MISSOURI DELTA MEDICAL CENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MISSOURI DELTA MEDICAL CENTER (EIN 43-0633449)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-13
- IRS object ID
- 201332259349300418
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-13T08:15:31-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 211 N BROADWAY SUITE 600 | AddressLine1 |
| City | ST LOUIS | City |
| State | MO | State |
| ZIP Code | 631022733 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 430633449 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Missouri Delta Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % JON BRANSTETTER | InCareOfName |
| Name Control | MISS | NameControl |
| Phone | 5734711600 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1008 NORTH MAIN STREET | AddressLine1 |
| City | SIKESTON | City |
| State | MO | State |
| ZIP Code | 638015044 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JON BRANSTETTER | Name |
| Title | VICE PRESIDENT OF FINANCE | Title |
| Phone | 5734711600 | Phone |
| Date Signed | 2013-08-08 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Troy A Lindsey | Name |
| Phone | 3142315544 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JASON SCHRUMPF | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1008 NORTH MAIN STREET | AddressLine1 |
| City | SIKESTON | City |
| State | MO | State |
| ZIP Code | 638015044 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 97085375 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MISSOURIDELTA.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1948 | YearFormation |
| State Legal Domicile | MO | StateLegalDomicile |
| Activity Or Mission Description | MISSOURI DELTA MEDICAL CENTER IS A NOT FOR PROFIT CORPORATION WHICH WILL STRIVE 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 Body | 26 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 19 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1023 | TotalNbrEmployees |
| Total Nbr Volunteers | 52 | TotalNbrVolunteers |
| Total Gross UBI | -20662 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -20662 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 851778 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 348557 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 88822984 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 94527177 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3077679 | InvestmentIncomePriorYear |
| Investment Income Current Year | 959482 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 548652 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1206572 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 93301093 | TotalRevenuePriorYear |
| Total Revenue Current Year | 97041788 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 92500 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 49000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 48648740 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 51598880 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 101609 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 44458716 | OtherExpensePriorYear |
| Other Expenses Current Year | 46614498 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 93199956 | TotalExpensesPriorYear |
| Total Expenses Current Year | 98262378 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 101137 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1220590 | RevenuesLessExpensesCY |
| Total Assets BOY | 60044388 | TotalAssetsBOY |
| Total Assets EOY | 59444886 | TotalAssetsEOY |
| Total Liabilities BOY | 18252743 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 18601366 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 41791645 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 40843520 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | MISSOURI DELTA MEDICAL CENTER IS A NOT FOR PROFIT CORPORATION WHICH WILL STRIVE TO PROVIDE A COMPLETE HEALTH CARE SYSTEM TO RESIDENTS IN THE SERVICE AREA EITHER DIRECTLY OR IN COOPERATION WITH OTHERS. REFERRAL AGREEMENTS WILL BE SOUGHT FOR SERVICES NOT OFFERED LOCALLY. THE HOSPITAL WILL ALSO ACTIVELY OFFER OR SUPPORT APPROPRIATE PROGRAMS TO PROMOTE THE GENERAL HEALTH, AND TO MEET THE REHABILITATION, EDUCATIONAL AND SOCIAL NEEDS OF OUR SERVICE AREA. SERVICES WILL BE PROVIDED TO ALL RESIDENTS OF OUR SERVICE AREA REGARDLESS OF RACE, COLOR, RELIGION, SEX, AGE, NATIONAL ORIGIN, OR DISABILITY. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 91950378 | Expense |
| Grants | 49000 | Grants |
| Revenue | 94527177 | Revenue |
| Description | MISSOURI 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 23,438 NUMBER OF INPATIENT ADMISSIONS 5,104 NUMBER OF OUTPATIENT VISITS 141,514 ACUTE INPATIENT REHAB: NUMBER OF INPATIENT REHAB PATIENT DAYS 1,816 NUMBER OF INPATIENT REHAB PATIENT ADMISSIONS 156 PSYCHIATRIC FACILITY: NUMBER OF PATIENT DAYS 3,092 NUMBER OF PATIENT ADMISSIONS 355 THE HOSPITAL PROVIDED FREE CARE TO INDIGENT PATIENTS IN THE AMOUNT OF $11,777,479 IN FY 2012, 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 | Description |
| Total Program Service Expense | 91950378 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | true | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | true | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | true | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 97 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1023 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 26 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 19 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JON BRANSTETTER | NamePerson |
| Telephone Number | 5734711600 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1008 NORTH MAIN STREET | AddressLine1 |
| City | SIKESTON | City |
| State | MO | State |
| ZIP Code | 638015044 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (33 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JIM CULLISON | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| BRIAN MENZ | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| DIANE PETERSEN | |||||||
| CHAIRMAN | 5.0 | X | 0 | 0 | 0 | X | |
| CHRIS STEWARD | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| LINDA BOYD | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| ROBERT BUCHANAN | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| JOHN BOLLINGER | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| KEITH DAVIDSON | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| EDWARD DEMENT | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| JON GILMORE | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| BILL HAMPTON | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| DAN JENNINGS JR | |||||||
| VICE CHAIRMAN | 2.0 | X | 0 | 0 | 0 | X | |
| ELIZABETH JOHNSON | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| MICHAEL JONES | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| JEFF HUX | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| ROBERT MACGILLIVRAY | |||||||
| TREASURER | 1.0 | X | 0 | 0 | 0 | X | |
| DENNY KOONCE | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| BRITT MCCONNELL | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| ROBERT MITCHELL | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| MIKE MOLL | |||||||
| SECRETARY | 1.0 | X | 0 | 0 | 0 | X | |
| DOUG SCOTT | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| CHARLES MOXLEY | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| MIKE POBST | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| GERALD SETTLES | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| STEVE SIKES | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| RON WATKINS | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| JON BRANSTETTER | |||||||
| VICE PRESIDENT FINANCE | 40.0 | 140815 | 0 | 6191 | X | ||
| JASON SCHRUMPF | |||||||
| PRESIDENT | 40.0 | 179228 | 0 | 9961 | X | ||
| MOWAFFAQ SAID MD | |||||||
| PHYSICIAN | 40.0 | 603613 | 0 | 12406 | X | ||
| LY T PHAN MD | |||||||
| PHYSICIAN | 40.0 | 422347 | 0 | 11222 | X | ||
| HOLLIS TIDMORE MD | |||||||
| PHYSICIAN | 40.0 | 424653 | 0 | 10432 | X | ||
| MUHAMMAD NASEERUDDIN MD | |||||||
| PHYSICIAN | 40.0 | 504310 | 0 | 12406 | X | ||
| EJAZ ALAM MD | |||||||
| PHYSICIAN | 40.0 | 467199 | 0 | 6636 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2742165 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 69254 | TotalOtherCompensation |
| Number Individuals GT100 K | 48 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| HORIZON HEALTH MENTAL HEALTH | |||||
| PO BOX 840839 | DALLAS | TX | 752840839 | PSYCHIATRIC SERVICES | 945187 |
| CARESTREAM HEALTH INC | |||||
| DEPT CH 19286 | PALATINE | IL | 600559286 | RADIOLOGY | 478334 |
| AMERICAN RED CROSS | |||||
| PO BOX 73013 | CHICAGO | IL | 606737013 | BLOOD SERVICES | 467850 |
| MAYO COLLABORATIVE SERVICES INC | |||||
| PO BOX 9146 | MINNEAPOLIS | MN | 554809146 | LABORATORY SERVICES | 500435 |
| SHARED MEDICAL SERVICES INC | |||||
| PO BOX 330 | COTTAGE GROVE | WI | 535270330 | MRI SERVICES | 511710 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 31 | NumberOfContractorsGT100K |
| Related Organizations | 323557 | RelatedOrganizations |
| All Other Contributions | 25000 | AllOtherContributions |
| Total Contributions | 348557 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | 93782300 | 93782300 |
| EMR INCENTIVE PAYMENT | 621110 | 744877 | 744877 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 94527177 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 956379 | TotalRevenueColumn |
| Exclusion | $956,379 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 14400 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 39279 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -24879 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -24879 | TotalRevenueColumn |
| Unrelated Business Revenue | -20662 | UnrelatedBusinessRevenue |
| Exclusion | -$4,217 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 7411 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 4308 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3103 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3103 | TotalRevenueColumn |
| Exclusion | $3,103 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| PENSION TERM INCOME | 900099 | 692024 | $692,024 |
| CAFETERIA INCOME | 722210 | 361097 | $361,097 |
| MEDICAL RECORD REVENUE | 621990 | 119017 | $119,017 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 59313 | TotalRevenueColumn |
| Exclusion | $59,313 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1231451 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 97041788 | TotalRevenueColumn |
| Related Or Exempt Function Income | 94527177 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | -20662 | UnrelatedBusinessRevenue |
| Exclusion | $2,186,716 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49000 | Total |
| Program Services | 49000 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 336916 | Total |
| Management And General | 336916 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40106897 | Total |
| Program Services | 37714923 | ProgramServices |
| Management And General | 2317914 | ManagementAndGeneral |
| Fundraising | 74060 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 447558 | Total |
| Program Services | 420866 | ProgramServices |
| Management And General | 25866 | ManagementAndGeneral |
| Fundraising | 826 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8123446 | Total |
| Program Services | 7638964 | ProgramServices |
| Management And General | 469482 | ManagementAndGeneral |
| Fundraising | 15000 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2584063 | Total |
| Program Services | 2429949 | ProgramServices |
| Management And General | 149342 | ManagementAndGeneral |
| Fundraising | 4772 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16125 | Total |
| Management And General | 16125 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 129837 | Total |
| Management And General | 129837 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7569325 | Total |
| Program Services | 7044400 | ProgramServices |
| Management And General | 524925 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 169179 | Total |
| Program Services | 2994 | ProgramServices |
| Management And General | 166185 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18722949 | Total |
| Program Services | 18029360 | ProgramServices |
| Management And General | 686798 | ManagementAndGeneral |
| Fundraising | 6791 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 311340 | Total |
| Management And General | 311340 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 878399 | Total |
| Program Services | 693935 | ProgramServices |
| Management And General | 184464 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 202600 | Total |
| Program Services | 190615 | ProgramServices |
| Management And General | 11835 | ManagementAndGeneral |
| Fundraising | 150 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47532 | Total |
| Program Services | 46917 | ProgramServices |
| Management And General | 615 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 660157 | Total |
| Program Services | 660157 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3953146 | Total |
| Program Services | 3122985 | ProgramServices |
| Management And General | 830161 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1302546 | Total |
| Program Services | 1302546 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| BAD DEBT | 12251217 | 12251217 | ||
| DUES & SUBSCRIPTIONS | 189280 | 140684 | 48586 | 10 |
| RECRUITING | 101819 | 101819 | ||
| FARM EXPENSE | 109047 | 109047 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 98262378 | Total |
| Program Services | 91950378 | ProgramServices |
| Management And General | 6210391 | ManagementAndGeneral |
| Fundraising | 101609 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8371361 | BOY |
| EOY | 7926268 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 700189 | BOY |
| EOY | 746607 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10433531 | BOY |
| EOY | 9675095 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1256191 | BOY |
| EOY | 1164084 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3178697 | BOY |
| EOY | 3524873 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1391804 | BOY |
| EOY | 1130561 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 79392332 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 45231251 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33689701 | BOY |
| EOY | 34161081 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1022914 | BOY |
| EOY | 1116317 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60044388 | BOY |
| EOY | 59444886 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7910485 | BOY |
| EOY | 6758972 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3440698 | BOY |
| EOY | 3134692 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6901560 | BOY |
| EOY | 8707702 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18252743 | BOY |
| EOY | 18601366 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41576698 | BOY |
| EOY | 40603573 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 214947 | BOY |
| EOY | 239947 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41791645 | BOY |
| EOY | 40843520 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60044388 | BOY |
| EOY | 59444886 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1220590 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 272465 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $11,406 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 11406 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 205741 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 6867 | InvestmentEarningsOrLosses |
| End Of Year Balance | 212608 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 219883 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -3185 | InvestmentEarningsOrLosses |
| Other Expenditures | 10957 | OtherExpenditures |
| End Of Year Balance | 205741 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3322552 | BeginningOfYearBalance |
| Contributions | 2500 | Contributions |
| Investment Earnings Or Losses | 73935 | InvestmentEarningsOrLosses |
| Other Expenditures | 3179104 | OtherExpenditures |
| End Of Year Balance | 219883 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7388571 | BeginningOfYearBalance |
| Contributions | 146208 | Contributions |
| Investment Earnings Or Losses | 287786 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 42482 | GrantsOrScholarships |
| Other Expenditures | 4457531 | OtherExpenditures |
| End Of Year Balance | 3322552 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 3061774 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 618603 | OtherCostOrOtherBasis |
| Book Value | 3680377 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 32144139 | OtherCostOrOtherBasis |
| Depreciation | 14355244 | Depreciation |
| Book Value | 17788895 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 41940112 | OtherCostOrOtherBasis |
| Depreciation | 29832013 | Depreciation |
| Book Value | 12108099 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1627704 | OtherCostOrOtherBasis |
| Depreciation | 1043994 | Depreciation |
| Book Value | 583710 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 34161081 | TotalOfBookValueLandBuildings |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS | SCHEDULE D, PART V, LINE 4 | THE 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. |
| FIN 48 DISCLOSURE | SCHEDULE D, PART X, LINE 2 | MANAGEMENT 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. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 180. | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3338439 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3338439 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03880 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 22821453 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19590514 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3230939 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03760 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 26159892 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19590514 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6569378 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07640 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9091 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 9091 | NetCommunityBenefitExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 55035 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 55035 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 64126 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 64126 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 26224018 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19590514 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6633504 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07700 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $12,251,217 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 27703117 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 31899455 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -4196338 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | 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 | MISSOURI DELTA MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1008 NORTH MAIN STREET | AddressLine1 |
| City | SIKESTON | City |
| State | MO | State |
| ZIP Code | 63801 | 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 | MISSOURI DELTA MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 100 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 180. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Lowest Negotiated Rates | X | LowestNegotiatedRates |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 16 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (16 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| CONTINU-CARE HOME HEALTH | ||||
| 104 SMITH STREET | SIKESTON | MO | 63801 | HOME HEALTH AGENCY |
| CHARLESTON COMMUNITY CARE CENTER | ||||
| 1200 EAST MARSHALL STREET | SIKESTON | MO | 63834 | RURAL HEALTH CLINIC |
| RESTART OF CHARLESTON | ||||
| 512 EAST MARSHALL STREET | SIKESTON | MO | 63834 | PHYSICAL THERAPY |
| RESTART OF NEW MADRID | ||||
| 406 HIGHWAY 61 | NEW MADRID | MO | 63869 | PHYSICAL THERAPY |
| RESTART OF EAST PRAIRIE | ||||
| 106 SOUTH WASHINGTON | EAST PRAIRIE | MO | 63845 | PHYSICAL THERAPY |
| BARTON-JOLLEY PHYSICIAN SVCS BUILDING | ||||
| 1013 NORTH MAIN STREET | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| MUHANNAD AL-KILANI MD | ||||
| 1118 NORTH MAIN STREEET | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| MISSOURI DELTA CANCER & INFUSION CENTER | ||||
| 1126 NORTH MAIN STREET | SIKESTON | MO | 63801 | INFUSION CENTER |
| KENNETH STONE MD | ||||
| 121 SMITH STREET | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| SMITH STREET CLINIC | ||||
| 119 SMITH STREET | SIKESTON | MO | 63801 | RURAL HEALTH CLINIC |
| JAYCEE RENAL DIALYSIS CENTER | ||||
| 135 PLAZA DRIVE | SIKESTON | MO | 63801 | DIALYSIS CENTER |
| LINZA KILLION MD | ||||
| 1106 NORTH MAIN STREET | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| MISSOURI DELTA PRIMARY CARE | ||||
| 1015 NORTH MAIN STREET | SIKESTON | MO | 63801 | RURAL HEALTH CLINIC |
| MISSOURI DELTA ORTHOPEDICS | ||||
| 201 PLAZA DRIVE | SIKESTON | MO | 63801 | PHYSICIAN OFFICE BUILDING |
| MISSOURI DELTA WOUND & HYPERBARIC CENTER | ||||
| 201 PLAZA DRIVE | SIKESTON | MO | 63801 | WOUND CARE CENTER |
| MISSOURI DELTA MEDICAL EQUIPMENT | ||||
| 102 SMITH STREET | SIKESTON | MO | 63801 | DURABLE MEDICAL EQUIPMENT |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| COMMUNITY BENEFIT PERCENTAGE OF TOTAL COST | PART I, LINE 7, COLUMN F | THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $12,251,217 REPORTED ON FORM 990, PART IX, LINE 25; HOWEVER, THIS EXPENSE HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. |
| COMMUNITY BENEFIT COST | PART I, LINE 7 | THE 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 | PART III, LINE 4 | ACCOUNTS 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 THIRD-PARTY COVERAGE, THE CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS 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 SELF-PAY BALANCES (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY 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 ORGANIZATION'S 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 | PART III, LINE 8 | IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. 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 | PART III, LINE 9 | THE 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 ASSESSMENT | PART VI, LINE 2 | THE 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, AND/OR 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 HOSPITAL'S ADMINISTRATIVE TEAM AND INCORPORATED INTO THE HOSPITAL'S 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 ASSISTANCE | PART VI, LINE 3 | ALL 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 INFORMATION | PART VI, LINE 4 | MISSOURI 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 59% OF THE MISSOURI DELTA MEDICAL CENTER'S NET PATIENT SERVICE REVENUE IS FROM PARTICIPATION IN THE MEDICARE AND STATE SPONSORED MEDICAID PROGRAM FOR THE YEAR ENDED SEPTEMBER 30, 2012. |
| PROMOTION OF COMMUNITY HEALTH | PART VI, LINE 5 | OUR 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 SYSTEM | PART VI, LINE 6 | NOT APPLICABLE. |
| STATE FILING OF COMMUNITY BENEFIT REPORT | PART VI, LINE 7 | NOT APPLICABLE. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | MEDICAL STUDENT SCHOLARSHIPS | TypeOfGrant |
| Number Of Recipients | 7 | NumberOfRecipients |
| Amount Of Cash Grant | 49000 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES | Identifier |
| Return Reference | SCHEDULE I, PART I, LINE 2 | ReturnReference |
| Explanation | THE 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 MOTIVATION FOR NURSING EITHER BY APTITUDE 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 SCHOLARSHIP COMMITTEE. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MOWAFFAQ SAID MD | |||||||||||||
| 603199 | 0 | 0 | 0 | 414 | 0 | 4900 | 0 | 7506 | 0 | 616019 | 0 | 0 | 0 |
| LY T PHAN MD | |||||||||||||
| 422167 | 0 | 0 | 0 | 180 | 0 | 4900 | 0 | 6322 | 0 | 433569 | 0 | 0 | 0 |
| HOLLIS TIDMORE MD | |||||||||||||
| 398879 | 0 | 0 | 0 | 25774 | 0 | 4900 | 0 | 5532 | 0 | 435085 | 0 | 0 | 0 |
| MUHAMMAD NASEERUDDIN MD | |||||||||||||
| 504040 | 0 | 0 | 0 | 270 | 0 | 4900 | 0 | 7506 | 0 | 516716 | 0 | 0 | 0 |
| EJAZ ALAM MD | |||||||||||||
| 467019 | 0 | 0 | 0 | 180 | 0 | 0 | 0 | 6636 | 0 | 473835 | 0 | 0 | 0 |
| JASON SCHRUMPF | |||||||||||||
| 179174 | 0 | 0 | 0 | 54 | 0 | 3720 | 0 | 6241 | 0 | 189189 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part III Form990ScheduleLPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Interested Person | ALEC PETERSEN | NameOfInterestedPerson |
| Relationship With Organization | SON OF CHAIRMAN | RelationshipWithOrganization |
| Amount Of Grant | 2000 | AmountOfGrant |
| Type Of Assistance | SCHOLARSHIP | TypeOfAssistance |
Form990 Schedule L Part IV Form990ScheduleLPartIV (9 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| JASON SCHRUMPF | |||
| SON-IN-LAW OF DIRECTOR | 179228 | EMPLOYEE COMPENSATION | false |
| CATHERINE SCHRUMPF | |||
| DAUGHTER OF DIRECTOR | 38150 | EMPLOYEE COMPENSATION | false |
| CATHERINE SCHRUMPF | |||
| SPOUSE OF PRESIDENT | 38150 | EMPLOYEE COMPENSATION | false |
| BROOKE BUCHANAN | |||
| DAUGHTER-IN-LAW OF DIR. | 17249 | EMPLOYEE COMPENSATION | false |
| ROBERT BUCHANAN | |||
| SON OF DIRECTOR | 45474 | EMPLOYEE COMPENSATION | false |
| RHONDA MENZ | |||
| WIFE OF DIRECTOR | 28035 | EMPLOYEE COMPENSATION | false |
| JUDITH MENZ | |||
| MOTHER OF DIRECTOR | 90074 | EMPLOYEE COMPENSATION | false |
| ANTHONY COPPAGE | |||
| BROTHER-IN-LAW OF DIR. | 69291 | EMPLOYEE COMPENSATION | false |
| ELIZABETH JOHNSON | |||
| DIRECTOR | 207134 | SEE PART V | false |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | BUSINESS TRANSACTION WITH INTERESTED PERSONS | Identifier |
| Return Reference | SCHEDULE L, PART IV | ReturnReference |
| Explanation | ELIZABETH JOHNSON IS PRESIDENT OF MITCHELL INSURANCE. MISSOURI DELTA MEDICAL CENTER PURCHASES INSURANCE FROM MITCHELL INSURANCE AT MARKET RATES. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE RELATIONSHIPS | FORM 990, PART VI, LINE 2 | ROBERT MITCHELL AND ELIZABETH JOHNSON HAVE A FAMILY RELATIONSHIP. LINDA BOYD AND JOHN BOLLINGER HAVE A FAMILY RELATIONSHIP. STEVE SIKES AND JASON SCHRUMPF HAVE A FAMILY RELATIONSHIP. DAN JENNINGS JR AND JOHN BOLLINGER HAVE A BUSINESS RELATIONSHIP. BRITT MCCONNELL, ROBERT MACGILLIVRAY, AND KEITH DAVIDSON HAVE A BUSINESS RELATIONSHIP. |
| PROCESS TO REVIEW FORM 990 | FORM 990, PART VI, LINE 11B | BEFORE 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 ORGANIZATION'S FORM 990 HAS BEEN FILED. |
| COMPLIANCE WITH CONFLICT OF INTEREST POLICY | FORM 990, PART VI, LINE 12C | THE 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 OFFICER 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 OWNERSHIP, 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 INCLUDES 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; ANY "INTERESTED PERSON" MUST DISCLOSE TO THE HOSPITAL AND ANY AFFILIATED ORGANIZATION ALL FINANCIAL INTERESTS AND ALL MATERIAL FACTS RELATING THERETO. 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 INTERESTS AND FOR ITS OWN BENEFIT AND IS FAIR AND REASONABLE TO THE HOSPITAL OR AFFILIATED ORGANIZATION. 4. TAKE APPROPRIATE 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 A 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 INDIVIDUAL'S COMPENSATION. EVERY MEMBER OF THE BOARD OF DIRECTORS, PRINCIPAL OFFICER, AND MEMBER 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. |
| PROCESS FOR DETERMINING COMPENSATION OF OFFICERS | FORM 990, PART VI, LINE 15A & 15B | THE 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 ENDING SEPTEMBER 30, 2012. |
| DOCUMENTS AVAILABLE TO THE PUBLIC | FORM 990, PART VI, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST. |
| OTHER CHANGES IN NET ASSETS OR FUND BALANCES | FORM 990, PART XI, LINE 5 | UNREALIZED GAIN/(LOSS): $ 27,801 TRANSFERS RELATED TO CONSOLIDATION: 176,459 CHANGE IN FAIR VALUE OF INTEREST RATE SWAP: 68,205 -------- $ 272,465 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JON GILMORE TITLE:DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JEFF HUX TITLE:DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JON BRANSTETTER TITLE:VICE PRESIDENT FINANCE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JASON SCHRUMPF TITLE:PRESIDENT HOURS:2 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| CONTINU-CARE HOMEMAKER SERVICES | ||||||||||
| 1008 NORTH MAIN STREET | SIKESTON | MO | 63801 | 431835384 | HOME HEALTH | MO | 501(C)(3) | 9 | MDMC | true |
| MISSOURI DELTA MEDICAL CENTER FOUNDATION | ||||||||||
| 1008 NORTH MAIN STREET | SIKESTON | MO | 63801 | 431577510 | FUNDRAISING | MO | 501(C)(3) | 11-I | MDMC | true |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEAST MO UROLOGY CONSULTANTS INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1106 NORTH MAIN | AddressLine1 |
| City | SIKESTON | City |
| State | MO | State |
| ZIP Code | 63801 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431723563 | EIN |
| Primary Activity | HEALTH CARE | PrimaryActivity |
| Legal Domicile State | MO | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MDMC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORP | TypeOfEntity |
| Share Of Total Income | 29026 | ShareOfTotalIncome |
| Share Of EOY Assets | 962 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| CONTINU-CARE HOMEMAKER SERVICES INC | ||
| R | 148201 | CASH |
| MISSOURI DELTA MEDICAL CENTER FOUNDATION | ||
| C | 323557 | CASH |
| MISSOURI DELTA MEDICAL CENTER FOUNDATION | ||
| R | 29353 | CASH |