ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS INC (EIN 63-1143638)
- Tax period
- 2019-10-01 to 2020-09-30
- Filed
- 2021-08-16
- IRS object ID
- 202122289349303522
- Schema version
- 2019v5.0
- Note
- A later return for the same period supersedes this one.
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-08-16T15:18:55-05:00 | ReturnTs |
| Tax Period End | 2020-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 580914992 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317081309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 631143638 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ESCAMBIA COUNTY ALABAMA COMMUNITY | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITALS INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ESCA | BusinessNameControlTxt |
| Phone | 2518098494 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 MEDICAL PARK DRIVE | AddressLine1Txt |
| City | ATMORE | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 365023006 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHEN FISCHER | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2518098313 | PhoneNum |
| Signature | 2021-08-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JACQUELINE G ATKINS | PreparerPersonNm |
| PTIN | P00861721 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2021-08-16 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ATMORE COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JEFF BOOTH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 MEDICAL PARK DRIVE | AddressLine1Txt |
| City | ATMORE | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 365023006 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $20,344,793 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ATMOREHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | AL | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION'S PRIMARY MISSION IS DEDICATED TO MEETING THE HEALTHCARE NEEDS IN ESCAMBIA COUNTY ALABAMA AND THE SURROUNDING COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 287 | TotalEmployeeCnt |
| Total Volunteers | 31 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $330,455 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,397,898 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $25,952,346 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,635,806 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,757 | PYInvestmentIncomeAmt |
| CY Investment Income | $20,575 | CYInvestmentIncomeAmt |
| PY Other Revenue | $687,712 | PYOtherRevenueAmt |
| CY Other Revenue | $290,514 | CYOtherRevenueAmt |
| PY Total Revenue | $26,977,270 | PYTotalRevenueAmt |
| CY Total Revenue | $20,344,793 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,352,720 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,842,097 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,621,366 | PYOtherExpensesAmt |
| CY Other Expenses | $9,458,984 | CYOtherExpensesAmt |
| PY Total Expenses | $27,974,086 | PYTotalExpensesAmt |
| CY Total Expenses | $21,301,081 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$996,816 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$956,288 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,546,636 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,525,702 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,512,862 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,448,216 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,033,774 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,077,486 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION'S PRIMARY MISSION IS DEDICATED TO MEETING THE HEALTHCARE NEEDS IN ESCAMBIA COUNTY ALABAMA AND THE SURROUNDING COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $18,823,530 | ExpenseAmt |
| Revenue | $17,794,422 | RevenueAmt |
| Desc | ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS DBA ATMORE COMMUNITY HOSPITAL (ACH) OPERATES ONE ACUTE CARE HOSPITAL IN THE ESCAMBIA COUNTY COMMUNITY. ACH ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN FISCAL YEAR 2020, THE HOSPITAL TREATED 871 INPATIENTS FOR A TOTAL OF 5,165 PATIENT DAYS. THE THREE RURAL HEALTH CLINICS SAW 23,607 PATIENT VISITS DURING THE FISCAL YEAR. | Desc |
| Total Program Service Expenses | $18,823,530 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | 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 | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 45 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 287 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | 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 | false | 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 | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHEN FISCHER | PersonNm |
| Phone | 2518098313 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 BELLEVILLE AVENUE | AddressLine1Txt |
| City | BREWTON | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 364261306 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| JONAH M MCINTYRE MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $299,691 | $0 | $28,632 | |||
| SHELDON J HARIGEL MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $251,949 | $0 | $28,185 | |||
| WILIAM S HARIGEL MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $238,280 | $0 | $21,362 | |||
| CHRIS GRIFFIN | ||||||||
| CEO LEFT 5/2 | 25.00 | $95,050 | $95,050 | $13,000 | 26.00 | Yes (X) | ||
| STEPHEN FISCHER | ||||||||
| CFO | 25.00 | $77,838 | $77,838 | $0 | 26.00 | Yes (X) | ||
| BRITTANY H LEE | ||||||||
| PHARMACIST | 40.00 | Yes (X) | $137,190 | $0 | $0 | |||
| CATHY JIMMERSON | ||||||||
| STAFF | 40.00 | Yes (X) | $128,753 | $0 | $7,904 | |||
| SUZANNE MCGILL | ||||||||
| ADMINISTRATO | 40.00 | $91,801 | $0 | $17,307 | Yes (X) | |||
| A G BO BRANTLEY | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | 2.00 | Yes (X) | ||
| DEREK BROOKS | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | 2.00 | Yes (X) | ||
| SHARON DAVIDSON | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | 2.00 | Yes (X) | ||
| RUTH HARRELL | ||||||||
| VICE CHAIR | 1.00 | $0 | $0 | $0 | 2.00 | Yes (X) | Yes (X) | |
| KEITH HORTON | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | 2.00 | Yes (X) | ||
| AL FONTO HOLLEY JR | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | 2.00 | Yes (X) | ||
| NANCY W LOWERY | ||||||||
| CHAIR | 1.00 | $0 | $0 | $0 | 2.00 | Yes (X) | Yes (X) | |
| DEBORAH ROWELL | ||||||||
| SECRETARY | 1.00 | $0 | $0 | $0 | 2.00 | Yes (X) | Yes (X) | |
| STEPHEN VANPELT | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | 2.00 | Yes (X) | ||
| DON WARD | ||||||||
| TREASURER | 1.00 | $0 | $0 | $0 | 2.00 | Yes (X) | Yes (X) | |
| JEFF BOOTH | ||||||||
| CEO 5/2021 | 25.00 | $0 | $0 | $0 | 26.00 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,320,552 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $172,888 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $116,390 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (true) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HOSPITAL HOUSEKEEPING SYSTEM LLC | |||||
| P O BOX 734364 | DALLAS | TX | 753734364 | DIETARY/FACILIT | $517,357 |
| ALLIANCE HEALTHCARE SERVICES INC | |||||
| P O BOX 96485 | CHICAGO | IL | 60693 | MEDICAL SVCS | $138,288 |
| QUEST DIAGNOSTICS INC | |||||
| P OBOX 740736 | ATLANTA | GA | 303740736 | LAB SVCS | $115,082 |
| SOUTHWEST ALABAMA ANESTHESIA GROUP L | |||||
| P O BOX 124 | EXCEL | AL | 36439 | ANESTHESIOLOGY | $107,940 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,396,770 | GovernmentGrantsAmt |
| All Other Contributions | $1,001,128 | AllOtherContributionsAmt |
| Total Contributions | $2,397,898 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PROGRAM SERVICE REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $17,635,806 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,635,806 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,635,806 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,575 | TotalRevenueColumnAmt |
