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MISSOURI DELTA MEDICAL CENTER: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MISSOURI DELTA MEDICAL CENTER (EIN 43-0633449)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-14
IRS object ID
201432269349304558
Schema version
2012v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-14T16:06:19-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KERBER ECK & BRAECKEL LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11116 W MAIN STAddressLine1
CityCARBONDALECity
StateILState
ZIP Code629012335ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN430633449EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MISSOURI DELTA MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMISSNameControl
Phone5734711600Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11008 NORTH MAIN STREETAddressLine1
CitySIKESTONCity
StateMOState
ZIP Code638015044ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJASON SCHRUMPFName
TitleCEOTitle
Phone5734711600Phone
Date Signed2014-08-12DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMARK DALLASName
Phone6185291040Phone
Date Prepared2014-08-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJASON SCHRUMPFNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11008 NORTH MAIN STREETAddressLine1
CitySIKESTONCity
StateMOState
ZIP Code638015044ZIPCode
FieldValueIRS element (for citing)
Gross Receipts86904912GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MISSOURIDELTA.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1948YearFormation
State Legal DomicileMOStateLegalDomicile
Activity Or Mission DescriptionMISSOURI DELTA MEDICAL CENTER IS A NOT FOR PROFIT CORPORATION WHICH STRIVES TO PROVIDE A COMPLETE HEALTH CARE SYSTEM TO RESIDENTS IN THE SERVICE AREA EITHER DIRECTLY OR IN COOPERATION WITH OTHERS.ActivityOrMissionDescription
Nbr Voting Members Governing Body26NbrVotingMembersGoverningBody
Nbr Independent Voting Members19NbrIndependentVotingMembers
Total Nbr Employees954TotalNbrEmployees
Total Nbr Volunteers52TotalNbrVolunteers
Total Gross UBI-23123TotalGrossUBI
Net Unrelated Business Txbl Income-18378NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year348557ContributionsGrantsPriorYear
Contributions Grants Current Year1375516ContributionsGrantsCurrentYear
Program Service Revenue Prior Year94527177ProgramServiceRevenuePriorYear
Program Service Revenue CY83308645ProgramServiceRevenueCY
Investment Income Prior Year959482InvestmentIncomePriorYear
Investment Income Current Year976424InvestmentIncomeCurrentYear
Other Revenue Prior Year1206572OtherRevenuePriorYear
Other Revenue Current Year1206804OtherRevenueCurrentYear
Total Revenue Prior Year97041788TotalRevenuePriorYear
Total Revenue Current Year86867389TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year49000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY56500GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year51598880SalariesEtcPriorYear
Salaries Etc Current Year49528490SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year161099TotalFundrsngExpCurrentYear
Other Expense Prior Year46614498OtherExpensePriorYear
Other Expenses Current Year35340602OtherExpensesCurrentYear
Total Expenses Prior Year98262378TotalExpensesPriorYear
Total Expenses Current Year84925592TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1220590RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1941797RevenuesLessExpensesCY
Total Assets BOY59444886TotalAssetsBOY
Total Assets EOY67746871TotalAssetsEOY
Total Liabilities BOY18601366TotalLiabilitiesBOY
Total Liabilities EOY24735987TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY40843520NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY43010884NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionMISSOURI DELTA MEDICAL CENTER IS A NOT FOR PROFIT CORPORATION WHICH STRIVES TO PROVIDE A COMPLETE HEALTH CARE SYSTEM TO RESIDENTS IN THE SERVICE AREA EITHER DIRECTLY OR IN COOPERATION WITH OTHERS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense75453737Expense
Grants56500Grants
Revenue86966702Revenue
DescriptionMISSOURI DELTA MEDICAL CENTER PROVIDES QUALITY MEDICAL CARE TO THE RESIDENTS OF ITS COMMUNITY REGARDLESS OF ABILITY TO PAY. MISSOURI DELTA MEDICAL CENTER ALSO PROVIDES SHORT TERM REHABILITATION SERVICES THROUGH AN ACUTE INPATIENT REHABILITATION UNIT AND PSYCHIATRIC SERVICES THROUGH A GERIATRIC PSYCHIATRIC FACILITY. THESE SERVICES ARE SUMMARIZED AS FOLLOWS: HOSPITAL: NUMBER OF HOSPITAL PATIENT DAYS 21,414 NUMBER OF INPATIENT ADMISSIONS 4,659 NUMBER OF EMERGENCY ROOM VISITS 16,447 NUMBER OF RURAL HEALTH CLINIC VISITS 47,335 NUMBER OF LABORATORY TESTS PERFORMED 259,173 NUMBER OF RADIOLOGY EXAMS PERFORMED 64,374 NUMBER OF PHYSICAL THERAPY TREATMENTS 55,939 NUMBER OF OCCUPATIONAL THERAPY TREATMENTS 12,538 NUMBER OF PHYSICIAN OFFICE VISITS 55,195 ACUTE INPATIENT