Continuecare Hospital of Midland Inc: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- Continuecare Hospital of Midland Inc (EIN 46-3053684)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-14
- IRS object ID
- 201541349349308779
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-14T18:28:45-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 425 HOUSTON STREET SUITE 600 | AddressLine1 |
| City | FORT WORTH | City |
| State | TX | State |
| ZIP Code | 76102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 463053684 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Continuecare Hospital of Midland Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % Gregory Taylor | InCareOfNm |
| Business Name Control | CONT | BusinessNameControlTxt |
| Phone | 9729436400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7800 N DALLAS PARKWAY | AddressLine1 |
| Address Line2 | Suite 200 | AddressLine2 |
| City | PLANO | City |
| State | TX | State |
| ZIP Code | 75024 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL WILLIAMS | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Signature | 2015-05-12 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MELVA SCOTT | PreparerPersonNm |
| PTIN | P01207335 | PTIN |
| 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 | MICHAEL WILLIAMS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7800 N DALLAS PARKWAY STE 200 | AddressLine1 |
| City | PLANO | City |
| State | TX | State |
| ZIP Code | 75024 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,314,100 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 9703 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://CONTINUECARE.ORG/MIDLAND | WebsiteAddressTxt |
| Formation | 2012 | FormationYr |
| Legal Domicile State | DE | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 48 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,300,152 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $13,948 | CYOtherRevenueAmt |
| PY Total Revenue | $0 | PYTotalRevenueAmt |
| CY Total Revenue | $2,314,100 | 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 | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,776,881 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $0 | PYOtherExpensesAmt |
| CY Other Expenses | $2,407,082 | CYOtherExpensesAmt |
| PY Total Expenses | $0 | PYTotalExpensesAmt |
| CY Total Expenses | $5,183,963 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $0 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,869,863 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $0 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,957,631 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,827,494 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $0 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$2,869,863 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CONTINUECARE HOSPITAL OF MIDLAND, INC. (CCHM) IS ESTABLISHED TO PROVIDE LONG TERM, ACUTE CARE SERVICES TO INDIVIDUALS. CCHM WILL PROVIDE AN APPROPRIATE VENUE IN THE CONTINUUM OF CARE FOR PATIENTS REQUIRING AN EXTENDED STAY IN AN ACUTE CARE SETTING AND WHO RESIDE IN OR AROUND MIDLAND, TEXAS. CCHM IS ESTABLISHED TO PROVIDE LONG TERM, ACUTE CARE SERVICES TO INDIVIDUALS WITH CRITICAL DISEASE OR DISORDERS, INCLUDING BUT NOT LIMITED TO CHRONIC OR ACUTE INFECTION, CARDIOVASCULAR AND RESPIRATORY DISORDERS, POST SURGICAL AND CANCER PATIENTS, AND THOSE WEANABLE PATIENTS DEPENDENT UPON VENTILATOR CARE, WHOSE CONDITION IS SO SIGNIFICANT THAT A HOSPITAL STAY OF AT LEAST 14-30 DAYS(AGGREGATE 25 DAYS) IS EXPECTED. THE HOSPITAL INTENDS TO MEET THE MEDICAL, THERAPEUTIC, AND FAMILIAL NEEDS OF INDIVIDUALS IN THE MIDLAND, TEXAS AREA USING AN INTERDISCIPLINARY TEAM APPROACH, EFFECTIVELY IMPLEMENTING A RESPONSIVE CONTINUUM OF CARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,143,452 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,314,100 | RevenueAmt |
| Desc | CONTINUECARE HOSPITAL OF MIDLAND, INC. (CCHM) IS A LONG-TERM ACUTE CARE HOSPITAL OPERATING AS A HOSPITAL WITHIN A HOSPITAL AT MIDLAND MEMORIAL HOSPITAL MIDLAND, TEXAS. CCHM PROVIDES AN AVENUE OF CARE FOR PATIENTS THAT REQUIRE EXTENDED LENGTHS OF STAY IN AN ACUTE CARE SETTING. TYPICALLY, LENGTHS OF STAY WILL AVERAGE 25 DAYS OR LONGER. CONDITIONS APPROPRIATE FOR TREATMENT IN AN LTACH INCLUDE THE FOLLOWING: MEDICALLY COMPLEX RESPIRATORY DISORDERS INCLUDING TRACHEOTOMY, VENTILATOR DEPENDENT CARDIAC/CARDIOVASCULAR CONDITIONS, RENAL DISEASE, ONCOLOGY, AND WOUND CARE. CCHM OBTAINED A LICENSE TO OPERATE AN ACUTE CARE HOSPITAL and began operations ON AUGUST 31, 2013 AND IS IN THE DEMONSTRATION PERIOD TO OBTAIN ITS LONG TERM ACUTE CARE LICENSE. DURING THE FISCAL YEAR ENDED 6/30/2014, CCHM'S TOTAL PATIENTS ADMITTED WERE 97 AND THE TOTAL NUMBER OF PATIENT CARE DAYS PROVIDED WAS 2,470. THE AVERAGE DAILY CENSUS WAS 8.1 PATIENTS AND THE AVERAGE LENGTH OF STAY OF THE DISCHARGED PATIENTS EXCEEDED 25.46 Days. | Desc |
| Total Program Service Expenses | $3,143,452 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | 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 | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | 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 | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 16 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 48 | 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 |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | 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 | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 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 | false | CompensationProcessCEOInd |
| Compensation Process Other | false | 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 | Gregory Taylor | PersonNm |
| Phone | 9729436425 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7800 N DALLAS PARKWAY SUITE 200 | AddressLine1 |
| City | PLANO | City |
| State | TX | State |
| ZIP Code | 75024 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| Wilson Weber | |||||||
| Director | 1.0 | 39.0 | Yes (X) | $0 | $1,094,189 | $121,205 | |
| Jason Bootz | |||||||
| President/Director to 3/2014 | 1.0 | 39.0 | Yes (X) | $0 | $273,439 | $32,137 | Yes (X) |
| Russell Myers | |||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Larry Edgerton | |||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Margaret Robinson | |||||||
| Director/Chairman | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Michael Williams | |||||||
| President/Director | 1.0 | 39.0 | Yes (X) | $0 | $1,275,343 | $29,523 | Yes (X) |
| David Butler | |||||||
| Assistant Secretary | 1.0 | 39.0 | $0 | $398,597 | $30,114 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,041,568 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $212,979 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CARDINAL HEALTH | |||||
| 8950 NORTH CENTRAL EXPRESSWAY | DALLAS | TX | 75231 | PHARMACEUTICALS | $136,965 |
| LUKER PHARMACY | |||||
| PO BOX 478 | BLANCO | TX | 78606 | PHARM MGMT SVCs | $131,027 |
| UNIVERSAL HOSPITAL SERVICES | |||||
| 6625 WEST 78TH STREET SUITE 300 | MINNEAPOLIS | MN | 55439 | MDCL EQPMNT SVCS | $107,857 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $0 | FundraisingAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INPATIENT REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $2,300,152 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,300,152 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,300,152 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
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 |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
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 |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $13,948 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,948 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $13,948 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,314,100 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,314,100 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,300,448 | TotalAmt |
| Program Services | $1,960,877 | ProgramServicesAmt |
| Management And General | $339,571 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,410 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $36,410 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,412 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $264,412 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,611 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $175,611 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $221,935 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $221,935 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,031 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $11,031 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,759 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $20,759 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $548,765 | TotalAmt |
| Program Services | $422,063 | ProgramServicesAmt |
| Management And General | $126,702 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,309 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,309 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $763,593 | TotalAmt |
| Program Services | $736,572 | ProgramServicesAmt |
| Management And General | $27,021 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,990 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $117,990 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $426,305 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $426,305 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,511 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $85,511 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,562 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $47,562 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,332 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $44,332 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,810 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $19,810 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| BAD DEBT EXPENSE | $23,140 | $23,140 | $0 | $0 |
| MISCELLANEOUS EXPENSES | $75,040 | $800 | $74,240 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,183,963 | TotalAmt |
| Program Services | $3,143,452 | ProgramServicesAmt |
| Management And General | $2,040,511 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Joint Costs TotalJointCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $140,320 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,210,578 | 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 | $0 | BOYAmt |
| EOY | $68,514 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $42,911 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $539,847 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $44,332 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $495,515 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | 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 | $0 | BOYAmt |
| EOY | -$207 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,957,631 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,500,099 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,173,173 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,154,222 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $4,827,494 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | -$2,869,863 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | -$2,869,863 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,957,631 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,869,863 | ReconcilationRevenueExpnssAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $231,104 | OtherCostOrOtherBasisAmt |
| Depreciation | $39,998 | DepreciationAmt |
| Book Value | $191,106 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $308,743 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,334 | DepreciationAmt |
| Book Value | $304,409 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $495,515 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTERCOMPANY - VHA AND CCC | Desc |
| Amt | $1,154,222 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,154,222 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| 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 | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,339 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,339 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,339 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,339 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $49,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $49,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00950 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $49,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $49,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00950 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $59,339 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $59,339 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01150 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $23,140 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $1,350,493 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $1,785,620 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$435,127 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONTINUECARE HOSPITAL AT MIDLAND | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4214 ANDREWS HWY | AddressLine1 |
| City | MIDLAND | City |
| State | TX | State |
| ZIP Code | 79703 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://CONTINUECARE.ORG/MIDLAND | WebsiteAddressTxt |
| State License | 100210 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONTINUECARE HOSPITAL AT MIDLAND | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | false | CHNAConductedInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | false | FPGUsedDetermEligDscntCareInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| Nondis Emergency Care Policy | false | NondisEmergencyCarePolicyInd |
| No Emergency Care | Yes (X) | NoEmergencyCareInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE H, PART V, LINE 1 | FormAndLineReferenceDesc |
| Explanation | CONTINUECARE HOSPITAL AT MIDLAND WAS FORMED DURING FISCAL YEAR 2013 AND ACQUIRED ITS HOSPITAL LICENSE ON JANUARY 1, 2014. THE HOSPITAL WILL CONDUCT ITS INITIAL COMMUNITY HEALTH NEEDS ASSESSMENT DURING ITS FISCAL YEAR 2015. SCHEDULE H, PART V, LINE 11 CONTINUECARE HOSPITAL AT MIDLAND ONLY PROVIDES FREE CARE AND DOES NOT HAVE DISCOUNTED CARE. SCHEDULE H, PART V, LINE 20D CHARGES FOR MEDICAL CARE IF A PATIENT QUALIFIES UNDER ITS CHARITY CARE POLICY, CCHM DOES NOT BILL THE PATIENT FOR THE SERVICES. | ExplanationTxt |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PAYMENT FOR CHARITY CARE | IN THE STATE OF TEXAS, IT IS PERMISSIBLE TO PAY ANOTHER HEALTH PROVIDER FOR CHARITY CARE TO SATISFY THE CHARITY REQUIREMENTS. TOTAL CHARITY EXPENSE FOR FYE 6/30/14 TOTALED $49,000. SCHEDULE H, PART I, LINE 7, COLUMN (F) OUR TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) WAS $5,183,963. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $23,140. THIS LEFT A TOTAL EXPENSE OF $5,160,823. CONTINUECARE HOSPITAL OF MIDLAND, INC. (CCHM) IS CURRENTLY LICENSED AS AN ACUTE CARE HOSPITAL, BUT IS FUNCTIONING AS A LONG TERM ACUTE CARE HOSPITAL PENDING ITS LTACH CERTIFICATION FROM CMS, AND THEREFORE WILL HAVE LOWER PERCENTAGES THAN AN ACUTE CARE HOSPITAL. |
| SCHEDULE H, PART III, LINE 2 | THE BAD DEBT EXPENSE ON LINE 2 IS THE BAD DEBT EXPENSE FROM THE AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, LINE 4 | FOOTNOTE TO FINANCIAL STATEMENTS REGARDING BAD DEBT CCHM DOES NOT HAVE ITS OWN AUDIT. RATHER, IT IS PART OF VHA SOUTHWEST COMMUNITY HEALTH CORPORATION AND THE BAD DEBT DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS DOES NOT COMPLETELY MATCH THE ORGANIZATION'S PRACTICE. THE BAD DEBT COSTING METHODOLOGY VARIES BY PAYER TYPE. FOR MEDICARE, BAD DEBT IS RECORDED WHEN RECOGNIZED TO THE EXTENT OF 30%. MEDICARE REIMBURSES THE ORGANIZATION FOR ALLOWABLE BAD DEBT AT 70%. MEDICARE BAD DEBT RELATES TO THE PRIVATE PAY PORTION OF CARE SUCH AS CO-PAY AND DEDUCTIBLE AMOUNTS. FOR MANAGED CARE, WE RESERVE BAD DEBT WHEN RECOGNIZED AT 100% OF CO-PAY AND DEDUCTIBLE AMOUNTS. |
| SCHEDULE H, PART III, LINE 8 | TREATMENT OF MEDICARE SHORTFALL AS COMMUNITY BENEFIT THE SHORTFALL SHOULD BE COUNTED IN THE COMMUNITY BENEFIT SINCE THE HOSPITAL WAS A START-UP FACILITY FOR THE FIRST 5 MONTHS OF ITS OPENING. THE AVERAGE DAILY CENSUS WAS AN AVERAGE MONTHLY NET REVENUE TOTALING $109,000. MONTHLY EXPENSES FOR THE SAME PERIOD TOTALED $345,000. |
| SCHEDULE H, PART III, LINE 9B | APPLICATION OF COLLECTION PRACTICES TO THOSE QUALIFYING FOR FINANCIAL ASSISTANCE IF A PATIENT QUALIFIES UNDER ITS CHARITY CARE POLICY, CCHM DOES NOT BILL THE PATIENT FOR THE SERVICES. |
| SCHEDULE H, PART VI, QUESTION 2 | NEEDS ASSESSMENT THE HEALTH CARE NEEDS FOR THE COMMUNITY SERVED ARE ASSESSED BY A REVIEW OF THE PRIMARY AND TERTIARY SERVICE AREAS FOR DISEASE SPECIFIC MORTALITY RATES. DISEASE STATISTICS ARE GATHERED FROM THE TEXAS HEALTH PROMOTION UNIT OF TEXAS DEPARTMENT OF STATE HEALTH. INTERVIEWS WITH LOCAL HEALTH CARE AND ELDERLY SERVICE PROVIDERS ARE CONDUCTED TO ASSESS THEIR PERCEIVED UNMET NEEDS IN THE COMMUNITY. |
| SCHEDULE H, PART VI, QUESTION 3 | PATIENT EDUCATION PATIENTS AND PERSONS WHO MAY BE BILLED FOR SERVICES ARE INFORMED UPON ADMISSION TO CCHM BY HOSPITAL OFFICE ASSOCIATES. THE PATIENT FINANCIAL OBLIGATION IS DISCUSSED WITH THE RESPONSIBLE PARTY. THE HOSPITAL CHARITY CARE POLICY IS DISCUSSED WITH EACH RESPONSIBLE PARTY AND IF IT IS FELT THAT THE PATIENT WOULD QUALIFY FOR THE CHARITY PROGRAM THEN THE NECESSARY DOCUMENTS WOULD BE PRESENTED BY THE RESPONSIBLE PARTY TO THE BUSINESS OFFICE ASSOCIATE FOR REVIEW. THE CHARITY CARE POLICY IS ALSO POSTED IN THE ADMISSIONS OFFICE AND ON ITS WEBSITE. |
| SCHEDULE H, PART VI, QUESTION 4 | COMMUNITY INFORMATION CONTINUE CARE HOSPITAL OF MIDLAND, INC. PARTICIPATES WITH MIDLAND MEMORIAL HOSPITAL TO EDUCATE THE PUBLIC WITH HEALTHY PRACTICES TO AVOID HOSPITALIZATION WITH THE PREVENTION OF PULMONARY DISEASE DISORDERS. THE HOSPITAL ALSO PARTICIPATES WITH MIDLAND MEMORIAL HOSPITAL WITH AN ANNUAL HEART WALK AND PROVIDES EDUCATION FOR HEALTHY EATING. |
| SCHEDULE H, PART VI, QUESTION 5 | PROMOTION OF COMMUNITY HEALTH CCHM IS ESTABLISHED TO PROVIDE LONG TERM, ACUTE CARE SERVICES TO INDIVIDUALS WITH CRITICAL DISEASE OR DISORDERS, INCLUDING BUT NOT LIMITED TO CHRONIC OR ACUTE INFECTION, CARDIOVASCULAR AND RESPIRATORY DISORDERS, POST SURGICAL AND CANCER PATIENTS, AND THOSE WEANABLE PATIENTS DEPENDENT UPON VENTILATORS. CCHM WILL PROVIDE AN APPROPRIATE VENUE IN THE CONTINUUM OF CARE FOR PATIENTS REQUIRING AN EXTENDED STAY IN AN ACUTE CARE SETTING AND WHO RESIDE IN OR AROUND MIDLAND, TEXAS. SCHEDULE H, PART VI, QUESTION 6 CONTINUECARE HOSPITAL OF MIDLAND IS AN AFFILIATE OF MIDLAND MEMORIAL HEALTH SYSTEM IN MIDLAND, TEXAS. THE HEALTH PROMOTION ACTIVITIES FOR BOTH ORGANIZATIONS ARE COLLABORATIVE IN ORDER TO HAVE A FAR REACHING EFFECT ON THE COMMUNITY. EACH ORGANIZATION ASSESSES THE NEEDS OF THE COMMUNITY AND THEN WORKS IN WAYS THAT WOULD MEET ANY UNMET NEEEDS WITHIN THE COMMUNITY. SCHEDULE H, PART VI, QUESTION 7 STATE FILING OF COMMUNITY BENEFIT REPORT TX |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Wilson Weber | ||||||||||||||
| Director | $0 | $435,491 | $0 | $211,841 | $0 | $446,857 | $0 | $94,928 | $0 | $26,277 | $0 | $1,215,394 | $0 | $395,704 |
| Jason Bootz | ||||||||||||||
| President/Director to 3/2014 | $0 | $192,836 | $0 | $68,997 | $0 | $11,606 | $0 | $16,549 | $0 | $15,588 | $0 | $305,576 | $0 | $0 |
| David Butler | ||||||||||||||
| Assistant Secretary | $0 | $271,841 | $0 | $105,156 | $0 | $21,600 | $0 | $5,287 | $0 | $24,827 | $0 | $428,711 | $0 | $0 |
| Michael Williams | ||||||||||||||
| President/Director | $0 | $630,030 | $0 | $390,333 | $0 | $254,980 | $0 | $7,650 | $0 | $21,873 | $0 | $1,304,866 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 3 | COMPENSATION OF CEO/EXECUTIVE DIRECTOR CCHM'S EXECUTIVES, INCLUDING THE CEO, ARE EMPLOYED BY ITS WHOLLY-OWNED SUBSIDIARY, COMMUNITY HOSPITAL CONSULTING ("CHC"), WHICH FOLLOWS THE COMPENSATION POLICIES OF CHC. CHC ENGAGED SULLIVAN COTTER TO CONDUCT A COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITY, AND CURRENT INCUMBENTS' COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN PARTICIPATION WAS PAID TO: DAVID BUTLER $ 15,578 MICHAEL WILLIAMS $217,911 WILSON WEBER $508,658 JASON BOOTZ $ 8,614 |
| Schedule J, Part I, Line 7 | Non-fixed payments A PORTION OF THE DISCETIONARY INCENTIVE COMPENSATION PROGRAM WAS BASED ON THE EBIDA OF CHC. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part I, Line 1 | ORGANIZATION'S MISSION AS A "HOSPITAL WITH-IN a HOSPITAL," THE MISSION OF CONTINUECARE HOSPITAL AT MIDLAND, INC. (CCHM) IS TO ENHANCE COMMUNITY HEALTH THROUGH SERVICE WITH COMPASSION, CARING, ACCOUNTABILITY, RESPECT, AND EMPATHY. |
| FORM 990, PART VI, LINE 3 | DESCRIPTION OF MANAGEMENT ARRANGEMENT CHC COMMUNITY CARE, LLC PROVIDES CERTAIN FINANCIAL, TECHNICAL AND MANAGERIAL SUPPORT SERVICES TO THE HOSPITAL. |
| FORM 990, PART VI, LINE 6 | DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS THE SOLE SHAREHOLDER OF CCHM IS CHC COMMUNITY CARE, LLC, (CCC). |
| FORM 990, PART VI, LINE 7A | DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS THE SOLE SHAREHOLDER SHALL MAINTAIN A MINORITY VOTING INTEREST OF THE BOARD OF DIRECTORS. THE BOARD OF MANAGERS SHALL BE COMPRISED OF SIX VOTING MEMBERS, 1 FROM CCC, 1 FROM ITS COOPERATIVE PARTNER, MIDLAND MEMORIAL, AND FOUR COMMUNITY MEMBERS. EACH VOTING MEMBER CARRIES EQUAL WEIGHT AND CONSIDERATION WHEN TAKING ANY OFFICIAL BOARD ACTION. |
| FORM 990, PART VI, LINE 7B | CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS THE BOARD OF DIRECTORS MAY RECOMMEND, BUT SHALL NOT, WITHOUT EXPRESS WRITTEN CONSENT OF THE SOLE MEMBER, HAVE THE POWER TO TAKE ANY OF THE FOLLOWING ACTIONS: 1. ANY FUNDAMENTAL CHANGE IN THE MISSION OR PHILOSOPHY OF THE HOSPITAL; 2. THE INCURRANCE OF DEBT, INCLUDING WITHOUT LIMITATION, BORROWINGS, GUARANTEES, LOANS, ENCUMBRANCES, OPERATING LEASES, PURCHASE OF LEASE OF REAL ESTATE, AND CAPITAL LEASES; 3. ANY MERGER OR CONSOLIDATION TO WHICH THE HOSPITAL IS A PARTY; 4. THE SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE HOSPITAL; 5. POLICY CHANGES PERTAINING TO CHARITY CARE; 6. APPOINTMENT AND REMOVAL OF CORPORATE DIRECTORS; 7. ANY RELEASE OR CANCELLATION OF INDIVIDUAL CLAIMS IN EXCESS OF $25,000. |
| FORM 990, PART VI, LINE 8B | DOCUMENTATION OF MEETINGS OF COMMITTEES THERE WERE NO COMMITTEES OF THE GOVERNING BODY. |
| FORM 990, PART VI, LINE 11B | DESCRIBE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE DETAILED REVIEW OF THE FORM 990 IS CONDUCTED BY THE HOSPITAL'S MANAGEMENT FOLLOWING THE PREPARATION AND REVIEW OF THE RETURN BY THE ORGANIZATION'S PAID PREPARER. AN ELECTRONIC COPY OF THE FINAL FORM 990 IS EMAILED TO EACH BOARD MEMBER PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, LINE 12C | DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST THE ORGANIZATION FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS ADOPTED BY ITS SOLE MEMBER, CCC, WHICH IN TURN FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS ADMINISTERED BY ITS PARENT, VHA SOUTHWEST COMMUNITY HEALTH CORPORATION, WHICH REQUIRES ALL OFFICERS, DIRECTORS, KEY EMPLOYEES, HIGHLY COMPENSATED EMPLOYEES AND OTHER MANAGEMENT OFFICIALS ("COVERED PERSONS") TO DISCLOSE POTENTIAL CONFLICTS. THE ORGANIZATION'S BOARD FORMALLY ADOPTED CCC'S CONFLICT OF INTEREST POLICY FOR YEAR ENDED JUNE 30, 2014. PURSUANT TO THE POLICY, A DISCLOSURE STATEMENT IS CIRCULATED ANNUALLY TO COVERED PERSONS IN WHICH THE INDIVIDUAL MUST DISCLOSE TRANSACTIONS THAT MAY RESULT IN A CONFLICT. COVERED PERSONS ARE ALSO ENCOURAGED TO NOTIFY THE BOARD, APPROPRIATE MANAGEMENT PERSONNEL, CHIEF COMPLIANCE OFFICER, GENERAL COUNSEL OR THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BODY AS NECESSARY. WHEN NECESSARY, THE BOARD CHAIR OR APPROPRIATE BOARD COMMITTEE MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND RECOMMEND ALTERNATIVES TO THE APPLICABLE TRANSACTION OR ARRANGEMENT OR OTHERWISE DETERMINE IF THE CONFLICT CAN BE RESOLVED. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER THE CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION, AND WHETHER IT IS REASONABLE. THE GOVERNING BOARD OR COMMITTEE MAKES THE DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. ANY MEMBER OF THE BOARD OPERATING UNDER A CONFLICT IS NOT PERMITTED TO BE PRESENT OR OTHERWISE PARTICIPATE IN THE VOTE ON ANY MATTER TO WHICH THE CONFLICT RELATES. IF THE GOVERNING BOARD OR COMMITTEE OF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND AFTER INVESTIGATION THE BOARD OR COMMITTEE DETERMINES THAT THE COVERED PERSON FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE ORGANIZATION TAKES APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION, WHICH MAY INCLUDE, TERMINATION OF THE INDIVIDUAL'S MEMBERSHIP, EMPLOYMENT OR CONTRACT. |
| FORM 990, PART VI, QUESTIONS 15A & 15B | OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN THE ORGANIZATION FOLLOWS THE COMPENSATION POLICY OF VHA SOUTHWEST COMMUNITY HEALTH CORPORATION (CHC). CHC ENGAGED SULLIVAN COTTER TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITIES AND CURRENT INCUMBENTS' COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. THE ORGANIZATION FOLLOWED THE PROCESS FOR THE YEAR ENDED JUNE 30, 2014 FOR ITS OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES AND OTHER MANAGEMENT OFFICIALS. THIS PROCESS IS PERFORMED EACH YEAR PRIOR TO THE ANNUAL EMPLOYEE EVALUATION PROCESS, WHICH ENDS ON OCTOBER 1ST OF EACH YEAR. |
| FORM 990, PART VI, LINE 19 | PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE AT ITS BUSINESS OFFICE UPON REQUEST. |
| FORM 990, PART XII, QUESTION 2C | OVERSIGHT OR SELECTION PROCESS THE AUDIT COMMITTEE OF VHA SOUTHWEST COMMUNITY HEALTH CORPORATION, WHICH IS THE PARENT ORGANIZATION OF CCHM IS RESPONSIBLE FOR OVERSEEING THE EXTERNAL AUDIT OF THE CONSOLIDATED FINANCIALS. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES TOTAL FEES:430878 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:115849 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHYSICIAN FEES TOTAL FEES:788 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:AMBULANCE TOTAL FEES:1250 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (18 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| YOAKUM COMMUNITY HOSPITAL | ||||||||||
| 1200 CARL RAMERT DRIVE | YOAKUM | TX | 77995 | 742323822 | HOSPITAL | TX | 501(C)(3) | 3 | CHC | false |
| CONTINUECARE HOSPITAL OF TYLER | ||||||||||
| 800 E DAWSON STREET | TYLER | TX | 75701 | 200991990 | HOSPITAL | TX | 501(C)(3) | 3 | CCC | false |
| CONTINUECARE HOSPITAL OF SOUTHEAST TEXAS | ||||||||||
| 7800 N DALLAS PARKWAY 200 | PLANO | TX | 75024 | 201150480 | HOSPITAL | TX | 501(C)(3) | 3 | CCC | false |
| ST MARKS MEDICAL CENTER | ||||||||||
| ONE ST MARKS PLACE | LA GRANGE | TX | 78945 | 743019849 | HOSPITAL | TX | 501(C)(3) | 3 | CHC | false |
| CHC COMMUNITY CARE LLC | ||||||||||
| 7800 N DALLAS PARKWAY 200 | PLANO | TX | 75024 | 371485773 | SUPPORT ORG | TX | 501(C)(3) | 11C-III-FI | CHC | false |
| BAPTIST PHYSICIANS NETWORK | ||||||||||
| 3080 COLLEGE STREET | BEAUMONT | TX | 77701 | 760453250 | PRIMARY CARE | TX | 501(C)(3) | 3 | BHSET | false |
| CONTINUECARE HSPTL AT HENDRICK MDCL CNTR | ||||||||||
| 1900 PINE STREET 5TH FLOOR | ABILENE | TX | 79601 | 463607347 | HOSPITAL | DE | 501(C)(3) | 3 | CCC | false |
| CONTINUECARE HOSPITAL AT BAKERSFIELD | ||||||||||
| 7800 N DALLAS PARKWAY 200 | PLANO | TX | 75024 | 465236524 | HOSPITAL | DE | 501(C)(3) | 3 | CCC | false |
| CONTINUECARE HPTL AT BPTST HLTH MDSNVLLE | ||||||||||
| 7800 N DALLAS PARKWAY 200 | PLANO | TX | 75024 | 465033192 | HOSPITAL | DE | 501(C)(3) | 3 | CCC | false |
| CONTINUECARE HPTL AT BPTST HLTH PADUCAH | ||||||||||
| 7800 N DALLAS PARKWAY 200 | PLANO | TX | 75024 | 465032999 | HOSPITAL | DE | 501(C)(3) | 3 | CCC | false |
| CONTINUECARE HOSPITAL AT BAPTIST HEALTH | ||||||||||
| 1 TRILLIUM WAY | CORBIN | KY | 40701 | 200925675 | HOSPITAL | KY | 501(C)(3) | 3 | CCC | false |
| CRAWLEY MEMORIAL HOSPITAL | ||||||||||
| 706 KINGS STREET | KINGS MOUNTAIN | NC | 28086 | 560691100 | HOSPITAL | NC | 501(C)(3) | 3 | CAR CC | false |
| CAROLINAS COMMUNITY CARE | ||||||||||
| 7800 N DALLAS PARKWAY 200 | PLANO | TX | 75024 | 465590355 | SUPPORT ORG | DE | 501(C)(3) | 11C-III-FI | CHC | false |
| CAROLINAS CONTINUECARE HOSPITAL | ||||||||||
| 7800 N DALLAS PARKWAY 200 | PLANO | TX | 75024 | 463796709 | HOSPITAL | DE | 501(C)(3) | 3 | CAR CC | false |
| VHA Southwest Community Health Corp | ||||||||||
| 7800 N Dallas Parkway 200 | Plano | TX | 75024 | 752638469 | Support org | TX | 501(c)(3) | 11C-III-FI | NA | false |
| ARTESIA GENERAL HOSPITAL | ||||||||||
| 702 NORTH 13TH STREET | ARTESIA | NM | 88210 | 742851819 | HOSPITAL | NM | 501(C)(3) | 3 | CHC | false |
| BAPTIST HOSPITALS OF SOUTHEAST TEXAS | ||||||||||
| POST OFFICE BOX 1591 | BEAUMONT | TX | 77704 | 741303720 | HOSPITAL | TX | 501(C)(3) | 3 | SWCH INC | false |
| SOUTHWEST COMMUNITY HOSPITAL INC | ||||||||||
| 7800 N DALLAS PARKWAY 200 | PLANO | TX | 75024 | 752725353 | HOSPITAL | TX | 501(C)(3) | 11D,III-O | CHC | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1ForeignAddress/AddressLine1 | CityForeignAddress/City | CountryForeignAddress/Country | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY HEALTH ASSURANCE SPC LTD | |||||||||||||
| CAYMAN ISLANDS POB 69GT | GRAND CAYMAN | CJ | CAPTIVE INSURANCE | CJ | CHC | C CORP | false | ||||||
| COMMUNITY HOSPITAL CONSULTING INC | |||||||||||||
| MGMT CONSULTING | CHC | C CORP | false | 7800 N DALLAS PARKWAY SUITE 200 | PLANO | TX | 75024 | 204710183 | TX | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CHC Community Care LLC | ||
| O | $222,341 | FMV |
| CHC Community Care LLC | ||
| p | $397,799 | FMV |
| VHA Southwest Community Health Corp | ||
| P | $907,191 | FMV |