| Exclusion | $20,575 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $104,490 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $104,490 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $104,490 | TotalRevenueColumnAmt |
| Exclusion | $104,490 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| DISCOUNTS & REBATES | 621990 | $132,472 | $132,472 | |
| VENDING & CAFETERIA | 722514 | $27,408 | $27,408 | |
| MISCELLANEOUS REVENUES | 621990 | $19,485 | $19,485 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,659 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,659 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $186,024 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,344,793 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,794,422 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $152,473 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,495 | TotalAmt |
| Management And General | $288,495 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,543,080 | TotalAmt |
| Program Services | $8,990,421 | ProgramServicesAmt |
| Management And General | $552,659 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $235,551 | TotalAmt |
| Program Services | $215,930 | ProgramServicesAmt |
| Management And General | $19,621 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,177,078 | TotalAmt |
| Program Services | $1,079,027 | ProgramServicesAmt |
| Management And General | $98,051 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $597,893 | TotalAmt |
| Program Services | $548,089 | ProgramServicesAmt |
| Management And General | $49,804 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,988 | TotalAmt |
| Management And General | $36,988 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,032 | TotalAmt |
| Management And General | $18,032 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,356 | TotalAmt |
| Management And General | $2,356 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,118,906 | TotalAmt |
| Program Services | $3,979,781 | ProgramServicesAmt |
| Management And General | $139,125 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,486 | TotalAmt |
| Program Services | $4,883 | ProgramServicesAmt |
| Management And General | $10,603 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,767,977 | TotalAmt |
| Program Services | $1,193,606 | ProgramServicesAmt |
| Management And General | $574,371 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $627,820 | TotalAmt |
| Program Services | $390,456 | ProgramServicesAmt |
| Management And General | $237,364 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $641,509 | TotalAmt |
| Program Services | $616,683 | ProgramServicesAmt |
| Management And General | $24,826 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,486 | TotalAmt |
| Program Services | $76,109 | ProgramServicesAmt |
| Management And General | $377 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,189 | TotalAmt |
| Program Services | $10,285 | ProgramServicesAmt |
| Management And General | $8,904 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,938 | TotalAmt |
| Management And General | $20,938 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $667,064 | TotalAmt |
| Program Services | $641,249 | ProgramServicesAmt |
| Management And General | $25,815 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $251,274 | TotalAmt |
| Management And General | $251,274 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $720,637 | $720,595 | $42 |
| REPAIRS & MAINTENANCE | $365,857 | $311,257 | $54,600 |
| MISCELLANEOUS | $40,705 | $7,828 | $32,877 |
| DUES & SUBSCRIPTIONS | $36,603 | $33,474 | $3,129 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,157 | TotalAmt |
| Program Services | $3,857 | ProgramServicesAmt |
| Management And General | $27,300 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,301,081 | TotalAmt |
| Program Services | $18,823,530 | ProgramServicesAmt |
| Management And General | $2,477,551 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,312,243 | BOYAmt |
