MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT FUND: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT FUND (EIN 23-7374256)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-15
- IRS object ID
- 201203209349304510
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-15T12:24:30-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351178661 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8800 LYRA DRIVE SUITE 450 | AddressLine1 |
| City | COLUMBUS | City |
| State | OH | State |
| ZIP Code | 43240 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237374256 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCCULLOUGH-HYDE MEMORIAL INC ENDOWMENT FUND | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MCCU | NameControl |
| Phone | 5135232111 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 NORTH POPLAR | AddressLine1 |
| City | OXFORD | City |
| State | OH | State |
| ZIP Code | 45056 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN CLEMENTS | Name |
| Title | CFO | Title |
| Phone | 5135245310 | Phone |
| Date Signed | 2012-10-19 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | NANCY KIRCHNER | Name |
| PTIN | P00386751 | PTIN |
| Phone | 6148852583 | 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 | JOHN CLEMENTS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 NORTH POPLAR STREET | AddressLine1 |
| City | OXFORD | City |
| State | OH | State |
| ZIP Code | 45056 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1764099 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MHMH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1942 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | TO SUPPORT HEALTH, EDUCATIONAL, AND BUILDING PROGRAMS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 104610 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 296717 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -31224 | InvestmentIncomePriorYear |
| Investment Income Current Year | 380590 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 79964 | OtherRevenuePriorYear |
| Other Revenue Current Year | 70895 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 153350 | TotalRevenuePriorYear |
| Total Revenue Current Year | 748202 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 18773 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 15575 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 26219 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 595997 | OtherExpensePriorYear |
| Other Expenses Current Year | 547170 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 614770 | TotalExpensesPriorYear |
| Total Expenses Current Year | 562745 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -461420 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 185457 | RevenuesLessExpensesCY |
| Total Assets BOY | 10419036 | TotalAssetsBOY |
| Total Assets EOY | 10167153 | TotalAssetsEOY |
| Total Liabilities BOY | 1268390 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1701503 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 9150646 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 8465650 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SUPPORT THE HOSPITAL WITH HEALTH PROGRAMS, EDUCATION ASSISTANCE, BUILDING AND EQUIPMENT NEEDS | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 184384 | Expense |
| Description | SUPPORT FOR MHMH DEVELOPMENT OFFICE | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 72044 | Expense |
| Description | SUPPORT FOR MHMH CAPITAL NEEDS | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 81246 | Expense |
| Description | SUPPORT FOR EDUCATION PROGRAMS | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 28266 | Expense |
| Grants | 15575 | Grants |
| Description | SUPPORT FOR HEALTH PROGRAMS | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 28266 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 15575 | TotalOfOtherProgramServiceGrnt |
| Total Program Service Expense | 365940 | 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 | 1 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 0 | Hospital |
| Grants To Organizations | 1 | 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 | 0 | 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 | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 17 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| 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 | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | 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 | 1 | 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 | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OH | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JAMES MILLER CONTROLLER | NamePerson |
| Telephone Number | 5135245310 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 NORTH POPLAR STREET | AddressLine1 |
| City | OXFORD | City |
| State | OH | State |
| ZIP Code | 45056 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 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 |
|---|---|---|---|---|---|---|---|
| JOHN HARLAND MD | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| SUSAN CROSS LIPNICKEY | |||||||
| VICE CHAIRMAN | 1.00 | X | 0 | 0 | 0 | ||
| JACK MANN | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| RICHARD M NORMAN | |||||||
| SECRETARY-TREASURER | 1.00 | X | 0 | 0 | 0 | ||
| ALAN OAK | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| WILLIAM R RICHARDSON | |||||||
| CHAIRMAN | 1.00 | X | 0 | 0 | 0 | ||
| WILLIAM DOUGLAS ROSS DO | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| MICHAEL RUDOLPH | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| THOMAS W SPEH | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| PAIGE WOOD | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| BRYAN HEHEMANN | |||||||
| OFFICER | 40.00 | 0 | 202613 | 14797 | X | ||
| JOHN CLEMENTS | |||||||
| OFFICER | 40.00 | 0 | 96330 | 4938 | X | ||
| PAMELA COLLINS | |||||||
| OFFICER | 40.00 | 0 | 127687 | 7511 | X | ||
| TAMMY WOOD | |||||||
| OFFICER | 40.00 | 0 | 118501 | 14378 | X | ||
| KENNETH KELLER | |||||||
| PHYSICIAN | 40.00 | 0 | 244989 | 3654 | X | ||
| MATTHEW BIRKLE | |||||||
| PHYSICIAN | 40.00 | 0 | 247235 | 3686 | X | ||
| RODNEY HOLDERMAN | |||||||
| PHARMACY DIRECTOR | 40.00 | 0 | 121681 | 15560 | X | ||
| MARK CRISTELL | |||||||
| PT DIRECTOR | 40.00 | 0 | 126735 | 15632 | X | ||
| MATTHEW DAGGY | |||||||
| PHYSICIAN | 40.00 | 0 | 111347 | 1708 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1397118 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 81864 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 296717 | AllOtherContributions |
| Total Contributions | 296717 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 277302 | TotalRevenueColumn |
| Exclusion | $277,302 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 69664 | 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 | 69664 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 69664 | TotalRevenueColumn |
| Exclusion | $69,664 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1119185 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1015897 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 103288 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 103288 | TotalRevenueColumn |
| Exclusion | $103,288 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 1231 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1231 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1231 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 748202 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1231 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $450,254 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15575 | Total |
| Program Services | 15575 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 200 | Total |
| Management And General | 200 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49981 | Total |
| Management And General | 49981 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11527 | Total |
| Program Services | 298 | ProgramServices |
| Management And General | 11229 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25734 | Total |
| Management And General | 25734 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49459 | Total |
| Management And General | 49459 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1078 | Total |
| Management And General | 1078 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32905 | Total |
| Management And General | 32905 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | FundraisingFundraising |
|---|---|---|---|
| TRUST FUNDED DEVELOPMEN | 135202 | 135202 | |
| BUILDING AND FACILITY P | 98263 | 72044 | 26219 |
| EDUCATION PROGRAMS | 81246 | 81246 | |
| HEALTH PROGRAM FUNDING | 61575 | 61575 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 562745 | Total |
| Program Services | 365940 | ProgramServices |
| Management And General | 170586 | ManagementAndGeneral |
| Fundraising | 26219 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 490123 | BOY |
| EOY | 787997 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33990 | BOY |
| EOY | 19275 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8500 | BOY |
| EOY | 43207 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 736546 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 434629 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 334823 | BOY |
| EOY | 301917 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9551600 | BOY |
| EOY | 9014757 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10419036 | BOY |
| EOY | 10167153 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27097 | BOY |
| EOY | 21759 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1241293 | BOY |
| EOY | 1679744 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1268390 | BOY |
| EOY | 1701503 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7177347 | BOY |
| EOY | 6488323 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 223380 | BOY |
| EOY | 176893 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1749919 | BOY |
| EOY | 1800434 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9150646 | BOY |
| EOY | 8465650 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10419036 | BOY |
| EOY | 10167153 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 185457 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -870452 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCCULLOUGH-HYDE MEMORIAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310650283 | EIN |
| Type Of Organization | 509(A)(3)(A) | TypeOfOrganization |
| Listed In Governing Doc | 0 | ListedInGoverningDoc |
| Supported Organization Notified | 1 | SupportedOrganizationNotified |
| Organized In US | 1 | OrganizedInUS |
| Amount | $277,226 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 277226 | SumOfAmounts |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number DA Fs Held | 9 | NumberDAFsHeld |
| Donor Advised Contributions | 138512 | DonorAdvisedContributions |
| Grants Paid From Donor Funds | 58905 | GrantsPaidFromDonorFunds |
| Aggregate DAF Value | 153974 | AggregateDAFValue |
| Disclosed Orgs Legal Control | 1 | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | 1 | DisclosedForCharitablePurposes |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 9551600 | BeginningOfYearBalance |
| Contributions | 296717 | Contributions |
| Investment Earnings Or Losses | -706525 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 127035 | GrantsOrScholarships |
| End Of Year Balance | 9014757 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 8626691 | BeginningOfYearBalance |
| Contributions | 137514 | Contributions |
| Investment Earnings Or Losses | 970829 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 183434 | GrantsOrScholarships |
| End Of Year Balance | 9551600 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7180113 | BeginningOfYearBalance |
| Contributions | 372373 | Contributions |
| Investment Earnings Or Losses | 1080059 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 5854 | GrantsOrScholarships |
| End Of Year Balance | 8626691 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 8858166 | BeginningOfYearBalance |
| Contributions | 1086641 | Contributions |
| Investment Earnings Or Losses | -2429378 | InvestmentEarningsOrLosses |
| Other Expenditures | 335316 | OtherExpenditures |
| End Of Year Balance | 7180113 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 87300 | OtherCostOrOtherBasis |
| Book Value | 87300 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 604395 | OtherCostOrOtherBasis |
| Depreciation | 409305 | Depreciation |
| Book Value | 195090 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13870 | OtherCostOrOtherBasis |
| Depreciation | 12516 | Depreciation |
| Book Value | 1354 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 30981 | OtherCostOrOtherBasis |
| Depreciation | 12808 | Depreciation |
| Book Value | 18173 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 301917 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO RELATED MCCULLOUGH-HYDE MEMORIAL HOSPITAL | Description |
| Amount | $1,679,744 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1679744 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | Identifier |
| Return Reference | PART V, LINE 4: | ReturnReference |
| Explanation | HEALTH EDUCATION, HOSPITAL EQUIPMENT, COMMUNITY HEALTH | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 0 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OXFORD FREE CLINIC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 18818 | AddressLine1 |
| City | FAIRFIELD | City |
| State | OH | State |
| ZIP Code | 45018 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 311604036 | EINOfRecipient |
| Amount Of Cash Grant | 15575 | AmountOfCashGrant |
| Purpose Of Grant | HEALTH CLINIC | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRYAN HEHEMANN | |||||||||||||
| 0 | 198026 | 0 | 0 | 0 | 4587 | 0 | 938 | 0 | 13859 | 0 | 217410 | 0 | 0 |
| KENNETH KELLER | |||||||||||||
| 0 | 240419 | 0 | 0 | 0 | 4570 | 0 | 0 | 0 | 3654 | 0 | 248643 | 0 | 0 |
| MATTHEW BIRKLE | |||||||||||||
| 0 | 247235 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3686 | 0 | 250921 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS PROVIDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW AND APPROVAL. THE RETURN IS THEN PRESENTED TO THE ENTIRE BOARD FOR FINAL APPROVAL. | |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL QUESTIONAIRE FROM CORPORATE COMPLIANCE COMMITTEE | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -870,452. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCCULLOUGH-HYDE MEMORIAL HOSPITAL INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 N POPLAR STREET | AddressLine1 |
| City | OXFORD | City |
| State | OH | State |
| ZIP Code | 45056 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310650283 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivities |
| Legal Domicile State | OH | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 3 | 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 | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | 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 | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |