CALHOUN-LIBERTY HOSPITAL ASSOCIATION INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- CALHOUN-LIBERTY HOSPITAL ASSOCIATION INC (EIN 59-3051173)
- Tax period
- 2024-01-01 to 2024-12-31
- Filed
- 2025-11-14
- IRS object ID
- 202533189349310148
- Schema version
- 2024v5.0
- 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 | 2025-11-14T15:07:51-05:00 | ReturnTs |
| Tax Period End | 2024-12-31 | 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 | 2024-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 593051173 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALHOUN-LIBERTY HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | ASSOCIATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CALH | BusinessNameControlTxt |
| Phone | 8506745411 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 16257 STATE ROAD 71 SOUTH | AddressLine1Txt |
| City | BLOUNTSTOWN | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32424 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VANN WINDHAM | PersonNm |
| Person Title | INTERIM CFO | PersonTitleTxt |
| Phone | 8506745411 | PhoneNum |
| Signature | 2025-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | false | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WILLIAM EDWARD PHILLIPS | PreparerPersonNm |
| PTIN | P00451499 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2025-11-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALHOUN-LIBERTY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | EMILY BROWN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 16257 STATE ROAD 71 SOUTH | AddressLine1Txt |
| City | BLOUNTSTOWN | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 324241045 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $26,403,564 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CALHOUNLIBERTYHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTH CARE SERVICES TO THE RESIDENTS IN THE COMMUNITY IT SERVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 209 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,124,682 | PYContributionsGrantsAmt |
| CY Contributions Grants | $11,514,597 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,145,657 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,322,175 | CYProgramServiceRevenueAmt |
| PY Investment Income | $159,102 | PYInvestmentIncomeAmt |
| CY Investment Income | $113,084 | CYInvestmentIncomeAmt |
| PY Other Revenue | $590,376 | PYOtherRevenueAmt |
| CY Other Revenue | $453,708 | CYOtherRevenueAmt |
| PY Total Revenue | $15,019,817 | PYTotalRevenueAmt |
| CY Total Revenue | $26,403,564 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,386,739 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,019,727 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,676,412 | PYOtherExpensesAmt |
| CY Other Expenses | $7,261,973 | CYOtherExpensesAmt |
| PY Total Expenses | $14,063,151 | PYTotalExpensesAmt |
| CY Total Expenses | $15,281,700 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $956,666 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $11,121,864 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,868,679 | TotalAssetsBOYAmt |
| Total Assets EOY | $44,656,683 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,605,975 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $28,272,115 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,262,704 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $16,384,568 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE HEALTH CARE SERVICES TO THE RESIDENTS IN THE COMMUNITY IT SERVES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $10,603,185 | ExpenseAmt |
| Revenue | $14,775,883 | RevenueAmt |
| Desc | TO PROVIDE QUALITY HEALTHCARE TO THE COMMUNITY THROUGH INPATIENT CARE, OUTPATIENT CARE, EMERGENCY ROOM CARE AND OTHER RELATED SERVICES. | Desc |
| Total Program Service Expenses | $10,603,185 | 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 | Yes (true) | 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 | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | 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 | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 209 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHRISTINIA JEPSEN | PersonNm |
| Phone | 8506745411 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 419 | AddressLine1Txt |
| City | BLOUNTSTOWN | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32424 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| JARED BARBER | |||||||
| PRIMARY CARE | 40.00 | Yes (X) | $256,157 | $0 | $3,887 | ||
| CHRISTINIA JEPSEN | |||||||
| FORMER CEO | 40.00 | $215,120 | $0 | $6,683 | Yes (X) | ||
| LAURA FORD | |||||||
| NURSE PRACTI | 40.00 | Yes (X) | $177,472 | $0 | $2,514 | ||
| JAMES C MILLER | |||||||
| CEO | 40.00 | $158,400 | $0 | $17,936 | Yes (X) | ||
| HAYLEY NICHOLS | |||||||
| NURSE PRACTI | 40.00 | Yes (X) | $151,104 | $0 | $2,244 | ||
| KATELYN HICKS | |||||||
| NURSE PRACTI | 40.00 | Yes (X) | $143,771 | $0 | $2,308 | ||
| HANNAH CAUSSEAUX | |||||||
| NURSE PRACTI | 40.00 | Yes (X) | $104,858 | $0 | $1,771 | ||
| EMILY BROWN | |||||||
| CEO | 40.00 | $91,954 | $0 | $667 | Yes (X) | ||
| VANN WINDHAM | |||||||
| INTERIM CFO | 40.00 | $40,775 | $0 | $6,677 | Yes (X) | ||
| LABAN BONTRAGER DMD | |||||||
| MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| TERRY EUBANKS | |||||||
| MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| MELBA FAUROT | |||||||
| MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| JOHN TOMLINSON JR | |||||||
| TREASURER | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| MARY SUE NEVES | |||||||
| MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| MARK PLUMMER | |||||||
| CHAIRMAN | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| H TIM REVELL | |||||||
| VICE-CHAIRMA | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| MARILYN RUSSELL | |||||||
| SECRETARY | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| LADDIE WILLIAMS | |||||||
| MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,339,611 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $44,687 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CRITICAL REHAB | |||||
| 4381 KIMBERLY CIRCLE | TALLAHASSEE | FL | 32309 | PHYSICAL THERAP | $155,150 |
| MISBAH FAROOQI | |||||
| 20454 NE FINLEY AVE | BLOUNTSTOWN | FL | 32424 | PHYSICAN SVS | $128,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $11,507,722 | GovernmentGrantsAmt |
| All Other Contributions | $6,875 | AllOtherContributionsAmt |
| Total Contributions | $11,514,597 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| NET PATIENT SERVICE REVENUE | $13,734,924 | $13,734,924 |
| 340B INCOME | $587,251 | $587,251 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,322,175 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $113,084 | TotalRevenueColumnAmt |
| Exclusion | $113,084 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| MISCELLANEOUS INCOME | $220,661 | $220,661 |
| RHC WRAP AND CAP PAYMENTS | $196,389 | $196,389 |
| MEDICAL RECORDS FEES | $16,197 | $16,197 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,461 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,461 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $453,708 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,403,564 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,775,883 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $113,084 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,637,186 | TotalAmt |
| Program Services | $4,780,765 | ProgramServicesAmt |
| Management And General | $1,856,421 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,789 | TotalAmt |
| Program Services | $103,571 | ProgramServicesAmt |
| Management And General | $40,218 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $720,749 | TotalAmt |
| Program Services | $519,156 | ProgramServicesAmt |
| Management And General | $201,593 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $518,003 | TotalAmt |
| Program Services | $373,118 | ProgramServicesAmt |
| Management And General | $144,885 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,485 | TotalAmt |
| Management And General | $23,485 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,107 | TotalAmt |
| Management And General | $1,107 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,842,245 | TotalAmt |
| Program Services | $2,061,374 | ProgramServicesAmt |
| Management And General | $1,780,871 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,353 | TotalAmt |
| Program Services | $8,353 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $829,258 | TotalAmt |
| Program Services | $763,410 | ProgramServicesAmt |
| Management And General | $65,848 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,859 | TotalAmt |
| Program Services | $5,859 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,504 | TotalAmt |
| Program Services | $187,504 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,038 | TotalAmt |
| Program Services | $49,038 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,988 | TotalAmt |
| Program Services | $19,988 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,787 | TotalAmt |
| Management And General | $34,787 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $296,990 | TotalAmt |
| Program Services | $296,990 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $461,346 | TotalAmt |
| Management And General | $461,346 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,145,422 | $1,145,422 | |
| REPAIRS & MAINTENANCE | $212,306 | $210,143 | $2,163 |
| PROVIDER TAX | $101,564 | $101,564 | |
| LICENSES & TAXES | $37,010 | $32,698 | $4,312 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,711 | TotalAmt |
| Program Services | -$55,768 | ProgramServicesAmt |
| Management And General | $61,479 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,281,700 | TotalAmt |
| Program Services | $10,603,185 | ProgramServicesAmt |
| Management And General | $4,678,515 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,789,767 | BOYAmt |
| EOY | -$509,495 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,439,388 | BOYAmt |
| EOY | $1,654,993 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $620,921 | BOYAmt |
| EOY | $615,648 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $147,083 | BOYAmt |
| EOY | $10,076 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $35,063,484 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,731,470 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,726,788 | BOYAmt |
| EOY | $28,332,014 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $14,064,567 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,144,732 | BOYAmt |
| EOY | $488,880 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,868,679 | BOYAmt |
| EOY | $44,656,683 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,229,495 | BOYAmt |
| EOY | $5,698,153 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,307,424 | BOYAmt |
| EOY | $2,270,312 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,680,063 | BOYAmt |
| EOY | $20,058,381 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $388,993 | BOYAmt |
| EOY | $245,269 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,605,975 | BOYAmt |
| EOY | $28,272,115 | 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 | $5,262,704 | BOYAmt |
| EOY | $16,384,568 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,262,704 | BOYAmt |
| EOY | $16,384,568 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,868,679 | BOYAmt |
| EOY | $44,656,683 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $11,121,864 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
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 | Yes (true) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $24,000 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $24,000 | 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 | CONTRACTOR IS PAID TO REPRESENT THE HOSPITAL'S INTEREST AND A PERCENTAGE OF DUES PAID TO MEMBERSHIP ORGANIZATION'S IS ALLOCATED TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $239,237 | OtherCostOrOtherBasisAmt |
| Book Value | $239,237 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,076,672 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,537,203 | DepreciationAmt |
| Book Value | $539,469 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,440 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,947 | DepreciationAmt |
| Book Value | $9,493 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,824,208 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,170,320 | DepreciationAmt |
| Book Value | $653,888 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,889,927 | OtherCostOrOtherBasisAmt |
| Book Value | $26,889,927 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $28,332,014 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $14,064,567 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $14,064,567 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| RECEIVABLE RESERVE | $236,295 |
| RIGHT-OF-USE ASSET | $8,974 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $245,269 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $26,403,564 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $26,403,564 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $26,403,564 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $15,281,700 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $15,281,700 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $15,281,700 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 3, PART X | AT THE TIME THE RETURN WAS FILED, THE AUDIT FOR THE CALENDAR YEAR WAS NOT COMPLETED. |
| SCHEDULE D, PAGE 4, PART XI, LINE 4B | GRANTS RECORDED AS CAPITAL CONTRIBUTIONS IN AFS 0 |
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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | false | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $181,714 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $181,714 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01190 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $238,681 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $720,313 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $420,395 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $720,313 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $181,714 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01190 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,237 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $43,237 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00280 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,620 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,620 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $44,857 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $44,857 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $465,252 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $720,313 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $226,571 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01480 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,201,435 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $2,768,486 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,052,306 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,283,820 | 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 | CALHOUN-LIBERTY PRIMARY CARE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20370 NE BURNS AVE | AddressLine1Txt |
| City | BLOUNTSTOWN | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32424 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CALHOUNLIBERTYHOSPITAL.COM | WebsiteAddressTxt |
| State License | 4019 | StateLicenseNum |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALHOUN-LIBERTY PRIMARY CARE | 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 | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.CALHOUNLIBERTYHOSPITAL.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 23 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.CALHOUNLIBERTYHOSPITAL.COM | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | false | 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 Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.CALHOUNLIBERTYHOSPITAL.COM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.CALHOUNLIBERTYHOSPITAL.COM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.CALHOUNLIBERTYHOSPITAL.COM | FAPSummaryOnWebsiteURLTxt |
| 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 |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | false | 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 |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, CALHOUN-LIBERTY PRIMARY CARE - PART V, LINE 3E | THE HOSPITAL PARTNERED WITH THE CALHOUN COUNTY PUBLIC HEALTH DEPARTMENT AND SUMMIT POINTE IN CONDUCTING ITS 2022 CHNA. THE FOLLOWING PRIORITIZED HEALTH NEEDS WERE IDENTIFIED FOR THE COMMUNITY- 1. BEHAVIORAL HEALTH (MENTAL HEALTH & MENTAL HEALTH ORDERS, AND ALCOHOL & DRUG USE) 2. ACCESS TO HEALTH SERVICES 3. HEALTH EQUITY (DISCRIMINATION OR INEQUITY BASED ON RACE/ETHNICITY, GENDER, AGE, SEX, AND DISABILITY) 4. WEIGHT STATUS, NUTRITION & HEALTHY EATING, AND DIABETES 5. CHILDRENS HEALTH 6. OLDER ADULTS 7. MATERNAL, FETAL, AND INFANT HEALTH 8. CRIME AND CRIME PREVENTION THE HOSPITAL ALSO PARTICIPATED IN THE LIBERTY COUNTY PUBLIC HEALTH DEPARTMENT CHNA FOR 2022. OBESITY WAS NAMED THE MOST SIGNIFICANT COMMUNITY HEALTH NEED TO BE ADDRESSED. |
| FACILITY 1, CALHOUN-LIBERTY PRIMARY CARE - PART V, LINE 5 | TO BETTER TARGET ACTIVITIES TO ADDRESS THE MOST PRESSING HEALTH NEEDS IN THE COMMUNITY, THE PUBLIC HEALTH DEPARTMENT CONVENED A GROUP OF COMMUNITY LEADERS TO PARTICIPATE IN A PRESENTATION OF DATA ON SIGNIFICANT HEALTH NEEDS FACILITATED BY CONDUENT HCI. DURING THE PRESENTATION AND DISCUSSION SESSION, PARTICIPANTS WERE GIVEN ACCESS TO AN ONLINE LINK TO COMPLETE A SCORING EXERCISE TO RANK THE SIGNIFICANT HEALTH NEEDS BASED ON A SET OF CRITERIA. THE PROCESS WAS CONDUCTED VIRTUALLY TO MAINTAIN SOCIAL DISTANCING AND SAFETY GUIDELINES RELATED TO THE COVID-19 PANDEMIC. CALHOUN COUNTYS CHNA PLANNING COMMITTEE REVIEWED THE SCORING RESULTS OF THE SIGNIFICANT COMMUNITY NEEDS AND DETERMINED PRIORITIZED HEALTH NEEDS BASED ON THE SAME SET OF CRITERIA USED IN THE SCORING EXERCISE.THE CHNA PRIORITIZATION PROCESS INCLUDED TWO MEETINGS WHERE COMMUNITY PARTNERS REVIEWED AND DISCUSSED THE RESULTS OF COMMUNITY INPUT AND SECONDARY DATA ANALYSIS. THIS LED TO THE PRELIMINARY SIGNIFICANT HEALTH NEEDS DISCUSSED IN DETAIL IN THE DATA SYNTHESIS PORTION OF THIS REPORT. DURING THE MEETINGS, PARTICIPANTS ACCESSED AN ONLINE SCORING TOOL AND HAD AN OPPORTUNITY TO SCORE EACH OF THE SIGNIFICANT HEALTH NEEDS BY HOW WELL THEY MET THE CRITERIA SET FORTH BY THE COUNTY HEALTH DEPARTMENT. COMPLETION OF THE ONLINE EXERCISE RESULTED IN A NUMERICAL SCORE FOR EACH HEALTH NEED THAT CORRELATED WITH HOW WELL THAT NEED MET THE CRITERIA FOR PRIORITIZATION. CONDUENT HCI DOWNLOADED THE ONLINE RESULTS, CALCULATED THE SCORES, AND THEN RANKED THE SIGNIFICANT HEALTH NEEDS ACCORDING TO THEIR TOPIC SCORES, WITH THE HIGHEST-SCORING HEALTH NEED RECEIVING THE HIGHEST PRIORITY RANKING. |
| FACILITY 1, CALHOUN-LIBERTY PRIMARY CARE - PART V, LINE 6B | FLORIDA DEPARTMENT OF HEALTH IN CALHOUN AND IN LIBERTY COUNTIES. |
| FACILITY 1, CALHOUN-LIBERTY PRIMARY CARE - PART V, LINE 11 | THE HOSPITAL WILL FOCUS ON THE 3 AREAS THAT IT BELIEVES IT CAN HAVE THE MOST IMPACT IN THE COMMUNITY - ACCESS TO CARE; OBESITY, WEIGHT AND DIABETES; AND MENTAL HEALTH/SUBSTANCE ABUSE. THE HOSPITAL ATTEMPTS TO ADDRESS EACH SIGNIFICANT HEALTH NEED TO THE EXTENT OF ITS FINANCIAL ABILITY, EITHER THROUGH DIRECT PROGRAMS, COMMUNITY OUTREACH AND COMMUNITY EDUCATION, OR THROUGH COLLABORATION WITH OTHER PROVIDERS AND/OR PUBLIC HEALTH DEPARTMENTS. |
| FACILITY 1, CALHOUN-LIBERTY PRIMARY CARE - PART V, LINE 13H | A PATIENT IS CONSIDERED MEDICALLY INDIGENT IF THEY ARE UNABLE TO PAY THE OUTSTANDING BALANCE IN THEIR ACCOUNT IF, AFTER ALL INSURANCE ANC 3RD PARTY PAYMENTS, THE AMOUNT OUTSTANDING EXCEEDS 5% OF ANNUAL HOUSEHOLD INCOME AND THE TOTAL ANNNUAL HOUSE HOLD INCOME EXCEEDS 300% OF FPG BUT IS LESS THAN 500% OF FPG. |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7 | COSTS FOR PART I, LINE 7A AND 7B WERE CALCULATED USING THE RCC CALCULATED IN WORKSHEET 2. OTHER COSTS WERE OBTAINED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. SEE ALSO THE DESCRIPTION FOR PART III, LINE 2. |
| SCHEDULE H, PART III, LINE 3 | NET PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE HOSPITAL EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS AND INCLUDES VARIABLE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS, REVIEWS, AND INVESTIGATIONS. GENERALLY, THE HOSPITAL BILLS THE PATIENTS AND THIRD-PARTY PAYORS SEVERAL DAYS AFTER THE SERVICES ARE PERFORMED AND/OR THE PATIENT IS DISCHARGED FROM THE FACILITY. REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED. PERFORMANCE OBLIGATIONS ARE DETERMINED BASED ON THE NATURE OF THE SERVICES PROVIDED BY THE HOSPITAL. REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED OVER TIME IS RECOGNIZED BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL EXPECTED (OR ACTUAL) CHARGES. THE HOSPITAL BELIEVES THAT THIS METHOD PROVIDES A FAITHFUL DEPICTION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. GENERALLY, PERFORMANCE OBLIGATIONS SATISFIED OVER TIME RELATE TO PATIENTS RECEIVING PATIENT CARE SERVICES. THE HOSPITAL MEASURES THE PERFORMANCE OBLIGATION FROM ADMISSION INTO THE HOSPITAL TO THE POINT WHEN IT IS NO LONGER REQUIRED TO PROVIDE SERVICES TO THAT PATIENT, WHICH IS GENERALLY AT THE TIME OF DISCHARGE. THESE SERVICES ARE CONSIDERED TO BE A SINGLE PERFORMANCE OBLIGATION AND HAVE A DURATION OF LESS THAN ONE YEAR. REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED AT A POINT IN TIME IS RECOGNIZED WHEN SERVICES ARE PROVIDED AND THE HOSPITAL DOES NOT BELIEVE IT IS REQUIRED TO PROVIDE ADDITIONAL SERVICES TO THE PATIENT. SEE FOOTNOTE 3 FOR A SUMMARY OF UNCOMPENSATED SERVICES, INCLUDING PRICE CONCESSIONS (BAD DEBTS). |
