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WINSTON COUNTY MEDICAL FOUNDATION: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
WINSTON COUNTY MEDICAL FOUNDATION (EIN 64-6010402)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-09-23
IRS object ID
201902669349300890
Schema version
2018v3.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2019-09-23T15:09:39-05:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN640394922PreparerFirmEIN

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 311AddressLine1Txt
CityEUPORACityNm
State AbbreviationMSStateAbbreviationCd
ZIP39744ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN646010402EIN

Business Name BusinessName

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPAUL BLACKPersonNm
Person TitleCEOPersonTitleTxt
Phone6627736211PhoneNum
Signature2019-09-19SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTHOMAS BROWDER CPAPreparerPersonNm
PTINP00444647PTIN
Phone6622582331PhoneNum
Preparation2019-09-19PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address173.235.108.2IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-09-23IPDt
IP Tm15:09:39IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDC99C678DB09C71046FB33B12BD2A29600D48728AtSubmissionCreationDeviceId
At Submission Filing Device IdEA7A735E5DCB644256DC488400B3F28678E4EA2FAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

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

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 967AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationMSStateAbbreviationCd
ZIP39339ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$29,679,921GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.WINSTONMEDICAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateMSLegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTH CARE SERVICES TO RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND SURROUNDING AREASActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee407TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,809,100PYContributionsGrantsAmt
CY Contributions Grants$4,582,418CYContributionsGrantsAmt
PY Program Service Revenue$21,630,918PYProgramServiceRevenueAmt
CY Program Service Revenue$24,612,631CYProgramServiceRevenueAmt
PY Investment Income$418,903PYInvestmentIncomeAmt
CY Investment Income$398,638CYInvestmentIncomeAmt
PY Other Revenue$107,489PYOtherRevenueAmt
CY Other Revenue$86,234CYOtherRevenueAmt
PY Total Revenue$23,966,410PYTotalRevenueAmt
CY Total Revenue$29,679,921CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,835,936PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,429,095CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$20,731,212PYOtherExpensesAmt
CY Other Expenses$17,465,841CYOtherExpensesAmt
PY Total Expenses$32,567,148PYTotalExpensesAmt
CY Total Expenses$30,894,936CYTotalExpensesAmt
PY Revenues Less Expenses-$8,600,738PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,215,015CYRevenuesLessExpensesAmt
Total Assets BOY$38,724,120TotalAssetsBOYAmt
Total Assets EOY$38,260,935TotalAssetsEOYAmt
Total Liabilities BOY$7,910,467TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,662,297TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$30,813,653NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$29,598,638NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HEALTH CARE TO THE RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND THE SURROUNDING AREASMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$25,319,827ExpenseAmt
Revenue$24,698,865RevenueAmt
DescWINSTON COUNTY MEDICAL FOUNDATION D/B/A WINSTON MEDICAL CENTER PROVIDES HEALTH CARE SERVICES TO THE RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND SURROUNDING AREAS INCLUDING PERSONS UNABLE TO PAY FOR REQUIRED SERVICES.Desc
Total Program Service Expenses$25,319,827TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document29IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee407EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
LAURA HARRIS
TRUSTEE1.00Yes (X)$0$0$0
MARCUS KINCAID
TRUSTEE1.00Yes (X)$0$0$0
TERRY WOODS
TRUSTEE1.00Yes (X)$0$0$0
AL PORTER
TRUSTEE1.00Yes (X)$0$0$0
LEX TAYLOR
TRUSTEE1.00Yes (X)$0$0$0
PAUL BLACK
CEO40.00$149,901$0$16,551Yes (X)
DUSTIN GENTRY
PHYSICIAN40.00$436,348$0$43,796Yes (X)
MICHAEL ARD
PHYSICIAN50.00$289,001$0$29,853Yes (X)
JANA EBBERT
PHYSICIAN40.00$272,160$0$9,384Yes (X)
HEATHER GILMER
FNP40.00$120,835$0$18,220Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,268,245TotalReportableCompFromOrgAmt
Total Other Compensation$117,804TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ENDURACARE ACUTE CARE SERVICES
PO BOX 654072DALLASTX752654072THERAPY DEPT.$1,004,384
MORRISON MANAGEMENT SPECIALISTS
PO BOX 102289ATLANTAGA30368DIETARY SERVICE$955,545
EMERGENCY ROOM MD LLC
46 HOLTZENGER AVE APT GSTARKVILLEMS39759EMERGENCY ROOM$725,684
HOSPITAL HOUSEKEEPING SYSTEMS
PO BOX 734367DALLASTX753734367HOUSEKEEPING$603,959
COMPREHENSIVE PHARMACY SERVICES
PO BOX 638316CINCINNATIOH45263PHARMACY$304,606
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Government Grants$2,457,418GovernmentGrantsAmt
All Other Contributions$2,125,000AllOtherContributionsAmt
Total Contributions$4,582,418TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT CAREDesc
Total Revenue Column$24,612,631TotalRevenueColumnAmt
Related Or Exempt Func Income$24,612,631RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$24,612,631TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$398,638TotalRevenueColumnAmt
Exclusion$398,638ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$86,234RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$86,234RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$86,234TotalRevenueColumnAmt
Related Or Exempt Func Income$86,234RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,679,921TotalRevenueColumnAmt
Related Or Exempt Func Income$24,698,865RelatedOrExemptFuncIncomeAmt
Exclusion$398,638ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,215,253TotalAmt
Program Services$10,315,703ProgramServicesAmt
Management And General$899,550ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$462,192TotalAmt
Program Services$413,662ProgramServicesAmt
Management And General$48,530ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$915,439TotalAmt
Program Services$819,318ProgramServicesAmt
Management And General$96,121ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$836,211TotalAmt
Program Services$748,409ProgramServicesAmt
Management And General$87,802ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$56,381TotalAmt
Management And General$56,381ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$61,940TotalAmt
Management And General$61,940ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$86,773TotalAmt
Program Services$86,773ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$8,903TotalAmt
Program Services$8,903ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$771,384TotalAmt
Program Services$771,384ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$31,122TotalAmt
Program Services$20,640ProgramServicesAmt
Management And General$10,482ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$82,038TotalAmt
Program Services$82,038ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$111,836TotalAmt
Program Services$111,836ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CONTRACT SERVICES$6,625,947$6,400,103$225,844
RENTS$4,279,263$425,887$3,853,376
BAD DEBTS$1,645,957$1,645,957
SUPPLIES$1,267,335$1,224,414$42,921

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,436,962TotalAmt
Program Services$2,244,800ProgramServicesAmt
Management And General$192,162ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$30,894,936TotalAmt
Program Services$25,319,827ProgramServicesAmt
Management And General$5,575,109ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$120,956BOYAmt
EOY$198,950EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,236,613BOYAmt
EOY$1,411,633EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,827,280BOYAmt
EOY$4,233,922EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$200,494BOYAmt
EOY$203,252EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$170,150BOYAmt
EOY$184,262EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$821,695LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$372,032LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$509,408BOYAmt
EOY$449,663EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$31,659,219BOYAmt
EOY$31,579,253EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$38,724,120BOYAmt
EOY$38,260,935EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,033,400BOYAmt
EOY$2,785,230EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,656,425BOYAmt
EOY$4,656,425EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,910,467BOYAmt
EOY$8,662,297EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$30,813,653BOYAmt
EOY$29,598,638EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$30,813,653BOYAmt
EOY$29,598,638EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$38,724,120BOYAmt
EOY$38,260,935EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,215,015ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$280,467OtherCostOrOtherBasisAmt
Depreciation$70,802DepreciationAmt
Book Value$209,665BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$541,228OtherCostOrOtherBasisAmt
Depreciation$301,230DepreciationAmt
Book Value$239,998BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$449,663TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (7 entries)

DescDescBook ValueBookValueAmt
STATE LEVERAGE LOAN$15,898,515
FEDERAL LEVERAGE LOAN$13,938,752
FEMA AND MEMA RECECIVABLE$1,219,348
OTHER RECEIVABLES$295,865
EQUITY IN MHA INSURANCE$141,832
CIP$71,044
INTEREST RECEIVABLE$13,897
FieldValueIRS element (for citing)
Total Book Value Other Assets$31,579,253TotalBookValueOtherAssetsAmt
Total Rev Etc Audited Fincl Stmt$28,033,964TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$1,645,957OtherRevenueAmt
Revenue Not Reported-$1,645,957RevenueNotReportedAmt
Revenue Subtotal$29,679,921RevenueSubtotalAmt
Total Revenue Per Form990$29,679,921TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$29,248,979TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included-$1,645,957OtherExpensesIncludedAmt
Expenses Not Reported-$1,645,957ExpensesNotReportedAmt
Expenses Subtotal$30,894,936ExpensesSubtotalAmt
Total Expenses Per Form990$30,894,936TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 4, PART XI, LINE 2DBAD DEBTS ARE INCLUDED AS A REDUCTION OF REVENUE ON THE FS -1,645,957
SCHEDULE D, PAGE 4, PART XII, LINE 2DBAD DEBTS ARE INCLUDED AS A REDUCTION OF REVENUE ON THE FS -1,645,957

Schedule H IRS990ScheduleH

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,902,815TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,902,815NetCommunityBenefitExpnsAmt
Total Expense0.06160TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,772,210TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,371,152DirectOffsettingRevenueAmt
Net Community Benefit Expns$401,058NetCommunityBenefitExpnsAmt
Total Expense0.01300TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,675,025TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,371,152DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,303,873NetCommunityBenefitExpnsAmt
Total Expense0.07460TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,675,025TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,371,152DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,303,873NetCommunityBenefitExpnsAmt
Total Expense0.07460TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$1,645,957BadDebtExpenseAmt
Reimbursed By Medicare$7,034,719ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$7,216,019CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$181,300MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

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

US Address USAddress

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

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1WINSTON COUNTY MEDICAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.WINSTONMEDICAL.ORGOwnWebsiteURLTxt
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLWWW.WINSTONMEDICAL.ORGStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp

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

Supplemental Information Detail SupplementalInformationDetail (4 entries)

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

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
PAUL BLACK
CEO$149,901$16,551$166,452
DUSTIN GENTRY
PHYSICIAN$436,348$43,796$480,144
MICHAEL ARD
PHYSICIAN$289,001$29,853$318,854
JANA EBBERT
PHYSICIAN$272,160$9,384$281,544

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE RETURN WAS REVIEWED WITH MANAGEMENT AND THE TAX PREPARER.
FORM 990, PAGE 6, PART VI, LINE 12CDURING THE YEAR END AUDIT, RELATED PARTY TRANSACTIONS ARE REVIEWED.
FORM 990, PAGE 6, PART VI, LINE 15ATHE BOARD OF TRUSTEES REVIEWS THE JOB PERFORMANCE OF THE ADMINISTRATOR AND BASED UPON PAY OF OTHER SIMILAR ADMINISTRATORS ADJUSTS HIS PAY ACCORDINGL Y.
FORM 990, PAGE 6, PART VI, LINE 15BTHE APPLICABLE DEPARTMENT HEADS REVIEW EACH EMPLOYEE AND SUBMIT A RECOMMEN DED PAY ADJUSTMENT TO THE ADMINISTRATOR, THE ADMINISTRATOR THEN GOES TO TH E BOARD OF TRUSTEES WHO WILL DECIDE ON A PAY RAISE, IF ANY.
FORM 990, PAGE 6, PART VI, LINE 19THE TAX RETURN AND AUDIT ARE MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 9BAD DEBTS ARE INCLUDED AS A REDUCTION OF REVENUE ON THE FS -1,645,957 BAD DEBTS ARE INCLUDED AS A REDUCTION OF REVENUE ON THE FS 1,645,957 RESTATEMENT OF PRIOR YEAR 0