| EOY | $510,724 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $9,664,640 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,535,539 | BOYAmt |
| EOY | $5,268,072 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $362,603 | BOYAmt |
| EOY | $373,093 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,209 | BOYAmt |
| EOY | $224,792 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $20,014,889 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $16,802,682 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,912,622 | BOYAmt |
| EOY | $3,212,207 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $256,876 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $323,420 | BOYAmt |
| EOY | $15,298 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,546,636 | BOYAmt |
| EOY | $19,525,702 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,332,311 | BOYAmt |
| EOY | $1,961,852 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,466 | BOYAmt |
| EOY | $2,241,383 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,146,085 | BOYAmt |
| EOY | $11,244,981 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,512,862 | BOYAmt |
| EOY | $15,448,216 | 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 | $5,033,774 | BOYAmt |
| EOY | $4,077,486 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,033,774 | BOYAmt |
| EOY | $4,077,486 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,546,636 | BOYAmt |
| EOY | $19,525,702 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$956,288 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 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 | $2,835 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,835 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS MEMBERSHIP DUES TO NATIONAL AND STATE ORGANIZATIONS. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THOSE ORGANIZATIONS PARTICIPATE. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,052 | OtherCostOrOtherBasisAmt |
| Book Value | $22,052 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,297,530 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,035,296 | DepreciationAmt |
| Book Value | $1,262,234 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $51,026 | OtherCostOrOtherBasisAmt |
| Depreciation | $41,983 | DepreciationAmt |
| Book Value | $9,043 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,806,589 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,725,403 | DepreciationAmt |
| Book Value | $1,081,186 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,374,515 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| CARES ACT ADVANCE | $8,445,267 |
| OTHER LIABILITIES | $1,434,272 |
| DUE RELATED PARTIES | $1,321,358 |
| DUE TO THIRD PARTY PAYORS | $44,084 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,244,981 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | ECACH IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND IS ALSO EXEMPT FROM STATE INCOME TAXES. ECACH DOES FILE THE INFORMATIONAL FORM 990 TAX RETURN AND FORM 990T FOR ANY UNRELATED INCOME. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | false | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,218 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,218 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,754,974 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,005,926 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,758,192 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,005,926 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,218 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,861,722 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,915,836 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $945,886 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04440 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,861,722 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,915,836 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $945,886 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04440 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,619,914 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,921,762 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $949,104 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04460 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $11,436,010 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $3,593,096 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,761,683 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$168,587 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ATMORE COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 MEDICAL PARK DRIVE | AddressLine1Txt |
| City | ATMORE | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 36502 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.ATMOREHEALTH.ORG | WebsiteAddressTxt |
| State License | H2704 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | SWING BED, RHCS | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ATMORE COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.ATMOREHEALTH.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.ATMOREHEALTH.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.ATMOREHEALTH.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, ATMORE COMMUNITY HOSPITAL - PART V, LINE 3E | THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IS IDENTIFIED AND THE METHODOLOGY FOR PRIORITIZING EACH NEED IS DESCRIBED ON PAGES 12-14 OF THE 2019 CHNA. |
| FACILITY 1, ATMORE COMMUNITY HOSPITAL - PART V, LINE 5 | IN COMPLIANCE WITH THE REQUIREMENTS OF THE 2010 PATIENT PROTECTION AND AFFORDABLE CARE ACT (SECTION 501(R)), THE ESCAMBIA COUNTY HEALTHCARE AUTHORITY CONVENED A COLLABORATIVE TEAM FROM DW MCMILLAN, ATMORE, HAND ARENDALL HARRISON SALE, LLC, SBC CONSULTING, LLC, AND A BROAD, DIVERSE GROUP OF COMMUNITY LEADERS AND STAKEHOLDERS IN ESCAMBIA COUNTY TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE INITIAL MEETING OF THE ESCAMBIA COUNTY 2019 CHNA STAKEHOLDERS WAS HELD ON JUNE 13, 2019, WITH 25 MEMBERS PARTICIPATING. THE STAKEHOLDER COMMITTEE REVIEWED DATA PRESENTED BY THE FACILITATORS AND DISCUSSED THEIR THOUGHTS REGARDING LOCAL ISSUES OF HEALTH IN ESCAMBIA COUNTY. THE FACILITATORS PROVIDED A ROUND-TABLE DISCUSSION. STAKEHOLDERS INCLUDED REPRESENTATIVES OF THE MEDICALLY UNDERSERVED, MINORITIES, AND THE LOW-INCOME AS WELL AS THOSE WITH PUBLIC HEALTH EXPERTISE, BUSINESS LEADERS, GOVERNMENT LEADERS, RELIGIOUS LEADERS, LAW ENFORCEMENT, AND EDUCATORS. |
| FACILITY 1, ATMORE COMMUNITY HOSPITAL - PART V, LINE 6A | IN CONFORMITY WITH THE PROVISIONS OF THE 2010 PATIENT PROTECTION AND AFFORDABLE CARE ACT, THIS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT IS A JOINT EFFORT BETWEEN DW MCMILLAN MEMORIAL HOSPITAL AND ATMORE COMMUNITY HOSPITAL. BOTH HOSPITALS ARE LOCATED WITHIN THE SAME SERVICE AREA AND PROVIDE A COMPREHENSIVE ARRAY OF SERVICES TO RESIDENTS IN THE SERVICE AREA. |
| FACILITY 1, ATMORE COMMUNITY HOSPITAL - PART V, LINE 11 | AFTER AN EXHAUSTIVE REVIEW OF THE STAKEHOLDERS IDENTIFIED ISSUES OF HEALTH AS WELL AS THE QUANTITATIVE DATA THAT WAS PROVIDED, THE STAKEHOLDER GROUP AND THE LEADERSHIP OF DW MCMILLAN AND ATMORE COMMUNITY HOSPITAL DETERMINED TWO ISSUES OF HEALTH SHOULD BE PRIORITIZED. THIS DECISION WAS BASED ON POTENTIAL EFFECTIVENESS, AVAILABLE RESOURCES, AND FINANCIAL FEASIBILITY. PLANS AND PROGRAMS CURRENTLY IN PLACE PROVIDING COMMUNITY BENEFIT WERE ALSO CONSIDERED. THE INTENT IS TO IMPROVE THE QUALITY OF LIFE FOR THE CITIZENS OF ESCAMBIA COUNTY. THE PRIORITIZED NEEDS ARE: - ACCESS TO CARE - RISK FACTORS THAT LEAD TO THE OVERALL POOR HEALTH IN THE COMMUNITY AND DISEASES SUCH AS DIABETES, HEART DISEASE, STROKE, AND CANCER. ALTHOUGH OTHER NEEDS WERE IDENTIFIED THROUGH THIS PROCESS, IT WAS DETERMINED THAT NEEDS NOT DEEMED PRIORITIES COULD BE ADDRESSED THROUGH OTHER RESOURCES OR ACTION PLANS TO ADDRESS THOSE NEEDS THAT WERE NOT FINANCIALLY FEASIBLE. DW MCMILLAN AND ATMORE COMMUNITY HOSPITAL ARE RURAL HOSPITALS WITH LIMITED CAPITAL RESOURCES AND ADDRESSING ALL THE IDENTIFIED NEEDS WOULD PLACE A HARDSHIP ON THE HOSPITALS. THE 2019 CHNA AND IMPLEMENTATION PLAN (ACTION PLAN IS FOUND ON PAGES 12-14 OF THE CHNA) CAN BE FOUND ON THE ORGANIZATION'S WEBSITE AT HTTPS://WWW.ATMOREHEALTH.ORG/GETPAGE.PHP? NAME=HEALTHCARE_AUTHORITY&SUB=ABOUT%20US |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| ACH FAMILY RHC | ||||
| 611 EAST LAUREL ST | ATMORE | AL | 36502 | RURAL HEALTH CLINIC |
| ACH PRIMARY CARE | ||||
| 402 MEDICAL PARK DR | ATMORE | AL | 36502 | RURAL HEALTH CLINIC |
| ACH OUTPATIENT CLINIC | ||||
| 401 MEDICAL PARK DR | ATMORE | AL | 36502 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7G | ACH OPERATES THREE RURAL HEALTH CLINICS WHICH PROVIDE ASSISTANCE TO FINANCIALLY AND MEDICALLY INDIGENT PATIENTS IN AN EFFORT TO REDUCE THEIR NEED FOR EMERGENCY AND INPATIENT HOSPITAL CARE. TOTAL COSTS OF OPERATING THESE THREE CLINICS ARE 945,886 FOR THE FISCAL YEAR 2020. |
| SCHEDULE H, PART I, LINE 7 | THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". SEE ALSO THE DESCRIPTION FOR PART III, LINE 2. |
| SCHEDULE H, PART III, LINE 2 | AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. |
| SCHEDULE H, PART III, LINE 4 | THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS FOOTNOTE CAN BE FOUND ON PAGE 13 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, LINE 8 | MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. |
| SCHEDULE H, PART III, LINE 9B | FOR PATIENTS WHO ARE FINANCIALLY OR MEDICALLY INDIGENT (BASED UPON THE PATIENTS HOUSEHOLD INCOME AS DEFINED ANNUALLY BY THE U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES IN THE FEDERAL REGISTER AS THE FEDERAL POVERTY LEVEL (FPL GUIDELINES): A) PATIENTS ARE DEEMED FINANCIALLY INDIGENT IF THEIR INCOME IS BELOW 200% OF FPL. IF A PATIENT MAKES BETWEEN 200% AND 400% OF THE FPL, THEN THEY MAY ONLY RECEIVE A PARTIAL WRITE-OFF. B) PATIENTS MAY BE DEEMED MEDICALLY INDIGENT IF THEIR HOUSEHOLD MEDICAL EXPENSES EXCEED 25% OF THE ANNUAL HOUSEHOLD INCOME REGARDLESS OF INCOME LEVEL. FOR ANY PATIENT THAT QUALIFIES UNDER THE ORGANIZATIONS CHARITY CARE POLICY, THE PATIENT ACCOUNT IS WRITTEN OFF AS CHARITY CARE AND THE ORGANIZATION DOES NOT PURSUE ANY COLLECTIONS. |
| SCHEDULE H, PART VI, LINE 2 | THE ORGANIZATION CONDUCTS REGULAR NEEDS ASSESSMENT THROUGH FORMAL AND INFORMAL SURVEYS AND PROCESSES, INCLUDING COLLABORATIONS WITH PUBLIC AND COMMUNITY AGENCIES. THROUGH STRATEGIC PLANNING AND COMMUNITY INTERVIEWS, THE ORGANIZATION DEVELOPS PROGRAMS AND SERVICES THAT CONSIDER THE ECONOMIC IMPERATIVES OF THE REGION, THE EFFECT OF LEGISLATION AND THE INVOLVEMENT OF OTHER COMMUNITY-BASED ORGANIZATIONS AND PARTNERS. |
| SCHEDULE H, PART VI, LINE 3 | ALL EMPLOYEES WORKING IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENT AREA HAVE BEEN TRAINED TO BE FULLY VERSED IN ALL FINANCIAL ASSISTANCE-RELATED POLICIES, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND ARE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE REPRESENTATIVES FOR NON-EMERGENCY PURPOSES. EVERY FILE FOR A PATIENT THAT HAS PRE-SCHEDULED AN OFFICE VISIT OR PROCEDURE IS REVIEWED BEFORE THE PATIENT ARRIVES AT THE HOSPITAL. A FINANCIAL COUNSELOR IS ASSIGNED TO THAT PATIENT IF IT IS DETERMINED THAT THE INDIVIDUAL MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ETC. ALSO, WHEN A PATIENT RECEIVES A BILL, THE ORGANIZATION INCLUDES PAPERWORK EXPLAINING THAT FINANCIAL ASSISTANCE IS AVAILABLE. |
| SCHEDULE H, PART VI, LINE 4 | ATMORE COMMUNITY HOSPITAL (ACH) IS LOCATED IN ATMORE, ALABAMA, IN ESCAMBIA COUNTY, ALABAMA. APPROXIMATELY 90 PERCENT OF THE PATIENTS ADMITTED TO ACH RESIDE IN ESCAMBIA COUNTY, ALABAMA. ACH IS LOCATED APPROXIMATELY 30 MILES FROM D.W. MCMILLAN MEMORIAL HOSPITAL. GEOGRAPHICALLY, ESCAMBIA COUNTY IS LOCATED IN SOUTH ALABAMA AND BORDERS BALDWIN, MONROE, CONECUH, AND COVINGTON COUNTIES IN ALABAMA AND THREE COUNTIES IN NORTH FLORIDA. THE COUNTY ENCOMPASSES 953 SQUARE MILES OF WHICH 99 PERCENT IS UNDEVELOPED LAND. THE POPULATION OF THE COUNTY IS ONLY 37,447. ALMOST 50 PERCENT OF THE POPULATION LIVES IN THE MUNICIPALITIES OF BREWTON, EAST BREWTON, AND ATMORE, WHERE BOTH HOSPITALS ARE LOCATED. APPROXIMATELY 18 PERCENT OF THE POPULATION IS AGED 65 AND OLDER AND ACCORDING TO THE CENTER FOR ECONOMIC BUSINESS AND RESEARCH AT THE UNIVERSITY OF ALABAMA, THAT NUMBER IS PROJECTED TO GROW SUBSTANTIALLY THROUGH 2040 WHILE THE OVERALL POPULATION IS EXPECTED TO DECREASE. THESE PATIENT DEMOGRAPHICS WILL REQUIRE ADDITIONAL RESOURCES AND HEALTHCARE FOR THIS GROUP AS STUDIES SHOW THE ELDERLY TYPICALLY HAVE MULTIPLE COMORBIDITIES AND SUBSEQUENTLY REQUIRE MORE SERVICES. THE MEDIAN AGE IN ESCAMBIA COUNTY IS 39.6 AND THE MEDIAN HOUSEHOLD INCOME IS 37,077. THE POVERTY RATE IS 23.8 PERCENT COMPARED TO THE NATIONAL AVERAGE OF 13.4 PERCENT AND FEMALES AGED 25-34 MAKE UP THE LARGEST DEMOGRAPHIC GROUP LIVING IN POVERTY. THIRTY-ONE PERCENT OF THE CHILDREN IN ESCAMBIA COUNTY ARE LIVING IN POVERTY COMPARED TO 25 PERCENT OF CHILDREN LIVING IN POVERTY THROUGHOUT ALABAMA. APPROXIMATELY 84.4 PERCENT OF THE POPULATION HAVE HEALTH COVERAGE WITH THE MAJORITY OF THAT COVERAGE FALLING UNDER EMPLOYEE PLANS (41%) AND 15.6 PERCENT OF THE POPULATION ARE UNINSURED. ACCORDING TO THE MOST RECENT DATA FROM THE ALABAMA DEPARTMENT OF LABOR, ESCAMBIA COUNTY'S UNEMPLOYMENT RATE WAS 4.2 PERCENT. |
| SCHEDULE H, PART VI, LINE 5 | ACH FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH IN THE COMMUNITY IN A VARIETY OF WAYS AS WELL AS THOSE ALREADY DESCRIBED IN SCHEDULE H. THE GOVERNING BODY IS PRIMARILY COMPRISED OF PERSONS WHO ARE NOT EMPLOYEES, CONTRACTORS (NOR FAMILY MEMBERS THEREOF), AND WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THE HOSPITAL'S MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS IN THE REGION. FOR THOSE PHYSICIANS IN THE REGION WHO DO NOT HAVE PRIVILEGES, ACH PROVIDES A PROCESS FOR ADMITTING PATIENTS VIA THE HOSPITALISTS OR THROUGH OTHER PHYSICIANS. FUNDS RECEIVED FROM THE OPERATIONS OF THE HOSPITAL AND FACILITIES (AFTER OPERATING EXPENSES) ARE USED TO SUPPORT VARIOUS OUTREACH EFFORTS DESCRIBED IN SCHEDULE H; TO FURTHER IMPROVEMENT IN PATIENT CARE BY PROVIDING MEDICAL EDUCATION TO PATIENTS AND THE COMMUNITY, CONDUCTING RESEARCH, AND IMPLEMENTING TECHNOLOGY THAT NOT ONLY PROVIDES THE LATEST IN TREATMENT, BUT ALLOWS PATIENTS TO RECEIVE HIGH QUALITY CARE IN THEIR OWN COMMUNITY AND ALLOWS US TO CONTINUALLY IMPROVE PATIENT SAFETY BY IMPLEMENTING TECHNOLOGY THAT PREVENTS MEDICATION ERRORS, ETC. |
| SCHEDULE H, PART VI, LINE 6 | ESCAMBIA COUNTY HEALTH CARE AUTHORITY (ECHCA), AN ALABAMA NON-PROFIT ORGANIZATION, OPERATES AND MANAGES D.W. MCMILLAN MEMORIAL HOSPITAL (MMH) AND ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC. DBA ATMORE COMMUNITY HOSPITAL (ACH). MMH IS A GOVERNMENTAL NOT-FOR-PROFIT 46-BED ACUTE CARE HOSPITAL. ACH, A 501(C)(3) ACUTE CARE HOSPITAL, OPERATES 61 ADULT AND PEDIATRIC BEDS, 43 NURSERY BEDS, A SWING-BED NURSING HOME, AND THREE RURAL HEALTH CLINICS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| JONAH M MCINTYRE MD | |||||||||||
| PHYSICIAN | $213,845 | $85,691 | $155 | $8,991 | $19,641 | $328,323 | |||||
| SHELDON J HARIGEL MD | |||||||||||
| PHYSICIAN | $229,847 | $21,949 | $153 | $7,558 | $20,627 | $280,134 | |||||
| WILIAM S HARIGEL MD | |||||||||||
| PHYSICIAN | $229,745 | $8,280 | $255 | $7,148 | $14,214 | $259,642 | |||||
| CHRIS GRIFFIN | |||||||||||
| CEO LEFT 5/21 | $83,479 | $11,571 | $6,500 | $101,550 | $83,479 | $11,571 | $6,500 | $101,550 | |||
| STEPHEN FISCHER | |||||||||||
| CFO | $77,838 | $77,838 | $77,838 | $77,838 | |||||||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 3 | NONE OF THE INDIVIDUAL BOARD MEMBERS OR OFFICERS ARE COMPENSATED BY THE FILING ORGANIZATION. THE FILING ORGANIZATION, INSTEAD, RELIES ON THE METHODS USED BY THE SOLE MEMBER, ECHCA, TO ESTABLISH COMPENSATION OF THE CEO AND EXECUTIVE OFFICERS. COMPENSATION DETERMINATION BY ECHCA INCLUDES AN INDEPENDENT COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT AND SURVEYS, WRITTEN EMPLOYMENT CONTRACT, AND BOARD APPROVAL. THESE METHODS ARE WELL DOCUMENTED. |
| SCHEDULE J, PART III | ESCAMBIA COUNTY HEALTH CARE AUTHORITY (ECHCA), SOLE MEMBER OF ACH (THE FILING ORGANIZATION) AND D.W. MCMILLAN MEMORIAL HOSPITAL, INC., ENTERED INTO A MANAGEMENT AGREEMENT WITH MEDCENTRIA, LLC, AN UNRELATED ORGANIZATION, TO PROVIDE AN INTERIM CFO. ECHCA COMPENSATED MEDCENTRIA 155,677 IN CALENDAR YEAR 2019 FOR CFO SERVICES PROVIDED BY STEPHEN FISCHER WHO DIVIDED HIS TIME EVENLY BETWEEN THE TWO HOSPITALS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 | AT THE TIME OF FILING, THE FY 2020 AUDITED FINANCIAL STATEMENTS WERE UNAVAILABLE. HOWEVER, FY 2019 FINANCIAL STATEMENTS ARE ATTACHED AS THE MOST RECENTLY AVAILABLE. THE ORGANIZATION INTENDS TO FILE AN AMENDED RETURN ONCE THE AUDITED FINANCIAL STATEMENTS FOR FISCAL YEAR ENDED SEPTEMBER 30, 2020 ARE AVAILABLE AND WILL MAKE OTHER ADJUSTMENTS TO THE RETURN AT THAT TIME. |
| FORM 990, PAGE 6, PART VI, LINE 3 | ACH HAD AN AGREEMENT WITH MEDCENTRIA, LLC FOR MANAGEMENT SERVICES PROVIDED BY THE CFO STEPHEN FISCHER DURING CY 2019. |
| FORM 990, PAGE 6, PART VI, LINE 6 | ESCAMBIA COUNTY HEALTH CARE AUTHORITY (ECHCA), AN ALABAMA NON-PROFIT ORGANIZATION, IS THE SOLE MEMBER OF ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC. DBA ATMORE COMMUNITY HOSPITAL (ACH). ECHCA HAS THE RIGHT TO ELECT THE BOARD OF DIRECTORS OF THE HOSPITAL. |
| FORM 990, PAGE 6, PART VI, LINE 7A | ESCAMBIA COUNTY COMMISSION APPOINTS THE MEMBERS OF ECHCA'S BOARD OF DIRECTORS. PER ACH'S BYLAWS, ALL CURRENT DIRECTORS OF ECHCA, THE SOLE MEMBER, SERVE AS ACH'S BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 7B | THE FOLLOWING ACTIONS SHALL REQUIRE ADVANCE APPROVAL BY THE ECHCA, THE SOLE MEMBER: - ELECTION OF THE BOARD OF DIRECTORS OF THE HOSPITAL, - REMOVAL OF A BOARD DIRECTOR, - ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY MAY BECOME EFFECTIVE, - APPOINTMENT OR TERMINATION OF THE ADMINISTRATOR OF THE HOSPITAL AND ANY HEALTHCARE FACILITY OPERATED BY THE HOSPITAL, - ANY CONTRACT OR PURCHASE ORDER IN EXCESS OF 250,000, - INCURRANCE OF INDEBTEDNESS IN EXCESS OF 250,000, - ANNUAL CAPITAL AND OPERATING BUDGETS, - TRANSFER OF ANY ASSETS EXCEEDING 100,000 IN NET VALUE. |
| FORM 990, PAGE 6, PART VI, LINE 11B | AN INDEPENDENT ACCOUNTING FIRM PREPARES THE FORM 990. DUE TO VARIOUS EXTRAORDINARY CIRCUMSTANCES, INCLUDING PANDEMIC-RELATED PROJECTS, MANAGEMENT CHANGES, AND STAFF SHORTAGES, THE FORM 990 WILL NOT BE DISTRIBUTED TO CURRENT VOTING BOARD MEMBERS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. HOWEVER, MANAGEMENT WILL CONDUCT A CURSORY REVIEW PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | BOARD MEMBERS AND OFFICERS COMPLETE AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE. OFFICERS AND KEY STAFF ALSO ARE REQUIRED TO SIGN AN ATTESTATION FORM CONFIRMING THAT THEY WILL DISCLOSE ANY CONFLICTS THAT VIOLATE THE HOSPITAL'S POLICY. THE BOARD REVIEWS ALL CONFLICTS AND DETERMINE IF FURTHER ACTION NEEDS TO BE TAKEN. BOARD MEMBERS ARE RECUSED FROM ALL DISCUSSIONS AND VOTES ON ANY CONFLICTED MATTERS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE HOSPITAL HAS ALL GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE ANNUAL FINANCIAL STATEMENTS ON FILE IN THE ACCOUNTING AND ADMINISTRATION DEPARTMENTS. ALL DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR 727,061 3,567 0 PROFESSIONAL FEES 1,013,219 297 0 PURCHASED SERVICES 2,003,334 43,199 0 CONSULTING FEES 236,167 92,062 0 TOTAL 3,979,781 139,125 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ESCAMBIA CO HEALTH CARE AUTHORITY | |||||||||||
| 1301 BELLEVILLE AVENUE | BREWTON | AL | 364261306 | 630897255 | TAX AUTHOR | AL | 501A | 6 | N/A | false | |
| DW MCMILLAN MEMORIAL HOSPITAL | |||||||||||
| 1301 BELLEVILLE AVENUE | BREWTON | AL | 364261306 | 636000288 | HOSPITAL | AL | 501A | 6 | false | ECHCA | |
| 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 | false | 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 | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | 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 |