| SCHEDULE H, PART III, LINE 4 | SEE THE DISCUSSION REGARDING UNINSURED PATIENTS AND BAD DEBT EXPENSE WITH THE NET PATIENT SERVICE REVENUE AND UNCOMPENSATED SERVICES FOOTNOTES ON PAGES 12-17 ON THE ACCOMPANYING 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 VI, LINE 2 | IN ADDITION TO CONDUCTING A CHNA EVERY 3 YEARS, THE HOSPITAL SEEKS INPUT FROM MEMBERS OF THE COMMUNITY, MEDICAL AND NURSING STAFF AND COMMUNITY HEALTH LEADERS THROUGHOUT THE YEAR. |
| SCHEDULE H, PART VI, LINE 3 | THE FAP, APPLICATION AND SUMMARY ARE POSTED ON THE ORGANIZATION'S WEBSITE. SIGNAGE THROUGHOUT THE HOSPITAL PROVIDES NOTICE OF THE FAP AND PATIENTS ARE INFORMED OF FINANCIAL ASSISTANCE PRIOR TO DISCHARGE. THE APPLICATION, FAP AND PLAIN LANGUAGE SUMMARY ARE AVAILABE UPON REQUEST AT THE HOSPITAL FACILITY'S ADMISSION POINTS. |
| SCHEDULE H, PART VI, LINE 4 | THE HOSPITAL'S SERVICE AREA IS DEFINED LIBERTY COUNTY, FLORIDA. THE COUNTYS POPULATION IS COMPRISED OF AN ESTIMATED 8,333 RESIDENTS, LESS THAN 0.1% OF THE ESTIMATED POPULATION FOR THE STATE OF FLORIDA. THE MEDIAN AGE OF THE POPULATION IS 40.6 YEARS OLD; CHILDREN (INDIVIDUALS AGES 17 AND UNDER) MAKE UP LESS THAN ONE-FIFTH (17%) OF THE POPULATION AND ADULTS AGES 65 AND OLDER COMPRISE 13%. MALES MAKE UP 59% OF THE POPULATION WHILE WOMEN MAKE UP 41%. |
| SCHEDULE H, PART VI, LINE 5 | THE HOSPITAL HAS AN EMERGENCY ROOM OPEN 24/7/365 TO ALL PATIENTS ON A NON- DISCIMINATORY BASIS WITHOUT REGARD FOR THE PATIENT'S ABILITY TO PAY. THE HOSPITAL IS LEAD BY A BOARD OF DIRECTORS COMPRISED ON INDEPENDENT COMMUNITY MEMBERS AND THE MEDICAL STAFF IS OPEN TO PROPERLY CREDENTIALED PHYSICIANS. THE HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS. |
| SCHEDULE H, PART VI | THE HOSPITAL AND ITS SERVICE COMMUNITY WERE SEVERELY IMPACTED BY THE LANDFALL OF HURRICANE MICHAEL, A CATEGORY 5 STORM THAT INFLICTED TREMENDOUS DAMAGE THROUGHT LIBERTY AND CALHOUN COUNTIES AFTER IT CAME ASHORE IN MEXICO BEACH FLORIDA WHICH IS 41 MILES SOUTHWEST OF BLOUNTSTOWN. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt |
|---|---|---|---|---|---|---|
| JARED BARBER | ||||||
| PRIMARY CARE PROVIDE | $222,999 | $32,200 | $958 | $3,887 | $260,044 | |
| CHRISTINIA JEPSEN | ||||||
| FORMER CEO | $212,902 | $2,218 | $221,803 | $6,683 | ||
| LAURA FORD | ||||||
| NURSE PRACTITIONER | $119,061 | $58,411 | $2,514 | $179,986 | ||
| JAMES C MILLER | ||||||
| CEO | $158,224 | $176 | $176,336 | $17,936 | ||
| HAYLEY NICHOLS | ||||||
| NURSE PRACTITIONER | $150,811 | $200 | $93 | $2,244 | $153,348 | |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART III | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL'S CEO, CFO AND CERTAIN OTHER MANAGEMENT POSITIONS ARE PROVIDED BY ALLIANT MANAGEMENT SERVICES, INC. THE IRS MAY CONSIDER THESE INDIVIDUALS AS EMPLOYEES OF CALHOUN LIBERTY HOSPITAL SINCE THEY SERVE AS OFFICERS. THEIR COMPENSATION IS REPORTED IN PART VII OF FORM 990. DURING 2024, CALHOUN LIBERTY PAID 834,380 TO ALLIANT MANAGEMENT SERVICES, INC. THIS AMOUNT INCLUDES THE COMPENSATION OF THE OFFICERS PROVIDED, AS WELL AS MANAGEMENT FEES. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 3 | THE POSITIONS OF HOSPITAL ADMINISTRATOR (AS WELL AS CERTAIN OTHER DUTIES) HAVE BEEN CONTRACTED TO AN UNRELATED MANAGEMENT COMPANY THAT COMPENSATES THOSE POSITIONS DIRECTLY. THE HOSPITAL PAYS A FEE TO THE MANAGEMENT COMPANY FOR THESE SERVICES. |
| FORM 990, PAGE 6, PART VI, LINE 11B | AN INDEPEDENT CPA PREPARES THE RETURN FROM INFORMATION OBTAINED DURING THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND FROM MANAGEMENT. THE RETURN IS REVIEWED BY MANAGEMENT AND A COPY IS PROVIDED TO MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS AND THE OTHER INFORMATION ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES 1,055,860 0 0 PHYSICIAN FEES 2,700 0 0 PURCHASED SERVICES 1,001,572 1,780,572 0 COLLECTION FEES 0 299 0 MEDICAL PROFESSIONALS 1,242 0 0 TOTAL 2,061,374 1,780,871 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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BIG BEND HEALTH ALLIANCE | ||||||||||||
| 20370 NE BURNS AVENUE | BLOUNTSTOWN | FL | 32424 | 922938056 | HEALTHCARE | FL | 501C3 | 12A | TMHC | TALLAHASSEE MEMORIAL HEALTHCARE | false | |
| CLH QALICB | ||||||||||||
| 20370 NE BURNS AVENUE | BLOUNTSTOWN | FL | 32424 | 991590843 | SUPPORT | FL | 501C3 | 12C | false | N/A | ||
| 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 | false | 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 | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |