NMC SERVICES INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- NMC SERVICES INC (EIN 62-1046595)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-04-25
- IRS object ID
- 201721159349300542
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-04-25T14:52:36-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 620713250 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KRAFTCPAS PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 GREAT CIRCLE ROAD | AddressLine1Txt |
| City | NASHVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37228 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621046595 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHCREST MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 6153841711 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 NORTHCREST DRIVE | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 371723961 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KIM PRIDGEN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6153841711 | PhoneNum |
| Signature | 2017-04-25 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | FRANCES E LEAHY | PreparerPersonNm |
| PTIN | P00713593 | PTIN |
| Phone | 6152427351 | PhoneNum |
| Preparation | 2017-04-24 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KIM PRIDGEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 NORTHCREST DRIVE | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 371723961 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $78,026,623 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NORTHCREST.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1987 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | OPERATION OF A NONPROFIT 109-BED ACUTE CARE FACILITY IN SPRINGFIELD, TENNESSEE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 770 | TotalEmployeeCnt |
| Total Volunteers | 68 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $389,267 | PYContributionsGrantsAmt |
| CY Contributions Grants | $152,043 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $71,806,126 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $75,647,919 | CYProgramServiceRevenueAmt |
| PY Investment Income | $333,002 | PYInvestmentIncomeAmt |
| CY Investment Income | $208,828 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,816,552 | PYOtherRevenueAmt |
| CY Other Revenue | $2,017,833 | CYOtherRevenueAmt |
| PY Total Revenue | $74,344,947 | PYTotalRevenueAmt |
| CY Total Revenue | $78,026,623 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $55,008 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $70,320 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $27,916,774 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $29,054,915 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $44,367,989 | PYOtherExpensesAmt |
| CY Other Expenses | $44,175,712 | CYOtherExpensesAmt |
| PY Total Expenses | $72,339,771 | PYTotalExpensesAmt |
| CY Total Expenses | $73,300,947 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,005,176 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,725,676 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $86,413,633 | TotalAssetsBOYAmt |
| Total Assets EOY | $88,223,837 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $70,275,446 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $50,054,280 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $16,138,187 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $38,169,557 | NetAssetsOrFundBalancesEOYAmt |
| Mission | NORTHCREST MEDICAL CENTER IS A TENNESSEE NONPROFIT CORPORATION THAT OPERATES A 109-BED GENERAL ACUTE CARE FACILITY. THE HOSPITAL PROVIDES A FULL RANGE OF MEDICAL SERVICES TO BOTH INPATIENTS AND OUTPATIENTS IN AND AROUND THE SPRINGFIELD, TENNESSEE AREA. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $68,161,538 | ExpenseAmt |
| Grant | $70,320 | GrantAmt |
| Revenue | $76,487,806 | RevenueAmt |
| Desc | IN ADDITION TO HEALTH SERVICES, NORTHCREST MEDICAL CENTER SPONSORS MONTHLY SUPPORT GROUPS FOR GRIEF, CANCER AND DIABETES EDUCATION, HOSTS PRENATAL CLASSES, PUBLISHES A QUARTERLY NEWSLETTER, AND PROVIDES STROKE AND PROSTATE CANCER SCREENINGS ALONG WITH FREE BLOOD PRESSURE CHECKS. NORTHCREST MEDICAL CENTER ALSO CONDUCTS SEMINARS ON EXERCISE, NUTRITION, WEIGHT LOSS, ARTHRITIS AND SODIUM PROTECTION. | Desc |
| Total Program Service Expenses | $68,161,538 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 103 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 770 | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KIM PRIDGEN | PersonNm |
| Phone | 6153841515 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 NORTHCREST DR | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37172 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DAVID BELLAR | ||||||||
| TRUSTEE, CHAIRMAN | 1.00 | Yes (X) | $3,466 | $0 | $0 | |||
| JAMES G BOWENS | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $3,079 | $0 | $0 | |||
| HOWARD BRADLEY | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $3,000 | $0 | $0 | |||
| TATIA CUMMINGS | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $3,631 | $0 | $0 | |||
| GEORGE DAHIR | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $3,000 | $0 | $0 | |||
| GERALDINE FARMER | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $3,000 | $0 | $0 | |||
| AMY GALLAGHER | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $3,000 | $0 | $0 | |||
| KEITH GOLDBERG | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $14,000 | $0 | $0 | |||
| DAN GREEN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $3,000 | $0 | $0 | |||
| TRACY LANGSTON | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $3,000 | $0 | $0 | |||
| JASON REYNOLDS | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $3,000 | $0 | $0 | |||
| TED STUBBLEFIELD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $3,000 | $0 | $0 | |||
| RANDY DAVIS | ||||||||
| PRESIDENT/CEO | 40.00 | $285,219 | $0 | $6,646 | 1.00 | Yes (X) | ||
| ANGELA BEARD | ||||||||
| CNO | 40.00 | $205,125 | $0 | $6,989 | Yes (X) | |||
| KIM PRIDGEN | ||||||||
| CFO | 40.00 | $193,538 | $0 | $6,449 | 1.00 | Yes (X) | ||
| AMBER KING | ||||||||
| CHRO/ VP OF COMPLIANCE (END 4/21/15) | 40.00 | $191,739 | $0 | $4,065 | Yes (X) | |||
| TABETHA PARHAM | ||||||||
| NP SUPERVISOR | 40.00 | $124,939 | $0 | $1,333 | Yes (X) | |||
| WENDY VICK | ||||||||
| NP SUPERVISOR/APN (END 4/9/2016) | 40.00 | $124,397 | $0 | $1,341 | Yes (X) | |||
| SHARON VANDERPOOL | ||||||||
| DEPARTMENT DRIECTOR (END 11/2/2015) | 40.00 | $108,900 | $0 | $1,237 | Yes (X) | |||
| REBECCA PIERCE | ||||||||
| RN MANAGER | 40.00 | $108,604 | $0 | $1,343 | Yes (X) | |||
| MIKE TINAL | ||||||||
| PFS DIRECTOR | 40.00 | $108,287 | $0 | $2,316 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,498,924 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $31,719 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LIFELINC ANESTHESIA SPRINGFIELD LLC | |||||
| 308 NORTHCREST DR | SPRINGFIELD | TN | 37172 | CONTRACTED SERVICES | $223,899 |
| WALLER LANSDEN DORTCH & DAVIS | |||||
| 511 UNION ST 2100 | NASHVILLE | TN | 37219 | CONTRACTED SERVICES | $190,336 |
| JACKSON MD RONNIE L | |||||
| 496 NORTHCREST DRIVE | SPRINGFIELD | TN | 37172 | CONTRACTED SERVICES | $154,539 |
| LEE MEDICAL | |||||
| PO BOX 682027 | FRANKLIN | TN | 37068 | CONTRACTED SERVICES | $148,825 |
| CHADALAVADA MD RAMESH | |||||
| 221 NORTHCREST DRIVE | SPRINGFIELD | TN | 37172 | CONTRACTED SERVICES | $138,400 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $35,611 | RelatedOrganizationsAmt |
| Government Grants | $47,683 | GovernmentGrantsAmt |
| All Other Contributions | $68,749 | AllOtherContributionsAmt |
| Total Contributions | $152,043 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HEALTHCARE REVENUE | Desc |
| Business | 621900 | BusinessCd |
| Total Revenue Column | $75,647,919 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $75,647,919 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $75,647,919 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $208,828 | TotalRevenueColumnAmt |
| Exclusion | $208,828 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,177,946 | 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 | $1,177,946 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,177,946 | TotalRevenueColumnAmt |
| Exclusion | $1,177,946 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MISCELLANEOUS | 623990 | $528,643 | $528,643 |
| CAFETERIA SALES | 722210 | $298,679 | $298,679 |
| VENDING MACHINES | 623990 | $12,565 | $12,565 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $839,887 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $78,026,623 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $76,487,806 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,386,774 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,320 | TotalAmt |
| Program Services | $70,320 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,472,889 | TotalAmt |
| Program Services | $1,385,417 | ProgramServicesAmt |
| Management And General | $87,472 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,219,691 | TotalAmt |
| Program Services | $21,900,484 | ProgramServicesAmt |
| Management And General | $1,319,207 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,444,380 | TotalAmt |
| Program Services | $2,348,136 | ProgramServicesAmt |
| Management And General | $96,244 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,917,955 | TotalAmt |
| Program Services | $1,839,292 | ProgramServicesAmt |
| Management And General | $78,663 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $318,910 | TotalAmt |
| Program Services | $275,706 | ProgramServicesAmt |
| Management And General | $43,204 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $304,369 | TotalAmt |
| Program Services | $301,911 | ProgramServicesAmt |
| Management And General | $2,458 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $655,104 | TotalAmt |
| Program Services | $258,192 | ProgramServicesAmt |
| Management And General | $396,912 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,126,779 | TotalAmt |
| Program Services | $1,117,155 | ProgramServicesAmt |
| Management And General | $9,624 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,830 | TotalAmt |
| Program Services | $84,701 | ProgramServicesAmt |
| Management And General | $24,129 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,882,775 | TotalAmt |
| Program Services | $1,882,775 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,120,434 | TotalAmt |
| Program Services | $4,120,434 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,105,181 | TotalAmt |
| Program Services | $3,545,414 | ProgramServicesAmt |
| Management And General | $559,767 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $13,211,785 | $13,200,570 | $11,215 | $0 |
| BAD DEBT EXPENSE | $7,528,415 | $7,528,415 | $0 | $0 |
| CONTRACT SERVICES | $6,560,500 | $4,268,260 | $2,292,240 | $0 |
| EQUIPMENT & RENTAL MAIN | $3,341,023 | $3,246,247 | $94,776 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $911,607 | TotalAmt |
| Program Services | $788,109 | ProgramServicesAmt |
| Management And General | $123,498 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,300,947 | TotalAmt |
| Program Services | $68,161,538 | ProgramServicesAmt |
| Management And General | $5,139,409 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,891,925 | BOYAmt |
| EOY | $8,039,284 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,494,640 | BOYAmt |
| EOY | $2,818,296 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,662,866 | BOYAmt |
| EOY | $12,574,169 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $251,114 | BOYAmt |
| EOY | $263,217 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,374,484 | BOYAmt |
| EOY | $1,393,234 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $731,479 | BOYAmt |
| EOY | $828,378 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $95,216,544 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $67,183,645 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,750,349 | BOYAmt |
| EOY | $28,032,899 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,335,784 | BOYAmt |
| EOY | $10,685,025 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,920,992 | BOYAmt |
| EOY | $23,589,335 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,413,633 | BOYAmt |
| EOY | $88,223,837 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,670,580 | BOYAmt |
| EOY | $6,146,519 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,390,393 | BOYAmt |
| EOY | $38,165,311 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,214,473 | BOYAmt |
| EOY | $5,742,450 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,275,446 | BOYAmt |
| EOY | $50,054,280 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,138,187 | BOYAmt |
| EOY | $38,169,557 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,138,187 | BOYAmt |
| EOY | $38,169,557 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,413,633 | BOYAmt |
| EOY | $88,223,837 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,725,676 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$166,329 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $17,472,023 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $9,154 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $9,154 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | NORTHCREST MEDICAL CENTER PAYS THE FOLLOWING DUES TO TENNESSEE HOSPITAL ASSOCIATION TOTALING $33,246, OF WHICH 18.76% ($6,237) IS ATTRIBUTABLE TO LOBBYING AND DUES TO AMERICAN HOSPITAL ASSOCIATION TOTALING $11,857, OF WHICH 24.6% ($2,917) IS ATTRIBUTABLE TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,333,348 | OtherCostOrOtherBasisAmt |
| Book Value | $4,333,348 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $47,476,302 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,764,757 | DepreciationAmt |
| Book Value | $18,711,545 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $43,373,714 | OtherCostOrOtherBasisAmt |
| Depreciation | $38,418,888 | DepreciationAmt |
| Book Value | $4,954,826 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,180 | OtherCostOrOtherBasisAmt |
| Book Value | $33,180 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $28,032,899 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| MORTGAGE-BACKED SECURITIES | $136,385 | C |
| MUTUAL FUNDS | $10,009,911 | C |
| ETF'S | $538,729 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $10,685,025 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| UNAMORTIZED BOND ISSUE COSTS | $1,454,123 |
| DUE FROM AFFILIATES | $22,064,009 |
| OTHER RECEIVABLES | $71,203 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $23,589,335 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTEREST RATE SWAP AGREEMENT | Desc |
| Amt | $5,742,450 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,742,450 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL AND THE FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3), AND, ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL'S WHOLLY-OWNED SUBSIDIARIES ARE FOR-PROFIT CORPORATIONS AND ARE TAXED UNDER SUBCHAPTER "C" OF THE INTERNAL REVENUE CODE. THESE FOR-PROFIT CORPORATIONS HAVE INCURRED SIGNIFICANT TAX LOSSES. DUE TO THE UNCERTAINTY OF FUTURE TAXABLE INCOME, NET DEFERRED TAX ASSETS OF APPROXIMATELY $4,270,,000 AT JUNE 30, 2016 AND $3,810,000 AT JUNE 30, 2015 HAVE BEEN FULLY RESERVED. THE MOST SIGNIFICANT DEFERRED ITEMS RELATE TO NET OPERATING LOSS CARRYFORWARDS, THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND ACCRUED VACATION. THESE ENTITIES HAVE APPROXIMATELY $16,870,000 OF NET OPERATING LOSSES AVAILABLE AT JUNE 30, 2016 THAT MAY BE USED TO OFFSET FUTURE TAXABLE INCOME. THE NET OPERATING LOSSES EXPIRE IN VARIOUS YEARS BEGINNING JUNE 30, 2019. THE HOSPITAL FOLLOWS THE GUIDANCE FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN THE HOSPITAL'S CONSOLIDATED FINANCIAL STATEMENTS THAT PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE GUIDANCE ALSO ADDRESSES THE DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS AND REQUIRED DISCLOSURES. THE HOSPITAL HAS DETERMINED THAT THERE ARE NO SIGNIFICANT UNCERTAIN TAX POSITIONS AT JUNE 30, 2016 OR 2015. IF INTEREST AND PENALTIES ARE INCURRED RELATED TO UNCERTAIN TAX POSITIONS, SUCH AMOUNTS WOULD BE RECOGNIZED IN INCOME TAX EXPENSE. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,120,939 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,120,939 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03220 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,370,734 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,249,795 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,120,939 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03220 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,491,673 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,249,795 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,241,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06440 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,491,673 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,249,795 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,241,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06440 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $7,528,415 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $602,273 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $14,638,156 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $15,196,358 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$558,202 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | NORTHCREST MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 NORTHCREST DRIVE | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37172 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | NORTHCREST MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.NORTHCREST.COM/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.NORTHCREST.COM | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Actions On Nonpayment | 0 | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| NORTHCREST MEDICAL CENTER | PART V, SECTION B, LINE 5: THE NORTHCREST EXECUTIVE COUNCIL WAS CHARGED WITH THE CHNA PROCESS. THE COUNCIL DETERMINED A COMMITTEE WOULD BE CREATED TO CONDUCT THE CHNA AND THE ASSOCIATED IMPLEMENTATION STRATEGY. IN DECEMBER 2015, NORTHCREST IDENTIFIED KEY STAFF MEMBERS TO BEGIN WORK ON A COMPREHENSIVE CHNA. THE NORTHCREST EXECUTIVE COUNCIL IDENTIFIED KEY PERSONNEL TO SERVE ON THE NEWLY FORMED CHNA COMMITTEE. KEY COMMUNITY HEALTH AND SOCIAL SERVICE STAKEHOLDERS WERE ENGAGED TO ASSIST IN THE PROCESS TO ENSURE INPUT FROM THE UNDERSERVED, CHRONICALLY ILL, LOW INCOME AND MINORITY POPULATIONS IN THE NORTHCREST SERVICE AREA WAS TAKEN INTO ACCOUNT. SPECIFICALLY, THE FOLLOWING SERVED ON THE CHNA COMMITTEE:KIM PRIDGEN NORTHCREST ACCOUNTINGADELE WATTS NORTHCREST FOUNDATIONCHRIS LOCKE NORTHCREST PHYSICIAN SERVICESROB DEBERRY NORTHCREST COMMUNITY DEVELOPMENTMICHAEL LEWIS, MD COMMUNITY PHYSICIANHOWARD BRADLEY COUNTY MAJOR & FORMER EDUCATORDAVID LIMPUS ROBERTSON COUNTY YMCADANA HOLT ROBERTSON COUNTY SCHOOL NURSEVANESSA WATKINS DIRECTOR OF ROBERTSON COUNTY HEALTH DEPARTMENTJAMES BOWENS BOARD MEMBER/ROBERTSON COMMISSIONERFRANK CALLIS ELECTROLUXTHE COMMITTEE MET THREE TIMES OVER THE SIX MONTH TIME-FRAME AND WAS REQUESTED TO ASSIST WITH AND PROVIDE DIRECTION FOR THE FOLLOWING RESPONSIBILITIES: - IDENTIFYING PRIMARY AND SECONDARY DATA SOURCES - IDENTIFYING KEY COMMUNITY PARTNERS - DEVELOPING THE ORGANIZATION'S CHNA INSTRUMENT AND METHODOLOGY - DEVELOPING TARGETED INTERVIEW QUESTIONS INCLUDING IDENTIFICATION OF ITS COMMUNITY'S POPULATION HEALTH EXPERTS - COMPILING AND INTERPRETING THE DATA ACCUMULATED THROUGH THE SURVEY - ACHIEVING CONSENSUS, WITH ITS IDENTIFIED COMMUNITY PARTNERS, CITIZENS AND PUBLIC HEALTH EXPERTS, IN IDENTIFYING THE TOP HEALTH ISSUES FACING ITS COMMUNITY - DEVELOPING THE HOSPITAL'S IMPLEMENTATION STRATEGY TO ADDRESS THE FINDINGS OF THE CHNA |
| NORTHCREST MEDICAL CENTER | PART V, SECTION B, LINE 13H: DEMOGRAPHICS |
| NORTHCREST MEDICAL CENTER | PART V, SECTION B, LINE 20E: COLLECTIONS AGENCY HAS THE HOSPITAL POLICY ON FINANCIAL ASSISTANCE AND SUPPLIES THIS DURING THE COLLECTIONS PROCESS IF REQUESTED. |
| NORTHCREST MEDICAL CENTER | PART V, SECTION B, LINE 22D: UNINSURED CHARGES ARE DISCOUNTED NOT TO EXCEED ONE HUNDRED SEVENTY-FIVE PERCENT (175%) OF THE COST FOR THE SERVICES PROVIDED (CALCULATED USING THE COST TO CHARGE RATIO IN THE MOST RECENT JOINT ANNUAL REPORT). |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - NORTHCREST IMAGING AND SPECIALTY CLINIC | ||||
| 2536 HWY 49 SUITE 120 | PLEASANT VIEW | TN | 37146 | DIAGNOSTIC CENTER |
| 2 - NORTHCREST MEDICAL CARE IN WHITE HOUSE | ||||
| 121 HWY 76 | WHITE HOUSE | TN | 37188 | DIAGNOSTIC CENTER |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 7,528,415. |
| PART III, LINE 4: | AND PART III, LINE 2:PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF BOTH AN ESTIMATED ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE CONTRACTUAL ALLOWANCE REPRESENTS THE DIFFERENCE BETWEEN ESTABLISHED BILLING RATES AND ESTIMATED REIMBURSEMENT FROM MEDICARE, TENNCARE AND OTHER THIRD PARTY PAYER PROGRAMS. RECEIVABLES ARE GENERALLY UNCOLLATERALIZED, BUT CREDIT RISK RELATING TO ACCOUNTS RECEIVABLE IS LIMITED TO SOME EXTENT BY THE DIVERSITY AND NUMBER OF PATIENTS AND PAYORS. THE HOSPITAL ROUTINELY ACCEPTS ASSIGNMENT OF, OR IS OTHERWISE ENTITLED TO RECEIVE, PATIENT BENEFITS PAYABLE UNDER HEALTH INSURANCE PROGRAMS, PLANS OR POLICIES. LATE FEES AND INTEREST CHARGES, IF ANY, ARE RECOGNIZED WHEN RECEIVED.THE BAD DEBT ALLOWANCE IS ESTIMATED BASED UPON THE AGE OF THE ACCOUNT, PRIOR EXPERIENCE AND ANY UNUSUAL CIRCUMSTANCES WHICH AFFECT THE COLLECTIBILITY INCLUDING TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COST WAS OBTAINED FROM THE 06/30/2016 COST REPORT. |
| PART III, LINE 9B: | THERE ARE NO COLLECTION EFFORTS TAKEN ON THE PATIENTS THAT QUALIFY FOR CHARITY CARE. THEIR ACCOUNTS ARE WRITTEN OFF SO NO MONEY IS OWED AND NO CHARGES ARE RECORDED AS INCOME. |
| PART III, LINE 3: | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), 8% WAS AN ACCURATE ESTIMATE FOR BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. |
| PART VI, LINE 2: | NORTHCREST MEDICAL CENTER IS ALWAYS LOOKING FOR BETTER WAYS TO SERVE ITS COMMUNITY. WE USE MANY DIFFERENT SURVEYS TO GATHER INFORMATION ABOUT OUR HEALTHCARE SERVICES FROM OUR COMMUNITY. THE PATIENT SATISFACTION SURVEY PROVIDES OUR PATIENTS WITH THE OPPORTUNITY TO TELL US HOW WELL WE ARE PROVIDING OUR SERVICES. THE COMMUNITY PERCEPTION SURVEY ALLOWS THOSE THAT MAY NOT USE OUR FACILITY THE ABILITY TO PROVIDE US FEEDBACK. ALSO, ANOTHER OPPORTUNITY FOR FEEDBACK IS THE COMMUNITY NEEDS SURVEY WHICH ALLOWS THE COMMUNITY TO EXPRESS WHAT ADDITIONAL SERVICES IT WOULD LIKE FOR US TO PROVIDE. |
| PART VI, LINE 3: | PATIENTS ARE SCREENED UPON REGISTRATION TO SEE IF THEY QUALIFY FOR CHARITY CARE. THE PAPERWORK IS EXPLAINED AND PRESENTED AT THAT TIME. UNINSURED PATIENTS WITH NO MEANS OF PAYMENT ARE ALSO MAILED CHARITY APPLICATIONS AFTER DISCHARGE AND PRIOR TO COLLECTION AGENCY PLACEMENT. COLLECTION AGENCY IS ALSO EDUCATED IN EXPLAINING CHARITY POLICY AND WILL REFER QUALIFYING PATIENT TO HOSPITAL FOR REVIEW. WHILE SCREENING FOR CHARITY CARE QUALIFICATION, THE HOSPITAL DOES MEDICAID ELIGIBILITY SCREENING IF THE PATIENT IS MEDICAID ELIGIBLE. THE HOSPITAL ASSISTS THE PATIENT WITH THE APPLICATION AND FOLLOW UP. THIS BENEFITS THE PATIENTS LONG TERM WITH A PORTABLE INSURANCE OPTION. |
| PART VI, LINE 4: | NORTHCREST MEDICAL CENTER IS A COMMUNITY, NOT-FOR-PROFIT HOSPITAL LOCATED IN ROBERTSON COUNTY, WHICH IS LOCATED IS NORTHERN MIDDLE TENNESSEE AND INCLUDES EIGHT INDIVIDUAL MUNICIPALITIES. NORTHCREST MEDICAL CENTER IS THE ONLY HOSPITAL LOCATED IN THE COUNTY WITH A POPULATION OF APPROXIMATELY 68,000 CITIZENS. ROBERTSON COUNTY HAS AN AVERAGE HOUSEHOLD INCOME OF $53,151, AND ITS POPULATION IS MADE UP OF 90% CAUCASIAN, 8% AFRICAN-AMERICAN, AND 6% HISPANIC. |
| PART VI, LINE 5: | NORTHCREST MEDICAL CENTER IS A NOT-FOR-PROFIT, INDEPENDENT, COMMUNITY HOSPITAL THAT HAS BEEN PROVIDING COMPASSIONATE, QUALITY HEALTHCARE SINCE 1956 WITH A MISSION OF ENHANCING COMMUNITY AND PATIENT WELLNESS. NORTHCREST PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY MEDICAL SERVICES TO NORTHERN MIDDLE TENNESSEE AND SOUTHERN KENTUCKY. NORTHCREST MEDICAL CENTER IS GOVERNED BY A BOARD OF TRUSTEES MADE UP OF LOCAL COMMUNITY-MINDED MEN AND WOMEN. NORTHCREST'S LOCAL BOARD ALLOWS US TO FOCUS ON THE NEEDS OF OUR COMMUNITY AND USE THE MEDICAL CENTER'S RESOURCES TO PROVIDE ADVANCED, HIGH QUALITY CARE IN A CONVENIENT LOCATION FOR OUR CITIZENS AND SUPPORT OUR COMMUNITY'S ORGANIZATIONS AND EVENTS. NORTHCREST'S MEDICAL STAFF IS MADE UP OF HIGHLY TRAINED AND SKILLED PHYSICIANS FROM THROUGHOUT THE WORLD. THE MEDICAL STAFF IS DEDICATED TO SUPPORTING THE MEDICAL CENTER AND ITS MISSION. NORTHCREST IS ALSO LOOKING TO ADD SERVICES AND PHYSICIANS THAT ARE NEEDED FOR THE COMMUNITY. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Purpose Of GrantPurposeOfGrantTxt | IRC SectionIRCSectionDesc |
|---|---|---|---|---|---|---|---|---|---|
| ROBERTSON COUNTY BOARD OF EDUCATION | |||||||||
| 2121 WOODLAND STREET | SPRINGFIELD | TN | 37172 | 626000810 | $8,525 | FAIR MARKET VALUE | N/A | TO FURTHER EXEMPT PURPOSE OF ROBERTSON COUNTY SCHOOLS | |
| OPEN DOOR PREGNANCY CENTER | |||||||||
| PO BOX 117 | SPRINGFIELD | TN | 37172 | 780223296 | $5,000 | FAIR MARKET VALUE | N/A | TO FURTHER EXEMPT PURPOSE OF THE OPEN DOOR PREGNANCY CENTER | 501(C)(3) |
| ROBERTSON COUNTY FAMILY YMCA | |||||||||
| 3332 TOM AUSTIN HIGHWAY | SPRINGFIELD | TN | 37172 | 620476243 | $10,000 | FAIR MARKET VALUE | N/A | TO FURTHER EXEMPT PURPOSE OF THE YMCA OF ROBERTSON COUNTY | 501(C)(3) |
| AMERICAN HEART ASSOCIATION | |||||||||
| PO BOX 50015 | PRESCOTT | AZ | 86304 | 135613797 | $10,000 | FAIR MARKET VALUE | N/A | TO FURTHER EXEMPT PURPOSE OF THE AMERICAN HEART ASSOCIATION | 501(C)(3) |
| (no name) | |||||||||
| FLU SHOTS GIVEN AWAY | |||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 4 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | NORTHCREST MEDICAL CENTER ONLY PROVIDE FUNDS TO CHARITIES AND QUALIFIED GOVERNMENTAL ENTITIES TO SUPPORT PROJECTS RELATED TO THE HOSPITAL'S EXEMPT PURPOSES AND THOSE THAT BENEFIT THE COMMUNITY SERVED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | 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 (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RANDY DAVIS | ||||||||||||||
| PRESIDENT/CEO | $285,219 | $0 | $0 | $0 | $0 | $0 | $1,754 | $0 | $4,892 | $0 | $291,865 | $0 | $0 | $0 |
| ANGELA BEARD | ||||||||||||||
| CNO | $205,125 | $0 | $0 | $0 | $0 | $0 | $1,367 | $0 | $5,622 | $0 | $212,114 | $0 | $0 | $0 |
| KIM PRIDGEN | ||||||||||||||
| CFO | $193,538 | $0 | $0 | $0 | $0 | $0 | $1,102 | $0 | $5,347 | $0 | $199,987 | $0 | $0 | $0 |
| AMBER KING | ||||||||||||||
| CHRO/ VP OF COMPLIANCE (END 4/21/15) | $191,739 | $0 | $0 | $0 | $0 | $0 | $330 | $0 | $3,735 | $0 | $195,804 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4A | FormAndLineReferenceDesc |
| Explanation | SEVERAL OFFICERS PARTICIPATED IN A RETIREMENT PLAN THROUGH THE MEDICAL CENTER IN 2016: ANGELA BEARD $1,367 RANDY DAVIS 1,754 AMBER KING 330 KIM PRIDGEN 1,102 | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE HEALTH AND EDUCATIONAL FACILITIES BOARD OF THE CITY OF SPRINGFIELD TN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 521353943 | BondIssuerEIN |
| CUSIP | 85141WAA8 | CUSIPNum |
| Bond Issued | 2010-10-30 | BondIssuedDt |
| Issue Price | $43,400,000 | IssuePriceAmt |
| Purpose | FUNDS BEING USED TO RESTRUCTURE DEBT | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $7,610,100 | RetiredAmt |
| Total Proceeds | $43,400,000 | TotalProceedsAmt |
| Working Capital Expenditures | $43,400,000 | WorkingCapitalExpendituresAmt |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MORGAN KEEGAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 22.080000000000 | TermOfHedgePct |
| Superintegrated Hedge | 0 | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | AFTER COMPLETION OF FORM 990, THE RETURN IS REVIEWED BY THE CFO FOR ACCURACY AND COMPLETION. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY THE BOARD AND A CONFLICT DISCLOSURE IS SIGNED. |
| FORM 990, PART VI, SECTION B, LINE 15 | BOARD REVIEWS DIFFERENT SOURCES, SUCH AS MARKET ANALYSIS, BEFORE APPROVING COMPENSATION OF CEO. CEO THEN, IN TURN, REVIEWS AND APPROVES COMPENSATION OF KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE REQUESTS FOR GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS GO THROUGH THE COMPLIANCE OFFICER, AND THE LEGALLY REQUIRED DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT -975,129. EQUITY METHOD LOSS - NORTHCREST PHYSICIAN SERVICES -2,369,972. INVESTMENT IN PHYSICIAN SERVICES AND OTHERS-RECLASS FROM LIABILITY 20,817,124. |
| FORM 990, PART XII, LINE 2C | THE BOARD OF DIRECTORS HAS AN AUDIT COMMITTEE THAT IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT. THEIR PROCESSES FOR REVIEW AND SELECTION OF INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| NORTHCREST MEDICAL CENTER FOUNDATION | ||||||||||
| 100 NORTHCREST DRIVE | SPRINGFIELD | TN | 372123961 | 204224449 | SUPPORT & AID | TN | 501(C)(3) | 509(A)(3) | NORTHCREST MEDICAL CENTER | Yes (1) |
| NORTHCREST HEALTH NETWORK LLC | ||||||||||
| 100 NORTHCREST DRIVE | SPRINGFIELD | TN | 372123961 | 453765273 | SUPPORT & AID | TN | 501(C)(3) | 509(A)(3) | NORTHCREST MEDICAL CENTER | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTHCREST STRATEGIC SERVICES INC | ||||||||||||
| 100 NORTHCREST DRIVE | SPRINGFIELD | TN | 37212 | 621638556 | OPERATIONS LAB | TN | NORTHCREST MEDICAL CENTER | C | $650 | $12,981 | 1.00000 | 0 |
| NORTHCREST PHYSICIANS SERVICES INC | ||||||||||||
| 100 NORTHCREST DRIVE | SPRINGFIELD | TN | 37212 | 621638557 | FAMILY PHYSICIAN | TN | NORTHCREST STRATEGIC SERVICES INC | C | $12,466,188 | $2,137,105 | 1.00000 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | 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 | Yes (1) | 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 | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| NORTHCREST MEDICAL CENTER FOUNDATION | ||
| C | $35,611 | FAIR MARKET VALUE |
| NORTHCREST PHYSICIAN SERVICES | ||
| A | $364,998 | FAIR MARKET VALUE |
| NORTHCREST MEDICAL CENTER FOUNDATION | ||
| O | $520,698 | FAIR MARKET VALUE |
| NORTHCREST PHYSICIAN SERVICES | ||
| K | $15,080 | FAIR MARKET VALUE |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE R, PART V, LINE 10 - SHARING OF PAID EMPLOYEES WITH | FormAndLineReferenceDesc |
| Explanation | RELATED ORGANIZATIONS: NORTHCREST MEDICAL CENTER AND NORTHCREST MEDICAL CENTER FOUNDATION SHARE THE FOLLOWING PAID EMPLOYEES: RANDY DAVIS - TOTAL FISCAL YEAR COMPENSATION $310,581 KIM PRIDGEN - TOTAL FISCAL YEAR COMPENSATION $210,116 NORTHCREST MEDICAL CENTER COMPENSATES THESE EMPLOYEES SINCE THE MAJORITY OF THE EMPLOYEES' TIME IS DEVOTED TO NORTHCREST MEDICAL CENTER. | ExplanationTxt |