2018-04-26T08:19:32-05:00 2017-06-30 450250958 EIDE BAILLY LLP 621 N ROBINSON AVE STE 200 OKLAHOMA CITY OK 731026232 990 2016-07-01 680632560 Coal County Extended Care Incorporated COAL 5809272327 PO Box 326 Coalgate OK 74538 Billy Johnson Administrator 5809272327 2018-04-18 1 Kim Hunwardsen P00484560 4054783334 2018-04-18 98.173.248.226 2018-04-18 11:14:51 CD P E10085862974BF89EE8F231EB831862A8F193D10 E10085862974BF89EE8F231EB831862A8F193D10 2016 2021-01-29 14:40:06Z Ruth Wilson Hurley Manor Phillip Simmons PO Box 326 Coalgate OK 74538 3748063 0 X n/a X 2006 OK Nursing home facility to provide quality nursing care services for the residents of Coal County. 5 5 118 5 0 0 11500 1997 3759861 3712941 6245 125 33000 33000 3810606 3748063 0 0 0 0 1862789 2180560 0 0 0 1895211 1623303 3758000 3803863 52606 -55800 730855 753016 778666 856627 -47811 -103611 X Organized specifically for the exclusive support and benefit of Coal County General Hospital, Incorporated, doing business as Mary Hurley Hospital in Coalgate, Oklahoma. 0 0 3101682 3712941 The Corporation is organized and operated exclusively for charitable, scientific and educational purposes and operates Ruth Wilson Manor, a seventy-five bed nursing home facility in Coalgate, Oklahoma. The Corporation is organized specifically for the exclusive support and benefit of Coal County General Hospital, Inc., which provides continuing health care services to patients of the Hospital and residents of Coal County and surrounding communities. Program service accomplishments continued on Schedule O.The Organization's activities include Home Health Blood Pressure Clinics, Home Health Benefits for employees, Relay for Life, Home Health Career Fair and Health Fairs, Athletic Booster sponsor, FFA Booster, Community Christmas parade, Community 4th of July parade, and Salvation Army bell ringer. 3101682 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 16 0 1 118 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 1 0 0 OK X Diane Downard 5809272327 6 N Covington Coalgate OK 74538 Rick Chaney Chair 2.00 0.00 X X 0 0 0 Gerry Watkins Secretary 2.00 0.00 X X 0 0 0 Travis Williams Board Member 2.00 0.00 X 0 0 0 Phyllis Mixon Board Member 2.00 0.00 X 0 0 0 Imogene Mowdy Board Member 2.00 0.00 X 0 0 0 Diane Downard CFO 10.00 30.00 X 6549 48405 6093 Phillip Simmons Administrator 40.00 0.00 X 52119 0 2771 58668 48405 8864 0 0 0 0 Medical PRN Staffing Inc 1512 Meadow Lane Ardmore OK 73401 Contract Nursing 339241 Okla Medical Professional Staffing 312 South Commerce Ardmore OK 73401 Contract Nursing 175691 Occupational Therapy SolutionsPLLC P O Box 596 Ada OK 74821 Contract Therapy Services 123703 Boomer Solutions LLC 310 South First Street Eufaula OK 74432 Pharmacy consultant, software 117108 4 1997 1997 Net patient revenue 623000 3306845 3306845 Supporting revenue 900099 406096 406096 3712941 125 125 33000 0 33000 33000 33000 3748063 3712941 0 33125 X 59360 59360 1751360 1635634 115726 236828 213984 22844 133012 120154 12858 9573 9573 598119 550109 48010 812 812 80119 72949 7170 89279 89279 23519 20270 3249 408 408 38836 38836 63189 63189 OHCA Assessment 252919 252919 Medical supplies 214742 214742 Food 153773 153773 Bad debt expense 76013 76013 22002 4810 17192 3803863 3101682 702181 0 333160 169217 277691 440656 4550 3917 815147 715604 78621 99543 33333 33333 3500 6350 730855 753016 198459 211362 8374 13000 11586 4719 560247 627546 778666 856627 X -47811 -103611 -47811 -103611 730855 753016 -55800 0 X X 0 1 X 1 0 X 3146 4000 11500 1997 20643 3536660 3484527 3515145 3759861 3712941 18009134 3539806 3488527 3515145 3771361 3714938 18029777 0 409936 459465 490206 516546 419408 2295561 409936 459465 490206 516546 419408 2295561 15734216 81 15117 36121 39245 33125 123689 81 15117 36121 39245 33125 123689 3539887 3503644 3551266 3810606 3748063 18153466 0.86670 0.86550 0.00680 0.00510 X 0 1 X 15773 3153 12620 799374 712451 86923 99543 Due to related party 627546 627546 3671642 -76421 -76421 3748063 0 3748063 3727442 0 3727442 76421 76421 3803863 Part IV, Line 2b: Deposits from patients held by the Organization. Part XI, Line 2d - Other Adjustments: Bad debt expense included in revenue on the financial statements -76,013. Interest expense included in nonoperating revenue on the financial statement -408. Part XII, Line 4b - Other Adjustments: Bad debt expense included in revenue on the financial statement 76,013. Interest expense included in revenue on the financial statement 408. Form 990, Part VI, Section A, line 1 The Chairman shall appoint members and chairs of all committees. Each committee may consist of one or more of the Directors and have such name or names as may be determined by the Board. The Board may designate one or more Directors as alternate members of any committee who may replace any absent or disqualified member at any meeting of the committee. Any committee, to the extent provided in a resolution of the Board, shall have and may exercise the authority of the Board in the management of the business and affairs of the Corporation and may generally perform duties and exercise authority as may be directed or delegated by the Board. Each committee shall regularly report to the Board as and when required. The Chairman may appoint persons who are not Directors to serve as members of a committee, as long as the powers and authority of the Board have not been delegated to that committee. Form 990, Part VI, Section A, line 6 The sole member of the Corporation is Coal County General Hospital Holding Company. Form 990, Part VI, Section A, line 7a The Member elects the Directors at its annual meeting by ballot from a list of qualified persons whose names are submitted as nominees of the Nominating Committee of the Member. Form 990, Part VI, Section A, line 7b The Member, acting through its Board of Directors, shall vote, furnish any necessary consent or approval, or take other action on any issue that may be presented to the Member. The following matters must receive approval of the Membership of the Member: (a) the amendment, restatement or repeal of the Certificate of Incorporation of the Corporation; (b) the amendment, restatement or repeal of these Bylaws to the extent the rights or obligations of the Member or its Membership are affected thereby; (c) the election of the directors of the Corporation; (d) the merger, consolidation or disposition of all or substantially all of the assets of the Corporation; (e) the dissolution, liquidation or termination of the business of the Corporation; (f) a material change in the purposes for which the Corporation was formed; and (g) the filing of a voluntary petition under any law having for its purpose the adjudication of the Corporation as bankrupt or insolvent or the taking of any action with respect to the reorganization or liquidation of the Corporation. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the Board of Directors before it is filed. The CEO and CFO review the 990. Form 990, Part VI, Section B, line 12c Annual disclosures are made by officers and board members and are reviewed by the entire Board. The Board determines whether a conflict exists. Any person with activity deemed a conflict of interest is required to cease and desist or resign. Form 990, Part VI, Section B, line 15a Compensation for the Administrator is reviewed and approved annually by the Coal County General Hospital's Board of Directors. Coal County General Hospital is a related organization. OHA data as well as prevailing rates in the area are used to determine proper compensation. The deliberation and decision are documented in personnel files and board minutes. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part IX, line 11g Contract labor: Program service expenses 513,429. Management and general expenses 0. Fundraising expenses 0. Total expenses 513,429. Purchased services: Program service expenses 3,897. Management and general expenses 24,780. Fundraising expenses 0. Total expenses 28,677. Repairs and maintenance: Program service expenses 31,770. Management and general expenses 23,230. Fundraising expenses 0. Total expenses 55,000. Recruitment: Program service expenses 1,013. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,013. Form 990, Part XII, Line 2c: The Coal County General Hospital's Board of Directors assumes responsibility for oversight of the audit of its financial statements and selection of an independent accountant. Coal County General Hospital Inc 6 N Covington Coalgate OK 74538 731235996 Provision of health care services OK 501(c)(3) Line 3 Coal County General Hospital Holding Co 0 Coal County General Hospital Holding Company 6 N Covington Coalgate OK 74538 680632558 To own and operate hospital and nursing home facilities OK 501(c)(3) Line 12b, II N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0