MARGARET MARY COMMUNITY HOSPITAL INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MARGARET MARY COMMUNITY HOSPITAL INC (EIN 35-6067049)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-15
- IRS object ID
- 201733199349302928
- 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 I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-15T08:44:05-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Blue & Co LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 N Meridian St Suite 200 | AddressLine1Txt |
| City | Indianapolis | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | 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 | 356067049 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Margaret Mary Community Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MARG | BusinessNameControlTxt |
| Phone | 8129346624 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 Mitchell Avenue | AddressLine1Txt |
| City | Batesville | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 470060226 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Brian Daeger | PersonNm |
| Person Title | VP of Finance | PersonTitleTxt |
| Phone | 8129346624 | PhoneNum |
| Signature | 2017-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Amber Kocher CPA | PreparerPersonNm |
| PTIN | P01286298 | PTIN |
| Phone | 3176334705 | PhoneNum |
| Preparation | 2017-11-10 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 50.90.4.15 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-10 | IPDt |
| IP Tm | 13:42:26 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B19D0506B86ED19F1A0FD2AFEEB91090E576B51F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Margaret Mary Health | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Brian Daeger | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 Mitchell Avenue | AddressLine1Txt |
| City | Batesville | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 470060226 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $137,968,488 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MMHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1967 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 799 | TotalEmployeeCnt |
| Total Volunteers | 55 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $637,195 | PYContributionsGrantsAmt |
| CY Contributions Grants | $510,664 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $87,186,161 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $91,291,461 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,066,435 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,467,242 | CYInvestmentIncomeAmt |
| PY Other Revenue | $705,581 | PYOtherRevenueAmt |
| CY Other Revenue | $767,816 | CYOtherRevenueAmt |
| PY Total Revenue | $89,595,372 | PYTotalRevenueAmt |
| CY Total Revenue | $96,037,183 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $271,314 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $280,197 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $45,171,537 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $49,523,096 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $36,556,460 | PYOtherExpensesAmt |
| CY Other Expenses | $37,479,522 | CYOtherExpensesAmt |
| PY Total Expenses | $81,999,311 | PYTotalExpensesAmt |
| CY Total Expenses | $87,282,815 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,596,061 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $8,754,368 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $147,977,928 | TotalAssetsBOYAmt |
| Total Assets EOY | $155,453,661 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $43,477,885 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $40,830,638 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $104,500,043 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $114,623,023 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Improve the health of the communities it serves. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $68,951,410 | ExpenseAmt |
| Grant | $280,197 | GrantAmt |
| Revenue | $91,409,062 | RevenueAmt |
| Desc | HEALTH CARE SERVICES RELATED TO IMPROVING THE HEALTH OF THE COMMUNITY FOR BOTH INPATIENT AND OUTPATIENT PROGRAMS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,495,188 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | Subsidized Health Services - 44,479 individuals received benefits from our hospital owned Outpatient Services. This includes Osgood physician practice located in a rural area and is also located in a medically underserved area. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,261,109 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $108,357 | RevenueAmt |
| Desc | Community Health Services- 84,185 individuals participated in services and programs such as cancer screenings, cpr and aed training, diabetes care, flu clinics, nutrition classes, smoking cessation support, blood pressure and thyroid screenings, women's health events, osteoporosis screenings, wellness screenings, emergency preparedness, and health insurance enrollment and referrals. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (2 entries)
| ExpenseExpenseAmt | GrantGrantAmt | RevenueRevenueAmt | DescDesc |
|---|---|---|---|
| $1,331,751 | $0 | $0 | Financial and in-kind contributions - 637 individuals received benefits from our EMS and paramedic training and subsidy programs. MMH subsidizes a portion of the Ripley County Paramedic/EMS director's salary. MMH also coordinates and subsidizes training for the 4 Ripley county squads located in Versailles, Sunman, Milan, and Batesville. In addition, various MMH team members serve on numerous community boards including March of Dimes, Relay for Life, and the Batesville coordinated school health board. |
| $0 | $0 | $0 | Other programs and services 4,747 individuals participated in additional programs and services provided by MMH, including career and workforce development for physician, nursing, and other medical students through our mentoring programs and career fairs. MMH is involved in clinical research at the Hansen Center, a cancer treatment center owned and operated by MMH in Batesville. MMH continually assess community needs and health issues to address needs in the community. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,331,751 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $74,039,458 | 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 | 0 | 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 | Yes (1) | 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 | 96 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 799 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 13 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | 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 | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eric Busch ACCOUNTING MANAGER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8129346624 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 Mitchell Avenue | AddressLine1Txt |
| City | Batesville | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 470060226 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| TIMOTHY PUTNAM | ||||||||
| President | 40.00 | 2.00 | Yes (X) | Yes (X) | $589,644 | $0 | $35,930 | |
| GEORGE JUNKER | ||||||||
| Board Chair | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DONALD KARBOWSKI | ||||||||
| Board Vice Chair | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RONALD KNUEVEN | ||||||||
| Board Treasurer | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| John Dickey | ||||||||
| Board Secretary | 2.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Clay Kellerman | ||||||||
| MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Cindy Lauber | ||||||||
| mEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Charles McGovern | ||||||||
| Member/PHYSICIAN | 40.00 | 0.00 | Yes (X) | $236,570 | $0 | $34,206 | ||
| SAM ROW | ||||||||
| Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Jan Santerre | ||||||||
| Member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Tom Tepe | ||||||||
| MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MARY ANN WISE-CASTNER | ||||||||
| member | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Tim Ziemke | ||||||||
| MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Chris Trainor | ||||||||
| Member-term ended June '16 | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BRIAN DAEGER | ||||||||
| VP Finance | 40.00 | 0.00 | Yes (X) | $279,435 | $0 | $31,269 | ||
| Julie Keene | ||||||||
| VP Physician Services | 40.00 | 0.00 | Yes (X) | $194,615 | $0 | $31,204 | ||
| Bonnie Ploeger | ||||||||
| VP Inpatient Services | 40.00 | 0.00 | Yes (X) | $184,446 | $0 | $15,835 | ||
| Liz Leising | ||||||||
| vp outpatient Srvs Jun-Dec'16 | 40.00 | 0.00 | Yes (X) | $126,845 | $0 | $546 | ||
| nancy marticke | ||||||||
| VP Outpatient Srvs Jan-Sept'16 | 40.00 | 0.00 | Yes (X) | $261,600 | $0 | $29,334 | ||
| Kim Inscho | ||||||||
| VP Human Resources | 40.00 | 2.00 | Yes (X) | $229,659 | $0 | $27,782 | ||
| JEFFREY HATCHER MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $554,513 | $0 | $39,891 | Yes (X) | ||
| Paul Jarvis MD | ||||||||
| PhySICIAN | 40.00 | 0.00 | $531,537 | $0 | $34,206 | Yes (X) | ||
| Howard Cooper OD | ||||||||
| PhySICIAN | 40.00 | 0.00 | $510,306 | $0 | $34,206 | Yes (X) | ||
| Jon Geers MD | ||||||||
| PHYSICIAN | 40.00 | 2.00 | $448,860 | $0 | $34,560 | Yes (X) | ||
| Thomas Brown MD | ||||||||
| pHYSICIAN | 40.00 | 0.00 | $428,936 | $0 | $37,631 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,576,966 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $386,600 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 57 | 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 |
|---|---|---|---|---|---|
| KPM-EDLLC | |||||
| 7770 Cooper Road Suite 8 | Montgomery | OH | 45242 | ER Physician staffing Service | $2,176,410 |
| TriMedx | |||||
| PO Box 636129 | Cincinnati | OH | 45263 | Clinical Equipment Maintenance | $898,138 |
| HALL render killian | |||||
| 39778 Treasury Center | Chicago | IL | 60694 | Legal Fees | $422,440 |
| BSA lifestructures | |||||
| PO Box 6069 | Indianapolis | IN | 46206 | design consultants | $292,446 |
| south bend medical foundation | |||||
| po box 2030 | Mishawaka | IN | 46546 | lab services | $253,611 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $78,187 | RelatedOrganizationsAmt |
| Government Grants | $395,678 | GovernmentGrantsAmt |
| All Other Contributions | $36,799 | AllOtherContributionsAmt |
| Total Contributions | $510,664 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Net Patient Service Revenue | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $91,291,461 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $91,291,461 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $91,291,461 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,343,120 | TotalRevenueColumnAmt |
| Exclusion | $2,343,120 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $225,958 | 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 | $225,958 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $225,958 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $225,958 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $43,034,993 | SecuritiesAmt |
| Other | $20,434 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $41,931,305 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,103,688 | SecuritiesAmt |
| Other | $20,434 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,124,122 | TotalRevenueColumnAmt |
| Exclusion | $1,124,122 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Cafeteria | 900099 | $368,978 | $368,978 |
| Vending | 900099 | $2,667 | $2,667 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $170,213 | TotalRevenueColumnAmt |
| Exclusion | $170,213 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $541,858 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $96,037,183 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $91,517,419 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,009,100 | 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 | $256,197 | TotalAmt |
| Program Services | $256,197 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,000 | TotalAmt |
| Program Services | $24,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,038,144 | TotalAmt |
| Program Services | $1,712,041 | ProgramServicesAmt |
| Management And General | $326,103 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,194,047 | TotalAmt |
| Program Services | $30,402,999 | ProgramServicesAmt |
| Management And General | $5,791,048 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,222,171 | TotalAmt |
| Program Services | $1,038,845 | ProgramServicesAmt |
| Management And General | $183,326 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,565,963 | TotalAmt |
| Program Services | $6,431,069 | ProgramServicesAmt |
| Management And General | $1,134,894 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,502,771 | TotalAmt |
| Program Services | $2,127,355 | ProgramServicesAmt |
| Management And General | $375,416 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,874,891 | TotalAmt |
| Program Services | $8,781,184 | ProgramServicesAmt |
| Management And General | $2,093,707 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $458,685 | TotalAmt |
| Program Services | $389,102 | ProgramServicesAmt |
| Management And General | $69,583 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $396,917 | TotalAmt |
| Program Services | $79,383 | ProgramServicesAmt |
| Management And General | $317,534 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,662,848 | TotalAmt |
| Program Services | $1,410,594 | ProgramServicesAmt |
| Management And General | $252,254 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $384,979 | TotalAmt |
| Program Services | $326,578 | ProgramServicesAmt |
| Management And General | $58,401 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $269,891 | TotalAmt |
| Program Services | $228,949 | ProgramServicesAmt |
| Management And General | $40,942 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,112,217 | TotalAmt |
| Program Services | $943,494 | ProgramServicesAmt |
| Management And General | $168,723 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,863,375 | TotalAmt |
| Program Services | $5,822,201 | ProgramServicesAmt |
| Management And General | $1,041,174 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $724,091 | TotalAmt |
| Program Services | $614,246 | ProgramServicesAmt |
| Management And General | $109,845 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Supplies - Medical and | $12,500,934 | $12,500,934 |
| Food | $586,360 | $586,360 |
| Dues & Sub. | $363,927 | $363,927 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,280,407 | TotalAmt |
| Management And General | $1,280,407 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,282,815 | TotalAmt |
| Program Services | $74,039,458 | ProgramServicesAmt |
| Management And General | $13,243,357 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,114,396 | BOYAmt |
| EOY | $5,283,380 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,840,873 | BOYAmt |
| EOY | $10,935,461 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,075,747 | BOYAmt |
| EOY | $1,104,045 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,348,548 | BOYAmt |
| EOY | $1,357,408 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $137,485,551 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $78,364,388 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,260,099 | BOYAmt |
| EOY | $59,121,163 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,637,761 | BOYAmt |
| EOY | $77,271,070 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $700,504 | BOYAmt |
| EOY | $381,134 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $147,977,928 | BOYAmt |
| EOY | $155,453,661 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,913,601 | BOYAmt |
| EOY | $9,776,544 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,165,175 | BOYAmt |
| EOY | $26,224,151 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,399,109 | BOYAmt |
| EOY | $4,829,943 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,477,885 | BOYAmt |
| EOY | $40,830,638 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,452,395 | BOYAmt |
| EOY | $114,565,404 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,648 | BOYAmt |
| EOY | $57,619 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,500,043 | BOYAmt |
| EOY | $114,623,023 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $147,977,928 | BOYAmt |
| EOY | $155,453,661 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $8,754,368 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $966,899 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $401,713 | 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 | $4,792 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,792 | 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 | portion of annual membership dues paid to trade associations allocated to lobbying. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $72,637,761 | BeginningYearBalanceAmt |
| Contributions | $31,767 | ContributionsAmt |
| Investment Earnings Or Losses | $4,623,338 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $21,796 | OtherExpendituresAmt |
| End Year Balance | $77,271,070 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $71,259,202 | BeginningYearBalanceAmt |
| Contributions | $13,867 | ContributionsAmt |
| Investment Earnings Or Losses | $1,377,146 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $12,454 | OtherExpendituresAmt |
| End Year Balance | $72,637,761 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $67,824,756 | BeginningYearBalanceAmt |
| Contributions | $20,859 | ContributionsAmt |
| Investment Earnings Or Losses | $3,451,480 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $37,893 | OtherExpendituresAmt |
| End Year Balance | $71,259,202 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $54,342,520 | BeginningYearBalanceAmt |
| Contributions | $76,357 | ContributionsAmt |
| Investment Earnings Or Losses | $13,478,498 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $72,619 | OtherExpendituresAmt |
| End Year Balance | $67,824,756 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $42,803,442 | BeginningYearBalanceAmt |
| Contributions | $77,247 | ContributionsAmt |
| Investment Earnings Or Losses | $11,574,274 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $112,443 | OtherExpendituresAmt |
| End Year Balance | $54,342,520 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.99930 | BoardDesignatedBalanceEOYPct |
| Term Endowment Balance EOY | 0.00070 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,553,658 | OtherCostOrOtherBasisAmt |
| Book Value | $2,553,658 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $76,529,724 | OtherCostOrOtherBasisAmt |
| Depreciation | $40,405,226 | DepreciationAmt |
| Book Value | $36,124,498 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,023,803 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,959,162 | DepreciationAmt |
| Book Value | $15,064,641 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,378,366 | OtherCostOrOtherBasisAmt |
| Book Value | $5,378,366 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $59,121,163 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Derivative Liability | $1,898,894 |
| Estimated third-party settlement | $2,931,049 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,829,943 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | The assets whose use is limited are assets whose use is limited by internal board designation including cash and cash equivalents, accrued interest receivable, and market securities which are being used for capital improvements, retirement plan, and for debt service payments. Temporarily restricted net assests are the funds whose use has been limited by exteranal sources for a specific time period or purpose which are being used for scholarships and other Hospital programs. |
| Part X, Line 2: | FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 SUPERSEDED BY FASB ACCOUNTING STANDARD CODIFICATION 740-10: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2016 AND 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. |
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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 275.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 275.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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) |
|---|---|---|
| Persons Served | 1461 | PersonsServedCnt |
| Total Community Benefit Expns | $939,532 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,064 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $921,468 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01060 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,388,194 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,407,608 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,980,586 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02270 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1461 | PersonsServedCnt |
| Total Community Benefit Expns | $4,327,726 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,425,672 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,902,054 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03330 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 52 | ActivitiesOrProgramsCnt |
| Persons Served | 84616 | PersonsServedCnt |
| Total Community Benefit Expns | $1,613,104 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $108,357 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,504,747 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01720 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 2585 | PersonsServedCnt |
| Total Community Benefit Expns | $281,666 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $281,666 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 44479 | PersonsServedCnt |
| Total Community Benefit Expns | $2,495,188 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,495,188 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02860 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 232 | PersonsServedCnt |
| Total Community Benefit Expns | $142,908 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $142,908 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 637 | PersonsServedCnt |
| Total Community Benefit Expns | $159,166 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $159,166 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 67 | ActivitiesOrProgramsCnt |
| Persons Served | 132549 | PersonsServedCnt |
| Total Community Benefit Expns | $4,692,032 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $108,357 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,583,675 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05240 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 67 | ActivitiesOrProgramsCnt |
| Persons Served | 134010 | PersonsServedCnt |
| Total Community Benefit Expns | $9,019,758 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,534,029 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,485,729 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08570 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 23 | PersonsServedCnt |
| Total Community Benefit Expns | $14,026 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,026 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 843 | PersonsServedCnt |
| Total Community Benefit Expns | $4,817 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,817 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 24 | PersonsServedCnt |
| Total Community Benefit Expns | $45,912 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $45,912 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 609 | PersonsServedCnt |
| Total Community Benefit Expns | $331,261 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $331,261 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00380 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 1499 | PersonsServedCnt |
| Total Community Benefit Expns | $396,016 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $396,016 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00460 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $7,183,005 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,397,236 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,190,443 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,793,207 | 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 | 0 | 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 | MARGARET MARY HEALTH | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 Mitchell Avenue | AddressLine1Txt |
| City | Batesville | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47006 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.mmhealth.org | WebsiteAddressTxt |
| State License | 17-004718-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARGARET MARY HEALTH | 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 |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 16 | 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 | https://www.mmhealth.org | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.mmhealth.org | StrategyWebsiteURLTxt |
| 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 | 275.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 275.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, Page 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Page 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Page 8 | 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 |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MARGARET MARY HEALTH | Part V, Section B, Line 3j: Healthy People provides science-based, 10-year national objectives for improving the health of all Americans. The Healthy People initiative is grounded in the principle that setting national objectives and monitoring progress can motivate action. For three decades, Healthy People has established benchmarks and monitored progress over time in order to:-Encourage collaborations across sectors.-Guide individuals toward making informed health decisions.-Measure the impact of prevention activities.Healthy People 2020 is the product of an extensive stakeholder feedback process that is unparalleled in government and health. It integrates input from public health and prevention experts, a wide range of federal, state and local government officials, a consortium of more than 2,000 organizations, and perhaps most importantly, the public. More than 8,000 comments were considered in drafting a comprehensive set of Healthy People 2020 objectives. |
| MARGARET MARY HEALTH | Part V, Section B, Line 5: Community input was gathered through focus groups and phone surveys. |
| MARGARET MARY HEALTH | Part V, Section B, Line 7d: The Community Health Needs assessment can be found on the Hospital's redesigned webpage at the bottom under Publication Library <<https://www.mmhealth.org/wellness/publication-library/>> OR at https://www.mmhealth.org/wp-content/uploads/2016-PRC-CHNA-Report-Margaret-Mary-Health-Feb-2017.pdf |
| MARGARET MARY HEALTH | Part V, Section B, Line 11: The 2016 implementation plan 2017-2019 will be addressing 10 needs identified in the 2016 CHNA report. Due to current financial constraints limiting Hospital resources, there are three needs the hospital could not address in the 2013 implementation strategy covering potentially disabling conditions, Alzheimer's disease, and Oral health. Additionally, these three issues are outside the scope of the organization's strategic priorities. |
| MARGARET MARY HEALTH | Part V, Section B, Line 16j: The FAP, FAP application and PLS are available on the hospital's website at the following address:https://www.mmhealth.org/pay-your-bill/charity-care.html |
| MARGARET MARY HEALTH | Part V, Section B, Line 20e: Other reasonable efforts made prior to initiating any ECAs listed in question 19 also include for the Hospital:Offering a plain language summary and application at intake and discharge.Providing a wrtten notice about upcoming ECAs at least 30 days before initating the ECA. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 11 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Outpatient & Cancer Treatment Center | ||||
| 24 Six Pine Ranch Rd | Batesville | IN | 47006 | Outpatient & Cancer Treatment |
| 2 - Rehabilitation Center | ||||
| 206 ST Rd 129 S | Batesville | IN | 47006 | Therapy |
| 3 - Occupational Health Services & Wellness | ||||
| 1051 ST Rd 229 N | Batesville | IN | 47006 | Clinic |
| 4 - Physician Center | ||||
| 26 Six Pine Ranch Rd | Batesville | IN | 47006 | OBGYN/Surgery/Primary Care |
| 5 - Orthopaedic & Specialty Center | ||||
| 256 ST Rd 129 S | Batesville | IN | 47006 | Orthopaedic & Specialty |
| 6 - Home Health & Hospice | ||||
| 108 N Elm St | Batesville | IN | 47006 | Home Health and Hospice |
| 7 - HMR Clinic | ||||
| 121 S Depot St Ste 1 | batesville | IN | 47009 | Clinic |
| 8 - Physician Partners of Osgood | ||||
| 112 N Buckeye ST | Osgood | IN | 47037 | Primary Care |
| 9 - Medical Arts Center | ||||
| 188 State Rd 129 S | Batesville | IN | 47006 | Primary Care |
| 10 - Health Center of Brookville | ||||
| 11137 US 52 | Brookville | IN | 47012 | Primary Care |
| 11 - Professional Center | ||||
| 1033 State Rd 229 N | Batesville | IN | 47006 | Outpatient & Specialty Medicine |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | For Eligibility guidelines A sliding scale is used for discounted care if the patient is over our 275% Federal Poverty Guidelines. |
| Part I, Line 7: | The cost to charge ratio method was used to calculate the Charity Care and Certain Other Community benefits at cost. |
| Part I, Line 7g: | The Organization does not include any cost attributable to a physician clinic in the subsidized health services costs. |
| Part I, Ln 7 Col(f): | Total Bad debt expense of $0 included on Form 990, Part IX, line 25, column (A) has been excluded from the denominator for the percentage calculation per IRS instruction. Effective with the adoption of ASU 2011-07, the standard requires certain healthcare entities to present the provision for bad debt relating to patient service revenue as a deduction from patient service revenue. |
| Part II, Community Building Activities: | MMH supports community building by participating and being an active partner in emergency preparedness. MMH promotes building the future of healthcare by developing mentor and career development programs in the healthcare field. MMH also has a recruitment plan to ensure access to the medical care. |
| Part III, Line 3: | No other bad debt amounts have been included as community benefit. The hospital has a detailed financial assistance policy which states that to participate in charity care, candidates must cooperate fully. In addition, the hospital educates patients with limited ability to pay regarding financial assistance. For this reason, the organization believes it accurately captures all charity care deductions provided according to the financial assistance policy and the amount of bad debt expense attributable to patients eligible under the organization's charity care policy is negligible. |
| Part III, Line 4: | Audited Financial Statement bad debt footnote can be found on page 7 and 8 under the heading Allowance for Uncollectible Accounts. |
| Part III, Line 8: | The source used to determine the amount of Medicare allowable costs reported for Part III, Section B, Medicare has been provided from the Year Ended December 31, 2016 report: Hospital Statement of Reimbursable Cost. |
| Part VI, Line 2: | MMH COMPLETES A COMMUNITY HEALTH ASSESSMENT EVERY 3 YEARS WHICH INCLUDES FOCUS GROUPS WITH LOCAL PARTNERS AND LEADERS. |
| Part VI, Line 3: | MMH informs and educates patients and persons about eligibility for assistance with posted signage in all registration areas and on our website. |
| Part VI, Line 4: | MMH serves a primary and secondary market that includes Ripley, Franklin, and Decatur counties. This is primarily a rural community. |
| Part VI, Line 5: | MMH IS GOVERNED BY A COMMUNITY BOARD. MMcH OPERATES A 24 HOUR EMERGENCY ROOM. MMH COMPLETES A COMMUNITY ASSESSMENT AND A PLAN TO ADDRESS OUR COMMUNITY NEEDS. |
| Part VI, Line 6: | THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.PART VI, LINE 7: STATE COMMUNITY BENEFIT REPORT FILED: INDIANA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARGARET MARY HEALTH FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 Mitchell Ave | AddressLine1Txt |
| City | Batesville | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47006 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 455039355 | RecipientEIN |
| IRC Section | 501c3 | IRCSectionDesc |
| Cash Grant | $256,197 | CashGrantAmt |
| Purpose Of Grant | IN-KIND EXPENSES PAID TO ASSIST THE FOUNDATION. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | Scholarships: Nine Recipients received $1,000 and five received $3,000 | GrantTypeTxt |
| Recipient | 14 | RecipientCnt |
| Cash Grant | $24,000 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | Assistance to Organizations: All grants are provided to 501(c)(3) public charities for general support. Margaret Mary Health does not monitor the use of these funds by these public charities. Current year support was for expenses paid to assist Margaret Mary Health Foundation. Assistance to Individuals: Scholarship applications are reviewed by Senior Managers and a Human Resource representative. Criteria reviewed include GPA, degree pursuing, year they would graduate and the need of MMH. To receive future installments student must maintain minimum 3.0 GPA and provide a copy of transcripts. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIMOTHY PUTNAM | ||||||||||||||
| President | $589,644 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $27,980 | $0 | $625,574 | $0 | $0 | $0 |
| Charles McGovern | ||||||||||||||
| Member/PHYSICIAN | $236,570 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $26,256 | $0 | $270,776 | $0 | $0 | $0 |
| BRIAN DAEGER | ||||||||||||||
| VP Finance | $279,435 | $0 | $0 | $0 | $0 | $0 | $7,726 | $0 | $23,543 | $0 | $310,704 | $0 | $0 | $0 |
| Julie Keene | ||||||||||||||
| VP Physician Services | $194,615 | $0 | $0 | $0 | $0 | $0 | $5,457 | $0 | $25,747 | $0 | $225,819 | $0 | $0 | $0 |
| Bonnie Ploeger | ||||||||||||||
| VP Inpatient Services | $184,446 | $0 | $0 | $0 | $0 | $0 | $5,165 | $0 | $10,670 | $0 | $200,281 | $0 | $0 | $0 |
| nancy marticke | ||||||||||||||
| VP Outpatient Srvs Jan-Sept'16 | $261,600 | $0 | $0 | $0 | $0 | $0 | $7,608 | $0 | $21,726 | $0 | $290,934 | $0 | $0 | $0 |
| Kim Inscho | ||||||||||||||
| VP Human Resources | $229,659 | $0 | $0 | $0 | $0 | $0 | $6,234 | $0 | $21,548 | $0 | $257,441 | $0 | $0 | $0 |
| JEFFREY HATCHER MD | ||||||||||||||
| PHYSICIAN | $554,513 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $31,941 | $0 | $594,404 | $0 | $0 | $0 |
| Paul Jarvis MD | ||||||||||||||
| PhySICIAN | $531,537 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $26,256 | $0 | $565,743 | $0 | $0 | $0 |
| Howard Cooper OD | ||||||||||||||
| PhySICIAN | $510,306 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $26,256 | $0 | $544,512 | $0 | $0 | $0 |
| Jon Geers MD | ||||||||||||||
| PHYSICIAN | $448,860 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $26,610 | $0 | $483,420 | $0 | $0 | $0 |
| Thomas Brown MD | ||||||||||||||
| pHYSICIAN | $428,936 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $29,681 | $0 | $466,567 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| Indiana Health Facility Financing Authority | ||||||||
| A | 351611409 | 454798PAL | 2004-04-01 | $22,000,000 | See Part VI | 0 | 0 | 0 |
| Indiana Health Facility Financing Authority | ||||||||
| B | 351602316 | 2010-12-16 | $16,625,235 | See Part VI | 0 | 0 | 0 | |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $22,000,000 | $264,000 | $21,736,000 | 2004 | 0 | 0 | Yes (1) | Yes (1) | ||
| B | $16,625,235 | $16,625 | $3,162,004 | 2012 | 0 | 0 | Yes (1) | Yes (1) | $8,625,235 | $4,821,371 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Business Name Line2HedgeProviderName/BusinessNameLine2Txt | Term Of HedgeTermOfHedgePct | Superintegrated HedgeSuperintegratedHedgeInd | Hedge TerminatedHedgeTerminatedInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Piper Jaffray | |||||||||||||
| A | 0 | 0 | Yes (1) | 0 | Yes (1) | Yes (1) | Financial Products | 25.000000000000 | 0 | 0 | 0 | 0 | Yes (1) |
| (no name) | |||||||||||||
| B | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) | ||||
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule K, Part I, Column (f), Description of Purpose: | FormAndLineReferenceDesc |
| Explanation | Bond Issue (A): Finance oncology and outpatient centers. Bond Issue (B): Refinance 2008 bonds and finance 28,000 square feed medical office building. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Item C, Doing Business As: | Margaret Mary Health Margaret Mary Health Partners Osgood Primary Care Margaret Mary Health Hospice |
| Form 990, Part VI, Section A, line 6 | The Organization has members. All adult residents of the area served by Margaret Mary Health shall be eligible for membership in the Organization. Any such resident may become a member by payment of the annual membership fee provided for in the By-laws of the Organization. |
| Form 990, Part VI, Section A, line 7a | Each member whose current annual membership has been paid at least ten days in advance of any meeting shall be entitled to one vote at any meeting of the members. The members of the Organization elect the Board of Directors. |
| Form 990, Part VI, Section B, line 11b | The process of reviewing the Form 990 entails a detailed review by the organization's accounting department. The Form 990 is then presented and reviewed with the Finance Committee. Once approved by the Finance Committee, the governing body receives an electronic copy of the Form 990 including requested schedules, as ultimately filed with the IRS, for review and approval prior to filing with the IRS. |
| Form 990, Part VI, Section B, line 12c | THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY KIM INSCHO, MMH CORPORATE COMPLIANCE OFFICER. THE SCOPE OF THIS POLICY INCLUDES ALL BOARD AND FINANCE COMMITTEE MEMBERS, SENIOR MANAGEMENT OF MMH, AND ANY PHYSICIAN WHO HOLDS A MEDICAL DIRECTORSHIP POSITION AT MMH. THE POLICY IS IN PLACE TO IDENTIFY AND APPROPRIATELY DEAL WITH A CONFLICT OF INTEREST SITUATION THAT MAY EXIST. THE COVERED PERSONS ARE TO REFRAIN FROM TRANSACTIONS THAT COULD POTENTIALLY CREATE A CONFLICT OF INTEREST. A SELF DISCLOSURE FROM COVERED PERSONS TO KIM INSCHO, MMH CORPORATE COMPLIANCE OFFICER, IS REQUIRED ON ANY POTENTIAL CONFLICTS OF INTEREST. DEPENDING ON THE TYPE OF CONFLICT OF INTEREST, THE COVERED PERSON WOULD NOT PARTICIPATE IN ANY DELIBERATION OR DECISIONS ON SUCH TRANSACTIONS. THIS WOULD INCLUDE ABSTAINING FROM VOTING ON CERTAIN MATTERS. KIM INSCHO, MMH CORPORATE COMPLIANCE OFFICER, IS RESPONSIBLE FOR REVIEWING AND RESEARCHING THE CONFLICTS DISCLOSED. |
| Form 990, Part VI, Section B, line 15 | The process for determining compensation for the Chief Executive Officer is made by the independent board of directors. The Board thoroughly reviews compensation information and hires outside consultants to advise appropriate salary ranges. The deliberation and decision is documented in the minutes. Other officers or key employees compensation is determined by CEO. |
| Form 990, Part VI, Section C, line 19 | The governing documents, conflict of interest policy, and financial statements are made available to the public upon written request. |
| Form 990, Part IX, line 11g | Contract Labor/Temporary Services: Program service expenses 7,464,006. Management and general expenses 1,779,651. Fundraising expenses 0. Total expenses 9,243,657. Professional Fees - Medical: Program service expenses 1,317,178. Management and general expenses 314,056. Fundraising expenses 0. Total expenses 1,631,234. |
| Form 990, Part XI, line 9: | net unrealized gains/(losses) derivative 401,713. |
| Oversight of Audit | The finance committee of the board of directors assumes responsibility for the oversight of the audit of the financial statements and no processes have changed from the prior year. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARGARET MARY HEALTH FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 Mitchell Ave | AddressLine1Txt |
| City | Batesville | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47006 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 455039355 | EIN |
| Primary Activities | fundraising | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 12a, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Margaret Mary Community Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | 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 |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Margaret Mary Health Foundation | ||
| B | $256,197 | Cost |
| Margaret Mary Health Foundation | ||
| C | $78,187 | Cost |