HMH PHYSICIAN ORGANIZATION: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- HMH PHYSICIAN ORGANIZATION (EIN 76-0500960)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-11
- IRS object ID
- 201831319349301108
- Schema version
- 2016v3.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-11T08:11:19-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 721396621 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARR RIGGS & INGRAM LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO RIVERWAY FLOOR 15 | AddressLine1Txt |
| City | HOUSTON | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 77056 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 760500960 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HMH PHYSICIAN ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HMHP | BusinessNameControlTxt |
| Phone | 9362913411 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 MEMORIAL HOSPITAL DRIVE | AddressLine1Txt |
| City | HUNTSVILLE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 77340 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN MOORE | PersonNm |
| Person Title | INTERIM CFO | PersonTitleTxt |
| Phone | 9364352230 | PhoneNum |
| Signature | 2018-05-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KRISTEN SIMPSON | PreparerPersonNm |
| PTIN | P01268482 | PTIN |
| Phone | 7136218090 | PhoneNum |
| Preparation | 2018-05-04 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN MOORE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 MEMORIAL HOSPITAL DRIVE | AddressLine1Txt |
| City | HUNTSVILLE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 77340 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,747,746 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | ALLOWS PATIENTS TO REMAIN IN THE HUNTSVILLE COMMUNITY TO RECEIVE TREATMENT AND FOLLOW UP FOR MEDICAL CONDITIONS WHICH GREATLY IMPROVES WALKER COUNTY HOSPITAL CORP'S ABILITY TO PROVIDE MEDICAL SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 44 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $983 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,034 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,121,425 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,673,587 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $63,313 | PYOtherRevenueAmt |
| CY Other Revenue | $71,125 | CYOtherRevenueAmt |
| PY Total Revenue | $3,185,721 | PYTotalRevenueAmt |
| CY Total Revenue | $4,747,746 | 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 | $5,077,929 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,616,189 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,089,404 | PYOtherExpensesAmt |
| CY Other Expenses | $2,493,729 | CYOtherExpensesAmt |
| PY Total Expenses | $7,167,333 | PYTotalExpensesAmt |
| CY Total Expenses | $9,109,918 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,981,612 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,362,172 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,651,578 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,073,822 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $584,168 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $559,269 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,067,410 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,514,553 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE OHMH PHYSICIANS ORGANIZATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY TO CARRY OUT ANY AND ALL OF THE FOLLOWING PURPOSES: (A) THE CARRYING OUT OF SCIENTIFIC RESEARCH AND RESEARCH PROJECTS IN THE PUBLIC INTEREST IN THE FIELDS OF MEDICAL SCIENCES, MEDICAL ECONOMICS, PUBLIC HEALTH, SOCIOLOGY AND RELATED FIELDS; (B) THE SUPPORTING OF MEDICAL EDUCATION IN MEDICAL SCHOOLS THROUGH GRANTS AND SCHOLARSHIPS; (C)THE IMPROVING AND DEVELOPING OF THE CAPABILITIES OF INDIVIDUALS AND INSTITUTIONS STUDYING, TEACHING AND PRACTICING MEDICINE; (D) THE DELIVERY OF HEALTH CARE TO THE PUBLIC; (E) THE ENGAGING IN THE INSTRUCTION OF THE GENERAL PUBLIC IN THE AREAS OF MEDICAL SCIENCE, PUBLIC HEATH, AND HYGIENE AND RELATED INSTRUCTION USEFUL TO THE INDIVIDUAL AND BENEFICIAL TO THE COMMUNITY; AND (F) OTHER ACTIVITIES USEFUL OR APPROPRIATE TO THE ACCOMPLISHMENT OF THE FOREGOING PURPOSES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,954,583 | ExpenseAmt |
| Revenue | $795,435 | RevenueAmt |
| Desc | THE ORGANIZATION EXPANDED IN 2014 WITH THE ADDITION OF A NEUROLOGIST, RHEUMATOLOGIST AND WOUND CARE PHYSICIANS. INCREASED PATIENT VOLUME FOR NEPHROLOGY, RHEUMATOLOGY AND WOUND CARE SERVICES HAVE ALLOWED HUNTSVILLE MEMORIAL HOSPITAL TO NOW OFFER INPATIENT ACUTE DIALYSIS SERVICES. THIS ADDITION OF SERVICES FURTHER DECREASED THE AMOUNT OF PATIENT TRANSFERS FOR THOSE PATIENTS WITH CHRONIC ILLNESSES WHO ALSO REQUIRED DIALYSIS SERVICES WHILE IN A HOSPITAL SETTING. THE ORGANIZATION ADDED AN OB/GYN IN NOVEMBER OF 2015. A NEW CLINIC WAS ALSO OPENED IN WILLIS AND LIVINGSTON IN 2015. INPATIENT VISITS 2,435, OFFICE VISITS 20,434. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $7,004,493 | ExpenseAmt |
| Revenue | $3,878,152 | RevenueAmt |
| Desc | THE ORGANIZATION EXPANDED IN 2011 WITH THE ADDITION OF TWO ORTHOPEDICSURGEONS. THE ADDITION OF THE ORTHOPEDICS AND PHYSICIAN ASSISTANT HASALLOWED HUNTSVILLE MEMORIAL HOSPITAL TO INCREASE SPORTS MEDICINESERVICES AVAILABLE TO THE COMMUNITY. THROUGH THEIR INVOLVEMENT, THEHOSPITAL HAS INCREASED THEIR PRESENCE IN VARIOUS COMMUNITIES FORATHLETIC TRAINING SERVICES AND NOW SERVES AS THE OFFICIAL HEALTHCAREPROVIDER FOR BEARKAT ATHLETICS THROUGH SAM HOUSTON STATE UNIVERSITY.INPATIENT VISITS 126, OFFICE VISITS 4,769. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3 | ExpenseAmt |
| Revenue | $0 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES OTHER VALUABLE HEALTH SERVICES FOR THE COMMUNITY. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $8,959,079 | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 57 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 44 | 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 |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | JOHN MOORE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9364352230 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 MEMORIAL HOSPITAL DRIVE | AddressLine1Txt |
| City | HUNTSVILLE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 77340 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DALTON D HEATH MD | ||||||||
| DIRECTOR/CHAIRMAN | 40.00 | Yes (X) | Yes (X) | $547,613 | $0 | $35,408 | ||
| NHU T BRUCE MD | ||||||||
| PHYSICIAN/BOARD | 40.00 | Yes (X) | $411,272 | $0 | $33,817 | |||
| DAVE KHURANA MD | ||||||||
| PHYSICIAN/BOARD | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LAWRENCE BOYLE MD | ||||||||
| PHYSICIAN/BOARD | 40.00 | Yes (X) | $258,469 | $0 | $15,757 | 1.00 | ||
| TEMITOPE EKWO MD | ||||||||
| PHYSICIAN/BOARD | 40.00 | Yes (X) | $116,761 | $0 | $4,665 | 1.00 | ||
| SHANNON BROWN | ||||||||
| PRESIDENT/CEO | 1.00 | Yes (X) | $0 | $475,456 | $15,125 | 40.00 | ||
| ANDREA HARRIS | ||||||||
| SECRETARY | 40.00 | Yes (X) | $67,825 | $0 | $25,775 | |||
| JESSE WARD | ||||||||
| PHYSICIAN | 40.00 | $517,412 | $0 | $31,748 | Yes (X) | |||
| ANIL WARRIER MD | ||||||||
| PHYSICIAN | 40.00 | $320,862 | $0 | $24,352 | Yes (X) | |||
| ELIDA CERVANTES MD | ||||||||
| PHYSICIAN | 40.00 | $171,109 | $0 | $10,664 | Yes (X) | |||
| MELISSA TUCK-WHITE MD | ||||||||
| PHYSICIAN | 40.00 | $199,813 | $0 | $19,486 | Yes (X) | |||
| JOHN TANKSLEY MD | ||||||||
| PHYSICIAN | 40.00 | $166,678 | $0 | $8,679 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,777,814 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $475,456 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $225,476 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDICAL OFFICE PARK - HUNTSVILLE LP | |||||
| 100 MEDICAL CENTER BLVD SUITE 200 | CONROE | TX | 77304 | BUILDING LEASE | $150,451 |
| GENZYME CORPORATION | |||||
| 55 CAMBRIDGE PARKWAY | CAMBRIDGE | MA | 02142 | MEDICAL SUPPLIES | $110,081 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $3,034 | AllOtherContributionsAmt |
| Total Contributions | $3,034 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OUTPATIENT REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $4,673,587 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,673,587 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,673,587 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $60,365 | 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 | $60,365 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $60,365 | TotalRevenueColumnAmt |
| Exclusion | $60,365 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $10,760 | TotalRevenueColumnAmt |
| Exclusion | $10,760 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $10,760 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,747,746 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,673,587 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $71,125 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,677,443 | TotalAmt |
| Program Services | $5,594,551 | ProgramServicesAmt |
| Management And General | $82,892 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,929 | TotalAmt |
| Program Services | $96,499 | ProgramServicesAmt |
| Management And General | $1,430 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $554,997 | TotalAmt |
| Program Services | $546,894 | ProgramServicesAmt |
| Management And General | $8,103 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $285,820 | TotalAmt |
| Program Services | $281,647 | ProgramServicesAmt |
| Management And General | $4,173 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,019 | TotalAmt |
| Program Services | $91,019 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,254 | TotalAmt |
| Program Services | $10,093 | ProgramServicesAmt |
| Management And General | $161 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,879 | TotalAmt |
| Program Services | $53,033 | ProgramServicesAmt |
| Management And General | $846 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,042 | TotalAmt |
| Program Services | $6,042 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $726,512 | TotalAmt |
| Program Services | $726,512 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,995 | TotalAmt |
| Program Services | $26,571 | ProgramServicesAmt |
| Management And General | $424 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,406 | TotalAmt |
| Program Services | $94,406 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,412 | TotalAmt |
| Program Services | $134,412 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASES SERVICES | $638,823 | $602,987 | $35,836 |
| MEDICAL SUPPLIES | $555,966 | $551,463 | $4,503 |
| OTHER FEES | $60,732 | $49,161 | $11,571 |
| PHYSICIAN RECRUITMENT | $32,475 | $31,965 | $510 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,214 | TotalAmt |
| Program Services | $61,824 | ProgramServicesAmt |
| Management And General | $390 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,109,918 | TotalAmt |
| Program Services | $8,959,079 | ProgramServicesAmt |
| Management And General | $150,839 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,852 | BOYAmt |
| EOY | $65,725 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $650,319 | BOYAmt |
| EOY | $971,329 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,460 | BOYAmt |
| EOY | $65,575 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,184,370 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $231,606 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $869,367 | BOYAmt |
| EOY | $952,764 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,580 | BOYAmt |
| EOY | $18,429 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,651,578 | BOYAmt |
| EOY | $2,073,822 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $584,168 | BOYAmt |
| EOY | $559,269 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $584,168 | BOYAmt |
| EOY | $559,269 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,067,410 | BOYAmt |
| EOY | $1,514,553 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,067,410 | BOYAmt |
| EOY | $1,514,553 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,651,578 | BOYAmt |
| EOY | $2,073,822 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,362,172 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $4,809,315 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,052,984 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,893,810 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,304 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $983 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,034 | CurrentTaxYearAmt |
| Total | $2,954,115 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,535,475 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,669,416 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,416,853 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,121,425 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,673,587 | CurrentTaxYearAmt |
| Total | $14,416,756 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,588,459 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,563,226 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,420,157 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,122,408 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,676,621 | CurrentTaxYearAmt |
| Total | $17,370,871 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $1,889,475 | CurrentTaxYearMinus3YearsAmt |
| Total | $1,889,475 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,026,388 | CurrentTaxYearMinus4YearsAmt |
| Total | $1,026,388 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,026,388 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,889,475 | CurrentTaxYearMinus3YearsAmt |
| Total | $2,915,863 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $14,455,008 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $50,942 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $54,566 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $53,025 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $59,281 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $60,365 | CurrentTaxYearAmt |
| Total | $278,179 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $50,942 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $54,566 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $53,025 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $59,281 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $60,365 | CurrentTaxYearAmt |
| Total | $278,179 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $432 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,026 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $391 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,032 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,760 | CurrentTaxYearAmt |
| Total | $22,641 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,639,833 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,624,818 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,473,573 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,185,721 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,747,746 | CurrentTaxYearAmt |
| Total | $17,671,691 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.81800 | PublicSupportCY509Pct |
| Public Support PY509 | 0.74220 | PublicSupportPY509Pct |
| Investment Income CY | 0.01570 | InvestmentIncomeCYPct |
| Investment Income PY | 0.01540 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME - 2012 AMOUNT: $ 432. 2013 AMOUNT: $ 7,026. 2014 AMOUNT: $ 391. 2015 AMOUNT: $ 4,032. 2016 AMOUNT: $ 10,760. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $802,182 | OtherCostOrOtherBasisAmt |
| Depreciation | $100,949 | DepreciationAmt |
| Book Value | $701,233 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $358,418 | OtherCostOrOtherBasisAmt |
| Depreciation | $111,788 | DepreciationAmt |
| Book Value | $246,630 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,770 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,869 | DepreciationAmt |
| Book Value | $4,901 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $952,764 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $4,747,746 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,747,746 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,747,746 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,109,918 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,109,918 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,109,918 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DALTON D HEATH MD | ||||||||||||||
| DIRECTOR/CHAIRMAN | $428,083 | $0 | $119,530 | $0 | $0 | $0 | $7,311 | $0 | $28,097 | $0 | $583,021 | $0 | $0 | $0 |
| NHU T BRUCE MD | ||||||||||||||
| PHYSICIAN/BOARD | $289,559 | $0 | $121,713 | $0 | $0 | $0 | $8,287 | $0 | $25,530 | $0 | $445,089 | $0 | $0 | $0 |
| LAWRENCE BOYLE MD | ||||||||||||||
| PHYSICIAN/BOARD | $258,469 | $0 | $0 | $0 | $0 | $0 | $5,096 | $0 | $10,661 | $0 | $274,226 | $0 | $0 | $0 |
| SHANNON BROWN | ||||||||||||||
| PRESIDENT/CEO | $0 | $365,966 | $0 | $109,490 | $0 | $0 | $0 | $8,121 | $0 | $7,004 | $0 | $490,581 | $0 | $0 |
| JESSE WARD | ||||||||||||||
| PHYSICIAN | $427,674 | $0 | $89,738 | $0 | $0 | $0 | $9,710 | $0 | $22,038 | $0 | $549,160 | $0 | $0 | $0 |
| ANIL WARRIER MD | ||||||||||||||
| PHYSICIAN | $274,095 | $0 | $46,767 | $0 | $0 | $0 | $3,332 | $0 | $21,020 | $0 | $345,214 | $0 | $0 | $0 |
| ELIDA CERVANTES MD | ||||||||||||||
| PHYSICIAN | $171,109 | $0 | $0 | $0 | $0 | $0 | $4,039 | $0 | $6,625 | $0 | $181,773 | $0 | $0 | $0 |
| MELISSA TUCK-WHITE MD | ||||||||||||||
| PHYSICIAN | $199,813 | $0 | $0 | $0 | $0 | $0 | $3,846 | $0 | $15,640 | $0 | $219,299 | $0 | $0 | $0 |
| JOHN TANKSLEY MD | ||||||||||||||
| PHYSICIAN | $166,678 | $0 | $0 | $0 | $0 | $0 | $3,281 | $0 | $5,398 | $0 | $175,357 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 3A | THE TAXPAYER HAS DETERMINED IN GOOD FAITH THAT THE TAXPAYER DOES NOT HAVE ANY ACTIVITIES GENERATING UNRELATED BUSINESS TAXABLE INCOME (AS DEFINED IN IRC 152 (A)) IN THE CURRENT YEAR. THEREFORE, THE TAXPAYER IS NOT REQUIRED TO FILE ANY RETURN OTHER THAN FORM 990. |
| FORM 990, PART VI, SECTION A, LINE 6 | WALKER COUNTY HOSPITAL DBA HUNTSVILLE MEMORIAL HOSPITAL IS THE SOLE MEMBER OF THE HMH PHYSICIANS ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | WALKER COUNTY HOSPITAL CORPORATION DBA HUNTSVILLE MEMORIAL HOSPITAL AS THE SOLE MEMBER MAY APPROVE OR REMOVE AT ANY TIME ANY TRUSTEE FROM THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | WALKER COUNTY HOSPITAL CORPORATION DBA HUNTSVILLE MEMORIAL HOSPITAL AS THE SOLE MEMBER HAS THE POWER TO ALTER, AMEND OR REPEAL THE ARTICLES OF INCORPORATION, AND BYLAWS. THE FOLLOWING MATTERS SHALL REQUIRE THE APPROVAL OF THE MEMBER FOLLOWING CONSULTATION WITH THE BOARD OF TRUSTEES: - ANNUAL OPERATING AND CAPITAL BUDGETS; - MATERIAL ($500) DEVIATIONS FROM ANNUAL OPERATIONS AND CAPITAL BUDGETS; - THE PURCHASE OR ACQUISITION OF ANY PROPERTY, REAL, PERSONAL, OR MIXED, BY THE CORPORATION EXCEEDING $500; - THE SALE, GIFT OR OTHER DISPOSITION OF ANY PROPERTY, REAL, PERSONAL, OR MIXED, BY THE CORPORATION EXCEEDING $500; - THE MORTGAGE OR OTHER ENCUMBRANCE OF ANY PROPERTY, REAL, PERSONAL, OR MIXED BY THE CORPORATION EXCEEDING $500; - THE MERGER, ACQUISITION, LIQUIDATION, DISSOLUTION OR CONSOLIDATION OF THE CORPORATION; - THE CREATION OF OR INVESTMENT IN ANY SUBSIDIARY ENTITY; - THE SETTLEMENT OF CLAIMS OR LITIGATION; AND - THE APPROVAL AND ADOPTION OF THE SALARIES, COMPENSATION AND OTHER BENEFITS TO BE PAID TO PHYSICIANS EMPLOYED BY THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE DETAILED REVIEW OF THE FORM 990 IS CONDUCTED BY THE ORGANIZATION FOLLOWING THE PREPARATION AND REVIEW OF THE RETURN BY THE ORGANIZATION'S PAID PREPARER. AN ELECTRONIC COPY OF THE FINAL FORM 990 IS EMAILED TO EACH BOARD MEMBER PRIOR TO THE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS OF ITS PARENT, WALKER COUNTY HOSPITAL CORPORATION DBA HUNTSVILLE MEMORIAL HOSPITAL, WHICH REQUIRES ALL OFFICERS, DIRECTORS, KEY EMPLOYEES, HIGHLY COMPENSATED EMPLOYEES AND OTHER MANAGEMENT OFFICIALS ("COVERED PERSONS") TO DISCLOSE POTENTIAL CONFLICTS PURSUANT TO THE POLICY, A DISCLOSURE STATEMENT IS CIRCULATED ANNUALLY TO COVERED PERSONS IN WHICH THE INDIVIDUAL MUST DISCLOSE TRANSACTIONS THAT MAY RESULT IN A CONFLICT. COVERED PERSONS ARE ALSO ENCOURAGED TO NOTIFY THE BOARD, APPROPRIATE MANAGEMENT PERSONNEL, CHIEF COMPLIANCE OFFICE, GENERAL COUNSEL, OR THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BODY AS NECESSARY. WHEN NECESSARY, THE BOARD CHAIR OR APPROPRIATE BOARD COMMITTEE MAY APPOINT A DISINTERESTED PERSON(S) OR COMMITTEE TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND RECOMMEND ALTERNATIVES TO THE APPLICABLE TRANSACTION OF ARRANGEMENT OR OTHERWISE DETERMINE IF THE CONFLICT CAN BE RESOLVED. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER THE CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION, AND WHETHER IT IS REASONABLE. THE GOVERNING BOARD OR COMMITTEE MAKES THE DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. ANY MEMBER OF THE BOARD OPERATING UNDER A CONFLICT IS NOT PERMITTED TO BE PRESENT OR OTHERWISE PARTICIPATE IN THE VOTE ON ANY MATTER TO WHICH THE CONFLICT RELATES. IF THE GOVERNING BOARD OR COMMITTEE OF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND AFTER INVESTIGATION THE BOARD OR COMMITTEE DETERMINES THAT THE COVERED PERSON FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE ORGANIZATION TAKES APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION, WHICH MAY INCLUDE TERMINATION OF THE INDIVIDUAL'S MEMBERSHIP, EMPLOYMENT, OR CONTRACT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION FOLLOWS THE COMPENSATION POLICY OF WALKER COUNTY HOSPITAL CORPORATION DBA HUNTSVILLE MEMORIAL HOSPITAL, ITS SOLE MEMBER. HMH ALSO UTILIZES SALARY REVIEWS AND SURVEYS FOR COMPARISON WHEN DETERMINING COMPENSATION OF HIGHLY COMPENSATED EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE AT ITS ADMINISTRATION OFFICE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | INTERNAL TRANSFER FROM HUNTSVILLE MEMORIAL HOSPITAL 4,809,315. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WALKER COUNTY HOSPITAL CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4001 | AddressLine1Txt |
| City | HUNTSVILLE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 77342 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 203069241 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivitiesTxt |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 3 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUNTSVILLE HEART & VASCULAR CENTER LLC (CLOSED FEBRUARY 15 2016) | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 MEMORIAL HOSPITAL DRIVE | AddressLine1Txt |
| City | HUNTSVILLE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 77340 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 463408635 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | 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 | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART V, LINE 1C | FormAndLineReferenceDesc |
| Explanation | HMH PHYSICIAN ORGANIZATION IS 100% OWNED BY HUNTSVILLE MEMORIAL HOSPITAL ( HEREINAFTER REFERRED TO AS " THE HOSPITAL") AND IS A CONTROLLED ENTITY OF THE HOSPITAL. DURING THE TAX YEAR ENDED 6.30.2017, THE HOSPITAL RECLASSIFIED $4,809,315 NET INTERCOMPANY TRANSACTION BALANCES TO THE FUND BALANCE TRANSFERS FROM THE HOSPITAL TO HMH PHYSICIAN ORGANIZATION FOR THE BOOK PURPOSES. ALL THE INTERCOMPANY TRANSACTIONS WERE TO FURTHER THE EXEMPT FUNCTIONS OF BOTH THE HOSPITAL AND HMH PHYSICIAN ORGANIZATION. | ExplanationTxt |