CITIZENS MEMORIAL HEALTH CARE FOUNDATION: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- CITIZENS MEMORIAL HEALTH CARE FOUNDATION (EIN 43-1425356)
- Tax period
- 2019-06-01 to 2020-05-31
- Filed
- 2021-04-12
- IRS object ID
- 202101029349301020
- Schema version
- 2019v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-04-12T12:55:59-05:00 | ReturnTs |
| Tax Period End | 2020-05-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-06-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431425356 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITIZENS MEMORIAL HEALTH CARE FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % RENEE MEYER | InCareOfNm |
| Business Name Control | CITI | BusinessNameControlTxt |
| Phone | 4173266000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 N OAKLAND AVENUE | AddressLine1Txt |
| City | BOLIVAR | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65613 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GARY D FULBRIGHT | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Signature | 2021-02-25 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 4178658701 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GARY D FULBRIGHT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 N OAKLAND AVENUE | AddressLine1Txt |
| City | BOLIVAR | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65613 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $55,979,741 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CITIZENSMEMORIAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION CARES FOR EVERY GENERATION THROUGH EXCEPTIONAL SERVICES BY LEADING PHYSICIANS AND A COMPASSIONATE HEALTH TEAM. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 1046 | TotalEmployeeCnt |
| Total Volunteers | 71 | TotalVolunteersCnt |
| Total Gross UBI | $2,976,144 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$16,635 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $413,345 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,160,495 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $50,203,551 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $53,915,836 | CYProgramServiceRevenueAmt |
| PY Investment Income | $163,486 | PYInvestmentIncomeAmt |
| CY Investment Income | -$757,739 | CYInvestmentIncomeAmt |
| PY Other Revenue | $799,503 | PYOtherRevenueAmt |
| CY Other Revenue | $236,223 | CYOtherRevenueAmt |
| PY Total Revenue | $51,579,885 | PYTotalRevenueAmt |
| CY Total Revenue | $54,554,815 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $134,269 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $156,382 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $31,149,813 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $32,802,442 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,142,887 | PYOtherExpensesAmt |
| CY Other Expenses | $22,968,833 | CYOtherExpensesAmt |
| PY Total Expenses | $51,426,969 | PYTotalExpensesAmt |
| CY Total Expenses | $55,927,657 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $152,916 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,372,842 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $48,571,243 | TotalAssetsBOYAmt |
| Total Assets EOY | $49,851,782 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $29,538,470 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $32,217,889 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,032,773 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $17,633,893 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SUPPORT AND ASSIST CITIZENS MEMORIAL HOSPITAL DISTRICT, OR ITS SUCCESSORS, OR ANY HEALTH CARE INSTITUTION WITH WHICH IT MAY MERGE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $30,443,654 | ExpenseAmt |
| Revenue | $34,822,614 | RevenueAmt |
| Desc | PROVIDE LONG TERM CARE SERVICES TO MEDICAID RECIPIENTS (APPROXIMATELY 115,295 RESIDENT DAYS) IN SKILLED FACILITIES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,089,261 | ExpenseAmt |
| Revenue | $6,910,674 | RevenueAmt |
| Desc | PROVIDE MEDICATIONS AND PHARMACISTS CONSULTATIONS TO PATIENTS OF LONG TERM CARE FACILITIES AND MEMBERS OF THE COMMUNITIES WE SERVE. DISPENSED A TOTAL OF 163,577 PRESCRIPTIONS IN FY 2020. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,029,199 | ExpenseAmt |
| Revenue | $5,199,398 | RevenueAmt |
| Desc | PROVIDE HOME CHORE SERVICES TO PEOPLE LIVING AT HOME BUT UNABLE TO COMPLETELY CARE FOR THEMSELVES. THROUGH HOMEMAKER PLUS, 12,038 SERVICE UNITS WERE PROVIDED THROUGH LIGHT HOUSEKEEPING, LAUNDRY, SHOPPING AND RESPITE CARE SERVICES. DURING THE FISCAL YEAR, HOME HEALTH VISITS TOTALED 16,088 AND HOSPICE PATIENT DAYS WERE 18,614. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $5,947,068 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $156,382 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $6,983,150 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $46,509,182 | 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 | Yes (true) | 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 | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 93 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1046 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form1098 C Filed | false | Form1098CFiledInd |
| 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 | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 | Yes (true) | 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 | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RENEE MEYER | PersonNm |
| Phone | 4173286258 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 NORTH OAKLAND AVE | AddressLine1Txt |
| City | BOLIVAR | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65613 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DONALD BABB | ||||||||
| EXEC DTR END 2/20/MBR BEG 2/20 | 1.0 | 1.0 | Yes (X) | $136,174 | $514,928 | $13,607 | ||
| D MICHEALE MEENTS | ||||||||
| BOARD MEMBER | 1.0 | 45.0 | Yes (X) | $0 | $362,579 | $19,655 | ||
| GARY FULBRIGHT | ||||||||
| BRD TREAS END 2/20/EXEC DTR | 20.0 | 25.0 | Yes (X) | $0 | $294,814 | $13,614 | Yes (X) | |
| RENEE MEYER | ||||||||
| CHIEF FINANCIAL OFFICER | 20.0 | 25.0 | $204,164 | $0 | $9,075 | Yes (X) | ||
| CINDY KAY KOLKMEYER | ||||||||
| PHARMACIST | 45.0 | 0.0 | $168,054 | $0 | $10,020 | Yes (X) | ||
| BEVERLY DERRICKSON | ||||||||
| CHIEF OPERATING OFFICER | 45.0 | 0.0 | $171,488 | $0 | $5,735 | Yes (X) | ||
| PATRICIA GRBCICH | ||||||||
| PHARMACIST | 45.0 | 0.0 | $169,923 | $0 | $6,039 | Yes (X) | ||
| CYNTHIA HADFIELD | ||||||||
| PHARMACIST | 45.0 | 0.0 | $163,125 | $0 | $7,005 | Yes (X) | ||
| WILLIAM DONNELL | ||||||||
| BOARD MEMBER/PHYSICIAN | 1.0 | 45.0 | Yes (X) | $3,000 | $157,074 | $9,900 | ||
| TIM FRANCKA | ||||||||
| ADMIN DIR-LTC EAST | 45.0 | 0.0 | $159,777 | $0 | $8,413 | Yes (X) | ||
| CATHERINE S MOLDER | ||||||||
| BOARD SECRETARY - NONVOTING | 1.0 | 45.0 | $0 | $111,852 | $8,383 | Yes (X) | ||
| DAVE STRADER | ||||||||
| BOARD PRESIDENT | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| BRADLEY GREGORY | ||||||||
| BOARD VICE PRESIDENT | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JANIECA HANCOCK | ||||||||
| BOARD MBER/TREASURER BEG 11/20 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JOHN KALLENBACH | ||||||||
| BOARD MEMBER BEG 06/19 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| DEREK HUNTER | ||||||||
| BOARD MEMBER END 06/19 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| NEALE JOHNSON | ||||||||
| BOARD MEMBER END 08/19 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,175,705 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,441,247 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $111,446 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 21 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AYA HEALTHCARE INC | |||||
| 5930 CORNERSTONE CT WEST STE 300 | SAN DIEGO | CA | 92121 | CONTRACT NURSING | $186,890 |
| BKD LLP | |||||
| 910 E ST LOUIS STREET | SPRINGFIELD | MO | 65806 | CONSULTING/AUDIT/TAX | $182,897 |
| BP BUILDERS | |||||
| 4940 S FARM RD 189 | ROGERSVILLE | MO | 65742 | CONSTRUCTION | $350,809 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $85,996 | FundraisingAmt |
| Government Grants | $933,393 | GovernmentGrantsAmt |
| All Other Contributions | $141,106 | AllOtherContributionsAmt |
| Noncash Contributions | $5,989 | NoncashContributionsAmt |
| Total Contributions | $1,160,495 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 623000 | $51,772,186 | $48,796,042 | $2,976,144 |
| RENTAL INCOME FROM AFFILIATE | 531120 | $1,857,593 | $1,857,593 | |
| TRANSIT | 900099 | $143,802 | $143,802 | |
| CAFETERIA | 722514 | $125,081 | $125,081 | |
| OTHER REVENUE | 900099 | $17,174 | $17,174 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $53,915,836 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $197,040 | TotalRevenueColumnAmt |
| Exclusion | $197,040 | 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 |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $493,676 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $130,038 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $363,638 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $363,638 | TotalRevenueColumnAmt |
| Exclusion | $363,638 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $138,471 | SecuritiesAmt |
| Other | $45,009 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $112,159 | SecuritiesAmt |
| Other | $1,026,100 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $26,312 | SecuritiesAmt |
| Other | -$981,091 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$954,779 | TotalRevenueColumnAmt |
| Exclusion | -$954,779 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $29,214 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $85,996 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $156,629 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$127,415 | TotalRevenueColumnAmt |
| Exclusion | -$127,415 | ExclusionAmt |
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,554,815 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $50,939,692 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,976,144 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$521,516 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,000 | TotalAmt |
| Program Services | $9,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,382 | TotalAmt |
| Program Services | $147,382 | ProgramServicesAmt |
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 | $353,661 | TotalAmt |
| Management And General | $353,661 | 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 | $23,778,698 | TotalAmt |
| Program Services | $21,286,373 | ProgramServicesAmt |
| Management And General | $2,492,325 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $713,374 | TotalAmt |
| Program Services | $535,227 | ProgramServicesAmt |
| Management And General | $178,147 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,045,998 | TotalAmt |
| Program Services | $4,600,049 | ProgramServicesAmt |
| Management And General | $1,445,949 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,910,711 | TotalAmt |
| Program Services | $1,464,230 | ProgramServicesAmt |
| Management And General | $446,481 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,036,772 | TotalAmt |
| Program Services | $82,932 | ProgramServicesAmt |
| Management And General | $1,953,840 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,747 | TotalAmt |
| Management And General | $19,747 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,036 | TotalAmt |
| Management And General | $173,036 | 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 | $56,299 | TotalAmt |
| Program Services | $44,313 | ProgramServicesAmt |
| Management And General | $11,986 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,789 | TotalAmt |
| Management And General | $67,789 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,143,167 | TotalAmt |
| Program Services | $2,386,099 | ProgramServicesAmt |
| Management And General | $757,068 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,854 | TotalAmt |
| Program Services | $169,015 | ProgramServicesAmt |
| Management And General | $199,839 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,706,447 | TotalAmt |
| Program Services | $2,327,537 | ProgramServicesAmt |
| Management And General | $378,910 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $422,326 | TotalAmt |
| Program Services | $183,953 | ProgramServicesAmt |
| Management And General | $238,373 | 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 | $26,508 | TotalAmt |
| Program Services | $11,505 | ProgramServicesAmt |
| Management And General | $15,003 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $955,911 | TotalAmt |
| Program Services | $846,822 | ProgramServicesAmt |
| Management And General | $109,089 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,374,799 | TotalAmt |
| Program Services | $2,103,786 | ProgramServicesAmt |
| Management And General | $271,013 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $227,306 | TotalAmt |
| Management And General | $227,306 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $7,152,914 | $7,152,914 | |
| PROVIDER TAX & FEES | $2,382,152 | $2,382,152 | |
| BAD DEBT | $659,356 | $659,356 | |
| MISCELLANEOUS | $71,471 | $52,736 | $18,735 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,979 | TotalAmt |
| Program Services | $63,801 | ProgramServicesAmt |
| Management And General | $60,178 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,927,657 | TotalAmt |
| Program Services | $46,509,182 | ProgramServicesAmt |
| Management And General | $9,418,475 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $416,176 | BOYAmt |
| EOY | $1,357,356 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,475,677 | BOYAmt |
| EOY | $2,076,797 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,359 | BOYAmt |
| EOY | $14,359 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,375,477 | BOYAmt |
| EOY | $6,051,705 | 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 | $1,028,558 | BOYAmt |
| EOY | $1,599,529 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $283,034 | BOYAmt |
| EOY | $241,514 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $71,901,990 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $38,483,129 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,511,560 | BOYAmt |
| EOY | $33,418,861 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,225,530 | BOYAmt |
| EOY | $2,212,203 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,054,071 | BOYAmt |
| EOY | $1,118,364 | 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 | $983,286 | BOYAmt |
| EOY | $983,286 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $203,515 | BOYAmt |
| EOY | $777,808 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,571,243 | BOYAmt |
| EOY | $49,851,782 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,597,803 | BOYAmt |
| EOY | $6,174,728 | 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 | $201,509 | BOYAmt |
| EOY | $1,679,773 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,230,000 | BOYAmt |
| EOY | $8,110,000 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,978 | BOYAmt |
| EOY | $95,168 | 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 | $9,442,574 | BOYAmt |
| EOY | $10,230,118 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $343,912 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,672,694 | BOYAmt |
| EOY | $5,928,102 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,538,470 | BOYAmt |
| EOY | $32,217,889 | 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 | $17,189,111 | BOYAmt |
| EOY | $15,704,111 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,843,662 | BOYAmt |
| EOY | $1,929,782 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,032,773 | BOYAmt |
| EOY | $17,633,893 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,571,243 | BOYAmt |
| EOY | $49,851,782 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,372,842 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$57,261 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $31,223 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $160,804 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $460,170 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $173,204 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $413,345 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,160,495 | CurrentTaxYearAmt |
| Total | $2,368,018 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $45,367,861 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $46,546,395 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $47,305,926 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $50,203,551 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $53,915,836 | CurrentTaxYearAmt |
| Total | $243,339,569 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $39,126 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $29,214 | CurrentTaxYearAmt |
| Total | $68,340 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $45,528,665 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $47,006,565 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $47,479,130 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $50,656,022 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $55,105,545 | CurrentTaxYearAmt |
| Total | $245,775,927 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $245,775,927 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $816,333 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $723,496 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $756,911 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $604,224 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $690,716 | CurrentTaxYearAmt |
| Total | $3,591,680 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $26,013 | CurrentTaxYearMinus4YearsAmt |
| Total | $26,013 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $842,346 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $723,496 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $756,911 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $604,224 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $690,716 | CurrentTaxYearAmt |
| Total | $3,617,693 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $454,045 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $454,045 | CurrentTaxYearMinus1YearAmt |
| Total | $908,090 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $46,371,011 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $47,730,061 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $48,690,086 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $51,714,291 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $55,796,261 | CurrentTaxYearAmt |
| Total | $250,301,710 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98192 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98324 | PublicSupportPY509Pct |
| Investment Income CY | 0.01445 | InvestmentIncomeCYPct |
| Investment Income PY | 0.01487 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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 | $1,506 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,506 | 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, QUESTION 1(I) | FormAndLineReferenceDesc |
| Explanation | OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS ANNUAL DUES TO THE MISSOURI HEALTH CARE ASSOCIATION (MHCA) AND THE AMERICAN HEALTH CARE ASSOCIATION (AHCA). A PORTION OF THESE DUES ARE ALLOCABLE TO LOBBYING: $866 MHCA AND $640 AHCA. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (true) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,648,276 | OtherCostOrOtherBasisAmt |
| Book Value | $5,648,276 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,761,626 | OtherCostOrOtherBasisAmt |
| Depreciation | $31,244,457 | DepreciationAmt |
| Book Value | $22,517,169 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $306,646 | OtherCostOrOtherBasisAmt |
| Depreciation | $178,212 | DepreciationAmt |
| Book Value | $128,434 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,071,279 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,853,090 | DepreciationAmt |
| Book Value | $4,218,189 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,114,163 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,207,370 | DepreciationAmt |
| Book Value | $906,793 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $33,418,861 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED PARTY | $3,270,638 |
| DUE TO THIRD PARTY PAYOR | $1,849,468 |
| CAPITAL LEASE LIABILITY | $807,996 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,928,102 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $55,527,555 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$64,180 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $7,293 | OtherRevenueAmt |
| Revenue Not Reported | -$56,887 | RevenueNotReportedAmt |
| Revenue Subtotal | $55,584,442 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$1,029,627 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$1,029,627 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $54,554,815 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $57,012,555 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $1,234,255 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $1,234,255 | ExpensesNotReportedAmt |
| Expenses Subtotal | $55,778,300 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $149,357 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $149,357 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $55,927,657 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART IV, LINE 2B | ESCROW ACCOUNT LIABILITY: THE FOUNDATION WAS THE TRUSTEE OF $95,168 AND $49,978, RESPECTIVELY, AT MAY 31, 2020 AND 2019, IN FUNDS RECEIVED ON BEHALF OF VARIOUS RESIDENTS. THE FOUNDATION HAS FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THE BANK ACCOUNTS AND THE DISTRIBUTION OF THE FUNDS TO RESIDENTS. |
| SCHEDULE D, PART X, LINE 2 | UNCERTAIN TAX POSITIONS: 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. |
| SCHEDULE D, PART XI, LINE 2D | AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $ 149,357 NET ASSETS RELEASED FROM RESTRICTIONS ( 149,357) SCHOLARSHIPS GRANTED 7,293 CHANGE IN EQUITY INVESTMENT ------------ $ 7,293 |
| SCHEDULE D, PART XII, LINE 4B | AMOUNTS INCLUDED ON FROM 990, PART VII, LINE 12, BUT NOT ON LINE 1: $( 130,038) RENTAL EXPENSE ( 123,126) SPECIAL EVENT EXPENSE ( 981,091) LOSS ON DISPOSAL OF PROPERTY 111,158 TEMPORARILY RESTRICTED INVESTMENT INCOME 93,470 TEMPORARILY RESTRICTED CONTRIBUTIONS ------------ $(1,209,627) |
| SCHEDULE D, PART XII, LINE 2D | AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 123,126 SPECIAL EVENT EXPENSE 130,038 RENTAL EXPENSE 981,091 LOSS ON DISPOSAL OF PROPERTY ------------ $ 1,234,255 |
| SCHEDULE D, PART XII, LINE 4B | AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 149,357 SCHOLARSHIPS GRANTED |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | BURGUNDY BALL | Event1Nm |
| Gross Receipts Event1 | $70,172 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $49,680 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $20,492 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $9,357 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $27,963 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $36,081 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $39,186 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF TOURNAMENT | Event2Nm |
| Gross Receipts Event2 | $45,038 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $36,316 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $8,722 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $18,864 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $8,722 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $5,430 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $11,026 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $115,210 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $85,996 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $29,214 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $18,864 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $18,079 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $33,393 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $36,081 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $50,212 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $156,629 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$127,415 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITIZENS MEMORIAL HOSPITAL DISTRICT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 N OAKLAND AVENUE | AddressLine1Txt |
| City | BOLIVAR | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65613 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 431142176 | RecipientEIN |
| IRC Section | GOVERNMENTAL | IRCSectionDesc |
| Cash Grant | $9,000 | CashGrantAmt |
| Purpose Of Grant | SENIOR HEALTH CTR | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| VARIOUS SCHOLARSHIPS AWARDED | 44 | $98,100 |
| CANCER PATIENT ASSISTANCE | 217 | $49,282 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 & PART III, LINE 1 | FormAndLineReferenceDesc |
| Explanation | GRANT MONITORING: CITIZENS MEMORIAL HEALTH CARE FOUNDATION HAS A MEDICAL EXCELLENCE SCHOLARSHIP COMMITTEE MADE UP OF BOARD MEMBERS, EMPLOYEES AND COMMUNITY MEMBERS. APPLICATIONS FOR THE SCHOLARSHIP MUST BE SUBMITTED EACH YEAR BY MARCH 1. THE COMMITTEE DETERMINES WHO THE SCHOLARSHIPS ARE AWARDED TO. IF THE AWARDED DOES NOT ENROLL IN A MEDICAL RELATED CLASS TIMELY, THE SCHOLARSHIP IS WITHDRAWN. MANY OF THE PAYMENTS ARE MADE DIRECTLY TO THE SCHOOL AND NOT THE INDIVIDUAL. CITIZENS MEMORIAL HEALTH CARE FOUNDATION HAS A CANCER PATIENT ASSISTANCE PROGRAM. ASSISTANCE IS AWARDED BASED ON A NEEDS ASSESSMENT PERFORMED BY CANCER CENTER COORDINATOR. AFTER ASSESSING & DETERMINING PATIENT NEEDS DETAILS ARE ESCALATED TO THE EXECUTIVE DIRECTOR AND/OR CHIEF FINANCIAL OFFICER FOR APPROVAL AND AUTHORIZATION. EXECUTIVE DIRECTOR/CFO THEN SENDS TO ACCOUNTS PAYABLE FOR PROCESSING. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| 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 | Yes (true) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DONALD BABB | ||||||||||||||
| EXEC DTR END 2/20/MBR BEG 2/20 | $136,055 | $426,346 | $119 | $113 | $0 | $88,469 | $1,248 | $1,305 | $0 | $11,054 | $137,422 | $527,287 | $0 | $0 |
| D MICHEALE MEENTS | ||||||||||||||
| BOARD MEMBER | $0 | $361,776 | $0 | $113 | $0 | $690 | $0 | $2,800 | $0 | $16,855 | $0 | $382,234 | $0 | $0 |
| WILLIAM DONNELL | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $3,000 | $153,152 | $0 | $112 | $0 | $3,810 | $0 | $1,570 | $0 | $8,330 | $3,000 | $166,974 | $0 | $0 |
| GARY FULBRIGHT | ||||||||||||||
| BRD TREAS END 2/20/EXEC DTR | $0 | $263,604 | $0 | $113 | $0 | $31,097 | $0 | $2,800 | $0 | $10,814 | $0 | $308,428 | $0 | $0 |
| RENEE MEYER | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $186,176 | $0 | $112 | $0 | $17,876 | $0 | $2,032 | $0 | $7,043 | $0 | $213,239 | $0 | $0 | $0 |
| TIM FRANCKA | ||||||||||||||
| ADMIN DIR-LTC EAST | $145,310 | $0 | $213 | $0 | $14,254 | $0 | $1,574 | $0 | $6,839 | $0 | $168,190 | $0 | $0 | $0 |
| PATRICIA GRBCICH | ||||||||||||||
| PHARMACIST | $168,209 | $0 | $56 | $0 | $1,658 | $0 | $1,696 | $0 | $4,343 | $0 | $175,962 | $0 | $0 | $0 |
| CINDY KAY KOLKMEYER | ||||||||||||||
| PHARMACIST | $167,626 | $0 | $56 | $0 | $372 | $0 | $1,721 | $0 | $8,299 | $0 | $178,074 | $0 | $0 | $0 |
| BEVERLY DERRICKSON | ||||||||||||||
