2022-11-15T15:40:59-05:00 2021-12-31 640394922 WATKINS WARD AND STAFFORD PLLC PO BOX 311 EUPORA MS 39744 990 2021-01-01 646010402 WINSTON COUNTY MEDICAL FOUNDATION WINS 6627736211 PO BOX 967 LOUISVILLE MS 39339 PAUL BLACK CEO 6627736211 2022-11-14 true PAUL BLACK 999009999 ANITA C GOODRUM CPA P00634142 6622582331 2022-11-14 2021 2022-09-23 18:48:47Z WINSTON MEDICAL CENTER PAUL BLACK PO BOX 967 LOUISVILLE MS 39339 32023351 false X WWW.WINSTONMEDICAL.ORG X 1994 MS TO PROVIDE HEALTH CARE SERVICES TO RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND SURROUNDING AREAS 5 5 356 0 8468860 6138330 26700921 25299603 478451 432856 152562 152562 35800794 32023351 0 0 13118107 14130575 0 0 17339807 17604548 30457914 31735123 5342880 288228 45286748 41792206 8343059 4560289 36943689 37231917 TO PROVIDE HEALTH CARE TO THE RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND THE SURROUNDING AREAS false false 30266244 25452165 WINSTON 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. 30266244 true false false false false false false false false false true false false true true false true false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false true 29 0 false 356 true false false false false false false false false X 5 5 false false false false false false false true true false false true true true true true true true true false X WINSTON COUNTY MEDICAL FOUNDATION DBA WINSTON MEDICAL CENTER 6627736211 PO BOX 967 LOUISVILLE MS 39339 DUSTIN GENTRY PHYSICIAN 40.00 X 559414 0 33255 MICHAEL ARD PHYSICIAN 40.00 X 261689 0 27273 PAUL BLACK CEO 50.00 X 169942 0 18542 HEATHER GILMER FNP 40.00 X 156373 0 17991 EMILY PERKINS FNP 40.00 X 140826 0 10652 MARCUS KINCAID TRUSTEE 1.00 X 0 0 0 BRUCE LEE TRUSTEE 1.00 X 0 0 0 MARY TABOR TRUSTEE 1.00 X 0 0 0 DOW THOMAS TRUSTEE 1.00 X 0 0 0 TERRY WOODS TRUSTEE 1.00 X 0 0 0 1288244 107713 10 false true false ENDURACARE ACUTE CARE SERVICES PO BOX 654072 DALLAS TX 752654072 THERAPY DEPT. 1394944 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 DIETARY SERVICE 869011 HOSPITAL HOUSEKEEPING SUSTEMS PO BOX 734367 DALLAS TX 753734367 HOUSEKEEPING 750842 INCARE TECHNOLOGIES 600 W LAKESHORE PKWY BIRMINGHAM AL 35209 COMPUTER MAINT. 326838 COMPREHENSIVE PHARMACY SERVICES PO BOX 638316 CINCINNATI OH 45263 PHARMACY 134128 6 3955030 2183300 6138330 PATIENT CARE 25299603 25299603 25299603 432856 432856 152562 152562 152562 152562 32023351 25452165 432856 169942 169942 11637485 10968948 668537 581202 539929 41273 895753 832143 63610 846193 786102 60091 15218 15218 64724 64724 25634 25634 6429 6429 741211 741211 16889 13498 3391 23545 23545 101772 101772 CONTRACT SERVICES 7075888 6864463 211425 RENTS 3384100 3384100 BAD DEBTS 2262655 2262655 SUPPLIES 1665830 1616721 49109 2220653 2154702 65951 31735123 30266244 1468879 0 1645774 733992 7668708 6155759 3956976 3072334 365934 389357 286936 276550 1444578 711648 788336 732930 30574084 30431284 45286748 41792206 1391024 1325034 69192 3684142 1220642 3198701 2014613 8343059 4560289 X 36943689 37231917 36943689 37231917 45286748 41792206 X 288228 X false true X true true true X 744565 185988 558577 700013 525660 174353 732930 STATE LEVERAGE LOAN 15898515 FEDERAL LEVERAGE LOAN 13938752 OTHER RECEIVABLES 438288 EQUITY IN MHA INSURANCE 141832 INTEREST RECEIVABLE 13897 30431284 CMS AAP PROGRAM PAYMENTS 1736230 DUE TO WMC PBC 278383 2014613 29760696 -2262655 -2262655 32023351 32023351 29472468 -2262655 -2262655 31735123 31735123 SCHEDULE D, PAGE 4, PART XI, LINE 2D BAD DEBTS ARE INCLUDED AS A REDUCTION OF REVENUE ON THE FS -2,262,655 SCHEDULE D, PAGE 4, PART XII, LINE 2D BAD DEBTS ARE INCLUDED AS A REDUCTION OF REVENUE ON THE FS -2,262,655 true true true X false true true false false 1594920 1594920 0.05030 8192253 11629255 9787173 11629255 1594920 0.05030 9787173 11629255 1594920 0.05030 true 2599109 5645920 5718916 -72996 X true true 1 1 WINSTON COUNTY MEDICAL FOUNDATION PO BOX 967 LOUSIVILLE MS 39339 16-208 X X X WINSTON COUNTY MEDICAL FOUNDATION 1 false false true X X X X X X X 19 true false false true X WWW.WINSTONMEDICAL.ORG true 19 true WWW.WINSTONMEDICAL.ORG false false true X 150.000000000000 X true true X X X X true X X X true X false true false false FACILITY 1, WINSTON COUNTY MEDICAL FOUNDATION - PART V, LINE 5 THE FACILITY INQUIRED WITH COMMUNITY LEADERS AND HEALTHCARE OFFICIALS ABOUT THE NEEDS OF THE COMMUNITY. SCHEDULE H, PART III, LINE 2 THE METHODOLOGY USED IS A REVIEW OF THE AGINGS OF THE ACCOUNT BALANCES SCHEDULE H, PART III, LINE 3 THE 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 4 PATIENT 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 9B THE FACILITY HAS IN PLACE A CHARITY CARE APPLICACTION FOR WHICH ANY PATIENT CAN APPLY, PROVIDED THEY MEET THE QUAL IFICATIONS ON THE APPLICATION. X false false false false false false false false false DUSTIN GENTRY PHYSICIAN 559414 33255 592669 MICHAEL ARD PHYSICIAN 261689 27273 288962 PAUL BLACK CEO 169942 18542 188484 HEATHER GILMER FNP 156373 17991 174364 EMILY PERKINS FNP 140826 10652 151478 FORM 990, PAGE 6, PART VI, LINE 11B THE RETURN WAS REVIEWED WITH MANAGEMENT AND THE TAX PREPARER. FORM 990, PAGE 6, PART VI, LINE 12C DURING THE YEAR END AUDIT, RELATED PARTY TRANSACTIONS ARE REVIEWED. FORM 990, PAGE 6, PART VI, LINE 15A THE 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 15B THE 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 19 THE TAX RETURN AND AUDIT ARE MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9 BAD 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