CAMERON REGIONAL MEDICAL CENTER INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- CAMERON REGIONAL MEDICAL CENTER INC (EIN 44-0668347)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-14
- IRS object ID
- 201212279349302391
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-14T14:03:15-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wendling Noe Nelson & Johnson LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 534 S Kansas Ave Suite 1500 | AddressLine1 |
| City | Topeka | City |
| State | KS | State |
| ZIP Code | 666033491 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 440668347 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cameron Regional Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CAME | NameControl |
| Phone | 8166322101 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 East Evergreen Street | AddressLine1 |
| City | Cameron | City |
| State | MO | State |
| ZIP Code | 64429 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Joseph Abrutz Jr | Name |
| Title | Administrator | Title |
| Phone | 8166322101 | Phone |
| Date Signed | 2012-08-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Gary D Knoll | Name |
| Phone | 7852334226 | Phone |
| Date Prepared | 2012-08-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Joseph Abrutz Jr | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 East Evergreen Street | AddressLine1 |
| City | Cameron | City |
| State | MO | State |
| ZIP Code | 64429 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 52386222 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1963 | YearFormation |
| State Legal Domicile | MO | StateLegalDomicile |
| Activity Or Mission Description | To provide acute inpatient and outpatient medical care to area residents regardless of ability to pay. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 501 | TotalNbrEmployees |
| Total Nbr Volunteers | 120 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 34985 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 8004 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 49424373 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 51136034 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 266887 | InvestmentIncomePriorYear |
| Investment Income Current Year | 976338 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 130073 | OtherRevenuePriorYear |
| Other Revenue Current Year | 188493 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 49856318 | TotalRevenuePriorYear |
| Total Revenue Current Year | 52308869 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 20855322 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 22743648 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 24784445 | OtherExpensePriorYear |
| Other Expenses Current Year | 25397049 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 45639767 | TotalExpensesPriorYear |
| Total Expenses Current Year | 48140697 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4216551 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 4168172 | RevenuesLessExpensesCY |
| Total Assets BOY | 55590113 | TotalAssetsBOY |
| Total Assets EOY | 58637423 | TotalAssetsEOY |
| Total Liabilities BOY | 23552825 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 23152981 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 32037288 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 35484442 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Our mission at Cameron Regional Medical Center, Inc., is caring for all patients. To this end, we organize people, equipment, and facilities in a manner that best responds to their needs and to the needs of our service area. Our priorities are: patients and families; physicians; and employees. Our goal is to be a regionally-recognized leader in patient satisfaction by exceeding customer expectations and continuing to achieve excellence in quality and cost-effective health care services. CRMC will provide services in an atmosphere that involves compliance with governmental mandates. Throughout our organization, our employees strive to provide sensitive, quality health care at all times by living our values. Lastly, CRMC recognizes the importance of viable and profitable operations to guarantee the continued existence/growth of the facility. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 44366051 | Expense |
| Revenue | 51534046 | Revenue |
| Description | Acute care hospital organized to provide inpatient and outpatient care to area residents regardless of ability to pay. | Description |
| Total Program Service Expense | 44366051 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 1 | 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 | 49 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 501 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | 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 | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MO | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Joseph Abrutz Jr | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8166322101 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 East Evergreen St | AddressLine1 |
| City | Cameron | City |
| State | MO | State |
| ZIP Code | 64429 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Warren McElwain | |||||||
| President | 1.00 | X | X | 0 | 0 | 0 | |
| Jennifer White | |||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 | |
| Michael Poland | |||||||
| Treasurer | 1.00 | X | X | 0 | 0 | 0 | |
| Weldon Wilhoit | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Steve Huitt | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Barbara Ballew | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Ken Raffety | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Steve Tinnen | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Mike Brown | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| David Just | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Kendall DeSelms DO | |||||||
| Physician & Director | 40.00 | X | 225305 | 0 | 0 | X | |
| Laeeq Azmat MD | |||||||
| Physician & Director | 40.00 | X | 592020 | 0 | 0 | X | |
| Joseph F Abrutz Jr | |||||||
| Administrator | 40.00 | X | 278966 | 0 | 0 | ||
| Rosa Patti | |||||||
| Chief Financial Officer | 40.00 | X | 80616 | 0 | 0 | ||
| John Barton III | |||||||
| Physician | 40.00 | 349157 | 0 | 0 | X | ||
| James Dancer | |||||||
| Staff CRNA | 40.00 | 261474 | 0 | 0 | X | ||
| Muhammad Amin | |||||||
| Physician | 40.00 | 274834 | 0 | 0 | X | ||
| James Neely | |||||||
| Physician | 40.00 | 249506 | 0 | 0 | X | ||
| Shahzad Shafique | |||||||
| Physician | 40.00 | 288869 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2600747 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 18 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Cameron Emergency Physicians | |||||
| 1600 E Evergreen Suite A | Cameron | MO | 64429 | ER Coverage | 851533 |
| Premier Specialty Network | |||||
| 1835 E Republic Rd Suite 200 | Springfield | MO | 65804 | Contracted consulting physicians | 559789 |
| Wendling Noe Nelson & Johnson LLC | |||||
| 534 S Kansas Ave Suite 1500 | Topeka | KS | 66603 | Auditing/Accounting Services | 152514 |
| Benesto Tumanut MD | |||||
| 1101 SW 47th St | Kansas City | MO | 64112 | Physician | 120000 |
| Barton & Associates | |||||
| 10 Dearborn Rd | Peabody | MA | 01960 | ER Coverage | 101925 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 12 | NumberOfContractorsGT100K |
| All Other Contributions | 8004 | AllOtherContributions |
| Total Contributions | 8004 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient service revenu | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 51136034 | TotalRevenueColumn |
| Related Or Exempt Function Income | 51136034 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 51136034 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 603642 | TotalRevenueColumn |
| Exclusion | $603,642 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17982 | TotalRevenueColumn |
| Exclusion | $17,982 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 60122 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 60122 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 60122 | TotalRevenueColumn |
| Exclusion | $60,122 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 371002 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 16288 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 371002 | Securities |
| Other | -16288 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 354714 | TotalRevenueColumn |
| Related Or Exempt Function Income | 354714 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 72336 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 61065 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11271 | TotalRevenueColumn |
| Exclusion | $11,271 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| Cafeteria | 722210 | 73802 | $73,802 | |
| Other income | 900099 | 43298 | 43298 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 117100 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 52308869 | TotalRevenueColumn |
| Related Or Exempt Function Income | 51534046 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $766,819 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1242826 | Total |
| Program Services | 814299 | ProgramServices |
| Management And General | 428527 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17681014 | Total |
| Program Services | 16470214 | ProgramServices |
| Management And General | 1210800 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 295889 | Total |
| Program Services | 273630 | ProgramServices |
| Management And General | 22259 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2215066 | Total |
| Program Services | 2057401 | ProgramServices |
| Management And General | 157665 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1308853 | Total |
| Program Services | 1194521 | ProgramServices |
| Management And General | 114332 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 106384 | Total |
| Management And General | 106384 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 165179 | Total |
| Management And General | 165179 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 253061 | Total |
| Program Services | 77562 | ProgramServices |
| Management And General | 175499 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 927482 | Total |
| Program Services | 845611 | ProgramServices |
| Management And General | 81871 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 486443 | Total |
| Program Services | 404010 | ProgramServices |
| Management And General | 82433 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 353791 | Total |
| Program Services | 313399 | ProgramServices |
| Management And General | 40392 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 936551 | Total |
| Program Services | 936551 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2722628 | Total |
| Program Services | 2722628 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 449919 | Total |
| Program Services | 167192 | ProgramServices |
| Management And General | 282727 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad debts | 6010598 | 6010598 | |
| Medical supplies | 3067908 | 3067908 | |
| Medical professional fe | 2698296 | 2633632 | 64664 |
| Purchased services | 2469026 | 2119586 | 349440 |
| Pharmaceuticals | 2465866 | 2465866 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2283917 | Total |
| Program Services | 1791443 | ProgramServices |
| Management And General | 492474 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48140697 | Total |
| Program Services | 44366051 | ProgramServices |
| Management And General | 3774646 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12723 | BOY |
| EOY | 23604 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5962696 | BOY |
| EOY | 7154136 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9138610 | BOY |
| EOY | 10848960 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 705461 | BOY |
| EOY | 780492 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 240476 | BOY |
| EOY | 288529 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 41880156 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 23883948 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18591412 | BOY |
| EOY | 17996208 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17101456 | BOY |
| EOY | 18141018 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3837279 | BOY |
| EOY | 3404476 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55590113 | BOY |
| EOY | 58637423 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3845577 | BOY |
| EOY | 3518980 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19015416 | BOY |
| EOY | 18670542 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 691832 | BOY |
| EOY | 963459 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23552825 | BOY |
| EOY | 23152981 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31463301 | BOY |
| EOY | 34881578 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 573987 | BOY |
| EOY | 602864 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32037288 | BOY |
| EOY | 35484442 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55590113 | BOY |
| EOY | 58637423 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 4168172 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -721018 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15204131 | OtherCostOrOtherBasis |
| Depreciation | 7152408 | Depreciation |
| Book Value | 8051723 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17882615 | OtherCostOrOtherBasis |
| Depreciation | 12496336 | Depreciation |
| Book Value | 5386279 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8793410 | OtherCostOrOtherBasis |
| Depreciation | 4235204 | Depreciation |
| Book Value | 4558206 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 17996208 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (4 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Equity mutual funds | 3595126 | F |
| Fixed income mutual funds | 3730059 | F |
| Common stock | 5848956 | F |
| Publicly traded funds | 4966877 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 18141018 | TotalOfBookValueSecurities |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Deffered debt issuance costs | 479911 |
| Third party payer settlements | 2054031 |
| Beneficial interest in net assets of foundation | 431169 |
| Other receivables | 439365 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 3404476 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Capital Lease Obligations | Description |
| Amount | $963,459 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 963459 | TotalOfAmounts |
| Total Revenue | 52308869 | TotalRevenue |
| Total Expenses | 48140697 | TotalExpenses |
| Excess Or Deficit For Year | 4168172 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -749895 | NetUnrealizedGLOnInvestments |
| Other | $28,877 | OtherAmount |
| Total Adjustments | -721018 | TotalAdjustments |
| Excess Or Deficit Per FS | 3447154 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 52369934 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 61065 | OtherRevenues |
| Revenue Not Rptd F990 | 61065 | RevenueNotRptdF990 |
| Revenue Subtotal | 52308869 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 52308869 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 48201762 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 61065 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 61065 | ExpensesNotRptdF990 |
| Expenses Subtotal | 48140697 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 48140697 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Uncertain Tax Positions Under FIN 48: | Part X: | The Medical Center is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code and is exempt from federal income taxes on their related income pursuant to Section 501(a) of the Code. Management is not aware of any uncertainties in income tax positions. For the years ended September 30, 2011, 2010, 2009, and 2008, remain subject to examination for both federal and state purposes. |
| Part XI, Line 8 - Other Adjustments: | Change in beneficial interest in net assets of Foundation 29,102. Other decreases in restricted assets -35,989. Restricted Contributions 35,764. | |
| Part XII, Line 2d - Other Adjustments: | Expenses associated with special fundraisers 61,065. | |
| Part XIII, Line 2d - Other Adjustments: | Expenses associated with special fundraisers 61,065. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Golf Fundraiser | NameOfEvent1 |
| Gross Receipts Event1 | 57995 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 57995 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 5815 | CashPrizesEvent1 |
| Non Cash Prizes Event1 | 17611 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 5529 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 4901 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 7078 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Fun Run Fundraiser | NameOfEvent2 |
| Gross Receipts Event2 | 6501 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 6501 | GrossRevenueEvent2 |
| Non Cash Prizes Event2 | 408 | NonCashPrizesEvent2 |
| Entertainment Event2 | 377 | EntertainmentEvent2 |
| Other Direct Expenses Event2 | 4808 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 2 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 7840 | GrossReceiptsOtherEvents |
| Gross Revenue Other Events | 7840 | GrossRevenueOtherEvents |
| Non Cash Prizes Other Events | 102 | NonCashPrizesOtherEvents |
| Rent Facility Costs Other Events | 1175 | RentFacilityCostsOtherEvents |
| Food And Beverage Other Events | 1720 | FoodAndBeverageOtherEvents |
| Entertainment Other Events | 3400 | EntertainmentOtherEvents |
| Other Direct Expenses Other Events | 8141 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 72336 | GrossReceiptsTotal |
| Gross Revenue Total Events | 72336 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 5815 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 18121 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 6704 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 6621 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 3777 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 20027 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 61065 | DirectExpenseSummaryEvents |
| Net Income Summary | 11271 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 127.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 777820 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 813637 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -35817 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5549316 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3724535 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1824781 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04330 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6327136 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4538172 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1788964 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04330 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 169317 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4410 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 164907 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00390 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 31457 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 22457 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5541518 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2752090 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2789428 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06620 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 29427 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 29427 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5771719 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2765500 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3006219 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07130 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12098855 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7303672 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4795183 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.11460 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,480,283 | BadDebtExpenseAmount |
| Amount Attributable To | 248028 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 17302860 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 19233295 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1930435 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | 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 | Cameron Regional Medical Center | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 East Evergreen Street | AddressLine1 |
| City | Cameron | City |
| State | MO | State |
| ZIP Code | 64429 | 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 | Cameron Regional Medical Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 127.000000000000 | FPGDiscountPercent |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Collection Activities | 1 | CollectionActivities |
| Lawsuit | X | Lawsuit |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 12 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (12 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Cameron Medical Clinic | ||||
| 1600 E Evergreen | Cameron | MO | 64429 | Medical Clinic |
| Walnut Medical Clinic | ||||
| 221 E 7th Street | Cameron | MO | 64429 | Medical Clinic |
| Westside Medical Offices | ||||
| 1608 E Evergreen | Cameron | MO | 64429 | Medical Clinic |
| Cameron Specialists - Internal Medicine | ||||
| 1608 E Evergreen | Cameron | MO | 64429 | Medical Clinic |
| Hamilton Family Health Center | ||||
| 212 N Davis | Hamilton | MO | 64644 | Rural Health Clinic |
| Gallatin Family Medicine | ||||
| 502 S Main | Gallatin | MO | 64640 | Rural Health Clinic |
| Jamesport Outreach Clinic | ||||
| 409 W Auberry Grove | Jamesport | MO | 64648 | Rural Health Clinic |
| Stewartsville Medical Clinic | ||||
| 106 E 4th | Stewartsville | MO | 64490 | Rural Health Clinic |
| Plattsburg Family Medicine | ||||
| 214 N Main | Plattsburg | MO | 64477 | Rural Health Clinic |
| Pattonsburg Medical Clinic | ||||
| 110 N Central Ave | Pattonsburg | MO | 64670 | Rural Health Clinic |
| Polo Family Health Center | ||||
| 101 E Meadowbrook | Polo | MO | 64671 | Rural Health Clinic |
| Lathrop Medical Clinic | ||||
| 705 Oak Street | Lathrop | MO | 64465 | Medical Clinic |
Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 6010598. | |
| Part III, Line 4: The Medical Center provides for accounts receivable that could become uncollectible in the future by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable value. The Medical Center estimates this allowance based on the aging of its accounts receivable and its historical collection experience for each type of payor.Part III, Line 2Provisions for bad debts are related to accounts that have been deemed uncollectible during the year. The uncollectible amount is then written off pursuant with Medical Center policy. The cost of the bad debts reported was determined using the cost to charge ratio and total bad debt expense.Part III, Line 3The estimate of provisions for bad debts attributable to patients eligible under the organization's financial assistance policy was determined using by a conservative estimate that 10 percent of all bad debt expense is attributable to patients eligible under the organization's financial assistance policy. | |
| Part III, Line 8: Amounts were obtained from the cost report filed with Medicare for the period ending September 30, 2011. The shortfall represents unpaid costs of public programs for low-income and elderly persons. | |
| Part V, Section B, Line 19d: The Medical Center bills all patients and payer types equally for the gross charges of the services rendered. The Medical Center accounts for several factors including Medicare reimbursement when establishing acceptable charge rates for their services. | Cameron Regional Medical Center, Inc. |
| Part V, Section B, Line 21: The Medical Center bills all patients and payer types equally for the gross charges of the services rendered. | Cameron Regional Medical Center, Inc. |
| Part VI, Line 2: The Medical Center relies on the feedback and request taken from patients of the Medical Center and its numerous clinics, as well as the residents from the primary service area. | |
| Part VI, Line 3: The Medical Center employs a social worker that informs all patients of all available payment options. Each patient receives a HELP program brochure to ensure that the patient has all information needed. | |
| Part VI, Line 4: Cameron Regional Medical Center and its seven rural health clinics are located in Northwest Missouri. The primary service area is comprised of four rural counties consisting of Daviess, Caldwell, DeKalb, and Clinton. There are approximately 51,500 individuals that reside in the primary service area. Of these residents approximately 11.6% of them have an annual income below the federal poverty level. The median annual income per household for the four counties is approximately $43,643. Approximately 45% of the total services provided are for Medicare patients and 13% are for Medicaid patients. The nearest surrounding hospitals are located in Smithville, Excelsior Springs, and Richmond. The distance between these facilities and Cameron Regional Medical Center is approximately 28, 28, and 31 miles respectively. | |
| Part VI, Line 6: Cameron Regional Medical Center's governing body is comprised of residents from the primary service area. The Medical Center extends medical privileges to all local physicians. All surplus funds are used to maintain and improve the medical facility and medical equipment in order to provide the best medical treatment possible to every patient. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kendall DeSelms DO | |||||||||||||
| 181882 | 0 | 0 | 0 | 43423 | 0 | 0 | 0 | 0 | 0 | 225305 | 0 | 132877 | 0 |
| Laeeq Azmat MD | |||||||||||||
| 527947 | 0 | 0 | 0 | 64073 | 0 | 0 | 0 | 0 | 0 | 592020 | 0 | 399095 | 0 |
| Joseph F Abrutz Jr | |||||||||||||
| 278966 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 278966 | 0 | 210052 | 0 |
| John Barton III | |||||||||||||
| 329166 | 0 | 0 | 0 | 19991 | 0 | 0 | 0 | 0 | 0 | 349157 | 0 | 239510 | 0 |
| James Dancer | |||||||||||||
| 243474 | 0 | 0 | 0 | 18000 | 0 | 0 | 0 | 0 | 0 | 261474 | 0 | 176162 | 0 |
| Muhammad Amin | |||||||||||||
| 239481 | 0 | 0 | 0 | 35353 | 0 | 0 | 0 | 0 | 0 | 274834 | 0 | 144780 | 0 |
| James Neely | |||||||||||||
| 230006 | 0 | 0 | 0 | 19500 | 0 | 0 | 0 | 0 | 0 | 249506 | 0 | 168082 | 0 |
| Shahzad Shafique | |||||||||||||
| 240754 | 0 | 0 | 0 | 48115 | 0 | 0 | 0 | 0 | 0 | 288869 | 0 | 172098 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| The Industrial Development Authority of the City of Cameron Missouri | |||||||
| 431679396 | 133451BF0 | 2007-05-17 | 10000000 | Health Facilities Revenue Bonds, Series 2007A | 0 | 0 | 0 |
| The Industrial Development Authority of Clinton County Missouri | |||||||
| 521734480 | 133451AB6 | 2007-05-17 | 9994879 | Health Facilities Revenue Bonds, Series 2007B | 0 | 0 | 0 |
| The Industrial Development Authority of the City of Cameron Missouri | |||||||
| 431679396 | 2006-12-06 | 664000 | Health Facilities Revenue Bonds, Series 2006 | 0 | 0 | 0 | |
Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)
| Amount Bond DefeasedAmountBondDefeased | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|
| 9798262 | 197701 | 4037 | 2007 | 0 | 1 | 1 | 1 |
| 8884388 | 197054 | 913437 | 2007 | 0 | 1 | 1 | 1 |
| 589215 | 10000 | 64785 | 2006 | 1 | 0 | 0 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Ken Raffety Director Cameron Region | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Director Cameron Regional Medical Center Foundation | Relationship |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section B, line 11 | A copy of form 990 is made available to the governing body prior to filing. | |
| Employees and Directors are required to complete an annual disclosure information form. | Form 990, Part VI, Section B, line 12c | |
| Organization makes its governing documents available upon request. | Form 990, Part VI, Section C, line 19 | |
| Changes in Net Assets or Fund Balances: | Net unrealized losses on investments: -749,895. Change in beneficial interest in net assets of Foundation 29,102. Other decreases in restricted assets -35,989. Restricted Contributions 35,764. Total to Form 990, Part XI, Line 5: -721,018. | Form 990, Part XI, line 5: |
| Financial Statements and Reporting | Cameron Regional Medical Center's Finance Committee is responsible for each of these functions. | 990, Part XI, Page 11, Line 2c |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cameron Regional Medical Center Foundation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 East Evergreen Street | AddressLine1 |
| City | Cameron | City |
| State | MO | State |
| ZIP Code | 64429 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 742933060 | EIN |
| Primary Activities | To support the operation of the Cameron Regional Medical Center, Inc.. | PrimaryActivities |
| Legal Domicile State | MO | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | 170(b)(1) (A)(vi) | PublicCharityStatus |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 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 | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| Cameron Regional Medical Center Foundation | |
| C | 28805 |
| Cameron Regional Medical Center Foundation | |
| P | 10682 |