CROSBYTON CLINIC HOSPITAL: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- CROSBYTON CLINIC HOSPITAL (EIN 75-0711276)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-08-28
- IRS object ID
- 201802409349301305
- Schema version
- 2017v2.3
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-28T16:58:44-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 752570395 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DURBIN & COMPANY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2950 50TH STREET | AddressLine1Txt |
| City | LUBBOCK | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 79413 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 750711276 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROSBYTON CLINIC HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CROS | BusinessNameControlTxt |
| Phone | 8066752382 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 710 WEST MAIN STREET | AddressLine1Txt |
| City | CROSBYTON | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 79322 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEBRA MILLER | PersonNm |
| Person Title | ADMINISTRATOR | PersonTitleTxt |
| Phone | 8066752382 | PhoneNum |
| Signature | 2018-08-28 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GAYLE DE HAAS | PreparerPersonNm |
| PTIN | P01774581 | PTIN |
| Phone | 8067911591 | PhoneNum |
| Preparation | 2018-08-24 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DEBRA MILLER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 710 WEST MAIN STREET | AddressLine1Txt |
| City | CROSBYTON | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 79322 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,010,257 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CROSBYTONCLINICHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1945 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTHCARE TO THE CITIZENS OF CROSBY COUNTY AND THE SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 116 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,926,615 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,921,225 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,274 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,257 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,444,482 | PYOtherRevenueAmt |
| CY Other Revenue | $1,084,775 | CYOtherRevenueAmt |
| PY Total Revenue | $7,376,371 | PYTotalRevenueAmt |
| CY Total Revenue | $6,010,257 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,729,326 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,477,345 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,249,606 | PYOtherExpensesAmt |
| CY Other Expenses | $3,102,614 | CYOtherExpensesAmt |
| PY Total Expenses | $6,978,932 | PYTotalExpensesAmt |
| CY Total Expenses | $6,579,959 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $397,439 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$569,702 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,965,139 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,393,930 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $339,024 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $337,517 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,626,115 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,056,413 | NetAssetsOrFundBalancesEOYAmt |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,193,885 | ExpenseAmt |
| Revenue | $6,006,000 | RevenueAmt |
| Desc | OUR HOSPITAL PROVIDES GENERAL MEDICAL SERVICES TO THE CITIZENS OF CROSBYTON AND SURROUNDING AREAS. OUR LARGEST PROGRAMS ARE INPATIENT, SWING BED, AND OUTPATIENT SERVICES. WE OPERATE 25 ACUTE CARE BEDS. IN THE CURRENT YEAR, HOSPITAL PATIENT DAYS WERE 356 AND SWING BED DAYS WERE 192. WE PERFORMED 16,207 LAB PROCEDURES AND 3399 RADIOLOGY PROCEDURES AS WELL AS 1408 PHYSICAL THERAPY AND WOUND CARE VISITS. IN ADDITION, OUR RURAL HEALTH CLINIC LOGGED 6573 VISITS AND OUR EMERGENCY ROOM SAW 2707 PATIENTS. | Desc |
| Total Program Service Expenses | $6,193,885 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 54 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 116 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | 0 | Form8899Filedind |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8066758700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 710 WEST MAIN STREET | AddressLine1Txt |
| City | CROSBYTON | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 79322 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DANNY BROOKS ELLISON | ||||||||
| CHAIRMAN | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KELLY WING | ||||||||
| VICE CHAIRMAN | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOAN BURKE MURRAY | ||||||||
| SECRETARY | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BOBBY MAX HAM | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LESTER BOWNDS | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| NATHAN BOARDMAN | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JACKY DEWBRE | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BELLE C PARKHILL | ||||||||
