MISSOURI DELTA MEDICAL CENTER: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- MISSOURI DELTA MEDICAL CENTER (EIN 43-0633449)
- Tax period
- 2020-10-01 to 2021-09-30
- Filed
- 2022-08-08
- IRS object ID
- 202212209349300931
- Schema version
- 2020v4.2
- 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 B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-08T10:18:09-05:00 | ReturnTs |
| Tax Period End | 2021-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 430352985 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KERBER ECK & BRAECKEL LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3401 OFFICE PARK DRIVE | AddressLine1Txt |
| City | MARION | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62959 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 430633449 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MISSOURI DELTA MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MISS | BusinessNameControlTxt |
| Phone | 5734711600 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1008 NORTH MAIN ST | AddressLine1Txt |
| City | SIKESTON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 638015044 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JASON SCHRUMPF | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5734711600 | PhoneNum |
| Signature | 2022-08-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JASON | PersonFirstNm |
| Person Last | SCHRUMPF | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMBER HALSTEAD | PreparerPersonNm |
| PTIN | P01343727 | PTIN |
| Phone | 6189938724 | PhoneNum |
| Preparation | 2022-08-04 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JASON SCHRUMPF | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1008 NORTH MAIN ST | AddressLine1Txt |
| City | SIKESTON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 638015044 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $139,273,478 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MISSOURIDELTA.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1948 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | MISSOURI DELTA MEDICAL CENTER IS A NOT FOR PROFIT CORPORATION WHICH STRIVESTO PROVIDE A COMPLETE HEALTH CARE SYSTEM TO RESIDENTS IN THE SERVICEAREA EITHER DIRECTLY OR IN COOPERATION WITH OTHERS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 19 | VotingMembersIndependentCnt |
| Total Employee | 1098 | TotalEmployeeCnt |
| Total Volunteers | 24 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,655,179 | PYContributionsGrantsAmt |
| CY Contributions Grants | $12,719,604 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $88,328,147 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $111,815,670 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,119,463 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,525,258 | CYInvestmentIncomeAmt |
| PY Other Revenue | $15,168,710 | PYOtherRevenueAmt |
| CY Other Revenue | $13,229,996 | CYOtherRevenueAmt |
| PY Total Revenue | $106,271,499 | PYTotalRevenueAmt |
| CY Total Revenue | $139,290,528 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $8,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $12,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $56,497,737 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $66,305,461 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $51,607,553 | PYOtherExpensesAmt |
| CY Other Expenses | $60,688,322 | CYOtherExpensesAmt |
| PY Total Expenses | $108,113,290 | PYTotalExpensesAmt |
| CY Total Expenses | $127,005,783 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,841,791 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $12,284,745 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $111,187,514 | TotalAssetsBOYAmt |
| Total Assets EOY | $113,462,739 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $61,364,845 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $49,346,706 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $49,822,669 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $64,116,033 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | MISSOURI DELTA MEDICAL CENTER IS A NOT FOR PROFIT CORPORATION WHICHWILL STRIVE TO PROVIDE A COMPLETE HEALTH CARE SYSTEM TO RESIDENTS INTHE SERVICE AREA EITHER DIRECTLY OR IN COOPERATION WITH OTHERS.REFERRAL AGREEMENTS WILL BE SOUGHT FOR SERVICES NOT OFFERED LOCALLY.THE HOSPITAL WILL ALSO ACTIVELY OFFER OR SUPPORT APPROPRIATE PROGRAMSTO PROMOTE THE GENERAL HEALTH, AND TO MEET THE REHABILITATION,EDUCATIONAL AND SOCIAL NEEDS OF OUR SERVICE AREA. SERVICES WILL BEPROVIDED TO ALL RESIDENTS OF OUR SERVICE AREA REGARDLESS OF RACE,COLOR, RELIGION, SEX, AGE, NATIONAL ORIGIN, OR DISABILITY." | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $100,839,033 | ExpenseAmt |
| Grant | $12,000 | GrantAmt |
| Revenue | $111,832,720 | RevenueAmt |
| Desc | MISSOURI DELTA MEDICAL CENTER PROVIDES QUALITY MEDICAL CARE TO THERESIDENTS OF ITS COMMUNITY REGARDLESS OF ABILITY TO PAY. MDMC ALSO PROVIDES SHORT TERM REHABILITATION SERVICES THROUGH AN ACUTE IP REHABILITATION UNIT AND PSYCHIATRIC SERVICES THROUGH AN ACUTE IP GERIATRIC PSYCHIATRIC FACILITY. THESE SERVICES ARE SUMMARIZED AS FOLLOWS:HOSPITAL:ACUTE INPATIENT DAYS 13,513ACUTE INPATIENT ADMISSIONS 3,102EMERGENCY ROOM VISITS 19,665RURAL HEALTH CLINIC VISITS 93,676 LABORATORY TESTS PERFORMED 437,581 RADIOLOGY EXAMS PERFORMED 47,850 PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY TREATMENTS 107,501 PHYSICIAN OFFICE VISITS 61,082 REHAB INPATIENT DAYS 2,022REHAB INPATIENT ADMISSIONS 204GERIATRIC PSYCH INPATIENT DAYS 4,020GERIATRIC PSYCH INPATIENT ADMISSIONS 499ADOLESCENT PSYCH INPATIENT DAYS 2,475ADOLESCENT PSYCH INPATIENT ADMISSIONS 569THE HOSPITAL PROVIDED FREE CARE TO INDIGENT PATIENTS IN THE AMOUNTOF $605,934 IN FY 2021, VALUED AT BILLED CHARGES. THE HOSPITALALSO PROVIDED NUMEROUS FREE PROGRAMS AND REDUCED PRICE SERVICESTHROUGH THE YEAR THAT THE HOSPITAL BELIEVES SERVES A COMMUNITYNEED. SERVICES PROVIDED FREE OF CHARGE OR BELOW COST TO THEGENERAL PUBLIC INCLUDE:1. PERIODIC BLOOD PRESSURE AND CHOLESTEROL SCREENS2. OUTPATIENT DIABETIC EDUCATION AND OTHER HEALTH EDUCATION CLASSES3. CHILDBIRTH CLASSES, FIRST AID CLASSES, AND CPR COURSES4. RED CROSS BLOOD DRIVES5. COVID 19 VACCINATION CLINICS6. HEALTH EDUCATION ARTICLES IN THE LOCAL NEWSPAPER | Desc |
| Total Program Service Expenses | $100,839,033 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | 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 | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | 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 | 0 | 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 | 171 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1098 | 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 |
| 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 | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 19 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | MO | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREG CARDA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5734711600 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1008 NORTH MAIN STREET | AddressLine1Txt |
| City | SIKESTON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 638015044 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DWIGHT BIZZELL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN BOLLINGER | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LEVEN COX | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| EDWARD DEMENT | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOEL PATRICK EVANS | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BART GRANT | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JEFFREY HUX | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHARLES D JENNINGS JR | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ELIZABETH JOHNSON | ||||||||
| CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL JONES | ||||||||
| VICE CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DANIEL DEKE LAPE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT MACGILLIVRAY | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRITT MCCONNELL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRIAN MENZ | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JEFF PARTRIDGE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MATT TANNER | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TAMMY BURCH | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MATHEW DRAKE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID JONES | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MIKE MARSHALL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRETT MATTHEWS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JULIE AYCOCK | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JASON SCHRUMPF | ||||||||
| PRESIDENT/CEO | 40.00 | $361,529 | $0 | $12,946 | Yes (X) | |||
| GREG CARDA | ||||||||
| VP. FINANCE | 40.00 | $226,200 | $0 | $12,524 | Yes (X) | |||
| JIM HENSON | ||||||||
| SENIOR VICE PRESIDENT | 40.00 | $231,804 | $0 | $9,521 | Yes (X) | |||
| JULIE FRASER | ||||||||
| VP, NURSING | 40.00 | $191,870 | $0 | $11,586 | Yes (X) | |||
| DR RUDY RODRIGUEZ | ||||||||
| PHYSICIAN | 40.00 | $1,246,766 | $0 | $14,532 | Yes (X) | |||
| DR KENNETH MOY | ||||||||
| PHYSICIAN | 40.00 | $665,301 | $0 | $10,983 | Yes (X) | |||
| DR MUHANNAD AL-KILANI | ||||||||
| PHYSICIAN | 40.00 | $622,130 | $0 | $15,914 | Yes (X) | |||
| DR ANIMESH SAHAI | ||||||||
| PHYSICIAN | 40.00 | $587,829 | $0 | $5,800 | Yes (X) | |||
| DR PAUL MONTANY | ||||||||
| PHYSICIAN | 40.00 | $702,828 | $0 | $8,550 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,836,257 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $102,356 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 86 | 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 |
|---|---|---|---|---|---|
| HORIZON HEALTH | |||||
| PO BOX 840839 | DALLAS | TX | 752840839 | MANAGEMENT SERVICES | $2,295,920 |
| TRUSTAFF TRAVEL NURSES LLC | |||||
| 4675 CORNELL ROAD SUITE 100 | CINCINNATI | OH | 45241 | CONTRACTED NURSES | $2,195,980 |
| MORRISON HEALTHCARE | |||||
| PO BOX 102289 | ATLANTA | GA | 303682289 | DIETARY SERVICES | $1,813,168 |
| MEDICAL SOLUTIONS LLC | |||||
| 1010 NORTH 102ND ST SUITE 300 | OMAHA | NE | 68114 | CONTRACTED NURSES | $1,340,526 |
| RESOURCE ANESTHESIOLOGY ASSOCIATION | |||||
| 450 MAMARONECK AVENUE | HARRISON | NY | 11528 | ANESTHESIA SERVICES | $1,336,371 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 34 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $275,499 | RelatedOrganizationsAmt |
| Government Grants | $12,444,105 | GovernmentGrantsAmt |
| Total Contributions | $12,719,604 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $111,815,670 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $111,815,670 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $111,815,670 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,508,208 | TotalRevenueColumnAmt |
| Exclusion | $1,508,208 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$17,050 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $17,050 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,050 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,050 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| 340 B PHARMACY PROGRAM | 900099 | $8,005,802 | $8,005,802 |
| EMPLOYEE PHARMACY SALES | 722514 | $3,005,328 | $3,005,328 |
| OTHER OPERATING REVENUE | 621990 | $1,842,243 | $1,842,243 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $376,623 | TotalRevenueColumnAmt |
| Exclusion | $376,623 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $13,229,996 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $139,290,528 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $111,832,720 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $14,738,204 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,000 | TotalAmt |
| Program Services | $12,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,011,403 | TotalAmt |
| Management And General | $1,011,403 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,710,176 | TotalAmt |
| Program Services | $47,274,990 | ProgramServicesAmt |
| Management And General | $5,435,186 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $711,786 | TotalAmt |
| Program Services | $626,372 | ProgramServicesAmt |
| Management And General | $85,414 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,559,076 | TotalAmt |
| Program Services | $7,531,987 | ProgramServicesAmt |
| Management And General | $1,027,089 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,313,020 | TotalAmt |
| Program Services | $2,915,458 | ProgramServicesAmt |
| Management And General | $397,562 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,210 | TotalAmt |
| Program Services | $16,947 | ProgramServicesAmt |
| Management And General | $7,263 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $157,790 | TotalAmt |
| Program Services | $110,453 | ProgramServicesAmt |
| Management And General | $47,337 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,759,678 | TotalAmt |
| Program Services | $2,631,775 | ProgramServicesAmt |
| Management And General | $1,127,903 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,177 | TotalAmt |
| Program Services | $70,124 | ProgramServicesAmt |
| Management And General | $30,053 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,940,984 | TotalAmt |
| Program Services | $1,355,089 | ProgramServicesAmt |
| Management And General | $585,895 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,499,558 | TotalAmt |
| Program Services | $2,449,691 | ProgramServicesAmt |
| Management And General | $1,049,867 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,962 | TotalAmt |
| Program Services | $55,973 | ProgramServicesAmt |
| Management And General | $23,989 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,350 | TotalAmt |
| Program Services | $70,945 | ProgramServicesAmt |
| Management And General | $30,405 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $370,214 | TotalAmt |
| Program Services | $259,150 | ProgramServicesAmt |
| Management And General | $111,064 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,858,329 | TotalAmt |
| Program Services | $3,400,830 | ProgramServicesAmt |
| Management And General | $1,457,499 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,163,082 | TotalAmt |
| Program Services | $814,157 | ProgramServicesAmt |
| Management And General | $348,925 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $22,354,034 | $15,647,824 | $6,706,210 |
| PURCHASE SERVICE | $18,490,618 | $12,943,433 | $5,547,185 |
| REPAIRS AND MAINTENANCE | $2,160,012 | $1,512,008 | $648,004 |
| OTHER | $1,179,436 | $825,605 | $353,831 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $448,888 | TotalAmt |
| Program Services | $314,222 | ProgramServicesAmt |
| Management And General | $134,666 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,005,783 | TotalAmt |
| Program Services | $100,839,033 | ProgramServicesAmt |
| Management And General | $26,166,750 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,645,150 | BOYAmt |
| EOY | $2,940,556 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,937,960 | BOYAmt |
| EOY | $25,732,772 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,432,783 | BOYAmt |
| EOY | $23,010,066 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $489,989 | BOYAmt |
| EOY | $377,231 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,260,344 | BOYAmt |
| EOY | $3,658,084 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,433,278 | BOYAmt |
| EOY | $3,112,581 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $132,118,357 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $78,727,665 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,618,566 | BOYAmt |
| EOY | $53,390,692 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,369,444 | BOYAmt |
| EOY | $1,240,757 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,187,514 | BOYAmt |
| EOY | $113,462,739 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,616,118 | BOYAmt |
| EOY | $17,762,940 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,952,862 | BOYAmt |
| EOY | $1,454,614 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,395,728 | BOYAmt |
| EOY | $9,593,312 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $681,919 | BOYAmt |
| EOY | $1,084,778 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,718,218 | BOYAmt |
| EOY | $19,451,062 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,364,845 | BOYAmt |
| EOY | $49,346,706 | 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 | $49,822,669 | BOYAmt |
| EOY | $64,116,033 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,822,669 | BOYAmt |
| EOY | $64,116,033 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,187,514 | BOYAmt |
| EOY | $113,462,739 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $12,284,745 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,008,619 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $12,210 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $12,210 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $849,547 | OtherCostOrOtherBasisAmt |
| Book Value | $849,547 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $54,513,270 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,882,631 | DepreciationAmt |
| Book Value | $27,630,639 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $61,312,353 | OtherCostOrOtherBasisAmt |
| Depreciation | $50,850,580 | DepreciationAmt |
| Book Value | $10,461,773 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $8,018,099 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $7,425,088 | OtherCostOrOtherBasisAmt |
| Depreciation | $994,454 | DepreciationAmt |
| Book Value | $14,448,733 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $53,390,692 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| PROFESSIONAL LIABILITY | $929,703 |
| DUE TO THIRD PARTY | $18,521,359 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $19,451,062 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITION UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. | 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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 180.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,145,687 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,145,687 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00900 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,037,965 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,637,890 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,400,075 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03460 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,183,652 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,637,890 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,545,762 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04360 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $103,550 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $103,550 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $103,550 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $103,550 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,287,202 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,637,890 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,649,312 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04440 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $12,955,611 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $31,019,920 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $28,877,406 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $2,142,514 | 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 | MISSOURI DELTA MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1008 NORTH MAIN STREET | AddressLine1Txt |
| City | SIKESTON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MISSOURI DELTA MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 |
| CHNA Conducted | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.MISSOURIDELTA.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.MISSOURIDELTA.COM | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 180.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.MISSOURIDELTA.COM | FAPAvailableOnWebsiteURLTxt |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Defer Deny Rqr Payment | Yes (X) | PermitDeferDenyRqrPaymentInd |
| Permit Legal Judicial Process | Yes (X) | PermitLegalJudicialProcessInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Engage Defer Deny Rqr Payment | Yes (X) | EngageDeferDenyRqrPaymentInd |
| Engaged Legal Judicial Process | Yes (X) | EngagedLegalJudicialProcessInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MISSOURI DELTA MEDICAL CENTER | PART V, SECTION B, LINE 6A: FOR THE PURPOSES OF THE ASSESSMENT, COMMUNITY IS DEFINED AS THE GEOGRAPHIC AREA FROM WHICH A SIGNIFICANT NUMBER OF PATIENTS USING MDMC SERVICES RESIDE. THE PRIMARY SERVICE AREA FOR MDMC IS BASED ON THE NUMBER OF INPATIENT DISCHARGES AND OUTPATIENT VISITS BY PATIENTS THAT RESIDE IN SCOTT, MISSISSIPPI AND NEW MADRID COUNTIES. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR SCOTT COUNTY WAS CONDUCTED IN PARTNERSHIP WITH SAINT FRANCIS MEDICAL CENTER. AS MISSISSIPPI COUNTY AND NEW MADRID COUNTY WERE THE PRIMARY SERVICE AREAS OF MDMC ALONE THE CHNA WAS NOT CONDUCTED IN PARTERNSHIP WITH SAINT FRANCIS MEDICAL CENTER. |
| MISSOURI DELTA MEDICAL CENTER | PART V, SECTION B, LINE 6B: FOR PURPOSES OF THE ASSESSMENT, THE HOSPITAL HAS BEEN WORKING WITH THE FOLLOWING LOCAL ENTITIES TO CONDUCT THE CHNA: (1) MISSISSIPPI COUNTY HEALTH DEPARTMENT, (2) NEW MADRID COUNTY HEALTH DEPARTMENT, (3) L&S PHARMACY, (4) BOOTHEEL COUNSELING, (5) SEMO HEALTH NETWORK, (6) DAOEC. |
| MISSOURI DELTA MEDICAL CENTER | PART V, SECTION B, LINE 11: MEMBERS OF THE MISSOURI DELTA CHNA TEAM ANALYZED THE SURVEY DATA, FOCUS GROUP DATA, AND SECONDARY DATA TO PRIORITIZE THE COMMUNITY HEALTH NEEDS FOR MISSISSIPPI, NEW MADRID AND SCOTT COUNTIES. THE TOP FIVE PRIORITY NEEDS INCLUDE:1. CHILD AND ADULT OBESITY2. CHRONIC DISEASE A. DIABETES (DIET AND EXERCISE)B. CHRONIC RESPIRATORY DISEASE (SMOKING)C. HEART DISEASE (SMOKING/DIET AND EXERCISE)D. STROKE (HEALTHY LIFESTYLE)3. CANCER (SMOKING)4. MENTAL ILLNESS5. DRUG AND ALCOHOL ABUSECHILD AND ADULT OBESITY:SPECIFIC STRATEGIES INCLUDE EDUCATIONAL ACTIVITY BOOKS GEARED TOWARD FAMILIES WHICH INCLUDES HEALTHY EATING HABITS. BOOKS WILL BE AVAILABLE IN MDMC CLINIC WAITING ROOMS AND THE EMERGENCY ROOM. CREATON OF FITKIDZ THROUGH POSTERS, HANDOUTS, TV LOBBY, AND HEALTH FAIRS. CONTINUE TO HOLD CHRONIC DISEASE EDUCATIONAL WORKSHOPS AT MISSOURI DELTA MEDICAL CENTER. CONTINUE TO IDENTIFY PATIENTS IN NEED OF ATTENDING CHRONIC DESEASE EDUCATION WORKSHOPS OFFERED. PROVIDE SPEAKERS/PRESENTERS ABOUT HEALTHY EATING AT EVENTS SUCH AS THE ANNUAL WOMEN'S SHOW AND THE ANNUAL WOMEN'S HEALTH CONFERENCE. PARTICIPATE IN THE ANNUAL HEALTHY KIDS DAY PROGRAM AT THE YMCA WITH EDUCATIONAL DIETARY INFORMATION. PARTNER WITH STRATUS MEDICAL GROUP WITH PROMOTION OF THEIR HEALTHY WEIGHT MANAGEMENT PROGRAM. CHRONIC DISEASE: SPECIFIC STRATEGIES INCLUDE TO CONTINUE OFFERING CHRONIC DISEASE EDUCATIONAL WORKSHOPS AND PROMOTING THOSE THROUGH THE PHYSICIANS, CASE MANAGERS AND OTHER CIVIC ORGANIZATIONS. CONTINUE TO PROVIDE FREE PUBLIC HEALTH SCREENINGS AT HEALTH FAIRS THROUGHOUT THE COUNTIES WE SERVE; BLOOD PRESSURE, GLUCOSE, LUNG. POPULATION HEALTH WORKING THROUGH OUTREACH TO HELP EDUCATE PATIENTS AND PREVENT READMISSIONS. WORK WITH LOCAL HEALTH DEPARTMENTS IN EACH COUNTY TO PROMOTE THEIR DIABETES SUPPORT GROUPS AND SELF-HELP PROGRAMS. CANCER: SPECIFIC STRATEGIES INCLUDE TO CONTINUE TO PROMOTE SMOKING-CESSATION PROGRAMS THE LOCAL HEALTH DEPARTMENTS ARE PROVIDING AND EDUCATE MEDICAL PROVIDERS ON THE RESOURCES AVAILABLE FOR PATIENTS WHO WANT TO QUIT TOBACCO USAGE. MENTAL ILLNESS AND DRUG AND ALCOHOL ABUSE:SPECIFIC STRATEGIES INCLUDE TO PARTNER WITH BOOTHEEL COUNSELING IN PROVIDING MENTAL HEALTH FIRST AID PROGRAMS TO AREA EMPLOYERS. THIS PROGRAM INTRODUCES PARTICIPANTS TO RISK FACTORS AND WARNING SIGNS OF MENTAL ILLNESS. CONTINUE TO SUPPORT THE MENTAL HEALTH COUNSELORS IMPLEMENTED IN MDMC'S RURAL HEALTH CLINICS IN SIKESTON AND NEW MADRID. PARTNER WITH PHARMACIES THAT OFFER A MEDICATION RECONCILIATION PROGRAM IN WHICH THE PHARMACIST VISITS THE PATIENT'S HOME AND COMPARES HOME MEDS WITH DISCHARGE MEDS TO ENSURE NO DISCREPANCIES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 31 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (31 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - RESTART OF SIKESTON | ||||
| 1008 NORTH MAIN STREET | SIKESTON | MO | 63801 | PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY |
| 2 - RESTART OF CHARLESTON | ||||
| 512 EAST MARSHALL STREET | CHARLESTON | MO | 63834 | PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY |
| 3 - RESTART OF NEW MADRID | ||||
| 406 HIGHWAY 61 | NEW MADRID | MO | 63869 | PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY |
| 4 - RESTART OF EAST PRAIRIE | ||||
| 106 SOUTH WASHINGTON | EAST PRAIRIE | MO | 63845 | PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY |
| 5 - BARTON-JOLLY PHYSICIAN SERVICES | ||||
| 1019 NORTH MAIN STREET | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| 6 - EXPRESS CARE | ||||
| 1008 NORTH MAIN STREET | SIKESTON | MO | 63801 | RURAL HEALTH CLINIC |
| 7 - MISSOURI DELTA ORTHOPEDICS | ||||
| 201 PLAZA DRIVE | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| 8 - WOMEN'S CARE CENTER | ||||
| 1013 NORTH MAIN STREET | SIKESTON | MO | 63801 | RURAL HEALTH CLINIC |
| 9 - WELLPOINT PAIN CENTER | ||||
| 201 PLAZA DRIVE | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| 10 - MISSOURI DELTA CANCER & INFUSION CENTER | ||||
| 1126 NORTH MAIN STREET | SIKESTON | MO | 63801 | INFUSION CENTER |
| 11 - MEDX MEDICAL EQUIPMENT | ||||
| 708 N MAIN STREET | SIKESTON | MO | 63801 | DURABLE MEDICAL EQUIPMENT |
| 12 - SMITH STREET CLINIC | ||||
| 123 SMITH STREET | SIKESTON | MO | 63801 | RURAL HEALTH CLINIC |
| 13 - MISSOURI DELTA PRIMARY CARE | ||||
| 102 HOSPITALITY DRIVE | SIKESTON | MO | 63801 | RURAL HEALTH CLINIC |
| 14 - PORTAGEVILLE COMMUNITY CARE CENTER | ||||
| 204 EAST 3RD STREET | SIKESTON | MO | 63801 | RURAL HEALTH CLINIC |
| 15 - MISSOURI DELTA UROLOGY | ||||
| 1106 NORTH MAIN STREET | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| 16 - SURGEONS NORTH | ||||
| 1124 NORTH MAIN STREET | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| 17 - FAMILY MEDICINE | ||||
| 1017 NORTH MAIN | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| 18 - SURGEONS - 1ST FLOOR JOLLY BUILDING | ||||
| 1013 NORTH MAIN STREET | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| 19 - NEW MADRID COMMUNITY CARE CENTER | ||||
| 615 MAIN STREET | SIKESTON | MO | 63801 | RURAL HEALTH CLINIC |
| 20 - MISSOURI DELTA WOUND & HYPERBARIC | ||||
| 201 PLAZA DRIVE | SIKESTON | MO | 63801 | WOUND CARE CENTER |
| 21 - CHARLESTON COMMUNITY CARE CENTER | ||||
| 1403 EAST MARSHALL STREET | CHARLESTON | MO | 63834 | RURAL HEALTH CLINIC |
| 22 - MISSOURI DELTA ENDOCRINE & DIABETES CENT | ||||
| 1118 NORTH MAIN STREET | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| 23 - RESTART SOUTH | ||||
| 806 SOUTH KINGSHIGHWAY | SIKESTON | MO | 63801 | PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY |
| 24 - DEXTER COMMUNITY CARE CENTER | ||||
| 911B WEST BUS HWY 60 | DEXTER | MO | 63841 | RURAL HEALTH CLINIC |
| 25 - BENTON COMMUNITY CARE CENTER | ||||
| 6468 STATE HWY 77 | BENTON | MO | 63736 | RURAL HEALTH CLINIC |
| 26 - CHAFFEE MEDICAL CENTER | ||||
| 209 WEST YOAKUM | CHAFFEE | MO | 63740 | RURAL HEALTH CLINIC |
| 27 - MISSOURI DELTA OCCUPATIONAL MEDICINE | ||||
| 135 PLAZA DRIVE SUITE 202 | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| 28 - GYNECOLOGIC ONCOLOGY | ||||
| 201 PLAZA DRIVE SUITE C | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| 29 - ENT & ALLERGY CLINIC | ||||
| 135 PLAZA DRIVE SUITE 102 | SIKESTON | MO | 63801 | RURAL HEALTH CLINIC |
| 30 - SPECIALTY CLINIC | ||||
| 135 PLAZA DRIVE SUITE 102 | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| 31 - DERMATOLOGY | ||||
| 1015 NORTH MAIN | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 2: | THE CENTER REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHERS. THE CENTER PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE CENTER BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. |
| PART III, LINE 8: | IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUONT REPORTED ON LINE 6 IS ESTIMATED BY USING THE PERCENT OF OPERATING EXPENSE TO PATIENT REVENUE. |
| PART III, LINE 9B: | THE BAD DEBT POLICY STATES THAT IF IT IS DETERMINED THAT A PATIENT IS INDIGENT, PROCEED AS FOLLOWS: A. COMPLETE ACCOUNT ADJUSTMENT FORMS FOLLOWING ACCOUNT ADJUSTMENT PROCEDURES OR NOTE THE BALANCE WILL BE WRITTEN OFF AS CHARITY ACCORDING TO THE CHARITY CARE POLICY.B. ENTER THE FOLLOWING NOTATIONS ON THE COPY OF THE PATIENT ACCOUNTS ADMISSION REGISTRATION FORMS OR IN ACCOUNTS RECEIVABLE NOTES IN THE COMPUTER: "CHARGES DUE BY PATIENT WILL BE WRITTEN OFF AS MEDICARE BAD DEBT OR UNCOMPENSATED CARE." |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (5 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| RAY CLINTON HEALTHCARE SCHOLARSHIPS | 2 | $2,000 |
| JUANITA WILLIAMS NURSING SCHOLARSHIPS | 3 | $3,000 |
| COOPER SCHOLARSHIPS | 2 | $2,000 |
| BRUCE MEMORIAL SCHOLARSHIPS | 4 | $4,000 |
| CASH SCHOLARSHIP FUND | 1 | $1,000 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE SCHOLARSHIP PROGRAM IS DESIGNED TO PROVIDE A CONSISTENT FLOW OF REGISTERED NURSES TO MISSOURI DELTA MEDICAL CENTER. THE OBJECTIVE OF THE PLAN IS TO ENCOURAGE AND FINANCIALLY ASSIST QUALIFIED STUDENTS IN THEIR ENDEAVOR TO BECOME A REGISTERED NURSE. TO THE EXTENT OF AVAILABLE FUNDS, THE MEDICAL CENTER WILL PAY SCHOLARSHIPS TO QUALIFIED STUDENTS OF AN ACCREDITED REGISTERED NURSE PROGRAM. TO QUALIFY FOR THE PROGRAM A STUDENT MUST: A. HIGH SCHOOL GRADUATE 1. RANK IN THE UPPER THIRD OF HIGH SCHOOL CLASS ACADEMICALLY. 2. SHOW EVIDENCE OF MOTIVATION FOR NURSING EITHER BY APTITUDE TESTING OR BY REPORTED DEMONSTRATION OF INTEREST. 3. PROVIDE LETTER OF RECOMMENDATION FROM AN APPROPRIATE SCHOOL OFFICIAL. 4. BE APPROVED BY THE HOSPITAL SCHOLARSHIP SELECTION COMMITTEE. B. STUDENT NURSES - ALL STUDENT NURSES MUST: 1. HAVE AT LEAST THE EQUIVALENT OF A 2.5 GRADE POINT AVERAGE IN A 4 POINT SYSTEM. 2. MUST PROVIDE A LETTER OF RECOMMENDATION FROM RESPONSIBLE AND APPROPRIATE PERSON. 3. BE APPROVED BY THE SCHOLARSHIP COMMITTEE. C. CURRENT EMPLOYEES - ALL CURRENT EMPLOYEES MUST: 1. BE ENROLLED IN A NURSING PROGRAM AS A FULL-TIME STUDENT. 2. NOT BE RECEIVING ANY HOSPITAL BENEFITS. 3. BE APPROVED BY THE SCHOLARSHIP COMMITTEE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | 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 (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR RUDY RODRIGUEZ | ||||||||||||||
| PHYSICIAN | $768,233 | $0 | $459,533 | $0 | $19,000 | $0 | $5,800 | $0 | $8,732 | $0 | $1,261,298 | $0 | $0 | $0 |
| DR PAUL MONTANY | ||||||||||||||
| PHYSICIAN | $370,622 | $0 | $313,206 | $0 | $19,000 | $0 | $5,800 | $0 | $2,750 | $0 | $711,378 | $0 | $0 | $0 |
| DR KENNETH MOY | ||||||||||||||
| PHYSICIAN | $260,734 | $0 | $385,567 | $0 | $19,000 | $0 | $5,800 | $0 | $5,183 | $0 | $676,284 | $0 | $0 | $0 |
| DR MUHANNAD AL-KILANI | ||||||||||||||
| PHYSICIAN | $394,850 | $0 | $207,620 | $0 | $19,660 | $0 | $5,800 | $0 | $10,114 | $0 | $638,044 | $0 | $0 | $0 |
| DR ANIMESH SAHAI | ||||||||||||||
| PHYSICIAN | $212,286 | $0 | $356,543 | $0 | $19,000 | $0 | $5,800 | $0 | $0 | $0 | $593,629 | $0 | $0 | $0 |
| JASON SCHRUMPF | ||||||||||||||
| PRESIDENT/CEO | $289,793 | $0 | $52,530 | $0 | $19,206 | $0 | $5,800 | $0 | $7,146 | $0 | $374,475 | $0 | $0 | $0 |
| JIM HENSON | ||||||||||||||
| SENIOR VICE PRESIDENT | $214,071 | $0 | $17,646 | $0 | $87 | $0 | $4,338 | $0 | $5,183 | $0 | $241,325 | $0 | $0 | $0 |
| GREG CARDA | ||||||||||||||
| VP. FINANCE | $208,179 | $0 | $17,646 | $0 | $375 | $0 | $4,286 | $0 | $8,238 | $0 | $238,724 | $0 | $0 | $0 |
| JULIE FRASER | ||||||||||||||
| VP, NURSING | $176,695 | $0 | $14,858 | $0 | $317 | $0 | $3,653 | $0 | $7,933 | $0 | $203,456 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (9 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| RAYMOND EARL SISK | |||
| SON-IN-LAW OF DIRECTOR | $146,657 | EMPLOYEE COMPENSATION | 0 |
| CATHERINE SCHRUMPF | |||
| SPOUSE OF PRESIDENT | $18,868 | EMPLOYEE COMPENSATION | 0 |
| ANTHONY COPPAGE | |||
| BROTHER-IN-LAW OF DIRECTOR | $90,743 | EMPLOYEE COMPENSATION | 0 |
| TRACY COPPAGE | |||
| SISTER OF DIRECTOR | $63,976 | EMPLOYEE COMPENSATION | 0 |
| RHONDA MENZ | |||
| WIFE OF DIRECTOR | $35,026 | EMPLOYEE COMPENSATION | 0 |
| JUDITH MENZ | |||
| MOTHER OF DIRECTOR | $89,224 | EMPLOYEE COMPENSATION | 0 |
| CHRIS STEWARD-STEWARD STEEL | |||
| BOARD MEMBER | $7,873 | BUILDING SUPPLIES | 0 |
| BETH JOHNSON- MITCHELL INSURANCE | |||
| BOARD MEMBER | $68,834 | INSURANCE POLICIES | 0 |
| JEFFERY HUX- HUX AND HUX | |||
| BOARD MEMBER | $15,514 | LEGAL SERVICES | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | DAN JENNINGS JR AND JOHN BOLLINGER HAVE A BUSINESS RELATIONSHIP. BRITT MCCONNEL AND ROBERT MACGILLIVRAY HAVE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11B | BEFORE THE FORM 990 IS FILED, THE VICE-PRESIDENT OF FINANCE OF THE ORGANIZATION REVIEWS THE FORM 990, WHICH IS PREPARED BY AN OUTSIDE TAX PREPARER. THE FINANCE COMMITTEE OF MISSOURI DELTA MEDICAL CENTER WILL ALSO PERFORM A REVIEW OF THE FORM 990 AFTER THE FORM HAS BEEN FILED. IN ADDITION, COPIES OF THE FORM 990 WILL BE AVAILABLE TO THE MISSOURI DELTA MEDICAL CENTER'S BOARD OF DIRECTORS AFTER THE ORGANIZATION'S FORM 990 HAS BEEN FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE POLICY IS AS FOLLOWS: MEMBERS OF THE BOARD OF DIRECTORS, PRINCIPAL OFFICERS, AND MEMBERS OF ANY COMMITTEE WITH BOARD-DELEGATED POWERS HAVE AN OBLIGATION TO MAKE DECISIONS AND TO PERFORM THEIR DUTIES FOR THE SOLE BENEFIT OF THE HOSPITAL. ALL PERSONS SERVING IN SUCH CAPACITY SHOULD AVOID PLACING HIMSELF/HERSELF IN A POSITION WHERE PERSONAL INTERESTS ARE IN CONFLICT WITH THE INTERESTS OF THE HOSPITAL. THE FOLLOWING DEFINITIONS SHALL APPLY TO THIS POLICY: 1. AN "INTERESTED PERSON" IS A MEMBER OF THE BOARD OF DIRECTORS, PRINCIPAL OFFICER OR MEMBER OF ANY COMMITTEE WITH BOARD DELEGATED POWERS; 2. A PERSON HAS A "FINANCIAL INTEREST" IF THE PERSON HAS, DIRECTLY OR INDIRECTLY, THROUGH BUSINESS, INVESTMENT OR FAMILY: A. A PRESENT OR POTENTIAL OWNERSHIP, INVESTMENT, INTEREST, OR COMPENSATION ARRANGEMENT IN ANY ENTITY WITH WHICH THE HOSPITAL HAS OR MAY HAVE A TRANSACTION OR ARRANGEMENT; B. A COMPENSATION ARRANGEMENT WITH THE HOSPITAL OR ANY ENTITY OR INDIVIDUAL WITH WHICH THE ORGANIZATION HAS A TRANSACTION OR ARRANGEMENT. COMPENSATION INCLUDES ANY REMUNERATION, DIRECTLY OR INDIRECTLY, AND GIFTS OF FAVORS, WHICH ARE SUBSTANTIAL IN NATURE; 3. AN "AFFILIATED ORGANIZATION" INCLUDES ANY ORGANIZATION OR ENTITY OWNED OR OPERATED BY THE HOSPITAL OR IN WHICH THE HOSPITAL HAS A DIRECT FINANCIAL INTEREST; ANY "INTERESTED PERSON" MUST DISCLOSE TO THE HOSPITAL AND ANY AFFILIATED ORGANIZATION ALL FINANCIAL INTERESTS AND ALL MATERIAL FACTS RELATING THERETO. IF A CONFLICT DOES ARISE, THE HOSPITAL AND ANY AFFILIATED ORGANIZATION SHALL: 1. REQUIRE THAT THE "INTERESTED PERSON" LEAVE THE MEETING DURING THE DISCUSSION OF AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST; 2. APPOINT, IF APPROPRIATE, UNDER THE CIRCUMSTANCES THEN APPEARING, A NON-INTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; 3. DETERMINE, BY A MAJORITY VOTE OF NON-INTERESTED PERSONS PRESENT, THAT THE TRANSACTION OR ARRANGEMENT IS IN THE HOSPITAL OR AFFILIATED ORGANIZATION'S BEST INTERESTS AND FOR ITS OWN BENEFIT AND IS FAIR AND REASONABLE TO THE HOSPITAL OR AFFILIATED ORGANIZATION. 4. TAKE APPROPRIATE DISCIPLINARY ACTION WITH RESPECT TO AN "INTERESTED PERSON" WHO VIOLATES THIS CONFLICT OF INTEREST POLICY TO PROTECT THE ORGANIZATION'S BEST INTERESTS. THE MINUTES OF ANY MEETING OF THE BOARD OF DIRECTORS OR ANY COMMITTEE WITH BOARD-DELEGATED POWERS SHALL INCLUDE THE FOLLOWING: 1. THE NAMES OF THE PERSONS WHO DISCLOSED FINANCIAL INTERESTS AND THE NATURE OF THEIR FINANCIAL INTEREST; 2. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT AND A RECORD OF THE VOTE. NO PHYSICIAN, WHO RECEIVES COMPENSATION DIRECTLY OR INDIRECTLY FROM THE HOSPITAL OR ANY AFFILIATED ORGANIZATION, SHALL BE A MEMBER OR SERVE ON ANY COMMITTEE DECIDING ON COMPENSATION FOR INDEPENDENT CONTRACTORS OR PRINCIPAL OFFICERS OF THE CORPORATION. NO MEMBER OF ANY COMPENSATION COMMITTEE WHO HAS A CONFLICT OF INTEREST SHALL, DIRECTLY OR INDIRECTLY, VOTE ON MATTERS PERTAINING TO THAT INDIVIDUAL'S COMPENSATION. EVERY MEMBER OF THE BOARD OF DIRECTORS, PRINCIPAL OFFICER, AND MEMBER OF ANY COMMITTEE WITH BOARD-DELEGATED POWERS SHALL SIGN AN ANNUAL STATEMENT THAT SUCH PERSON: 1. RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; 2. READ AND UNDERSTANDS THE POLICY; 3. AGREES TO COMPLY WITH THE POLICY; 4. UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5. UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS TAX EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S SALARY AND ADMINISTRATIVE REVIEW COMMITTEE, WHICH IS MADE UP OF MEMBERS OF THE BOARD OF DIRECTORS, REVIEWS THE COMPENSATION FOR THE PRESIDENT AND VICE-PRESIDENT OF THE MEDICAL CENTER. THE REVIEW OF COMPENSATION UTILIZES THE ANNUAL 'EXECUTIVE COMPENSATION REPORT' THAT IS PUBLISHED BY THE MISSOURI HOSPITAL ASSOCIATION. A REVIEW OF THE MISSOURI DELTAL MEDICAL CENTER'S PRESIDENT AND VICE-PRESIDENTS COMPENSATION WAS CONDUCTED FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2021. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATIONS' GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MISSOURI DELTA MEDICAL CENTER FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1008 NORTH MAIN STREET | AddressLine1Txt |
| City | SIKESTON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431577510 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivitiesTxt |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MISSOURI DELTA MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | 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 | 0 | 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 | Yes (1) | TransferFromOtherOrgInd |