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COMMUNITY MEDICAL CENTER OF IZARD COUNTY: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY MEDICAL CENTER OF IZARD COUNTY (EIN 71-0410601)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-11
IRS object ID
201443159349303184
Schema version
2013v3.1
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)
Return2014-11-11T14:42:35-08:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Hughes Welch & MilliganCPASLTDBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO Box 2094AddressLine1
CityBatesvilleCity
StateARState
ZIP Code725032094ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN710410601EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY MEDICAL CENTER OF IZARD COUNTYBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone8702973739PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 438AddressLine1
CityCALICO ROCKCity
StateARState
ZIP Code72519ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKIM SKIDMOREPersonNm
Person TitleCEOPersonTitleTxt
Signature2014-11-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWILLIAM T COUCHPreparerPersonNm
PTINP00183609PTIN
Phone8707935231PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$6,226,532GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.cmcofic.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1991FormationYr
Legal Domicile StateARLegalDomicileStateCd
Activity Or MissionCMCIC TAKES RESPONSIBILITY FOR THE HEALTH AND MEDICAL CARE OF THE PEOPLE IN COMMUNITIES OF THEIR SERVICE AREA, PROVIDING EFFICIENT, QUALITY MEDICAL AND SURGICAL CARE WITH CHRISTIAN COMPASSION, DIGNITY AND UNDERSTANDINGActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee148TotalEmployeeCnt
Total Volunteers40TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$71,872PYContributionsGrantsAmt
CY Contributions Grants$34,530CYContributionsGrantsAmt
PY Program Service Revenue$6,959,337PYProgramServiceRevenueAmt
CY Program Service Revenue$5,575,654CYProgramServiceRevenueAmt
PY Investment Income$99,740PYInvestmentIncomeAmt
CY Investment Income$479,350CYInvestmentIncomeAmt
PY Other Revenue$330,847PYOtherRevenueAmt
CY Other Revenue$136,998CYOtherRevenueAmt
PY Total Revenue$7,461,796PYTotalRevenueAmt
CY Total Revenue$6,226,532CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,759,378PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,559,085CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,594,125PYOtherExpensesAmt
CY Other Expenses$3,227,166CYOtherExpensesAmt
PY Total Expenses$8,353,503PYTotalExpensesAmt
CY Total Expenses$6,786,251CYTotalExpensesAmt
PY Revenues Less Expenses-$891,707PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$559,719CYRevenuesLessExpensesAmt
Total Assets BOY$5,520,879TotalAssetsBOYAmt
Total Assets EOY$4,883,481TotalAssetsEOYAmt
Total Liabilities BOY$5,715,818TotalLiabilitiesBOYAmt
Total Liabilities EOY$5,638,139TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$194,939NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$754,658NetAssetsOrFundBalancesEOYAmt
MissionCMCIC TAKES RESPONSIBILITY FOR THE HEALTH AND MEDICAL CARE OF THE PEOPLE IN COMMUNITIES OF THEIR SERVICE AREA, PROVIDING EFFICIENT, QUALITY MEDICAL AND SURGICAL CARE WITH CHRISTIAN COMPASSION, DIGNITY AND UNDERSTANDINGMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$4,162,724ExpenseAmt
DescTHE HOSPITAL PROVIDES ACUTE HOSPITAL AND OUTPATIENT CARE TO RESIDENTS OF IZARD COUNTY AND SURROUNDING AREAS.Desc
Total Program Service Expenses$4,162,724TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document20IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee148EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Excess Business HoldingsfalseExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesfalseMinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedurefalseWrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKIM SKIDMOREPersonNm
Phone8702973739PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 438AddressLine1
CityCALICO ROCKCity
StateARState
ZIP Code72519ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
DR MERLY GRASSE
Director1.000.00Yes (X)$0$0$0
ROBERT C LANE MD
Director1.000.00Yes (X)$0$0$0
JAY KNIGHT
Director1.000.00Yes (X)$0$0$0
SUSAN KEMP
Secretary1.000.00Yes (X)$0$0$0Yes (X)
DANNY MOSER
Director1.000.00Yes (X)$0$0$0
PAUL MILLER
Vice President1.000.00Yes (X)$0$0$0Yes (X)
REED PERRYMAN
President1.000.00Yes (X)$0$0$0Yes (X)
KIM SKIDMORE
CEO40.000.00$75,000$0$0Yes (X)
JESSICA MCCLAIN
PHARMACIST40.000.00$114,164$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$189,164TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CORRECT CARE INCBusinessNameLine1

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line117438 HARD HAT DRIVEAddressLine1
CityCOVINGONCity
StateLAState
ZIP Code70435ZIPCode
FieldValueIRS element (for citing)
ServicesER PHYSICANIANSServicesDesc
Compensation$593,945CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
All Other Contributions$34,530AllOtherContributionsAmt
Total Contributions$34,530TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Total Revenue Column$5,575,654TotalRevenueColumnAmt
Related Or Exempt Func Income$5,575,654RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$5,575,654TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,886TotalRevenueColumnAmt
Exclusion$23,886ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$75,325RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$75,325RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$75,325TotalRevenueColumnAmt
Exclusion$75,325ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$455,464OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$455,464OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$455,464TotalRevenueColumnAmt
Exclusion$455,464ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MEAL REVENUE$48,460$48,460
MEDICAL RECORDS$3,537$3,537
VENDING MACHINES$9,071$9,071

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$605TotalRevenueColumnAmt
Exclusion$605ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$61,673OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,226,532TotalRevenueColumnAmt
Related Or Exempt Func Income$5,575,654RelatedOrExemptFuncIncomeAmt
Exclusion$616,348ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$75,000TotalAmt
Management And General$75,000ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,001,890TotalAmt
Program Services$2,322,453ProgramServicesAmt
Management And General$679,437ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$20,669TotalAmt
Program Services$15,502ProgramServicesAmt
Management And General$5,167ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$233,116TotalAmt
Program Services$174,874ProgramServicesAmt
Management And General$58,242ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$228,410TotalAmt
Program Services$171,307ProgramServicesAmt
Management And General$57,103ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$166,180TotalAmt
Program Services$10,397ProgramServicesAmt
Management And General$155,783ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$17,349TotalAmt
Program Services$14,406ProgramServicesAmt
Management And General$2,943ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$173,884TotalAmt
Management And General$173,884ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$309,576TotalAmt
Program Services$309,576ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$128,067TotalAmt
Management And General$128,067ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PURCHASED SERVICES$1,366,193$430,044$936,149
SUPPLIES & OTHER$1,065,917$714,165$351,752

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,786,251TotalAmt
Program Services$4,162,724ProgramServicesAmt
Management And General$2,623,527ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$54,118BOYAmt
EOY$194,318EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,308,986BOYAmt
EOY$1,015,621EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$107,212BOYAmt
EOY$88,945EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$50,651BOYAmt
EOY$111,189EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,376,640LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,917,618LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,886,393BOYAmt
EOY$3,459,022EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$113,519BOYAmt
EOY$14,386EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,520,879BOYAmt
EOY$4,883,481EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,249,388BOYAmt
EOY$1,389,753EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,466,430BOYAmt
EOY$4,248,386EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,715,818BOYAmt
EOY$5,638,139EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$194,939BOYAmt
EOY-$754,658EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$194,939BOYAmt
EOY-$754,658EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,520,879BOYAmt
EOY$4,883,481EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$559,719ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$66,556OtherCostOrOtherBasisAmt
Book Value$66,556BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,058,444OtherCostOrOtherBasisAmt
Depreciation$1,636,840DepreciationAmt
Book Value$2,421,604BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$135,368OtherCostOrOtherBasisAmt
Depreciation$119,774DepreciationAmt
Book Value$15,594BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,066,032OtherCostOrOtherBasisAmt
Depreciation$4,156,252DepreciationAmt
Book Value$909,780BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,240OtherCostOrOtherBasisAmt
Depreciation$4,752DepreciationAmt
Book Value$45,488BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,459,022TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$6,226,532TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$6,226,532RevenueSubtotalAmt
Total Revenue Per Form990$6,226,532TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$6,786,251TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$6,786,251ExpensesSubtotalAmt
Total Expenses Per Form990$6,786,251TotalExpensesPerForm990Amt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other110.000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportfalseAnnualCommunityBnftReportInd
Report Publically AvailablefalseReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$140,810TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$140,810NetCommunityBenefitExpnsAmt
Total Expense0.02070TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$140,810TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$140,810NetCommunityBenefitExpnsAmt
Total Expense0.02070TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$140,810TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$140,810NetCommunityBenefitExpnsAmt
Total Expense0.02070TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$999,837BadDebtExpenseAmt
Bad Debt Expense Attributable$733,925BadDebtExpenseAttributableAmt
Reimbursed By Medicare$2,794,654ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$2,769,813CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$24,841MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY MED CTR OF IZARD COBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 438AddressLine1
CityCALICO ROCKCity
StateARState
ZIP Code72519ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY MED CTR OF IZARD COBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailablefalseCHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.CMCOFIC.ORGOwnWebsiteURLTxt
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
All Needs AddressedYes (true)AllNeedsAddressedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Form4720 FiledfalseForm4720FiledInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (true)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care100.0000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (true)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care110.0000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (true)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Medical IndigencyYes (X)MedicalIndigencyInd
Insurance StatusYes (X)InsuranceStatusInd
Uninsured DiscountYes (X)UninsuredDiscountInd
Medicaid MedicareYes (X)MedicaidMedicareInd
State RegulationYes (X)StateRegulationInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Provided On AdmissionYes (X)ProvidedOnAdmissionInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Collection ActivitiesYes (true)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 3 - Account Input from Person Who Represent the CommunityCOMMUNITY INPUT QUESTIONNAIRE
Part V, Line 20d - Other Billing Determination of Individuals Without Insurance15% DISCOUNT FOR BILLS PAID IN FULL

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsPATIENTS ARE INFORMED OF CHARITY CARE PROGRAM.
Part VI - Needs AssessmentUTILIZES ANNUAL STATISTICAL REPORT WITH DEMOGRAPHIC INFORMATION FROM DHS AS WELL AS REPORTS SHOWING PERCENT OF ACTIVITY OF COMMUNITY PAYOR SOURCE
Part VI - Patient Education of Eligibility for AssistanceINFORMS PATIENTS UPON ADMISSION AND POSTS NOTICES IN CONSPICUOUS AREAS
Part VI - Community InformationRURAL SETTING, PREDOMINANTLY AGRICULTURAL BASE, AVERAGE INCOME AT OR BELOW POVERTY GUIDELINES. PREDOMINANTLY CAUCASION, HIGH SCHOOL EDUCATED AND GERIATRIC IN NATURE.
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeOPEN MEDICAL STAFF AND HEALTHCARE EDUCATON IN THE COMMUNITY
Part V - Explanation of Number of Facility Type1-HOSPITAL WITH 3-RURAL CLINICS UNDER THEIR OWNERSHIP
Part VI - Additional InformationCMCIC HOSTS VARIOUS HEALTH FAIRS THROUGHOUT THE YEAR TO HELP PROMOTE COMMUNITY AWARENESS

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessEXAMINED AND APPROVED BY BOARD. AVAILABLE FOR REVIEW UPON REQUEST.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableAVAILABLE UPON REQUEST FROM ADMINISTRATION