COFFEYVILLE REGIONAL MEDICAL CENTER INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- COFFEYVILLE REGIONAL MEDICAL CENTER INC (EIN 48-1178846)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-08
- IRS object ID
- 201733129349301548
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-08T10:25:34-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 481026809 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wendling Noe Nelson & Johnson LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 534 S Kansas Ave Suite 1500 | AddressLine1Txt |
| City | Topeka | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 666033491 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481178846 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Coffeyville Regional Medical Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COFF | BusinessNameControlTxt |
| Phone | 6202511200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 W 4th Street | AddressLine1Txt |
| City | Coffeyville | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67337 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mark Woodring | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6202511200 | PhoneNum |
| Signature | 2017-11-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Eric L Otting | PreparerPersonNm |
| PTIN | P00298454 | PTIN |
| Phone | 7852334226 | PhoneNum |
| Preparation | 2017-11-06 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 98.172.114.81 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-06 | IPDt |
| IP Tm | 11:35:40 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | C25D5B149A5DEB5B624D2ED84480DFAE7FBA67D7 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | C25D5B149A5DEB5B624D2ED84480DFAE7FBA67D7 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Mark Woodring | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 W 4th Street | AddressLine1Txt |
| City | Coffeyville | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67337 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $46,694,321 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | http://crmcinc.org/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | Medical care and services by an acute care hospital. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 503 | TotalEmployeeCnt |
| Total Volunteers | 70 | TotalVolunteersCnt |
| Total Gross UBI | $1,120 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $662,719 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,515,486 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $40,023,835 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $43,359,033 | CYProgramServiceRevenueAmt |
| PY Investment Income | $348,341 | PYInvestmentIncomeAmt |
| CY Investment Income | $284,527 | CYInvestmentIncomeAmt |
| PY Other Revenue | $212,728 | PYOtherRevenueAmt |
| CY Other Revenue | $535,275 | CYOtherRevenueAmt |
| PY Total Revenue | $41,247,623 | PYTotalRevenueAmt |
| CY Total Revenue | $46,694,321 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $11,760 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $9,986 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $20,245,201 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,694,103 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $44,695 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $24,410,542 | PYOtherExpensesAmt |
| CY Other Expenses | $22,340,989 | CYOtherExpensesAmt |
| PY Total Expenses | $44,667,503 | PYTotalExpensesAmt |
| CY Total Expenses | $47,045,078 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,419,880 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$350,757 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $39,609,755 | TotalAssetsBOYAmt |
| Total Assets EOY | $35,038,334 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,416,669 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,140,128 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $31,193,086 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $30,898,206 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To promote general health and well being through the development, promotion, improvement, and support of all forms of health care services in Coffeyville, Kansas and the surrounding area. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $42,327,358 | ExpenseAmt |
| Grant | $9,986 | GrantAmt |
| Revenue | $43,688,626 | RevenueAmt |
| Desc | Coffeyville Regional Medical Center operates an acute care hospital located in southeast Kansas. We provide inpatient, outpatient, urgent and emergent care, and physician services to all patients regardless of race, creed, sex, national origin, or ability to pay. | Desc |
| Total Program Service Expenses | $42,327,358 | 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 | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 90 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 503 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mark Woodring CEO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6202511200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 W 4th | AddressLine1Txt |
| City | Coffeyville | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67337 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Mike Ewy | |||||||
| Vice Chairman | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Debbie Carter | |||||||
| Secretary/Treasurer | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Judy Hiner | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Neal Barkley | |||||||
| Chairman | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Monte Coffman | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Dr Garrick Rettele | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Jeff Morris | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Mark Woodring | |||||||
| CEO | 40.00 | Yes (X) | $245,165 | $0 | $40,219 | ||
| Dean Ohmart | |||||||
| CFO | 40.00 | Yes (X) | $155,272 | $0 | $19,472 | ||
| Kalapurakkal Menon | |||||||
| Physician | 40.00 | $629,371 | $0 | $41,596 | Yes (X) | ||
| Baba Abudu | |||||||
| Anesthesiologist | 40.00 | $365,712 | $0 | $41,596 | Yes (X) | ||
| James Lin | |||||||
| Physician | 40.00 | $650,956 | $0 | $40,456 | Yes (X) | ||
| Anne Hogsett | |||||||
| Physician | 40.00 | $318,377 | $0 | $37,421 | Yes (X) | ||
| Dara Gibson | |||||||
| Physician | 40.00 | $296,425 | $0 | $41,596 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,661,278 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $262,356 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 26 | 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 |
|---|---|---|---|---|---|
| Green Country Emergency Physicians | |||||
| 4500 S Garnett Rd Ste 300 | Tulsa | OK | 74146 | ER Coverage | $830,545 |
| Spinal Neurosurgical Associates | |||||
| 6921 E 109th St S | Tulsa | OK | 74133 | Physician | $821,248 |
| Alliance Recruiting | |||||
| PO Box 670416 | Dallas | TX | 75267 | Hospitalist services | $663,739 |
| Medical Information Technology | |||||
| Meditech Circle | Westwood | MA | 02090 | IT services | $358,172 |
| Silvercreek Medical | |||||
| 2400 N Broadway | Pittsburg | KS | 66762 | Billing services | $346,109 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 18 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $90,793 | RelatedOrganizationsAmt |
| Government Grants | $2,299,970 | GovernmentGrantsAmt |
| All Other Contributions | $124,723 | AllOtherContributionsAmt |
| Noncash Contributions | $44,000 | NoncashContributionsAmt |
| Total Contributions | $2,515,486 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net patient service revenue | 621990 | $43,012,381 | $43,012,381 |
| Other patient related services | 621990 | $284,197 | $284,197 |
| Educ, lifeline, wellness and misc | 900099 | $62,455 | $62,455 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $43,359,033 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $281,977 | TotalRevenueColumnAmt |
| Exclusion | $281,977 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $55,261 | 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 | $55,261 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,261 | TotalRevenueColumnAmt |
| Exclusion | $55,261 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,550 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,550 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,550 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,550 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|---|
| EHR incentive revenue | 900099 | $325,930 | $325,930 | ||
| Cafeteria and dietary income | 722210 | $151,851 | $151,851 | ||
| Catering revenue | 722320 | $1,120 | $1,120 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,113 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,113 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $480,014 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,694,321 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $43,688,626 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,120 | UnrelatedBusinessRevenueAmt |
| Exclusion | $489,089 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,986 | TotalAmt |
| Program Services | $9,986 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $448,884 | TotalAmt |
| Management And General | $448,884 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,311,402 | TotalAmt |
| Program Services | $17,876,859 | ProgramServicesAmt |
| Management And General | $1,403,034 | ManagementAndGeneralAmt |
| Fundraising | $31,509 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,593,985 | TotalAmt |
| Program Services | $1,479,726 | ProgramServicesAmt |
| Management And General | $111,658 | ManagementAndGeneralAmt |
| Fundraising | $2,601 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,060,600 | TotalAmt |
| Program Services | $1,876,045 | ProgramServicesAmt |
| Management And General | $181,193 | ManagementAndGeneralAmt |
| Fundraising | $3,362 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,279,232 | TotalAmt |
| Program Services | $1,184,205 | ProgramServicesAmt |
| Management And General | $92,940 | ManagementAndGeneralAmt |
| Fundraising | $2,087 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,608 | TotalAmt |
| Management And General | $97,608 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,604 | TotalAmt |
| Management And General | $70,604 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,365 | TotalAmt |
| Management And General | $72,365 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,490,801 | TotalAmt |
| Program Services | $6,221,114 | ProgramServicesAmt |
| Management And General | $1,269,687 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,350 | TotalAmt |
| Program Services | $121,097 | ProgramServicesAmt |
| Management And General | $4,253 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,112 | TotalAmt |
| Program Services | $117,022 | ProgramServicesAmt |
| Management And General | $53,090 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,265 | TotalAmt |
| Program Services | $52,248 | ProgramServicesAmt |
| Management And General | $4,902 | ManagementAndGeneralAmt |
| Fundraising | $115 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,001,785 | TotalAmt |
| Program Services | $808,241 | ProgramServicesAmt |
| Management And General | $191,641 | ManagementAndGeneralAmt |
| Fundraising | $1,903 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,146 | TotalAmt |
| Program Services | $166,636 | ProgramServicesAmt |
| Management And General | $12,510 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,548 | TotalAmt |
| Program Services | $35,118 | ProgramServicesAmt |
| Management And General | $3,430 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,364 | TotalAmt |
| Program Services | $66,364 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,130,862 | TotalAmt |
| Program Services | $2,686,059 | ProgramServicesAmt |
| Management And General | $441,685 | ManagementAndGeneralAmt |
| Fundraising | $3,118 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $460,195 | TotalAmt |
| Program Services | $363,310 | ProgramServicesAmt |
| Management And General | $96,885 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Medical supplies | $4,664,563 | $4,664,563 |
| Pharmacy drugs | $3,468,212 | $3,468,212 |
| Medicaid provider asses | $266,238 | $266,238 |
| Repairs and maintenance | $262,296 | $262,296 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $718,675 | TotalAmt |
| Program Services | $602,019 | ProgramServicesAmt |
| Management And General | $116,656 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,045,078 | TotalAmt |
| Program Services | $42,327,358 | ProgramServicesAmt |
| Management And General | $4,673,025 | ManagementAndGeneralAmt |
| Fundraising | $44,695 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,261,133 | BOYAmt |
| EOY | $594,062 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,476,063 | BOYAmt |
| EOY | $3,793,243 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,456,165 | BOYAmt |
| EOY | $5,285,721 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,384 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,324,502 | BOYAmt |
| EOY | $1,401,804 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $783,838 | BOYAmt |
| EOY | $676,482 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $67,598,081 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $49,529,517 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,870,455 | BOYAmt |
| EOY | $18,068,564 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,583,894 | BOYAmt |
| EOY | $2,751,758 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,839,321 | BOYAmt |
| EOY | $2,466,700 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,609,755 | BOYAmt |
| EOY | $35,038,334 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,516,070 | BOYAmt |
| EOY | $3,814,076 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,669,868 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $930,731 | BOYAmt |
| EOY | $21,052 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $300,000 | BOYAmt |
| EOY | $305,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,416,669 | BOYAmt |
| EOY | $4,140,128 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,823,947 | BOYAmt |
| EOY | $28,538,086 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,998,471 | BOYAmt |
| EOY | $1,989,452 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $370,668 | BOYAmt |
| EOY | $370,668 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,193,086 | BOYAmt |
| EOY | $30,898,206 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,609,755 | BOYAmt |
| EOY | $35,038,334 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$350,757 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $64,896 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$9,019 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $11,643 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $19,000 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $30,643 | 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 | Coffeyville Regional Medical Center, Inc. is a member of the Kansas Hospital Association. This organization engages in lobbying activities for hospital and general health care interests as part of the services provided to members. The Medical Center also contracted for lobbying services to represent the Medical Center's interests. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $370,668 | BeginningYearBalanceAmt |
| End Year Balance | $370,668 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $370,668 | BeginningYearBalanceAmt |
| End Year Balance | $370,668 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $370,668 | BeginningYearBalanceAmt |
| End Year Balance | $370,668 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $370,668 | BeginningYearBalanceAmt |
| End Year Balance | $370,668 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $370,668 | BeginningYearBalanceAmt |
| End Year Balance | $370,668 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $76,477 | OtherCostOrOtherBasisAmt |
| Book Value | $76,477 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,693,322 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,582,018 | DepreciationAmt |
| Book Value | $10,111,304 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,595,518 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,986,153 | DepreciationAmt |
| Book Value | $3,609,365 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,232,764 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,961,346 | DepreciationAmt |
| Book Value | $4,271,418 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $18,068,564 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Other receivables | $106,580 |
| Beneficial interest in net assets of foundation | $2,360,120 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,466,700 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Liability for receivables sold with recourse | $55,000 |
| Estimated third-party payor settlements | $250,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $305,000 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $46,750,198 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $64,896 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $64,896 | RevenueNotReportedAmt |
| Revenue Subtotal | $46,685,302 | RevenueSubtotalAmt |
| Other Revenues Not Included | $9,019 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $9,019 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $46,694,321 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $47,045,078 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $47,045,078 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $47,045,078 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | The Coffeyville Regional Medical Center Foundation's endowment consists of a fund established for dietary scholarships. |
| Part X, Line 2: | The Medical Center is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. |
| Part XI, Line 4b - Other Adjustments: | Contributions for purchase of property and equipment 9,019. |
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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 185.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | 0 | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $889,359 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $170,666 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $718,693 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01530 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,141,116 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,009,950 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,131,166 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04530 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,030,475 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,180,616 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,849,859 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06060 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $124,780 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,122 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $119,658 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,017,064 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,201,808 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,815,256 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05980 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,300 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,300 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,151,144 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,206,930 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,944,214 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06250 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,181,619 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,387,546 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,794,073 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12310 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,894,290 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $254,582 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $14,711,150 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $16,711,520 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,000,370 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (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 | Coffeyville Regional Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 W 4th Street | AddressLine1Txt |
| City | Coffeyville | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67337 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | H063102 | 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 | Coffeyville Regional Medical Center Inc | 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 |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://crmcinc.org | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 185.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://crmcinc.org/patients-visitors/billing-insurance/financial-assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://crmcinc.org/patients-visitors/billing-insurance/financial-assistance | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | Yes (1) | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Coffeyville Regional Medical Center, Inc | Part V, Section B, Line 5: In August 2016 Coffeyville Regional Medical Center in conjunction with the Coffeyville and Independence Chambers of Commerce, Montgomery County Health Department, Ministerial Association, Community Health Center of SE Kansas, and Four County Mental Health began the process of updating the 2013 CHNA. The process included requesting various stakeholders in completing an on-line survey which was followed by a Town Hall Discussion in September 2016. The process included a wide variety of stake holders including business owners, civic leaders, consumers of health care, hospital personnel, and other local health care professionals. |
| Coffeyville Regional Medical Center, Inc | Part V, Section B, Line 6b: Coffeyville and Independence Chambers of Commerce, Montgomery County Health Department, Ministerial Association, Community Health Center of SE Kansas, and Four County Mental Health |
| Coffeyville Regional Medical Center, Inc | Part V, Section B, Line 11: Area of Need: Economic Development- Hospital staff have joined the Montgomery County Economic Development Advisory Group to help lead local efforts and activity to recruit new business and retain existing businesses.- CRMC partners with local High School, Field Kindley High School, to offer high school seniors the opportunity of performing rotations through the different departments of the hospital through their On The Job Training program.- CRMC continues to partner with Coffeyville Junior College and Labette Junior College for radiology and nursing students to have rotations within our hospital.- Human Resources representatives attend recruiting fairs and job fairs in area schools and businesses to educate the community on jobs available at the hospital.- CRMC participates in promotions of the area Chambers of Commerce by providing healthcare materials/education that is provided to new businesses and families of Montgomery County.Area of Need: Primary Care Providers- CRMC recruited Dr. Anne Hogsett, Internal Medicine, to lead our Hospitalist Program, and Susan Jenkins, CRNA was added to our surgical team.- CRMC opened a new medical clinic in Independence, KS - CRMC Medical Group. This new location housed primary care, pediatrics, and OB/GYN physicians and extenders.Area of Need: Chronic Disease Management- CRMC continues to have a dietician onsite 2 days a week.- CRMC actively participates in the County Wellness Coalition.- CRMC provided free FIT Tests during March (Colorectal Cancer Month) through the Tatman Cancer Center.- Provided free and low cost cancer screenings during March at CRMC Medical Group location in Coffeyville and Independence. Screenings included Pap smear and skin cancer.- CRMC participated in the annual American Cancer Society "Relay for Life" in Coffeyville. CRMC served 85 cancer survivors and family members at the event and raised $11,000.- "I am Living Hope" - this print and social media campaign featured 4 breast cancer survivors and their stories of hope and encouragement.- CRMC hosted the 29th annual Cancer Symposium in September 2016 which includes several speakers on the topic.- Pretty in Pink - Breast Cancer Awareness events were held at two locations in October of 2016 - Independence (103 in attendance) and Coffeyville (79 in attendance). These events promoted the importance of breast health.- Website Education included: - 7 Reasons to Exercise During and After Cancer Treatment - 5 Tips to Help You Quit Smoking - When should you have Breast Reconstruction Surgery? - What Is Your Risk of Developing Cancer? - Quiz: How Much Do You Know About Skin Cancer? - Do You Need to Be Screened for Lung Cancer? - How Often Do Women Need Pap Tests? - Talk to Your Doctor About Prostate Cancer - When Should I get a Mammogram? - Fight Cancer from Your Kitchen - Tanning This Summer? Remember Melanoma - Does Exercise Affect Breast Cancer Recovery?- CRMC published an annual Cancer Report.- CRMC sponsors the annual Pink Night at the "Interstate Fair and Rodeo" in Coffeyville.- CRMC also held a "Let's Talk Teal" breakfast with the Coffeyville Area Chamber of Commerce.- CRMC sent "Have Faith in Heart" kits to local clergy to promote education on women and heart disease within their congregations.- CRMC participated in the national campaign - Little Hats, Big Hearts for raising awareness for children born with heart defects. Each baby born at CRMC in the month of February gets a special red hat from the American Heart Association.- Fair and Rodeo Sponsorship Night - Tough Enough To Wear Pink Breast Cancer Awareness - Honored our Cancer Survivors by having them sit in Chute heaven and giving them free tickets to the rodeo and educating them about Breast Cancer Awareness by wearing Pink - August 2016 and 2017. Shirts were also sold and the proceeds went back to our Care N' Share Fund through CRMC Foundation that helps CRMC Cancer Patients.- CRMC continues to provide Annual Mammogram Discount coupons to any women who schedule their mammogram in the months of October or April.Area of Need: Affordable/Safe Housing- Although not a part of CRMC's mission of critical operations, CRMC will partner on any tactics implemented by the city or county.Area of Need: Wellness, Nutrition, Fitness- CRMC began publishing and distributing a new health education magazine called "Health Partners" in October 2016. This magazine is designed to provide information about services available at CRMC, highlight new physicians, and provide health education and a listing of all CRMC providers. CRMC published 10,000 per quarter - mailing out 8,200 and delivering the remainder to area businesses, churches, libraries, and schools. The magazine is free of charge to the community.