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CENTRAL PENINSULA GENERAL HOSPITAL, INC.

Contents

Company Details

Name: CENTRAL PENINSULA GENERAL HOSPITAL, INC.
Jurisdiction: Alaska
Legal type: Nonprofit Corporation
Status: Good Standing
Date of registration: 07 Dec 1992 (32 years ago)
Entity Number: 50675D
ZIP code: 99669
County: Kenai Peninsula
Place of Formation: ALASKA
Address: 250 HOSPITAL PLACE, SOLDOTNA, AK 99669
Supporting healthcare providers fighting with COVID-19: $14,049,725

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

622110 GENERAL MEDICAL AND SURGICAL HOSPITALS

Officers

Name Role
Jessie Kincaid Director
Silverio Mattero Director
Steve Horn Director
Steve Horn President
Max Best Director
Jay Rohloff Director
Trena Richardson Director
Carrie Couey Secretary
Carrie Couey Treasurer
Carrie Couey Director

Unique Entity ID

Unique Entity ID Expiration Date Physical Address
YER6XJDDTND9 2024-10-23 250 HOSPITAL PL, SOLDOTNA, AK, 99669, 7559, USA
Mailing Address 250 HOSPITAL PL, SOLDOTNA, AK, 99669, 7559, USA

Business Information

URL http://www.cpgh.org
Division Name CENTRAL PENINSULA GENERAL HOSPITAL, INC.
Congressional District 00
State/Country of Incorporation AK, USA
Activation Date 2023-10-26
Initial Registration Date 2004-06-17
Entity Start Date 1971-06-21
Fiscal Year End Close Date Jun 30

Points of Contacts

Electronic Business
Title PRIMARY POC
Name MICHAEL J HAGGERTY
Role CFO
Address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669, 7559, USA
Title ALTERNATE POC
Name NICKI MCKINNEY
Role CONTROLLER
Address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669, 7559, USA
Government Business
Title PRIMARY POC
Name MICHAEL J HAGGERTY
Role CFO
Address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669, 7559, USA
Title ALTERNATE POC
Name SHAUN KEEF
Role CEO
Address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669, 7559, USA
Past Performance
Title PRIMARY POC
Name MICHAEL J HAGGERTY
Role CFO
Address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669, 7559, USA
Title ALTERNATE POC
Name NICKI MCKINNEY
Role CONTROLLER
Address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669, 7559, USA

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
3WUX8 Obsolete Non-Manufacturer 2004-06-18 2023-10-26 - 2024-10-23

Contact Information

POC MICHAEL J. HAGGERTY
Phone +1 907-714-4722
Fax +1 907-714-4969
Address 250 HOSPITAL PL, SOLDOTNA, AK, 99669 7559, UNITED STATES

Ownership of Offeror Information

Highest Level Owner -
Immediate Level Owner -
List of Offerors (0) -

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
CENTRAL PENINSULA GENERAL HOSPITAL LIFE, AD&D, DEPENDENT LIFE, SHORT-TERM DISABILITY 2012 920077523 2013-12-18 583
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1994-07-01
Sponsor CENTRAL PENINSULA GENERAL HOSPITAL
Business code 622000
Sponsor’s telephone number 9077144404
Plan sponsor’s mailing address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Plan sponsor’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669

Number of participants as of the end of the plan year

Active participants 620

Signature of

Role Plan administrator
Date 2013-12-17
Name of individual signing DEBI HONER
Valid signature Filed with authorized/valid electronic signature
CENTRAL PENINSULA GENERAL HOSPITAL FLEXIBLE BENEFIT PLAN 2012 920077523 2013-12-18 146
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1989-11-01
Sponsor CENTRAL PENINSULA GENERAL HOSPITAL
Business code 622000
Sponsor’s telephone number 9077144404
Plan sponsor’s mailing address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Plan sponsor’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669

Plan administrator’s name and address

Administrator’s EIN 920077523
Plan administrator’s name CENTRAL PENINSULA GENERAL HOSPITAL
Plan administrator’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Administrator’s telephone number 9077144404

