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FOUNDATION RESOLUTION CORPORATION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
FOUNDATION RESOLUTION CORPORATION (EIN 59-2890430)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-10
IRS object ID
201222239349301047
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-08-10T13:32:48-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PERSHING YOAKLEY & ASSOCIATES PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12963 GULF TO BAY BLVD STE 267AddressLine1
CityCLEARWATERCity
StateFLState
ZIP Code337594255ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN592890430EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Citrus Memorial Health Foundation IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCITRNameControl
Phone3525606898Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1502 W Highland BlvdAddressLine1
CityInvernessCity
StateFLState
ZIP Code344524720ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMark WilliamsName
TitleCFOTitle
Phone3525606898Phone
Date Signed2012-08-10DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameTerry HaefnerName
Phone7274427110Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRyan BeatyNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1502 W Highland BlvdAddressLine1
CityInvernessCity
StateFLState
ZIP Code344524720ZIPCode
FieldValueIRS element (for citing)
Gross Receipts184914404GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.citrusmh.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1987YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionThe organization's primary purpose is to provide a wide range of healthcare services for the benefit of the citizens and residents of Citrus County.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees1831TotalNbrEmployees
Total Nbr Volunteers410TotalNbrVolunteers
Total Gross UBI627TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1689544ContributionsGrantsPriorYear
Contributions Grants Current Year200168ContributionsGrantsCurrentYear
Program Service Revenue Prior Year171754870ProgramServiceRevenuePriorYear
Program Service Revenue CY177011889ProgramServiceRevenueCY
Investment Income Prior Year1089843InvestmentIncomePriorYear
Investment Income Current Year264086InvestmentIncomeCurrentYear
Other Revenue Prior Year271056OtherRevenuePriorYear
Other Revenue Current Year3546696OtherRevenueCurrentYear
Total Revenue Prior Year174805313TotalRevenuePriorYear
Total Revenue Current Year181022839TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year73059287SalariesEtcPriorYear
Salaries Etc Current Year76956388SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year207335TotalFundrsngExpCurrentYear
Other Expense Prior Year106749257OtherExpensePriorYear
Other Expenses Current Year104162410OtherExpensesCurrentYear
Total Expenses Prior Year179808544TotalExpensesPriorYear
Total Expenses Current Year181118798TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-5003231RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-95959RevenuesLessExpensesCY
Total Assets BOY143277438TotalAssetsBOY
Total Assets EOY141299059TotalAssetsEOY
Total Liabilities BOY94134824TotalLiabilitiesBOY
Total Liabilities EOY107868469TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY49142614NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY33430590NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionCitrus Memorial Health System exists to improve the health and quality of life of the people and communities we serve.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense142301284Expense
Revenue158693640Revenue
DescriptionCitrus Memorial Hospital is a 198-bed, general short-term acute care hospital. The hospital's services include Same Day Surgery, 24-hour Emergency and Lab Services, Diagnostic Imaging, Rehabilitation, Cardiology and Catherization, Critical Care, Ear-Nose-Throat, Endoscopy, General Surgery, Gynecology and Obstetrics, Laparoscopic Surgery, Laser Surgery, Lithotripsy, Neurology, Opthalmology, Orthopedic, Pediatric Pulmonary, Radiation Therapy, Urology, Vascular Services and community education programs. Citrus Memorial Hospital was established as a general short-term acute care hospital in 1957. It is operated by the Citrus Memorial Health Foundation, Inc. The hospital charges each patient for services rendered; however, it is recognized that not all individuals have the ability to pay for these services. A determination is made to identify those persons that qualify for hospital sponsored care. The hospital follows the guidelines established by the State of Florida for qualifying hospital sponsored care. When an individual is qualified for hospital sponsored care, the bill is written off in most cases and partially written off in the remaining cases. When a patient does not have insurance, additional discounts are available. The total amount of uncompensated care absorbed by the hospital in 2011 was $45,242,090 including $13,636,847 of charity care, $23,640,104 of bad debt and $7,965,139 of self-pay discounts. The rate of reimbursement for Medicare and Medicaid payments is below the cost of providing such care. Thus, the hospital must recognize these amounts as necessary in meeting its mission.The following statistics show the level of care that was provided by the hospital in 2011, thus enhancing the quality of life in its service area: Annual Admissions 10,229Newborn Admissions 573Patient Days 41,021Newborn Days 1,025Operations Performed 6,070ER Visits 38,966Outpatient Registrations 158,255 The hospital has many other activities in keeping with its commitment to serve the healthcare needs of Citrus County:- Distributes a wide variety of literature that educates patients on topics ranging from emergency medical problems to Medicare benefits.- Sponsors a free Share Club for senior citizens to provide health care seminars and screenings, exercise programs, perscription cards, Medicare assistance and other opportunities to its over 14,000 members.- Provides some 200 educational programs annually that are available at no cost to the community, medical workers and physicians.- Operates walk-in and diagnostic imaging centers to provide health care to the residents in the center of the county.- Participates in and hosts health fairs throughout the county, offering health care screenings and information in order to foster health education in the community.- Sponsors various health awareness programs and seminars to educate the general public about various health topics.- Provides speakers for various civic organizations.- Sponsors free community resource service to provide information on health services, support groups and assistance programs available at the hospital and throughout the community.- Sponsors free 24/7 physician referral service for Citrus and Sumter counties to help increase accessibility to healthcare.- Offers monthly and periodic free or low-cost health exams and screenings such as blood pressure, cholesterol, hemoglobin and various cancer screenings, among others. This aids awareness of personal health and detects problems or possible problems.- Sponsors and participates in events such as local parades, safety fairs, Chamber of Commerce events and an annual county baby shower to increase community awareness of our services.- Provides organizational and operational skills and meeting facilities for numerous groups including but not limited to Ostomy Support Group, Diabetes Support Group, American Cancer Society, Mended Hearts, various cancer support groups, Stroke Support Group, American Heart Association and Breast Cancer Support Group.- Provides assistance to educators through our work with student nursing, radiology technologist and phlebotomist programs in the local community colleges and vocational training center. Also participates in local high school career fairs to increase awareness of career opportunities in healthcare.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense15991905Expense
Revenue19148446Revenue
DescriptionCitrus Memorial maintains offsite external services for the community including family practice, internal medicine and rehab services. These clinics are located conveniently throughout the county. In addition, the offices participate in local health fairs, provide free physicals for various local student organizations and host educational seminars on a variety of healthcare related topics.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense2641211Expense
Revenue2525487Revenue
DescriptionThe Citrus Memorial Home Health Agency was establised to provide care to those that are homebound or need continuing post-hospital care. Services include skilled nursing, rehabiliation therapy, social and nutritional. This agency provides an alternative to hospitalization or nursing home placement. The home health agency is certified by the Joint Commission on accreditation of healthcare organizations.Description
FieldValueIRS element (for citing)
Total Program Service Expense160934400TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account1EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109680NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1831NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of1Form8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form1098 C Filed1Form1098CFiled
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure0WrittenPolicyOrProcedure
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Mark WilliamsBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3525606898TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1502 W Highland BlvdAddressLine1
CityInvernessCity
StateFLState
ZIP Code34452ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
Robert Henigar
Chairperson2.00XX000
James Sanders
Vice Chairperson10.00XX000
Robert Collins
Secretary/Treasurer2.00XX000
Sandra Chadwick
Board Member2.00X000
Joseph Brannen
Board Member3.00X000
Venugopala Reddy
Board Member2.00X000
David Langer
Board Member2.00X000
Sanjiv Shah
Board Member2.00X000
Ryan Beaty
CEO60.00X431977077522
Jerrald Deloach
COO60.00X208600024058
Emery Hensley
CFO60.00X214047043323
Mark Williams
CFO60.00X160462011218
Linda McCarthy
CNO60.00X202436016925
Lee Glotzback
CHRO60.00X152851022316
Eric Hirsch MD
Physician60.00474907040780X
Neil Katz MD
Physician60.0039283204163X
John Gelin MD
Physician60.00336490075597X
Julie Sudduth MD
Physician60.00261606021697X
Michael Brown MD
Physician60.00261823021705X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3098031TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation359304TotalOtherCompensation
Number Individuals GT100 K40NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Carlton Fields Attorney at Law
PO Box 3239TampaFL33601legal services2128587
Associated Radiologists of Inverness P
2325 Stonebridge DriveFlintMI48532radiology1532926
LifeSouth Community Blood Centers Inc
MSC 514 PO Box 830469BirminghamAL35283blood bank services1087067
Citrus Anesthesiology
131 S Citrus AvenueInvernessFL34452anesthesia1023429
Robins & Morton Group
400 Shades Creek Parkway Suite 200BirminghamAL35209general contractor960235
FieldValueIRS element (for citing)
Number Of Contractors GT100 K32NumberOfContractorsGT100K
Fundraising Events158759FundraisingEvents
All Other Contributions41409AllOtherContributions
Noncash Contributions32784NoncashContributions
Total Contributions200168TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
Hospital Service Reven621110174157494174157494
SMP-Florida Medicaid62111016023741602374
Citrus County Hospital621110833706833706
Cafeteria Sales900099384610$384,610
Miscellaneous Program9000993370533705
FieldValueIRS element (for citing)
Total Program Service Revenue177011889TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column444204TotalRevenueColumn
Exclusion$444,204ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real294782Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real110256Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real184526Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column184526TotalRevenueColumn
Exclusion$184,526ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3533494Securities
Other16350Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3539114Securities
Other190848Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-5620Securities
Other-174498Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-180118TotalRevenueColumn
Exclusion-$180,118ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events57206GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events158759CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses51347FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column5859TotalRevenueColumn
Exclusion$5,859ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Miscellaneous Revenue90009933556843355684
Catering722320627627
FieldValueIRS element (for citing)
Total Other Revenue3356311TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column181022839TotalRevenueColumn
Related Or Exempt Function Income179982963RelatedOrExemptFunctionIncome
Unrelated Business Revenue627UnrelatedBusinessRevenue
Exclusion$839,081ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1091599Total
Management And General1091599ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total58106162Total
Program Services54044279ProgramServices
Management And General3922893ManagementAndGeneral
Fundraising138990Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2479488Total
Program Services2250012ProgramServices
Management And General221288ManagementAndGeneral
Fundraising8188Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total11071714Total
Program Services8009979ProgramServices
Management And General3037379ManagementAndGeneral
Fundraising24356Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4207425Total
Program Services3858721ProgramServices
Management And General338684ManagementAndGeneral
Fundraising10020Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2254968Total
Management And General2254968ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total70200Total
Management And General70200ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total13493344Total
Program Services10290858ProgramServices
Management And General3196971ManagementAndGeneral
Fundraising5515Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total393639Total
Program Services16439ProgramServices
Management And General374468ManagementAndGeneral
Fundraising2732Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total37697372Total
Program Services37488898ProgramServices
Management And General197616ManagementAndGeneral
Fundraising10858Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3029948Total
Program Services3013717ProgramServices
Management And General16151ManagementAndGeneral
Fundraising80Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total8484612Total
Program Services8410793ProgramServices
Management And General69276ManagementAndGeneral
Fundraising4543Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total197469Total
Program Services179302ProgramServices
Management And General17503ManagementAndGeneral
Fundraising664Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total26355Total
Program Services10287ProgramServices
Management And General15971ManagementAndGeneral
Fundraising97Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total2830515Total
Management And General2830515ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total7146925Total
Program Services7146925ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total2039386Total
Program Services303109ProgramServices
Management And General1736277ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Bad Debts2364010423640104
Indigent Assessment18386941838694
Miscellaneous8434443007205416721052
Education17543513156343632240

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total181118798Total
Program Services160934400ProgramServices
Management And General19977063ManagementAndGeneral
Fundraising207335Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY23338401BOY
EOY21483661EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1000000BOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY145871BOY
EOY172397EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY14295273BOY
EOY16499513EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3455880BOY
EOY3793534EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2742651BOY
EOY2665009EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis161165135LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec95011637LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY65532319BOY
EOY66153498EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY14070556BOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY15215051BOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY575604EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY4901000EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3481436BOY
EOY25054843EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY143277438BOY
EOY141299059EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY22666890BOY
EOY19890870EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY58193072BOY
EOY56914451EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY986285BOY
EOY412381EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY12288577BOY
EOY30650767EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY94134824BOY
EOY107868469EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY47628625BOY
EOY31721478EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1513989BOY
EOY1709112EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY49142614BOY
EOY33430590EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY143277438BOY
EOY141299059EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-95959ReconcilationRevenueExpenses
Reconcilation Other Changes-15616065ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis7217686OtherCostOrOtherBasis
Book Value7217686BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis84595014OtherCostOrOtherBasis
Depreciation42255127Depreciation
Book Value42339887BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis3670440OtherCostOrOtherBasis
Depreciation3188983Depreciation
Book Value481457BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis64855430OtherCostOrOtherBasis
Depreciation49567527Depreciation
Book Value15287903BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis826565OtherCostOrOtherBasis
Book Value826565BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings66153498TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
Other Receivable1408046
Third Party Settlements124992
Other Assets546524
Malpractice Funding Arrangement2155941
Under Indenture Agreement4125127
Deferred Bond Costs495277
Assets Limited as to Use16198936
FieldValueIRS element (for citing)
Total Book Value Other Assets25054843TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Liability for Pension Benefits$23,228,950
CSI Recourse Liability$21,903
Other Current Liabilities$4,799,465
Professional Liability$2,600,449
FieldValueIRS element (for citing)
Total Of Amounts30650767TotalOfAmounts
Total Revenue181022839TotalRevenue
Total Expenses181118798TotalExpenses
Excess Or Deficit For Year-95959ExcessOrDeficitForYear
Net Unrealized GL On Investments-16258NetUnrealizedGLOnInvestments
Other-$15,599,807OtherAmount
Total Adjustments-15616065TotalAdjustments
Excess Or Deficit Per FS-15712024ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt181021768TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal181021768RevenueSubtotal
Other Revenues Not Included1071OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1071RevenueNotRptdOnFinStmt
Total Revenue Per Form990181022839TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt181119243TotExpensesEtcAuditedFinclStmt
Other Expenses Included445OtherExpensesIncluded
Expenses Not Rptd F990445ExpensesNotRptdF990
Expenses Subtotal181118798ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990181118798TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Uncertain Tax Positions Under FIN 48:Part X:The Foundation is exempt from income taxes under Section 501(c)(3) of the IRC. Accordingly, the financial statements do not reflect a provision for income taxes. At September 30, 2011, the Foundation does not have any uncertain tax positions that would require recognition or disclosure in the financial statements. The Foundation is no longer subject to federal or state income tax examinations by tax authorities for the years before 2007.
Part XI, Line 8 - Other Adjustments:Contributions in Net Assets 242,499. Net Assts Released from Restrictions -47,376. Pension Plan Adjustments -15,793,414. Other Changes in Net Assets -1,516.
Part XII, Line 4b: Other Revenue 1,071 Part XIII, Line 2d: Other Expenses 445

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Golf TournamentNameOfEvent1
Gross Receipts Event1127079GrossReceiptsEvent1
Charitable Contributions Event193334CharitableContributionsEvent1
Gross Revenue Event133745GrossRevenueEvent1
Cash Prizes Event11200CashPrizesEvent1
Non Cash Prizes Event156NonCashPrizesEvent1
Rent Facility Costs Event114163RentFacilityCostsEvent1
Food And Beverage Event17658FoodAndBeverageEvent1
Other Direct Expenses Event110884OtherDirectExpensesEvent1
Name Of Event2Charity BallNameOfEvent2
Gross Receipts Event288886GrossReceiptsEvent2
Charitable Contributions Event265425CharitableContributionsEvent2
Gross Revenue Event223461GrossRevenueEvent2
Food And Beverage Event211007FoodAndBeverageEvent2
Entertainment Event22500EntertainmentEvent2
Other Direct Expenses Event23879OtherDirectExpensesEvent2
Gross Receipts Total215965GrossReceiptsTotal
Charitable Contributions Total158759CharitableContributionsTotal
Gross Revenue Total Events57206GrossRevenueTotalEvents
Cash Prizes Total Events1200CashPrizesTotalEvents
Non Cash Prizes Total Events56NonCashPrizesTotalEvents
Rent Facility Costs Total Events14163RentFacilityCostsTotalEvents
Food And Beverage Total Events18665FoodAndBeverageTotalEvents
Entertainment Total Events2500EntertainmentTotalEvents
Other Direct Expenses Total Events14763OtherDirectExpensesTotalEvents
Direct Expense Summary Events51347DirectExpenseSummaryEvents
Net Income Summary5859NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense7325598TotalCommunityBenefitExpense
Direct Offsetting Revenue1602374DirectOffsettingRevenue
Net Community Benefit Expense5723224NetCommunityBenefitExpense
Percent Of Total Expense0.03630PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense16589226TotalCommunityBenefitExpense
Direct Offsetting Revenue12595408DirectOffsettingRevenue
Net Community Benefit Expense3993818NetCommunityBenefitExpense
Percent Of Total Expense0.02540PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense23914824TotalCommunityBenefitExpense
Direct Offsetting Revenue14197782DirectOffsettingRevenue
Net Community Benefit Expense9717042NetCommunityBenefitExpense
Percent Of Total Expense0.06170PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense583705TotalCommunityBenefitExpense
Net Community Benefit Expense583705NetCommunityBenefitExpense
Percent Of Total Expense0.00370PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense9585TotalCommunityBenefitExpense
Net Community Benefit Expense9585NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense81876TotalCommunityBenefitExpense
Net Community Benefit Expense81876NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense35181TotalCommunityBenefitExpense
Net Community Benefit Expense35181NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense710347TotalCommunityBenefitExpense
Net Community Benefit Expense710347NetCommunityBenefitExpense
Percent Of Total Expense0.00450PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense24625171TotalCommunityBenefitExpense
Direct Offsetting Revenue14197782DirectOffsettingRevenue
Net Community Benefit Expense10427389NetCommunityBenefitExpense
Percent Of Total Expense0.06620PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$6,004,586BadDebtExpenseAmount
Amount Reimbursed By Medicare61659347AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare73010623CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-11351276MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (4 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipOfficers Etc Profit Or OwnershipOfficersEtcProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
1 Nature Coast Development Group-Crystal River
Rental0.500000.000000.25000
2 Nature Coast Development Group-Meadowcrest
Rental0.500000.000000.50000
3 Citrus County Medical Group
Rental0.170000.00000
4 North Central Florida Health Partners
Buying Group0.500000.00000
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Citrus Memorial HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1502 W Highland BlvdAddressLine1
CityInvernessCity
StateFLState
ZIP Code34452ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Citrus Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities25NumberOfOtherFacilities

Other Facilities OtherFacilities (25 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Citrus Orthopedic & Joint Institute
951 N Avalon WayLecantoFL34461Rehabilitation Clinic
Gulf Coast Aquatic & Rehab
819 Medical Court EastInvernessFL34452Rehabilitation Clinic
Inverness Surgical Associates
403 W Highland BlvdInvernessFL34452Surgical OP/IP Physician Clinic
HomosassaSugarmill Woods Lab Coll Ctr
7945 S Suncoast BlvdHomosassaFL34446Laboratory Draw Station
Gulf Coast Aquatic & Rehab
6043 W Nordling LoopCrystal RiverFL34429Rehabilitation Clinic
Beverly Hills Laboratory Coll Ctr
8 Regina BlvdBeverly HillsFL34465Laboratory Draw Station
Citrus Memorial Home Health Agency
502 W Highland BlvdInvernessFL34452Home Healthcare
Sugarmill Woods Rehabilitation Center
7945 S Suncoast BlvdHomosassaFL34446Rehabilitation Clinic
Beverly Hills Rehabilitation Center
3402 N Lecanto Hwy Suite BBeverly HillsFL34465Rehabilitation Clinic
Sugarmill Woods Diagnostic Imaging
7945 S Suncoast BlvdHomosassaFL34446Diagnostic Imaging Center
Citrus Hills Laboratory Coll Center
1978 N Prospect AvenueLecantoFL34461Laboratory Draw Station
Dunnellon Laboratory Coll Center
11352 N Williams StreetDunnellonFL34432Laboratory Draw Station
Citrus Primary Care-Homosassa
7945 S Suncoast BlvdHomosassaFL34446Outpatient Physician Clinic
Allen Ridge Family Care Center
540 N Lecanto HwyLecantoFL34461Outpatient Physician Clinic
Allen Ridge Diagnostic Imaging Center
520 N Lecanto HwyLecantoFL34461Diagnostic Imaging Center
Citrus Primary Care-Beverly Hills
450 W Roosevelt BlvdBeverly HillsFL34465Outpatient Physician Clinic
Citrus Primary Care-Floral City
7648 S Florida AvenueFloral CityFL34436Outpatient Physician Clinic
Citrus Primary Care-Inverness
131 S Citrus AvenueInvernessFL34452Outpatient Physician Clinic
Citrus Primary Care-Crystal River
700 SE 5th Terrace Suite 7Crystal RiverFL34429Outpatient Physician Clinic
Sugarmill Woods Family Care Center
7945 S Suncoast BlvdHomosassaFL34446Outpatient Physician Clinic
Citrus Primary Care-Citrus Springs
10334 N Citrus Springs BlvdCitrus SpringsFL34434Outpatient Physician Clinic
CMH Orthopedic & Joint Specialists
3402 N Lecanto Hwy Suite CBeverly HillsFL34465Ortho Outpatient Physician Clinic
Citrus Primary Care-Bushnell
417 Market Street 7BushnellFL33513Outpatient Physician Clinic
Citrus Springs Rehabilitation Center
10489 N Florida Avenue Suite FCitrus SpringsFL34434Rehabilitation Clinic
West Florida Diagnostic Center
3533 N Lecanto HwyBeverly HillsFL34465Diagnostic Imaging Center

Form990 Schedule H Part VI Form990ScheduleHPartVI (6 entries)

ExplanationExplanation
Part I, L7 Col(f): Bad debt expense included in Frm 990, part IX, line 25, column (a) is $23,640,104. The Hospital excluded the full amount, $23,640,104, for purposes of calculating the percentage in column (f), on part I, line 7.
Part III, Line 8: Although we were not able to determine a dollar amount, we believe a portion of the Medicare shortfall could be considered community benefit since Medicare is such a predominant payor in our facility. For example, Citrus Memorial has an open heart program. This program does not generate positive contribution margins for the hospital; however we consider the program to be an integral benefit to the community. Without the heart program residents would be required to travel out of the county to receive services. It is estimated that this program loses over $1 million on an annual basis. Typically commercial or managed care providers make up the deficit of the governmental payors; unfortunately, we do not have the better paying population to make up for these deficits. Our tax exempt status allows CMHS to provide care at a level that would be impossible without this determination. The organization provides a vital service to the community for the insured as well as the uninsured alike.
Part VI, Line 2: Citrus Memorial Health System personnel is actively involved with the community and strives to "feel the pulse" of the county's needs. CMH hosted a round table discussion with members of the community who represent the underserved including clergy, social workers, and the local food bank. An advisory group was then formed to brainstorm ideas to reach out to those in need. As a result, CMHS now sponsors a biweekly program where approximately 6 patients per week from a very impoverished area are transported to one of our primary care facilities for check-ups and treatment at no cost. Lifesaving surgeries and diagnostic testing have been performed to patients at no cost - otherwise they would have received no care. One patient told us that he had not seen a doctor since Vietnam! At our clinics, we turn away no patients based on their ability to pay. Many of these patients were referred to us by "for profit" physician practices. Our hospital also has an "Advisory Committee" where representatives from throughout the community discuss the best use of donated funds from our philanthropy endeavors. An education center, among other things, is being planned resulting from the discussions that ensued from those meetings.Citrus Memorial also develops a strategic plan based on the needs of the community. Consultants and community experts are utilized to determine the underserved programs and patients in our community. We then determine a "roadmap" to direct our activities in the best possible manner
Part VI, Line 3: Citrus Memorial's financial counselors are well schooled in the area of financial assistance. Upon registration and once a need is determined, our patients are informed of possible Medicaid eligibility and charity care sponsorship. We are affiliated with a company that qualifies patients for Medicaid, and we also have recently opened a Medicaid service center in which community members can come to our center and complete paperwork to become eligible for this service. We have even partnered with other community agencies and conducted "healthcare fairs" to provide screenings and financial direction to patients. We provided information on our sponsorship program and provide information on Medicaid to the needy in the community.
Part VI, Line 4: Citrus County is a rural area with a significant elderly and indigent population. Citrus County is the second oldest population in the state. According to the latest census, 31% of residents are older than 65 - Florida's average is 17.2% aged greater than 65. There is virtually no industry in the area, and most jobs are related to the "service industry". The per capita income in the county is $22,714 with the Florida average being $26,503. Citrus County residents have fewer years of education with only 16.7% of the population holding a bachelor's degree or higher with the Florida average being 25.6%. Citrus County has 141,236 residents with Citrus Memorial being the primary provider of hospital care in the county. There is a smaller for-profit hospital on the other side of the county that does not offer the array of services of CMHS and does not have the capacity to serve the volume of patients CMHS serves.
Part VI, Line 6: Citrus Memorial Health System provides critical services to the citizens of Citrus County. Not only do we provide acute care hospital services, but also Home Health and primary care - all providing care to the indigent. We receive many indigent referrals from the other for-profit health establishments in the community including diagnostic imaging, infusion therapy, endoscopy, lab testing, and OP therapy. Please see schedule O for a more comprehensive list of our services.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses0WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Ryan Beaty
4211310001084607684306790509499000
Jerrald Deloach
2086000000019429046290232658000
Emery Hensley
2140470000041798015250257370000
Mark Williams
160462000008482027360171680000
Linda McCarthy
2024360000013796031290219361000
Lee Glotzback
1528510000019687026290175167000
Eric Hirsch MD
4749070000038457023230515687000
Neil Katz MD
392832000000041630396995000
John Gelin MD
99761023672900071968036290412087000
Julie Sudduth MD
105164015644200019068026290283303000
Michael Brown MD
2587090003114020583011220283528000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 1bThese amounts are paid in accordance with the employment contracts. There is no written policy regarding payment or provision of the benefits described above.
Part I, Line 4aEmery Hensley, former CFO, received severance pay of $35,876. This amount is included in Part II, Column (B)(i).

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Citrus County Hospital Board
596017150NoneAvail2006-09-2610000000See Part V000
Citrus County Hospital Board
596017150NoneAvail2008-09-0110000000See Part V000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
1000000076169992386120080011
1000000055189994481120100011

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00001
00001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
010000
010000

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

IdentifierIdentifierExplanationExplanation
Part I, Line A, Column F, Description of Purpose:(1) Financing a portion of the construction of hospital facilities and equipment including, but not limited to: the bed tower and emergency services expansion and ancillary department renovation located at Citrus Memorial Health System. (2) Providing for reimbursement of capital expenditures and to finance future routine capital expenditures at Citrus Memorial Health System. (3) Paying certain costs of issuance.
Part I, Line B, Column F, Description of Purpose:(1) Renovation of the emergency department located at Citrus Memorial Health System, including renovation of the existing space and 5,400 new square feet, an increase of 12 patient beds and an ability to improve patient flow. (2) Sugarmill Woods Diagnostic, Rehabilitation and Clinic facility, an approximately 21,400 square foot single store outpatient facility. (3) Renovations to patient elevators. (4) Paying certain costs of issuance.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonJames T SandersNamePerson
FieldValueIRS element (for citing)
RelationshipBoard MemberRelationship
Amount Of Transaction14587AmountOfTransaction
Description Of TransactionMr. Sanders has a family member employed by the organizationDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule M IRS990ScheduleM

Works Of Art WorksOfArt

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions3NumberOfContributions
Noncash Contribs Rptd F990674NoncashContribsRptdF990
Method Of Determining RevenuesSelling PriceMethodOfDeterminingRevenues

Books And Publications BooksAndPublications

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F9904570NoncashContribsRptdF990
Method Of Determining RevenuesSelling PriceMethodOfDeterminingRevenues

Clothing And Household Goods ClothingAndHouseholdGoods

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F9905079NoncashContribsRptdF990
Method Of Determining RevenuesSelling PriceMethodOfDeterminingRevenues

Cars And Other Vehicles CarsAndOtherVehicles

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F99010800NoncashContribsRptdF990
Method Of Determining RevenuesSelling PriceMethodOfDeterminingRevenues

Food Inventory FoodInventory

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions9NumberOfContributions
Noncash Contribs Rptd F9902050NoncashContribsRptdF990
Method Of Determining RevenuesSelling PriceMethodOfDeterminingRevenues

Other Non Cash Contributions Table OtherNonCashContributionsTable (4 entries)

Non Cash CheckboxNonCashCheckboxDescriptionDescriptionNumber Of ContributionsNumberOfContributionsNoncash Contribs Rptd F990NoncashContribsRptdF990Method Of Determining RevenuesMethodOfDeterminingRevenues
XGive Aways685124Selling Price
XGift Cards81480Selling Price
XTrips112732Selling Price
XSports Memorabilia3275Selling Price
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 6:The number of volunteers was obtained through the Volunteer Works System which is used on a daily basis. The main purpose of the system is to maintain a personal profile on each volunteer and to be able to track volunteer service hours and assignments. It is also used for recognition awards and various reports that are needed throughout the year. The types of positions/services provided by the volunteers are as follows: Transporters; Couriers/Information Desk; Patient Care Partners (PCPs); ER Greeters/PCPs; Assistants to Cardiac Rehab, Chart Room, EVS, General Stores, Nutritional Services, Pharmacy and office assistants in various other departments; Gift Shop Buyers/Clerks; Lab Host/Hostess; Medical Records Messengers; newspaper delivery to the floors/departments; OB PCPs; Pre-Admit Host/Hostess and Stamping; Shuttle Drivers, Share Club Visitors, Surgery Host/Hostess and Wheelchair Repair.
The Foundation has no committees with the authority to act on behalf of the governing body.Form 990, Part VI, Section A, line 8b
A copy of the Form 990 is provided to the Board of Directors prior to filing the return. Any questions or concerns are addressed as quickly as possible. In addition, the accounting staff review each section of the return upon receipt of the draft. The staff ensure that the statements contained in the Form 990 are accurate and the figures are true to the audited financial statements. The CFO also reviews the return to ensure it is complete and accurate.Form 990, Part VI, Section B, line 11
Form 990, Part VI, Section B, line 12cThe conflict of interest policy covers all members of the Board of Directors as well as all officers of the organization. Board members are required to abstain from voting on matters where a conflict of interest may exist.
Form 990, Part VI, Section B, line 15A national human resources firm was used to provide information regarding compensation for the following positions: Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, Chief Nursing Officer and Chief Human Resources Officer. The firm used a combination of national and regional data to provide their comparisons. The results of the study, including recommended compensation, were approved by the Compensation Committee.
Form 990, Part VI, Section C, line 19The governing documents, conflict of interest policy and financial statements are all made available to the public upon request. The financial statements are also made available on our website (unaudited are posted monthly and the audited financials are posted upon receipt).
Form 990, Part XI, line 5:Net unrealized losses on investments: -16,258. Contributions in Net Assets 242,499. Net Assts Released from Restrictions -47,376. Pension Plan Adjustments -15,793,414. Other Changes in Net Assets -1,516. Total to Form 990, Part XI, Line 5: -15,616,065.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatus
Citrus County Hospital Board
PO Box 1030InvernessFL34451596017150hospitalFLN/A0
Citrus Memorial Hospital Auxiliary
502 W Highland BlvdInvernessFL34452592774537hospitalFLN/A1501(c)(3)Line 3

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
Nature Coast Development Group-Crystal River
502 W Highland BlvdInvernessFL34452550907519real estateFLN/Aexcluded1563222154701
Nature Coast Development Group-Meadowcrest
502 W Highland BlvdInvernessFL34452203938808real estateFLN/Aexcluded-911326902600

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1CMH Foundation Managements Services CorporationBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1502 W Highland BlvdAddressLine1
CityInvernessCity
StateFLState
ZIP Code344524720ZIPCode
FieldValueIRS element (for citing)
EIN650409040EIN
Primary Activitymanagement servicesPrimaryActivity
Legal Domicile StateFLLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg