SWISHER MEMORIAL HEALTHCARE SYSTEM: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- SWISHER MEMORIAL HEALTHCARE SYSTEM (EIN 45-2230827)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-09
- IRS object ID
- 202213139349303201
- Schema version
- 2021v4.2
- Note
- A later return for the same period supersedes this one.
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-09T11:26:07-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14241 DALLAS PARKWAY SUITE 1100 | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452230827 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Swisher Memorial Healthcare System | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % LUKE BREWER | InCareOfNm |
| Business Name Control | SWIS | BusinessNameControlTxt |
| Phone | 8069953581 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 808 | AddressLine1Txt |
| City | Tulia | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 79088 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LUKE BREWER | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9727028262 | PhoneNum |
| Signature | 2022-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | luke | PersonFirstNm |
| Person Last | brewer | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jeanette Verrelli | PreparerPersonNm |
| PTIN | P00742631 | PTIN |
| Phone | 9727028262 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LUKE BREWER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 539 SE SECOND STREET | AddressLine1Txt |
| City | TULIA | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 79088 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,608,197 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SWISHERHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY HEALTHCARE TO THE CITIZENS OF SWISHER COUNTY AND THE SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 95 | TotalEmployeeCnt |
| Total Volunteers | 4 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,135,564 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,575,096 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,764,929 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,911,938 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$56,222 | PYInvestmentIncomeAmt |
| CY Investment Income | $237 | CYInvestmentIncomeAmt |
| PY Other Revenue | $117,685 | PYOtherRevenueAmt |
| CY Other Revenue | $120,926 | CYOtherRevenueAmt |
| PY Total Revenue | $12,961,956 | PYTotalRevenueAmt |
| CY Total Revenue | $14,608,197 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $4,863 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $6,078 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,319,980 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,323,732 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,060,204 | PYOtherExpensesAmt |
| CY Other Expenses | $6,940,934 | CYOtherExpensesAmt |
| PY Total Expenses | $11,385,047 | PYTotalExpensesAmt |
| CY Total Expenses | $12,270,744 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,576,909 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,337,453 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,057,131 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,170,345 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,251,960 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,027,721 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,805,171 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,142,624 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE QUALITY HEALTHCARE TO THE CITIZENS OF SWISHER COUNTY AND THE SURROUNDING AREAS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $10,954,704 | ExpenseAmt |
| Grant | $6,078 | GrantAmt |
| Revenue | $12,004,788 | RevenueAmt |
| Desc | PROVIDED ACCESSIBLE AND QUALITY HEALTHCARE SERVICES TO THE CITIZENS OF SWISHER COUNTY AND THE SURROUNDING AREAS. THE HOSPITAL HAD 24,055 ENCOUNTERS - 13,751 CLINIC, 2,044 ER, 174 INPATIENT, 10,080 OUTPATIENT, 50 SWING BED, 7 ASSISTED LIVING; 0 SURGERIES; 482 INPATIENT DAYS; 727 SWING BED DAYS. IN 2021, SWISHER MEMORIAL CONTINUED TO OFFER CHIROPRACTIC SERVICES ONCE A WEEK. THE MEDICAL ADVICE LINE THAT IS AVAILABLE 24/7 TO OUR PATIENTS AND COMMUNITY IS STILL RUNNING SMOOTHLY. SMHS WAS STILL UNABLE TO HOST THE ANNUAL COMMUNITY HEALTH FAIR DUE TO COVID. | Desc |