- In August 2016, CRMC launched a newly re-designed website. The new site is user friendly, easy to navigate, and provides a more comprehensive listing of services, centers, and providers. Site improvements include: - Comprehensive listing of services, including contact information and providers. - Health information library which changes monthly and seasonally. The information provides practical and easy tips on how to live a healthier lifestyle, nutritional recipes, and wellness/prevention information, quizzes, and assessments.- CRMC attended the Health on Purpose health fair by providing informational brochures on Cancer Services, Rehabilitation, Home Health, CRMC Medical Group, Women's Health, and General Services of the hospital - September 2016. - CRMC provided discounted lab draws for the Health on Purpose Health Fair and had a table with informational brochures to educate the community.- Launched a walking club called the CRMC Basement Bunch. Members can join free, log their miles, and walk on the indoor track - January 2016.- CRMC Cafeteria has implemented portion controlled snacks such as cheese and cracker cups, veggie and dip cups, health sandwiches, 100 calorie greek yogurt, and an upgraded salad bar with a protein choice to put on your salad.- Facebook and Twitter was revamped to help target the healthy recipes and articles from our website to facebook and twitter.- Started CRMC Health Partners magazine which highlights important health topics, services, and medical providers. CRMC distributes 10,000 magazines quarterly.- CRMC re-established the SANE/SART program. |
| Coffeyville Regional Medical Center, Inc | Part V, Section B, Line 23: During preparation of the 2016 990 tax return, the Medical Center discovered that there were a few isolated incidences during 2016 when FAP - eligible individuals were inadvertently charged amounts in excess of amounts generally billed. The Medical Center noted that some of these accounts were subsequently written off and others have paid a portion of the amounts charged, with one paying $9.70 more than AGB. The Medical Center is implementing corrective actions related to these patients. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - CRMC Primary Care Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 808 Willow Street | AddressLine1Txt |
| City | Coffeyville | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67337 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Primary Care Physician Clinic | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | Amounts for financial assistance and certain other community benefit programs were obtained using known related charges and cost to charge ratios. The cost to charge ratios used include the overall cost to charge ratio derived from Worksheet 2 as well as individual department cost to charge ratios identified for the calculation of subsidized health services information. |
| Part I, Line 7g: | Subsidized health services are made up of services that the Medical Center provides despite a financial loss to the organization. These services include ambulance, home health, physical therapy, occupational therapy, speech therapy, and physician clinics. |
| Part III, Line 4: | The Medical Center provides for accounts receivable that could become uncollectible in the future by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable value. The Medical Center estimates this allowance based on the aging of its accounts receivable and its historical collection experience.Part III, Line 2Provisions for bad debts are related to accounts that have been deemed uncollectible during the year. The uncollectible amount is then written off pursuant with Hospital policy. The cost of the bad debts reported was determined based upon the cost to charge ratio multiplied by the total charges written off to bad debt expense.Part III, Line 3The estimate of bad debt expense attributable to patients who we believe would be eligible under the organization's financial assistance policy was estimated at 15% which was based on previous years charges written off for patients with incomplete charity care applications. The gross charge amount was then adjusted to cost using the overall cost to charge ratio obtained from worksheet 2. It is our belief that much more of the amount written off to bad debts relates to patients that would qualify for charity; however, do not take the time to complete the application process due to their individual circumstances. |
| Part III, Line 8: | The 2016 Medicare Cost Report was used to determine the Medicare revenue and related cost. The shortfall is a benefit to the Medical Center's community since it represents health care provided at less than cost to elderly and needy residents of the Medical Center's service area. |
| Part III, Line 9b: | Admission representatives review accounts during the admissions process to identify patients with possible financial need. To be considered for charity care, the financial policy states that financial advisors will determine if the patient is eligible to apply for Medicaid or other financial assistance programs. The advisors will then assist the patient through the process of applying for financial assistance programs within and outside of the Medical Center. Whenever possible, prior to admission, the Hospital will conduct a pre-admission interview with the patient, the guarantor, and or legal representative. Patients who may qualify for financial assistance from a governmental program will be referred to the appropriate program prior to being considered for charity care. |
| Part VI, Line 2: | The Medical Center periodically engages a consulting firm to assist with developing a strategic plan. Part of that process is to interview people in the community for their opinion on what the Medical Center can do to meet the community needs. Interviews include physicians, board members, auxiliary personnel, and business leaders in the community to help get a feel for what they see as most important for our community. |
| Part VI, Line 3: | The hospital has signs posted in each admission window and other locations in the hospital encouraging patients to ask about the available payment options and how to apply for financial assistance. The financial assitance policy and application form is also made available on the hospitals website. The patient may be referred to meet with one of the hospital's Financial Advisors, who will determine the patients' eligibility for benefits and help them through the process of applying for assistance. |
| Part VI, Line 4: | Coffeyville is located in the southeastern part of Montgomery County, located in Southeast Kansas. It is located 64 miles north of Tulsa, Oklahoma. The US Census Bureau estimates the 2016 population of Montgomery County, Kansas to be 32,746. 19.0% of the population is 65 years of age or older, the median household income is $41,083, and 19.9% of individuals are below poverty level. |
| Part VI, Line 5: | Health fairs, fundraising for relay for life, public education, and resources on Coffeyville Regional Medical Center's website are some examples of activities the Medical Center does to support health in the community. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mark Woodring | ||||||||||||||
| CEO | $245,165 | $0 | $0 | $0 | $0 | $0 | $22,950 | $0 | $17,269 | $0 | $285,384 | $0 | $0 | $0 |
| Dean Ohmart | ||||||||||||||
| CFO | $155,272 | $0 | $0 | $0 | $0 | $0 | $14,253 | $0 | $5,219 | $0 | $174,744 | $0 | $0 | $0 |
| Kalapurakkal Menon | ||||||||||||||
| Physician | $629,371 | $0 | $0 | $0 | $0 | $0 | $24,327 | $0 | $17,269 | $0 | $670,967 | $0 | $0 | $0 |
| Baba Abudu | ||||||||||||||
| Anesthesiologist | $365,712 | $0 | $0 | $0 | $0 | $0 | $24,327 | $0 | $17,269 | $0 | $407,308 | $0 | $0 | $0 |
| James Lin | ||||||||||||||
| Physician | $650,956 | $0 | $0 | $0 | $0 | $0 | $24,327 | $0 | $16,129 | $0 | $691,412 | $0 | $0 | $0 |
| Anne Hogsett | ||||||||||||||
| Physician | $288,377 | $0 | $30,000 | $0 | $0 | $0 | $24,327 | $0 | $13,094 | $0 | $355,798 | $0 | $0 | $0 |
| Dara Gibson | ||||||||||||||
| Physician | $296,425 | $0 | $0 | $0 | $0 | $0 | $24,327 | $0 | $17,269 | $0 | $338,021 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Neal Barkley | |||
| Wife of Board Member | $33,137 | Employee Compensation | 0 |
| Debbie Carter | |||
| Son-in-law of Board Member | $82,461 | Employee Compensation | 0 |
Schedule M IRS990ScheduleM
Real Estate Commercial RealEstateCommercialGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $44,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Fair market value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | The 990 is made available for the Board of Directors review at their request. |
| Form 990, Part VI, Section B, line 12c | The organization reviews concerns when identified. Members are required to remove themselves from any discussion which may involve a conflict of interest. |
| Form 990, Part VI, Section B, line 15 | The salary for the CEO is determined by the Board of Directors and is based upon performance and comparative information obtained from the Kansas Hospital Association wage survey. |
| Form 990, Part VI, Section C, line 19 | The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon written request. |
| Form 990, Part IX, line 11g | Physician and specialist fees: Program service expenses 2,926,097. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,926,097. Contract labor: Program service expenses 926,759. Management and general expenses 17,441. Fundraising expenses 0. Total expenses 944,200. Other fees for services: Program service expenses 2,368,258. Management and general expenses 1,252,246. Fundraising expenses 0. Total expenses 3,620,504. |
| Form 990, Part XI, line 9: | Decrease in beneficial interest in net assets of CRMC Foundation -9,019. |
| Form 990 Part XI, Line 2c: | The Finance Committee reviews the audit prior to the presentation to the Board by the auditor. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Coffeyville Regional Medical Center Foundation Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 W 4th Street | AddressLine1Txt |
| City | Coffeyville | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67337 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480981990 | EIN |
| Primary Activities | To provide philanthropic assistance to Coffeyville Regional Medical Center | PrimaryActivitiesTxt |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 7 | PublicCharityStatusTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | 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 |