STRATEGY STUDIO / PUBLIC DATA EXPLORER

MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT FUND: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT FUND (EIN 23-7374256)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-10
IRS object ID
201513149349302511
Schema version
2014v5.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2015-11-10T12:44:28-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN351178661PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line18800 LYRA DRIVE SUITE 450AddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43240ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN237374256EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT FUNDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMCCUBusinessNameControlTxt
Phone5135245310PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 NORTH POPLARAddressLine1Txt
CityOXFORDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45056ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBRYAN HEHEMANNPersonNm
Person TitleCEOPersonTitleTxt
Phone5135245310PhoneNum
Signature2015-11-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNANCY KIRCHNERPreparerPersonNm
PTINP00386751PTIN
Phone6148852583PhoneNum
Preparation2015-11-09PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBRYAN HEHEMANNPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 NORTH POPLAR STREETAddressLine1Txt
CityOXFORDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45056ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,380,739GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MHMH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1942FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTO SUPPORT HEALTH, EDUCATIONAL, AND BUILDING PROGRAMS OF MCCULLOUGH-HYDE MEMORIAL HOSPITALActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$265,525PYContributionsGrantsAmt
CY Contributions Grants$224,452CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$580,076PYInvestmentIncomeAmt
CY Investment Income$1,058,707CYInvestmentIncomeAmt
PY Other Revenue$83,383PYOtherRevenueAmt
CY Other Revenue-$13,285CYOtherRevenueAmt
PY Total Revenue$928,984PYTotalRevenueAmt
CY Total Revenue$1,269,874CYTotalRevenueAmt
PY Grants And Similar Paid$410,379PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$425,838CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$73,166PYOtherExpensesAmt
CY Other Expenses$56,711CYOtherExpensesAmt
PY Total Expenses$483,545PYTotalExpensesAmt
CY Total Expenses$482,549CYTotalExpensesAmt
PY Revenues Less Expenses$445,439PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$787,325CYRevenuesLessExpensesAmt
Total Assets BOY$13,035,000TotalAssetsBOYAmt
Total Assets EOY$11,005,233TotalAssetsEOYAmt
Total Liabilities BOY$2,290,270TotalLiabilitiesBOYAmt
Total Liabilities EOY$144,257TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$10,744,730NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$10,860,976NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSUPPORT THE HOSPITAL WITH HEALTH PROGRAMS, EDUCATION ASSISTANCE, BUILDING AND EQUIPMENT NEEDSMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$173,351ExpenseAmt
Grant$173,351GrantAmt
DescDEVELOPMENT OFFICE SUPPORT:THE TRUST PROVIDES SUPPORT FOR THE HOSPITAL DEVELOPMENT DEPARTMENT THAT ACTS AS A LIASON BETWEEN THE HOSPITAL AND THE DONOR COMMUNITY. EFFORTS OF THIS OFFICE OVER THE YEARS HAS PRODUCED AN ENDOWMENT OF $8.3 MILLION IN UNRESTRICTED CONTRIBUTIONS AND $2.5 MILLION IN DESIGNATED GIFTS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$148,796ExpenseAmt
Grant$148,796GrantAmt
DescSUPPORT FOR BLDG & EQUIPMENT NEEDS:FUNDED ALL OR PART OF 6 EQUIPMENT PURCHASES INCLUDING A CRITICAL CARE BED FOR ICU, BIRTHING BED FOR OB, LAB EQUIPMENT AND PHYSICAL THERAPY EQUIPMENT. IN ADDITION, BUILDING IMPROVEMENTS FOR THE ONCOLOGY PROGRAM WERE SUPPORTED.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$67,323ExpenseAmt
Grant$67,323GrantAmt
DescSUPPORT FOR HEALTH PROGRAMS:PROVIDED SUPPORT FOR NEEDY PATIENTS REQUIRING TRANSPORTATION, ONCOLOGY MEDS AND TEMPORARY ASSISTANCE DURING MEDICAL EMERGENCIES AND SUPPORT FOR THE OXFORD FREE CLINIC.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$36,368ExpenseAmt
Grant$36,368GrantAmt
DescSUPPORT FOR EDUCATIONAL NEEDS:FUNDED HEALTH CAREER SCHOLARSHIPS, EARLY CHILDHOOD DEVELOPMENT, STAFF CONTINUING EDUCATION AND STAFF CAREER DEVELOPMENT PROGRAMS.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$36,368TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$36,368TotalOtherProgSrvcGrantAmt
Total Program Service Expenses$425,838TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised FundYes (1)DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document8IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJAMES MILLER CONTROLLERPersonNm
Phone5135245310PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 NORTH POPLAR STREETAddressLine1Txt
CityOXFORDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45056ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JOHN HARLAN MD
VICE CHAIRMAN1.001.00Yes (X)Yes (X)$0$0$0
ERIKA DARKS
DIRECTOR1.001.00Yes (X)$0$0$0
RICHARD M NORMAN
CHAIRMAN1.001.00Yes (X)Yes (X)$0$0$0
ALAN OAK
SECRETARY-TREASURER1.001.00Yes (X)Yes (X)$0$0$0
STEPHEN FLEE
DIRECTOR1.001.00Yes (X)$0$0$0
SUSAN LIPNICKEY
DIRECTOR1.001.00Yes (X)$0$0$0
THOMAS W SPEH
DIRECTOR1.001.00Yes (X)$0$0$0
RALPH GUTOWSKI
DIRECTOR1.001.00Yes (X)$0$0$0
HILLARY EVANS MD
DIRECTOR1.001.00Yes (X)$0$0$0
JAMES FORMAL
DIRECTOR1.001.00Yes (X)$0$0$0
BRYAN HEHEMANN
PRESIDENT AND CEO40.0040.00Yes (X)$0$213,624$19,295
JOHN CLEMENTS
VICE PRESIDENT AND CFO40.0040.00Yes (X)$0$146,434$8,908
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$360,058TotReportableCompRltdOrgAmt
Total Other Compensation$28,203TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$224,452AllOtherContributionsAmt
Noncash Contributions$51,449NoncashContributionsAmt
Total Contributions$224,452TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$289,540TotalRevenueColumnAmt
Exclusion$289,540ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$97,580RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$110,865RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$13,285RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$13,285TotalRevenueColumnAmt
Exclusion-$13,285ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$769,167SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$769,167SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$769,167TotalRevenueColumnAmt
Exclusion$769,167ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,269,874TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,045,422ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$425,838TotalAmt
Program Services$425,838ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$400TotalAmt
Management And General$400ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$51,127TotalAmt
Management And General$51,127ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,000TotalAmt
Management And General$5,000ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescBANK FEESDesc
Total$184TotalAmt
Management And General$184ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$482,549TotalAmt
Program Services$425,838ProgramServicesAmt
Management And General$56,711ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$859,639BOYAmt
EOY$974,453EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,500BOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$59,091BOYAmt
EOY$17,709EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,086,792LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$553,631LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$565,128BOYAmt
EOY$533,161EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$11,548,642BOYAmt
EOY$9,479,910EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$13,035,000BOYAmt
EOY$11,005,233EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$24,775BOYAmt
EOY$19,796EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,265,495BOYAmt
EOY$124,461EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,290,270BOYAmt
EOY$144,257EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,240,600BOYAmt
EOY$8,332,932EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$460,960BOYAmt
EOY$388,373EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,043,170BOYAmt
EOY$2,139,671EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,744,730BOYAmt
EOY$10,860,976EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,035,000BOYAmt
EOY$11,005,233EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$787,325ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$671,079OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN310650283EIN
Organization Type509(A)(3)(A)OrganizationTypeDesc
Governing Document Listed0GoverningDocumentListedInd
Support$420,313SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$420,313SupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Donor Advised Funds Held10DonorAdvisedFundsHeldCnt
Donor Advised Funds Contri$19,743DonorAdvisedFundsContriAmt
Donor Advised Funds Grants$151,686DonorAdvisedFundsGrantsAmt
Donor Advised Funds Vl EOY$51,701DonorAdvisedFundsVlEOYAmt
Disclosed Org Leg CtrlYes (1)DisclosedOrgLegCtrlInd
Disclosed For Charitable PrpsYes (1)DisclosedForCharitablePrpsInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$11,548,642BeginningYearBalanceAmt
Contributions$184,959ContributionsAmt
Investment Earnings Or Losses$427,284InvestmentEarningsOrLossesAmt
Grants Or Scholarships$164,936GrantsOrScholarshipsAmt
Other Expenditures$2,516,039OtherExpendituresAmt
End Year Balance$9,479,910EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,045,352BeginningYearBalanceAmt
Contributions$384,066ContributionsAmt
Investment Earnings Or Losses$1,270,951InvestmentEarningsOrLossesAmt
Grants Or Scholarships$151,727GrantsOrScholarshipsAmt
End Year Balance$11,548,642EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,014,757BeginningYearBalanceAmt
Contributions$97,325ContributionsAmt
Investment Earnings Or Losses$1,099,844InvestmentEarningsOrLossesAmt
Grants Or Scholarships$166,574GrantsOrScholarshipsAmt
End Year Balance$10,045,352EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,551,600BeginningYearBalanceAmt
Contributions$296,717ContributionsAmt
Investment Earnings Or Losses-$706,525InvestmentEarningsOrLossesAmt
Grants Or Scholarships$127,035GrantsOrScholarshipsAmt
End Year Balance$9,014,757EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$8,626,691BeginningYearBalanceAmt
Contributions$137,514ContributionsAmt
Investment Earnings Or Losses$970,829InvestmentEarningsOrLossesAmt
Grants Or Scholarships$183,434GrantsOrScholarshipsAmt
End Year Balance$9,551,600EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.95900BoardDesignatedBalanceEOYPct
Term Endowment Balance EOY0.04100TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$149,670OtherCostOrOtherBasisAmt
Book Value$149,670BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$876,186OtherCostOrOtherBasisAmt
Depreciation$514,073DepreciationAmt
Book Value$362,113BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$29,955OtherCostOrOtherBasisAmt
Depreciation$18,703DepreciationAmt
Book Value$11,252BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$30,981OtherCostOrOtherBasisAmt
Depreciation$20,855DepreciationAmt
Book Value$10,126BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$533,161TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO RELATED MCCULLOUGH-HYDE MEMORIAL HOSPITALDesc
Amt$124,461Amt
FieldValueIRS element (for citing)
Total Liability$124,461TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:HEALTH EDUCATION, HOSPITAL EQUIPMENT, COMMUNITY HEALTH
PART X, LINE 2:ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE TRUST AND THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THEY HAVE TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2014 AND 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE TRUST AND THE HOSPITAL ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
OXFORD FREE CLINIC
PO BOX 18818FAIRFIELDOH45018204253386501(C)(3)$5,525HEALTH CLINIC
MCCULLOUGH-HYDE MEMORIAL HOSPITAL
110 NORTH POPLAR STREETOXFORDOH45056310650283501(C)(3)$420,313PATIENT SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION HAS REPRESENTATION ON THE BOARD THAT OVERSEES OPERATIONS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
BRYAN HEHEMANN
PRESIDENT AND CEO$0$213,624$0$0$0$0$0$938$0$18,357$0$232,919$0$0
JOHN CLEMENTS
VICE PRESIDENT AND CFO$0$146,434$0$0$0$0$0$938$0$7,970$0$155,342$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINES 4A-BFormAndLineReferenceDesc
ExplanationBRYAN HEHEMANN - LIFE INSURANCE POLICY - PAID UP POLICY AT 65. FACE AMOUNT IS $100K WITH CASH SURRENDER VALUE. THERE IS AN ANNUAL PREMIUM OF $8,874 WITH THE VALUE AT 12/31/14 AT $54,377.ExplanationTxt

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescEQUIPMENTDesc
Contribution1ContributionCnt
Noncash Contributions Rpt F990$51,449NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE 990 IS REVIEWED BY THE CFO AND FINANCE COMMITTEE OF THE BOARD PRIOR TO SUBMISSION. ALL BOARD MEMBERS ARE INVITED ATTEND. THE FINANCE COMMITTEE REVIEWS WITH THE FULL BOARD AT THE NEXT SCHEDULED MEETING.
FORM 990, PART VI, SECTION B, LINE 12CALL MEMBERS OF ADMINISTRATION, DEPARTMENT DIRECTORS, MANAGERS, SUPERVISORS AND OTHER INDIVIDUALS WHO ARE, OR MAY BE, RESPONSIBLE FOR THE DIRECT PURCHASE OF GOODS AND/OR SERVICES ON BEHALF OF THE HOSPITAL SHALL BE REQUIRED TO REVIEW THIS POLICY AND COMPLETE A CONFLICT OF INTEREST FORM FOR SUBMISSION TO THE CORPORATE COMPLIANCE OFFICER ANNUALLY. WHEN A CONFLICT OF INTEREST ARISES OR A POTENTIAL CONFLICT OF INTEREST DEVELOPS, THE PERSON WHO IS OR MAY BE IN A CONFLICT OF INTEREST SITUATION IS REQUIRED TO MAKE A FULL WRITTEN DISCLOSURE OF THE SITUATION OR POTENTIAL SITUATION BY COMPLETING AND SIGNING A CONFLICT OF INTEREST QUESTIONNAIRE AND RETURNING IT TO HIS/HER DEPARTMENT DIRECTOR AND/OR APPROPRIATE ADMINISTRATOR, WHO WILL FORWARD THE CONFLICT OF INTEREST FORM TO THE CORPORATE COMPLIANCE OFFICER FOR REVIEW AND APPROPRIATE ACTION. THE CORPORATE COMPLIANCE COMMITTEE SHALL CONDUCT A FULL REVIEW AND ASSESSMENT OF THE POTENTIAL CONFLICT AND WILL PROVIDE ONE OF THE FOLLOWING WRITTEN RECOMMENDATIONS/CONCLUSIONS: 1. THE CIRCUMSTANCES REPORTED DO NOT PRESENT A PROBLEM. 2. ALTERNATE ARRANGEMENTS MADE BY/WITH THE EMPLOYEE ARE ACCEPTABLE AND PRESENT NO PROBLEM. 3. ALTERNATE ARRANGEMENTS ARE NOT ACCEPTABLE AND THE CONFLICT WILL BE DEALT WITH ON AN INDIVIDUAL BASIS.
FORM 990, PART VI, SECTION C, LINE 19THE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:CHANGE IN TEMPORARILY RESTRICTED NET ASSETS -72,587. CHANGE IN PERMANENTLY RESTRICTED NET ASSETS 96,501. NET UNREALIZED LOSSED ON INVESTMENTS -694,993.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 N POPLAR STREETAddressLine1Txt
CityOXFORDCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45056ZIPCd
FieldValueIRS element (for citing)
EIN310650283EIN
Primary ActivitiesHOSPITALPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 3PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT TRUSTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
MCCULLOUGH HYDE MEMORIAL HOSPITAL
B$136,175COST
MCCULLOUGH HYDE MEMORIAL HOSPITAL
P$284,138COST