| Total Program Service Expenses | $10,954,704 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 95 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | false | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LUKE BREWER | PersonNm |
| Phone | 8069958268 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 539 SE SECOND STREET | AddressLine1Txt |
| City | TULIA | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 79088 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| CYNTHIA ARCHER | ||||||||
| PHYSICIAN ASSISTANT | 40.0 | 0.0 | Yes (X) | $218,703 | $0 | $24,165 | ||
| LUKE BREWER | ||||||||
| CEO | 40.0 | 0.0 | $199,686 | $0 | $42,400 | Yes (X) | ||
| KARA DYER | ||||||||
| PHYSICAL THERAPIST | 40.0 | 0.0 | Yes (X) | $173,185 | $0 | $29,033 | ||
| KELLY MAXWELL | ||||||||
| CNO | 40.0 | 0.0 | $155,169 | $0 | $43,027 | Yes (X) | ||
| SCOTT DYER | ||||||||
| PT DIRECTOR | 40.0 | 0.0 | Yes (X) | $168,715 | $0 | $21,450 | ||
| KIMBERELY GEORGE | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $113,370 | $0 | $41,610 | ||
| SHERRY THORNTON | ||||||||
| ASSISTED LIVING DIRECTOR | 40.0 | 0.0 | Yes (X) | $106,803 | $0 | $44,691 | ||
| LIZZIE DUTTON | ||||||||
| CFO | 40.0 | 0.0 | $108,015 | $0 | $15,838 | Yes (X) | ||
| CHARLOTTE O'DANIEL | ||||||||
| BOARD CHAIRMAN | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| GWYN ANN SHANNON | ||||||||
| VICE CHAIRMAN | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| KA WILFONG | ||||||||
| SECRETARY | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| ALYSSA IRLBECK | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,243,646 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $262,214 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CERNER CORPORATION | |||||
| 2800 ROCKCREEK PKWY | KANSAS CITY | MO | 64117 | EHR SERVICES | $335,435 |
| FORVIS LLP | |||||
| 510 N VALLEY MILLS DRIVE | WACO | TX | 76710 | ACCOUNTING SERVICES | $137,761 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,575,096 | GovernmentGrantsAmt |
| All Other Contributions | $0 | AllOtherContributionsAmt |
| Total Contributions | $2,575,096 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 621110 | $10,292,796 | $10,292,796 |
| Incentive Revenue | 900099 | $1,090,954 | $1,090,954 |
| Other Operating Revenue | 900099 | $39,708 | $39,708 |
| PHARMACY REVENUE | 446110 | $488,480 | $488,480 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,911,938 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $237 | TotalRevenueColumnAmt |
| Exclusion | $237 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Guest & Employee Meals | 722514 | $27,306 | $27,306 | |
| Wellness Center Revenue | 713940 | $5,980 | $5,980 | |
| Medical Records | 561000 | $792 | $792 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $86,848 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $86,078 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $770 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $120,926 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,608,197 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,004,788 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $28,313 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,078 | TotalAmt |
| Program Services | $6,078 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $564,136 | TotalAmt |
| Program Services | $282,068 | ProgramServicesAmt |
| Management And General | $282,068 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,638,510 | TotalAmt |
| Program Services | $3,245,798 | ProgramServicesAmt |
| Management And General | $392,712 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,550 | TotalAmt |
| Program Services | $134,493 | ProgramServicesAmt |
| Management And General | $10,057 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $664,884 | TotalAmt |
| Program Services | $612,611 | ProgramServicesAmt |
| Management And General | $52,273 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,652 | TotalAmt |
| Program Services | $260,713 | ProgramServicesAmt |
| Management And General | $50,939 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186 | TotalAmt |
| Management And General | $186 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,761 | TotalAmt |
| Management And General | $137,761 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,674,794 | TotalAmt |
| Program Services | $1,477,569 | ProgramServicesAmt |
| Management And General | $197,225 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,649 | TotalAmt |
| Program Services | $4,892 | ProgramServicesAmt |
| Management And General | $10,757 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,491 | TotalAmt |
| Program Services | $118,845 | ProgramServicesAmt |
| Management And General | $74,646 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $251,242 | TotalAmt |
| Program Services | $241,439 | ProgramServicesAmt |
| Management And General | $9,803 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,075,740 | TotalAmt |
| Program Services | $1,065,678 | ProgramServicesAmt |
| Management And General | $10,062 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,065 | TotalAmt |
| Program Services | $1,037 | ProgramServicesAmt |
| Management And General | $28 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,110 | TotalAmt |
| Program Services | $14,419 | ProgramServicesAmt |
| Management And General | $6,691 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,473 | TotalAmt |
| Program Services | $27,540 | ProgramServicesAmt |
| Management And General | $3,933 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $289,564 | TotalAmt |
| Program Services | $253,380 | ProgramServicesAmt |
| Management And General | $36,184 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,696 | TotalAmt |
| Program Services | $66,307 | ProgramServicesAmt |
| Management And General | $9,389 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Bad Debt Expense | $1,545,847 | $1,545,847 | |
| Medical Supplies | $1,534,797 | $1,534,797 | |
| DUES & SUBSCRIPTIONS | $22,441 | $5,703 | $16,738 |
| Repairs & Equipment | $12,295 | $7,313 | $4,982 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,783 | TotalAmt |
| Program Services | $48,177 | ProgramServicesAmt |
| Management And General | $9,606 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,270,744 | TotalAmt |
| Program Services | $10,954,704 | ProgramServicesAmt |
| Management And General | $1,316,040 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,289,863 | BOYAmt |
| EOY | $7,429,989 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,018,900 | BOYAmt |
| EOY | $1,219,938 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $270,429 | BOYAmt |
| EOY | $276,933 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $405,455 | BOYAmt |
| EOY | $58,185 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,167,987 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,654,289 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,544,984 | BOYAmt |
| EOY | $1,513,698 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $527,500 | BOYAmt |
| EOY | $671,602 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,057,131 | BOYAmt |
| EOY | $11,170,345 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $498,308 | BOYAmt |
| EOY | $643,079 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,483,000 | BOYAmt |
| EOY | $410,863 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $509,499 | BOYAmt |
| EOY | $286,646 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $761,153 | BOYAmt |
| EOY | $687,133 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,251,960 | BOYAmt |
| EOY | $2,027,721 | 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 | $6,805,171 | BOYAmt |
| EOY | $9,142,624 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,805,171 | BOYAmt |
| EOY | $9,142,624 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,057,131 | BOYAmt |
| EOY | $11,170,345 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,337,453 | ReconcilationRevenueExpnssAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | 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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $1,120 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,120 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1I | FormAndLineReferenceDesc |
| Explanation | OTHER ACTIVITIES: Dues Paid % Lobbying Lobbying THA $2,856 8.00% $228 AHA $5,828 10.00% $583 TORCH $3,085 10.00% $309 ---------------------------------------------------- Total $11,769 $1,120 | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,059,595 | OtherCostOrOtherBasisAmt |
| Depreciation | $749,241 | DepreciationAmt |
| Book Value | $310,354 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,108,392 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,905,048 | DepreciationAmt |
| Book Value | $1,203,344 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $1,513,698 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM 3RD PARTY PAYOR | $599,999 |
| Other Asset | $71,603 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $671,602 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| EST SELF-INSURANCE COSTS | $150,060 |
| EST DUE TO THIRD-PARTY PAYORS | $537,073 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $687,133 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | ASC 740 FOOTNOTE: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS 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 (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $985,484 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $491,729 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $493,755 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04600 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,191,238 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,649,630 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,176,722 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,141,359 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $493,755 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04600 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $72,706 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $72,706 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00680 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,078 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,078 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $78,784 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $78,784 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00740 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,255,506 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,141,359 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $572,539 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05340 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,545,847 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $4,406,571 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,604,862 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$198,291 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 | SWISHER MEMORIAL HEALTHCARE SYSTEM | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 539 SE SECOND STREET | AddressLine1Txt |
| City | TULIA | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 79088 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SWISHERHOSPITAL.COM | WebsiteAddressTxt |
| State License | 100122 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Facility Reporting Group | 1 | FacilityReportingGroupCd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SWISHER MEMORIAL HEALTHCARE SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, Section C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Section C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Section C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY: THE HOSPITAL COMPLETED INTERVIEWS AND FOCUS GROUPS WITH REPRESENTATIVES FROM VARIOUS AREAS OF THE COMMUNITY INCLUDING: BUSINESS AND INDUSTRY LEADERS, ELECTED CITY OFFICIALS, CITIZENS OF OUTLYING COMMUNITIES, SENIOR CITIZENS AND YOUNG ADULTS, REPRESENTATIVES OF THE LOCAL CHURCH, THE CHAMBER OF COMMERCE, AND BOARD MEMBERS OF THE DISTRICT. ADDITIONAL INTERVIEWS WITH THE HOSPITAL DIRECTORS, THE CEO AND THE CFO WERE CONDUCTED AS WELL. |
| SCHEDULE H, PART V, SECTION B, LINE 7A & 10A | CHNA AND IMPLEMENTATION STRATEGY AVAILABILITY: https://www.swisherhospital.com/getpage.php?name=Community_Health_Needs_As sessment&sub=About%20Us OUR CHNA IS AVAILABLE ANYTIME WHEN REQUESTED IN PERSON OR ON OUR WEBSITE; BOTH ARE FREE OF CHARGE. |
| SCHEDULE H, PART V, SECTION B, LINE 11 | NEEDS IDENTIFIED IN CHNA: THE STRATEGY TO ADDRESS THE NEEDS IDENTIFIED IS POSTED ON THE HOSPITAL'S WEBSITE. THE HOSPITAL COMPLETED THE COMMUNITY HEALTH NEEDS ASSESSMENT IN EARLY 2021. THE NEW CHNA IDENTIFIED THAT IT NEEDED TO CONTINUE TO ADDRESS THE FOUR NEEDS OF THE COMMUNITY IDENTIFIED IN THE 2017 CHNA: - AVAILABILITY OF LOCAL SPECIALISTS - CHRONIC DISEASE MANAGEMENT - COMMUNITY EDUCATION ON CHRONIC DISEASE, NUTRITION, AND HEALTHY LIFESTYLES - MARKETING OF THE HOSPITAL ALL NEEDS IDENTIFIED IN THE CHNA ARE BEING ADDRESSED BY THE HOSPITAL. THE HOSPITAL'S NEWEST PHYSICIAN SPECIALIZES IN PEDIATRIC CARE. WE ARE TRYING TO GET SPECIALISTS BACK IN, BUT COVID DETERRED MOST OF THAT. THE HEALTH NEEDS OF AN AGING POPULATION WERE DISCUSSED BY MANY. WE STILL HAVE THE ARCHITECTURAL PLANS FOR A NEW ASSISTED LIVING FACILITY, BUT ARE STILL ON HOLD FOR THAT PROJECT UNTIL FUNDING ALIGNS. WE HAVE IMPLEMENTED A CHRONIC CARE MANAGEMENT PROGRAM FOR OUR MEDICARE AGED POPULATION TO BETTER MANAGE THOSE CONDITIONS OF OUR AGING POPULATION. ADDRESSING MENTAL HEALTH, DRUG, AND ALCOHOL ABUSE WERE ALSO DISCUSSED DURING THE FOCUS GROUPS. THE HOSPITAL FACILITATED A TELEPSYCHIATRY OPPORTUNITY FOR AN EXTENDED PERIOD OF TIME, BUT HAD LITTLE TO NO USAGE OF IT. WE ARE EXPLORING OTHER OPPORTUNITIES TO BETTER CARE FOR THOSE PATIENTS IN NEED. SWISHER MEMORIAL HEALTHCARE SYSTEM CONTINUES TO OFFER COMMUNITY WIDE HEALTH FAIRS AND HAS HAD GREAT PARTICIPATION FROM THE COMMUNITY PRE-COVID. WE WILL CONTINUE TO OFFER EDUCATION ON DIABETES, NUTRITION, ALZHEIMER'S, AND DEMENTIA. THE HOSPITAL'S MARKETING EFFORTS ARE CONTINUING TO PAY OFF. WE WILL CONTINUE TO PROMOTE OUR SERVICES AND PROVIDERS. WE WILL CONTINUE TO BRING READING MATERIALS IN BOTH ENGLISH AND SPANISH, AS OVER 40% OF THE POPULATION IS HISPANIC. THE HOSPITAL PARTICIPATED IN A TORCH MARKETING PROJECT TO CREATE A NEW TRIFOLD DESIGN AND DEVELOPED NEW FACEBOOK/SOCIAL MEDIA MATERIAL ACCESS. |
| SCHEDULE H, PART V, SECTION B, LINE 13H | OTHER CRITERIA FOR FINANCIAL ASSISTANCE: THE OTHER ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE IS THE PATIENT'S HOUSEHOLD SIZE. |
| SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C | FINANCIAL ASSISTANCE AVAILABILITY: THE FAP, THE FAP APPLICATION FORM, AND A PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE FOLLOWING WEBSITE: https://www.swisherhospital.com/getpage.php?name=Financial_Assistance&sub= Patient%20Info |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART III, SECTION A, LINE 2 | BAD DEBT EXPENSE: AN ATB IS PROCESSED FOR INPATIENTS AND OUTPATIENTS BY CURRENT FINANCIAL CLASS MONTHLY. BASED ON THE HISTORICAL DATA, A SET PERCENTAGE IS ESTABLISHED AND THAT PERCENTAGE IS APPLIED AND ASSUMED UNCOLLECTIBLE. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCE POLICY: THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. BAD DEBT EXPENSE SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE THIS IS UNCOMPENSATED HEALTHCARE PROVIDED TO RESIDENTS OF THE COMMUNITY. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | BAD DEBT FOOTNOTE: NOT APPLICABLE DUE TO ADOPTION OF ASU 606 REVENUE FROM CONTRACTS WITH CUSTOMERS. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | COSTING METHODOLOGY: THE SYSTEM USES MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS (ROOM AND BOARD) BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. IN ADDITION, THE ORGANIZATION PROVIDES CARE TO ALL PATIENTS REGARDLESS OF SOURCE OF PAYMENT; THEREFORE, COSTS TO PROVIDE CARE TO MEDICARE PATIENTS SHOULD BE CONSIDERED A COMMUNITY BENEFIT TO THE EXTENT COSTS EXCEED MEDICARE REIMBURSEMENT. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | COLLECTION PRACTICES: ONCE A PATIENT HAS QUALIFIED FOR OUR INDIGENT PROGRAM, NO ADDITIONAL COLLECTION EFFORTS ARE MADE ON THAT ACCOUNT. THERE ARE DIFFERENT LEVELS OF CHARITY THAT WE AWARD, MOST OF THE TIME 75-100%, AND WE DO TRY TO COLLECT ON THE REMAINING 25%. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT: SWISHER MEMORIAL HEALTHCARE SYSTEM UTILIZES HCAHPS SURVEYS TO MEASURE THE PATIENTS' PERSPECTIVES AND SATISFACTION REGARDING HOSPITAL CARE. IN ADDITION, THE SYSTEM IS ACTIVE IN ALL OF ITS COMMUNITY SERVICE ORGANIZATIONS. THE CEO ATTENDS THESE SERVICE CLUB MEETINGS TO INVITE PATIENTS, THEIR FAMILIES, AND LOCAL CITIZENS TO SHARE THEIR CONCERNS ABOUT THE COMMUNITY'S NEEDS WITH THE ORGANIZATION. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY CAN BE FOUND ON THE SYSTEM'S WEBSITE IN BOTH ENGLISH AND SPANISH AND DISCUSSED AT SERVICE ORGANIZATION MEETINGS IN OUR COMMUNITY. IT IS ALSO SHARED WITH VARIOUS GOVERNMENT AGENCIES SUCH AS HEALTH AND HUMAN SERVICES. FINALLY, ALL UNINSURED PATIENTS WHO ARE SEEN IN THE SYSTEM'S CLINIC OR EMERGENCY DEPARTMENT ARE REFERRED TO OUR PATIENT ADVOCATE WHO INVESTIGATES ALL POTENTIAL SOURCES OF ASSISTANCE. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION: SWISHER MEMORIAL HEALTHCARE SYSTEM SERVES ALL OF SWISHER COUNTY, TX AS WELL AS SOUTHERN RANDALL COUNTY, WESTERN BRISCOE COUNTY, AND EASTERN CASTRO COUNTY. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH: OUR HOSPITAL CEO AND CNO MEET WITH LOCAL AND COUNTY GOVERNMENT OFTEN TO DISCUSS ANY ACTIONS THE SYSTEM AND/OR DISTRICT MAY BE ABLE TO PARTICIPATE IN, PERFORM, OFFER, OR ENCOURAGE WITHIN OUR COMMUNITY. ALSO, OUR QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT/DISASTER PREPAREDNESS DIRECTOR AND TRAUMA COORDINATOR ARE ACTIVE WITH THE REGIONAL ADVISORY COUNCIL AND OTHER COMMUNITY PREPAREDNESS ACTIVITIES. OUR CLINIC OFFERS AN INFLUENZA VACCINATION CLINIC YEARLY, FOR A FLAT FEE, WITH THE OPTION TO BILL MEDICARE FOR MEDICARE PATIENTS. WE CONTINUE TO PROVIDE A MEDICAL ADVICE LINE TO OUR PATIENTS FREE OF CHARGE THROUGH THE 1115 WAIVER. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM: ALTHOUGH THERE IS NOT A CONTROL OF GOVERNANCE, SWISHER MEMORIAL HEALTHCARE SYSTEM AND SWISHER MEMORIAL HOSPITAL DISTRICT DO COOPERATE IN PROVIDING HEALTH CARE TO THE COMMUNITY. AS HIGHLIGHTED IN THE SCHEDULE H, PART VI - PROMOTION OF COMMUNITY HEALTH, BOTH ENTITIES PARTICIPATE IN VARIOUS PROGRAMS AND CLINICS TO FURTHER THE HEALTH OF SWISHER COUNTY. SWISHER MEMORIAL HOSPITAL DISTRICT CONTRACTS OUT THE EMERGENCY SERVICES TO AMR. SWISHER MEMORIAL HEALTHCARE SYSTEM OFFERS A LEVEL 4 EMERGENCY DEPARTMENT, CRITICAL ACCESS HOSPITAL WITH TWENTY BEDS, AND TULIA RURAL HEALTH CLINIC THAT SERVICES THE MAJORITY OF SWISHER COUNTY. THE DISTRICT AND THE SYSTEM WORK TOGETHER COHESIVELY IN PROVIDING EXCELLENT CARE TO ALL PATIENTS THAT UTILIZE OUR SERVICES. |
| SCHEDULE H, PART VI, LINE 7 | STATE FILING OF COMMUNITY BENEFIT REPORT: TEXAS |
| Schedule H, Part I, Line 3C | FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: THE HOSPITAL USES THE FOLLOWING OTHER CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: - Asset level - MEDICAL INDIGENCY - INSURANCE STATUS - UNDERINSURANCE STATUS - Household size |
| SCHEDULE H, PART I, LINE 7, COLUMN F | PERCENT OF TOTAL EXPENSE: BAD DEBT EXPENSE OF $1,545,847 WAS INCLUDED IN TOTAL EXPENSE ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FROM TOTAL EXPENSE FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSE IN COLUMN (F). |
| SCHEDULE H, PART I, LINE 7 | COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. COSTS COMPUTED ON WORKSHEET 4 AND 8 WERE COMPUTED USING INTERNAL COST SYSTEMS. |
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 | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LUKE BREWER | ||||||||||||||
| CEO | $159,994 | $0 | $32,000 | $0 | $7,692 | $0 | $8,000 | $0 | $34,400 | $0 | $242,086 | $0 | $0 | $0 |
| KELLY MAXWELL | ||||||||||||||
| CNO | $133,775 | $0 | $17,943 | $0 | $3,451 | $0 | $7,101 | $0 | $35,926 | $0 | $198,196 | $0 | $0 | $0 |
| CYNTHIA ARCHER | ||||||||||||||
| PHYSICIAN ASSISTANT | $218,012 | $0 | $691 | $0 | $0 | $0 | $11,178 | $0 | $12,987 | $0 | $242,868 | $0 | $0 | $0 |
| SCOTT DYER | ||||||||||||||
| PT DIRECTOR | $157,793 | $0 | $4,960 | $0 | $5,962 | $0 | $8,267 | $0 | $13,183 | $0 | $190,165 | $0 | $0 | $0 |
| KARA DYER | ||||||||||||||
| PHYSICAL THERAPIST | $164,898 | $0 | $3,393 | $0 | $4,894 | $0 | $8,376 | $0 | $20,657 | $0 | $202,218 | $0 | $0 | $0 |
| KIMBERELY GEORGE | ||||||||||||||
| PHYSICIAN | $108,638 | $0 | $458 | $0 | $4,274 | $0 | $5,836 | $0 | $35,774 | $0 | $154,980 | $0 | $0 | $0 |
| SHERRY THORNTON | ||||||||||||||
| ASSISTED LIVING DIRECTOR | $95,244 | $0 | $2,102 | $0 | $9,457 | $0 | $5,406 | $0 | $39,285 | $0 | $151,494 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | NON-FIXED PAYMENTS: A PERCENTAGE OF INCENTIVE COMPENSATION REPORTED BY THE INDIVIDUALS LISTED ON PART VII, SECTION A IS CONTINGENT ON MEETING THE ANNUAL BUDGET. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 8B | DOCUMENTATION OF COMMITTEES ACTING ON BEHALF OF THE GOVERNING BODY: ANY ACTIONS OF THE COMMITTEES (MEDICAL STAFF, QAPI, NURSING) THAT ARE PART OF THE SYSTEM'S OPERATION ARE REPORTED BY THE CNO/CEO/CFO AT QUARTERLY BOARD MEETINGS. THERE ARE NO COMMITTEES OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS TO REVIEW THE FORM 990: THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE ORGANIZATION'S CEO REVIEWS THE RETURN PRIOR TO FILING. A COPY IS ALSO SENT OUT TO THE GOVERNING BODY FOR REVIEW AND APPROVAL PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: BOARD MEMBERS ARE POLLED ANNUALLY TO DETERMINE IF/WHERE CONFLICTS MAY OCCUR. DEBBIE GARZA OF THE HR DEPARMENT MONITORS COMPLIANCE, AND IF A MEMBER HAS A POSSIBLE CONFLICT THEY ABSTAIN FROM VOTING ON THE TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | COMPENSATION REVIEW: ALL KEY POSITIONS ARE EVALUATED IN COMPARISON TO THE TORCH ANNUAL SURVEY OF HOSPITAL SALARIES AND OTHER SOURCES. EVALUATIONS ARE CONDUCTED EACH YEAR ON COMPENSATION. ONCE THEY HAVE BEEN REVIEWED, WE TAKE IT TO THE BOARD FOR FURTHER REVIEW AND APPROVAL. THIS WAS DONE IN OCTOBER IN PRIOR YEARS AND PRESENTED TO THE BOARD AT THE OCTOBER BOARD MEETING. HOWEVER, WE HAVE SINCE MOVED ANNUAL REVIEWS AND RAISES TO BE CONDUCTED IN APRIL AND AWARDED IN MAY. ALL OF THE COMPENSATION APPROVAL IS DOCUMENTED IN THE BOARD MEETING MINUTES. THE LAST COMPENSATION REVIEW WAS COMPLETED IN 2021 BY THE HOSPITAL CEO. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABILITY OF DOCUMENTS: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST AT THE ORGANIZATION'S OFFICE. |
| FORM 990, PART XII, LINE 2C | RESPONSIBILITY FOR OVERSIGHT OF AUDIT: DUE TO THE SIZE OF THE BOARD, THERE IS NO COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT. INSTEAD, THE FULL BOARD IS RESPONSIBLE. |
| FORM 990, PART IV, LINE 12 & PART XII, LINE 2 | AUDITED FINANCIAL STATEMENTS: THE ORGANIZATION HAS ANSWERED "NO" TO THE QUESTIONS REGARDING AN AUDIT IN PART IV, LINE 12A AND PART XII. THE ORGANIZATION IS IN THE PROCESS OF AN AUDIT OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31, 2021. HOWEVER, AT THE TIME OF FILING THIS RETURN, THE AUDIT IS NOT YET COMPLETE. THE ORGANIZATION HAS ATTACHED A COPY OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31, 2020 AND DECEMBER 31, 2019 TO THE 990 AND ANSWERED YES TO PART IV, LINE 20B. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES TOTAL FEES:464915 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT SERVICES TOTAL FEES:346250 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHYSICIAN FEES TOTAL FEES:775835 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:87794 |