Number of participants as of the end of the plan year

Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of

Role Plan administrator
Date 2013-12-17
Name of individual signing DEBI HONER
Valid signature Filed with authorized/valid electronic signature
CENTRAL PENINSULA GENERAL HOSPITAL LIFE, AD&D, DEPENDENT LIFE, SHORT-TERM DISABILITY 2011 920077523 2013-03-05 588
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1994-07-01
Sponsor CENTRAL PENINSULA GENERAL HOSPITAL
Business code 622000
Sponsor’s telephone number 9077144404
Plan sponsor’s mailing address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Plan sponsor’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669

Plan administrator’s name and address

Administrator’s EIN 920077523
Plan administrator’s name CENTRAL PENINSULA GENERAL HOSPITAL
Plan administrator’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Administrator’s telephone number 9077144404

Number of participants as of the end of the plan year

Active participants 583

Signature of

Role Plan administrator
Date 2013-03-05
Name of individual signing DEBI HONER
Valid signature Filed with authorized/valid electronic signature
CENTRAL PENINSULA GENERAL HOSPITAL FLEXIBLE BENEFIT PLAN 2011 920077523 2013-03-05 169
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1989-11-01
Sponsor CENTRAL PENINSULA GENERAL HOSPITAL
Business code 622000
Sponsor’s telephone number 9077144404
Plan sponsor’s mailing address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Plan sponsor’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669

Plan administrator’s name and address

Administrator’s EIN 920077523
Plan administrator’s name CENTRAL PENINSULA GENERAL HOSPITAL
Plan administrator’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Administrator’s telephone number 9077144404

Number of participants as of the end of the plan year

Active participants 146

Signature of

Role Plan administrator
Date 2013-03-05
Name of individual signing DEBI HONER
Valid signature Filed with authorized/valid electronic signature
CENTRAL PENINSULA GENERAL HOSPITAL FLEXIBLE BENEFIT PLAN 2010 920077523 2012-01-16 134
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1989-11-01
Sponsor CENTRAL PENINSULA GENERAL HOSPITAL
Business code 622000
Sponsor’s telephone number 9077144404
Plan sponsor’s mailing address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Plan sponsor’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669

Plan administrator’s name and address

Administrator’s EIN 920077523
Plan administrator’s name CENTRAL PENINSULA GENERAL HOSPITAL
Plan administrator’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Administrator’s telephone number 9077144404

Number of participants as of the end of the plan year

Active participants 169

Signature of

Role Plan administrator
Date 2012-01-16
Name of individual signing DEBI HONER
Valid signature Filed with authorized/valid electronic signature
CENTRAL PENINSULA GENERAL HOSPITAL LIFE, AD&D, DEPENDENT LIFE, SHORT-TERM DISABILITY 2010 920077523 2012-01-23 551
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1994-07-01
Sponsor CENTRAL PENINSULA GENERAL HOSPITAL
Business code 622000
Sponsor’s telephone number 9077144404
Plan sponsor’s mailing address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Plan sponsor’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669

Plan administrator’s name and address

Administrator’s EIN 920077523
Plan administrator’s name CENTRAL PENINSULA GENERAL HOSPITAL
Plan administrator’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Administrator’s telephone number 9077144404

Number of participants as of the end of the plan year

Active participants 588

Signature of

Role Plan administrator
Date 2012-01-23
Name of individual signing DEBI HONER
Valid signature Filed with authorized/valid electronic signature
CENTRAL PENINSULA GENERAL HOSPITAL LIFE, AD&D, DEPENDENT LIFE, SHORT-TERM DISABILITY 2009 920077523 2010-12-15 533
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1994-07-01
Sponsor CENTRAL PENINSULA GENERAL HOSPITAL
Business code 622000
Sponsor’s telephone number 9077144404
Plan sponsor’s mailing address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Plan sponsor’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669

Plan administrator’s name and address

Administrator’s EIN 920077523
Plan administrator’s name CENTRAL PENINSULA GENERAL HOSPITAL
Plan administrator’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Administrator’s telephone number 9077144404

Number of participants as of the end of the plan year

Active participants 551
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of

Role Plan administrator
Date 2010-12-15
Name of individual signing DEBI HONER
Valid signature Filed with authorized/valid electronic signature
CENTRAL PENINSULA GENERAL HOSPITAL FLEXIBLE BENEFIT PLAN 2009 920077523 2010-12-15 158
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1989-11-01
Sponsor CENTRAL PENINSULA GENERAL HOSPITAL
Business code 622000
Sponsor’s telephone number 9077144404
Plan sponsor’s mailing address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Plan sponsor’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669

Plan administrator’s name and address

Administrator’s EIN 920077523
Plan administrator’s name CENTRAL PENINSULA GENERAL HOSPITAL
Plan administrator’s address 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Administrator’s telephone number 9077144404

Number of participants as of the end of the plan year

Active participants 134
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of

Role Plan administrator
Date 2010-12-15
Name of individual signing DEBI HONER
Valid signature Filed with authorized/valid electronic signature

Business Licenses

License Number Type Status Issue Date Date of renewal Expiration date Description
227830 Business License Active 1996-06-18 2024-11-19 2026-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 622110 - GENERAL MEDICAL AND SURGICAL HOSPITALS

Professional Licenses

License Number Program Type Status Issue Date Effective Date Expiration Date
PHAR437 Pharmacy Pharmacy Active 2007-03-09 2024-05-08 2026-06-30
159954 Telemedicine Business Registry Telemedicine Business Registry Active 2020-03-31 2020-03-31 -
159956 Telemedicine Business Registry Telemedicine Business Registry Active 2020-03-31 2020-03-31 -
159957 Telemedicine Business Registry Telemedicine Business Registry Active 2020-03-31 2020-03-31 -
159959 Telemedicine Business Registry Telemedicine Business Registry Active 2020-03-31 2020-03-31 -
159961 Telemedicine Business Registry Telemedicine Business Registry Active 2020-03-31 2020-03-31 -
159983 Telemedicine Business Registry Telemedicine Business Registry Active 2020-03-31 2020-03-31 -
159984 Telemedicine Business Registry Telemedicine Business Registry Active 2020-03-31 2020-03-31 -
159986 Telemedicine Business Registry Telemedicine Business Registry Active 2020-03-31 2020-03-31 -
159987 Telemedicine Business Registry Telemedicine Business Registry Active 2020-03-31 2020-03-31 -

Court Cases Opinions

Package ID Category Cause Nature Of Suit
USCOURTS-akd-3_19-cv-00154 Judicial Publications 42:1983 Prisoner Civil Rights Prisoner - Civil Rights (U.S. defendant)
Collection United States Courts Opinions
SuDoc JU 4.15
Court Type District
Court Name United States District Court District of Alaska
Circuit 9th
Office Location Anchorage
Case Type civil

Parties

Name Michael T. Blake
Role Defendant
Name Debra A. Blizzard
Role Defendant
Name John Bramante
Role Defendant
Name Irving Carlisle
Role Defendant
Name CENTRAL PENINSULA GENERAL HOSPITAL, INC.
Role Defendant
Name Cy Cox
Role Defendant
Name T.J. Cox
Role Defendant
Name Dianne J. Cronin
Role Defendant
Name Mark Dixson
Role Defendant
Name Levi Doss
Role Defendant
Name Rachel Gilliland
Role Defendant
Name Jason Helton
Role Defendant
Name Casey Hershberger
Role Defendant
Name Katelin E. Himes
Role Defendant
Name Steven Horn
Role Defendant
Name Henry Kane
Role Defendant
Name Michael Levy
Role Defendant
Name Steve Manley
Role Defendant
Name Sal Mattero
Role Defendant
Name James McHale
Role Defendant
Name Matthew M. Meade
Role Defendant
Name Joseph Minnick
Role Defendant
Name Gregg Montonaga
Role Defendant
Name Mark Pearson
Role Defendant
Name Russell Peterson
Role Defendant
Name Mark Premo
Role Defendant
Name Trena Richardson
Role Defendant
Name Debra Shuey
Role Defendant
Name Jessica Smith
Role Defendant
Name Samuel J. Webber
Role Defendant
Name Michael L. McLaughlin
Role Plaintiff

Opinions

Opinion ID USCOURTS-akd-3_19-cv-00154-0
Date 2019-12-31
Notes ORDER RE AMENDED JUDGMENT: re 13 MOTION Seeking to Alter or Amend the Judgment re 9 Judgment filed by Michael L. McLaughlin. The Court removes the strike against Mr. McLaughlin. The Clerk of Court is directed to amend the judgment. (See Order for details). Signed by Judge Timothy M. Burgess on 12/31/2019. (CME, COURT STAFF)
View View File

Court View Cases

Title Date Case Type Status Open
3AN-11-12713CI Kahtnu Ventures LLC vs. State of Alaska, Dept of Health & Social Services et al PJM 2011-12-13 Civil Superior Ct (3AN) Closed Open Case Link

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
- IDV VA26012A0100 2012-10-01 - -
Unique Award Key CONT_IDV_VA26012A0100_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description

Title NURSING HOME SERVICES
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q401: MEDICAL- NURSING

Recipient Details

Recipient CENTRAL PENINSULA GENERAL HOSPITAL INC
UEI YER6XJDDTND9
Legacy DUNS 145406034
Recipient Address UNITED STATES, 250 HOSPITAL PL, SOLDOTNA, 996696999

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
347448367 1050210 2024-04-30 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Inspection Type Complaint
Scope Partial
Safety/Health Health
Close Conference 2024-06-26
Case Closed 2024-07-25
347194441 1050210 2024-01-03 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Inspection Type Referral
Scope Records
Safety/Health Health
Close Conference 2024-01-03
Case Closed 2024-02-07
343525044 1050210 2018-10-08 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Inspection Type Complaint
Scope Partial
Safety/Health Health
Close Conference 2018-10-08
Emphasis S: HEALTHCARE
Case Closed 2020-01-06

Related Activity

Type Complaint
Activity Nr 1389102
Health Yes

Violation Items

Citation ID 01001
Citaton Type Serious
Standard Cited 19100132 D01 I
Issuance Date 2019-03-19
Abatement Due Date 2019-04-15
Current Penalty 1594.0
Initial Penalty 1875.0
Final Order 2019-04-09
Nr Instances 1
Nr Exposed 8
Gravity 5
FTA Current Penalty 0.0
Citation ID 01002
Citaton Type Serious
Standard Cited 19100151 C
Issuance Date 2019-03-19
Abatement Due Date 2019-05-06
Current Penalty 1594.0
Initial Penalty 1875.0
Final Order 2019-04-09
Nr Instances 1
Nr Exposed 8
Gravity 5
FTA Current Penalty 0.0
Citation ID 01003A
Citaton Type Serious
Standard Cited 19101030 D04 III A 3II
Issuance Date 2019-03-19
Abatement Due Date 2019-04-15
Current Penalty 3825.0
Initial Penalty 4500.0
Final Order 2019-04-09
Nr Instances 5
Nr Exposed 8
Related Event Code (REC) Complaint
Gravity 10
FTA Current Penalty 0.0
Citation ID 01003B
Citaton Type Serious
Standard Cited 19101030 D04 III B 1 I
Issuance Date 2019-03-19
Abatement Due Date 2019-04-15
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2019-04-09
Nr Instances 4
Nr Exposed 8
Related Event Code (REC) Complaint
Gravity 10
FTA Current Penalty 0.0
Citation ID 01003C
Citaton Type Serious
Standard Cited 19101030 G01 I A
Issuance Date 2019-03-19
Abatement Due Date 2019-04-15
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2019-04-09
Nr Instances 3
Nr Exposed 8
Related Event Code (REC) Complaint
Gravity 10
FTA Current Penalty 0.0
Citation ID 02001
Citaton Type Other
Standard Cited 19100037 A03
Issuance Date 2019-03-19
Abatement Due Date 2019-04-15
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2019-04-09
Nr Instances 2
Nr Exposed 5
FTA Current Penalty 0.0
Citation ID 02002
Citaton Type Other
Standard Cited 19100037 B02
Issuance Date 2019-03-19
Abatement Due Date 2019-04-15
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2019-04-09
Nr Instances 1
Nr Exposed 9
FTA Current Penalty 0.0
Citation ID 02003
Citaton Type Other
Standard Cited 19101200 E01
Issuance Date 2019-03-19
Abatement Due Date 2019-04-15
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2019-04-09
Nr Instances 1
Nr Exposed 6
FTA Current Penalty 0.0
Citation ID 02004A
Citaton Type Other
Standard Cited AS 18.60.880(C)(1)
Issuance Date 2019-03-19
Abatement Due Date 2019-04-15
Current Penalty 620.0
Initial Penalty 765.0
Final Order 2019-04-09
Nr Instances 9
Nr Exposed 9
FTA Current Penalty 0.0
Citation ID 02004B
Citaton Type Other
Standard Cited AS 18.60.880(C)(2)
Issuance Date 2019-03-19
Abatement Due Date 2019-04-15
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2019-04-09
Nr Instances 9
Nr Exposed 9
FTA Current Penalty 0.0
Citation ID 02004C
Citaton Type Other
Standard Cited AS 18.60.880(C)(3)(E)
Issuance Date 2019-03-19
Abatement Due Date 2019-04-15
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2019-04-09
Nr Instances 9
Nr Exposed 9
FTA Current Penalty 0.0
Citation ID 02004D
Citaton Type Other
Standard Cited AS 18.60.880(C)(3)(F)
Issuance Date 2019-03-19
Abatement Due Date 2019-04-15
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2019-04-09
Nr Instances 9
Nr Exposed 9
FTA Current Penalty 0.0
Citation ID 02004E
Citaton Type Other
Standard Cited AS 18.60.880(C)(3)(H)
Issuance Date 2019-03-19
Abatement Due Date 2019-04-15
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2019-04-09
Nr Instances 9
Nr Exposed 9
FTA Current Penalty 0.0
343487252 1050210 2018-07-02 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Inspection Type Referral
Scope Partial
Safety/Health Safety
Close Conference 2018-07-02
Emphasis S: AKH
Case Closed 2018-12-24

Related Activity

Type Referral
Activity Nr 1353958
Safety Yes
341248870 1050210 2016-02-12 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Inspection Type Referral
Scope Records
Safety/Health Health
Close Conference 2016-02-24
Case Closed 2016-03-17

Related Activity

Type Referral
Activity Nr 1062458
Health Yes

Violation Items

Citation ID 01001
Citaton Type Other
Standard Cited 19040032 A01
Issuance Date 2016-03-01
Abatement Due Date 2016-03-07
Current Penalty 1000.0
Initial Penalty 1000.0
Final Order 2016-03-16
Nr Instances 3
Nr Exposed 850
Related Event Code (REC) Referral
FTA Current Penalty 0.0
Citation ID 01002
Citaton Type Other
Standard Cited 19040032 A01
Issuance Date 2016-03-01
Abatement Due Date 2016-03-07
Current Penalty 1000.0
Initial Penalty 1000.0
Final Order 2016-03-16
Nr Instances 2
Nr Exposed 850
Related Event Code (REC) Referral
FTA Current Penalty 0.0
Citation ID 01003
Citaton Type Other
Standard Cited 19040032 A01
Issuance Date 2016-03-01
Abatement Due Date 2016-03-07
Current Penalty 1000.0
Initial Penalty 1000.0
Final Order 2016-03-16
Nr Instances 2
Nr Exposed 850
Related Event Code (REC) Referral
FTA Current Penalty 0.0
124076563 1050210 1994-09-12 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Inspection Type Accident
Scope Partial
Safety/Health Safety
Close Conference 1994-09-12
Case Closed 1994-11-25

Related Activity

Type Accident
Activity Nr 360179857
124076100 1050210 1994-06-14 250 HOSPITAL PLACE, SOLDOTNA, AK, 99669
Inspection Type Referral
Scope Partial
Safety/Health Health
Close Conference 1994-06-14
Emphasis L: AKH, N: BLOOD
Case Closed 1994-06-28

Related Activity

Type Referral
Activity Nr 902186014
Safety Yes
Health Yes

Date of last update: 24 Jan 2025

Sources: State of Alaska - Department of Commerce, Community, and Economic Development