| CFO | 16.00 | 1.00 | Yes (X) | $25,000 | $0 | $0 | ||
| DEBRA MILLER | ||||||||
| ADMINISTRATOR | 40.00 | 1.00 | Yes (X) | $80,000 | $0 | $0 | ||
| JOHN HODGES | ||||||||
| FNP | 40.00 | $140,000 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $245,000 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CONCORD MEDICAL GROUP | |||||
| PO BOX 489 | MULESHOE | TX | 79347 | ER MEDICAL | $331,669 |
| STEVE ALLEY MD PA | |||||
| 536 S AYRSHIRE | CROSBYTON | TX | 79322 | ER MEDICAL | $312,000 |
| COVENANT MEDICAL GROUP | |||||
| 3420 22ND PLACE | LUBBOCK | TX | 79410 | PHYSICIAN SERVICES | $223,191 |
| WAEL QUBTI MD | |||||
| 16002 CR 1865 | LUBBOCK | TX | 79424 | ER MEDICAL | $120,910 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $4,921,225 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,921,225 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,921,225 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,257 | TotalRevenueColumnAmt |
| Exclusion | $4,257 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $10,056 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $10,056 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,056 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,056 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| 340B REVENUE | 621990 | $709,444 | $709,444 |
| UPL REVENUE | 621990 | $321,000 | $321,000 |
| MISCELLANEOUS | 621990 | $23,230 | $23,230 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,045 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,045 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,074,719 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,010,257 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,006,000 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,257 | 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 | $105,000 | TotalAmt |
| Management And General | $105,000 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,665,452 | TotalAmt |
| Program Services | $2,583,034 | ProgramServicesAmt |
| Management And General | $82,418 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,040 | TotalAmt |
| Program Services | $7,292 | ProgramServicesAmt |
| Management And General | $748 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $491,167 | TotalAmt |
| Program Services | $488,767 | ProgramServicesAmt |
| Management And General | $2,400 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $207,686 | TotalAmt |
| Program Services | $201,860 | ProgramServicesAmt |
| Management And General | $5,826 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,353 | TotalAmt |
| Management And General | $48,353 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,262,222 | TotalAmt |
| Program Services | $1,176,994 | ProgramServicesAmt |
| Management And General | $85,228 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,346 | TotalAmt |
| Program Services | $5,076 | ProgramServicesAmt |
| Management And General | $2,270 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,537 | TotalAmt |
| Program Services | $77,139 | ProgramServicesAmt |
| Management And General | $20,398 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $239,731 | TotalAmt |
| Program Services | $221,105 | ProgramServicesAmt |
| Management And General | $18,626 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,591 | TotalAmt |
| Program Services | $5,591 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,380 | TotalAmt |
| Program Services | $92,380 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,260 | TotalAmt |
| Program Services | $93,260 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $708,608 | $708,608 | |
| MEDICAL SUPPLIES | $313,933 | $313,933 | |
| PHARMACY 340 B MEDICINE | $215,809 | $215,809 | |
| MISCELLANEOUS | $12,745 | $2,048 | $10,697 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,099 | TotalAmt |
| Program Services | $989 | ProgramServicesAmt |
| Management And General | $4,110 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,579,959 | TotalAmt |
| Program Services | $6,193,885 | ProgramServicesAmt |
| Management And General | $386,074 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $187,321 | BOYAmt |
| EOY | $99,768 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,461,686 | BOYAmt |
| EOY | $1,863,433 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $773,631 | BOYAmt |
| EOY | $933,770 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,259 | BOYAmt |
| EOY | $100,973 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,071 | BOYAmt |
| EOY | $9,071 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,794,220 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,345,786 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $509,032 | BOYAmt |
| EOY | $448,434 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $931,139 | BOYAmt |
| EOY | $938,481 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,965,139 | BOYAmt |
| EOY | $4,393,930 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $339,024 | BOYAmt |
| EOY | $337,517 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $339,024 | BOYAmt |
| EOY | $337,517 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,626,115 | BOYAmt |
| EOY | $4,056,413 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,626,115 | BOYAmt |
| EOY | $4,056,413 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,965,139 | BOYAmt |
| EOY | $4,393,930 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$569,702 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,570 | OtherCostOrOtherBasisAmt |
| Book Value | $25,570 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,976,508 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,714,149 | DepreciationAmt |
| Book Value | $262,359 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,054,255 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,923,030 | DepreciationAmt |
| Book Value | $131,225 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $737,887 | OtherCostOrOtherBasisAmt |
| Depreciation | $708,607 | DepreciationAmt |
| Book Value | $29,280 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $448,434 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM CROSBYTON HEALTH SERVICES | $525,409 |
| THIRD PARTY RECIEVABLE | $413,072 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $938,481 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $5,567,892 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$442,365 | OtherRevenueAmt |
| Revenue Not Reported | -$442,365 | RevenueNotReportedAmt |
| Revenue Subtotal | $6,010,257 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $6,010,257 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,136,900 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $265,549 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $265,549 | ExpensesNotReportedAmt |
| Expenses Subtotal | $5,871,351 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $708,608 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $708,608 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,579,959 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL EVALUATES AND ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES (FORMERLY FASB INTERPRETATION 48 (FIN 48) ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THIS STANDARD REQUIRES CERTAIN DISCLOSURES ABOUT UNCERTAIN INCOME TAX POSITIONS. THE HOSPITAL EVALUATES ANY UNCERTAIN TAX POSITIONS USING THE PROVISIONS OF ASC 450, CONTINGENCIES. AS A RESULT, MANAGEMENT DOES NOT BELIEVE THAT ANY UNCERTAIN TAX POSITIONS CURRENTLY EXIST AND NO LOSS CONTINGENCY HAS BEEN RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL HAS FILED ALL APPLICABLE TAX RETURNS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CROSBYTON HEALTH SERVICES CORPORATION REVENUE 266,243. BAD DEBT EXPENSE -708,608. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | CROSBYTON HEALTH SERVICES CORPORATION EXPENSES 265,549. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 708,608. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $143,166 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $245,012 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $44,402 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $131,737 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $187,568 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $376,749 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $187,568 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $376,749 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $564,384 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $96,847 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $1,501,112 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,956,832 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,455,720 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 0 | 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 | CROSBYTON CLINIC HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 710 WEST MAIN STREET | AddressLine1Txt |
| City | CROSBYTON | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 79322 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 000176 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROSBYTON CLINIC HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | CROSBYTONCLINICHOSPITAL.COM/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | CROSBYTONCLINICHOSPITAL.COM | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | CROSBYTONCLINICHOSPITAL.COM | FAPAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CROSBYTON CLINIC HOSPITAL | PART V, SECTION B, LINE 5: THE CHNA WAS DESIGNED TO TAKE THE MISSION STATED BY THE HOSPITAL TO THE COMMUNITY AND DEVELOP IMPLEMENTABLE STRATEGIES TO ADDRESS THE NEEDS IDENTIFIED. BY LISTENING TO THE MEMBERS OF THE COMMUNITY, AND REVIEWING DEMOGRAPHIC AND STATISTICAL DATA, THE HOSPITAL CAN GAIN INFORMATION ON HEALTH STATUS, AND ON WHERE THE GAPS IN HEALTHCARE DELIVERY CURRENTLY EXIST. FURTHER, IT IDENTIFIED OPPORTUNITIES FOR GROWTH THAT MAY EXIST FOR THE HOSPITAL BY ASKING FOR DIRECT INPUT FROM COMMUNITY MEMBERS AND SOLIDIFIED THE HOSPITAL'S ROLE AS A PARTNER IN IMPROVING THE OVERALL HEALTH, EDUCATION, AND ECONOMIC DEVELOPMENT OF CROSBY COUNTY, TEXAS. THE CHNA INCLUDED SURVEYS, INTERVIEWS, AND FOCUS GROUPS WITH REPRESENTATIVES FROM THE FOLLOWING GROUPS:1. BUSINESS LEADERS2. HEALTHCARE PROFESSIONALS3. MINORITY COMMUNITY (HISPANIC AND AFRICAN AMERICAN)4. SENIOR CITIZENS5. SCHOOL DISTRICT7. LOW-INCOME PERSONS8. HOSPITAL ADMINISTRATION AND GOVERNANCE9. SUFFERERS OF CHRONIC DISEASES10. MEMBERS OF THE COMMUNITY UNDERSERVED BY THE HOSPITALADDITIONALLY, INTERVIEWS WERE HELD WITH CURRENT AND FORMER PATIENTS AND THE HOSPITAL CEO. THE SURVEY WAS DESIGNED TO IDENTIFY SELECT MEMBERS OF THE COMMUNITY WHO WERE REQUIRED BY THE ACA TO BE INCLUDED. THOSE WHO PARTICIPATED IN THE SURVEY AND VOLUNTEERED TO BE INCLUDED IN A FOCUS GROUP WERE THEN INTERVIEWED TO FURTHER DEVELOP THE RESULTS OF THIS CHNA. ALTHOUGH THE RESULTS WERE BROAD, COMMON NEEDS AND SOLUTIONS WERE IDENTIFIED THROUGH THE SURVEY, AND THE FOCUS GROUPS WERE TASKED WITH PRIORITIZING THE NEEDS AND SOLUTIONS PROPOSED. |
| CROSBYTON CLINIC HOSPITAL | PART V, SECTION B, LINE 11: THE FOLLOWING LIST ARE NEEDS WERE IDENTIFIED THROUGH THE CHNA COMPLETED IN 2016 AND HOW THE HOSPITAL INTENDS TO ADDRESS THOSE NEEDS.1. SPECIALISTS OR SERVICES AND PHYSICIAN AVAILABILITY - THE HOSPITAL WILL CONTINUE TO RECRUIT AND MAINTAIN RETENTION EFFORTS FOR PHYSICIANS.2. LACK OF RELIABLE TRANSPORTATION DUE TO LACK OF SPECIALISTS AND SERVICES IN CROSBYTON - THE HOSPITAL WILL TRY TO RECRUIT SPECIALISTS TO VISIT CROSBYTON ON A PERIODIC BASIS. IN ADDITION, THE HOSPITAL WILL EVALUATE TRANSPORTATION POSSIBILITIES AND OPPORTUNITIES WITH SURROUNDING COMMUNITIES.3. LACK OF USABLE INSURANCE FOR LOW INCOME HOUSEHOLDS - THE HOSPITAL WILL INCREASE AWARENESS OF CHARTIY AND INDIGENT CARE PROGRAMS AVAILABLE TO THE COMMUNITY.4. CHRONIC DISEASES, HEALTHY LIVING, SEX EDUCATION, ALCOHOL AND SUBSTANCE ABUSE, AND MENTAL HEALTH NEEDS - THE HOSPITAL WILL RESEARCH OPPORTUNITIES TO BETTER MARKET HEALTH EDUCATION IN THE COMMUNITY, SEARCH FOR OPPORTUNITIES TO WORK COOPERATIVELY WITH LOCAL ORGANIZATIONS TO INCREASE AWARENESS AND PREVENTION OF CHRONIC DISEASES, DEVELOP PROGRAMS TO INCREASE AWARENESS AND PREVENTION MARKETED TO THE UNDERSERVED, PROVIDE PATIENTS WITH RESOURCES IN ENGLISH AND SPANISH, AND PROMOTE AWARENESS OF EXISTING RESOURCES, PROGRAMS AND EQUIPMENT DESIGNED TO MEET THE NEEDS OF PATIENTS WITH CHRONIC DISEASES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - REEVES RHOADES TERRACE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 640 SOUTH HARRISON | AddressLine1Txt |
| City | CROSBYTON | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 79322 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | ASSISTED LIVING FACILITY | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 4: | PLEASE SEE PAGES 7-9 OF THE ATTACHED AUDIT REPORT. |
| PART III, LINE 8: | THE ORGANIZATION UTILIZES A COST TO CHARGE RATIO DETERMINED BY THEIR ANNUAL MEDICARE COST REPORT TO DETERMINE THE AMOUNT ON SCHEDULE H, PART III, SECTION B LINE 6. ALL OF THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. SENIOR MANAGEMENT CONSIDERS, COMPLETES, AND FINALIZES ALL DOCUMENTATION BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | VERBAL AND WRITTEN DOCUMENTATION CONCERNING ANY CONFLICT OF INTEREST OCCUR DURING EMPLOYEE REVIEW AND DURING FISCAL YEAR END. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO, BOARD COMMITTEE, AND COMPLETE BOARD OF DIRECTORS RESEARCH AND REVIEW ALL DATA PROVIDED DURING THE SEARCH PROCESS. SEVERAL REDUCTION LAYERS ARE INVOLVED WHEN MORE THAN SEVERAL CANDIDATES ARE INVOLVED. MARKET DATA IS USED TO CONSIDER COMPENSATION LEVELS. |
| FORM 990, PART VI, SECTION C, LINE 18 | EXCEPT AS PROVIDED FOR IN THE ORGANIZATION'S FORM 1023 AND FORM 990S, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATIONAL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER PROGRAM SERVICE FEES: PROGRAM SERVICE EXPENSES 1,176,994. MANAGEMENT AND GENERAL EXPENSES 85,228. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,262,222. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROSBYTON HEALTH SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 710 WEST MAIN STREET | AddressLine1Txt |
| City | CROSBYTON | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 79322 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 752916531 | EIN |
| Primary Activities | ASSISTED LIVING | PrimaryActivitiesTxt |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12B, II | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROSBYTON CLINIC HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROSBYTON HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | D | TransactionTypeTxt |
| Involved | $525,409 | InvolvedAmt |
| Method Of Amount Determination | BOOK | MethodOfAmountDeterminationTxt |