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MISSOURI DELTA MEDICAL CENTER: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MISSOURI DELTA MEDICAL CENTER (EIN 43-0633449)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-12
IRS object ID
201102289349300885
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

FieldValueIRS element (for citing)
Timestamp2011-08-12T14:38:11-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1211 N BROADWAY SUITE 600AddressLine1
CityST LOUISCity
StateMOState
ZIP Code631022733ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN430633449EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Missouri Delta Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMISSNameControl
Phone5734711600Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11008 NORTH MAIN STREETAddressLine1
CitySIKESTONCity
StateMOState
ZIP Code638015044ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJon BranstetterName
TitleCFOTitle
Date Signed2011-08-08DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTroy A LindseyName
Phone3142315544Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCHARLES ANCELLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11008 NORTH MAIN STREETAddressLine1
CitySIKESTONCity
StateMOState
ZIP Code638015044ZIPCode
FieldValueIRS element (for citing)
Gross Receipts86470719GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.MISSOURIDELTA.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1948YearFormation
State Legal DomicileMOStateLegalDomicile
Activity Or Mission DescriptionMISSOURI DELTA MEDICAL CENTER IS A NOT FOR PROFIT CORPORATION WHICH WILL STRIVE TO PROVIDE A COMPLETE HEALTH CARE SYSTEM TO RESIDENTS IN THE SERVICE AREA EITHER DIRECTLY OR IN COOPERATION WITH OTHERS.ActivityOrMissionDescription
Nbr Voting Members Governing Body26NbrVotingMembersGoverningBody
Nbr Independent Voting Members20NbrIndependentVotingMembers
Total Nbr Employees941TotalNbrEmployees
Total Nbr Volunteers64TotalNbrVolunteers
Total Gross UBI-29740TotalGrossUBI
Net Unrelated Business Txbl Income-29740NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year152472ContributionsGrantsPriorYear
Contributions Grants Current Year271586ContributionsGrantsCurrentYear
Program Service Revenue Prior Year77523619ProgramServiceRevenuePriorYear
Program Service Revenue CY84760472ProgramServiceRevenueCY
Investment Income Prior Year1047266InvestmentIncomePriorYear
Investment Income Current Year814537InvestmentIncomeCurrentYear
Other Revenue Prior Year517206OtherRevenuePriorYear
Other Revenue Current Year579833OtherRevenueCurrentYear
Total Revenue Prior Year79240563TotalRevenuePriorYear
Total Revenue Current Year86426428TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year86025GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY50675GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year41994579SalariesEtcPriorYear
Salaries Etc Current Year46280723SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year108922TotalFundrsngExpCurrentYear
Other Expense Prior Year37221058OtherExpensePriorYear
Other Expenses Current Year40251915OtherExpensesCurrentYear
Total Expenses Prior Year79301662TotalExpensesPriorYear
Total Expenses Current Year86583313TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-61099RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-156885RevenuesLessExpensesCY
Total Assets BOY59253073TotalAssetsBOY
Total Assets EOY58469300TotalAssetsEOY
Total Liabilities BOY17629033TotalLiabilitiesBOY
Total Liabilities EOY17123348TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY41624040NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY41345952NetAssetsOrFundBalancesEOY
Mission DescriptionMISSOURI DELTA MEDICAL CENTER IS A NOT FOR PROFIT CORPORATION WHICH WILL STRIVE TO PROVIDE A COMPLETE HEALTH CARE SYSTEM TO RESIDENTS IN THE SERVICE AREA EITHER DIRECTLY OR IN COOPERATION WITH OTHERS. REFERRAL AGREEMENTS WILL BE SOUGHT FOR SERVICES NOT OFFERED LOCALLY. THE HOSPITAL WILL ALSO ACTIVELY OFFER OR SUPPORT APPROPRIATE PROGRAMS TO PROMOTE THE GENERAL HEALTH, AND TO MEET THE REHABILITATION, EDUCATIONAL AND SOCIAL NEEDS OF OUR SERVICE AREA. SERVICES WILL BE PROVIDED TO ALL RESIDENTS OF OUR SERVICE AREA REGARDLESS OF RACE, COLOR, RELIGION, SEX, AGE, NATIONAL ORIGIN, OR DISABILITY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense80262729Expense
Grants50675Grants
Revenue84760472Revenue
DescriptionMISSOURI DELTA MEDICAL CENTER PROVIDES QUALITY MEDICAL CARE TO THE RESIDENTS OF ITS COMMUNITY REGARDLESS OF ABILITY TO PAY. MISSOURI DELTA MEDICAL CENTER ALSO PROVIDES SHORT TERM REHABILITATION SERVICES THROUGH AN ACUTE INPATIENT REHABILITATION UNIT AND PSYCHIATRIC SERVICES THROUGH A GERIATRIC PSYCHIATRIC FACILITY. THESE SERVICES ARE SUMMARIZED AS FOLLOWS: HOSPITAL: NUMBER OF HOSPITAL PATIENT DAYS 24,096 NUMBER OF INPATIENT ADMISSIONS 5,113 NUMBER OF OUTPATIENT VISITS 127,420 ACUTE INPATIENT REHAB: NUMBER OF INPATIENT REHAB PATIENT DAYS 1,618 NUMBER OF INPATIENT REHAB PATIENT ADMISSIONS 125 PSYCHIATRIC FACILITY: NUMBER OF PATIENT DAYS 3,788 NUMBER OF PATIENT ADMISSIONS 306 THE HOSPITAL PROVIDED FREE CARE TO INDIGENT PATIENTS IN THE AMOUNT OF $9,298,102 IN FY 2010, VALUED AT BILLED CHARGES. THE HOSPITAL ALSO PROVIDED NUMBEROUS FREE PROGRAMS AND REDUCED PRICE SERVICES THROUGH THE YEAR THAT THE HOSPITAL BELIEVES SERVES A COMMUNITY NEED. SERVICES PROVIDED FREE OF CHARGE OR BELOW COST TO THE GENERAL PUBLIC INCLUDE: 1. PERIODIC BLOOD PRESSURE AND CHOLESTEROL SCREENS 2. OUTPATIENT DIABETIC EDUCATION 3. FIRST AID CLASSES 4. CPR COURSES 5. CHILDBIRTH CLASSES 6. EMERGENCY PREPAREDNESS COURSES 7. HEALTH EDUCATION ARTICLES IN THE LOCAL NEWSPAPER 8. OTHER HEALTH EDUCATION CLASSESDescription
Total Program Service Expense80262729TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersontrueGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109684NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees941NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members26NbrVotingGoverningBodyMembers
Number Independent Voting Members20NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJON BRANSTETTERNamePerson
Telephone Number5734711600TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11008 NORTH MAIN STREETAddressLine1
CitySIKESTONCity
StateMOState
ZIP Code638015044ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (38 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
JIM CULLISON
DIRECTOR1.0X000
BRIAN MENZ
CHAIRMAN1.0X000X
DIANE PETERSEN
VICE CHAIRMAN1.0X000X
RIYADH TELLOW MD
SECRETARY1.0X000X
LINDA BOYD
DIRECTOR1.0X000
ROBERT BUCHANAN
DIRECTOR1.0X000
TERRY DAME
DIRECTOR1.0X000
KEITH DAVIDSON
DIRECTOR1.0X000
KEITH GREGSTON
DIRECTOR1.0X000
MYRON HAWES
DIRECTOR1.0X000
KEN HOLLOWELL
DIRECTOR1.0X000
DAN JENNINGS JR
TREASURER1.0X000X
ELIZABETH JOHNSON
DIRECTOR1.0X000
LINZA KILLION MD
DIRECTOR1.0X000
CHRISTOPHER MATTHEWS
DIRECTOR1.0X000
ROBERT MACGILLIVRAY
DIRECTOR1.0X000
SCOTT MATTHEWS
DIRECTOR1.0X000
BRITT MCCONNELL
DIRECTOR1.0X000
ROBERT MITCHELL
DIRECTOR1.0X000
MIKE MOLL
DIRECTOR1.0X000
CHRISTINE MONTGOMERY
DIRECTOR1.0X000
CHARLES MOXLEY
DIRECTOR1.0X000
HARRIETTE MYERS
DIRECTOR1.0X000
JOHN ROWLAND
DIRECTOR1.0X000
STEVE SIKES
DIRECTOR1.0X000
RON WATKINS
DIRECTOR1.0X000
EDWARD DEMENT
DIRECTOR1.0X000
JON GILMORE
DIRECTOR1.0X000
JEFF HUX
DIRECTOR1.0X000
MIKE POBST
DIRECTOR1.0X000
GERALD SETTLES
DIRECTOR1.0X000
CHARLES ANCELL
PRESIDENT40.0187974011014X
JON BRANSTETTER
VICE PRESIDENT FINANCE40.011959305966X
MOWAFFAQ SAID MD
PHYSICIAN40.0616887014280X
LY T PHAN MD
PHYSICIAN40.0407917013905X
MUHAMMAD A SALMANULLAH MD
PHYSICIAN40.042938107323X
KEVIN RANKIN MD
PHYSICIAN40.0388938015745X
MUHAMMAD NASEERUDDIN MD
PHYSICIAN40.043336006869X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2584050TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation75102TotalOtherCompensation
Number Individuals GT100 K39NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HORIZON HEALTH MENTAL HEALTH
PO BOX 840839DALLASTX752840839PSYCHIATRIC SERVICES910992
BOARD OF MUNICIPAL UTILITIES
PO BOX 370SIKESTONMO63801UTILITIES479508
KIEFNER BROTHERS INC
1459 NORTH KINGSHIGHWAYCAPE GIRARDEAUMO637012188CONSTRUCTION3078912
MAYO COLLABORATIVE SERVICES INC
PO BOX 9146MINNEAPOLISMN554809146LABORATORY SERVICES423314
SHARED MEDICAL SERVICES INC
PO BOX 330COTTAGE GROVEWI53527MRI SERVICES463980
FieldValueIRS element (for citing)
Number Of Contractors GT100 K25NumberOfContractorsGT100K
Related Organizations249095RelatedOrganizations
All Other Contributions22491AllOtherContributions
Total Contributions271586TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Business Code621110BusinessCode
Total Revenue Column84760472TotalRevenueColumn
Related Or Exempt Function Income84760472RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue84760472TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column814537TotalRevenueColumn
Exclusion$814,537ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real14400Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real44291Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-29891Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-29891TotalRevenueColumn
Unrelated Business Revenue-29740UnrelatedBusinessRevenue
Exclusion-$151ExclusionAmount

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA REVENUE722210346519$346,519
MEDICAL RECORD REVENUE62199098344$98,344
DIETARY REVENUE6241007739$7,739

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column157122TotalRevenueColumn
Exclusion$157,122ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue609724TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column86426428TotalRevenueColumn
Related Or Exempt Function Income84760472RelatedOrExemptFunctionIncome
Unrelated Business Revenue-29740UnrelatedBusinessRevenue
Exclusion$1,424,110ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total50675Total
Program Services50675ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total324546Total
Management And General324546ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total35767869Total
Program Services33434158ProgramServices
Management And General2261744ManagementAndGeneral
Fundraising71967Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total908067Total
Program Services848819ProgramServices
Management And General57421ManagementAndGeneral
Fundraising1827Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6911675Total
Program Services6460715ProgramServices
Management And General437053ManagementAndGeneral
Fundraising13907Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2368566Total
Program Services2214026ProgramServices
Management And General149774ManagementAndGeneral
Fundraising4766Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total27512Total
Management And General27512ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total143662Total
Management And General143662ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5618399Total
Program Services5117402ProgramServices
Management And General500251ManagementAndGeneral
Fundraising746Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total450775Total
Program Services61042ProgramServices
Management And General389733ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total17432797Total
Program Services16772032ProgramServices
Management And General645056ManagementAndGeneral
Fundraising15709Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total277816Total
Management And General277816ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total876320Total
Program Services683789ProgramServices
Management And General192531ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total116515Total
Program Services110885ProgramServices
Management And General5630ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total39709Total
Program Services34332ProgramServices
Management And General5377ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total536222Total
Program Services536222ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3394168Total
Program Services2648456ProgramServices
Management And General745712ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1221445Total
Program Services1221445ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT97837879783787
DUES & SUBSCRIPTIONS15643010858647844
RECRUITING106705106705
FARM EXPENSE6965369653

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total86583313Total
Program Services80262729ProgramServices
Management And General6211662ManagementAndGeneral
Fundraising108922Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY12042964BOY
EOY12124737EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3322552BOY
EOY219883EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY10348625BOY
EOY11066836EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1072640BOY
EOY1174516EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2366275BOY
EOY2711424EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY912502BOY
EOY1052705EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis73569419LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec44300530LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY28322907BOY
EOY29268889EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY864608BOY
EOY850310EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY59253073BOY
EOY58469300EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY7005163BOY
EOY6185555EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY4494909BOY
EOY4251610EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY6128961BOY
EOY6686183EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY17629033BOY
EOY17123348EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY41411594BOY
EOY41131005EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY212446BOY
EOY214947EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY41624040BOY
EOY41345952EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY59253073BOY
EOY58469300EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$7,637GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB7637TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance3322552BeginningOfYearBalance
Contributions2500Contributions
Investment Earnings Or Losses73935InvestmentEarningsOrLosses
Other Expenditures3179104OtherExpenditures
End Of Year Balance219883EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance7388571BeginningOfYearBalance
Contributions146208Contributions
Investment Earnings Or Losses287786InvestmentEarningsOrLosses
Grants Or Scholarships42482GrantsOrScholarships
Other Expenditures4457531OtherExpenditures
End Of Year Balance3322552EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.02240BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.97760PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis3044865InvestmentCostOrOtherBasis
Other Cost Or Other Basis518603OtherCostOrOtherBasis
Book Value3563468BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis27729334OtherCostOrOtherBasis
Depreciation12513519Depreciation
Book Value15215815BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis40277563OtherCostOrOtherBasis
Depreciation30711488Depreciation
Book Value9566075BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1999054OtherCostOrOtherBasis
Depreciation1075523Depreciation
Book Value923531BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings29268889TotalOfBookValueLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
INTENDED USES OF THE ENDOWMENT FUNDSPART V, LINE 4THE ORGANIZATION'S ENDOWMENT FUNDS ARE RESTRICTED BY DONORS AND SET ASIDE BY THE BOARD OF DIRECTORS FOR FUTURE CAPITAL IMPROVEMENTS OVER WHICH THE BOARD RETAINS CONTROL AND MAY AT ITS DISCRETION SUBSEQUENTLY USE FOR OTHER PURPOSES.
UNCERTAIN TAX POSITIONSSCHEDULE D, PART X, LINE 2MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage180.DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2768790TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2768790NetCommunityBenefitExpense
Percent Of Total Expense0.03610PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense20007693TotalCommunityBenefitExpense
Direct Offsetting Revenue18710637DirectOffsettingRevenue
Net Community Benefit Expense1297055NetCommunityBenefitExpense
Percent Of Total Expense0.01690PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense22776483TotalCommunityBenefitExpense
Direct Offsetting Revenue18710637DirectOffsettingRevenue
Net Community Benefit Expense4065845NetCommunityBenefitExpense
Percent Of Total Expense0.05300PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense29658TotalCommunityBenefitExpense
Direct Offsetting Revenue4091DirectOffsettingRevenue
Net Community Benefit Expense25567NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense59161TotalCommunityBenefitExpense
Direct Offsetting Revenue3450DirectOffsettingRevenue
Net Community Benefit Expense55711NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense5000TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense5000NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense93819TotalCommunityBenefitExpense
Direct Offsetting Revenue7541DirectOffsettingRevenue
Net Community Benefit Expense86278NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense22870302TotalCommunityBenefitExpense
Direct Offsetting Revenue18718178DirectOffsettingRevenue
Net Community Benefit Expense4152123NetCommunityBenefitExpense
Percent Of Total Expense0.05380PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$3,095,591BadDebtExpenseAmount
Amount Attributable To307168AmountAttributableTo
Amount Reimbursed By Medicare37012409AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare38292021CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1279612MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part V Form990ScheduleHPartV (12 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursOtherOther
MISSOURI DELTA MEDICAL CENTER
1008 NORTH MAIN STREETSIKESTONMO63801XXX
CONTINU-CARE HOME HEALTH
104 SMITH STREETSIKESTONMO63801HOME HEALTH AGENCY
CHARLESTON COMMUNITY CARE CENTER
1200 EAST MARSHALL STREETSIKESTONMO63834RURAL HEALTH CLINIC
RESTART OF CHARLESTON
512 EAST MARSHALL STREETSIKESTONMO63834PHYSICAL THERAPY SATELLITE CLINIC
RESTART OF NEW MADRID
406 HIGHWAY 61NEW MADRIDMO63869PHYSICAL THERAPY SATELLITE CLINIC
RESTART OF EAST PRAIRIE
106 SOUTH WASHINGTONEAST PRAIRIEMO63845PHYSICAL THERAPY SATELLITE CLINIC
BARTON-JOLLEY PHYSICIAN SVCS BUILDING
1013 NORTH MAIN STREETSIKESTONMO63801PHYSICIAN OFFICE BUILDING
MUHANNAD AL-KILANI MD
1118 NORTH MAIN STREETSIKESTONMO63801PHYSICIAN OFFICE BUILDING
MISSOURI DELTA CANCER & INFUSION CENTER
1126 NORTH MAIN STREETSIKESTONMO63801INFUSION CENTER
DR KENNETH STONE
121 SMITH STREETSIKESTONMO63801PHYSICIAN OFFICE BUILDING
SMITH STREET CLINIC
119 SMITH STREETSIKESTONMO63801RURAL HEALTH CLINIC
JAYCEE RENAL DIALYSIS CENTER
135 PLAZA DRIVESIKESTONMO63801DIALYSIS CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Costing Method UsedTHE COSTS REPORTED IN THE TABLE IN PART I, LINE 7 USED A RATIO OF PATIENT CARE COSTS TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM INSTRUCTIONS. THIS METHODOLOGY WAS USED FOR ALL PATIENT SEGMENTS.CostingMethodUsed
Percent Of Total Expense ExplnTHE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $9,783,787, REPORTED ON PART IX, LINE 25, HOWEVER, IT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN.PercentOfTotalExpenseExpln
Bad Debt FootnoteTHE CENTER REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHERS. THE CENTER PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE CENTER BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENTS ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELIQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. COSTING METHODOLOGY USED TO DETERMINE AMOUNTS REPORTED AS BAD DEBTS AND BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER CHARITY CARE POLICY IS ESTIMATED USING THE PERCENT OF OPERATING EXPENSE TO PATIENT REVENUE. IT IS DIFFICULT TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO COULD QUALIFY FOR CHARITY CARE DUE TO THE LIMITED NUMBER OF FINANCIAL APPLICATIONS COMPLETED BY PATIENTS.BadDebtFootnote
Shortfall As Community BenefitIRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATE THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS ESTIMATED BY USING THE PERCENT OF OPERATING EXPENSE TO PATIENT REVENUE.ShortfallAsCommunityBenefit
Debt Collection PolicyTHE BAD DEBT POLICY STATES THAT IF IT IS DECIDED THAT A PATIENT IS INDIGENT, PROCEED AS FOLLOWS: A. COMPLETE ACCOUNT ADJUSTMENT FORMS FOLLOWING ACCOUNT ADJUSTMENT PROCEDURES OR NOTE THE BALANCE WILL BE WRITTEN OFF AS CHARITY ACCORDING TO THE CHARITY CARE POLICY. B. ENTER THE FOLLOWING NOTATIONS ON THE COPY OF THE PATIENT ACCOUNTS ADMISSION REGISTRATION FORMS OR IN ACCOUNTS RECEIVABLE NOTES IN THE COMPUTER: "CHARGES DUE BY PATIENT WILL BE WRITTEN OFF AS MEDICARE BAD DEBT OR UNCOMPENSATED CARE."DebtCollectionPolicy
Needs AssessmentTHE DETERMINATION OF CURRENT AND FUTURE HEALTH CARE NEEDS OF THE COMMUNITY OR COMMUNITIES SERVED BY MISSOURI DELTA MEDICAL CENTER IS BASED ON ALL OR A COMBINATION OF THE FOLLOWING FACTORS: EXISTENCE OR NONEXISTENCE OF SERVICES, OPPORTUNITY, SUPPLY, DEMONSTRATED NEED, VOICE OF THE CUSTOMER, AND/OR COLLABORATIVE EFFORTS WITH OUTSIDE ENTITIES, GOVERNMENT AGENCIES, AND OTHER HEALTH CARE PROVIDERS THAT WOULD ENABLE THE FILLING OF A NEED OR ENHANCE AND COMPLIMENT AN ALREADY EXISTING SERVICE. DATA IS GATHERED CONSTANTLY THROUGH HIDI, BENCHMARKING, MARKET RESEARCH, CUSTOMER SURVEYS, PHYSICIAN INPUT (REGARDING TECHNOLOGIES REQUIRED TO KEEP SERVICES ON THE CUTTING EDGE), AND THROUGH CONSTANT MONITORING OF STATE AND FEDERAL GUIDELINES. THIS INFORMATION IS REVIEWED AND ANALYZED BY THE HOSPITAL'S ADMINISTRATIVE TEAM AND INCORPORATED INTO THE HOSPITAL'S STRATEGIC PLANNING PROCESS THROUGH THE PLANNING COMMITTEE OF THE BOARD OF DIRECTORS AND EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS.NeedsAssessment
Patient Education AssistanceALL PATIENT BILLING STATEMENT FOR MISSOURI DELTA MEDICAL CENTER INCLUDE A STATEMENT THAT THE PATIENT MAY CONTACT THE MEDICAL CENTER WITH ANY QUESTIONS OR PAYMENT ISSUES REGARDING THEIR BILL. IF A PATIENT CONTACTS THE CENTER WITH AN INABILITY TO MAKE PAYMENT ISSUE, THEY INFORM THE PATIENT OF THE AVAILABLE OPTION INCLUDING CHARITY CARE AND OTHER ASSISTANCE. THEY ALSO EXPLAIN HOW THE PATIENT CAN APPLY FOR ASSISTANCE. OUR SOCIAL WORKERS WILL ALSO COMMUNICATE WITH THOSE PATIENTS WHO MAY QUALIFY FOR MEDICAID AND ASSIST THOSE PATIENTS IN COMPLETING THEIR MEDICAID APPLICATIONS.PatientEducationAssistance
Community InformationMISSOURI DELTA MEDICAL CENTER IS A SOLE COMMUNITY HOSPITAL IN SIKESTON, MISSOURI THAT PRIMARILY SERVES THE RESIDENTS OF SCOTT, MISSISSIPPI, STODDARD, AND NEW MADRID COUNTIES IN SOUTHEASTERN MISSOURI. MISSOURI DELTA MEDICAL CENTER SERVES PATIENTS WITHOUT REGARD TO AGE, GENDER, INCOME, ETHNIC ORIGIN, INSURANCE COVERAGE, OR ABILITY TO PAY. APPROXIMATELY 61% OF THE MISSOURI DELTA MEDICAL CENTER'S NET PATIENT SERVICE REVENUE IS FROM PARTICIPATION IN THE MEDICARE AND STATE SPONSORED MEDICAID PROGRAM FOR THE YEAR ENDED SEPTEMBER 30, 2010.CommunityInformation
Community Building ActivitiesNOT APPLICABLE.CommunityBuildingActivities
Other InformationOUR BOARD OF DIRECTORS IS MADE UP OF 26 COMMUNITY MEMBERS FROM OUR SERVICE AREAS. THESE BOARD MEMBERS HAVE REGULAR INPUT ON STRATEGIC PLANNING, NEW SERVICES, TECHNOLOGY, AND PHYSICIAN RECRUITMENT FOR OUR COMMUNITY. THE USE OF ANY SURPLUS FUNDS IS REINVESTED BACK INTO THE MEDICAL CENTER THROUGH THE PURCHASE OF PROPERTY AND EQUIPMENT TO PROVIDE SERVICES THAT FULFILL THE NEEDS OF THE SERVICE AREA.OtherInformation
Affiliated Health Care SystemNOT APPICABLE.AffiliatedHealthCareSystem
Reports Filed With StatesMOReportsFiledWithStates

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantMEDICAL STUDENT SCHOLARSHIPSTypeOfGrant
Number Of Recipients13NumberOfRecipients
Amount Of Cash Grant50675AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierMONITORING GRANTS EXPLANATIONIdentifier
Return ReferencePART I, LINE 2ReturnReference
ExplanationTHE SCHOLARSHIP PROGRAM IS DESIGNED TO PROVIDE A CONSISTENT FLOW OF REGISTERED NURSES TO MISSOURI DELTA MEDICAL CENTER. THE OBJECTIVE OF THE PLAN IS TO ENCOURAGE AND FINANCIALLY ASSIST QUALIFIED STUDENTS IN THEIR ENDEAVOR TO BECOME A REGISTERED NURSE. TO THE EXTENT OF AVAILABLE FUNDS, THE MEDICAL CENTER WILL PAY SCHOLARSHIPS TO QUALIFIED STUDENTS OF AN ACCREDITED REGISTERED NURSE PROGRAM. TO QUALIFY FOR THE PROGRAM A STUDENT MUST: A. HIGH SCHOOL GRADUATE 1. RANK IN THE UPPER THIRD OF HIGH SCHOOL CLASS ACADEMICALLY 2. SHOW EVIDENCE OF MOTIVATION FOR NURSING EITHER BY APTITUDE TESTING OR BY REPORTED DEMONSTRATION OF INTEREST 3. PROVIDE LETTER OF RECOMMENDATION FROM AN APPROPRIATE SCHOOL OFFICIAL. 4. BE APPROVED BY THE HOSPITAL SCHOLARSHIP SELECTION COMMITTEE B. STUDENT NURSES - ALL STUDENT NURSES MUST: 1. HAVE AT LEAST THE EQUIVALENT OF A 2.5 GRADE POINT AVERAGE IN A 4 POINT SYSTEM 2. MUST PROVIDE A LETTER OF RECOMMENDATION FROM RESPONSIBLE AND APPROPRIATE PERSON 3. BE APPROVED BY THE SCHOLARSHIP COMMITTEE C. CURRENT EMPLOYEES - ALL CURRENT EMPLOYEES MUST: 1. BE ENROLLED IN A NURSING PROGRAM AS A FULL-TIME STUDENT 2. NOT BE RECEIVING ANY HOSPITAL BENEFITS 3. BE APPROVED BY THE SCHOLARSHIP COMMITTEE.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 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
CHARLES ANCELL
18757800039605639053750198988000
MOWAFFAQ SAID MD
61661700027006900073800631167000
LY T PHAN MD
4078800003706900070050421822000
MUHAMMAD A SALMANULLAH MD
42921900016200073230436704000
KEVIN RANKIN MD
38816400077406900088450404683000
MUHAMMAD NASEERUDDIN MD
43316300019700068690440229000

Schedule L IRS990ScheduleL

Form990 Schedule L Part III Form990ScheduleLPartIII

FieldValueIRS element (for citing)
Name Of Interested PersonELIZABETH KILLIONNameOfInterestedPerson
Relationship With OrganizationDAUGHTER OF DIRECTORRelationshipWithOrganization
Amount Of Grant3085AmountOfGrant
Type Of AssistanceSCHOLARSHIPTypeOfAssistance

Form990 Schedule L Part IV Form990ScheduleLPartIV (8 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
JASON SCHRUMPF
SON IN LAW OF DIRECTOR158210EMPLOYEE COMPENSATIONfalse
CATHERINE SCHRUMPF
DAUGHTER OF DIRECTOR40835EMPLOYEE COMPENSATIONfalse
JAMES HENSON
SON IN LAW OF SECRETARY89540EMPLOYEE COMPENSATIONfalse
BROOKE BUCHANAN
DAUGHTER IN LAW OF DIR.25858EMPLOYEE COMPENSATIONfalse
ROBERT BUCHANAN
SON OF DIRECTOR48946EMPLOYEE COMPENSATIONfalse
RHONDA MENZ
WIFE OF CHAIRMAN31958EMPLOYEE COMPENSATIONfalse
JUDITH MENZ
MOTHER OF CHAIRMAN90923EMPLOYEE COMPENSATIONfalse
SUSAN WATKINS
WIFE OF DIRECTOR12553EMPLOYEE COMPENSATIONfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OFFICER, DIRECTOR, TRUSTEE OR KEY EMPLOYEE RELATIONSHIPSPART 990, PART VI, LINE 2ROBERT MITCHELL AND ELIZABETH JOHNSON HAVE A FAMILY RELATIONSHIP. SCOTT MATTHEWS AND CHRISTOPHER MATTHEWS HAVE A BUSINESS RELATIONSHIP.
FORM 990 REVIEW PROCESSFORM 990, PART VI, LINE 11BEFORE THE FORM 990 IS FILED, THE VICE-PRESIDENT OF FINANCE OF THE ORGANIZATION REVIEWS THE FORM 990, WHICH IS PREPARED BY AN OUTSIDE TAX PREPARER. THE FINANCE COMMITTEE OF MISSOURI DELTA MEDICAL CENTER WILL ALSO PERFORM A REVIEW OF THE FORM 990 AFTER THE FORM HAS BEEN FILED. IN ADDITION, COPIES OF THE FORM 990 WILL BE AVAILABLE TO THE MISSOURI DELTA MEDICAL CENTER'S BOARD OF DIRECTORS AFTER ORGANIZATION'S FORM 990 HAS BEEN FILED.
COMPLIANCE WITH CONFLICT OF INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS AS FOLLOWS: MEMBERS OF THE BOARD OF DIRECTORS, PRINCIPAL OFFICERS, AND MEMBERS OF ANY COMMITTEE WITH BOARD-DELEGATED POWERS HAVE AN OBLIGATION TO MAKE DECISIONS AND TO PERFORM THEIR DUTIES FOR THE SOLE BENEFIT OF THE HOSPITAL. ALL PERSONS SERVING IN SUCH CAPACITY SHOULD AVOID PLACING HIMSELF/HERSELF IN A POSITION WHERE PERSONAL INTERESTS ARE IN CONFLICT WITH THE INTERESTS OF THE HOSPITAL. THE FOLLOWING DEFINITIONS SHALL APPLY TO THIS POLICY: 1. AN "INTERESTED PERSON" IS A MEMBER OF THE BOARD OF DIRECTORS, PRINCIPAL OFFICER OR MEMBER OF ANY COMMITTEE WITH BOARD-DELEGATED POWERS; 2. A PERSON HAS A "FINANCIAL INTEREST" IF THE PERSON HAS, DIRECTLY OR INDIRECTLY, THROUGH BUSINESS, INVESTMENT OR FAMILY: A. A PRESENT OR POTENTIAL OWNERSHIP, INVESTMENT, INTEREST, OR COMPENSATION ARRANGEMENT IN ANY ENTITY WITH WHICH THE HOSPITAL HAS OR MAY HAVE A TRANSACTION OR ARRANGEMENT; B. A COMPENSATION ARRANGEMENT WITH THE HOSPITAL OR ANY ENTITY OR INDIVIDUAL WITH WHICH THE ORGANIZATION HAS A TRANSACTION OR ARRANGEMENT. COMPENSATION INCLUDES ANY REMUNERATION, DIRECTLY OR INDIRECTLY, AND GIFTS OF FAVORS, WHICH ARE SUBSTANTIAL IN NATURE; 3. AN "AFFILIATED ORGANIZATION" INCLUDES ANY ORGANIZATION OR ENTITY OWNED OR OPERATED BY THE HOSPITAL OR IN WHICH THE HOSPITAL HAS A DIRECT FINANCIAL INTEREST; ANY "INTERESTED PERSON" MUST DISCLOSE TO THE HOSPITAL AND ANY AFFILIATED ORGANIZATION ALL FINANCIAL INTERESTS AND ALL MATERIAL FACTS RELATING THERETO. IF A CONFLICT DOES ARISE, THE HOSPITAL AND ANY AFFILIATED ORGANIZATION SHALL: 1. REQUIRE THAT THE "INTERESTED PERSON" LEAVE THE MEETING DURING THE DISCUSSION OF AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST; 2. APPOINT, IF APPROPRIATE, UNDER THE CIRCUMSTANCES THEN APPEARING, A NON-INTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT; 3. DETERMINE, BY A MAJORITY VOTE OF NON-INTERESTED PERSONS PRESENT, THAT THE TRANSACTION OR ARRANGEMENT IS IN THE HOSPITAL OR AFFILIATED ORGANIZATION'S BEST INTERESTS AND FOR ITS OWN BENEFIT AND IS FAIR AND REASONABLE TO THE HOSPITAL OR AFFILIATED ORGANIZATION. 4. TAKE APPROPRIATE DISCIPLINARY ACTION WITH RESPECT TO AN "INTERESTED PERSON" WHO VIOLATES THIS CONFLICT OF INTEREST POLICY TO PROTECT THE ORGANIZATION'S BEST INTERESTS. THE MINUTES OF ANY MEETING OF THE BOARD OF DIRECTORS OR ANY COMMITTEE WITH BOARD-DELEGATED POWERS SHALL INCLUDE THE FOLLOWING: 1. THE NAMES OF THE PERSONS WHO DISCLOSED FINANCIAL INTERESTS AND THE NATURE OF THEIR FINANCIAL INTEREST; 2. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT AND A RECORD OF THE VOTE. NO PHYSICIAN, WHO RECEIVES COMPENSATION DIRECTLY OR INDIRECTLY FROM THE HOSPITAL OR ANY AFFILIATED ORGANIZATION, SHALL BE A MEMBER OR SERVE ON ANY COMMITTEE DECIDING ON COMPENSATION FOR INDEPENDENT CONTRACTORS OR PRINCIPAL OFFICERS OF THE CORPORATION. NO MEMBER OF ANY COMPENSATION COMMITTEE WHO HAS A CONFLICT OF INTEREST SHALL, DIRECTLY OR INDIRECTLY, VOTE ON MATTERS PERTAINING TO THAT INDIVIDUAL'S COMPENSATION. EVERY MEMBER OF THE BOARD OF DIRECTORS, PRINCIPAL OFFICER, AND MEMBER OF ANY COMMITTEE WITH BOARD-DELEGATED POWERS SHALL SIGN AN ANNUAL STATEMENT THAT SUCH PERSON: 1. RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; 2. READ AND UNDERSTANDS THE POLICY; 3. AGREES TO COMPLY WITH THE POLICY; 4. UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5. UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS TAX EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES.
OFFICER COMPENSATION REVIEW PROCESSFORM 990, PART VI, SECTION B, LINE 15A AND 15BTHE ORGANIZATION'S SALARY AND ADMINISTRATIVE REVIEW COMMITTEE, WHICH IS MADE UP OF MEMBERS OF THE BOARD OF DIRECTORS, REVIEWS THE COMPENSATION FOR THE PRESIDENT AND VICE-PRESIDENTS OF THE MEDICAL CENTER. THE REVIEW OF COMPENSATION UTILIZES THE ANNUAL "EXECUTIVE COMPENSATION REPORT" THAT IS PUBLISHED BY THE MISSOURI HOSPITAL ASSOCIATION. A REVIEW OF THE MISSOURI DELTA MEDICAL CENTER'S PRESIDENT AND VICE-PRESIDENTS WAS CONDUCTED FOR THE YEAR ENDING SEPTEMBER 30, 2010.
DOCUMENTS AVAILABLE TO THE PUBLICFORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CONTINUE-CARE HOMEMAKER SERVICES
1008 NORTH MAIN STREETSIKESTONMO63801431835384HOME HEALTHMO501(C)(3)9NA
MISSOURI DELTA MEDICAL CENTER FOUNDATION
1008 NORTH MAIN STREETSIKESTONMO63801431577510FUNDRAISINGMO501(C)(3)11-INA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
CONTINUE-CARE HOMEMAKER SERVICES INC
R355600
MISSOURI DELTA MEDICAL CENTER FOUNDATION
C249095