REHAB: NUMBER OF INPATIENT REHAB PATIENT DAYS 1,843 NUMBER OF INPATIENT REHAB PATIENT ADMISSIONS 151 PSYCHIATRIC FACILITY: NUMBER OF PATIENT DAYS 3,333 NUMBER OF PATIENT ADMISSIONS 358 THE HOSPITAL PROVIDED FREE CARE TO INDIGENT PATIENTS IN THE AMOUNT OF 13,752,239 IN FY 2013, VALUED AT BILLED CHARGES. THE HOSPITAL ALSO PROVIDED NUMEROUS FREE PROGRAMS AND REDUCED PRICE SERVICES THROUGH THE YEAR THAT THE HOSPITAL BELIEVES SERVES A COMMUNITY NEED. SERVICES PROVIDED FREE OF CHARGE OR BELOW COST TO THE GENERAL PUBLIC INCLUDE: 1. PERIODIC BLOOD PRESSURE AND CHOLESTEROL SCREENS 2. OUTPATIENT DIABETIC EDUCATION 3. FIRST AID CLASSES 4. CPR COURSES 5. CHILDBIRTH CLASSES 6. EMERGENCY PREPAREDNESS COURSES 7. HEALTH EDUCATION ARTICLES IN THE LOCAL NEWSPAPER 8. OTHER HEALTH EDUCATION CLASSES 8. OTHER HEALTH EDUCATION CLASSESDescription
Total Program Service Expense75453737TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersontrueGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109688NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees954NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members26NbrVotingGoverningBodyMembers
Number Independent Voting Members19NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJON BRANSTETTERNamePerson
Telephone Number5734711600TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11008 NORTH MAIN STREETAddressLine1
CitySIKESTONCity
StateMOState
ZIP Code638015044ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (33 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
JIM CULLISON
DIRECTOR1.00X000
BRIAN MENZ
DIRECTOR1.00X000
DIANE PETERSON
CHAIRMAN5.00X000X
CHRIS STEWARD
DIRECTOR1.00X000
LINDA BOYD
DIRECTOR1.00X000
ROBERT BUCHANAN
DIRECTOR1.00X000
JOHN BOLLINGER
DIRECTOR1.00X000
KEITH DAVIDSON
DIRECTOR1.00X000
EDWARD DEMENT
DIRECTOR1.00X000
JON GILMORE
DIRECTOR1.00X000
BILL HAMPTON
DIRECTOR1.00X000
DAN JENNINGS JR
VICE CHAIRMA2.00X000X
ELIZABETH JOHNSON
DIRECTOR1.00X000
MICHAEL JONES
DIRECTOR1.00X000
JEFF HUX
DIRECTOR1.00X000
ROBERT MACGILLIVRAY
TREASURER1.00X000X
DENNY KOONCE
DIRECTOR1.00X000
BRITT MCCONNELL
DIRECTOR1.00X000
ROBERT MITCHELL
DIRECTOR1.00X000
MIKE MOLL
SECRETARY1.00X000X
DOUG SCOTT
DIRECTOR1.00X000
CHARLES MOXLEY
DIRECTOR1.00X000
MIKE POBST
DIRECTOR1.00X000
GERALD SETTLES
DIRECTOR1.00X000
STEVE SIKES
DIRECTOR1.00X000
RON WATKINS
DIRECTOR1.00X000
JASON SCHRUMPF
PRESIDENT40.0017641509698X
JON BRANSTETTER
VP FINANCE40.0014225805642X
MOWAFFAQ SAID MD
PHYSICIAN40.0064778409699X
LAWRENCE L CONLEY JR DO
PHYSICIAN40.0059610706024X
CARY SANDERS MD
PHYSICIAN40.0059493007168X
LINZA KILLION MD
PHYSICIAN40.0040136605530X
LY T PHAN MD
PHYSICIAN40.0040007108077X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2958931TotalReportableCompFromOrg
Total Other Compensation51838TotalOtherCompensation
Number Individuals GT100 K48NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HORIZON HEALTH MENTAL HEALTH
PO BOX 840839DALLASTX752840839PSYCH SERVICES1082326
MAYO COLLABORATIVE SERVICES INC
PO BOX 9146MINNEAPOLISMN554809146LABORATORY SVC542762
HORIZON HEALTH ACUTE REHAB
PO BOX 840839DALLASTX752840839ACUTE REHAB358797
PREMIER HOSPITALIST GROUP
2909 INDEPENDENCECAPE GIRARDEAUMO63703HOSPITALISTS337444
SAINT FRANCIS MEDICAL CENTER
211 ST FRANCIS DRIVECAPE GIRARDEAUMO63703ONCOLOGISTS332953
FieldValueIRS element (for citing)
Number Of Contractors GT100 K13NumberOfContractorsGT100K
Related Organizations163516RelatedOrganizations
All Other Contributions1212000AllOtherContributions
Noncash Contributions1212000NoncashContributions
Total Contributions1375516TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE6211108119929581199295
EMR INCENTIVE PAYMENT62111021093502109350
FieldValueIRS element (for citing)
Total Program Service Revenue83308645TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column976424TotalRevenueColumn
Exclusion$976,424ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real14400Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real37523Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-23123Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-23123TotalRevenueColumn
Unrelated Business Revenue-23123UnrelatedBusinessRevenue

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
OTHER OPERATING REVENUE900099912197$912,197
CAFETERIA INCOME722514208506$208,506
MEDICAL RECORD REVENUE621990109224$109,224
FieldValueIRS element (for citing)
Total Other Revenue1229927TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column86867389TotalRevenueColumn
Related Or Exempt Function Income83308645RelatedOrExemptFunctionIncome
Unrelated Business Revenue-23123UnrelatedBusinessRevenue
Exclusion$2,206,351ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total56500Total
Program Services56500ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total334013Total
Management And General334013ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total40695292Total
Program Services37619442ProgramServices
Management And General2995735ManagementAndGeneral
Fundraising80115Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total331935Total
Program Services302061ProgramServices
Management And General26555ManagementAndGeneral
Fundraising3319Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5573921Total
Program Services5072268ProgramServices
Management And General445914ManagementAndGeneral
Fundraising55739Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2593329Total
Program Services2359424ProgramServices
Management And General227284ManagementAndGeneral
Fundraising6621Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total29526Total
Management And General29526ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total149080Total
Management And General149080ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total8793904Total
Program Services7153217ProgramServices
Management And General1638871ManagementAndGeneral
Fundraising1816Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total147304Total
Program Services2247ProgramServices
Management And General145057ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total5128449Total
Program Services3405505ProgramServices
Management And General1710413ManagementAndGeneral
Fundraising12531Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total903679Total
Program Services903645ProgramServices
Management And General34ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total171353Total
Program Services160718ProgramServices
Management And General10117ManagementAndGeneral
Fundraising518Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total33185Total
Program Services32760ProgramServices
Fundraising425Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total632734Total
Program Services632734ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4529005Total
Program Services4529005ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total1234324Total
Program Services81ProgramServices
Management And General1234243ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES131169531308925427699
DUES & SUBSCRIPTIONS1847471343715036115
RECRUITING183797505183292
FARM EXPENSE102562102562

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total84925592Total
Program Services75453737ProgramServices
Management And General9310756ManagementAndGeneral
Fundraising161099Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY7926268BOY
EOY5037769EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY746607BOY
EOY759153EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9675095BOY
EOY14947812EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1164084BOY
EOY1247027EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3524873BOY
EOY3448068EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1130561BOY
EOY3757414EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis79125929LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec41623385LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY34161081BOY
EOY37502544EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1116317BOY
EOY1047084EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY59444886BOY
EOY67746871EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6758972BOY
EOY14010295EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY3134692BOY
EOY2810511EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY8707702BOY
EOY7915181EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY18601366BOY
EOY24735987EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY40603573BOY
EOY42770937EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY239947BOY
EOY239947EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY40843520BOY
EOY43010884EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY59444886BOY
EOY67746871EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1941797ReconcilationRevenueExpenses
Reconcilation Other Changes225567ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$7,179GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB7179TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance212608BeginningOfYearBalance
Investment Earnings Or Losses-926InvestmentEarningsOrLosses
End Of Year Balance211682EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance205741BeginningOfYearBalance
Investment Earnings Or Losses6867InvestmentEarningsOrLosses
End Of Year Balance212608EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance219883BeginningOfYearBalance
Investment Earnings Or Losses-3185InvestmentEarningsOrLosses
Other Expenditures10957OtherExpenditures
End Of Year Balance205741EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3322552BeginningOfYearBalance
Contributions2500Contributions
Investment Earnings Or Losses73935InvestmentEarningsOrLosses
Other Expenditures3179104OtherExpenditures
