NORTHWEST MEDICAL CENTER ASSOCIATION INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- NORTHWEST MEDICAL CENTER ASSOCIATION INC (EIN 44-0580870)
- Tax period
- 2014-04-01 to 2015-03-31
- Filed
- 2016-02-16
- IRS object ID
- 201610479349301811
- Schema version
- 2014v6.0
- 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 G
- Schedule H
- Schedule I
- Schedule J
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-02-16T14:57:44-06:00 | ReturnTs |
| Tax Period End | 2015-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 Walnut Suite 1700 | AddressLine1Txt |
| City | Kansas City | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 641062246 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 440580870 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWEST MEDICAL CENTER ASSOCIATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JON DOOLITTLE | InCareOfNm |
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 6607263941 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 705 N COLLEGE ST | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64402 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JON DOOLITTLE | PersonNm |
| Person Title | REGIONAL PRESIDENT | PersonTitleTxt |
| Phone | 6607263941 | PhoneNum |
| Signature | 2016-02-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Michael J Engle | PreparerPersonNm |
| PTIN | P00482834 | PTIN |
| Phone | 8162216300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWEST MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JON DOOLITTLE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 705 N COLLEGE ST | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $17,039,315 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NORTHWESTMEDICALCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1955 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | NORTHWEST MEDICAL CENTER SERVES AS A COMPASSIONATE, EFFICIENT HEALTH HOME THAT ENCOURAGES WELLNESS, RESTORES HEALTH AND PROMOTES A SUPERIOR QUALITY OF LIFE. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 205 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $84,257 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$1,529 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $69,111 | PYContributionsGrantsAmt |
| CY Contributions Grants | $73,661 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $16,735,436 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,504,393 | CYProgramServiceRevenueAmt |
| PY Investment Income | $211,468 | PYInvestmentIncomeAmt |
| CY Investment Income | $87,217 | CYInvestmentIncomeAmt |
| PY Other Revenue | $497,233 | PYOtherRevenueAmt |
| CY Other Revenue | $359,869 | CYOtherRevenueAmt |
| PY Total Revenue | $17,513,248 | PYTotalRevenueAmt |
| CY Total Revenue | $17,025,140 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $15,878 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $7,212,423 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,311,289 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,414,266 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,824,748 | PYOtherExpensesAmt |
| CY Other Expenses | $8,529,107 | CYOtherExpensesAmt |
| PY Total Expenses | $18,151,915 | PYTotalExpensesAmt |
| CY Total Expenses | $26,155,796 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$638,667 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$9,130,656 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,690,097 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,078,840 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,683,717 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $12,125,198 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $14,006,380 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,953,642 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WITH THE HELP OF TRUSTED, INTEGRATED PARTNERS, NORTHWEST MEDICAL CENTER SERVES AS A COMPASSIONATE, EFFICIENT HEALTH HOME THAT ENCOURAGES WELLNESS, RESTORES HEALTH AND PROMOTES A SUPERIOR QUALITY OF LIFE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $4,846,888 | ExpenseAmt |
| Revenue | $3,708,287 | RevenueAmt |
| Desc | INPATIENT HOSPITAL CARE: OUR ACUTE CARE AND SWINGBED PROGRAM SAW A TOTAL OF 2,157 PATIENT DAYS. MEDICARE PATIENT DAYS CONSISTED OF 1,834 DAYS OR 85% OF TOTAL DAYS. MEDICAID PATIENT DAYS WERE 7% OR 152 PATIENT DAYS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,295,309 | ExpenseAmt |
| Revenue | $2,521,195 | RevenueAmt |
| Desc | EMERGENCY SERVICES: TOTAL PATIENTS SEEN IN THE EMERGENCY ROOM WERE 2,563. OF THAT AMOUNT 40% OF REVENUE WAS FROM MEDICARE PATIENTS AND 17% WAS FROM MEDICAID PATIENTS | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $13,539,872 | ExpenseAmt |
| Grant | $7,212,423 | GrantAmt |
| Revenue | $10,359,168 | RevenueAmt |
| Desc | OUTPATIENT SERVICES: THERE WERE 24,105 OUPATIENT VISITS. MEDICARE PATIENTS ACCOUNTED FOR 52.44% AND MEDICAID PATIENTS WERE 10.26% | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $21,682,069 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | Yes (true) | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 72 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 205 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MO | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JON DOOLITTLE | PersonNm |
