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WINSTON COUNTY MEDICAL FOUNDATION: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
WINSTON COUNTY MEDICAL FOUNDATION (EIN 64-6010402)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-08-07
IRS object ID
201522199349301002
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)
Return2015-08-07T10:12:48-05:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN640394922PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WATKINS WARD AND STAFFORD PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 311AddressLine1Txt
CityEUPORACityNm
State AbbreviationMSStateAbbreviationCd
ZIP39744ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN646010402EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WINSTON COUNTY MEDICAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlWINSBusinessNameControlTxt
Phone6627736211PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 967AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationMSStateAbbreviationCd
ZIP39339ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPAUL BLACKPersonNm
Person TitleCEOPersonTitleTxt
Phone6627736211PhoneNum
Signature2015-08-05SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTHOMAS BROWDER CPAPreparerPersonNm
PTINP00444647PTIN
Phone6622582331PhoneNum
Preparation2015-08-06PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1WINSTON MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerPAUL BLACKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 967AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationMSStateAbbreviationCd
ZIP39339ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$39,973,082GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.WINSTONMEDICAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateMSLegalDomicileStateCd
Activity Or MissionTO PROVIDE HEALTH CARE TO THE RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND THE SURROUNDING AREASActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee269TotalEmployeeCnt
Total Volunteers15TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$10,000PYContributionsGrantsAmt
CY Contributions Grants$29,596CYContributionsGrantsAmt
PY Program Service Revenue$21,238,657PYProgramServiceRevenueAmt
CY Program Service Revenue$11,783,579CYProgramServiceRevenueAmt
PY Investment Income$112,404PYInvestmentIncomeAmt
CY Investment Income$116,659CYInvestmentIncomeAmt
PY Other Revenue$219,411PYOtherRevenueAmt
CY Other Revenue$28,043,248CYOtherRevenueAmt
PY Total Revenue$21,580,472PYTotalRevenueAmt
CY Total Revenue$39,973,082CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,575,350PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,538,337CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$13,403,269PYOtherExpensesAmt
CY Other Expenses$9,612,055CYOtherExpensesAmt
PY Total Expenses$21,978,619PYTotalExpensesAmt
CY Total Expenses$17,150,392CYTotalExpensesAmt
PY Revenues Less Expenses-$398,147PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$22,822,690CYRevenuesLessExpensesAmt
Total Assets BOY$18,030,092TotalAssetsBOYAmt
Total Assets EOY$37,495,828TotalAssetsEOYAmt
Total Liabilities BOY$4,917,877TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,560,924TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$13,112,215NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$35,934,904NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HEALTH CARE TO THE RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND THE SURROUNDING AREASMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$16,018,508ExpenseAmt
DescWINSTON COUNTY MEDICAL FOUNDATION D/B/A WINSTON MEDICAL CENTER PROVIDES HEALTH CARE SERVICES TO THE RESIDENTS OF WINSTON COUNTY, MISSISSIPPI AND SURROUNDING AREAS INCLUDING PERSONS UNABLE TO PAY FOR REQUIRED SERVICES.Desc
Total Program Service Expenses$16,018,508TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document31IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee269EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WINSTON COUNTY MEDICAL FOUNDATIONBusinessNameLine1Txt
Business Name Line2DBA WINSTON MEDICAL CENTERBusinessNameLine2Txt
FieldValueIRS element (for citing)
Phone6627736211PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 967AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationMSStateAbbreviationCd
ZIP39339ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
LEX TAYLOR
TRUSTEE10.00Yes (X)$0$0$0
JACK MILLER
TRUSTEE10.00Yes (X)$0$0$0
TERRY WOODS
TRUSTEE10.00Yes (X)$0$0$0
WILL HILL
TRUSTEE10.00Yes (X)$0$0$0
AL PORTER
TRUSTEE10.00Yes (X)$0$0$0
PAUL BLACK
CEO40.00$130,994$0$10,679Yes (X)
MICHAEL ARD
PHYSICIAN50.00$251,561$0$20,848Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$382,555TotalReportableCompFromOrgAmt
Total Other Compensation$31,527TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MEDICOMP
PO BOX 426MAGEEMS39111THERAPY SERVICE$874,666
EMERGENCY ROOM MD
46 HOLTZENGER AVE APT GSTARKVILLEMS39759ER PHYSICIANS$774,000
MORRISON MANAGEMENT SPECIALISTS
PO BOX 102289ATLANTAGA30368FOOD SERVICE$551,739
HOSPITAL HOUSEKEEPING SYSTEMS
PO BOX 826SAN ANTONIOTX78293HOUSEKEEPING$512,528
COMPREHENSIVE PHARMACY
PO BOX 638319CINCINNATIOH45263PHARMACY SERVIC$361,307
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
All Other Contributions$29,596AllOtherContributionsAmt
Total Contributions$29,596TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT CAREDesc
Total Revenue Column$11,783,579TotalRevenueColumnAmt
Exclusion$11,783,579ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$11,783,579TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$116,659TotalRevenueColumnAmt
Exclusion$116,659ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$62,539RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$62,539RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$62,539TotalRevenueColumnAmt
Related Or Exempt Func Income$62,539RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
GAIN ON DISPOSAL$22,753,745$22,753,745
INSURANCE PROCEEDS$5,226,964$5,226,964
FieldValueIRS element (for citing)
Other Revenue Total$27,980,709OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$39,973,082TotalRevenueColumnAmt
Related Or Exempt Func Income$28,043,248RelatedOrExemptFuncIncomeAmt
Exclusion$11,900,238ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$130,994TotalAmt
Management And General$130,994ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,757,319TotalAmt
Program Services$5,173,184ProgramServicesAmt
Management And General$584,135ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$317,099TotalAmt
Program Services$283,804ProgramServicesAmt
Management And General$33,295ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$898,858TotalAmt
Program Services$804,478ProgramServicesAmt
Management And General$94,380ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$434,067TotalAmt
Program Services$388,490ProgramServicesAmt
Management And General$45,577ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$22,416TotalAmt
Management And General$22,416ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$46,775TotalAmt
Management And General$46,775ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$30,022TotalAmt
Program Services$30,022ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$11,468TotalAmt
Program Services$11,468ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$408,774TotalAmt
Program Services$408,774ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$34,086TotalAmt
Program Services$21,970ProgramServicesAmt
Management And General$12,116ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$89,180TotalAmt
Program Services$89,180ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$732,044TotalAmt
Program Services$732,044ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CONTRACT SERVICES$3,948,696$3,870,728$77,968
BAD DEBTS$1,286,680$1,286,680
SUPPLIES$799,626$748,193$51,433
RENTS$732,688$722,275$10,413

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,469,600TotalAmt
Program Services$1,447,218ProgramServicesAmt
Management And General$22,382ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$17,150,392TotalAmt
Program Services$16,018,508ProgramServicesAmt
Management And General$1,131,884ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$308,421BOYAmt
EOY$54,830EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,797,510BOYAmt
EOY$16,736,427EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,846,452BOYAmt
EOY$2,501,528EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$229,599BOYAmt
EOY$146,693EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$165,763BOYAmt
EOY$771,083EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$7,788,954LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,390,088LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$8,035,695BOYAmt
EOY$5,398,866EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$646,652BOYAmt
EOY$11,886,401EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$18,030,092BOYAmt
EOY$37,495,828EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$958,058BOYAmt
EOY$1,560,924EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,959,819BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,917,877BOYAmt
EOY$1,560,924EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$13,112,215BOYAmt
EOY$35,934,904EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,112,215BOYAmt
EOY$35,934,904EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,030,092BOYAmt
EOY$37,495,828EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$22,822,690ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$1OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$123,162OtherCostOrOtherBasisAmt
Book Value$123,162BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,233,131OtherCostOrOtherBasisAmt
Depreciation$1,324,771DepreciationAmt
Book Value$3,908,360BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,776OtherCostOrOtherBasisAmt
Depreciation$6,886DepreciationAmt
Book Value$1,890BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,423,885OtherCostOrOtherBasisAmt
Depreciation$1,058,431DepreciationAmt
Book Value$1,365,454BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,398,866TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (8 entries)

DescDescBook ValueBookValueAmt
NON CURRENT PROPERTY INS PROCEEDS$8,084,740
PROPERTY INSURANCE PROCEEDS$2,581,577
CIP$535,914
OTHER RECEIVABLES$396,167
EQUITY IN MHA INSURANCE$141,832
GOODWILL$98,540
DUE FROM MEDICAID (EHR)$46,350
INTEREST RECEIVABLE$1,281
FieldValueIRS element (for citing)
Total Book Value Other Assets$11,886,401TotalBookValueOtherAssetsAmt
Total Rev Etc Audited Fincl Stmt$39,973,082TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$39,973,082RevenueSubtotalAmt
Total Revenue Per Form990$39,973,082TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$17,150,393TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$1OtherExpensesIncludedAmt
Expenses Not Reported$1ExpensesNotReportedAmt
Expenses Subtotal$17,150,392ExpensesSubtotalAmt
Total Expenses Per Form990$17,150,392TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 4, PART XII, LINE 2DFormAndLineReferenceDesc
ExplanationBOOK / TAX DEPRECIATION DIFFERENCE 1ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportfalseAnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$571,337TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$56,524DirectOffsettingRevenueAmt
Net Community Benefit Expns$514,813NetCommunityBenefitExpnsAmt
Total Expense0.03000TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,744,552TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,284,126DirectOffsettingRevenueAmt
Net Community Benefit Expns$460,426NetCommunityBenefitExpnsAmt
Total Expense0.02680TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,315,889TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,340,650DirectOffsettingRevenueAmt
Net Community Benefit Expns$975,239NetCommunityBenefitExpnsAmt
Total Expense0.05690TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,315,889TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,340,650DirectOffsettingRevenueAmt
Net Community Benefit Expns$975,239NetCommunityBenefitExpnsAmt
Total Expense0.05690TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$1,286,680BadDebtExpenseAmt
Bad Debt Expense Attributable$214,596BadDebtExpenseAttributableAmt
Reimbursed By Medicare$2,789,850ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$2,599,387CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$190,463MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WINSTON COUNTY MEDICAL FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 967AddressLine1Txt
CityLOUSIVILLECityNm
State AbbreviationMSStateAbbreviationCd
ZIP39339ZIPCd
FieldValueIRS element (for citing)
State License16-208StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1WINSTON COUNTY MEDICAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.WINSTONMEDICAL.ORGOwnWebsiteURLTxt
Implementation Strategy AdoptfalseImplementationStrategyAdoptInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesYes (true)CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp

FieldValueIRS element (for citing)
Form And Line ReferenceFACILITY 1, WINSTON COUNTY MEDICAL FOUNDATION - PART V, LINE 5FormAndLineReferenceDesc
ExplanationTHE FACILITY INQUIRED WITH COMMUNITY LEADERS AND HEALTHCARE OFFICIALS ABOUT THE NEEDS OF THE COMMUNITY.ExplanationTxt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGYTHE METHODOLOGY USED IS A REVIEW OF THE AGINGS OF THE ACCOUNT BALANCES
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATIONTHE FACILITY HAS IN PLACE A CHARITY CARE APPLICACTION FOR WHICH ANY PATIENT CAN APPLY, PROVIDED THEY MEET THE QUAL IFICATIONS ON THE APPLICATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonMICHAEL ARDPersonNm
TitlePHYSICIANTitleTxt
Base Compensation Filing Org$251,561BaseCompensationFilingOrgAmt
Deferred Compensation Flng Org$20,848DeferredCompensationFlngOrgAmt
Total Compensation Filing Org$272,409TotalCompensationFilingOrgAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE RETURN WAS REVIEWED WITH MANAGEMENT AND THE TAX PREPARER.
FORM 990, PAGE 6, PART VI, LINE 12CDURING THE YEAR END AUDIT, RELATED PARTY TRANSACTIONS ARE REVIEWED.
FORM 990, PAGE 6, PART VI, LINE 15ATHE BOARD OF TRUSTEES REVIEWS THE JOB PERFORMANCE OF THE ADMINISTRATOR AND BASED UPON PAY OF OTHER SIMILAR ADMINISTRATORS ADJUSTS HIS PAY ACCORDINGL Y.
FORM 990, PAGE 6, PART VI, LINE 15BTHE APPLICABLE DEPARTMENT HEADS REVIEW EACH EMPLOYEE AND SUBMIT A RECOMMEN DED PAY ADJUSTMENT TO THE ADMINISTRATOR, THE ADMINISTRATOR THEN GOES TO TH E BOARD OF TRUSTEES WHO WILL DECIDE ON A PAY RAISE, IF ANY.
FORM 990, PAGE 6, PART VI, LINE 19THE TAX RETURN AND AUDIT ARE MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 9BOOK / TAX DEPRECIATION DIFFERENCE -1