End Of Year Balance219883EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance7388571BeginningOfYearBalance
Contributions146208Contributions
Investment Earnings Or Losses287786InvestmentEarningsOrLosses
Grants Or Scholarships42482GrantsOrScholarships
Other Expenditures4457531OtherExpenditures
End Of Year Balance3322552EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis4273774InvestmentCostOrOtherBasis
Other Cost Or Other Basis618603OtherCostOrOtherBasis
Book Value4892377BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis31903892OtherCostOrOtherBasis
Depreciation15083179Depreciation
Book Value16820713BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis41273191OtherCostOrOtherBasis
Depreciation25714735Depreciation
Book Value15558456BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1056469OtherCostOrOtherBasis
Depreciation825471Depreciation
Book Value230998BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings37502544TotalOfBookValueLandBuildings

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
LIABILITY UNDER FIN 48 FOOTNOTESCHEDULE D, PAGE 3, PART XMANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SUPPLEMENTAL FINANCIAL INFORMATIONSCHEDULE D, PAGE 4, PART XIIITHE ORGANIZATION'S ENDOWMENT FUNDS ARE RESTRICTED BY DONORS AND SET ASIDE BY THE BOARD OF DIRECTORS FOR FUTURE CAPITAL IMPROVEMENTS OVER WHICH THE BOARD RETAINS CONTROL AND MAY AT ITS DISCRETION SUBSEQUENTLY USE FOR OTHER PURPOSES.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage1.80000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense4131802TotalCommunityBenefitExpense
Net Community Benefit Expense4131802NetCommunityBenefitExpense
Percent Of Total Expense0.04870PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense21259715TotalCommunityBenefitExpense
Direct Offsetting Revenue24222035DirectOffsettingRevenue
Net Community Benefit Expense-2962320NetCommunityBenefitExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense25391517TotalCommunityBenefitExpense
Direct Offsetting Revenue24222035DirectOffsettingRevenue
Net Community Benefit Expense1169482NetCommunityBenefitExpense
Percent Of Total Expense0.04870PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense68779TotalCommunityBenefitExpense
Net Community Benefit Expense68779NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense68779TotalCommunityBenefitExpense
Net Community Benefit Expense68779NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense25460296TotalCommunityBenefitExpense
Direct Offsetting Revenue24222035DirectOffsettingRevenue
Net Community Benefit Expense1238261NetCommunityBenefitExpense
Percent Of Total Expense0.04950PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$10,604,349BadDebtExpenseAmount
Amount Reimbursed By Medicare24373249AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare29021925CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-4648676MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1MISSOURI DELTA MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11008 NORTH MAIN STREETAddressLine1
CitySIKESTONCity
StateMOState
ZIP Code63801ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MISSOURI DELTA MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
OtherXOther
Needs Assessment Conducted13NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize ServicesXPrioritizeServices
All Needs AddressedfalseAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100.0FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent180.0FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Lowest Negotiated RatesXLowestNegotiatedRates
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities18NumberOfOtherFacilities

Other Facilities OtherFacilities (18 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
CONTINU-CARE HOME HEALTH
104 SMITH STREETSIKESTONMO63801HOME HEALTH AGENCY
CHARLESTON COMMUNITY CARE CENTER
1200 EAST MARSHALL STREETCHARLESTONMO63834RURAL HEALTH CLINIC
RESTART OF CHARLESTON
512 EAST MARSHALL STREETCHARLESTONMO63834PHYSICAL THERAPY
RESTART OF NEW MADRID
406 HIGHWAY 61NEW MADRIDMO63869PHYSICAL THERAPY
RESTART OF EAST PRAIRIE
106 SOUTH WASHINGTONEAST PRAIRIEMO63845PHYSICAL THERAPY
BARTON-JOLLEY PHYSICIAN SVCS
1013 NORTH MAIN STREETSIKESTONMO63801PHYSICIAN OFFICE BUILDING
MUHANNAD AL-KILANI MD
1118 NORTH MAIN STREETSIKESTONMO63801PHYSICIAN OFFICE BUILDING
MISSOURI DELTA CANCER & INFUSION
1126 NORTH MAIN STREETSIKESTONMO63801INFUSION CENTER
KENNETH STONE MD
121 SMITH STREETSIKESTONMO63801PHYSICIAN OFFICE BUILDING
SMITH STREET CLINIC
119 SMITH STREETSIKESTONMO63801RURAL HEALTH CLINIC
JAYCEE RENAL DIALYSIS CENTER
135 PLAZA DRIVESIKESTONMO63801DIALYSIS CENTER
LINZA KILLION MD
1106 NORTH MAIN STREETSIKESTONMO63801PHYSICIAN OFFICE BUILDING
MISSOURI DELTA PRIMARY CARE
1015 NORTH MAIN STREETSIKESTONMO63801RURAL HEALTH CLINIC
MISSOURI DELTA ORTHOPEDICS
201 PLAZA DRIVESIKESTONMO63801PHYSICIAN OFFICE BUILDING
MISSOURI DELTA WOUND & HYPERBARIC
201 PLAZA DRIVESIKESTONMO63801WOUND CARE CENTER
MISSOURI DELTA MEDICAL EQUIPMENT
102 SMITH STREETSIKESTONMO63801DURABLE MEDICAL EQUIPMENT
NEW MADRID COMMUNITY CARE
615 MAIN STREETNEW MADRIDMO63869RURAL HEALTH CLINIC
PORTAGEVILLE COMMUNITY CARE
204 EAST 3RD STREETPORTAGEVILLEMO63873RURAL HEALTH CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
COSTING METHODOLOGY EXPLANATIONPART I LINE 7THE COSTS REPORTED IN THE TABLE IN PART I LINE 7 USED A RATIO OF PATIENT CARE COSTS TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM INSTRUCTIONS THIS METHODOLOGY WAS USED FOR ALL PATIENT SEGMENTS
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE THE CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRDPARTY COVERAGE THE CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCUONTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS IF NECESSARY FOR EXAMPLE FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD PARTY PAYER HAS NOT YET PAID OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY FOR RECEIVABLES ASSOCIATED WITH SELFPAY BALANCES WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARY COVERAGE EXISTS FOR PART OF THE BILL THE CENTER RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE THE DIFFERENCE BETWEEN THE STANDARD RATES OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 WAS THE AMOUNT OF THE EXPENSE REPORTED ON THE ORGANIZATIONS AUDITED FINANCIAL STATEMENTS WHICH IS VALUED AT BILLED CHARGES IT IS DIFFICULT TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO COULD QUALIFY FOR CHARITY CARE DUE TO THE LIMITED NUMBER OF FINANCIAL APPLICATIONS COMPLETED BY PATIENTS
MEDICARE EXPLANATIONPART III LINE 8IRS REVENUE RULING 69545 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 THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS ESTIMATED BY USING THE PERCENT OF OPERATING EXPENSE TO PATIENT REVENUE
COLLECTION PRACTICES EXPLANATIONPART III LINE 9BTHE BAD DEBT POLICY STATES THAT IF IT IS DECIDED THAT A PATIENT IS INDIGENT PROCEED AS FOLLOWS A COMPLETE ACCOUNT ADJUSTMENT FORMS FOLLOWING ACCOUNT ADJUSTMENT PROCEDURES OR NOTE THE BALANCE WILL BE WRITTEN OFF AS CHARITY ACCORDING TO THE CHARITY CARE POLICY B ENTER THE FOLLOWING NOTATIONS ON THE COPY OF THE PATIENT ACCOUNTS ADMISSION REGISTRATION FORMS OR IN ACCOUNTS RECEIVABLE NOTES IN THE COMPUTER CHARGES DUE BY PATIENT WILL BE WRITTEN OFF AS MEDICARE BAD DEBT OR UNCOMPENSATED CARE
NEEDS ASSESSMENTPART VITHE DETERMINATION OF CURRENT AND FUTURE HEALTH CARE NEEDS OF THE COMMUNITY OR COMMUNITIES SERVED BY MISSOURI DELTA MEDICAL CENTER IS BASED ON ALL OR A COMBINATION OF THE FOLLOWING FACTORS EXISTENCE OR NONEXISTENCE OF SERVICES OPPORTUNITY SUPPLY DEMONSTRATED NEED VOICE OF THE CUSTOMER ANDOR COLLABORATIVE EFFORTS WITH OUTSIDE ENTITIES GOVERNMENT AGENCIES AND OTHER HEALTH CARE PROVIDERS THAT WOULD ENABLE THE FILLING OF A NEED OR ENHANCE AND COMPLIMENT AN ALREADY EXISTING SERVICE DATA IS GATHERED CONSTANTLY THROUGH HIDI BENCHMARKING MARKET RESEARCH CUSTOMER SURVEYS PHYSICIAN INPUT REGARDING TECHNOLOGIES REQUIRED TO KEEP SERVICES ON THE CUTTING EDGE AND THROUGH CONSTANT MONITORING OF STATE AND FEDERAL GUIDELINES THIS INFORMATION IS REVIEWED AND ANALYZED BY THE HOSPITALS ADMINISTRATIVE TEAM AND INCORPORATED INTO THE HOSPITALS STRATEGIC PLANNING PROCESS THROUGH THE PLANNING COMMITTEE OF THE BOARD OF DIRECTORS AND EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VIALL PATIENT BILLING STATEMENTS FOR MISSOURI DELTA MEDICAL CENTER INCLUDE A STATEMENT THAT THE PATIENT MAY CONTACT THE MEDICAL CENTER WITH ANY QUESTIONS OR PAYMENT ISSUES REGARDING THEIR BILL IF A PATIENT CONTACTS THE CENTER WITH AN INABILITY TO MAKE PAYMENT ISSUE THEY INFORM THE PATIENT OF THE AVAILABLE OPTION INCLUDING CHARITY CARE AND OTHER ASSISTANCE THEY ALSO EXPLAIN HOW THE PATIENT CAN APPLY FOR ASSISTANCE OUR SOCIAL WORKERS WILL ALSO COMMUNICATE WITH THOSE PATIENTS WHO MAY QUALIFY FOR MEDICAID AND ASSIST THOSE PATIENTS IN COMPLETING THEIR MEDICAID APPLICATIONS
COMMUNITY INFORMATIONPART VIMISSOURI DELTA MEDICAL CENTER IS A SOLE COMMUNITY HOSPITAL IN SIKESTON MISSOURI THAT PRIMARILY SERVES THE RESIDENTS OF SCOTT MISSISSIPPI STODDARD AND NEW MADRID COUNTIES IN SOUTHEASTERN MISSOURI MISSOURI DELTA MEDICAL CENTER SERVES PATIENTS WITHOUT REGARD TO AGE GENDER INCOME ETHNIC ORIGIN INSURANCE COVERAGE OR ABILITY TO PAY APPROXIMATELY 72 OF THE MISSOURI DELTA MEDICAL CENTERS NET PATIENT REVENUE IS FROM PARTICIPATION IN THE MEDICARE AND STATE SPONSORED MEDICAID PROGRAM FOR THE YEAR ENDED SEPTEMBER 30 2013
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VIOUR BOARD OF DIRECTORS IS MADE UP OF 26 COMMUNITY MEMBERS FROM OUR SERVICE AREAS THESE BOARD MEMBERS HAVE REGULAR INPUT ON STRATEGIC PLANNING NEW SERVICES TECHNOLOGY AND PHYSICIAN RECRUITMENT FOR OUR COMMUNITY THE USE OF ANY SURPLUS FUNDS IS REINVESTED BACK INTO THE MEDICAL CENTER THROUGH THE PURCHASE OF PROPERTY AND EQUIPMENT TO PROVIDE SERVICES THAT FULFILL THE NEEDS OF THE SERVICE AREA
AFFILIATED HEALTH CARE INFORMATIONPART VINOT APPLICABLE
ADDITIONAL INFORMATIONPART VISCHEDULE H PART I LINE 7B THE MEDICAID BENEFIT REIMBURSES THE HOSPITAL TO HELP COVER THE UNCOMPENSATED COST OF TREATING THE UNINSURED MEDICARE AND MEDICAID PATIENTS MISSOURI DELTA MEDICAL CENTER HAS A LARGE AMOUNT OF UNINSURED MEDICARE AND MEDICAID PATIENTS INCLUDING DUAL BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS DUE TO THE LARGE MIX OF THESE TYPES OF PATIENTS THE HOSPITAL HAS AN OVERALL LARGE AMOUNT OF UNCOMPENSATED CARE WHICH CAUSES AN INCREASE TO THE MEDICAID ADDON PAYMENT
MISSOURI DELTA MEDICAL CENTER LINE NUMBER 1 PART V LINE 3PART V LINE 3PRIMARY DATA COLLECTION FOR THE CHNA INCLUDED A FOCUS GROUP HELD IN EACH OF THE THREE COUNTIES DEFINED AS THE GEOGRAPHIC AREA OF PATIENTS USING MDMC WHICH ARE SCOTT MISSISSIPPI AND NEW MADRID COUNTIES INDIVIDUALS FROM A BROAD INTEREST WERE INCLUDED IN THE FOCUS GROUPS EFFORTS WERE MADE TO INCLUDE ATRISK TARGETED POPULATIONS AND PRINCIPLE SPECIALTY AREAS THAT ARE SERVED BY THE HOSPITAL AND PRESENT WITHIN THE COMMUNITY SUCH AS THE MEDICALLY UNDERSERVED LOW INCOME PERSONS MINORITY GROUPS AND THOSE WITH CHRONIC DISEASE NEEDS PRIMARY DATA WAS ALSO GATHERED THROUGH THE USE OF A COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY A QUESTIONNAIRESTYLE SELF ADMINISTERED SURVEY AVAILABLE ONLY TO THOSE PARTICIPANTS THAT A GRADUATE STUDENT SOCIAL WORKER AND A HOSPITAL MARKETING INTERN CAME INTO CONTACT WITH AT CERTAIN LOCATIONS THE SURVEY WAS DESIGNED TO COLLECT DATA ON HEALTH BELIEFS HEALTH BEHAVIORS ACCESS TO AND UTILIZATION OF HEALTH CARE SERVICES AND CONCERNS ABOUT COMMUNITY HEALTH ISSUES
MISSOURI DELTA MEDICAL CENTER LINE NUMBER 1 PART V LINE 4PART V LINE 4FOR THE PURPOSES OF THE ASSESSMENT COMMUNITY IS DEFINED AS THE GEOGRAPHIC AREA FROM WHICH A SIGNIFICANT NUMBER OF PATIENTS USING MDMC SERVICES RESIDE THE PRIMARY SERVICE AREA FOR MDMC IS BASED ON THE NUMBER OF INPATIENT DISCHARGES AND OUTPATIENT VISITS BY PATIENTS THAT RESIDE IN SCOTT MISSISSIPPI AND NEW MADRID COUNTIES THE COMMUNITY HEALTH NEEDS ASSESSMENT CHNA FOR SCOTT COUNTY WAS CONDUCTED IN PARTNERSHIP WITH SOUTHEASTHEALTH AND SAINT FRANCIS MEDICAL CENTER AS MISSISSIPPI COUNTY AND NEW MADRID COUNTY WERE THE PRIMARY SERVICE AREA OF MDMC ALONE THE CHNA WAS NOT CONDUCTED IN PARTNERSHIP WITH SOUTHEASTHEALTH AND SAINT FRANCIS MEDICAL CENTER
MISSOURI DELTA MEDICAL CENTER LINE NUMBER 1 PART V LINE 7PART V LINE 7THE SUBSTANCE ABUSE NEED WAS NOT ADDRESSED DUE TO LIMITED FUNDS AND EXPERTISE IN THE AREA OF SUBSTANCE ABUSE HOSPITAL LEADERSHIP DID NOT MOVE FORWARD WITH IMPLEMENTING STRATEGIES TO IMPROVE THE ISSUE OF SUBSTANCE ABUSE IN THE COMMUNITY

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantMEDICAL STUDENT SCHOLARSHTypeOfGrant
Number Of Recipients9NumberOfRecipients
Amount Of Cash Grant56500AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATESIdentifier
Return ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2ReturnReference
ExplanationTHE SCHOLARSHIP PROGRAM IS DESIGNED TO PROVIDE A CONSISTENT FLOW OF REGISTERED NURSES TO MISSOURI DELTA MEDICAL CENTER. THE OBJECTIVE OF THE PLAN IS TO ENCOURAGE AND FINANCIALLY ASSIST QUALIFIED STUDENTS IN THEIR ENDEAVOR TO BECOME A REGISTERED NURSE. TO THE EXTENT OF AVAILABLE FUNDS, THE MEDICAL CENTER WILL PAY SCHOLARSHIPS TO QUALIFIED STUDENTS OF AN ACCREDITED REGISTERED NURSE PROGRAM. TO QUALIFY FOR THE PROGRAM A STUDENT MUST: A. HIGH SCHOOL GRADUATE 1. RANK IN THE UPPER THIRD OF HIGH SCHOOL CLASS ACADEMICALLY. 2. SHOW EVIDENCE OF MOTIVIATION FOR NURSING EITHER BY APTITUTE TESTING OR BY REPORTED DEMONSTRATION OF INTEREST. 3. PROVIDE LETTER OF RECOMMENDATION FROM AN APPROPRIATE SCHOOL OFFICIAL. 4. BE APPROVED BY THE HOSPITAL SCHOLARSHIP SELECTION COMMITTEE. B. STUDENT NURSES - ALL STUDENT NURSES MUST: 1. HAVE AT LEAST THE EQUIVALENT OF A 2.5 GRADE POINT AVERAGE IN A 4 POINT SYSTEM. 2. MUST PROVIDE A LETTER OF RECOMMENDATION FROM RESPONSIBLE AND APPROPRIATE PERSON. 3. BE APPROVED BY THE SCHOLARSHIP COMMITTEE. C. CURRENT EMPLOYEES - ALL CURRENT EMPLOYEES MUST: 1. BE ENROLLED IN A NURSING PROGRAM AS A FULL-TIME STUDENT 2. NOT BE RECEIVING ANY HOSPITAL BENEFITS 3. BE APPROVED BY THE SHOLARSHIP COMMITTEE.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
JASON SCHRUMPF
PRESIDENT1764159698186113
MOWAFFAQ SAID MD
PHYSICIAN6477849699657483
LAWRENCE L CONLEY JR DO
PHYSICIAN5961076024602131
CARY SANDERS MD
PHYSICIAN5949307168602098
LINZA KILLION MD
PHYSICIAN4013665530406896
LY T PHAN MD
PHYSICIAN4000718077408148

Schedule L IRS990ScheduleL

Form990 Schedule L Part III Form990ScheduleLPartIII

FieldValueIRS element (for citing)
Name Of Interested PersonALEC PETERSONNameOfInterestedPerson
Relationship With OrganizationSON OF CHAIRMANRelationshipWithOrganization
Amount Of Grant2000AmountOfGrant
Type Of AssistanceSCHOLARSHIPTypeOfAssistance

Form990 Schedule L Part IV Form990ScheduleLPartIV (8 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
JASON SCHRUMPF
EMPLOYEE176415COMPENSATIONfalse
CATHERINE SCHRUMPF
EMPLOYEE28795COMPENSATIONfalse
BROOKE BUCHANAN
EMPLOYEE644COMPENSATIONfalse
ROBERT BUCHANAN
EMPLOYEE46008COMPENSATIONfalse
RHONDA MENZ
EMPLOYEE27817COMPENSATIONfalse
JUDITH MENZ
EMPLOYEE90370COMPENSATIONfalse
SUSAN WATKINS
EMPLOYEE11975COMPENSATIONfalse
ANTHONY COPPAGE
EMPLOYEE75703COMPENSATIONfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE L PART VReturnReference
ExplanationJASON SCHRUMPF IS THE SONINLAW OF A DIRECTOR CATHERINE SCHRUMPF IS THE SPOUSE OF JASON SCHRUMPF WHO IS MDMC PRESIDENT AND ALSO THE DAUGHTER OF A DIRECTOR BROOKE BUCHANAN IS THE DAUGHTERINLAW OF A DIRECTOR ROBERT BUCHANAN IS THE SON OF A DIRECTOR RHONDA MENZ IS THE WIFE OF A DIRECTOR JUDITH MENZ IS THE MOTHER OF A DIRECTOR SUSAN WATKINS IS THE WIFE OF A DIRECTOR ANTHONY COPPAGE IS THE BROTHERINLAW OF A DIRECTOR ELIZABETH JOHNSON IS PRESIDENT OF MITCHELL INSURANCE MISSOURI DELTA MEDICAL CENTER PURCHASES INSURANCE FROM MITCHELL INSURANCE AT MARKET RATESExplanation

Schedule M IRS990ScheduleM

Real Estate Other RealEstateOther

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F9901212000NoncashContribsRptdF990
Method Of Determining RevenuesAPPRAISALMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FIRST ACCOMPLISHMENT DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4ANUMBER OF LABORATORY TESTS PERFORMED 259,173 NUMBER OF RADIOLOGY EXAMS PERFORMED 64,374 NUMBER OF PHYSICAL THERAPY TREATMENTS 55,939 NUMBER OF OCCUPATIONAL THERAPY TREATMENTS 12,538 NUMBER OF PHYSICIAN OFFICE VISITS 55,195 ACUTE INPATIENT REHAB: NUMBER OF INPATIENT REHAB PATIENT DAYS 1,843 NUMBER OF INPATIENT REHAB PATIENT ADMISSIONS 151 PSYCHIATRIC FACILITY: NUMBER OF PATIENT DAYS 3,333 NUMBER OF PATIENT ADMISSIONS 358 THE HOSPITAL PROVIDED FREE CARE TO INDIGENT PATIENTS IN THE AMOUNT OF 13,752,239 IN FY 2013, VALUED AT BILLED CHARGES. THE HOSPITAL ALSO PROVIDED NUMEROUS FREE PROGRAMS AND REDUCED PRICE SERVICES THROUGH THE YEAR THAT THE HOSPITAL BELIEVES SERVES A COMMUNITY NEED. SERVICES PROVIDED FREE OF CHARGE OR BELOW COST TO THE GENERAL PUBLIC INCLUDE: 1. PERIODIC BLOOD PRESSURE AND CHOLESTEROL SCREENS 2. OUTPATIENT DIABETIC EDUCATION 3. FIRST AID CLASSES 4. CPR COURSES 5. CHILDBIRTH CLASSES 6. EMERGENCY PREPAREDNESS COURSES 7. HEALTH EDUCATION ARTICLES IN THE LOCAL NEWSPAPER 8. OTHER HEALTH EDUCATION CLASSES 8. OTHER HEALTH EDUCATION CLASSES
RELATED PARTY INFORMATION AMONG OFFICERSFORM 990, PAGE 6, PART VI, LINE 2ROBERT MITCHELL ELIZABETH JOHNSON DIRECTOR DIRECTOR FAMILY RELATIONSHIP JOHN BOLLINGER LINDA BOYD DIRECTOR DIRECTOR FAMILY RELATIONSHIP DAN JENNINGER JR JOHN BOLLINGER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP BRITT MCCONNELL ROBERT MACGILLIVRAY DIRECTOR TREASURER BUSINESS RELATIONSHIP BRITT MCCONNELL KEITH DAVIDSON DIRECTOR DIRECTOR BUSINESS RELATIONSHIP ROBERT MACGILLIVRAY KEITH DAVIDSON DIRECTOR DIRECTOR BUSINESS RELATIONSHIP JIM CULLISON MICHAEL JONES DIRECTOR DIRECTOR FAMILY RELATIONSHIP
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BBEFORE THE FORM 990 IS FILED, THE VICE-PRESIDENT OF FINANCE OF THE ORGANIZATION REVIEWS THE FORM 990, WHICH IS PREPARED BY AN OUTSIDE TAX PREPARER. THE FINANCE COMMITTEE OF MISSOURI DELTA MEDICAL CENTER WILL ALSO PERFORM A REVIEW OF THE FORM 990 AFTER THE FORM HAS BEEN FILED. IN ADDITION, COPIES OF THE FORM 990 WILL BE AVAILABLE TO THE MISSOURI DELTA MEDICAL CENTER'S BOARD OF DIRECTORS AFTER THE ORGANIZATIONS' FORM 990 HAS BEEN FILED.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CTHE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS AS FOLLOWS: MEMBERS OF THE BOARD OF DIRECTORS, PRINCIPAL OFFICERS, AND MEMBERS OF ANY COMMITTEE WITH BOARD-DELEGATED POWERS HAVE AN OBLIGATION TO MAKE DECISIONS AND TO PERFORM THEIR DUTIES FOR THE SOLE BENEFIT OF THE HOSPITAL. ALL PERSONS SERVING IN SUCH CAPACITY SHOULD AVOID PLACING HIMSELF/HERSELF IN A POSITION WHERE PERSONAL INTERESTS ARE IN CONFLICT WITH THE INTERESTS OF THE HOSPITAL. THE FOLLOWING DEFINITIONS SHALL APPLY TO THIS POLICY: 1. AN "INTERESTED PERSON" IS A MEMBER OF THE BOARD OF DIRECTORS, PRINCIPAL OFFICE OR MEMBER OF ANY COMMITTEE WITH BOARD-DELEGATED POWERS; 2. A PERSON HAS A "FINANCIAL INTEREST" IF THE PERSON HAS, DIRECTLY OR INDIRECTLY, THROUGH BUSINESS, INVESTMENT OR FAMILY: A. A PRESENT OR POTENTIAL OWNSERHIP, INVESTMENT, INTEREST, OR COMPENSATION ARRANGEMENT IN ANY ENTITY WITH WHICH THE HOSPITAL HAS OR MAY HAVE A TRANSACTION OR ARRANGEMENT; B. A COMPENSATION ARRANGEMENT WITH THE HOSPITAL OR ANY ENTITY OR INDIVIDUAL WITH WHICH THE ORGANIZATION HAS A TRANSACTION OR ARRANGEMENT. COMPENSATION INCLUES ANY REMUNERATION, DIRECTLY OR INDIRECTLY, AND GIFTS OF FAVORS, WHICH ARE SUBSTANTIAL IN NATURE; 3. AN "AFFILIATED ORGANIZATION" INCLUDES ANY ORGANIZATION OR ENTITY OWNED OR OPERATED BY THE HOSPITAL OR IN WHICH THE HOSPITAL HAS A DIRECT FINANCIAL INTEREST; IF A CONFLICT DOES ARISE, THE HOSPITAL AND ANY AFFILIATED ORGANIZATION SHALL: 1. REQUIRE THAT THE "INTERESTED PERSON" LEAVE THE MEETING DURING THE DISCUSSION OF AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST; 2. APPOINT, IF APPROPRIATE, UNDER THE CIRCUMSTANCES THEN APPEARING, A NON- INTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; 3. DETERMINE, BY A MAJORITY VOTE OF NON-INTERESTED PERSONS PRESENT, THAT THE TRANSACTION OR ARRANGEMENT IS IN THE HOSPITAL OR AFFILIATED ORGANIZATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND IS FAIR AND REASONABLE TO THE HOSPITAL OR AFFILIATED ORGANIZATION. 4. TAKE APPROPRAITE DISCIPLINARY ACTION WITH RESPECT TO AN "INTERESTED PERSON" WHO VIOLATES THIS CONFLICT OF INTEREST POLICY TO PROTECT THE ORGANIZATION'S BEST INTERESTS. THE MINUTES OF ANY MEETING OF THE BOARD OF DIRECTORS OR ANY COMMITTEE WITH BOARD-DELEGATED POWERS SHALL INCLUDE THE FOLLOWING: 1. THE NAMES OF THE PERSONS WHO DISCLOSED FINANCIAL INTERESTS AND THE NATURE OF THEIR FINANCIAL INTEREST; 2. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT AND RECORD OF THE VOTE. NO PHYSICIAN, WHO RECEIVES COMPENSATION DIRECTLY OR INDIRECTLY FROM THE HOSPITAL OR ANY AFFILIATED ORGANIZATION, SHALL BE A MEMBER OR SERVE ON ANY COMMITTEE DECIDING ON COMPENSATION FOR INDEPENDENT CONTRACTORS OR PRINCIPAL OFFICERS OF THE CORPORATION. NO MEMBER OF ANY COMPENSATION COMMITTEE WHO HAS A CONFLICT OF INTEREST SHALL, DIRECTLY OR INDIRECTLY, VOTE ON MATTERS PERTAINING TO THAT INDIVIDUALS' COMPENSATION. EVERY MEMBER OF THE BOARD OF DIRECTORS, PRINCIPAL OFFICERS, AND MEMBERS OF ANY COMMITTEE WITH BOARD-DELEGATED POWERS SHALL SIGN AN ANNUAL STATEMENT THAT SUCH PERSON: 1. RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; 2. READ AND UNDERSTANDS THE POLICY; 3. AGREES TO COMPLY WITH THE POLICY; 4. UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5. UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS TAX EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE ORGANIZATION'S SALARY AND ADMINISTRATIVE REVIEW COMMITTEE, WHICH IS MADE UP OF MEMBERS OF THE BOARD OF DIRECTORS, REVIEWS THE COMPENSATION FOR THE PRESIDENT AND VICE-PRESIDENTS OF THE MEDICAL CENTER. THE REVIEW OF COMPENSATION UTILIZES THE ANNUAL "EXECUTIVE COMPENSATION REPORT" THAT IS PUBLISHED BY THE MISSOURI HOSPITAL ASSOCIATION. A REVIEW OF THE MISSOURI DELTA MEDICAL CENTER'S PRESIDENT AND VICE-PRESIDENTS WAS CONDUCTED FOR THE YEAR ENDINGS SEPTEMBER 30, 2013.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BTHE ORGANIZATION'S SALARY AND ADMINISTRATIVE REVIEW COMMITTEE, WHICH IS MADE UP OF MEMBERS OF THE BOARD OF DIRECTORS, REVIEWS THE COMPENSATION FOR THE PRESIDENT AND VICE-PRESIDENTS OF THE MEDICAL CENTER. THE REVIEW OF COMPENSATION UTILIZES THE ANNUAL "EXECUTIVE COMPENSATION REPORT" THAT IS PUBLISHED BY THE MISSOURI HOSPITAL ASSOCIATION. A REVIEW OF THE MISSOURI DELTA MEDICAL CENTER'S PRESIDENT AND VICE-PRESIDENTS WAS CONDUCTED FOR THE YEAR ENDINGS SEPTEMBER 30, 2013.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19THE ORGANIZATIONS' GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST.
OTHER FEES FOR SERVICESFORM 990, PART IX, LINE 11G7,153,217 1,638,871 1,816
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 9INTEREST RATE SWAP 174,118 TRANSFERS RELATED TO CONSOLIDATION 51,449 THE ORGANIZATION HAD A CHANGE IN THE FAIR VALUE OF AN INTEREST RATE SWAP AND OTHER CHANGES IN NET ASSETS DUE TO TRANSFERS RELATED TO CONSOLIDATION.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
CONTINU-CARE HOMEMAKER SERVICES
1008 NORTH MAIN STREETSIKESTONMO63801431835384HOME HEALTMO501C39MDMCtrue
MISSOURI DELTA MEDICAL CENTER FOUND
1008 NORTH MAIN STREETSIKESTONMO63801431577510FUNDRAISINMO501C311AMDMCtrue

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SOUTHEAST MO UROLOGYBusinessNameLine1
Business Name Line2SOUTHEAST MO UROLOGYBusinessNameLine2

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11106 NORTH MAINAddressLine1
CitySIKESTONCity
StateMOState
ZIP Code63801ZIPCode
FieldValueIRS element (for citing)
EIN431723563EIN
Primary ActivityHEALTH CARPrimaryActivity
Legal Domicile StateMOLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MDMCBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPTypeOfEntity
Share Of Total Income-1087ShareOfTotalIncome
Percentage Ownership1.00000PercentageOwnership
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedBusiness Name Line2NameOfOtherOrganization/BusinessNameLine2
CONTINU-CARE HOMEMAKER SERVICES INC
R58724
MISSOURI DELTA MEDICAL CENTER
C163516FOUNDATION
MISSOUR DELTA MEDICAL CENTER
R13363FOUNDATION