MCCURTAIN MEMORIAL MEDICAL MANAGEMENT INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MCCURTAIN MEMORIAL MEDICAL MANAGEMENT INC (EIN 73-6617937)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-04-26
- IRS object ID
- 201311169349300036
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-04-26T15:00:18-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450250958 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 NW EXPRESSWAY SUITE 1900 | AddressLine1 |
| City | OKLAHOMA CITY | City |
| State | OK | State |
| ZIP Code | 73118 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 736617937 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | McCurtain Memorial Medical Management Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MCCU | NameControl |
| Phone | 5802867623 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 East Lincoln Rd | AddressLine1 |
| City | Idabel | City |
| State | OK | State |
| ZIP Code | 74745 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Ray Whitmore | Name |
| Title | CFO | Title |
| Phone | 5802867623 | Phone |
| Date Signed | 2013-04-23 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Carolyn Levings | Name |
| PTIN | P01083874 | PTIN |
| Phone | 4054783334 | Phone |
| Date Prepared | 2013-04-23 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Ray B Whitmore Jr | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 East Lincoln Rd | AddressLine1 |
| City | Idabel | City |
| State | OK | State |
| ZIP Code | 74745 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 22929042 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.mmhok.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1975 | YearFormation |
| State Legal Domicile | OK | StateLegalDomicile |
| Activity Or Mission Description | Hospital care | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 342 | TotalNbrEmployees |
| Total Nbr Volunteers | 34 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 978542 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1898261 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 21587861 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 20964928 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -83156 | InvestmentIncomePriorYear |
| Investment Income Current Year | 9865 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 66346 | OtherRevenuePriorYear |
| Other Revenue Current Year | 55679 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 22549593 | TotalRevenuePriorYear |
| Total Revenue Current Year | 22928733 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1029 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 2035 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 11661828 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12388200 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 11312479 | OtherExpensePriorYear |
| Other Expenses Current Year | 10398155 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 22975336 | TotalExpensesPriorYear |
| Total Expenses Current Year | 22788390 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -425743 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 140343 | RevenuesLessExpensesCY |
| Total Assets BOY | 6974617 | TotalAssetsBOY |
| Total Assets EOY | 8306037 | TotalAssetsEOY |
| Total Liabilities BOY | 3820661 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 5011738 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3153956 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3294299 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | McCurtain Memorial Hospital exists to provide appropriate, cost effective healthcare to our patients in a safe, healing environment while striving to be the healthcare leader of choice in our community. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 20819336 | Expense |
| Revenue | 20935825 | Revenue |
| Description | We continue to provide quality health care to McCurtain County, Oklahoma and its surrounding areas. In addition, we endeavor to serve the public through such activities as wellness programs, community education programs, special programs for the elderly, handicapped and medically underserved and a variety of broad community support activities. To fulfill our mission of community service, we provide care to patients who meet certain criteria under our charity care policy without charge or at amounts less than our established rates. We maintain records to identify and monitor the level of charity care we provide. These records include the amount of charges foregone for services and supplies furnished under our charity care policy and equivalent service statistics. The amount of charges forgone, based on established rates were approximately $383,000 for the year ended June 30, 2012. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 87518 | Expense |
| Revenue | 29103 | Revenue |
| Description | The Wellness Center is an exercise area that community members can subscribe to and use the exercise equipment as well as receive personal training and wellness assessments on a regular basis. There are personnel available to assist them. This program is available to community members in order to help advocate healthy lifestyles in addition to the walking track. Expenses include the cost of depreciation for equipment. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 24437 | Expense |
| Description | The Garden Meadows Walking Trail located at the Hospital is open to the public, in addition to employees, 24 hours a day, 7 days a week at no charge and is intended to promote physical activity for healthier lifestyles. Hospital expense to maintain the walking track includes water, electricity, and depreciation. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 20931291 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 60 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 342 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OK | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ray B Whitmore Jr | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5802083104 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 E Lincoln Rd | AddressLine1 |
| City | Idabel | City |
| State | OK | State |
| ZIP Code | 74745 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Billie Tomlinson | |||||||
| President | 1.00 | X | X | 0 | 0 | 0 | |
| Thomas Salyer DO | |||||||
| Vice President | 1.00 | X | X | 650 | 0 | 0 | |
| Irvin C Jones | |||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 | |
| Desmond Brown | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| David White | |||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | ||
| Robert P Hossenlopp | |||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | ||
| Nancy Woodruff MD | |||||||
| Bd Member, Chief of Staff | 1.00 | X | 12600 | 0 | 0 | ||
| George Freeman DO | |||||||
| Board Member, Chief of Medical Staff as of March 2 | 1.00 | X | 0 | 0 | 0 | ||
| Bristol Messer | |||||||
| CEO | 40.00 | X | 171809 | 0 | 19981 | ||
| Ray B Whitmore Jr | |||||||
| CFO | 40.00 | X | 89079 | 0 | 18026 | ||
| Jeffrey Martin | |||||||
| CRNA | 40.00 | 298979 | 0 | 13431 | X | ||
| Raymond Smith | |||||||
| Physician | 40.00 | 394904 | 0 | 15950 | X | ||
| John Oglesbee | |||||||
| Physician | 40.00 | 196204 | 0 | 15726 | X | ||
| Michael West | |||||||
| Physician | 40.00 | 107692 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1271917 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 83114 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Emcare Inc | |||||
| 7032 Collections Center Dr | Chicago | IL | 60693 | ER Physicians | 211166 |
| Reimbursement Technologies | |||||
| 1000 River Road Suite 100 | Conshohocken | PA | 19428 | ER Billing Service | 181228 |
| Delta Healthcare | |||||
| PO Box 202940 | Dallas | TX | 75234 | Physician Recruitment | 140250 |
| Jeff McIlroy | |||||
| 224 Deer Valley Dr | Catoosa | OK | 74015 | Psychiatric Physician | 117450 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Government Grants | 1228755 | GovernmentGrants |
| All Other Contributions | 669506 | AllOtherContributions |
| Total Contributions | 1898261 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Net Patient Serv. Rev | 900099 | 20930511 | 20930511 |
| Other Revenue | 900099 | 34417 | 34417 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 20964928 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6212 | TotalRevenueColumn |
| Exclusion | $6,212 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 55679 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 55679 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 55679 | TotalRevenueColumn |
| Exclusion | $55,679 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3962 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 309 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3653 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3653 | TotalRevenueColumn |
| Exclusion | $3,653 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22928733 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20964928 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $65,544 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2035 | Total |
| Program Services | 2035 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 331655 | Total |
| Program Services | 1247 | ProgramServices |
| Management And General | 330408 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10306704 | Total |
| Program Services | 9773791 | ProgramServices |
| Management And General | 532913 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71978 | Total |
| Program Services | 68123 | ProgramServices |
| Management And General | 3855 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 935247 | Total |
| Program Services | 725979 | ProgramServices |
| Management And General | 209268 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 742616 | Total |
| Program Services | 556962 | ProgramServices |
| Management And General | 185654 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8364 | Total |
| Management And General | 8364 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39938 | Total |
| Management And General | 39938 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1902636 | Total |
| Program Services | 1700471 | ProgramServices |
| Management And General | 202165 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25081 | Total |
| Program Services | 21193 | ProgramServices |
| Management And General | 3888 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 753866 | Total |
| Program Services | 704476 | ProgramServices |
| Management And General | 49390 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 690500 | Total |
| Program Services | 684758 | ProgramServices |
| Management And General | 5742 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70938 | Total |
| Program Services | 66221 | ProgramServices |
| Management And General | 4717 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 69985 | Total |
| Program Services | 69985 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 979996 | Total |
| Program Services | 734997 | ProgramServices |
| Management And General | 244999 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1060031 | Total |
| Program Services | 1060031 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad Debt Expense | 2502151 | 2502151 | |
| Medical Supplies | 1794850 | 1794850 | |
| Miscellaneous | 277476 | 241678 | 35798 |
| Physician Recruitment | 222343 | 222343 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22788390 | Total |
| Program Services | 20931291 | ProgramServices |
| Management And General | 1857099 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 309797 | BOY |
| EOY | 375583 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2353823 | BOY |
| EOY | 2554810 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 122500 | BOY |
| EOY | 122500 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 238320 | BOY |
| EOY | 191486 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 401683 | BOY |
| EOY | 402712 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 247632 | BOY |
| EOY | 305336 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 17224813 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 13858726 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3235873 | BOY |
| EOY | 3366087 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64989 | BOY |
| EOY | 987523 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6974617 | BOY |
| EOY | 8306037 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2513817 | BOY |
| EOY | 3785296 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1011973 | BOY |
| EOY | 947528 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 294871 | BOY |
| EOY | 278914 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3820661 | BOY |
| EOY | 5011738 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3153956 | BOY |
| EOY | 3294299 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3153956 | BOY |
| EOY | 3294299 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6974617 | BOY |
| EOY | 8306037 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 140343 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 37450 | OtherCostOrOtherBasis |
| Book Value | 37450 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8383997 | OtherCostOrOtherBasis |
| Depreciation | 6642178 | Depreciation |
| Book Value | 1741819 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 334350 | OtherCostOrOtherBasis |
| Depreciation | 260314 | Depreciation |
| Book Value | 74036 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7953851 | OtherCostOrOtherBasis |
| Depreciation | 6956234 | Depreciation |
| Book Value | 997617 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 515165 | OtherCostOrOtherBasis |
| Book Value | 515165 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 3366087 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Bond Origination Costs, Net | 2173 |
| Advances to Related Party | 57637 |
| Malpractice Insurance Receivable | 927713 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 987523 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Due to Third-Party Payor | Description |
| Amount | $278,914 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 278914 | TotalOfAmounts |
| Total Revenue | 22928733 | TotalRevenue |
| Total Expenses | 22788390 | TotalExpenses |
| Excess Or Deficit For Year | 140343 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 140343 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 22277477 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 22277477 | RevenueSubtotal |
| Other Revenues Not Included | 651256 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 651256 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 22928733 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 22788390 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 22788390 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 22788390 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Uncertain Tax Positions Under FIN 48: | Part X: | The Hospital is organized as an Oklahoma nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Hospital has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. |
| Part XII, Line 4b - Other Adjustments: | Capital Transfers Stated Separately on Financial Statements 549,187. Capital Contributions Stated Separately on Financial Statements 102,069. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 185000 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 35636 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 149364 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00740 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 185000 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 35636 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 149364 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00740 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 112198 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 29103 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 83095 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00410 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7476 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1876 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5600 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2179 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2179 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 121853 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 30979 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 90874 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00450 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 306853 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 66615 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 240238 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01190 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1042 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1042 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2849 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2849 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 882 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 882 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 334 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 334 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 273827 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 273827 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.01350 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 278934 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 278934 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.01370 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense | $2,502,151 | BadDebtExpenseAmount |
| Amount Attributable To | 625538 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 7923600 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 7771342 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 152258 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | McCurtain Memorial Medical Management | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 East Lincoln Rd | AddressLine1 |
| City | Idabel | City |
| State | OK | State |
| ZIP Code | 74745 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | McCurtain Memorial Medical ManagmentInc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Medicare Rate | X | MedicareRate |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 7 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (7 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Idabel Primary Care Clinic | ||||
| 1425 E Lincoln Road Suite B-4 | Idabel | OK | 74745 | Physician Clinic |
| Memorial North Health Center | ||||
| 510 South Park Drive | Broken Bow | OK | 74728 | Physician Clinic |
| McCurtain Memorial Home Health | ||||
| 1301 E Lincoln Road | Idabel | OK | 74745 | Home Health office on Hospital premises |
| Southeast Oklahoma Surgical Services | ||||
| 1425 E Lincoln Road Suite A-6 | Idabel | OK | 74745 | Physician Clinic |
| MedFast | ||||
| 1425 E Lincoln Road Suite B-2 | Idabel | OK | 74745 | Walk-in Clinic staffed with Nurse Practitioners |
| Southeast Regional Psychiatric Services | ||||
| 1425 E Lincoln Road Suite A | Idabel | OK | 74745 | Physician Clinic |
| Women and Health Clinic | ||||
| 1401 S Lynn lane | Idabel | OK | 74745 | Physician Clinic |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| Part I, Line 7: Charity care at cost on line 7a was calculated based on an overall cost-to-charge ratio addressing all patient segments. Amounts on line 7e, 7f and 7i were determined based on actual costs from the general ledger. | |
| Part I, L7 Col(f): The amount of bad debt expense removed from total expenses to determine the percentage was $2,502,151. | |
| Part II: The Hospital is a member of the Chambers of Commerce and Main Street programs in the communities of its service area which promote community and economic development. The Hospital actively recruits physicians and Allied Health professionals (nurse practitioners) to serve the citizens of its service area and increase the availability of providers. The Hospital is also involved in helping to prevent domestic violence in its community by providing leadership and participation to the McCurtain County Child Abuse Awareness Team as well as the Domestic Violence Task Force. In addition, the Hospital also participates in the McCurtain County Coalition for Change Program - Turning Point. | |
| Part III, Line 4: Accounts are not written off to bad debt until all payments, discounts and contractual allowances are applied and internal collection efforts have been exhausted. When a payment is received on an account previously written off to bad debt, the payment reduces the current year's bad debt expense.The amount of bad debt estimated to be attributable to patients under the organization's charity care policy is determined by using the percentage of the population in the service area that is under the federal poverty guideline established for charity care.Footnote from Financial Statements: The carrying amount of patient receivables is reduced by a valuation allowance that reflects management's estimate of amounts that will not be collected from patients and third-party payors. Management reviews patient receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third parties under contractual agreements and amounts that will not be collected from patients due to bad debts. Management considers the aging analysis in determining the estimated bad debt provision. | |
| Part III, Line 8: Total revenue received from Medicare (including DSH and IME) is the gross reimbursement plus settlement (including LSA). Both the total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. | |
| Part III, Line 9b: Self-pay patients are notified of the Financial Assistance Program upon registration during face-to-face interviews if at all possible. First time billing statements will be mailed to the responsible party of all self-pay patients within approximately 15 days of discharge. The message on this statement indicates the patient may be eligible for a discount and provides information on applying for discounts. If eligibility is established, the discounted amount is written off as charity care and no further collection will occur. If the individual does not provide the required information or the application is denied, normal collection procedures will commence. The Hospital is currently in the process of codifying its policies for compliance with new 501(r) requirements. | |
| Part V, Section B, Line 13g: The Hospital posts its charity care policy summary with financial assistance contact information in the financial services office. Summary information is also printed in pamphlets provided in the ER waiting room. Financial Assistance information is provided in "first-time" statements of patient bills. The entire Financial Assistance Policy is available upon request. | McCurtain Memorial Medical Managment,Inc |
| Part VI, Line 2: The Hospital holds an annual Strategic Planning Meeting in which the needs of the community are evaluated with an environmental assessment identifying internal and external issues that affect the organization and its ability to meet the needs of the community it serves. | |
| Part VI, Line 3: The Hospital posts its charity care policy summary with financial assistance contact information in the financial services office. Information is also printed in pamphlets provided in the ER waiting room. Financial Assistance guidance and information is provided to patients upon completion of medical evaluation and screening at which time potentially eligible patients are counseled by Financial Services. Financial Assistance information is not provided with discharge materials. Financial Assistance information is provided in "first-time" statements of patient bills. Financial Services counsels all patients who are potentially eligible for financial assistance by providing guidance in applying for assistance through federal, state and county programs. | |
| Part VI, Line 4: McCurtain Memorial Hospital is the only hospital located in McCurtain County, which is the 3rd largest county in the state. The entire county is designated as a Medically Underserved Area with portions of the county designated as Health Professional Shortage Areas due to geographical area, census tracts, and/or a Native American tribal population. According to 2010 census files of the U.S. Census Bureau, families below poverty level from 2007-2011 represent approximately 27.6% of the county's population in comparison to 16.3% for the State of Oklahoma. Approximately 30% of the people in McCurtain County are covered by Medicaid and the unemployment rate usually ranks in the top five of the state. The primary service area is approximately a 35-mile radius around Idabel. The 2010 US Census Bureau population count for McCurtain County is 33,151. With the exception of McCurtain Memorial Hospital there are no other major hospitals located within the county. McCurtain County has major employers such as Weyerhaeuser (now International Paper, IP), Tyson Foods, Hagale Industries, Huber Paper, Georgia Pacific and Pan Pacific Products. Unemployment rates in McCurtain County have improved during the second quarter of 2012, however, the county continues to have one of the highest unemployment rates in the state at 8.5%, well above the state rate of 4.7% as of June 2012. | |
| Part VI, Line 5: The McCurtain Memorial Hospital Board of Directors is comprised of persons who reside in the organization's primary service area who are neither employees nor contractors of the organization, nor family members thereof. Five of the board members are non-physician and two members are physicians on the medical staff of the hospital.The Hospital extends medical staff privileges to all qualified physicians in its community for all of its departments. The Hospital applies surplus funds to improvements in patient care and medical education. The Hospital continuously evaluates and monitors quality control initiatives. The hospital's emergency room is available to all regardless of ability to pay. Continuing education and seminars are provided to personnel on a regular basis including EKG monitoring classes, Venous Thrombo-embolism Prevention and Prophylaxis, ACLS, PALS, CPI, CPR, Medicare Workshops, Credentialing Updates in addition to allowances provided to employed physicians and CRNA for continuing medical education workshops and seminars. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Bristol Messer | |||||||||||||
| 162534 | 0 | 0 | 0 | 9275 | 0 | 4255 | 0 | 16025 | 0 | 192089 | 0 | 0 | 0 |
| Jeffrey Martin | |||||||||||||
| 298979 | 0 | 0 | 0 | 0 | 0 | 6125 | 0 | 7903 | 0 | 313007 | 0 | 0 | 0 |
| Raymond Smith | |||||||||||||
| 394904 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 15990 | 0 | 410894 | 0 | 0 | 0 |
| John Oglesbee | |||||||||||||
| 196204 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 15726 | 0 | 211930 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 1a | Rent and utilities paid by hospital for housing of CEO that is not on the business premises. However, beginning in FY2012, payment for these expenses were withheld from CEO salary through payroll deduction. As of end of fiscal year, June 30, 2012, CEO no longer resides in Hospital paid premises. |
| Part I, Line 1b | The board approved such expenditures at the beginning of the CEO's employment with the hospital and the hospital has continued to pay for those expenses since that time. However, beginning in FY2012, payment for these expenses were withheld from CEO salary through payroll deduction. As of end of fiscal year, June 30, 2012, CEO no longer resides in Hospital paid premises. |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Good Honest Medicine - Michael West | NamePerson |
| Purpose Of Loan | agreement to pay physician recruitment fees for physician practice | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $122,500 | OriginalPrincipalAmount |
| Balance Due | 122500 | BalanceDue |
| Default | 1 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 122500 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| New Program Services | Form 990, Part III, line 2 | Southeast Oklahoma Surgical Services reopened September 19, 2011 with addition of surgeon to medical staff. Southeast Regional Psychiatric Services reopened May 21, 2012 with addition of nurse practitioner to medical staff. Women's and Health Clinic opened June 1, 2012 Wound Care Clinic opened week of July 18, 2011. |
| Form 990, Part VI, Section B, line 11 | The return is reviewed by the CFO prior to filing and is also presented to the Board of Directors as available for review at last board meeting prior to filing deadline. If Form 990 is available in electronic format prior to meeting date, it may be emailed to board members for comments prior to board meeting date. | |
| Form 990, Part VI, Section B, line 12c | All officers, directors, and key employees fill out a conflict of interest disclosure annually. The disclosure forms are reviewed initially by the CEO and CFO for potential conflicts. Any actual conflicts are reviewed by the Board of Directors. A person with a conflict is restricted from voting on related matters. | |
| Form 990, Part VI, Section B, line 15a | The CEO compensation is determined by the Board of Directors based on comparability data and an annual evaluation. The CFO compensation is determined by the CEO based on an annual evaluation. | |
| Form 990, Part VI, Section C, line 19 | Form 990, Part VI, Section C, Line 19: These documents are available upon request during normal business hours. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | McCurtain Memorial Hospital Foundation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 Lincoln Rd | AddressLine1 |
| City | Idabel | City |
| State | OK | State |
| ZIP Code | 74745 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 731455422 | EIN |
| Primary Activities | Fundraising | PrimaryActivities |
| Legal Domicile State | OK | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11a | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| McCurtain Memorial Hospital Foundation | ||
| J | 134400 | Book |
| McCurtain Memorial Hospital Foundation | ||
| J | 54544 | Book |
| McCurtain Memorial Hospital Foundation | ||
| E | 200000 | Book |