| CHIEF OPERATING OFFICER | $170,666 | $0 | $213 | $0 | $609 | $0 | $1,707 | $0 | $4,028 | $0 | $177,223 | $0 | $0 | $0 |
| CYNTHIA HADFIELD | ||||||||||||||
| PHARMACIST | $160,460 | $0 | $56 | $0 | $2,609 | $0 | $1,639 | $0 | $5,366 | $0 | $170,130 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 1A | HEALTH OR SOCIAL CLUB DUES: THE ORGANIZATION PAYS ANNUAL DUES FOR A COUNTRY CLUB MEMBERSHIP FOR THE FOLLOWING INDIVIDUALS: $1,953 TIM FRANCKA $1,971 RENEE MEYER $1,971 GARY FULBRIGHT THESE AMOUNTS ARE INCLUDED IN THE EMPLOYEES W-2 AS TAXABLE WAGES. |
| SCHEDULE J, PART I, LINE 3 | CRITERIA TO ESTABLISH EXECUTIVE DIRECTOR COMPENSATION: THE FOUNDATION'S EXECUTIVE DIRECTOR, GARY FULBRIGHT, IS PAID THROUGH CITIZENS MEM HOSPITAL DISTRICT. AT THE DISTRICT LEVEL, HIS COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS USING COMPARABLE STATISTIC FOR SIMILAR POSITIONS IN THE HEALTHCARE INDUSTRY. |
| SCHEDULE J, PART I, LINE 6A | CONTINGENT COMPENSATION: IN FY 2020, THE FOUNDATION'S BOARD HAD APPROVED TO PAY OUT BONUSES AT 10% OF NET INCOME. HOWEVER, THERE WAS NO POSITIVE INCOME SO NOTHING WAS ACCRUED FOR BONUSES. THE BONUS WOULD BE ALLOCATED TO MANAGEMENT AND STAFF. NO BONUSES WERE PAID IN THE FISCAL YEAR OR CALENDAR YEAR 2019. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| INDUSTRIAL DVLP AUTH OF DALLAS COUNTY | |||||||
| A | 431546885 | 2014-02-25 | $5,940,000 | REFUND PORTION OF 2014 REV BONDS | false | false | false |
| INDUSTRIAL DVLP AUTH OF THE CITY OF ELDORDO SPRGS | |||||||
| B | 260025115 | 2016-12-22 | $2,365,000 | REFUND SERIES 2012 REV BONDS | false | false | false |
| INDUSTRIAL DVLP AUTHORITY OF POLK COUNTY | |||||||
| C | 010912805 | 2014-02-25 | $6,385,000 | REFUND SERIES 2004 REV BONDS/ACQUI | false | false | false |
| INDUSTRIAL DVLP AUTH OF DALLAS COUNTY | |||||||
| D | 431546885 | 2018-12-28 | $2,530,000 | REFUND PORTION OF 2014 BONDS | false | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $5,865,000 | $0 | $5,940,000 | $0 | $0 | $0 | $22,750 | $0 | $0 | $0 | $5,917,250 | $0 | 2014 | Yes (true) | false | Yes (true) | Yes (true) |
| B | $400,000 | $0 | $2,365,000 | $0 | $0 | $0 | $25,500 | $0 | $0 | $1,252,604 | $1,086,896 | $0 | 2016 | Yes (true) | false | Yes (true) | Yes (true) |
| C | $2,845,000 | $0 | $6,385,000 | $0 | $0 | $0 | $50,750 | $0 | $0 | $643,292 | $5,690,958 | $0 | 2016 | Yes (true) | false | Yes (true) | Yes (true) |
| D | $0 | $0 | $2,530,000 | $0 | $0 | $0 | $31,500 | $0 | $0 | $0 | $2,498,500 | $0 | 2018 | Yes (true) | false | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | 0 | false | false | false | Yes (true) |
| B | false | false | false | false | 0 | false | false | false | Yes (true) |
| C | false | false | false | false | 0 | false | false | false | Yes (true) |
| D | false | false | false | false | 0 | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/BusinessNameLine1Txt | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 0 | ||||||||||
| A | false | false | false | Yes (true) | false | false | false | 0 | false | false |
| 0 | ||||||||||
| B | false | Yes (true) | false | false | false | false | false | 0 | false | false |
| 0 | ||||||||||
| C | false | false | false | Yes (true) | false | false | false | 0 | false | false |
| 0 | ||||||||||
| D | false | Yes (true) | false | false | false | false | false | 0 | false | false |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
| C | Yes (true) |
| D | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART IV, LINE 2C, COLUMNS A & C | FormAndLineReferenceDesc |
| Explanation | DATE OF REBATE COMPUTATION: THE REBATE COMPUTATION WAS PERFORMED 04/24/2019 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | ORGANIZATION'S MISSION: THE ORGANIZATION WAS CREATED TO SUPPORT CMH HOSPITAL DISTRICT THROUGH LONG TERM CARE SERVICES SUCH AS SKILLED NURSING FACILITIES, RESIDENTIAL CARE FACILITIES, AND INDEPENDENT LIVING APARTMENTS, AND TO PROVIDE SERVICES TO THE LOCAL RURAL COMMUNITIES, SUCH AS MEDICAL EQUIPMENT AND SUPPLIES, HOME HEALTH AND HOSPICE, HEALTH TRANSPORTATION, HOMEMAKER CHORE SERVICES AND PHARMACY SERVICES. |
| FORM 990, PART I, LINE 6 | NUMBER OF VOLUNTEERS: THE TOTAL NUMBER OF VOLUNTEERS INCLUDES NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS ALONG WITH OTHER AUXILIARY VOLUNTEERS WHO ASSIST WITH A VARIETY OF OPPORTUNITIES AT THE FOUNDATION'S FACILITIES. |
| FORM 990, PART III, LINE 4A, 4B, 4C & 4D | PROGRAM SERVICE ACTIVITY DETAIL: WE OFFER CARE AT EVERY STAGE OF LIFE BY PROVIDING HOME CARE, INDEPENDENT LIVING, RESIDENTIAL CARE AND SKILLED NURSING (LONG TERM CARE) FACILITIES. ALL FACILITIES OFFER RESIDENT AND FAMILY SERVICES INCLUDING SOCIAL SERVICES; DAILY ACTIVITIES AND MONTHLY OUTINGS; BEAUTY AND BARBER SERVICES; VISITS FROM COMMUNITY AND SCHOOL ORGANIZATIONS; AND LAUNDRY, CHURCH AND PHARMACY SERVICES. MONTHLY FAMILY SUPPORT GROUPS AND RESIDENT CARE PLANNING MEETING ASSIST FAMILY MEMBERS WITH EDUCATION AND RESOURCES TO ENHANCE THE QUALITY OF TIME SHARED WITH LOVED ONES. IN ADDITION, IF PATIENTS NEED A LITTLE EXTRA HELP, HOMEMAKER PLUS CAN HELP THEM REMAIN INDEPENDENT IN THEIR HOME. OUR SERVICES ARE PROVIDED ON NONDISCRIMINATORY BASIS AND CAN BENEFIT EVERYONE, FROM THE ELDERLY AND PHYSICALLY CHALLENGED TO THE HEALTHY FAMILY ON THE GO. A CARING INDIVIDUAL WILL VISIT THE HOME AND ASSIST PATIENTS ON A LONG-TERM OR ONE-TIME BASIS WITH SKILLED NURSING, REHABILITATIVE SERVICES, HOUSEKEEPING CHORES, MEAL PLANNING, GROCERY SHOPPING AND A HOST OF OTHER IMPORTANT SERVICES. OUR SERVICES PROVIDED RESIDENTIAL CARE SERVICES FOR THE ELDERLY TO APPROXIMATELY 21,963 RESIDENT DAYS. |
| FORM 990, PART VI, SECTION A, LINE 2 | BOARD MEMBER BUSINESS RELATIONSHIP: BOARD MEMBERS BRAD GREGORY AND JANIECA HANCOCK HAVE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11B | 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A DRAFT OF THE 990 WILL BE REVIEWED BY TOP MANAGEMENT. A FINAL DRAFT WILL BE DISCUSSED AT A MEETING OF THE FULL BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY REVIEW: ANNUALLY, DURING THE MARCH BOARD OF DIRECTOR'S MEETING, THE OFFICERS AND DIRECTORS DISCLOSE ALL KNOWN CONFLICTS OF INTEREST. ANY BOARD MEMBER WITH A CONFLICT OF INTEREST ABSTAINS FROM VOTING ON ANY MATTER RELATED TO THAT CONFLICT. IN ADDITION, ALL CORPORATE OFFICERS AND KEY EMPLOYEES ARE ANNUALLY REQUIRED TO REPORT POTENTIAL CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION REVIEW POLICY: THE BOARD OF DIRECTORS OF CITIZENS MEMORIAL HOSPITAL DISTRICT ESTABLISHES THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER/EXECUTIVE DIRECTOR BASED UPON COMPENSATION FOR SIMILAR POSITIONS IN THE HEALTHCARE INDUSTRY. A WRITTEN EMPLOYMENT AGREEMENT DETAILS THE SALARY AND BENEFITS FOR THE CEO/EXECUTIVE DIRECTOR. CITIZENS MEMORIAL HEALTH CARE FOUNDATION PAYS A PERCENTAGE OF THE TOTAL BASED UPON THE ESTIMATED PERCENTAGE OF TIME SPLIT BETWEEN THE TWO ORGANIZATIONS. THIS PERCENTAGE IS NOT ANNUALLY REVIEWED OR APPROVED BY THE CITIZENS MEMORIAL HOSPITAL DISTRICT BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: MANY ORGANIZATION POLICIES ARE MADE AVAILABLE TO EMPLOYEES ON THE COMPANY INTRANET, FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN REQUEST TO ALL BONDHOLDERS FOR A LEGITIMATE BUSINESS PURPOSE, AND THE AUDIT REPORT IS MADE AVAILABLE TO ALL LENDERS. IN GENERAL, DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC BY ANY OTHER MEANS. |
| FORM 990, PART VII, SECTION A | BOARD MEMBER COMPENSATION: NO BOARD MEMBER RECEIVED COMPENSATION FOR THEIR DUTIES AS DIRECTORS. DONALD J BABB RECEIVED COMPENSATION FROM CITIZENS MEMORIAL HEALTH CARE FOUNDATION FOR HIS ROLE AS EXECUTIVE DIRECTOR, ENDING FEBRUARY OF 2020. WILLIAM DONNELL IS COMPENSATED BY THE ORGANIZATION FOR SERVING AS MEDICAL DIRECTOR FOR A SKILLED NURSING FACILITY AND IS COMPENSATED BY CITIZENS MEMORIAL HOSPITAL, A RELATED ORGANIZATION, AS A PHYSICIAN. D. MICHEALE MEENTS IS COMPENSATED BY CITIZENS MEMORIAL HOSPITAL, A RELATED ORGANIZATION, AS A PHYSICIAN. GARY FULBRIGHT RECEIVES COMPENSATION FROM CITIZENS MEMORIAL HOSPITAL, A RELATED ORGANIZATION, FOR HIS ROLE AS EXECUTIVE DIRECTOR, BEGINNING FEBRUARY OF 2020. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS: $ 7,293 CHANGE IN EQUITY INVESTMENTS 23,930 SCHOLARSHIPS GRANTED -------- $ 31,223 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CITIZENS MEMORIAL HOSPITAL | ||||||||||
| 1500 N OAKLAND | BOLIVAR | MO | 65613 | 431142176 | HOSPITAL | MO | 501(C)(3) | 3 | NA | false |
| RIVERSIDE MANAGEMENT AND REHABILITATION | ||||||||||
| 1500 N OAKLAND | BOLIVAR | MO | 65613 | 431776752 | MGT AND REHAB | MO | 501(C)(3) | 10 | CMH | false |
| CMH PROPERTIES | ||||||||||
| 1500 N OAKLAND | BOLIVAR | MO | 65613 | 463645590 | RE HOLDINGS | MO | 501(C)(3) | 12B II | CMHCF | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BOLIVAR MED BLDG | |||||||||||||
| BOLIVAR MO 65613 | BOLIVAR | MO | 65613 | 262797636 | MEDICAL BUILD | MO | CMHCF | EXCLUDED FROM TAX | $56,912 | $2,122,270 | false | false | 0.56250 |
| BOLIVAR CHARITIES LLC | |||||||||||||
| PO BOX 117 | BOLIVAR | MO | 65613 | 832879880 | RENTAL PROPERTY | MO | CMHCF | EXCLUDED FROM TAX | -$59,941 | $487,896 | false | false | 0.50000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (true) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |