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  5. South Peninsula Hospital, Inc.

South Peninsula Hospital, Inc.

Contents

Company Details

Name: South Peninsula Hospital, Inc.
Jurisdiction: Alaska
Legal type: Nonprofit Corporation
Status: Good Standing
Date of registration: 01 Oct 1969 (55 years ago)
Entity Number: 8951D
ZIP code: 99603
County: Kenai Peninsula
Place of Formation: ALASKA
Address: 4300 BARTLETT ST, HOMER, AK 99603
Mailing Address: 4300 BARTLETT ST., HOMER, AK 99603
Supporting healthcare providers fighting with COVID-19: $9,054,022

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

622110 GENERAL MEDICAL AND SURGICAL HOSPITALS

Officers

Name Role
CHRISTOPHER LANDESS Director
Ryan Smith Registered Agent
Preston Simmons Vice President
MATTHEW BULLARD Director
MICHAEL DYE Director
Walter Partridge Treasurer
AARON WEISSER President
Bernadette Wilson Director
Edson Knapp Director
MATTHEW HAMBRICK Director

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2020 920037099 2021-06-14 118
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2021-06-14
Name of individual signing ANGELA HINNEGAN
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2019 920037099 2020-10-15 116
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing ANGELA HINNEGAN
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2018 920037099 2019-10-09 105
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2019-10-09
Name of individual signing JAMES BASCH
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2017 920037099 2018-10-15 79
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing ANGELA HINNEGAN
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR UNION EMPLOYEES 2016 920037099 2017-10-16 39
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2015-03-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2017-10-16
Name of individual signing HOLLY TORRES
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2016 920037099 2017-10-16 81
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2017-10-16
Name of individual signing HOLLY TORRES
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2015 920037099 2016-10-17 71
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing TAMMY ACKERMAN
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR UNION EMPLOYEES 2015 920037099 2016-10-17 0
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2015-03-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing TAMMY ACKERMAN
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2014 920037099 2015-09-09 68
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2015-09-09
Name of individual signing LORI MEYER
Role Employer/plan sponsor
Date 2015-09-09
Name of individual signing LORI MEYER
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2013 920037099 2014-01-28 68
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2014-01-28
Name of individual signing LORI MEYER
Role Employer/plan sponsor
Date 2014-01-28
Name of individual signing LORI MEYER

Business Licenses

License Number Type Status Issue Date Date of renewal Expiration date Description
192072 Business License Active - 2024-12-02 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
PHAR232 Pharmacy Pharmacy Active 1992-05-07 2024-05-22 2026-06-30
137093 Telemedicine Business Registry Telemedicine Business Registry Active 2018-08-07 2018-08-07 -

Election Contributions

Date Amount Election Name Payment Detail
2024-12-04 ($8,076.91) 2024 - Kenai Peninsula Borough 2004
Transaction Type Income
Payment Type Check
Business Name South Peninsula Hospital
Purpose Of Expenditure Partial refund of contribution
Teport Type 105 Day Report
Election Type Statewide Municipal
Municipality Kenai Peninsula Borough
Office -
Filer Type Group
Name Yes on 1 for Local Healthcare
Report Year 2024
Submitted 1/13/2025

Address
Address 4300 Bartlett St
City Homer
State Alaska
Zip 99603
Country USA
2024-08-23 $50,000.00 2024 - Kenai Peninsula Borough -
Transaction Type Income
Payment Type Electronic Funds Transfer
Business Name South Peninsula Hospital
Purpose Of Expenditure -
Teport Type Thirty Day Report
Election Type Statewide Municipal
Municipality Kenai Peninsula Borough
Office -
Filer Type Group
Name Yes on 1 for Local Healthcare
Report Year 2024
Submitted 9/3/2024

Address
Address 4300 Bartlett St
City Homer
State Alaska
Zip 99603
Country USA
2024-07-29 $50,000.00 2024 - Kenai Peninsula Borough -
Transaction Type Income
Payment Type Electronic Funds Transfer
Business Name South Peninsula Hospital
Purpose Of Expenditure -
Teport Type Thirty Day Report
Election Type Statewide Municipal
Municipality Kenai Peninsula Borough
Office -
Filer Type Group
Name Yes on 1 for Local Healthcare
Report Year 2024
Submitted 9/3/2024

Address
Address 4300 Bartlett St
City Homer
State Alaska
Zip 99603
Country USA

Inspections

Inspection Type Most Recent Inspection Address
Routine 2024-06-06 4300 Barlett ST Homer, AK 99603

Violation Items
Inspector Comments No violations
Routine 2022-11-22 4300 Barlett ST Homer, AK 99603

Violation Items
Inspector Comments No violations
Routine 2020-01-16 4300 Barlett ST Homer, AK 99603

Violation Items
Inspector Comments No violations
Routine 2018-09-25 4300 Barlett ST Homer, AK 99603

Violation Items
Inspector Comments No violations
Routine 2017-12-27 4300 Barlett ST Homer, AK 99603

Violation Items
Inspector Comments The concentration of sanitizing solution was over 200ppm, exceeding the manufacturer’s recommendation for food contact surfaces. The sanitizer should be 50-100ppm to ensure proper sanitizing. Failure to use sanitizers at the proper concentrations could result in injury to employees and the consumer. Employee immediately diluted solution to proper concentration and verified with a test strip. Manager agreed to train all employees on how to make up the sanitizing solution.

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
347870768 1050210 2024-11-04 4135 HOHE STREET SERENE WATERS MENTAL HEALTH CLINIC, HOMER, AK, 99603
Inspection Type Complaint
Scope Partial
Safety/Health Health
345395487 1050210 2021-04-21 4300 BARTLETT STREET, HOMER, AK, 99603
Inspection Type Complaint
Scope Partial
Safety/Health Health
Close Conference 2021-08-02
Case Closed 2023-06-12
305764185 1050210 2004-07-01 4300 BARTLET STREET, HOMER, AK, 99603
Inspection Type Planned
Scope Partial
Safety/Health Health
Close Conference 2004-07-01
Emphasis L: HHT
Case Closed 2004-09-28

Violation Items
Citation ID 01001
Citaton Type Other
Standard Cited 19101030 G01 IA
Issuance Date 2004-08-31
Abatement Due Date 2004-09-08
Nr Instances 2
Nr Exposed 3
Citation ID 01002
Citaton Type Other
Standard Cited 19101030 G01 IC
Issuance Date 2004-08-31
Abatement Due Date 2004-09-10
Nr Instances 6
Nr Exposed 5
Citation ID 01003
Citaton Type Other
Standard Cited 19101200 F05
Issuance Date 2004-08-31
Abatement Due Date 2004-09-07
Nr Instances 1
Nr Exposed 3
Citation ID 01004
Citaton Type Other
Standard Cited 19101450 H01 II
Issuance Date 2004-08-31
Abatement Due Date 2004-09-24
Nr Instances 3
Nr Exposed 4
303701585 1050210 2002-06-19 4300 BARTLETT STREET, HOMER, AK, 99603
Inspection Type Referral
Scope Partial
Safety/Health Health
Close Conference 2002-06-19
Emphasis L: AKH
Case Closed 2002-09-24

Related Activity
Type Referral
Activity Nr 900128166
Health Yes

Violation Items
Citation ID 01001
Citaton Type Serious
Standard Cited 19101030 D04 IIA
Issuance Date 2002-07-23
Abatement Due Date 2002-08-10
Current Penalty 687.5
Initial Penalty 1375.0
Nr Instances 1
Nr Exposed 4
Gravity 03
301264990 1050210 1999-01-21 4300 BARTLETT STREET, HOMER, AK, 99603
Inspection Type Complaint
Scope Complete
Safety/Health Health
Close Conference 1999-01-21
Emphasis L: AKH
Case Closed 1999-04-01

Related Activity
Type Complaint
Activity Nr 79361903
Safety Yes
Health Yes

Violation Items
Citation ID 01001A
Citaton Type Serious
Standard Cited 19100212 B
Issuance Date 1999-03-02
Abatement Due Date 1999-01-21
Current Penalty 701.0
Initial Penalty 701.0
Nr Instances 1
Nr Exposed 2
Gravity 01
Citation ID 01001B
Citaton Type Serious
Standard Cited 19100215 A04
Issuance Date 1999-03-02
Abatement Due Date 1999-01-21
Nr Instances 1
Nr Exposed 3
Citation ID 01001C
Citaton Type Serious
Standard Cited 19100215 B09
Issuance Date 1999-03-02
Abatement Due Date 1999-01-21
Nr Instances 1
Nr Exposed 3
Citation ID 02001
Citaton Type Other
Standard Cited 19100134 H02 I
Issuance Date 1999-03-02
Abatement Due Date 1999-01-21
Nr Instances 1
Nr Exposed 1
105855035 1050210 1994-02-01 4300 BARTLETT STREET, HOMER, AK, 99603
Inspection Type Planned
Scope Partial
Safety/Health Safety
Close Conference 1994-02-01
Emphasis N: BLOOD, L: AK10
Case Closed 1994-02-08

Date of last update: 24 Jan 2025

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

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