERAL GRANTS AND CONTRACTS WITH PATIENT REVENUE: ILP AND DVPI HAVE REVENUE. |
| FORM 990, PAGE 6, PART VI, LINE 1A | THE BOARD MAY DELEGATE ITS POWERS AND ADMINISTRATIVE RESPONSIBILITIES TO THE EXECUTIVE COMMITTEE, WHICH ACTS IN THE STEAD OF THE BOARD BETWEEN THE BOARD'S REGULAR MEETINGS. THE EXCUTIVE COMMITTEE IS COMPRISED OF FOLLOWING BOARD PERSONS: CHAIRPERSON, FIRST VICE CHAIRPERSON, SECOND VICE CHAIRPERSON, SECRETARY, TREASURER, AND THE ASSISTANT SECRETARY-TREASURER, ALL OF WHOM SHALL BE ELECTED ANNUALLY BY THE DIRECTORS. THE PRESIDENT/CEO SERVES AS A NON-VOTING EX-OFFICIO MEMBER OF THE EXECUTIVE COMMITTEE. |
| FORM 990, PAGE 6, PART VI, LINE 2 | HEATHER PAYENNA KIRSTEN TIMBERS BOARD MEMBER VP HEALTH SV SPOUSES |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE ORGANIZATION'S FORM 990 IS REVIEWED BY THE CFO PRIOR TO FILING AND WILL BE PRESENTED AT A FULL BOARD MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT (HR) PROVIDES EMPLOYEE EDUCATION ON OUR POLICIES ON THE EMPLOYEE'S FIRST DAY OF WORK. ALL CORPORATE POLICIES ARE APPROVED BY THE BOARD OF DIRECTORS AND ENFORCED/ MONITORED BY ADMINISTRATION AND HR STAFF. THEY ARE MONITORED BY INTERACTION WITH MANAGERS AND OTHER STAFF. ANY ISSUES THAT ARE IDENTIFIED ARE FORWARDED TO HR FOR INVESTIGATION AND FOLLOW UP. |
| FORM 990, PAGE 6, PART VI, LINE 15A | NSHC'S PROCESS FOR DETERMINING COMPENSATION FOR EXECUTIVE LEVEL POSITIONS INCLUDES REVIEW AND APPROVAL OF COMPENSATION COMMITTEE; COMPARISON TO LIKE POSITIONS INCLUDED IN ALASKA STATE HOSPITAL AND NURSING HOME ASSOCIATION (ASHNA) SALARY SURVEY; AND DOCUMENTATION OF PROCESS UNDERTAKEN. MARKET PAY ANALYSIS - ADMINISTRATION WILL CONDUCT MARKET RESEARCH TO COMPARE LIKE POSITIONS EMPLOYED BY NSHC WITH LIKE POSITIONS EMPLOYED AT OUR COMPETITOR HEALTH CARE FACILITIES WITHIN THE STATE AND WITHIN THE REGION. DURING FY23, INFLATION ANALYSIS RESULTED IN A 6% PAY INCREASE TO ALL STAFF. |
| FORM 990, PAGE 6, PART VI, LINE 15B | NSHC EMPLOYS THE SAME PROCESS AND SCHEDULE FOR ALL TOP OFFICIALS, OFFICERS AND KEY EMPLOYEES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | UPN REQUEST, THE ORGANIZATION WILL MAKE ITS GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS AVAILABLE. |
| FORM 990, PART XI, LINE 9 | PROVISION FOR DOUBTFUL ACCOUNTS -664,677 PROVISION FOR DOUBTFUL ACCOUNTS 664,677 |
| Software ID: | |
| Software Version: |