WINSTON COUNTY MEDICAL FOUNDATION: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- WINSTON COUNTY MEDICAL FOUNDATION (EIN 64-6010402)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-09-17
- IRS object ID
- 201802609349301490
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-09-17T14:36:12-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 640394922 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WATKINS WARD AND STAFFORD PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 311 | AddressLine1Txt |
| City | EUPORA | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39744 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 646010402 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINSTON COUNTY MEDICAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WINS | BusinessNameControlTxt |
| Phone | 6627736211 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 967 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39339 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAUL BLACK | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6627736211 | PhoneNum |
| Signature | 2018-09-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THOMAS BROWDER CPA | PreparerPersonNm |
| PTIN | P00444647 | PTIN |
| Phone | 6622582331 | PhoneNum |
| Preparation | 2018-09-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 66.175.162.242 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-09-17 | IPDt |
| IP Tm | 14:36:12 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DC99C678DB09C71046FB33B12BD2A29600D48728 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | E773006910D34343A3EAB97B0BDAF7EB32D0E678 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2018-06-14 16:35:46Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINSTON MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PAUL BLACK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 967 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39339 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $23,966,410 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WINSTONMEDICAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTH CARE SERVICES TO RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND SURROUNDING AREAS | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 361 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $7,522,905 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,809,100 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $18,721,841 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,630,918 | CYProgramServiceRevenueAmt |
| PY Investment Income | $308,415 | PYInvestmentIncomeAmt |
| CY Investment Income | $418,903 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,490,269 | PYOtherRevenueAmt |
| CY Other Revenue | $107,489 | CYOtherRevenueAmt |
| PY Total Revenue | $28,043,430 | PYTotalRevenueAmt |
| CY Total Revenue | $23,966,410 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,916,612 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,835,936 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,380,200 | PYOtherExpensesAmt |
| CY Other Expenses | $20,731,212 | CYOtherExpensesAmt |
| PY Total Expenses | $21,296,812 | PYTotalExpensesAmt |
| CY Total Expenses | $32,567,148 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,746,618 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$8,600,738 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $47,580,348 | TotalAssetsBOYAmt |
| Total Assets EOY | $38,724,120 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,700,376 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,910,467 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $39,879,972 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $30,813,653 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE HEALTH CARE TO THE RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND THE SURROUNDING AREAS | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $28,582,139 | ExpenseAmt |
| Revenue | $21,738,407 | RevenueAmt |
| Desc | WINSTON COUNTY MEDICAL FOUNDATION D/B/A WINSTON MEDICAL CENTER PROVIDES HEALTH CARE SERVICES TO THE RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND SURROUNDING AREAS INCLUDING PERSONS UNABLE TO PAY FOR REQUIRED SERVICES. | Desc |
| Total Program Service Expenses | $28,582,139 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | 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 |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | false | 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 | 44 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 361 | 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 |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | 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 | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINSTON COUNTY MEDICAL FOUNDATION | BusinessNameLine1Txt |
| Business Name Line2 | DBA WINSTON MEDICAL CENTER | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6627736211 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 967 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39339 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| LAURA HARRIS | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JACK MILLER | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TERRY WOODS | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| AL PORTER | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LEX TAYLOR | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL BLACK | |||||||
| CEO | 40.00 | $151,965 | $0 | $16,562 | Yes (X) | ||
| DUSTIN GENTRY | |||||||
| PHYSICIAN | 50.00 | $401,218 | $0 | $41,000 | Yes (X) | ||
| MICHAEL ARD | |||||||
| PHYSICIAN | 50.00 | $316,979 | $0 | $32,168 | Yes (X) | ||
| OCTAVIUS IVY | |||||||
| FNP | 40.00 | $123,144 | $0 | $13,448 | Yes (X) | ||
| HEATHER GILMER | |||||||
| FNP | 40.00 | $110,980 | $0 | $17,635 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,104,286 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $120,813 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CENTURY CONSTRUCTION AND REALTY INC | |||||
| PO BOX 1366 | TUPELO | MS | 38802 | CONSTRUCTION | $7,558,625 |
| BIRDSONG CONSTRUCTION CO | |||||
| PO BOX 2235 | CLINTON | MS | 39060 | CONSTRUCTION | $3,031,768 |
| MOSES ELECTRIC INC | |||||
| PO BOX 16727 | JACKSON | MS | 39236 | CONSTRUCTION | $2,548,732 |
| MCLAIN PLUBMINS AND ELECTRIC SERVIC | |||||
| PO BOX 604 | PHILADELPHIA | MS | 39350 | CONSTRUCTION | $1,817,991 |
| MORRISON MANAGEMENT SPECIALISTS | |||||
| PO BOX 102289 | ATLANTA | GA | 30368 | DIETARY SERVICE | $1,016,143 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $167,100 | GovernmentGrantsAmt |
| All Other Contributions | $1,642,000 | AllOtherContributionsAmt |
| Total Contributions | $1,809,100 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT CARE | Desc |
| Total Revenue Column | $21,630,918 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,630,918 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,630,918 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $418,903 | TotalRevenueColumnAmt |
| Exclusion | $418,903 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $93,420 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $93,420 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $93,420 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $93,420 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INSURANCE PROCEEDS | Desc |
| Total Revenue Column | $14,069 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,069 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $14,069 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,966,410 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,738,407 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $418,903 | 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 | $9,970,544 | TotalAmt |
| Program Services | $9,045,074 | ProgramServicesAmt |
| Management And General | $925,470 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $409,712 | TotalAmt |
| Program Services | $366,692 | ProgramServicesAmt |
| Management And General | $43,020 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $751,926 | TotalAmt |
| Program Services | $672,974 | ProgramServicesAmt |
| Management And General | $78,952 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $703,754 | TotalAmt |
| Program Services | $629,860 | ProgramServicesAmt |
| Management And General | $73,894 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,101 | TotalAmt |
| Management And General | $57,101 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,788 | TotalAmt |
| Management And General | $68,788 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,925 | TotalAmt |
| Program Services | $36,925 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,925 | TotalAmt |
| Program Services | $15,925 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $593,599 | TotalAmt |
| Program Services | $593,599 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,276 | TotalAmt |
| Program Services | $27,210 | ProgramServicesAmt |
| Management And General | $11,066 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,590 | TotalAmt |
| Program Services | $61,590 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,164 | TotalAmt |
| Program Services | $119,164 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACT SERVICES | $5,465,614 | $5,084,350 | $381,264 |
| GRANT EXPENSE - WMC PBC | $5,077,861 | $5,077,861 | |
| RENTS | $3,698,596 | $1,535,576 | $2,163,020 |
| BAD DEBTS | $1,467,144 | $1,467,144 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,030,629 | TotalAmt |
| Program Services | $3,848,195 | ProgramServicesAmt |
| Management And General | $182,434 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,567,148 | TotalAmt |
| Program Services | $28,582,139 | ProgramServicesAmt |
| Management And General | $3,985,009 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $211,776 | BOYAmt |
| EOY | $120,956 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,253,036 | BOYAmt |
| EOY | $1,236,613 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,048,909 | BOYAmt |
| EOY | $4,827,280 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $151,015 | BOYAmt |
| EOY | $200,494 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $225,592 | BOYAmt |
| EOY | $170,150 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $769,604 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $260,196 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,282,125 | BOYAmt |
| EOY | $509,408 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,407,895 | BOYAmt |
| EOY | $31,659,219 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,580,348 | BOYAmt |
| EOY | $38,724,120 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,479,734 | BOYAmt |
| EOY | $2,033,400 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $4,656,425 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,220,642 | BOYAmt |
| EOY | $1,220,642 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,700,376 | BOYAmt |
| EOY | $7,910,467 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,879,972 | BOYAmt |
| EOY | $30,813,653 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,879,972 | BOYAmt |
| EOY | $30,813,653 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,580,348 | BOYAmt |
| EOY | $38,724,120 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$8,600,738 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$465,581 | OtherChangesInNetAssetsAmt |
| 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 D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $278,214 | OtherCostOrOtherBasisAmt |
| Depreciation | $56,388 | DepreciationAmt |
| Book Value | $221,826 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $491,390 | OtherCostOrOtherBasisAmt |
| Depreciation | $203,808 | DepreciationAmt |
| Book Value | $287,582 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $509,408 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| STATE LEVERAGE LOAN | $15,898,515 |
| FEDERAL LEVERAGE LOAN | $13,938,752 |
| FEMA AND MEMA RECECIVABLE | $1,224,270 |
| OTHER RECEIVABLES | $370,909 |
| EQUITY IN MHA INSURANCE | $141,832 |
| CIP | $71,044 |
| INTEREST RECEIVABLE | $13,897 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $31,659,219 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $22,499,266 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$1,467,144 | OtherRevenueAmt |
| Revenue Not Reported | -$1,467,144 | RevenueNotReportedAmt |
| Revenue Subtotal | $23,966,410 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $23,966,410 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $31,100,004 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$1,467,144 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$1,467,144 | ExpensesNotReportedAmt |
| Expenses Subtotal | $32,567,148 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $32,567,148 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 4, PART XI, LINE 2D | BAD DEBTS ARE INCLUDED AS A REDUCTION OF REVENUE ON THE FS -1,467,144 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | BAD DEBTS ARE INCLUDED AS A REDUCTION OF REVENUE ON THE FS -1,467,144 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| 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 | $152,610 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $152,610 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00470 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,188,151 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,577,589 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,340,761 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,577,589 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $152,610 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00470 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,340,761 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,577,589 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $152,610 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00470 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,467,144 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $31,680 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $5,634,354 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,070,428 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$436,074 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (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 | WINSTON COUNTY MEDICAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 967 | AddressLine1Txt |
| City | LOUSIVILLE | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39339 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 16-208 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINSTON COUNTY MEDICAL FOUNDATION | 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 |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.WINSTONMEDICAL.ORG | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.WINSTONMEDICAL.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| 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 |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, WINSTON COUNTY MEDICAL FOUNDATION - PART V, LINE 3E | MODIFIED LIFESTYLE DISEASES ARE ILLNESSES THAT CAN POTENTIALLY BE PREVENTED BY CHANGES IN DIET, ENVIRONMENT, PHYSICAL ACTIVITY AND OTHER LIFESTYLE FACTORS. THESE DISEASES INCLUDE HEART DISEASE, STROKE, OBESITY, DIABETES AND SOME TYPES OF CANCER. IN WINSTON COUNTY, THE THREE MAJOR DISEASES THAT RESULT IN THE MOST DEATHS ARE LIFESTYLE DISEASES. THEY ARE HEART DISEASE, CANCER AND STROKE. THIS IS WHY THE CHNA COMMITTEE HAS CHOSEN TO ADDRESS EDUCATIONAL AND LIFESTYLE INITIATIVES TO ASSIST IN LOWERING THE INCIDENCE OF THESE DISEASES. THE INITIATIVES ARE OUTLINES IN THE CHNA REPORT UNDER THE IMPLEMENTATION PLAN. |
| FACILITY 1, WINSTON COUNTY MEDICAL FOUNDATION - PART V, LINE 5 | THE FACILITY INQUIRED WITH COMMUNITY LEADERS AND HEALTHCARE OFFICIALS ABOUT THE NEEDS OF THE COMMUNITY. |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE METHODOLOGY USED IS A REVIEW OF THE AGINGS OF THE ACCOUNT BALANCES |
| PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE | THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | PATIENT RECEIVABLES ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENTS ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, MAJOR PAYOR SOURCES AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, ESTABLISHED GUIDELINES ARE USED FOR PLACING CERTAIN PAST- DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | THE FACILITY HAS IN PLACE A CHARITY CARE APPLICACTION FOR WHICH ANY PATIENT CAN APPLY, PROVIDED THEY MEET THE QUAL IFICATIONS ON THE APPLICATION. |
Schedule J IRS990ScheduleJ
| 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 (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| PAUL BLACK | ||||
| CEO | $151,965 | $12,160 | $4,402 | $168,527 |
| DUSTIN GENTRY | ||||
| PHYSICIAN | $401,218 | $32,800 | $8,200 | $442,218 |
| MICHAEL ARD | ||||
| PHYSICIAN | $316,979 | $25,966 | $6,202 | $349,147 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE RETURN WAS REVIEWED WITH MANAGEMENT AND THE TAX PREPARER. |
| FORM 990, PAGE 6, PART VI, LINE 12C | DURING THE YEAR END AUDIT, RELATED PARTY TRANSACTIONS ARE REVIEWED. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD OF TRUSTEES REVIEWS THE JOB PERFORMANCE OF THE ADMINISTRATOR AND BASED UPON PAY OF OTHER SIMILAR ADMINISTRATORS ADJUSTS HIS PAY ACCORDINGL Y. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE APPLICABLE DEPARTMENT HEADS REVIEW EACH EMPLOYEE AND SUBMIT A RECOMMEN DED PAY ADJUSTMENT TO THE ADMINISTRATOR, THE ADMINISTRATOR THEN GOES TO TH E BOARD OF TRUSTEES WHO WILL DECIDE ON A PAY RAISE, IF ANY. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE TAX RETURN AND AUDIT ARE MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 24E | SUPPLIES 1,023,929 26,590 0 LOSS ON DISPOSAL 656,168 0 0 MEDICIAD ASSESSMENTS 579,197 0 0 DRUGS 557,669 0 0 INSURANCE 495,417 0 0 REPAIRS AND MAINTENANCE 283,437 0 0 MISCELLANEOUS 118,570 148,779 0 DUES & SUBSCRIPTIONS 133,808 7,065 0 TOTAL 3,848,195 182,434 0 |
| FORM 990, PART XI, LINE 9 | RESTATEMENT OF PRIOR YEAR -465,581 |