NMC SERVICES INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- NMC SERVICES INC (EIN 62-1046595)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2024-07-03
- IRS object ID
- 202441859349300129
- Schema version
- 2021v4.2
- 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 D
- Schedule H
- Schedule I
- Schedule J
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-07-03T09:58:19-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 620713250 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KRAFTCPAS PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 GREAT CIRCLE ROAD | AddressLine1Txt |
| City | NASHVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37228 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621046595 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NMC SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NMCS | BusinessNameControlTxt |
| Phone | 6155046559 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 122 6TH AVENUE WEST | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37172 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERESA WILSON | PersonNm |
| Person Title | CHIEF WIND-DOWN OFFICER | PersonTitleTxt |
| Phone | 6155046559 | PhoneNum |
| Signature | 2024-07-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TERESA | PersonFirstNm |
| Person Last | WILSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | FRANCES E LEAHY | PreparerPersonNm |
| PTIN | P00713593 | PTIN |
| Phone | 6152427351 | PhoneNum |
| Preparation | 2024-06-06 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TERESA WILSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 122 6TH AVENUE WEST | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37172 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $51,250,036 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A AFTER 9/1/21 | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1987 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | OPERATION OF A NONPROFIT 109-BED ACUTE CARE FACILITY IN SPRINGFIELD, TN THAT WAS SOLD 9/01/21 | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 749 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $386,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $71,501,412 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,451,025 | CYProgramServiceRevenueAmt |
| PY Investment Income | $969,084 | PYInvestmentIncomeAmt |
| CY Investment Income | $11,502,494 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,318,366 | PYOtherRevenueAmt |
| CY Other Revenue | $622,022 | CYOtherRevenueAmt |
| PY Total Revenue | $80,174,862 | PYTotalRevenueAmt |
| CY Total Revenue | $23,575,541 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $334,109 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $19,663,675 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $31,907,258 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,973,547 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $41,047,997 | PYOtherExpensesAmt |
| CY Other Expenses | $50,138,316 | CYOtherExpensesAmt |
| PY Total Expenses | $73,289,364 | PYTotalExpensesAmt |
| CY Total Expenses | $75,775,538 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,885,498 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$52,199,997 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $98,763,260 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,311,126 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $41,116,696 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,094,416 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $57,646,564 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,216,710 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | NORTHCREST MEDICAL CENTER WAS A TENNESSEE NONPROFIT CORPORATION THAT OPERATED A 109-BED GENERAL ACUTE CARE FACILITY. THE HOSPITAL PROVIDED A FULL RANGE OF MEDICAL SERVICES TO BOTH INPATIENTS AND OUTPATIENTS IN AND AROUND THE SPRINGFIELD, TENNESSEE AREA. THE FACILITY WAS SOLD TO HCA ON 9/01/21, THUS ONLY TWO MONTHS OF HOSPITAL OPERATIONS ARE SHOWN. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $67,173,716 | ExpenseAmt |
| Grant | $19,663,675 | GrantAmt |
| Revenue | $12,073,047 | RevenueAmt |
| Desc | IN ADDITION TO HEALTH SERVICES, NORTHCREST MEDICAL CENTER SPONSORS MONTHLY SUPPORT GROUPS FOR GRIEF, CANCER AND DIABETES EDUCATION, HOSTS PRENATAL CLASSES, PUBLISHES A QUARTERLY NEWSLETTER, AND PROVIDES STROKE AND PROSTATE CANCER SCREENINGS ALONG WITH FREE BLOOD PRESSURE CHECKS. NORTHCREST MEDICAL CENTER ALSO CONDUCTS SEMINARS ON EXERCISE, NUTRITION, WEIGHT LOSS, ARTHRITIS AND SODIUM PROTECTION. THE FACILTY WAS SOLD 9/01/2021 AND IS WINDING DOWN OPERATIONS. DONATIONS OF THE PROCEEDS FROM THE SALE ARE BEING MADE TO A NEW 501C3 FOUNDATION IN THE ROBERTSON COUNTY AREA TO ASSIST WITH HEALTHCARE NEEDS IN THE LOCAL COMMUNITY. | Desc |
| Total Program Service Expenses | $67,173,716 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | Yes (1) | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 96 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 749 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | TN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TERESA WILSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6155046559 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 122 6TH AVENUE WEST | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37172 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| HOWARD BRADLEY | ||||||||
| TRUSTEE (END 8.21) | 1.00 | Yes (X) | $2,000 | $0 | $0 | |||
| JASON REYNOLDS | ||||||||
| TRUSTEE (END 8.21) | 1.00 | Yes (X) | $2,000 | $0 | $0 | |||
| SAM RAMSEY | ||||||||
| TRUSTEE (END 8.21) | 1.00 | Yes (X) | $2,000 | $0 | $0 | |||
| JACK TERRY PEARSON MD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $1,750 | $0 | $0 | 1.00 | ||
| TRACY LANGSTON | ||||||||
| TRUSTEE (END 8.21) | 1.00 | Yes (X) | $2,000 | $0 | $0 | |||
| DAN GREEN | ||||||||
| TRUSTEE (END 8.21) | 1.00 | Yes (X) | $2,000 | $0 | $0 | |||
| DIANE GOODMAN | ||||||||
| SECRETARY | 4.00 | Yes (X) | $2,000 | $0 | $0 | 1.00 | Yes (X) | |
| AMY GALLAGHER | ||||||||
| TRUSTEE (END 8.21) | 1.00 | Yes (X) | $8,000 | $0 | $0 | |||
| PAULA FARMER | ||||||||
| TRUSTEE (END 8.21) | 1.00 | Yes (X) | $1,750 | $0 | $0 | |||
| MARK SANDERS | ||||||||
| TRUSTEE (END 8.21) | 1.00 | Yes (X) | $2,000 | $0 | $0 | |||
| KEVIN VAUGHN | ||||||||
| CHAIRMAN OF THE BOARD | 4.00 | Yes (X) | $2,000 | $0 | $0 | 1.00 | Yes (X) | |
| TERESA WILSON | ||||||||
| CHIEF WIND-DOWN OFFICER | 40.00 | $138,904 | $33,333 | $16,767 | Yes (X) | |||
| RANDALL DAVIS END 821 | ||||||||
| CEO | 40.00 | $298,833 | $0 | $32,142 | Yes (X) | |||
| ANGELA BEARD END 821 | ||||||||
| CCO/ VP OF CLINICAL OPERATIONS | 40.00 | $424,365 | $0 | $32,171 | Yes (X) | |||
| KENNETH WARD END 821 | ||||||||
| CFO | 40.00 | $429,261 | $0 | $23,456 | Yes (X) | |||
| STEPHEN SANDERS END 821 | ||||||||
| DIRECTOR OF PLANT OPERATIONS | 40.00 | $103,391 | $0 | $20,055 | Yes (X) | |||
| KAREN HEAD END 821 | ||||||||
| RN/ CHARGE NURSE | 40.00 | $112,099 | $0 | $27,116 | Yes (X) | |||
| KIMBERLY WALKER END 821 | ||||||||
| DIRECTOR OF HUMAN RESOURCES | 40.00 | $121,236 | $0 | $9,892 | Yes (X) | |||
| MICHAEL TINAL END 821 | ||||||||
| DIRECTOR OF PATIENT FINANCIAL SVC | 40.00 | $161,035 | $0 | $15,796 | Yes (X) | |||
| CHRISTOPHER LOCKE END 821 | ||||||||
| VP BUSINESS DEVELOPMENT | 40.00 | $194,661 | $0 | $33,437 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,011,285 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $33,333 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $210,832 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CARDINAL HEALTH | |||||
| 21377 NETWORK PLACE | CHICAGO | IL | 60673 | PHARMACY STAFFING AND SUPPLIES | $4,772,454 |
| ARNALL GOLDEN GREGORY LLP | |||||
| 171 17TH STREET NW | ATLANTA | GA | 30363 | LEGAL SERVICES | $2,042,648 |
| PYA PC | |||||
| DEPT 888255 | KNOXVILLE | TN | 37995 | ACCOUNTING SERVICES | $329,563 |
| QUALIVIS LLC | |||||
| DEPARTMENT 3847 | DALLAS | TX | 75312 | STAFFING | $215,489 |
| LIFELINC ANESTHESIA SPFD PLLC | |||||
| 3340 PLAYERS CLUB PARKWAY | MEMPHIS | TN | 38125 | ANESTHESIA STAFFING & SERVICES | $171,032 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 621400 | $11,404,534 | $11,404,534 |
| CAFETERIA SALES | 722514 | $46,491 | $46,491 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,451,025 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,863 | TotalRevenueColumnAmt |
| Exclusion | $52,863 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $96,446 | SecuritiesAmt |
| Other | $39,027,680 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $27,674,495 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $96,446 | SecuritiesAmt |
| Other | $11,353,185 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,449,631 | TotalRevenueColumnAmt |
| Exclusion | $11,449,631 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $622,022 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $622,022 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $622,022 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,575,541 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,073,047 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $11,502,494 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,663,675 | TotalAmt |
| Program Services | $19,663,675 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $923,882 | TotalAmt |
| Management And General | $923,882 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,842,734 | TotalAmt |
| Program Services | $1,773,684 | ProgramServicesAmt |
| Management And General | $2,069,050 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,206,931 | TotalAmt |
| Program Services | $370,504 | ProgramServicesAmt |
| Management And General | $836,427 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,361,705 | TotalAmt |
| Program Services | $2,834,882 | ProgramServicesAmt |
| Management And General | $526,823 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,278,440 | TotalAmt |
| Program Services | $516,133 | ProgramServicesAmt |
| Management And General | $762,307 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,635 | TotalAmt |
| Program Services | $139,635 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,429,360 | TotalAmt |
| Program Services | $1,429,360 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,334,756 | TotalAmt |
| Program Services | $1,334,756 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OTHER - W/O NCPS | $37,819,297 | $37,819,297 | |
| MEDICAL SUPPLIES | $1,973,621 | $186,262 | $1,787,359 |
| BAD DEBT EXPENSE | $1,176,891 | $1,176,891 | |
| OTHER | $747,080 | $733,571 | $13,509 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $877,531 | TotalAmt |
| Program Services | $371,957 | ProgramServicesAmt |
| Management And General | $505,574 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,775,538 | TotalAmt |
| Program Services | $67,173,716 | ProgramServicesAmt |
| Management And General | $8,601,822 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,256,870 | BOYAmt |
| EOY | $5,417,770 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,483 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,105,267 | BOYAmt |
| EOY | $896,934 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,339 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,696,771 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $675,585 | BOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,927,575 | BOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,208,860 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,753,510 | BOYAmt |
| EOY | -$3,578 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,763,260 | BOYAmt |
| EOY | $6,311,126 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,654,714 | BOYAmt |
| EOY | $1,094,416 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,477,511 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,271,679 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,712,792 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,116,696 | BOYAmt |
| EOY | $1,094,416 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,646,564 | BOYAmt |
| EOY | $5,216,710 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,646,564 | BOYAmt |
| EOY | $5,216,710 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,763,260 | BOYAmt |
| EOY | $6,311,126 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$52,199,997 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$228,063 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$1,794 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990. PAGE 3, PART IV, LINE 11F | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL HAS DETERMINED THAT THERE ARE NO SIGNIFICANT UNCERTAIN TAX POSITIONS AT JUNE 30, 2022. IF INTEREST AND PENALTIES ARE INCURRED RELATED TO UNCERTAIN TAX POSITIONS, SUCH AMOUNTS WOULD BE RECOGNIZED IN INCOME TAX EXPENSE. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $218,553 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $218,553 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,071,929 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,042,451 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,029,478 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01380 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,290,482 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,042,451 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,248,031 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01670 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,290,482 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,042,451 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,248,031 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01670 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,176,891 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $94,151 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $1,828,512 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,629,388 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$800,876 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NMC SERVICES FKA NORTHCREST MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 NORTHCREST DRIVE | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37172 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NMC SERVICES FKA NORTHCREST MEDICAL CENT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.NORTHCREST.COM UNTIL 9/1/2021 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.NORTHCREST.COM UNTIL 9/1/2021 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Actions On Nonpayment | 0 | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE H, PART V, SECTION B | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL ONLY OPERATED FOR JULY AND AUGUST OF 2021, SO AFTER THE SALE ON 9/1/2021, THE WWW.NORTHCREST.COM WEBSITE WAS NO LONGER AVAILABLE. | ExplanationTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - NORTHCREST IMAGING AND SPECIALTY CLINIC | ||||
| 2536 HWY 49 SUITE 120 | PLEASANT VIEW | TN | 37146 | DIAGNOSTIC CENTER |
| 2 - NORTHCREST MEDICAL CARE IN WHITE HOUSE | ||||
| 121 HWY 76 | WHITE HOUSE | TN | 37188 | DIAGNOSTIC CENTER |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,176,891. |
| PART III, LINE 4: | AND PART III, LINE 2:PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF BOTH AN ESTIMATED ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE CONTRACTUAL ALLOWANCE REPRESENTS THE DIFFERENCE BETWEEN ESTABLISHED BILLING RATES AND ESTIMATED REIMBURSEMENT FROM MEDICARE, TENNCARE AND OTHER THIRD PARTY PAYER PROGRAMS. RECEIVABLES ARE GENERALLY UNCOLLATERALIZED, BUT CREDIT RISK RELATING TO ACCOUNTS RECEIVABLE IS LIMITED TO SOME EXTENT BY THE DIVERSITY AND NUMBER OF PATIENTS AND PAYORS. THE HOSPITAL ROUTINELY ACCEPTS ASSIGNMENT OF, OR IS OTHERWISE ENTITLED TO RECEIVE, PATIENT BENEFITS PAYABLE UNDER HEALTH INSURANCE PROGRAMS, PLANS OR POLICIES. LATE FEES AND INTEREST CHARGES, IF ANY, ARE RECOGNIZED WHEN RECEIVED.THE BAD DEBT ALLOWANCE IS ESTIMATED BASED UPON THE AGE OF THE ACCOUNT, PRIOR EXPERIENCE AND ANY UNUSUAL CIRCUMSTANCES WHICH AFFECT THE COLLECTIBILITY INCLUDING TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COST WAS OBTAINED FROM THE 08/31/2021 COST REPORT. |
| PART III, LINE 9B: | THERE ARE NO COLLECTION EFFORTS TAKEN ON THE PATIENTS THAT QUALIFY FOR CHARITY CARE. THEIR ACCOUNTS ARE WRITTEN OFF SO NO MONEY IS OWED AND NO CHARGES ARE RECORDED AS INCOME. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBERTSON COMMUNITY HEALTH FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 122 6TH AVENUE WEST | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37172 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 861599099 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $19,661,475 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | TO FURTHER EXEMPT PURPOSE OF ROBERTSON COMMUNITY HEALTH FOUNDATION | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ACCOUNTING PERSONNEL FOR BOTH RCHF AND NMC SERVICES PERFORM ACCOUNTING FOR BOTH ENTITIES. GRANTS WERE MADE ACCORDING TO THE SALE AGREEMENT OF THE HOSPITAL. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANGELA BEARD END 821 | ||||||||||||||
| CCO/ VP OF CLINICAL OPERATIONS | $178,894 | $0 | $32,105 | $0 | $213,366 | $0 | $1,828 | $0 | $30,343 | $0 | $456,536 | $0 | $0 | $0 |
| KENNETH WARD END 821 | ||||||||||||||
| CFO | $179,292 | $0 | $32,692 | $0 | $217,277 | $0 | $0 | $0 | $23,456 | $0 | $452,717 | $0 | $0 | $0 |
| RANDALL DAVIS END 821 | ||||||||||||||
| CEO | $239,433 | $0 | $59,400 | $0 | $0 | $0 | $2,434 | $0 | $29,708 | $0 | $330,975 | $0 | $0 | $0 |
| CHRISTOPHER LOCKE END 821 | ||||||||||||||
| VP BUSINESS DEVELOPMENT | $121,362 | $0 | $0 | $0 | $73,299 | $0 | $1,124 | $0 | $32,313 | $0 | $228,098 | $0 | $0 | $0 |
| TERESA WILSON | ||||||||||||||
| CHIEF WIND-DOWN OFFICER | $78,211 | $33,333 | $60,693 | $0 | $0 | $0 | $696 | $0 | $11,883 | $4,188 | $151,483 | $37,521 | $0 | $0 |
| MICHAEL TINAL END 821 | ||||||||||||||
| DIRECTOR OF PATIENT FINANCIAL SVC | $89,005 | $0 | $72,030 | $0 | $0 | $0 | $900 | $0 | $14,896 | $0 | $176,831 | $0 | $0 | $0 |
Schedule N IRS990ScheduleN
Disposition Of Assets Detail DispositionOfAssetsDetail (4 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| SPRINGFIELD HEALTH SERVICES | |||||||||
| CLASS III, IV, V, VI AND VII ASSETS WERE SOLD TO HCA SPRINGFIELD HEALTH SERVICES, LLC | 2021-09-01 | $40,000,000 | PURCHASE PRICE | 854366763 | ONE PARK PLAZA | NASHVILLE | TN | 37203 | CORPORATION |
| ROBERTSON COMMUNITY HEALTH FOUNDATION | |||||||||
| GRANT OF PROCEEDS FROM SALE OF HOSPITAL | 2021-08-01 | $8,761,475 | CASH | 861599099 | 122 6TH AVENUE WEST | SPRINGFIELD | TN | 37172 | 501(C)(3) |
| ROBERTSON COMMUNITY HEALTH FOUNDATION | |||||||||
| GRANT OF PROCEEDS FROM SALE OF HOSPITAL | 2021-09-01 | $9,500,000 | CASH | 861599099 | 122 6TH AVENUE WEST | SPRINGFIELD | TN | 37172 | 501(C)(3) |
| ROBERTSON COMMUNITY HEALTH FOUNDATION | |||||||||
| GRANT OF PROCEEDS FROM SALE OF HOSPITAL | 2022-06-01 | $1,400,000 | CASH | 861599099 | 122 6TH AVENUE WEST | SPRINGFIELD | TN | 37172 | 501(C)(3) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | Yes (1) | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | Yes (1) | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2Ind |
| Receive Compensation2 | 0 | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 2E: | FormAndLineReferenceDesc |
| Explanation | EXPLANATION OF INVOLVEMENT: KEVIN VAUGHN, DIANE GOODMAN, AND JACK TERRY PEARSON REMAINED BOARD MEMBERS OF NMC SERVICES, NCPS, AND NCSS AFTER THE SALE ON 9/1/2021. THEY ARE ALSO BOARD MEMBERS OF THE SUCCESSOR ORGANIZATION, ROBERTSON COMMUNITY HEALTH FOUNDATION (RCHF), AND ALL BUT ONE OF THE BOARD MEMBERS OF NORTHCREST MEDICAL CENTER BECAME BOARD MEMBERS OF RCHF. OFFICERS RANDALL DAVIS AND ANGELA BEARD BECAME EMPLOYED AT THE TRANSFEREE ORGANIZATION, HCA, AFTER THE SALE. MANY BOARD MEMBERS OF NMC SERVICES WERE APPOINTED TO HCAS BOARD OF DIRECTORS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINES 9, 10, 11, 15, 17 | THIS FY2022 RETURN WAS STILL BEING PREPARED AFTER THE FY2023 RETURN WAS FILED. SOME REVENUE AND EXPENSES WERE RECLASSIFIED AND THEREFORE THE CURRENT YEAR AMOUNTS ON THIS RETURN DO NOT MATCH WHAT WAS FILED FOR FY2023 FOR PRIOR YEAR LINES 9, 10, 11, 15, AND 17, BUT THE BOTTOM LINE REMAINED THE SAME. LINE 19 FOR THE CURRENT YEAR TIES TO THE FY2023 PRIOR YEAR LINE 19. |
| FORM 990, PART III, LINE 3 | THE FACILTY WAS SOLD 9/01/2021 AND IS WINDING DOWN OPERATIONS. DONATIONS OF THE PROCEEDS FROM THE SALE ARE BEING MADE TO A NEW 501C3 FOUNDATION IN THE ROBERTSON COUNTY AREA TO ASSIST WITH HEALTHCARE NEEDS IN THE LOCAL COMMUNITY. |
| FORM 990, PART VI, SECTION B, LINE 11B | AFTER COMPLETION OF FORM 990, THE RETURN IS REVIEWED BY THE CHIEF WIND-DOWN OFFICER FOR ACCURACY AND COMPLETION. THE BOARD OF DIRECTORS WERE PROVIDED A COMPLETE COPY OF THE FORM 990 AFTER FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY THE BOARD AND A CONFLICT DISCLOSURE IS SIGNED. |
| FORM 990, PART VI, SECTION B, LINE 15 | BOARD REVIEWS DIFFERENT SOURCES, SUCH AS MARKET ANALYSIS, BEFORE APPROVING COMPENSATION OF CEO. CEO THEN, IN TURN, REVIEWS AND APPROVES COMPENSATION OF KEY EMPLOYEES. NO CURRENT EMPLOYEES OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE REQUESTS FOR GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS GO THROUGH THE CHIEF WIND-DOWN OFFICER, AND THE LEGALLY REQUIRED DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| NORTHCREST MEDICAL CENTER FOUNDATION - END 9121 | ||||||||||
| 100 NORTHCREST DRIVE | SPRINGFIELD | TN | 37172 | 204224449 | SUPPORT AND AID | TN | 501(C)(3) | LINE 12A, I | NMC SERVICES INC | 0 |
| ROBERTSON COMMUNITY HEALTH FOUNDATION | ||||||||||
| 112 6TH AVENUE WEST | SPRINGFIELD | TN | 37172 | 861599099 | DISTRIBUTION OF SALE OF HOSPITAL | TN | 501(C)(3) | LINE 7 | NMC SERVICES INC | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| NCSS INC | ||||||||||
| 112 6TH AVENUE WEST | SPRINGFIELD | TN | 37172 | 621638556 | CLOSING OPERATIONS DUE TO SALE ON 9/1/2021 | TN | C | -$4,045 | 1.00000 | 0 |
| NCPS INC | ||||||||||
| 112 6TH AVENUE WEST | SPRINGFIELD | TN | 37172 | 621638557 | CLOSING OPERATIONS DUE TO SALE ON 9/1/2021 | TN | C | -$3,528,329 | 1.00000 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ROBERTSON COMMUNITY HEALTH FOUNDATION | ||
| B | $19,661,475 | SALE AGREEMENT |
| NCSS INC | ||
| O | $37,521 | EXPENSE ALLOCATION |