| Phone | 6607263941 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 705 N COLLEGE | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64402 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 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 |
|---|---|---|---|---|---|---|---|---|
| SERENA NAYLOR | ||||||||
| DIRECTOR/ CHAIR | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOANN GIBBANY | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| KIM FINDLEY | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MARY EWING | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JIM HUMPHREY | ||||||||
| DIRECTOR/ VICE CHAIR | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBERT MILLER | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT SMITH | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MATTHEW PEARL | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DR NASER SOGHRATI | ||||||||
| ER PHYSICIAN | 40.0 | 0.0 | Yes (X) | $277,742 | $0 | $13,181 | ||
| DR ANGELA MARTIN | ||||||||
| FAMILY PRACTICE PHYSICIAN | 40.0 | 0.0 | Yes (X) | $292,121 | $0 | $15,600 | ||
| CRAIG THOMPSON | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL PULIDO | ||||||||
| DIRECTOR/CHAIR | 1.0 | 39.0 | Yes (X) | Yes (X) | $0 | $398,043 | $87,832 | |
| JOHN P WILSON | ||||||||
| DIRECTOR, SECRETARY/TREASURER | 1.0 | 39.0 | Yes (X) | Yes (X) | $0 | $615,593 | $55,886 | |
| CURT KRETZINGER | ||||||||
| DIRECTOR/VICE-CHAIR | 1.0 | 39.0 | Yes (X) | Yes (X) | $0 | $697,482 | $78,576 | |
| S MARK LANEY MD | ||||||||
| DIRECTOR | 1.0 | 39.0 | Yes (X) | $0 | $1,083,762 | $34,032 | ||
| DONNA WALTER | ||||||||
| VP OF PATIENT CARE SERVICES | 40.0 | 0.0 | Yes (X) | $124,032 | $0 | $12,415 | ||
| JAMES CROUCH | ||||||||
| VP OF INFORMATION TECHNOLOGY | 40.0 | 0.0 | Yes (X) | $122,874 | $0 | $12,415 | ||
| JON DOOLITTLE | ||||||||
| PRESIDENT AND CEO | 40.0 | 0.0 | Yes (X) | $203,174 | $0 | $15,600 | ||
| NATHAN BLACKFORD | ||||||||
| COO | 40.0 | 0.0 | Yes (X) | $155,800 | $0 | $15,600 | ||
| BARB AXON | ||||||||
| EXECUTIVE VICE PRESIDENT | 36.0 | 0.0 | Yes (X) | $3,378 | $0 | $292 | ||
| CHRISTINA GILLESPIE | ||||||||
| VP & CFO | 40.0 | 0.0 | Yes (X) | $111,980 | $0 | $15,600 | ||
| JILL CLAIR | ||||||||
| SECRETARY | 40.0 | 0.0 | Yes (X) | $41,491 | $0 | $15,600 | ||
| DR JACKIE MILLER | ||||||||
| FAMILY PRACTICE PHYSICIAN | 40.0 | 0.0 | $433,733 | $0 | $6,945 | Yes (X) | ||
| DR KATIE DIAS | ||||||||
| FAMILY PRACTICE PHYSICIAN | 40.0 | 0.0 | $188,793 | $0 | $12,581 | Yes (X) | ||
| DR ARTURO TENORIO | ||||||||
| FAMILY PRACTICE PHYSICIAN | 40.0 | 0.0 | $275,706 | $0 | $0 | Yes (X) | ||
| JENNA A GIBSON | ||||||||
| PHARMACY DIRECTOR | 40.0 | 0.0 | $123,394 | $0 | $14,155 | Yes (X) | ||
| STACEY L KARNS | ||||||||
| PHYSICIANS ASSISTANT | 40.0 | 0.0 | $110,023 | $0 | $14,155 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,464,241 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,794,880 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $420,465 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| ServicesServicesDesc | CompensationCompensationAmt |
|---|---|
| HAVE A NICE DAY ANESTHESIA | |
| ANESTHESIA SERVICES | $141,795 |
| BKD LLP | |
| ACCOUNTING SERVICES | $121,892 |
| HEARTLAND REGIONAL MEDICAL CENTER | |
| CLINICAL SERVICES | $116,224 |
| WEATHERBY LOCUMS INC | |
| ER PHYSICIANS | $104,905 |
| DOCS WHO CARE | |
| CLINICIANS | $249,038 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $32,744 | FundraisingAmt |
| Government Grants | $39,417 | GovernmentGrantsAmt |
| All Other Contributions | $1,500 | AllOtherContributionsAmt |
| Total Contributions | $73,661 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $15,332,394 | $15,332,394 |
| EHR INCENTIVE PAYMENTS | 621110 | $102,112 | $102,112 |
| 340(B) PHARMACY INCOME | 621990 | $1,069,887 | $1,069,887 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,504,393 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $87,217 | TotalRevenueColumnAmt |
| Exclusion | $87,217 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,567 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,567 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,567 | TotalRevenueColumnAmt |
| Exclusion | $2,567 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $8,320 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $32,744 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $14,175 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$5,855 | TotalRevenueColumnAmt |
| Exclusion | -$5,855 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| CAFETERIA | 811000 | $76,033 | $76,033 | |
| VENDING MACHINE | 900099 | $769 | $769 | |
| MISCELLANEOUS | 900099 | $286,355 | $202,098 | $84,257 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $363,157 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,025,140 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,504,393 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $84,257 | UnrelatedBusinessRevenueAmt |
| Exclusion | $362,829 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,212,423 | TotalAmt |
| Program Services | $7,212,423 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,333,972 | TotalAmt |
| Program Services | $495,852 | ProgramServicesAmt |
| Management And General | $838,120 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,797,379 | TotalAmt |
| Program Services | $5,913,527 | ProgramServicesAmt |
| Management And General | $883,852 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,280 | TotalAmt |
| Program Services | $62,491 | ProgramServicesAmt |
| Management And General | $16,789 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,649,945 | TotalAmt |
| Program Services | $1,168,469 | ProgramServicesAmt |
| Management And General | $481,476 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $553,690 | TotalAmt |
| Program Services | $434,938 | ProgramServicesAmt |
| Management And General | $118,752 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,119 | TotalAmt |
| Management And General | $167,119 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,843 | TotalAmt |
| Management And General | $2,843 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,893,737 | TotalAmt |
| Program Services | $1,037,078 | ProgramServicesAmt |
| Management And General | $856,659 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,471 | TotalAmt |
| Management And General | $26,471 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $806,051 | TotalAmt |
| Program Services | $487,786 | ProgramServicesAmt |
| Management And General | $318,265 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,923 | TotalAmt |
| Program Services | $145,230 | ProgramServicesAmt |
| Management And General | $72,693 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $380,459 | TotalAmt |
| Program Services | $273,533 | ProgramServicesAmt |
| Management And General | $106,926 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,206 | TotalAmt |
| Program Services | $75,985 | ProgramServicesAmt |
| Management And General | $26,221 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,600 | TotalAmt |
| Management And General | $31,600 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $909,702 | TotalAmt |
| Program Services | $719,418 | ProgramServicesAmt |
| Management And General | $190,284 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $283,975 | TotalAmt |
| Program Services | $224,340 | ProgramServicesAmt |
| Management And General | $59,635 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $1,132,790 | $1,132,790 | |
| REPAIRS AND MAINTENANCE | $798,039 | $561,050 | $236,989 |
| EDUCATION | $23,833 | $18,231 | $5,602 |
| MEDICAL SUPPLIES | $1,662,893 | $1,662,893 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,466 | TotalAmt |
| Program Services | $56,035 | ProgramServicesAmt |
| Management And General | $33,431 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,155,796 | TotalAmt |
| Program Services | $21,682,069 | ProgramServicesAmt |
| Management And General | $4,473,727 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,026,436 | BOYAmt |
| EOY | $4,873,379 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,839 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,625,375 | BOYAmt |
| EOY | $1,875,775 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $268,265 | BOYAmt |
| EOY | $183,857 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $276,602 | BOYAmt |
| EOY | $290,873 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,351,619 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $238,355 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,799,063 | BOYAmt |
| EOY | $5,113,264 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,840,394 | BOYAmt |
| EOY | $4,741,692 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,832,123 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,690,097 | BOYAmt |
| EOY | $17,078,840 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,451,773 | BOYAmt |
| EOY | $1,276,942 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,387 | BOYAmt |
| EOY | $14,176 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,213,557 | BOYAmt |
| EOY | $105,387 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $10,728,693 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,683,717 | BOYAmt |
| EOY | $12,125,198 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,021,833 | BOYAmt |
| EOY | $4,820,877 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,851,782 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,765 | BOYAmt |
| EOY | $132,765 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,006,380 | BOYAmt |
| EOY | $4,953,642 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,690,097 | BOYAmt |
| EOY | $17,078,840 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$9,130,656 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $114,909 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$36,991 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (true) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $11,818 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $11,818 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1F | FormAndLineReferenceDesc |
| Explanation | A PORTION OF DUES PAID TO THE MHA AND AHA ARE USED FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $132,765 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $24,556 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $24,556 | OtherExpendituresAmt |
| End Year Balance | $132,765 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $132,765 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $56,276 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $56,276 | OtherExpendituresAmt |
| End Year Balance | $132,765 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $132,765 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $42,003 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $42,003 | OtherExpendituresAmt |
| End Year Balance | $132,765 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $132,765 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $6,077 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $6,077 | OtherExpendituresAmt |
| End Year Balance | $132,765 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $132,765 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $36,702 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $36,702 | OtherExpendituresAmt |
| End Year Balance | $132,765 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Land | LandGrp |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,734,203 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,891 | DepreciationAmt |
| Book Value | $3,727,312 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,413,511 | OtherCostOrOtherBasisAmt |
| Depreciation | $138,483 | DepreciationAmt |
| Book Value | $1,275,028 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $110,924 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $110,924 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,113,264 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO NWMC FOUNDATION | $7,199,288 |
| DUE TO HEARTLAND REG MEDICAL CENTER | $3,529,405 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,728,693 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $15,963,293 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $114,909 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $14,175 | OtherRevenueAmt |
| Revenue Not Reported | $129,084 | RevenueNotReportedAmt |
| Revenue Subtotal | $15,834,209 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,190,931 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,190,931 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $17,025,140 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $17,816,743 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $14,175 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $14,175 | ExpensesNotReportedAmt |
| Expenses Subtotal | $17,802,568 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $8,353,228 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $8,353,228 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $26,155,796 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 | THE ENDOWMENT IS USED FOR ANY AND ALL HOSPITAL EXPENSES OF ANY NATURE. |
| UNCERTAIN TAX POSITIONS DISCLOSURE | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| SCHEDULE D, PART XI, LINES 2D & 4B | LINE 2D: SPECIAL EVENT EXPENSES $ 14,175 LINE 4B: UBI GROSS RECEIPTS $ 21,150 NET ASSETS RELEASED FROM RESTRICTION 36,991 BAD DEBT EXPENSE 1,132,790 ---------- $ 1,190,931 |
| SCHEDULE D, PART XII, LINE 4B | LINE 2D: SPECIAL EVENT EXPENSES $ 14,175 LINE 4B: BAD DEBT EXPENSE $ 1,132,790 UBI GROSS RECEIPTS 21,150 GRANTS TO NWMC FOUNDATION 7,199,288 ---------- TOTAL 8,353,228 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $41,064 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $32,744 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $8,320 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $575 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $560 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $1,840 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $1,843 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $1,000 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $8,357 | OtherDirectExpensesEvent1Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $41,064 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $32,744 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $8,320 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $575 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $560 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $1,840 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $1,843 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $1,000 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $8,357 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $14,175 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$5,855 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 125. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $339,396 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $339,396 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01360 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,032,973 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,878,024 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,154,949 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04620 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,372,369 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,878,024 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,494,345 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05980 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,163 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,050 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,113 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,163 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,050 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,113 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,381,532 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,881,074 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,500,458 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,132,790 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $453,116 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,600,529 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,189,680 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$589,151 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWEST MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 705 NORTH COLLEGE ST | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.NORTHWESTMEDICAL.ORG | WebsiteAddressTxt |
| State License | 98-56 | 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 | NORTHWEST MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (true) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://NORTHWESTMEDICALCENTER.ORG/FILES/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://NORTHWESTMEDICALCENTER.ORG/FILES/5813/ | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 125. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.NORTHWESTMEDICALCENTER.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.NORTHWESTMEDICALCENTER.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | NORTHWESTMEDICALCENTER.ORG | 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 2 | EFFECTIVE DECEMBER 29, 2014, THE MEDICAL CENTER ENTERED INTO AN AFFILIATION AGREEMENT (THE AGREEMENT) WITH HEARTLAND HEALTH (HEARTLAND), A MISSOURI NONPROFIT CORPORATION LOCATED IN ST. JOSEPH, MISSOURI THAT PROVIDES, THROUGH ITS VARIOUS SUBSIDIARIES AND AFFILIATES, AN INTEGRATED HEALTH DELIVERY SYSTEM, INCLUDING PATIENT AND OUTPATIENT CARE AND PHYSICIAN SERVICES TO RESIDENTS OF NORTHWEST MISSOURI AND ADJACENT AREAS IN KANSAS, IOWA AND NEBRASKA. BOTH THE MEDICAL CENTER AND HEARTLAND BELIEVE THE AGREEMENT WILL ENHANCE THE MEDICAL CENTER'S ABILITY TO CONTINUE TO RESPOND TO PATIENT NEEDS AND EXPECTATIONS FOR A HIGH QUALITY, ACCESSIBLE HEALTH SYSTEM. |
| SCHEDULE H, PART V, SECTION B, LINE 5 | NORTHWEST MEDICAL CENTER ESTABLISHED AN INTERNAL COMMUNITY HEALTH NEEDS ASSESSMENT TEAM AND AN EXTERNAL PARTNER COMMITTEE. THE EXTERNAL PARTNERS GROUP WAS COMPRISED OF AREA AGENCY REPRESENTATIVES, INVOLVED COMMUNITY MEMBERS, AND ADDITIONAL ADMINISTRATIVE OFFICIALS. WE UTILIZED RESOURCES AND AREA PARTNERSHIPS TO DEFINE WHAT THE PROCESSES WERE AND DETERMINE THE NECESSARY REQUIREMENTS. NMC ALSO PARTNERED WITH AREA HOSPITALS ST. FRANCIS (SSM HEALTH CARE PROVIDER) AND HEARTLAND HEALTH TO UTILIZE THEIR RESOURCES INCLUDING SPEAKER AND TRAINING OPPORTUNITIES. WE THEN RELAYED ALL LEARNED INFORMATION AND SUGGESTIONS TO NMC STAFF, TEAM MEMBERS, AND ASSESSMENT GROUPS. NMC DEVELOPED A PRIMARY DATA ASSESSMENT THAT INCLUDES A COMPREHENSIVE SURVEY AND FOCUS GROUP INPUT. THE SURVEY CONTENT WAS DIVIDED INTO SECTIONS RELATED TO INDIVIDUAL, FAMILY, AND COMMUNITY NEEDS. EACH SECTION ADDRESSED A SERIES OF FACTORS INCLUDING HEALTH BEHAVIORS, CLINICAL CARE, SOCIAL/ECONOMIC FACTORS, AND PHYSICAL ENVIRONMENT. THE SURVEY WAS RANDOMLY DISTRIBUTED TO 1,000 RESIDENCES IN NMC'S SERVICE AREA. (LOCAL COMPANY, THE PRINTERY DISTRIBUTED THE SURVEYS VIA MAIL.) 226 COMPLETED SURVEYS WERE RETURNED AND ANALYZED, ALONG WITH THE COMPILED SECONDARY DATA. NMC'S FOCUS GROUP MET TO DISCUSS HEALTH RELATED ISSUES THEY FELT IMPACTED THE AREA MOST. REPRESENTATIVES FROM AREA GROUP HOMES, SCHOOL DISTRICTS, HEALTH DEPARTMENT, JOHNSON CONTROLS (A TOP EMPLOYER IN REGION), AND AREA CITIZENS FORMED THE FOCUS GROUP. NMC WAS ABLE TO REACH A BROAD DEMOGRAPHIC TO SOLICIT INPUT FOR THE CHNA. THE SURVEY RESPONSE AND FOCUS GROUPS WERE WELL REPRESENTED. ONE AREA THAT WAS DIFFICULT TO REACH/DISCERN INFORMATION FROM WAS THE LOCAL AMISH COMMUNITIES. WHILE WE WERE ABLE TO DELIVER SURVEY'S TO THE ADDRESSES, IT IS UNCERTAIN IF THEY ADEQUATELY COMPREHENDED THE SURVEY IN ITS ENTIRETY AND RESPONDED APPROPRIATELY. |
| SCHEDULE H, PART V, SECTION B, LINE 11 | NORTHWEST MEDICAL CENTER HAS BEEN HOSTING A WOMEN'S HEALTH EXPO AS WELL AS FOCUSING ON THE IMPORTANCE OF PREVENTATIVE CARE IN OUR MARKETING AND ALSO LOCATIONS. WE HAVE SPONSORED SEVERAL FUN RUNS/RACES AND ARE CURRENTY HOSTING MUFFINS AND MEDICINE WHICH ARE INFORMATIONAL SESSIONS FOR THE COMMUNITY WITH TOPICS ON VARIOUS WELLNESS AND HEALTHY LIFE CHOICES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| NMC CLINIC EAST | ||||
| 1607 EAST HWY 136 | ALBANY | MO | 64402 | PHYSICIAN CLINIC |
| NMC CLINIC WEST | ||||
| 402 EAST HWY 136 | ALBANY | MO | 64402 | PHYSICIAN CLINIC |
| NMC HOME HEALTH AGENCY | ||||
| 1607 EAST HWY 136 | ALBANY | MO | 64402 | HOME HEALTH AGENCY |
| NMC GRANT CITY CLINIC | ||||
| 16 WEST 4TH STREET | GRANT CITY | MO | 64456 | PHYSICIAN CLINIC |
| STANBERRY RURAL HEALTH CLINIC | ||||
| 202 EAST MAIN STREET | STANBERRY | MO | 64489 | RURAL HEALTH CLINIC |
| NMC NEW HAMPTON CLINIC | ||||
| 304 LINCOLN WAY | NEW HAMPTON | MO | 64471 | PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7, COLUMN F | THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES FOR CALCULATING THE NET COMMUNITY BENEFIT EXPENSE PERCENTAGE WAS $1,132,790. |
| SCHEDULE H, PART I, LINE 7 | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO. |
| SCHEDULE H, PART II | NORTHWEST MEDICAL CENTER PROVIDED STAFF TO HELP WITH RENOVATION AND PROGRAM DEVELOPMENT FOR THE SENIOR CENTER. NORTHWEST MEDICAL CENTER CONDUCTED A WOMEN'S HEALTH EXPO TO PROMOTE AWARENESS, PREVENTION AND IMPROVED WELLNESS FOR THE WOMEN IN ITS COVERED AREA. CERTAIN HEALTH SCREENINGS WERE PROVIDED AS PART OF EXPO. OF THE COMMUNITY AROUND US. WE PROVIDE FREE DENTAL CARE TO CHILDREN WHO CANNOT AFFORD DENTAL CARE ON THEIR OWN. WE HAVE ANNUAL HEALTH FAIRS AND SPORTS PHYSICALS AT ALL OUR AREA CLINICS. WE HAVE ALWAYS SUPPORTED LOCAL BUSINESSES AND SCHOOLS AS WELL AS ASSOCIATIONS. |
| SCHEDULE H, PART III, SECTION A, LINE 2 | IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | APPROXIMATELY 40% OF ALL BAD DEBT WOULD QUALIFY FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | SEE PAGE 7-8 OF THE AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | THE MEDICARE ALLOWABLE FAILS TO COVER COST. NON-PAYMENT BY MEDICARE RECIPIENTS FOR THEIR DEDUCTIBLE AND COINSURANCE AMOUNTS INCREASES FINANCIAL ASSISTANCE AND BAD DEBT. THESE SHORTFALLS DECREASE THE ORGANIZATION'S POOL OF ASSETS AND IT'S ABILITY TO SUCCESSFULLY ATTRACT HIGHLY-TRAINED STAFF AND INVEST IN MEDICAL TECHNOLOGY. IF SERVICES ARE TO BE MAINTAINED, THEN THE COSTS WILL HAVE TO BE COVERED BY THOSE WHO PAY. THE BURDEN FALLS ON THE COMMUNITY. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | WE SEND EVERY PATIENT 3 STATEMENTS ALL WITH THE MESSAGE OF FINANCIAL ASSISTANCE. IF NO PAYMENTS ARE RECEIVED, WE SEND A LETTER TO THE PATIENT OFFERING ASSISTANCE AND INFORMING THE PATIENT TO CALL FOR A PAYMENT PLAN OR ASSISTANCE. |
| SCHEDULE H, PART VI, LINE 2 | WE DO OUR NEEDS ASSESSMENT THROUGH OUR BALANCED SCORECARD COMMITTEE. WE LOOK AT WHO WE SERVE AND WHAT WE NEED TO DO DIFFERENTLY TO MAKE SURE WE ARE MEETING THE NEEDS OF OUR COMMUNITY. |
| SCHEDULE H, PART VI, LINE 3 | OUR SOCIAL WORKER/PATIENT ADVOCATE VISITS WITH PATIENTS TO DISCUSS WITH THEM ALL OF THEIR OPTIONS AND HELPS TO FILL OUT PAPERWORK AND FILE IT WITH THE APPROPRIATE AGENCY, IF NECESSARY. WE HAVE A DESIGNATED PERSON IN PATIENT FINANCIAL SERVICES TO HELP SET UP PAYMENTS, PROVIDE CHARITY CARE PACKETS, FOLLOW UP ON MISSING OR INCOMPLETE FORMS AND ANSWER ALL QUESTIONS PERTAINING TO OUR CHARITY CARE POLICY. |
| SCHEDULE H, PART VI, LINE 4 | WE SERVE A THREE COUNTY (GENTRY, WORTH, HARRISON) RURAL AREA THAT HAS A POPULATION OF 18,093 PEOPLE. HARRISON COUNTY DOES HAVE ITS OWN RURAL HOSPITAL SO WE DO NOT TARGET THAT COUNTY. THE MEDIAN INCOME LEVEL FOR THESE COUNTIES IS $28,700 WHICH IS $13,280 LESS THAN THE NATIONAL AVERAGE. |
| SCHEDULE H, PART VI, LINE 5 | WE HAVE A 5 PERSON BOARD OF DIRECTORS. EVERY DECISION WE MAKE IS BASED ON HOW IT EFFECTS THE COMMUNITY. WE GIVE DONATIONS AND CHARITY CARE TO AID IN LOCAL NEEDS. BECAUSE WE ARE A SMALL RURAL HOSPITAL AND ARE ONE OF THE LARGEST EMPLOYERS IN THE AREA, EVERYTHING WE DO EFFECTS THE COMMUNITY AROUND US. WE HAVE ANNUAL HEALTH FAIRS, FLU CLINICS AND SPORT PHYSICALS AT ALL OUR AREA CLINICS. WE ALSO HAVE A LONG HISTORY OF SUPPORTING LOCAL BUSINESSES AND SCHOOLS AS WELL AS ASSOCIATIONS. |
| SCHEDULE H, PART VI, LINE 6 | NORTHWEST MEDICAL CENTER SHALL CONTINUE TO PROVIDE HIGH QUALITY, ACCESSIBLE HEALTH CARE TO PATIENTS IN ITS COVERAGE AREA WITH THE ADDITIONAL RESOURCES AND EFFICIENCIES IT WILL NOW HAVE AS AN AFFILIATE OF HEARTLAND HEALTH. HEARTLAND BRINGS AFFILIATION WITH THE MAYO CLINIC NETWORK, A STRONG SPECIALTY PHYSICIAN COMMUNITY AND OTHER RESOURCES TO NORTHWEST MEDICAL CENTER. |
| SCHEDULE H, PART VI, LINE 7 | MO |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWEST MEDICAL CENTER FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 705 NORTH COLLEGE ST | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 473694893 | RecipientEIN |
| IRC Section | PENDING | IRCSectionDesc |
| Cash Grant | $7,199,288 | CashGrantAmt |
| Purpose Of Grant | OPERATIONS | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE I, PART I, LINE 2 | ALL GRANTS WERE MADE AS PART OF THE AFFILIATION AGREEMENT WITH HEARTLAND HEALTH. AS PART OF THE AGREEMENT THE NORTHWEST MEDICAL CENTER FOUNDATION WAS CREATED AND WAS TO BE TRANSFERRED CERTAIN ASSETS OF NORTHWEST MEDICAL CENTER ASSOCIATION, INC. |
| SCHEDULE I, PART II, LINE 1 | THE NORTHWEST MEDICAL CENTER FOUNDATION FORM 1023 APPLICATION FOR RECOGNITION OR EXEMPTION IS IN PROCESS WITH THE EXPECTATION OF RECEIVING 501(C)(3) STATUS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR NASER SOGHRATI | ||||||||||||||
| ER PHYSICIAN | $257,188 | $0 | $0 | $0 | $20,554 | $0 | $0 | $0 | $13,181 | $0 | $290,923 | $0 | $0 | $0 |
| DR ANGELA MARTIN | ||||||||||||||
| FAMILY PRACTICE PHYSICIAN | $256,565 | $0 | $0 | $0 | $35,556 | $0 | $0 | $0 | $15,600 | $0 | $307,721 | $0 | $0 | $0 |
| JON DOOLITTLE | ||||||||||||||
| PRESIDENT AND CEO | $150,690 | $0 | $37,500 | $0 | $14,984 | $0 | $0 | $0 | $15,600 | $0 | $218,774 | $0 | $0 | $0 |
| NATHAN BLACKFORD | ||||||||||||||
| COO | $121,923 | $0 | $20,000 | $0 | $13,877 | $0 | $0 | $0 | $15,600 | $0 | $171,400 | $0 | $0 | $0 |
| DR JACKIE MILLER | ||||||||||||||
| FAMILY PRACTICE PHYSICIAN | $395,145 | $0 | $0 | $0 | $38,588 | $0 | $0 | $0 | $6,945 | $0 | $440,678 | $0 | $0 | $0 |
| DR KATIE DIAS | ||||||||||||||
| FAMILY PRACTICE PHYSICIAN | $145,312 | $0 | $0 | $0 | $43,481 | $0 | $0 | $0 | $12,581 | $0 | $201,374 | $0 | $0 | $0 |
| DR ARTURO TENORIO | ||||||||||||||
| FAMILY PRACTICE PHYSICIAN | $259,668 | $0 | $0 | $0 | $16,038 | $0 | $0 | $0 | $0 | $0 | $275,706 | $0 | $0 | $0 |
| MICHAEL PULIDO | ||||||||||||||
| DIRECTOR/CHAIR | $0 | $309,778 | $0 | $58,800 | $0 | $29,465 | $0 | $64,531 | $0 | $23,301 | $0 | $485,875 | $0 | $0 |
| JOHN P WILSON | ||||||||||||||
| DIRECTOR, SECRETARY/TREASURER | $0 | $448,500 | $0 | $82,797 | $0 | $84,296 | $0 | $55,886 | $0 | $0 | $0 | $671,479 | $0 | $0 |
| CURT KRETZINGER | ||||||||||||||
| DIRECTOR/VICE-CHAIR | $0 | $478,592 | $0 | $94,710 | $0 | $124,180 | $0 | $70,649 | $0 | $7,927 | $0 | $776,058 | $0 | $0 |
| S MARK LANEY MD | ||||||||||||||
| DIRECTOR | $0 | $762,051 | $0 | $316,825 | $0 | $4,886 | $0 | $10,400 | $0 | $23,632 | $0 | $1,117,794 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | VESTED ACCRUED --------- --------- MICHAEL PULIDO $ 15,252 $ 53,739 JOHN P. WILSON $ 62,660 $ 45,486 CURT KRETZINGER $ 101,255 $ 60,249 THOSE LISTED ABOVE HAVE SIGNED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS WHICH RECOGNIZE THE VALUE OF THE INDIVIDUAL AND THE MUTUAL BENEFIT OF CONTINUED EMPLOYMENT FOR AN EXTENDED PERIOD OF TIME BY ESTABLISHING A 457F PLAN. THE PLAN IS FUNDED YEARLY AS THE RESULT OF A CALCULATION DESCRIBED IN THE AGREEMENT WHICH WILL REWARD THE INDIVIDUALS WITH 100% VESTING AT NORMAL RETIREMENT AGE OR UPON DEATH OR UPON SEPARATION FROM SERVICE DUE TO DISABILITY OR UPON INVOLUNTARY SEPARATION FROM SERVICE WITHOUT CAUSE, WITH LUMP SUM PAYMENT WITHIN 90 DAYS OF EACH SITUATION TAKING INTO CONSIDERATION A NON-COMPETE COVENANT. SEPARATION WITH CAUSE MAKES SUPPLEMENTAL EXECUTIVE RETIREMENT AGREEMENTS NULL AND VOID. | ExplanationTxt |
Schedule N IRS990ScheduleN
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liquidation Of Assets Table | LiquidationOfAssetsTableGrp |
Disposition Of Assets Detail DispositionOfAssetsDetail (15 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| NORTHWEST MEDICAL CENTER FOUNDATION | |||||||||
| HOSPITAL & CLINIC BUILDINGS/IMPROVEMENTS | 2014-12-29 | $3,503,430 | BOOK VALUE | 473694893 | 705 N COLLEGE | ALBANY | MO | 64402 | 1023 IN-PROGRESS |
| NORTHWEST MEDICAL CENTER FOUNDATION | |||||||||
| HOSPITAL & CLINIC LAND | 2014-12-29 | $41,867 | BOOK VALUE | 473694893 | 705 N COLLEGE | ALBANY | MO | 64402 | 1023 IN-PROGRESS |
| NORTHWEST MEDICAL CENTER FOUNDATION | |||||||||
| FIXED EQUIPMENT | 2014-12-29 | $173,936 | BOOK VALUE | 473694893 | 705 N COLLEGE | ALBANY | MO | 64402 | 1023 IN-PROGRESS |
| NORTHWEST MEDICAL CENTER FOUNDATION | |||||||||
| INVESTMENTS | 2014-12-29 | $4,671,340 | BOOK VALUE | 473694893 | 705 N COLLEGE | ALBANY | MO | 64402 | 1023 IN-PROGRESS |
| NORTHWEST MEDICAL CENTER FOUNDATION | |||||||||
| CASH | 2014-12-29 | $1,706,685 | BOOK VALUE | 473694893 | 705 N COLLEGE | ALBANY | MO | 64402 | 1023 IN-PROGRESS |
| NORTHWEST MEDICAL CENTER FOUNDATION | |||||||||
| ACCOUNTS RECEIVABLE (NET) | 2014-12-29 | $1,720,803 | BOOK VALUE | 473694893 | 705 N COLLEGE | ALBANY | MO | 64402 | 1023 IN-PROGRESS |
| NORTHWEST MEDICAL CENTER FOUNDATION | |||||||||
| PREPAID EXPENSES | 2014-12-29 | $146,869 | BOOK VALUE | 473694893 | 705 N COLLEGE | ALBANY | MO | 64402 | 1023 IN-PROGRESS |
| NORTHWEST MEDICAL CENTER FOUNDATION | |||||||||
| ACCOUNTS PAYABLE & OTHER LIAB | 2014-12-29 | -$1,126,211 | BOOK VALUE | 473694893 | 705 N COLLEGE | ALBANY | MO | 64402 | 1023 IN-PROGRESS |
| HEARTLAND HEALTH | |||||||||
| INVENTORY | 2014-12-29 | $264,356 | BOOK VALUE | 431283316 | 5325 FARAON | ST JOSEPH | MO | 64506 | 501 (C) (3) |
| HEARTLAND HEALTH | |||||||||
| PREPAID INSURANCE | 2014-12-29 | $181,573 | BOOK VALUE | 431283316 | 5325 FARAON | ST JOSEPH | MO | 64506 | 501 (C) (3) |
| HEARTLAND HEALTH | |||||||||
| ACCOUNTS RECEIVABLE | 2014-12-29 | $60,827 | BOOK VALUE | 431283316 | 5325 FARAON | ST JOSEPH | MO | 64506 | 501 (C) (3) |
| HEARTLAND HEALTH | |||||||||
| EQUIPMENT AND SOFTWARE | 2014-12-29 | $1,413,511 | BOOK VALUE | 431283316 | 5325 FARAON | ST JOSEPH | MO | 64506 | 501 (C) (3) |
| HEARTLAND HEALTH | |||||||||
| CAPITAL LEASE OBLIGATIONS | 2014-12-29 | -$117,505 | BOOK VALUE | 431283316 | 5325 FARAON | ST JOSEPH | MO | 64506 | 501 (C) (3) |
| HEARTLAND HEALTH | |||||||||
| LEASEHOLD IMPROVEMENTS | 2014-12-29 | $107,951 | BOOK VALUE | 431283316 | 5325 FARAON | ST JOSEPH | MO | 64506 | 501 (C) (3) |
| HEARTLAND HEALTH | |||||||||
| CONSTRUCTION IN PROGRESS | 2014-12-29 | $75,279 | BOOK VALUE | 431283316 | 5325 FARAON | ST JOSEPH | MO | 64506 | 501 (C) (3) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | Yes (true) | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | Yes (true) | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | false | OwnerOfSuccessor2Ind |
| Receive Compensation2 | false | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE N, PART II, LINE 2A | SERENA NAYLOR, JOANN GIBBANY, KIM FINDLEY, MARY EWING, JIM HUMPHREY, ROBERT MILLER, ROBERT SMITH, MATTHEW PEARL, DR. NASER SOGHRATI, DR. ANGELA MARTIN, AND CRAIG THOMPSON BECAME DIRECTORS OF NORTHWEST MEDICAL CENTER FOUNDATION, INC. |
| SCHEDULE N, PART II, LINE 2B | JON D. DOOLITTLE WAS PRESIDENT OF THE FORMER ORGANIZATION AND IS NOW REGIONAL PRESIDENT OF NORTHWEST MEDICAL CENTER ASSOCIATION, INC. NATE BLACKFORD WAS FIRST VICE PRESIDENT AND CHIEF OPERATING OFFICER OF THE FORMER ORGANIZATION AND IS NOW A PROCESS LEADER REGIONAL OPERATIONS FOR NORTHWEST MEDICAL CENTER ASSOCIATION, INC. DONNA WALTER WAS A VICE PRESIDENT FOR THE FORMER ORGANIZATION AND IS NOW A TEAM LEADER QUALITY FOR NORTHWEST MEDICAL CENTER ASSOCIATION, INC. JIM CROUCH WAS A VICE PRESIDENT AND CHIEF INFORMATION OFFICER FOR THE FORMER ORGANIZATION AND IS NOW A TEAM LEADER OF REGIONAL TECHNICAL SERVICES FOR NORTHWEST MEDICAL CENTER ASSOCIATION, INC. CHRISTINA GILLESPIE WAS VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER FOR THE FORMER ORGANIZATION AND BECAME REGIONAL CFO/TEAM LEADER FOR NORTHWEST MEDICAL CENTER ASSOCIATION, INC. MIRANDA FLOYD WAS CHIEF NURSING OFFICER FOR THE FORMER ORGANIZATION AND IS NOW A TEAM LEADER NURSING SERVICES FOR NORTHWEST MEDICAL CENTER ASSOCIATION, INC. JILL CLAIR WAS SECRETARY FOR THE FORMER ORGANIZATION AND IS NOW ASSISTANT TO REGIONAL PRESIDENT FOR NORTHWEST MEDICAL CENTER ASSOCIATION, INC. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | S. MARK LANEY, MD, MICHAEL PULIDO, JOHN P. WILSON, CURT KRETZINGER HAVE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 4 | ON DECEMBER 29, 2014 THE MEDICAL CENTER ENTERED INTO AN AFFILIATION AGREEMENT WITH HEARTLAND HEALTH. AS A RESULT OF THE THIS AGREEMENT THE BY-LAWS WERE AMENDED BY THE BOARD OF DIRECTORS OF NORTHWEST MEDICAL CENTER ASSOCIATION MAKING HEARTLAND HEALTH THE SOLE MEMBER. IN ADDITION, TO THE CHANGE IN MEMBERSHIP THE NUMBER AND COMPOSITION OF THE BOARD OF DIRECTORS WAS CHANGED TO BE ELECTED BY HEARTLAND HEALTH AND INCLUDE ONE PERSON FROM THE RETIRING BOARD OF DIRECTORS OF NORTHWEST MEDICAL CENTER ASSOCIATION. |
| FORM 990, PART VI, SECTION A, LINE 6 | HEARTLAND HEALTH, A MISSOURI NONPROFIT CORPORATION, IS THE SOLE MEMBER OF NORTHWEST MEDICAL CENTER ASSOCIATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | HEARTLAND HELATH BEING THE SOLE MEMBER OF NORTHWEST MEDICAL CENTER ASSOCIATION HAS THE RIGHT TO ELECT ALL THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE MEMBER (HEARTLAND HEALTH) SHALL HAVE THE FOLLOWING POWERS: OVERALL STRATEGIC DIRECTION, NUMBER AND ELECTION OF BOARD MEMBERS, APPOINTMENT OF AUDITORS AND LEGAL COUNSEL, ESTABLISHMENT OF BANKING RELATIONSHIPS AND MANAGEMENT OF CASH AND OTHER ASSETS, APPROVAL OF CHANGES TO THE ARTICLES OF INCORPORATION AND BYLAWS, LONG-RANGE PLANNING, ADOPTION OF ANNUAL OPERATING PLANS AND APPLICATION FOR CERTIFICATES OF NEED. |
| FORM 990, PART VI, SECTION B, LINE 11B | AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990 WITH INFORMATION PROVIDED FROM THE ORGANIZATION'S ACCOUNTING STAFF. THE INDEPENDENT ACCOUNTING FIRM PROVIDES A DRAFT OF THE FORM 990 TO THE ACCOUNTING STAFF OF THE ORGANIZATION FOR REVIEW. THE DRAFT FORM 990 IS REVISED FOR ANY CORRECTIONS OR CLARIFICATIONS BASED ON THE REVIEW BY THE ORGANIZATION'S ACCOUNTING STAFF. AFTER ANY NECESSARY CORRECTIONS OR CLARIFICATIONS ARE MADE TO THE FORM 990 A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO ALL VOTING MEMBERS OF THE BOARD VIA EMAIL PRIOR TO ELECTRONICALLY FILING THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH YEAR OFFICERS AND DIRECTORS READ AND SIGN A CONFLICT OF INTEREST STATEMENT STATING THEY UNDERSTAND WHAT THEY CAN AND CANNOT DO AND HOW THE REPORTING PROCESS IS HANDLED. IF THERE ARE ISSUES, ALL CONLFLICT OF INTEREST ARE REPORTED TO THE CORPORATE COMPLIANCE COMMITTEE FOR INVESTIGATION BY WHICH A RESOLUTION WILL BE SUGESTED TO THE GOVERNING BODY. ANY BOARD MEMBER THAT HAS A CONFLICT OF INTEREST DOES NOT VOTE ON THE ISSUE. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE CEO'S COMPENSATION IS REVIEWED BY THE EXECUTIVE COMMITTEE ON A ANNUAL BASIS. THE EXECUTIVE COMMITTEE COMES UP WITH THE COMPENSATION PLAN AND GIVES THAT PLAN TO THE HUMAN RESOURCES DIRECTOR UPON APPROVAL FROM THE CHAIRMAN OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15B | THE CEO REVIEWS ALL OTHER OFFICER'S COMPENSATION AND SHARES WITH THE HUMAN RESOURCES DIRECTOR ANY CHANGES. |
| 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 REQUEST. ALL OF THESE DOCUMENTS ARE LOCATED IN ADMINISTRATION. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HEARTLAND HEALTH (HH) | ||||||||||
| 5325 FARAON | ST JOSEPH | MO | 64506 | 431283316 | HEALTHCARE | MO | 501(C)(3) | 11A | NA | false |
| HEARTLAND FOUNDATION | ||||||||||
| 5325 FARAON | ST JOSEPH | MO | 64506 | 431262768 | SUPPORT | MO | 501(C)(3) | 7 | HH | Yes (true) |
| HEARTLAND LONG TERM ACUTE CARE HOSPITAL | ||||||||||
| 5325 FARAON | ST JOSEPH | MO | 64506 | 261972987 | HEALTHCARE | MO | 501(C)(3) | 3 | HH | Yes (true) |
| HEARTLAND REGIONAL MEDICAL CENTER | ||||||||||
| 5325 FARAON | ST JOSEPH | MO | 64506 | 440545289 | HEALTHCARE | MO | 501(C)(3) | 3 | HH | Yes (true) |
| HEARTLAND HEALTH CARE PLAN TRUST FUND | ||||||||||
| 5325 FARAON | ST JOSEPH | MO | 64506 | 431286484 | VEBA | MO | 501(C)(9) | HH | Yes (true) | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Controlled OrganizationControlledOrganizationInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MIDWESTERN HEALTH MANAGEMENT INC | ||||||||||||
| 5325 FARAON | ST JOSEPH | MO | 64506 | 431264358 | HEALTHCARE | MO | HH | C CORP | $0 | $0 | Yes (true) | |
| COMMUNITY HEALTH PLAN INSURANCE COMPANY | ||||||||||||
| 5325 FARAON | ST JOSEPH | MO | 64506 | 431210152 | INSURANCE | MO | HH | C CORP | $0 | $0 | Yes (true) | |
| HHS PROPERTIES INC | ||||||||||||
| 5325 FARAON | ST JOSEPH | MO | 64506 | 431593799 | INVESTMENT | MO | HH | C CORP | $0 | $0 | Yes (true) | |
| UPTOWN HOUSING INC | ||||||||||||
| 5325 FARAON | ST JOSEPH | MO | 64506 | 261416252 | REDEVELOPMENT | MO | HH | C CORP | $0 | $0 | Yes (true) | |
| UPTOWN ST JOSEPH REDEVELOPMENT CORP | ||||||||||||
| REDEVELOPMENT | ST JOSEPH | MO | 64506 | 201742813 | REDEVELOPMENT | MO | HH | C CORP | $0 | $0 | Yes (true) | |
| SHOAL CREEK FAMILY MEDICINE & ALLERGY | ||||||||||||
| 5325 FARAON | ST JOSEPH | MO | 64506 | 010754265 | HEALTHCARE | MO | HRMC | S CORP | $0 | $0 | Yes (true) | 0.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEARTLAND REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionTypeTxt |
| Involved | $3,529,405 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |