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  5. ST. MARY'S HOSPITAL, INC.

ST. MARY'S HOSPITAL, INC.

Company Details

Name: ST. MARY'S HOSPITAL, INC.
Jurisdiction: Idaho
Legal type: Non-Profit Corporation (D)
Status: Active-Good Standing
Date of registration: 24 Jan 1958 (67 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 102305
Place of Formation: IDAHO
File Number: 102305
ZIP code: 83522
County: Idaho County
Mailing Address: 701 LEWISTON ST COTTONWOOD, ID 83522-9750

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
DKW1MZFJAB38 2025-01-23 701 LEWISTON ST, COTTONWOOD, ID, 83522, 9750, USA P O BOX 137, COTTONWOOD, ID, 83522, 0137, USA

Business Information
URL www.smh-cvhc.org
Congressional District 01
State/Country of Incorporation ID, USA
Activation Date 2024-01-26
Initial Registration Date 2004-03-30
Entity Start Date 1958-01-24
Fiscal Year End Close Date Jun 30

Service Classifications
NAICS Codes 621111, 621910, 622110
Product and Service Codes 6532

Points of Contacts
Electronic Business
Title PRIMARY POC
Name JYL RULAND
Address P. O. BOX 137, COTTONWOOD, ID, 83522, 0137, USA
Title ALTERNATE POC
Name LENNE BONNER
Address PO BOX 137, 701 LEWISTON ST., COTTONWOOD, ID, 83522, 0137, USA
Government Business
Title PRIMARY POC
Name JYL RULAND
Address P. O. BOX 137, COTTONWOOD, ID, 83522, 0137, USA
Title ALTERNATE POC
Name LENNE BONNER
Address PO BOX 137, 701 LEWISTON ST., COTTONWOOD, ID, 83522, 0137, USA
Past Performance
Title PRIMARY POC
Name CODY WILKINSON
Address P. O. BOX 137, 701 LEWISTON ST., COTTONWOOD, ID, 83522, 0137, USA
Title ALTERNATE POC
Name LENNE BONNER
Address 701 LEWISTON ST., P. O. BOX 137, COTTONWOOD, ID, 83522, 0137, USA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ST. MARY'S HOSPITAL, INC. MEDICAL PLAN 2015 820226453 2017-03-02 ST. MARY'S HOSPITAL, INC 289
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2013-01-01
Business code 622000
Sponsor’s telephone number 2089622318
Plan sponsor’s mailing address 701 LEWISTON STREET, PO BOX 137, COTTONWOOD, ID, 835220137
Plan sponsor’s address 701 LEWISTON STREET, PO BOX 137, COTTONWOOD, ID, 835220137

Number of participants as of the end of the plan year
Active participants 285

Signature of
Role Plan administrator
Date 2017-02-21
Name of individual signing DEBBIE SCHUMACHER
Valid signature Filed with authorized/valid electronic signature
ST. MARY'S HOSPITAL, INC., MEDICAL PLAN 2014 820226453 2017-03-02 ST. MARY'S HOSPITAL, INC 281
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2013-01-01
Business code 622000
Sponsor’s telephone number 2089622318
Plan sponsor’s mailing address PO BOX 137, 701 LEWISTON STREET, COTTONWOOD, ID, 83522
Plan sponsor’s address PO BOX 137, 701 LEWISTON STREET, COTTONWOOD, ID, 83522

Number of participants as of the end of the plan year
Active participants 289

Signature of
Role Plan administrator
Date 2017-02-21
Name of individual signing DEBBIE SCHUMACHER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Joel P Hazel Agent 2003 KOOTENAI HEALTH WAY, STE 107, COEUR D ALENE, ID 83814

Director

Name Role Address Appointed On Resigned On
Matt Sartini Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2021-01-22 No data
Paul Nusser Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Lenny Hill Director 710 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Rene Forsman Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Kim Ingram Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Kelly McGrath Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Jeremy Evans Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Cindy O'Brien Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Tina Ulmer Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03
Lisa Maurer Director 701 LEWISTON ST, COTTONWOOD, ID 83522 2024-01-03 2024-01-03

Filing

Filing Name Filing Number Filing date
Annual Report 0006042281 2025-01-02
Annual Report 0005535832 2024-01-03
Annual Report 0005031416 2022-12-15
Annual Report 0004579336 2022-01-24
Annual Report 0004141497 2021-01-22
Restated Articles 0003845171 2020-04-14
Change of Registered Office/Agent/Both (by Entity) 0003831445 2020-04-07
Articles of Amendment 0003823177 2020-04-01
Annual Report 0003692501 2019-12-02
Annual Report 0003371870 2018-12-14

USAspending Awards. Financial Assistance

FAIN Awarding Agency Assistance Listings Start Date End Date Description
P10RH17185 Department of Health and Human Services 93.912 - RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH NETWORK DEVELOPMENT AND SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT PROGRAM 2010-03-01 2011-02-28 RURAL HEALTH NETWORK DEVELOPMENT PLANNING GRANT PROGRAM
Recipient ST. MARY'S HOSPITAL, INC.
Recipient Name Raw ST MARY'S HOSPITAL
Recipient UEI DKW1MZFJAB38
Recipient DUNS 076638667
Recipient Address PO BOX 137, COTTONWOOD, IDAHO, IDAHO, 83522, UNITED STATES
Obligated Amount 85000.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
345751861 1032500 2022-01-28 701 LEWISTON STREET, COTTONWOOD, ID, 83522
Inspection Type Fat/Cat
Scope Partial
Safety/Health Health
Close Conference 2022-01-28
Emphasis N: COVID-19
Case Closed 2022-06-22

Related Activity
Type Accident
Activity Nr 1860248

Violation Items
Citation ID 01001
Citaton Type Other
Standard Cited 19040039 A01
Issuance Date 2022-05-16
Current Penalty 4403.0
Initial Penalty 8806.0
Final Order 2022-06-22
Nr Instances 1
Nr Exposed 1
Related Event Code (REC) Accident
FTA Current Penalty 0.0
Citation text line 29 CFR 1904.39(a)(1): The employer did not report within 8-hours the death of an employee resulting from a work-related incident: (a) On or about January 28, 2022 and at times prior; an employer reported that an employee died on November 10, 2021. Abatement documentation is not required for this item.

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
9831327107 2020-04-15 1094 PPP 701 Lewiston Street, Cottonwood, ID, 83522-9750
Loan Status Date 2021-07-09
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 2287124
Loan Approval Amount (current) 2287124
Undisbursed Amount 0
Franchise Name -
Lender Location ID 525692
Servicing Lender Name Potlatch No. 1 Financial Credit Union
Servicing Lender Address 1025 Warner Avenue, Lewiston, ID, 83501
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address Cottonwood, IDAHO, ID, 83522-9750
Project Congressional District ID-01
Number of Employees 205
NAICS code 622110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 525692
Originating Lender Name Potlatch No. 1 Financial Credit Union
Originating Lender Address Lewiston, ID
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 2313190.95
Forgiveness Paid Date 2021-06-09

Related by officers

Joel P Hazel

KOOTENAI OUTPATIENT IMAGING, L.L.C. KOOTENAI CLINIC, LLC KOOTENAI CARE NETWORK, LLC KOOTENAI ACCOUNTABLE CARE, LLC NORTHERN IDAHO CRISIS CENTER, INC. Kootenai Health Staffing, LLC Kootenai Value Care, LLC Indigo Idaho Services, LLC KOOTENAI URGENT CARE, LLC

Matt Sartini

CLEARWATER VALLEY HOSPITAL AND CLINICS, INC.

Lenny Hill

HILLCO TECHNOLOGIES, INC.

Cindy O'Brien

CLEARWATER VALLEY HOSPITAL AND CLINICS, INC.

Related by address

No related companies by address

Date of last update: 30 Mar 2025

Sources: Idaho Secretary of State

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