ARKANSAS VALLEY REGIONAL MEDICAL CENTER 07011998: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- ARKANSAS VALLEY REGIONAL MEDICAL CENTER 07011998 (EIN 84-1465990)
- Tax period
- 2013-04-01 to 2014-03-31
- Filed
- 2015-02-13
- IRS object ID
- 201530449349302648
- 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 H
- Schedule J
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-02-13T17:49:40-06:00 | ReturnTs |
| Tax Period End | 2014-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STOCKMAN KAST RYAN & CO LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 102 N CASCADE AVENUE SUITE 400 | AddressLine1 |
| City | COLORADO SPRINGS | City |
| State | CO | State |
| ZIP Code | 80903 | 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 | 841465990 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Arkansas Valley Regional Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JANETTE BENDER | InCareOfNm |
| Business Name Control | ARKA | BusinessNameControlTxt |
| Phone | 7193836026 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1100 Carson Avenue | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | La Junta | City |
| State | CO | State |
| ZIP Code | 81050 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JANETTE BENDER | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7193836026 | PhoneNum |
| Signature | 2015-02-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DOREEN B MERZ | PreparerPersonNm |
| PTIN | P00841439 | PTIN |
| Phone | 7193836026 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Lynn Crowell | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1100 carson avenue | AddressLine1 |
| City | la junta | City |
| State | CO | State |
| ZIP Code | 81050 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $43,814,749 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.avrmc.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1998 | FormationYr |
| Legal Domicile State | CO | LegalDomicileStateCd |
| Activity Or Mission | THE CENTER IS A COMMUNITY-OWNED ORGANIZATION PROVIDING HIGH QUALITY, RESPECTFUL, AND COMPASSIONATE HEALTH CARE SERVICES TO INDIVIDUALS & FAMILIES IN SOUTHEAST COLORADO. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 502 | TotalEmployeeCnt |
| Total Volunteers | 80 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $12,559 | PYContributionsGrantsAmt |
| CY Contributions Grants | $80,835 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $40,094,373 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $40,474,058 | CYProgramServiceRevenueAmt |
| PY Investment Income | $95,970 | PYInvestmentIncomeAmt |
| CY Investment Income | $64,969 | CYInvestmentIncomeAmt |
| PY Other Revenue | $363,593 | PYOtherRevenueAmt |
| CY Other Revenue | $1,502,955 | CYOtherRevenueAmt |
| PY Total Revenue | $40,566,495 | PYTotalRevenueAmt |
| CY Total Revenue | $42,122,817 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $21,173,561 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $20,036,870 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $23,199,446 | PYOtherExpensesAmt |
| CY Other Expenses | $22,805,381 | CYOtherExpensesAmt |
| PY Total Expenses | $44,373,007 | PYTotalExpensesAmt |
| CY Total Expenses | $42,842,251 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,806,512 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$719,434 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $36,398,149 | TotalAssetsBOYAmt |
| Total Assets EOY | $34,508,649 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,431,649 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,276,723 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $30,966,500 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $30,231,926 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE CENTER IS A COMMUNITY-OWNED ORGANIZATION THAT WILL WORK IN PARTNERSHIP WITH THE COMMUNITIES WE SERVE TO PROMOTE THE HEALTH AND WELL-BEING OF INDIVIDUALS AND FAMILES IN SOUTHEASTERN COLORADO. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $32,772,844 | ExpenseAmt |
| Revenue | $41,977,013 | RevenueAmt |
| Desc | The Medical Center operates as an acute-care hospital and long-term care nursing home and PROVIDes inpatient, outpatient, and emergency HEALTH CARE SERVICES TO THE COMMUNITY REGARDLESS OF RACE AND INSURANCE. | Desc |
| Prog Srvc Accom Acty2 | ProgSrvcAccomActy2Grp | |
| Total Program Service Expenses | $32,772,844 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | 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 | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | 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 | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | 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 |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 201 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 502 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Excess Business Holdings | false | ExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | false | MinutesOfGoverningBodyInd |
| Minutes Of Committees | false | 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 | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JANETTE BENDER | PersonNm |
| Phone | 7193836001 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1100 CARSON AVENUE | AddressLine1 |
| City | la junta | City |
| State | CO | State |
| ZIP Code | 81050 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 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 |
|---|---|---|---|---|---|---|---|
| Robert W Blair | |||||||
| Board Chairman | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Evan Gamboa | |||||||
| Board Secretary/Treasurer | 1.0 | Yes (X) | Yes (X) | ||||
| Jim Clawson | |||||||
| Board Vice-Chairman | 1.0 | Yes (X) | Yes (X) | ||||
| Ron Davis | |||||||
| Board Member | 1.0 | Yes (X) | |||||
| Betty Velasquez | |||||||
| Board Member | 1.0 | Yes (X) | |||||
| Rob Pickering | |||||||
| Board Member | 1.0 | Yes (X) | |||||
| Margie Gardner | |||||||
| Board Member | 1.0 | Yes (X) | |||||
| H Randolph Frank MD | |||||||
| Board Member | 1.0 | Yes (X) | |||||
| Dale L Leighty | |||||||
| Board Member | 1.0 | Yes (X) | |||||
| Patrick Hancock | |||||||
| Board Member | 1.0 | Yes (X) | |||||
| Richard A Shand MD | |||||||
| Board Member | 1.0 | Yes (X) | |||||
| Lynn CROWELL | |||||||
| CEO- See Sch O | 40.0 | Yes (X) | $0 | $0 | |||
| Janette Bender | |||||||
| CFO | 40.0 | Yes (X) | $108,490 | $26,674 | |||
| Carrie Cutrell | |||||||
| CNO | 40.0 | Yes (X) | $127,319 | $31,035 | |||
| Michael Morley | |||||||
| Ortho Physician | 40.0 | $647,123 | $9,108 | Yes (X) | |||
| Jesus Carale | |||||||
| Gastro Physician | 40.0 | $448,075 | $42,094 | Yes (X) | |||
| Thomas M Jackson | |||||||
| Surgeon | 40.0 | $305,482 | $30,235 | Yes (X) | |||
| Kent E Gay | |||||||
| Surgeon | 40.0 | $279,483 | $25,669 | Yes (X) | |||
| James S Brady | |||||||
| Physician | 45.0 | $374,234 | $32,472 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,290,206 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $197,287 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| QUORUM HEALTH | |||||
| 105 Continental Pl | BRENTWOOD | TN | 370271018 | Management Services | $613,700 |
| Arthur J Gallagher | |||||
| 6399 S Fiddlers Green | GREENWOOD | CO | 80111 | Risk Management | $372,760 |
| GE Healthcare | |||||
| 373 Inverness Dr | ENGLEWOOD | CO | 80112 | Equip. Maintenance | $311,202 |
| Maxim Staffing Solutions | |||||
| 12558 Collections Ctr Dr | CHICAGO | IL | 60693 | Staffing | $300,962 |
| Delta Locum Tenens | |||||
| 1755 Wittington Pl | DALLAS | TX | 75234 | Locum coverage | $681,283 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 22 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $63,380 | GovernmentGrantsAmt |
| All Other Contributions | $17,455 | AllOtherContributionsAmt |
| Total Contributions | $80,835 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $40,474,058 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $40,474,058 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $40,474,058 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,210 | TotalRevenueColumnAmt |
| Exclusion | $54,210 | 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 | $153,895 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $115,892 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $38,003 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,003 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $38,003 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,586,799 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,576,040 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $10,759 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,759 | TotalRevenueColumnAmt |
| Exclusion | $10,759 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $37,007 | GrossSalesOfInventoryAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,007 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $37,007 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAFETERIA | 900099 | $148,000 | $148,000 |
| MEDICAL RECORDS | 900099 | $12,222 | $12,222 |
| RECOVERY OF COSTS | 900099 | $1,266,517 | $1,266,517 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,206 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,206 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,427,945 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $42,122,817 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $41,977,013 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $64,969 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $552,251 | TotalAmt |
| Management And General | $552,251 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
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 | $15,855,938 | TotalAmt |
| Program Services | $11,694,359 | ProgramServicesAmt |
| Management And General | $4,161,579 | 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 | $3,628,681 | TotalAmt |
| Program Services | $3,003,089 | ProgramServicesAmt |
| Management And General | $625,592 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $613,700 | TotalAmt |
| Management And General | $613,700 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,908 | TotalAmt |
| Management And General | $42,908 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,650 | TotalAmt |
| Management And General | $53,650 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,531 | TotalAmt |
| Management And General | $3,531 | ManagementAndGeneralAmt |
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 | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,364,579 | TotalAmt |
| Program Services | $6,743,059 | ProgramServicesAmt |
| Management And General | $621,520 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,472,385 | TotalAmt |
| Program Services | $3,923,370 | ProgramServicesAmt |
| Management And General | $1,549,015 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $436,679 | TotalAmt |
| Program Services | $280,268 | ProgramServicesAmt |
| Management And General | $156,411 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $17,437 | TotalAmt |
| Program Services | $12,501 | ProgramServicesAmt |
| Management And General | $4,936 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,247,687 | TotalAmt |
| Program Services | $1,611,456 | ProgramServicesAmt |
| Management And General | $636,231 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $2,850,143 | $2,850,143 | |
| REPAIRS & MAINTENANCE | $1,334,188 | $956,532 | $377,656 |
| OTHER OPERATING EXPENSES | $1,223,332 | $877,055 | $346,277 |
| UTILITIES | $1,145,162 | $821,012 | $324,150 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,842,251 | TotalAmt |
| Program Services | $32,772,844 | ProgramServicesAmt |
| Management And General | $10,069,407 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $287,275 | BOYAmt |
| EOY | $54,436 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,744,144 | BOYAmt |
| EOY | $2,460,451 | 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 | $4,489,962 | BOYAmt |
| EOY | $5,614,578 | 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 | $1,593,344 | BOYAmt |
| EOY | $1,592,503 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $680,133 | BOYAmt |
| EOY | $933,664 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $55,286,329 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $32,496,094 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,388,809 | BOYAmt |
| EOY | $22,790,235 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,557,547 | BOYAmt |
| EOY | $508,143 | 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 | $656,935 | BOYAmt |
| EOY | $554,639 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,398,149 | BOYAmt |
| EOY | $34,508,649 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,773,265 | BOYAmt |
| EOY | $3,920,389 | 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 | $0 | BOYAmt |
| EOY | $0 | 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 | $560,576 | BOYAmt |
| EOY | $356,334 | 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 | $97,808 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,431,649 | BOYAmt |
| EOY | $4,276,723 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,407,373 | BOYAmt |
| EOY | $29,677,287 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $559,127 | BOYAmt |
| EOY | $554,639 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,966,500 | BOYAmt |
| EOY | $30,231,926 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,398,149 | BOYAmt |
| EOY | $34,508,649 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$719,434 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$15,140 | NetUnrlzdGainsLossesInvstAmt |
| 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 | false | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
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 | |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $3,531 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,531 | TotalLobbyingExpendituresAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Other Activities | FormAndLineReferenceDesc |
| Explanation | ALLOCABLE PORTION OF DUES PAID TO CHA AND AHA DESIGNATED AS LOBBYING EXPENSES | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $559,127 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$4,488 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $554,639 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $557,188 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,939 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $559,127 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $560,041 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$2,853 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $557,188 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $563,460 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$3,419 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $560,041 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,546 | OtherCostOrOtherBasisAmt |
| Book Value | $9,546 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,548,708 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,052,893 | DepreciationAmt |
| Book Value | $17,495,815 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $871,752 | OtherCostOrOtherBasisAmt |
| Depreciation | $678,803 | DepreciationAmt |
| Book Value | $192,949 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,035,523 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,764,398 | DepreciationAmt |
| Book Value | $4,271,125 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $820,800 | OtherCostOrOtherBasisAmt |
| Book Value | $820,800 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $22,790,235 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
| Total Liability | $0 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $39,373,426 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$15,140 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $115,892 | OtherRevenueAmt |
| Revenue Not Reported | $100,752 | RevenueNotReportedAmt |
| Revenue Subtotal | $39,272,674 | RevenueSubtotalAmt |
| Other Revenues Not Included | $2,850,143 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $2,850,143 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $42,122,817 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $40,108,000 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $115,892 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $115,892 | ExpensesNotReportedAmt |
| Expenses Subtotal | $39,992,108 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,850,143 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,850,143 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $42,842,251 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, Line 4 | The Medical Center is the sole beneficiary of the Bertha Elrod Copeland and James Evan Copeland Hospital Trust (the Trust), a charitable trust whose principal is to be held in perpetuity. Assets of the Trust are invested and administered by a trustee and distributions are made to the Medical Center. The use of the distributions received from the Trust is restricted to the purchase of equipment. |
| PART X, LINE 2 | The Medical Center is exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. In addition, the Medical Center qualifies for the charitable contribution deduction. The Medical Center believes that it does not have any uncertain tax positions that are material to the financial statements. The Medical Centers income tax returns for 2011 through the current period remain open to examination by the Internal Revenue Service and relevant state authorities. |
| PART XI, LINE 2D | RENTAL EXPENSES OF $115,892 WAS RECLASSED FROM EXPENSES TO BE SHOWN NET AGAINST RENTAL INCOME ON PAGE 9 OF THE TAX RETURN. |
| PART XI, LINE 4B | BAD DEBT EXPENSE WAS TAKEN AGAINST PATIENT REVENUE PER THE AUDIT, BUT RECLASSED AS AN EXPENSE IN THE AMOUNT OF $2,850,143 FOR THE TAX RETURN. |
| PART XII, LINE 2D | RENTAL EXPENSES OF $115,892 WAS RECLASSED FROM EXPENSES TO BE SHOWN NET AGAINST RENTAL INCOME ON PAGE 9 OF THE TAX RETURN. |
| PART XII, LINE 4B | BAD DEBT EXPENSE WAS TAKEN AGAINST PATIENT REVENUE PER THE AUDIT, BUT RECLASSED AS AN EXPENSE IN THE AMOUNT OF $2,850,143 FOR THE TAX RETURN. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| 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 | $1,817,966 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $600,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,217,966 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03050 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,929,811 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,447,679 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,482,132 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13710 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,747,777 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,047,679 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,700,098 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16760 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,834 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,834 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,834 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,834 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,754,611 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,047,679 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,706,932 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16780 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $208,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $208,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00520 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 46 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $83,506 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $83,506 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 49 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $291,506 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $291,506 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00730 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,850,143 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $9,666,055 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,368,883 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$702,828 | 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 |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NONE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | NONE | PrimaryActivitiesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | ARKANSAS VALLEY REGIONAL MEDICAL CTR | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1100 CARSON AVENUE | AddressLine1 |
| City | LA JUNTA | City |
| State | CO | State |
| ZIP Code | 81050 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | State Lic. #010210 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | LONG-TERM NURSING State Lic. #020211 | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARKANSAS VALLEY REGIONAL MEDICAL CTR | 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 | www.avrmc.org | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | false | FPGUsedDeterEligFreeCareInd |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 250. | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Lien On Residence | Yes (X) | PermitLienOnResidenceInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| Liens On Residences | Yes (X) | LiensOnResidencesInd |
| Other Actions | Yes (X) | OtherActionsInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SUPPLEMENTAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | SCHEDULE H, PART V, SECTION B, LINE 3 In the AVRMC process, each local expert allocated 100 points among all identified needs, having the opportunity to introduce needs previously unidentified and to challenge conclusions developed from the data analysis. A rank order of priorities emerged, with some needs receiving virtually no support and other needs receiving identical point allocations. We received community input from 104 area residents from a survey completed online during the period April 1, 2012 through June 30, 2012; The terms of gaining input stipulated each respondent would remain anonymous; The internet-based survey was promoted through a paid advertisement in a local newspaper, at a health fair, and distributed to local civic and health organizations with a request for participation. Preliminary conclusions were presented to a local group of experts who were asked to validate prior assessments and to establish priority among various identified health and medical issues. When the analysis was complete, we put the information and summary conclusions before a local group of experts who were asked to agree or disagree with the summary conclusions. SCHEDULE H, PART V, SECTION B, LINE 7 We do not have adequate resources to solve all the problems identified. Some issues are beyond the mission of the hospital and action is best suited for a response by others. Some improvements will require personal actions by individuals rather than the response of an organization. We view this as a plan for how we, along with other organizations and agencies, can collaborate to bring the best each has to offer to address the more pressing identified needs. By definition, the needs identified as LOW Priority and for which AVRMC holds LOW RESPONSIBILITY for implementation are needs to which the hospital may devote resources while (in most cases) monitoring but otherwise not addressing. Reasons for this response: Actions required are beyond the mission of AVRMC; AVRMC can be more effective applying its resources to higher priority needs; The hospital does not possess the expertise necessary for substantive positive improvement; Actions contemplated for implementation fall more appropriately to the responsibility of others; Other than providing encouragement, implementation efforts for some needs require appropriate actions by individuals modifying their personal habits rather than a response by an organization or the Health System; The best use of AVRMC resources is to focus on resolving or improving higher priority needs rather than attempting to respond to everything with small, perhaps ineffective, efforts. SCHEDULE H, PART V, SECTION B, LINE 10 The only Charity Care defined for AVRMC's purpose is patients that qualify for Colorado Indigent Care. SCHEDULE H, PART V, SECTION B, LINE 17E THE CENTER ATTEMPTS TO OBTAIN COLLECTIONS THROUGH THE USE OF GARNISHING WAGES FROM CLIENTS WITH OUTSTANDING BALANCES. | ExplanationTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SUPPLEMENTAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | SCHEDULE H, PART III, LINE 2 THE COST METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED AS BAD DEBT EXPENSE IS USING A COST-TO-CHARGE RATIO. THE AMOUNT OF BAD DEBTS ATTRIBUTABLE TO PATIENT ACCOUNTS IS MULTIPLIED BY THE RATIO OF PATIENT CARE COST TO CHARGES CALCULATE THE ESTIMATED COST OF BAD DEBTS ATTRIBUTABLE TO PATIENT ACCOUNTS. A number of patients are truly unable to pay their out-of-pocket liability, but do not complete the process required to apply for financial assistance under the Hospital's charity care policy. These patients would qualify for charity care if they completed the paperwork, so the bad debt expense associated with treating them should be treated as community benefit. Sch H Part III, Section A, line 4. SEE PAGE 7,11, and 12 OF THE ATTACHED AUDIT REPORT FOR DESCRIPTION FROM THE AUDIT OF BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 8 MEDICARE COSTS WERE CALCULATED FROM THE MEDICARE COST REPORT FOR THE FYE MARCH 31, 2014. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. SCHEDULE H, PART VI, LINE 2 We deployed a Community Health Need Assessment survey within the local population for any resident to complete. We received community input from 104 area residents from a survey completed online during the period April 1, 2012 through June 30, 2012; The terms of gaining input stipulated each respondent would remain anonymous; The internet-based survey was promoted through a paid advertisement in a local newspaper, at a health fair, and distributed to local civic and health organizations with a request for participation. Preliminary conclusions were presented to a local group of experts who were asked to validate prior assessments and to establish priority among various identified health and medical issues; and Information analysis augmented by local opinions showed how Otero County relates among its peers in terms of primary and chronic needs, as well as other issues of uninsured persons, low-income persons, and minority groups; respondents commented on if they believe certain population groups (or people with certain situations) need help to improve their condition and if so, who needs to do what. When the analysis was complete, we put the information and summary conclusions before a local group of experts who were asked to agree or disagree with the summary conclusions. They were free to augment potential conclusions with additional statements of need; new needs could, and did, emerge from this exchange. Consultation with local experts was accomplished by having the local experts complete a survey individually. The survey identifying potential community needs the local experts participated in was a structured communication Delphi method technique, originally developed as a systematic, interactive forecasting method which relies on a panel of experts. The process encourages experts to revise their earlier answers in light of the replies of other members of their panel. Typically, this process decreases the range of answers and moves the expert opinions toward a consensus "correct" answer. The process was completed in one round which identified the most pressing, highest priority community needs. In the AVRMC process, each local expert allocated 100 points among all identified needs, having the opportunity to introduce needs previously unidentified and to challenge conclusions developed from the data analysis. A rank order of priorities emerged, with some needs receiving virtually no support and other needs receiving identical point allocations. We dichotomized the rank order into two groups: high priority needs and low priority needs. The determination of the break point, high as opposed to low, was a qualitative interpretation by QHR and the AVRMC executive team. When presented to the AVRMC executive team, the dichotomized need rank order identified which needs the hospital considered high responsibility to respond vs. low responsibility to respond. The result provided a matrix of needs and guided the hospital in developing its implementation response. Leading issues seem to relate to a lack of affordable health insurance coverage and the cost of medical care. Responses noted four topics as their most serious concerns: No health insurance is a major concern to 76% of respondents; Teen birth/pregnancy is a major concern to 63% of respondents; Diabetes is a major concern to 59% of respondents; and unhealthy food choices and obesity are major concerns to 55% of respondents. Mental health issues present as a focus on alcohol use, drug abuse, and smoking among youth as well as adult abuse of alcohol and drugs. Regardless of age, prescription abuse is also present as a focus; and Comments about individual, family, and healthy living concerns revolve around healthy living and healthcare availability. SCHEDULE H, PART VI, LINE 3 THE ORGANIZATION PROVIDES A BROCHURE TO EACH PATIENT OUTLINING THE GUIDELINES USED TO DETERMINE ELIGIBILITY FOR ASSISTANCE. SCHEDULE H, PART VI, LINE 4 In 2010, the Medical Center received 82.4% of its patients from the hospital's Primary Service Area. The Otero County 81050 and 81067 zip codes comprise 64.8% of all patients. County data is used as most information is not available at the geographic level of a zip code. The 2011 population for Otero County is estimated to be 18,345, but is expected to decline at a rate of 4%, projecting a 2016 population of 17,607. The population loss is in contrast to the Colorado state average rate of population increase of +7.2% and the national growth rate of +4%. The 65+ population of Otero County is 18.6% of the total population compared to the overall U.S. at 13.3%. The number of child-bearing-age females in the U.S. is expected to decrease 5.5%, while in Colorado it is expected to increase 2.1% by 2015. The Otero County 2011 Median Household Income is $42,283, which is considerably lower than the national median income of $67,529. Otero County's unemployment rate as of April 2012 is 9.2%, larger than the national unemployment rate of 8.1%. SCHEDULE H, PART VI, LINE 5 Arkansas Valley Regional Medical Center's board of directors is comprised of persons who reside in the La Junta, Colorado area. The majority of the organization's board members are neither employees nor contractors of the medical center. The board of directors is made mostly of community business people interested in maintaining quality health care in La Junta. SCHEDULE H, PART VI, LINE 6 N/A SCHEDULE H, PART VI, LINE 7 N/A | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| Carrie Cutrell | ||||
| CNO | $127,319 | $23,000 | $8,035 | $158,354 |
| Michael Morley | ||||
| Ortho Physician | $647,123 | $9,108 | $656,231 | |
| Jesus Carale | ||||
| Gastro Physician | $448,075 | $17,500 | $24,594 | $490,169 |
| Thomas M Jackson | ||||
| Surgeon | $305,482 | $15,478 | $14,757 | $335,717 |
| Kent E Gay | ||||
| Surgeon | $279,483 | $18,642 | $7,027 | $305,152 |
| James S Brady | ||||
| Physician | $374,234 | $15,600 | $16,872 | $406,706 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | The physician contracts allow for a QUARTERLY BONUS IF THEIR RELATIVE VALUE UNITS charged exceed quarterly benchmark standards. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| DALE LEIGHTY | |||
| BOARD MEMBER | $250,000 | CD'S HELD AT BANK | false |
| BOB BLAIR | |||
| BOARD MEMBER | $183,743 | CD'S HELD AT BANK | false |
| Roy Trivett | |||
| Brother-in-law of CFO | $19,783 | Contractor Services | false |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 1 | DALE LEIGHTY IS A MEMBER ON THE BOARD OF DIRECTORS AND ALSO THE PRESIDENT OF FIRST NATIONAL BANK OF LAS ANIMAS WHERE THE MEDICAL CENTER Holds a certificate of Deposit. |
| PART IV, LINE 2 | BOB BLAIR IS A MEMBER ON THE BOARD OF DIRECTORS AND ALSO THE PRESIDENT OF COLORADO EAST BANK WHERE THE MEDICAL CENTER holds a certificate of deposit. |
| PART IV, LINE 3 | CFO Janette Benders brother-in-law, Roy Trivett, owns Royal Electrical Services. The hospital uses them for various services. The hospital paid them $19,783 during the fiscal year ended 03/31/2014. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SUPPLEMENTAL INFORMATION | PART VI, SECTION A, LINE 3 THE ORGANIZATION CONTRACTS WITH QUORUM HEALTH RESOURCES, A HEALTHCARE MANAGEMENT COMPANY, TO PROVIDE SPECIALIZED HEALTHCARE SERVICES. THE CEO IS AN EMPLOYEE OF THE HEALTHCARE MANAGEMENT COMPANY. THE BOARD OF DIRECTORS WORKS IN CONJUNCTION WITH THE MANAGEMENT COMPANY AND THE BOARD HAS ULTIMATE AUTHORITY AND RESPONSIBILITY FOR THE ORGANIZATION. For the period ended March 31, 2014 the following are deemed officers of Arkansas Valley Regional Medical Center: Lynn Crowell, CEO Compensation: 208,858 Benefits: 72,459 PART VI, SECTION B, LINE 11B THE 990 is reviewed by the CEO, CFO, approved and signed by them. Then the Board is informed that the Form has been submitted. PART VI, SECTION B, LINE 12C EACH YEAR ALL KEY MEMBERS AND BOARD MEMBERS SUBMIT CONFLICTS OF INTEREST TO REGULARLY REVIEW ANY POSSIBLE CONFLICTS WITH THE WRITTEN CONFLICT OF INTEREST POLICY. PART VI, SECTION B, LINE 15C THE BOARD EVALUATES AND APPROVES WAGE PARAMETERS TO DETERMINE THE COMPENSATION OF INDEPENDENT PERSONS AND MANAGEMENT. PART VI, SECTION C, LINE 19 ORGANIZATIONAL DOCUMENTS ARE AVAILABLE AT PUBLIC BOARD MEETINGS AND UPON REQUEST. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROVIDER FEES TOTAL FEES:3360966 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTR. LABOR & PHYSICIAN FEES TOTAL FEES:4003613 |