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WINSTON COUNTY MEDICAL FOUNDATION: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
WINSTON COUNTY MEDICAL FOUNDATION (EIN 64-6010402)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-15
IRS object ID
202213199349319366
Schema version
2021v4.0
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

FieldValueIRS element (for citing)
Return2022-11-15T15:40:59-05:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN640394922PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WATKINS WARD AND STAFFORD PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 311AddressLine1Txt
CityEUPORACityNm
State AbbreviationMSStateAbbreviationCd
ZIP39744ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN646010402EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WINSTON COUNTY MEDICAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlWINSBusinessNameControlTxt
Phone6627736211PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 967AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationMSStateAbbreviationCd
ZIP39339ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPAUL BLACKPersonNm
Person TitleCEOPersonTitleTxt
Phone6627736211PhoneNum
Signature2022-11-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstPAULPersonFirstNm
Person LastBLACKPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANITA C GOODRUM CPAPreparerPersonNm
PTINP00634142PTIN
Phone6622582331PhoneNum
Preparation2022-11-14PreparationDt
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1WINSTON MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerPAUL BLACKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 967AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationMSStateAbbreviationCd
ZIP39339ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$32,023,351GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.WINSTONMEDICAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateMSLegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTH CARE SERVICES TO RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND SURROUNDING AREASActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee356TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$8,468,860PYContributionsGrantsAmt
CY Contributions Grants$6,138,330CYContributionsGrantsAmt
PY Program Service Revenue$26,700,921PYProgramServiceRevenueAmt
CY Program Service Revenue$25,299,603CYProgramServiceRevenueAmt
PY Investment Income$478,451PYInvestmentIncomeAmt
CY Investment Income$432,856CYInvestmentIncomeAmt
PY Other Revenue$152,562PYOtherRevenueAmt
CY Other Revenue$152,562CYOtherRevenueAmt
PY Total Revenue$35,800,794PYTotalRevenueAmt
CY Total Revenue$32,023,351CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$13,118,107PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,130,575CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$17,339,807PYOtherExpensesAmt
CY Other Expenses$17,604,548CYOtherExpensesAmt
PY Total Expenses$30,457,914PYTotalExpensesAmt
CY Total Expenses$31,735,123CYTotalExpensesAmt
PY Revenues Less Expenses$5,342,880PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$288,228CYRevenuesLessExpensesAmt
Total Assets BOY$45,286,748TotalAssetsBOYAmt
Total Assets EOY$41,792,206TotalAssetsEOYAmt
Total Liabilities BOY$8,343,059TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,560,289TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$36,943,689NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$37,231,917NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HEALTH CARE TO THE RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND THE SURROUNDING AREASMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$30,266,244ExpenseAmt
Revenue$25,452,165RevenueAmt
DescWINSTON COUNTY MEDICAL FOUNDATION D/B/A WINSTON MEDICAL CENTER PROVIDES HEALTH CARE SERVICES TO THE RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND SURROUNDING AREAS INCLUDING PERSONS UNABLE TO PAY FOR REQUIRED SERVICES.Desc
Total Program Service Expenses$30,266,244TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document29IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee356EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WINSTON COUNTY MEDICAL FOUNDATIONBusinessNameLine1Txt
Business Name Line2DBA WINSTON MEDICAL CENTERBusinessNameLine2Txt
FieldValueIRS element (for citing)
Phone6627736211PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 967AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationMSStateAbbreviationCd
ZIP39339ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
DUSTIN GENTRY
PHYSICIAN40.00Yes (X)$559,414$0$33,255
MICHAEL ARD
PHYSICIAN40.00Yes (X)$261,689$0$27,273
PAUL BLACK
CEO50.00$169,942$0$18,542Yes (X)
HEATHER GILMER
FNP40.00Yes (X)$156,373$0$17,991
EMILY PERKINS
FNP40.00Yes (X)$140,826$0$10,652
MARCUS KINCAID
TRUSTEE1.00$0$0$0Yes (X)
BRUCE LEE
TRUSTEE1.00$0$0$0Yes (X)
MARY TABOR
TRUSTEE1.00$0$0$0Yes (X)
DOW THOMAS
TRUSTEE1.00$0$0$0Yes (X)
TERRY WOODS
TRUSTEE1.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,288,244TotalReportableCompFromOrgAmt
Total Other Compensation$107,713TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K10IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ENDURACARE ACUTE CARE SERVICES
PO BOX 654072DALLASTX752654072THERAPY DEPT.$1,394,944
MORRISON MANAGEMENT SPECIALISTS
PO BOX 102289ATLANTAGA30368DIETARY SERVICE$869,011
HOSPITAL HOUSEKEEPING SUSTEMS
PO BOX 734367DALLASTX753734367HOUSEKEEPING$750,842
INCARE TECHNOLOGIES
600 W LAKESHORE PKWYBIRMINGHAMAL35209COMPUTER MAINT.$326,838
COMPREHENSIVE PHARMACY SERVICES
PO BOX 638316CINCINNATIOH45263PHARMACY$134,128
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Government Grants$3,955,030GovernmentGrantsAmt
All Other Contributions$2,183,300AllOtherContributionsAmt
Total Contributions$6,138,330TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT CAREDesc
Total Revenue Column$25,299,603TotalRevenueColumnAmt
Related Or Exempt Func Income$25,299,603RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$25,299,603TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$432,856TotalRevenueColumnAmt
Exclusion$432,856ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$152,562RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$152,562RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$152,562TotalRevenueColumnAmt
Related Or Exempt Func Income$152,562RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$32,023,351TotalRevenueColumnAmt
Related Or Exempt Func Income$25,452,165RelatedOrExemptFuncIncomeAmt
Exclusion$432,856ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$169,942TotalAmt
Management And General$169,942ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,637,485TotalAmt
Program Services$10,968,948ProgramServicesAmt
Management And General$668,537ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$581,202TotalAmt
Program Services$539,929ProgramServicesAmt
Management And General$41,273ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$895,753TotalAmt
Program Services$832,143ProgramServicesAmt
Management And General$63,610ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$846,193TotalAmt
Program Services$786,102ProgramServicesAmt
Management And General$60,091ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$15,218TotalAmt
Management And General$15,218ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$64,724TotalAmt
Management And General$64,724ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$25,634TotalAmt
Management And General$25,634ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,429TotalAmt
Management And General$6,429ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$741,211TotalAmt
Program Services$741,211ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$16,889TotalAmt
Program Services$13,498ProgramServicesAmt
Management And General$3,391ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$23,545TotalAmt
Management And General$23,545ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$101,772TotalAmt
Program Services$101,772ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CONTRACT SERVICES$7,075,888$6,864,463$211,425
RENTS$3,384,100$3,384,100
BAD DEBTS$2,262,655$2,262,655
SUPPLIES$1,665,830$1,616,721$49,109

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,220,653TotalAmt
Program Services$2,154,702ProgramServicesAmt
Management And General$65,951ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$31,735,123TotalAmt
Program Services$30,266,244ProgramServicesAmt
Management And General$1,468,879ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,645,774BOYAmt
EOY$733,992EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$7,668,708BOYAmt
EOY$6,155,759EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,956,976BOYAmt
EOY$3,072,334EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$365,934BOYAmt
EOY$389,357EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$286,936BOYAmt
EOY$276,550EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,444,578LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$711,648LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$788,336BOYAmt
EOY$732,930EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$30,574,084BOYAmt
EOY$30,431,284EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$45,286,748BOYAmt
EOY$41,792,206EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,391,024BOYAmt
EOY$1,325,034EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$69,192BOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$3,684,142BOYAmt
EOY$1,220,642EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,198,701BOYAmt
EOY$2,014,613EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,343,059BOYAmt
EOY$4,560,289EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$36,943,689BOYAmt
EOY$37,231,917EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$36,943,689BOYAmt
EOY$37,231,917EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$45,286,748BOYAmt
EOY$41,792,206EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$288,228ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$744,565OtherCostOrOtherBasisAmt
Depreciation$185,988DepreciationAmt
Book Value$558,577BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$700,013OtherCostOrOtherBasisAmt
Depreciation$525,660DepreciationAmt
Book Value$174,353BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$732,930TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
STATE LEVERAGE LOAN$15,898,515
FEDERAL LEVERAGE LOAN$13,938,752
OTHER RECEIVABLES$438,288
EQUITY IN MHA INSURANCE$141,832
INTEREST RECEIVABLE$13,897
FieldValueIRS element (for citing)
Total Book Value Other Assets$30,431,284TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
CMS AAP PROGRAM PAYMENTS$1,736,230
DUE TO WMC PBC$278,383
FieldValueIRS element (for citing)
Total Liability$2,014,613TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$29,760,696TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$2,262,655OtherRevenueAmt
Revenue Not Reported-$2,262,655RevenueNotReportedAmt
Revenue Subtotal$32,023,351RevenueSubtotalAmt
Total Revenue Per Form990$32,023,351TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$29,472,468TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included-$2,262,655OtherExpensesIncludedAmt
Expenses Not Reported-$2,262,655ExpensesNotReportedAmt
Expenses Subtotal$31,735,123ExpensesSubtotalAmt
Total Expenses Per Form990$31,735,123TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 4, PART XI, LINE 2DBAD DEBTS ARE INCLUDED AS A REDUCTION OF REVENUE ON THE FS -2,262,655
SCHEDULE D, PAGE 4, PART XII, LINE 2DBAD DEBTS ARE INCLUDED AS A REDUCTION OF REVENUE ON THE FS -2,262,655

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportfalseAnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,594,920TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,594,920NetCommunityBenefitExpnsAmt
Total Expense0.05030TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,192,253TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,629,255DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,787,173TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,629,255DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,594,920NetCommunityBenefitExpnsAmt
Total Expense0.05030TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,787,173TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,629,255DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,594,920NetCommunityBenefitExpnsAmt
Total Expense0.05030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$2,599,109BadDebtExpenseAmt
Reimbursed By Medicare$5,645,920ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$5,718,916CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$72,996MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WINSTON COUNTY MEDICAL FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 967AddressLine1Txt
CityLOUSIVILLECityNm
State AbbreviationMSStateAbbreviationCd
ZIP39339ZIPCd
FieldValueIRS element (for citing)
State License16-208StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1WINSTON COUNTY MEDICAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted19CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.WINSTONMEDICAL.ORGOwnWebsiteURLTxt
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLWWW.WINSTONMEDICAL.ORGStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp

FieldValueIRS element (for citing)
Form And Line ReferenceFACILITY 1, WINSTON COUNTY MEDICAL FOUNDATION - PART V, LINE 5FormAndLineReferenceDesc
ExplanationTHE FACILITY INQUIRED WITH COMMUNITY LEADERS AND HEALTHCARE OFFICIALS ABOUT THE NEEDS OF THE COMMUNITY.ExplanationTxt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART III, LINE 2THE METHODOLOGY USED IS A REVIEW OF THE AGINGS OF THE ACCOUNT BALANCES
SCHEDULE H, PART III, LINE 3THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE.
SCHEDULE H, PART III, LINE 4PATIENT RECEIVABLES ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENTS ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, MAJOR PAYOR SOURCES AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, ESTABLISHED GUIDELINES ARE USED FOR PLACING CERTAIN PAST- DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS.
SCHEDULE H, PART III, LINE 9BTHE FACILITY HAS IN PLACE A CHARITY CARE APPLICACTION FOR WHICH ANY PATIENT CAN APPLY, PROVIDED THEY MEET THE QUAL IFICATIONS ON THE APPLICATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
DUSTIN GENTRY
PHYSICIAN$559,414$33,255$592,669
MICHAEL ARD
PHYSICIAN$261,689$27,273$288,962
PAUL BLACK
CEO$169,942$18,542$188,484
HEATHER GILMER
FNP$156,373$17,991$174,364
EMILY PERKINS
FNP$140,826$10,652$151,478

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE RETURN WAS REVIEWED WITH MANAGEMENT AND THE TAX PREPARER.
FORM 990, PAGE 6, PART VI, LINE 12CDURING THE YEAR END AUDIT, RELATED PARTY TRANSACTIONS ARE REVIEWED.
FORM 990, PAGE 6, PART VI, LINE 15ATHE BOARD OF TRUSTEES REVIEWS THE JOB PERFORMANCE OF THE ADMINISTRATOR AND BASED UPON PAY OF OTHER SIMILAR ADMINISTRATORS ADJUSTS HIS PAY ACCORDINGL Y.
FORM 990, PAGE 6, PART VI, LINE 15BTHE APPLICABLE DEPARTMENT HEADS REVIEW EACH EMPLOYEE AND SUBMIT A RECOMMEN DED PAY ADJUSTMENT TO THE ADMINISTRATOR, THE ADMINISTRATOR THEN GOES TO TH E BOARD OF TRUSTEES WHO WILL DECIDE ON A PAY RAISE, IF ANY.
FORM 990, PAGE 6, PART VI, LINE 19THE TAX RETURN AND AUDIT ARE MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 9BAD DEBTS ARE INCLUDED AS A REDUCTION OF REVENUE ON THE FS -2,262,655 BAD DEBTS ARE INCLUDED AS A REDUCTION OF REVENUE ON THE FS 2,262,655 RESTATEMENT OF PRIOR YEAR 0