ADVANCE CARE HOSPITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- ADVANCE CARE HOSPITAL (EIN 71-0816634)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-08-15
- IRS object ID
- 201102279349301725
- Schema version
- 2009v1.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-08-15T11:17:20-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte tax llp | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 bagby street suite 4500 | AddressLine1 |
| City | houston | City |
| State | TX | State |
| ZIP Code | 770022591 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 710816634 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVANCE CARE HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ADVA | NameControl |
| Phone | 7132772300 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 WERNER STREET 3RD FLOOR | AddressLine1 |
| City | HOT SPRINGS | City |
| State | AR | State |
| ZIP Code | 71913 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN SELIG | Name |
| Title | President | Title |
| Phone | 7132772300 | Phone |
| Date Signed | 2011-08-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BROOKE KITCHEN | Name |
| Phone | 7139822000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JOHN SELIG | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 WERNER STREET 3RD FLOOR | AddressLine1 |
| City | HOT SPRINGS | City |
| State | AR | State |
| ZIP Code | 71913 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 22353558 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | n/a | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1998 | YearFormation |
| State Legal Domicile | AR | StateLegalDomicile |
| Activity Or Mission Description | Consistent with The Sisters of Mercy Health System - St. Louis, the mission of Advance Care Hospital is to continue the healing ministry of Jesus Christ. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 4 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 4 | TotalNbrVolunteers |
| Total Gross UBI | 6349637 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 306320 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 27761633 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 22336111 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 19002 | InvestmentIncomePriorYear |
| Investment Income Current Year | 16633 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1674 | OtherRevenuePriorYear |
| Other Revenue Current Year | 814 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 27782309 | TotalRevenuePriorYear |
| Total Revenue Current Year | 22353558 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1117642 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1067044 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 10994475 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9915500 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 14220168 | OtherExpensePriorYear |
| Other Expenses Current Year | 12190817 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 26332285 | TotalExpensesPriorYear |
| Total Expenses Current Year | 23173361 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1450024 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -819803 | RevenuesLessExpensesCY |
| Total Assets BOY | 12703604 | TotalAssetsBOY |
| Total Assets EOY | 8078468 | TotalAssetsEOY |
| Total Liabilities BOY | 7953493 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4148160 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4750111 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3930308 | NetAssetsOrFundBalancesEOY |
| Mission Description | Consistent with The Sisters of Mercy Health System - St. Louis, the mission of Advance Care Hospital is to continue the healing ministry of Jesus Christ. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 1 | SignificantChange |
| Expense | 20606665 | Expense |
| Grants | 1067044 | Grants |
| Revenue | 15986474 | Revenue |
| Description | GENERAL INFORMATIONThe Gospel values underlying the mission statement challenges Advance Care Hospital to make choices which respond to the patient's needs in providing the necessary setting for the appropriate continuum of care. Special consideration is given to those who are economically disadvantaged and underserved. The hospital cares for patients who are medically complex and may require daily monitoring; ventilator dependent patients, oxygen dependent patients needing respiratory rehabilitation, patients with slow healing wounds, patients benefiting from physical, occupational or speech therapy, and for patients requiring palliative and end of life care. The medical and therapeutic needs of the patients are met using an interdisciplinary, holistic team approach incorporating medical management, physical, respiratory, occupational and speech therapies in an effort to restore individual quality of life to as high a degree as possible and to promote self-help and independence to the extent feasible. The spiritual needs of the patients, families and significant others are provided for as well. The growth and development of Advance Care Hospital is determined by the health care needs of the communities that it serves, available resources, and the interrelationship of those serving and those being served. Responsible stewardship mandates that Advance Care Hospital search out new, effective means to deliver quality health care and to promote wholeness in the human person for those who require this long-term acute continuum of care.The vision of Advance Care Hospital is to provide health care that is spiritually rooted, fully integrated in the continuum of care, supportive of healthier communities, innovative and interdisciplinary in a holistic approach to care, and compassionate in response to the needs of patients in their life journey. Advance Care Hospital's approach to strengthen current ministries and to expand into new locations and services; to implement innovative approaches to caring for the whole person; to increase access to health care for the poor and underserved through advocacy and other initiatives; to make a contribution to creating healthy communities; and to create a work environment filled with hope, dignity, and mutual respect.COMMUNITY BENEFITSIn support of its mission and philosophy regarding social accountability, Advance Care Hospital provides care to patients who bear a significant health-care financial burden relative to their financial resources. Advance Care Hospital classifies the resources utilized for the care of patients bearing a significant health care financial burden as compared to their resources as charity care. Charity care includes the cost of services provided to persons who cannot afford health care because of the financial burden of the health care services and/or who are uninsured or underinsured. Charity care is provided without charge or at a charge that is less than the usual charge for such services. The determination as to the amount to be charged, if any, is made according to a patient's ability to pay, consideration of the patient's assets and liabilities, and determined by the established eligibility criteria based on the most current federal poverty guidelines. A financially indigent patient is one who is uninsured or underinsured and whose economic circumstances place them at or under 200% of the federal poverty guidelines. A medically indigent patient is a person who's medical or hospital bills after payment by third-party payers exceeds 25% of their annual gross income. No patient is refused necessary medical care on the basis of their inability to pay.In addition to uncompensated costs, Advance Care Hospital supports and participates in community benefit programs designed to positively impact the health status of the communities served.UNREIMBURSED GOVERNMENT SPONSORED PROGRAMSIn addition to the provision of care without expectation of payment (charity care), Advance Care Hospital provides services to persons covered under government sponsored programs, including Medicare, TRICARE (formerly CHAMPUS which provides civilian health care benefits to Military personnel, Military retirees and their dependents, and some members of the Reserve Component) and TRICARE for Life (a Medicare Supplement insurance program available to individuals who had been eligible for TRICARE). As already cited, Advance Care Hospital provided medical services to persons covered under the federal Medicare Program which, in fact, comprised the largest single payer classification of patients served by this health system. The payment rate for inpatient services is on a per discharge rate, calculated based on the diagnostic-related group into which the patient is categorized. Number of Patients Served by the LTACH: 505Number of Patient Days of Care Provided by the LTACH: 13,047Number of Patient Days of Charity Care Provided by the LTACH: 700Charity Care Cost: $990,684Community members served by the Laboratory (terminated June 30) 46,580TOTAL PROGRAM SERVICE EXPENSES (GRANTS $1,067,044) $20,606,665 | Description |
| Total Program Service Expense | 20606665 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | 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 |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | 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 |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 45 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 4 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Paul Veillon | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7132772300 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 W Loop South Suite 1100A | AddressLine1 |
| City | Houston | City |
| State | TX | State |
| ZIP Code | 770270000 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (6 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| John Selig | ||||||
| President/Board Member | 4.00 | X | X | 30252 | 0 | 0 |
| Mike Finley | ||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |
| Tony Holohan | ||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |
| Helen Harris | ||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |
| John Simpson | ||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |
| Erick Smith | ||||||
| Secretary/Treasurer | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 30252 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | 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 |
|---|---|---|---|---|---|
| St Edward Mercy Medical Center | |||||
| 5501 Euper Lane | Fort Smith | AR | 729030000 | Ancillary services | 1210785 |
| Christus Dubuis Health System | |||||
| 1700 West Loop South Ste 1100A | Houston | TX | 770270000 | Management services | 1148472 |
| St Joseph's Mercy Health Center | |||||
| 300 Werner Street | Hot Springs | AR | 719039001 | Ancillary services | 754113 |
| Arkansas Nephrology Services Inc | |||||
| 115 Wrights Street | Hot Springs | AR | 719130000 | Ancillary services | 137600 |
| SPA City Pathology | |||||
| PO Box 22304 | Hot Springs | AR | 719032304 | Ancillary services | 103644 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| Inpatient Revenues | 900099 | 15961702 | 15961702 | |
| Outpatient Revenues | 621500 | 6374409 | 24772 | 6349637 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 22336111 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16633 | TotalRevenueColumn |
| Exclusion | $16,633 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Vending machine income | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 814 | TotalRevenueColumn |
| Exclusion | $814 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 814 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22353558 | TotalRevenueColumn |
| Related Or Exempt Function Income | 15986474 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 6349637 | UnrelatedBusinessRevenue |
| Exclusion | $17,447 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1067044 | Total |
| Program Services | 1067044 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30252 | Total |
| Management And General | 30252 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7934081 | Total |
| Program Services | 7351748 | ProgramServices |
| Management And General | 582333 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 255769 | Total |
| Program Services | 235538 | ProgramServices |
| Management And General | 20231 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1242911 | Total |
| Program Services | 1144597 | ProgramServices |
| Management And General | 98314 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 452487 | Total |
| Program Services | 416695 | ProgramServices |
| Management And General | 35792 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 543457 | Total |
| Management And General | 543457 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1788 | Total |
| Management And General | 1788 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 605004 | Total |
| Management And General | 605004 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 809 | Total |
| Management And General | 809 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 367020 | Total |
| Program Services | 227362 | ProgramServices |
| Management And General | 139658 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4666 | Total |
| Management And General | 4666 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4806356 | Total |
| Program Services | 4632863 | ProgramServices |
| Management And General | 173493 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1174559 | Total |
| Program Services | 1174559 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 91884 | Total |
| Program Services | 71333 | ProgramServices |
| Management And General | 20551 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115833 | Total |
| Program Services | 115833 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78872 | Total |
| Management And General | 78872 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Purchased services | 3155974 | 3110791 | 45183 |
| Equipment rental | 723140 | 713749 | 9391 |
| Taxes | 394631 | 217729 | 176902 |
| Bad debt expense | 126824 | 126824 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23173361 | Total |
| Program Services | 20606665 | ProgramServices |
| Management And General | 2566696 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3804463 | BOY |
| EOY | 3293454 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2851228 | BOY |
| EOY | 1785392 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 339960 | BOY |
| EOY | 347713 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24475 | BOY |
| EOY | 13475 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1550604 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 954062 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 646574 | BOY |
| EOY | 596542 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5036904 | BOY |
| EOY | 2041892 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12703604 | BOY |
| EOY | 8078468 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1559909 | BOY |
| EOY | 1449950 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6393584 | BOY |
| EOY | 2698210 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7953493 | BOY |
| EOY | 4148160 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4750111 | BOY |
| EOY | 3930308 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4750111 | BOY |
| EOY | 3930308 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12703604 | BOY |
| EOY | 8078468 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $809 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 809 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i: | Identifier |
| Return Reference | Explanation of Other Lobbying Activities: | ReturnReference |
| Explanation | A portion of annual dues paid to the National Association of Long Term Hospitals is allocated to lobbying activities on behalf of the membership. | Explanation |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 27626 | OtherCostOrOtherBasis |
| Depreciation | 17508 | Depreciation |
| Book Value | 10118 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1522978 | OtherCostOrOtherBasis |
| Depreciation | 936554 | Depreciation |
| Book Value | 586424 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 596542 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | A/R St. Joseph Laboratory Service Fees | Description |
| Book Value | 2041892 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2041892 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Third Party Payor Settlements | $177,004 |
| Payable to Host Facilities | $56,360 |
| Payable to CHRISTUS Dubuis Health System | $263,922 |
| Payable to St. Joseph's Mercy Health System | $2,167,581 |
| Miscellaneous taxes payable | $33,343 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2698210 | TotalOfAmounts |
| Total Revenue | 22353558 | TotalRevenue |
| Total Expenses | 23173361 | TotalExpenses |
| Excess Or Deficit For Year | -819803 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | -819803 | ExcessOrDeficitPerFS |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 990684 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 990684 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04300 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 990684 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 990684 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04300 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1067044 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1067044 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04630 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1067044 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1067044 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04630 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2057728 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2057728 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08930 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 50000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 50000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 50000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 50000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $46,849 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 14266663 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 12724693 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 1541970 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | OtherOther |
|---|---|---|---|---|---|
| Advance Care Hospital of Hot Springs | |||||
| 300 Werner Street 3rd Floor | Hot Springs | AR | 71913 | X | Long Term Acute Care Hospital |
| Advance Care Hospital of Fort Smith | |||||
| 7301 Rogers Ave 4th Floor | Fort Smith | AR | 72917 | X | Long Term Acute Care Hospital |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Costing Method Used | Part I, Line 7: The Community Benefit of Cost of Charity Care was calculated as the total Voluntary Free Care times the ratio of cost to gross patient billing. The Community Benefit for Cash and In-kind contributions to Community Groups was calculated as the amount of the cash contribution. | CostingMethodUsed |
| Subsidized Health Services Expln | Part I, Line 7g: | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | Part I, Line 7f: | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: Patient accounts receivable are from patients and third-party payors for medical services and are net of allowances for contractual adjustments and doubtful accounts. Allowances are estimated based on established billing rates and historical experience. | BadDebtFootnote |
| Debt Collection Policy | Part III, Line 9b: Advance Care Hospital does not outsource patient balances to a third party debt collection agency. All collections are done by in-house collectors using collection letters. Patients are not subject to harassment or legal action due to their incapacity to pay. Upon admission, patients who have no insurance coverage and no ability to pay will be given consideration for charity care. Every effort will be made to obtain the appropriate financial documentation to determine the ability to pay for services. Patients receive private letters/bills each month indicating their balance due. Patients who have not made payments for a 30-day period will receive a letter requesting payment. Patients who are unable to pay their balance will be considered for charity care if appropriate. Collection efforts will continue for 120 days with the patient/guarantor receiving at least three letters requesting payment within said 120 day period. Accounts that are not deemed eligible for charity care or medical indigence will be written off as bad debt following the 120 day collection period. | DebtCollectionPolicy |
| Number Of Facility Type Expln | Part V: | NumberOfFacilityTypeExpln |
| Needs Assessment | Part VI, Line 2: Advance Care Hospital assesses the health care needs of the communities served through regular exchanges with civic, community and religious leaders, as well as patient surveys that solicit information on specific and general ongoing and upcoming needs. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: All patients are assessed during the registration process. Patients identified as possible charity cases will be asked to complete an application for financial assistance. Patients who may qualify for financial assistance from a governmental program but are not currently enrolled are referred to the appropriate program. Patients who can prove eligibility for Medicaid will be deemed as indigent and automatically qualify for charity care. Patients admitted to the hospital with Medicare as the only insurance will be monitored as Medicare days near depletion. Thirty days prior to the end of the Medicare coverage, an interview and an application for financial assistance will be requested as appropriate. These patients are assessed as to meeting the guidelines for receiving charity care if the stay should exceed Medicare coverage limits. As soon as sufficient information is available concerning the patient's financial resources and eligibility for government assistance, a determination is made concerning the patient's eligibility for charity. No collection effort is pursued on a charity account after such determinations are made. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: Advance Care Hospital's service areas in Arkansas include Long-Term Acute Care Hospitals in Fort Smith and Hot Springs. The Advance Care Hospital community is comprised of patients from local communities who are medically complex and may require daily monitoring: ventilator dependent patients, oxygen dependent patients needing respiratory rehabilitation, patients with slow healing wounds, patients benefiting from physical, occupational or speech therapy, and for patients requiring palliative and end of life care. Special efforts are taken to ensure that poor and other underserved individuals are included in the community served. Advance Care Hospital of Fort Smith is located in Sebastian County. Total population in the county is 125,744 of which 13.1% are ages 65 and over according to the 2009 Census Bureau. In addition, 17.6% of the population is below the poverty level. Advance Care Hospital of Hot Springs is located in Garland County. Total population in the county is 96,024 of which 21.7% are age 65 and over according to the 2009 Census Bureau. In addition, 14.7% of the population is below poverty level. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: In addition to its primary mission to provide long-term acute medical care to the community including the poor and underserved, Advance Care Hospital annually provides cash and in-kind support to tax-exempt charitable organizations with established need. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: The Advance Care Hospital is primarily focused on the provision of long-term acute care which is directed to persons who are medically complex and may require daily monitoring; ventilator dependent patients, oxygen dependent patients needing respiratory rehabilitation, patients with slow healing wounds, patients benefiting from physical, occupational or speech therapy, and for patients requiring palliative and end of life care. By contrast the Sisters of Mercy Health System includes over 400 clinic and hospital locations in the Midwest of the United States providing medical care at all levels. Neither Advance Care Hospital nor the Sisters of Mercy Health System will refuse to provide necessary medical teatment due to a patient's inability to pay. | AffiliatedHealthCareSystem |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance |
|---|---|---|---|---|---|---|---|---|---|---|
| St Joseph's Mercy Health Foundation | ||||||||||
| 300 Werner St | Hot Springs | AR | 71913 | 710804718 | 501(c)(3) | 500000 | Provide medical support to underserved and low income | |||
| St Edward Mercy Medical Center | ||||||||||
| 7301 Rogers Ave | Fort Smith | AR | 72917 | 710240352 | 501(c)(3) | 500000 | Provide medical support to underserved and low income | |||
| Garland County Habitat for Humanity | ||||||||||
| PO Box 171 | hot Springs | AR | 71902 | 710776139 | 501(c)(3) | 50000 | Charity housing | |||
| River Valley Medical Center | ||||||||||
| 200 North 3rd Street | Dardanelle | AR | 72834 | 208631167 | Provide needed beds to the hospital | 8758 | book | bed frames | ||
| St Edward Mercy Foundation | ||||||||||
| PO Box 17000 | Fort Smith | AR | 72917 | 237330425 | 501(c)(3) | 5500 | Provide medical support to underserved and low income | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 4 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: Donations are provided to tax-exempt charitable organizations with an established need. The decision to donate and the selection of the recipient charity determined by the hospital Administrator and/or the Board of Directors. All donations are documented. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part III, line 3 | Changes in Program Services | Effective March 30, 2008, Advance Care Hospital entered into a temporary agreement with St. Joseph's Mercy Health Center, an Arkansas non-profit corporation, to operate the Mercy Laboratory of Hot Springs to provide lab services to the patients of St. Joseph's Mercy Health Center and its affiliated satellite labs in the Hot Springs community. Advance Care Hospital and St. Joseph's Mercy Health Center did not renew or extend this operating agreement which terminated June 30, 2010. As a result of this termination, Advance Care Hospital's primary source of unrelated business income is also eliminated. |
| Form 990, Part VI | The corporate member does not control the daily operations of the organization. | |
| Form 990, Part VI, Section A, line 3 | Advance Care Hospital is managed by CHRISTUS Dubuis Health System, an unrelated exempt organization. | |
| Form 990, Part VI, Section A, line 6 | Advance Care Hospital's Corporate Member is Sisters of Mercy Health System, St. Louis, Inc. | |
| Form 990, Part VI, Section A, line 7a | The bylaws of Advance Care Hospital permit the corporate member to appoint one non-voting member of the Board who serves ex-officio, without vote. The corporate member does not control the daily operations of the organization. | |
| Form 990, Part VI, Section A, line 7b | The bylaws provide to the corporate member the power to approve or disapprove amendments, modifications or restatements to the Articles of Incorporation and Bylaws of the Corporation and corporations controlled by it; to appoint the initial members of the board; to appoint one non-voting member of the Board who serves ex-officio, without vote; and to approve or disapprove the following actions of the Corporation: 1. adoption of, or amendments to, the mission, vision and values of the corporation; 2. adoption of a plan of merger, consolidation or dissolution of corporation; and 3. authorization of any proposed changes in the tax status of the corporation. | |
| Form 990, Part VI, Section B, line 11 | The return is prepared by an independent accounting firm. The organization reviews the prepared return for accuracy. Upon completion of the final Form 990 by the independent accounting firm, the Form 990 is submitted to the Board of Directors prior to filing the return with the IRS. | |
| Form 990, Part VI, Section B, line 12c | Advance Care Hospital is managed by CHRISTUS Dubuis Health System (CDHS), an unrelated exempt organization. The management agreement states that CDHS shall provide all staffing requirements to the organization. CDHS maintains a conflict of interest policy for their employees which requires completion of an annual disclosure of any conflicts of interest. The policy includes officers, medical directors and other directors, and all other associates. The employee disclosure is reviewed by the employee's immediate supervisor. In addition, Key Leaders must certify annually their receipt and understanding of the Conflict of Interest policy. If any conflicts are present, the employee and the CDHS Administration will implement a mutually agreed upon plan to resolve the conflict. In addition, CDHS implements an Integrity program to support and maintain the corporate integrity of the organization. Advance Care Hospital maintains a policy for the members of the board of directors which requires annual disclosure of any conflicts of interest. The policy for the members of the board of directors requires any board member upon determination of a conflict of interest, to absent himself or herself without comment from not only the vote but also from the deliberation. Board members are not allowed to be employed by Advance Care Hospital unless they have first resigned from the board. In addition, at the beginning of each board meeting, the board chair asks the board members to review the agenda and share any potential conflicts of interest prior to the beginning of business. | |
| Form 990, Part VI, Section B, Line 15: Compensation for the CEO was initially determined by the organization upon formation in 1998. It was reevaluated and adjusted in 2004 and 2006 to ensure reasonableness and adherance to Advance Care Hospital's compensation philosophy. | ||
| Form 990, Part VI, Section C, line 19 | The organization's governing documents, conflict of interest policy and financial statements are not made available to the public. The articles of incorporation are available to the public from the Arkansas Secretary of State. | |
| Schedule R, Part V, Line 2: | Description of method used to determine the value of the services, etc: | Advance Care Hospital rents facilities from St. Joseph Regional Health Center and St. Edward Mercy Medical Center at the fair market value rent rate. Advance Care Hospital also receives ancillary services from St Joseph Regional Health Center and St. Edward Mercy Medical Center at cost. Ancillary services include physical, respiratory and occupational therapy, radiology, dietary, pharmacy, surgery, dialysis, anesthesiology, central services and laundry. |
| FORM 990, PART V, LINE 2A AND PART IX, LINES 7-10: | ADVANCE CARE HOSPITAL IS MANAGED BY CHRISTUS DUBUIS HEALTH SYSTEM (CDHS), AN UNRELATED EXEMPT ORGANIZATION. IN KEEPING WITH THE TERMS OF THE MANAGEMENT AGREEMENT, CDHS PROVIDES ALL OF ADVANCE CARE HOSPITAL'S STAFFING REQUIREMENTS VIA ITS OWN CDHS EMPLOYEES. CDHS APPROPRIATELY ISSUES ALL FORMS W-2 TO ITS EMPLOYEES. ADVANCE CARE HOSPITAL'S ASSOCIATED SALARY COSTS ARE REFLECTED ON FORM 990, PART IX, LINES 7-10. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (59 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| breech regional medical center | |||||||||
| 100 HOSPITal DRIVE | LEBANON | MO | 65536 | 431767432 | hOspital | MO | 501(c)(3) | 3 | N/A |
| carroll health foundation | |||||||||
| 214 CArTER STREET | BERRYVILLE | AR | 72616 | 710759301 | foundation | AR | 501(c)(3) | 11a | N/A |
| casa de misericordia | |||||||||
| 1602 McCLELLAND STREET | LAREDO | TX | 78044 | 742912461 | women shelter | TX | 501(c)(3) | 7 | N/A |
| healdton mercy hospital corporation | |||||||||
| 918 SOUTH STREET | HEALDTON | OK | 73438 | 263173902 | holding company | OK | 501(c)(3) | 3 | N/A |
| laredo medical group | |||||||||
| 14528 S OUTER FORTY STE 100 | CHESTERFIELD | MO | 63017 | 742764726 | inactive | TX | 501(c)(3) | 9 | N/A |
| mcauley portfolio management company | |||||||||
| 14528 S OUTER FORTY STE 100 | cHESTERFIELD | MO | 63017 | 261708048 | invst mgmt | MO | 501(c)(3) | 11b | N/A |
| mercy emergency medical services inc | |||||||||
| 4300 W MEMORIAL ROAD | OKLAHOMA CITY | OK | 73120 | 810627035 | inactive | OK | 501(c)(3) | 9 | N/A |
| mercy foundation for health innovation | |||||||||
| 14528 S OUTER FORTY STE 100 | chESTERFIELD | MO | 63017 | 200901499 | foundation | MO | 501(c)(3) | 11b | N/A |
| mercy health center foundation inc | |||||||||
| 4300 W MEMORIAL ROAD | okLAHOMA CITY | OK | 73120 | 731593024 | foundation | OK | 501(c)(3) | 11a | N/A |
| mercy health center inc | |||||||||
| 4300 W MEMORIAL ROAD | okLAHOMA CITY | OK | 73120 | 730579285 | hospital | OK | 501(c)(3) | 3 | N/A |
| mercy health center foundation | |||||||||
| 401 WOODLAND HILLS BLVD | FORT SCOTT | KS | 66701 | 481077073 | foundation | KS | 501(c)(3) | 11c | N/A |
| mercy health services inc | |||||||||
| 4300 W MEMORIAL ROAD | okLAHOMA CITY | OK | 73120 | 141838609 | urgent care | OK | 501(c)(3) | 9 | N/A |
| mercy health system of kansas inc | |||||||||
| 401 WOODLAND HILLS BLVD | forT SCOTT | KS | 66701 | 480956045 | hospital | KS | 501(c)(3) | 3 | N/A |
| mercy health system of northwest arkansas | |||||||||
| 2710 RIFE MEDICAL DRIVE | ROGERS | AR | 72758 | 621684203 | physician group | AR | 501(c)(3) | 11b | N/A |
| mercy health system of texas inc | |||||||||
| 14528 S OUTER FORTY STE 100 | chESTERFIELD | MO | 63017 | 742764727 | inactive | TX | 501(c)(3) | 11b | N/A |
| mercy health system inc | |||||||||
| 4300 W MEMORIAL ROAD | okLAHOMA CITY | OK | 73120 | 731453048 | holding company | OK | 501(c)(3) | 11b | N/A |
| mercy hospital foundation of independence | |||||||||
| 800 w myrtle | independence | KS | 67301 | 481079981 | foundation | KS | 501(c)(3) | 11a | N/A |
| mercy hospital of laredo | |||||||||
| 14528 S OUTER FORTY STE 100 | chESTERFIELD | MO | 63017 | 741189682 | inactive | TX | 501(c)(3) | 3 | N/A |
| mercy medical group | |||||||||
| 645 MAryVILLE CENTRE STE 100 | ST LOUIS | MO | 63141 | 431771217 | physician group | MO | 501(c)(3) | 9 | N/A |
| mercy memorial health center foundation | |||||||||
| 1011 14TH aVENUE NW | ARDMORE | OK | 73401 | 710962525 | foundation | OK | 501(c)(3) | 11a | N/A |
| mercy memorial health center inc | |||||||||
| 1011 14TH aVENUE NW | aRDMORE | OK | 73401 | 731500629 | hospital | OK | 501(c)(3) | 3 | N/A |
| mercy ministries of laredo | |||||||||
| 2500 ZacaTECaS | LAREDO | TX | 78043 | 200198462 | outreach | TX | 501(c)(3) | 7 | N/A |
| mercy physicians of oklahoma inc | |||||||||
| 4300 W MEMORIAL ROAD | oklAHOMA CITY | OK | 73120 | 270473057 | physician group | OK | 501(c)(3) | 9 | N/A |
| mhm support services | |||||||||
| 14528 S OUTER FORTY STE 100 | cheSTERFIELD | MO | 63017 | 202553101 | support health system | MO | 501(c)(3) | 11b | N/A |
| mission clinical services | |||||||||
| 300 WERNER STreet | hot Springs | AR | 71913 | 134239691 | physician group | AR | 501(c)(3) | 9 | N/A |
| ozarks regions health system inc | |||||||||
| 214 CArTER STREET | beRRYVILLE | AR | 72616 | 710759299 | hospital | AR | 501(c)(3) | 3 | N/A |
| sisters of mercy health system | |||||||||
| 14528 S OUTER FORTY STE 100 | chESTERFIELD | MO | 63017 | 431423050 | support health system | MO | 501(c)(3) | 1 | N/A |
| sisters of mercy ministries | |||||||||
| 14528 S OUTER FORTY STE 100 | cheSTERFIELD | MO | 63017 | 721069468 | counseling | MO | 501(c)(3) | 7 | N/A |
| st edward hlth fac-franklin co | |||||||||
| 801 w river street | ozark | AR | 72949 | 710689680 | hospital | AR | 501(c)(3) | 3 | N/A |
| st edward hlth fac-logan co | |||||||||
| 500 e academy | paris | AR | 72855 | 710655753 | hospital | AR | 501(c)(3) | 3 | N/A |
| st edward hlth fac-scott co | |||||||||
| 1341 W 6TH STREET | WALDRON | AR | 72958 | 710557895 | hospital | AR | 501(c)(3) | 3 | N/A |
| st edward mercy clinic inc | |||||||||
| 7301 ROGERS AVENUE | FORT SMITH | AR | 72917 | 261318597 | physician group | AR | 501(c)(3) | 9 | N/A |
| st edward mercy health system inc | |||||||||
| 7301 ROGERS AVENUE | fORT SmITH | AR | 72917 | 261318515 | holding company | AR | 501(c)(3) | 11b | N/A |
| st edward mercy medical center | |||||||||
| 7301 ROGERS AVENUE | fORT SmITH | AR | 72917 | 710240352 | hospital | AR | 501(c)(3) | 3 | N/A |
| st francis hospital mountain view mis | |||||||||
| 100 W HIGHWAY 60 | MOUNTAIN VIEW | MO | 65548 | 440607149 | hospital | MO | 501(c)(3) | 3 | N/A |
| st john's aurora inc | |||||||||
| 500 PORTER AVENUE | AURORA | MO | 65605 | 431936696 | lease hospital | MO | 501(c)(3) | 3 | N/A |
| st john's cassville inc | |||||||||
| 94 main street | cassville | MO | 65625 | 431936699 | lease hospital | MO | 501(c)(3) | 3 | N/A |
| st john's children's hospital inc | |||||||||
| 1235 E CHEROKEE STREET | SPRINGFIELD | MO | 65804 | inactive | MO | 501(c)(3) | 3 | N/A | |
| st john's clinic inc | |||||||||
| 1965 FREMONT STREET SUITE 295 | SPRINGFIELD | MO | 65804 | 431560263 | physician group | MO | 501(c)(3) | 9 | N/A |
| st john's fdn for comm health inc | |||||||||
| 1235 E CHEROKEE STREET | spRINGFIELD | MO | 65804 | 320195818 | foundation | MO | 501(c)(3) | 11b | N/A |
| st john's health system inc | |||||||||
| 1235 E CHEROKEE STREET | spRINGFIELD | MO | 65804 | 431856028 | holding company | MO | 501(c)(3) | 11b | N/A |
| st john's home care of berryville inc | |||||||||
| 214 CArTER STREET | berRYVILLE | AR | 72616 | 870781247 | home health | AR | 501(c)(3) | 11c | N/A |
| st john's medical research inst inc | |||||||||
| 1235 E CHEROKEE STREET | spRINGFIELD | MO | 65804 | 870796305 | research | MO | 501(c)(3) | 4 | N/A |
| st john's mercy foundation | |||||||||
| 645 MArYVILLE CENTRE STE 100 | st LOUIS | MO | 63141 | 562410022 | foundation | MO | 501(c)(3) | 11b | N/A |
| st john's mercy health care | |||||||||
| 645 MArYVILLE CENTRE STE 100 | st LOUIS | MO | 63141 | 431718408 | health system | MO | 501(c)(3) | 11b | N/A |
| st john's mercy health system | |||||||||
| 645 MArYVILLE CENTRE STE 100 | st LOUIS | MO | 63141 | 430653493 | hospital | MO | 501(c)(3) | 3 | N/A |
| st john's mercy hospital foundation | |||||||||
| 901 e fifth street | washington | MO | 63090 | 562410020 | foundation | MO | 501(c)(3) | 11b | N/A |
| st john's mercy support services | |||||||||
| 615 S NEW BALLAS ROAD | st LOUIS | MO | 63141 | 431677952 | inactive | MO | 501(c)(3) | 11c | N/A |
| st john's regional health center | |||||||||
| 1235 E CHEROKEE STREET | spRINGFIELD | MO | 65804 | 440552485 | hospital | MO | 501(c)(3) | 3 | N/A |
| st joseph's mercy clinic inc | |||||||||
| 1 mercy lane | hot Springs | AR | 71913 | 261125131 | physician group | AR | 501(c)(3) | 9 | N/A |
| st joseph's mercy health center | |||||||||
| 300 WERNER STreet | hoT Springs | AR | 71913 | 710236913 | hospital | AR | 501(c)(3) | 3 | N/A |
| st joseph's mercy health foundation | |||||||||
| 300 WERNER STreet | hoT Springs | AR | 71913 | 710804718 | foundation | AR | 501(c)(3) | 11b | N/A |
| st mary-rogers memorial hospital inc | |||||||||
| 2710 RIFE MEDICAL DRIVE | roGERS | AR | 72758 | 710294390 | hospital | AR | 501(c)(3) | 3 | N/A |
| st mary's hospital foundation | |||||||||
| 2710 RIFE MEDICAL DRIVE | roGERS | AR | 77858 | 710601687 | foundation | AR | 501(c)(3) | 11c | N/A |
| st mary's hospital of enid oklahoma inc | |||||||||
| 14528 S OUTER FORTY STE 100 | chESTERFIELD | MO | 63017 | 730614655 | inactive | OK | 501(c)(3) | 3 | N/A |
| the sister m cornelia blasko fndn | |||||||||
| 100 w HIGHWAY 60 | moUNTAIN VIEW | MO | 65548 | 431873914 | foundation | MO | 501(c)(3) | 11a | N/A |
| unity ambulatory care | |||||||||
| 645 MArYVILLE CENTRE STE 100 | st LOUIS | MO | 63141 | 431861745 | inactive | MO | 501(c)(3) | 11c | N/A |
| lebanon women's health center inc | |||||||||
| 100 HOSPITal DRIVE | leBANON | MO | 65536 | 020569599 | obstetrical | MO | 501(c)(3) | 9 | N/A |
| st joseph's mercy health system inc | |||||||||
| 300 WERNER STreet | hot Springs | AR | 71913 | 261125064 | holding company | AR | 501(c)(3) | 11b | N/A |
Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|
| hot springs equip | |||||||
| 300 werner street | hot springs | AR | 71913 | 204340915 | leasing equipment | AR | N/A |
| hot springs mri | |||||||
| 100 rway p | hot springs | AR | 72901 | 710675196 | mri center | AR | N/A |
| merc ambu surg ctr | |||||||
| 7301 rogers avenue | fort smith | AR | 72917 | 710827721 | surgery center | AR | N/A |
| res opt & innova | |||||||
| 645 maryville center | st louis | MO | 63141 | 460468368 | distribution center | MO | N/A |
| so ok diag ctr | |||||||
| 1011 14th avenue nw | ardmore | OK | 73401 | 431971232 | mri services | OK | N/A |
| fortsmith & med ser | |||||||
| 1701 greenwood | fort smith | AR | 72901 | 710416615 | emergency medical | AR | N/A |
| so ok phy hp org | |||||||
| 1011 14th avenue nw | ardmore | OK | 73401 | 731462104 | physician group | OK | N/A |
| sj pet center | |||||||
| 300 werner street | hot springs | AR | 72901 | 470886845 | pet/mri center | AR | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (13 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| consolidated logistics inc | ||||||||
| 2710 RIFE MeDiCAL LANE | rogers | AR | 72758 | 710474406 | holding company | AR | N/A | C |
| frontenac properties inc | ||||||||
| 14528 S OUTER FOrtY SUITe 100 | CHESTERFIELD | MO | 63017 | 521914421 | holding company | DE | N/A | C |
| inveno health inc | ||||||||
| 1235 E CHEROKEE STREet | SPRINGFIELD | MO | 65804 | 264509571 | it services | MO | N/A | C |
| mercy community services inc | ||||||||
| 401 WOODLAND hILLS BLVD | FORT SMiTH | KS | 66701 | 481078101 | catering | KS | N/A | C |
| mercy health center condominiums | ||||||||
| 4300 w MemoRIAL RD | OKLAHOMA CITY | OK | 73120 | 680640970 | real estate | OK | N/A | C |
| mercy health network of the | ||||||||
| 1011 14TH AVENUE NW | ardmore | OK | 73401 | 731580607 | health care | OK | N/A | C |
| mercy health network inc | ||||||||
| 4300 w MemoRIAL Road | okLAHOMA CITY | OK | 73120 | 731381689 | health care | OK | N/A | C |
| mercy managed care corporation | ||||||||
| 4300 w MemoRIAL Road | okLAHOMA CITY | OK | 73120 | 731441665 | holding company | OK | N/A | C |
| mercy medical services inc | ||||||||
| 14528 S OUTER FORtY SUITe 100 | chESTERFIELD | MO | 63017 | 710641246 | management | MO | N/A | C |
| mhp inc | ||||||||
| 14528 S OUTER FOrtY SUITe 100 | chESTERFIELD | MO | 63017 | 431697048 | holding company | DE | N/A | C |
| st edward medical services inc | ||||||||
| 7301 rogers avenue | fort SMlTH | AR | 72903 | 202965518 | medical services | AR | N/A | C |
| ur l corp inc | ||||||||
| 645 maryville centre drive suite 10 | st louis | MO | 63141 | 742499535 | holding company | MO | N/A | C |
| unity support services inc | ||||||||
| 645 maryville centre drive suite 10 | st louis | MO | 63141 | 431797042 | management | MO | N/A | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |