NORTHWEST MEDICAL CENTER ASSOCIATION INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- NORTHWEST MEDICAL CENTER ASSOCIATION INC (EIN 44-0580870)
- Tax period
- 2013-04-01 to 2014-03-31
- Filed
- 2015-02-16
- IRS object ID
- 201510479349300546
- Schema version
- 2013v4.0
- 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 O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-02-16T10:33:29-06:00 | ReturnTs |
| Tax Period End | 2014-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 Walnut Suite 1700 | AddressLine1 |
| City | Kansas City | City |
| State | MO | State |
| ZIP Code | 641062246 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-04-01 | 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 | BusinessNameLine1 |
| 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 NORTH COLLEGE ST | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | ALBANY | City |
| State | MO | State |
| ZIP Code | 64402 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JON DOOLITTLE | PersonNm |
| Person Title | PRESIDENT AND CEO | PersonTitleTxt |
| Phone | 6607263941 | PhoneNum |
| Signature | 2015-02-17 | 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 | 6607263941 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWEST MEDICAL CENTER | BusinessNameLine1 |
| 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 | AddressLine1 |
| City | ALBANY | City |
| State | MO | State |
| ZIP Code | 64402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $17,525,841 | 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 |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 210 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $88,657 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $4,843 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $12,720 | PYContributionsGrantsAmt |
| CY Contributions Grants | $69,111 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,543,335 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,735,436 | CYProgramServiceRevenueAmt |
| PY Investment Income | $201,083 | PYInvestmentIncomeAmt |
| CY Investment Income | $211,468 | CYInvestmentIncomeAmt |
| PY Other Revenue | $331,261 | PYOtherRevenueAmt |
| CY Other Revenue | $497,233 | CYOtherRevenueAmt |
| PY Total Revenue | $16,088,399 | PYTotalRevenueAmt |
| CY Total Revenue | $17,513,248 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $17,457 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $15,878 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,315,519 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,311,289 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,194,377 | PYOtherExpensesAmt |
| CY Other Expenses | $7,824,748 | CYOtherExpensesAmt |
| PY Total Expenses | $16,527,353 | PYTotalExpensesAmt |
| CY Total Expenses | $18,151,915 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$438,954 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$638,667 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,450,290 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,690,097 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,991,872 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,683,717 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $14,458,418 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,006,380 | 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 | $3,262,283 | ExpenseAmt |
| Grant | $15,828 | GrantAmt |
| Revenue | $3,991,356 | RevenueAmt |
| Desc | INPATIENT HOSPITAL CARE- OUR ACUTE CARE AND SWINGBED PROGRAM SAW A TOTAL OF 2,070 PATIENT DAYS. MEDICARE PATIENT DAYS CONSISTED OF 1,790 DAYS OF 87%. MEDICAID PATIENT DAYS WERE 72 DAYS OR 4%. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,078,041 | ExpenseAmt |
| Revenue | $2,542,453 | RevenueAmt |
| Desc | EMERGENCY SERVICES - TOTAL PATIENTS SEEN IN THE EMERGENCY ROOM WERE 2,842. OF THAT AMOUNT 26% OF PATIENTS SEEN WERE MEDICARE PATIENTS AND 28% WERE MEDICAID. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,410,630 | ExpenseAmt |
| Revenue | $10,290,284 | RevenueAmt |
| Desc | OUTPATIENT SERVICES - THERE WERE 20,529 OUTPATIENT VISITS. MEDICARE PATIENTS ACCOUNTED FOR 55.4% AND MEDICAID PATIENTS WERE 11%. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $13,750,954 | 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 | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | 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 | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 56 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 210 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | 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 | AddressLine1 |
| City | ALBANY | City |
| State | MO | State |
| ZIP Code | 64402 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt |
|---|---|---|---|---|---|---|---|---|
| SERENA NAYLOR | ||||||||
| DIRECTOR/ CHAIR | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOANN GIBBANY | ||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| KIM FINDLEY | ||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| MARY EWING | ||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| NORMA HILL | ||||||||
| DIRECTOR - RESIGNED AUG 13 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| JIM HUMPHREY | ||||||||
| DIRECTOR/ VICE CHAIR | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ROBERT MILLER | ||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT SMITH | ||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| MATTHEW PEARL | ||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| DR NASER SOGHRATI | ||||||||
| ER PHYSICIAN | 75.0 | Yes (X) | $319,399 | $0 | $1,404 | |||
| DR ANGELA MARTIN | ||||||||
| FAMILY PRACTICE PHYSICIAN | 40.0 | Yes (X) | $241,566 | $0 | $21,097 | |||
| CRAIG THOMPSON | ||||||||
| DIRECTOR | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| DONNA WALTER | ||||||||
| VP OF PATIENT CARE SERVICES | 40.0 | Yes (X) | $107,187 | $0 | $20,326 | |||
| JAMES CROUCH | ||||||||
| VP OF INFORMATION TECHNOLOGY | 40.0 | Yes (X) | $93,694 | $0 | $17,098 | |||
| JON DOOLITTLE | ||||||||
| PRESIDENT AND CEO | 40.0 | Yes (X) | $206,429 | $0 | $20,403 | |||
| NATHAN BLACKFORD | ||||||||
| COO | 40.0 | Yes (X) | $117,066 | $0 | $17,926 | |||
| BARB AXON | ||||||||
| EXECUTIVE VICE PRESIDENT | 36.0 | Yes (X) | $112,129 | $0 | $10,256 | |||
| CHRISTINA GILLESPIE | ||||||||
| VP & CFO | 40.0 | Yes (X) | $21,067 | $0 | $8,633 | |||
| DR JACKIE MILLER | ||||||||
| FAMILY PRACTICE PHYSICIAN | 40.0 | $372,199 | $0 | $8,727 | Yes (X) | |||
| DR KATIE DIAS | ||||||||
| FAMILY PRACTICE PHYSICIAN | 40.0 | $129,489 | $0 | $14,417 | Yes (X) | |||
| DR ARTURO TENORIO | ||||||||
| FAMILY PRACTICE PHYSICIAN | 40.0 | $133,726 | $0 | $353 | Yes (X) | 40.0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,853,951 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $140,640 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| ServicesServicesDesc | CompensationCompensationAmt |
|---|---|
| HAVE A NICE DAY ANESTHESIA | |
| ANESTHESIA SERVICES | $133,020 |
| BKD LLP | |
| ACCOUNTING SERVICES | $120,868 |
| HEARTLAND HEALTH | |
| CLINICAL SERVICES | $314,425 |
| WEATHERBY LOCUMS INC | |
| ER PHYSICIANS | $219,989 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $12,000 | FundraisingAmt |
| Government Grants | $51,895 | GovernmentGrantsAmt |
| All Other Contributions | $5,216 | AllOtherContributionsAmt |
| Total Contributions | $69,111 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $15,734,900 | $15,734,900 |
| EHR INCENTIVE PAYMENTS | 621110 | $1,000,536 | $1,000,536 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,735,436 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $211,448 | TotalRevenueColumnAmt |
| Exclusion | $211,448 | 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 | $4,200 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $4,200 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,200 | TotalRevenueColumnAmt |
| Exclusion | $4,200 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $20 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $20 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20 | TotalRevenueColumnAmt |
| Exclusion | $20 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $26,898 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $12,000 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $12,593 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,305 | TotalRevenueColumnAmt |
| Exclusion | $14,305 | 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 | $79,005 | $79,005 | |
| VENDING MACHINE | 900099 | $566 | $566 | |
| All Other Misc Revenue | 900099 | $399,157 | $310,500 | $88,657 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $399,157 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $88,657 | UnrelatedBusinessRevenueAmt |
| Exclusion | $310,500 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $478,728 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,513,248 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,735,436 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $88,657 | UnrelatedBusinessRevenueAmt |
| Exclusion | $620,044 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,828 | TotalAmt |
| Program Services | $15,828 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50 | TotalAmt |
| Program Services | $50 | ProgramServicesAmt |
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 | $1,466,547 | TotalAmt |
| Program Services | $602,967 | ProgramServicesAmt |
| Management And General | $863,580 | 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 | $6,526,834 | TotalAmt |
| Program Services | $5,658,279 | ProgramServicesAmt |
| Management And General | $868,555 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,785,648 | TotalAmt |
| Program Services | $1,249,068 | ProgramServicesAmt |
| Management And General | $536,580 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $532,260 | TotalAmt |
| Program Services | $416,482 | ProgramServicesAmt |
| Management And General | $115,778 | 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 | $133,580 | TotalAmt |
| Management And General | $133,580 | 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 | $2,302 | TotalAmt |
| Management And General | $2,302 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,517,835 | TotalAmt |
| Program Services | $748,926 | ProgramServicesAmt |
| Management And General | $768,909 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,740 | TotalAmt |
| Program Services | $146 | ProgramServicesAmt |
| Management And General | $24,594 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $928,430 | TotalAmt |
| Program Services | $579,415 | ProgramServicesAmt |
| Management And General | $349,015 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,124 | TotalAmt |
| Program Services | $122,608 | ProgramServicesAmt |
| Management And General | $75,516 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $316,945 | TotalAmt |
| Program Services | $249,505 | ProgramServicesAmt |
| Management And General | $67,440 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,632 | TotalAmt |
| Program Services | $90,401 | ProgramServicesAmt |
| Management And General | $27,231 | 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 | $59,131 | TotalAmt |
| Management And General | $59,131 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $829,605 | TotalAmt |
| Program Services | $656,225 | ProgramServicesAmt |
| Management And General | $173,380 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,553 | TotalAmt |
| Program Services | $162,387 | ProgramServicesAmt |
| Management And General | $43,166 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $1,455,865 | $1,455,865 | |
| REPAIRS AND MAINTENANCE | $832,085 | $582,733 | $249,352 |
| EDUCATION | $30,288 | $20,025 | $10,263 |
| MEDICAL SUPPLIES | $1,050,954 | $1,050,940 | $14 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,679 | TotalAmt |
| Program Services | $89,104 | ProgramServicesAmt |
| Management And General | $32,575 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,151,915 | TotalAmt |
| Program Services | $13,750,954 | ProgramServicesAmt |
| Management And General | $4,400,961 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $797,659 | BOYAmt |
| EOY | $1,026,436 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,823 | BOYAmt |
| EOY | $21,839 | 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 | $3,457,808 | BOYAmt |
| EOY | $2,625,375 | 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 | $292,427 | BOYAmt |
| EOY | $268,265 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $223,392 | BOYAmt |
| EOY | $276,602 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,704,804 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,905,741 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,165,703 | BOYAmt |
| EOY | $5,799,063 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,031,519 | BOYAmt |
| EOY | $1,840,394 | 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 | $4,459,959 | BOYAmt |
| EOY | $4,832,123 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,450,290 | BOYAmt |
| EOY | $16,690,097 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,432,065 | BOYAmt |
| EOY | $1,451,773 | 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 | $21,333 | BOYAmt |
| EOY | $18,387 | 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 | $1,538,474 | BOYAmt |
| EOY | $1,213,557 | 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 | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,991,872 | BOYAmt |
| EOY | $2,683,717 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,613,997 | BOYAmt |
| EOY | $10,021,833 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,711,656 | BOYAmt |
| EOY | $3,851,782 | 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 | $14,458,418 | BOYAmt |
| EOY | $14,006,380 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,450,290 | BOYAmt |
| EOY | $16,690,097 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$638,667 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $46,503 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $140,126 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 | $8,066 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $8,066 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
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 | $56,276 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $56,276 | 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 | $42,003 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $42,003 | 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 | $6,077 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $6,077 | 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 | $36,702 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $36,702 | 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 | $14,604 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $14,604 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $41,867 | OtherCostOrOtherBasisAmt |
| Book Value | $41,867 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,619,459 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,993,106 | DepreciationAmt |
| Book Value | $3,626,353 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $137,810 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,187 | DepreciationAmt |
| Book Value | $128,623 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,473,859 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,715,252 | DepreciationAmt |
| Book Value | $1,758,607 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $431,809 | OtherCostOrOtherBasisAmt |
| Depreciation | $188,196 | DepreciationAmt |
| Book Value | $243,613 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,799,063 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER ASSETS | $123,165 |
| INTEREST RECEIVABLE | $111,341 |
| INTEREST IN TRUST ASSETS | $3,851,782 |
| Due from Third Party Payers | $745,835 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,832,123 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $15,931,780 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $46,503 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $12,593 | OtherRevenueAmt |
| Revenue Not Reported | $59,096 | RevenueNotReportedAmt |
| Revenue Subtotal | $15,872,684 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,640,564 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,640,564 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $17,513,248 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $16,680,443 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $12,593 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $12,593 | ExpensesNotReportedAmt |
| Expenses Subtotal | $16,667,850 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,484,065 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,484,065 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $18,151,915 | 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. |
| SCHEDULE D, PART X, LINE 2 | 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 $ 12,593 LINE 4B: UBI GROSS RECEIPTS $ 28,200 NET ASSETS RELEASED FROM RESTRICTION 156,499 BAD DEBT EXPENSE 1,455,865 ---------- $ 1,640,564 |
| SCHEDULE D, PART XII, LINE 4B | LINE 2D: SPECIAL EVENT EXPENSES $ 12,593 LINE 4B: BAD DEBT EXPENSE $ 1,455,865 UBI GROSS RECEIPTS 28,200 ----------- TOTAL 1,484,065 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1Amt |
| Gross Receipts Event1 | $38,898 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $12,000 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $26,898 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $340 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $250 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $1,780 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $1,690 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $400 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $8,133 | OtherDirectExpensesEvent1Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $38,898 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $12,000 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $26,898 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $340 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $250 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $1,780 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $1,690 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $400 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $8,133 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $12,593 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $14,305 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| 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 | $1,090,371 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $950,864 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $139,507 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00840 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,148,026 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,497,011 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $651,015 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03900 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,238,397 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,447,875 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $790,522 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04740 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,122 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30,641 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$2,519 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,912 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,912 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,878 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $69,912 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30,641 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $39,271 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,308,309 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,478,516 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $829,793 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04980 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,878 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $15,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,878 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $15,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,455,865 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $582,346 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,824,090 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,167,923 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$343,833 | 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 | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 705 NORTH COLLEGE ST | AddressLine1 |
| City | ALBANY | City |
| State | MO | State |
| ZIP Code | 64402 | ZIPCode |
| 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 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://northwestmedicalcenter.org/files/ | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 125. | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200. | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| 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 |
| 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, LINE 3 | SURVEYS WERE SENT TO A RANDOM SAMPLE OF 1000 FROM THE COMMUNITIES WE SERVE. |
| SCHEDULE H, PART V, LINE 5A | BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN CAN BE FOUND AT: http://northwestmedicalcenter.org/files/7013/6752/7627/Community_Health_Ne eds_Assessment.pdf |
| SCHEDULE H, PART V, LINE 7 | Several goals have been partially achieved. We did not partner with 3 area employers to develop "Employee Wellness Plans", Our increase in colonscopies, wellness visits and mammographies have not reached 10%. All deficiencies can be traced to lack of funding and staffing. |
| 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/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | 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 (12 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 $1,455,865. |
| 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 | WE HAVE A BOARD OF DIRECTORS THAT IS MADE UP OF 9 VOLUNTEERS OF THE COMMUNITY AND 2 PHYSICIANS. 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 BUILDING OF THE COMMUNITY AROUND US. |
| SCHEDULE H, PART III, LINE 3 | THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE IS ESTIMATED AT 40% OF BAD DEBT EXPENSE BASED ON HISTRORICAL DATA. |
| SCHEDULE H, PART III, LINE 4 | ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. OUR BAD DEBT IS FIGURED ON THE ALLOWANCE METHOD, THEREFORE, ANYTHING OUTSTANDING IN THE AGING BUCKETS WOULD BE INCLUDED IN THE ALLOWANCE CALCULATION. THIS ALSO MEANS THAT THERE WILL BE PEOPLE WHO ARE CURRENTLY IN THE PROCESS OF SUBMITTING CHARITY CARE PAPERWORK THAT ARE INCLUDED IN THE BAD DEBT NUMBER. |
| SCHEDULE H, PART III, LINE 8 | SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. |
| SCHEDULE H, PART III, LINE 9B | IF THE PATIENT QUALIFIES FOR CHARITY CARE, THEN WE WRITE OFF THEIR BILL TO CHARITY CARE. THOSE PATIENTS NO LONGER OWE THE HOSPITAL WHAT IS OWED FOR THOSE PATIENT VISITS. |
| 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 PERSONALLY VISITS WITH PATIENTS TO DISCUSS WITH THEM ALL OF THEIR OPTIONS AND WILL HELP IN ANY WAY TO FILL OUT PAPERWORK AND FILE IT WITH THE APPROPRIATE AGENCY, IF NECESSARY. WE HAVE A DESIGNATED PERSON IN FINANCIAL PATIENT SERVICES TO HELP IN SETTING UP PAYMENTS, GIVING OUT CHARITY CARE PACKETS, FOLLOWING UP ON MISSING OR INCOMPLETE FORMS, AND TO 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 IS MADE UP OF 18,093 PEOPLE. HARRISON COUNTY DOES HAVE ITS OWN RURAL HOSPITAL SO THAT IS NOT OUR TARGET COUNTY ALTHOUGH WE DO SEE SOME PATIENTS FROM THERE. 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 11 MEMBER BOARD OF DIRECTORS THAT IS MADE UP OF 9 VOLUNTEERS OF THE COMMUNITY AS WELL AS 2 PHYSICIANS. 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 BUILDING 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 VI, LINE 7 | MISSOURI |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | THE RECIPIENTS OF THE GRANTS REQUEST AN EXACT AMOUNT OF FUNDS THAT IS SUPPORTED BY DOCUMENTATION THEY PROVIDE THE HOSPITAL. | ExplanationTxt |
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 | false | 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 (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR NASER SOGHRATI | ||||||||||||
| ER PHYSICIAN | $316,799 | $0 | $2,600 | $0 | $0 | $0 | $0 | $0 | $1,404 | $0 | $320,803 | $0 |
| DR ANGELA MARTIN | ||||||||||||
| FAMILY PRACTICE PHYSICIAN | $241,366 | $0 | $200 | $0 | $0 | $0 | $0 | $0 | $21,097 | $0 | $262,663 | $0 |
| JON DOOLITTLE | ||||||||||||
| PRESIDENT AND CEO | $143,729 | $0 | $62,700 | $0 | $0 | $0 | $0 | $0 | $20,403 | $0 | $226,832 | $0 |
| DR JACKIE MILLER | ||||||||||||
| FAMILY PRACTICE PHYSICIAN | $371,999 | $0 | $200 | $0 | $0 | $0 | $0 | $0 | $8,727 | $0 | $380,926 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | NMC OPENED AN ADDITIONAL RURAL HEALTH CLINIC IN NEW HAMPTON, MO TO BETTER SERVE THE COMMUNITY. |
| FORM 990, PART VI, SECTION A, LINES 7A AND 7B | LINE 7A: OUR HOSPITAL HAS MEMBERS OF THE HOSPITALS ASSOCIATION THAT VOTE ON THE BOARD MEMBERS EVERY YEAR IN AUGUST. THEY ARE NOT PAID AND ARE PEOPLE FROM THE COMMUNITY WHO PAY $10 PER PERSON (WHICH IS USED AS A DONATION) THAT WILL VOTE ON THE NOMINATED BOARD MEMBERS THAT WERE PICKED BY THE NOMINATIONS COMMITTEE WHICH IS MADE UP OF CURRENT BOARD MEMBERS. LINE 7B: THE VOTE BY THE ASSOCIATION ON THE NOMINATIONS FOR NEW BOARD MEMBERS BY THE NOMINATIONS COMMITTEE IS THE ONLY DECISION SUBJECT TO APPROVAL BY MEMBERS, STOCKHOLDERS, OR OTHER PERSONS. |
| FORM 990, PART VI, SECTION B, LINE 11B | WE DISTRIBUTE THE 990 VIA EMAIL TO THE BOARD MEMBERS. THEY REVIEW IT AND RELAY ANY ISSUES OR QUESTIONS. THE CEO AND CFO BOTH REVIEW IT AS WELL. IF THERE ARE ANY CORRECTIONS, THE PREPARING COMPANY IS NOTIFIED. UPON ALL AGREEMENT, THE 990 IS APPROVED FOR SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | EVERY YEAR ALL OFFICERS AND BOARD MEMBERS HAVE TO 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 CONFLICTS OF INTEREST ARE REPORTED THROUGH THE CORPORATE COMPLIANCE COMMITTEE FOR INVESTIGATION BY WHICH A RESOLUTION WILL BE SUGGESTED 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, LINES 15A & 15B | LINE 15A: THE CEO'S COMPENSATION IS REVIEWED BY THE EXECUTIVE COMMITTEE ON A YEARLY 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. 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, LINES 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. |
| FORM 990, PART XI, LINE 5 | NET GAIN ON INTEREST IN TRUST ASSETS $ 296,625 NET ASSETS RELEASED FROM RESTRICTION $ (156,499) ------------ $ 140,126 |