2011-10-25T11:32:47-07:00 2010-12-31 BKD LLP 7901 Woodway Drive Suite 100 Waco TX 76712 990 2010-01-01 750711276 Crosbyton Clinic Hospital CROS 8066752382 710 West Main Street Crosbyton TX 79322 Debra Miller 2011-10-25 Carol S McIntosh CPA 2547768244 2010 2016-03-07 17:11:31Z 6676914 false false X N/A X 1945 TX To provide quality healthcare to the citizens of Crosbyton and the surrounding area. 6 6 112 0 385550 517321 5898461 6059907 -3485 77170 0 6280526 6654398 0 0 2930680 3129561 0 0 2935277 2970675 5865957 6100236 414569 554162 3767012 4007698 1190624 877148 2576388 3130550 To provide quality healthcare to the citizens of Crosbyton and the surrounding area. false false 5218319 6059907 Provided healthcare services to the citizens of Crosbyton and surrounding areas. Operated a 25 acute care bed hospital providing services that included 931 inpatient days; 44,914 procedures such as EKG/EEG, respiratory, radiology, laboratory and IV therapies; 5,962 physicial, occupational and speech therapy visits; 2,838 emergency visits and 90 blood bank units used. The Hospital provided charity care in the amount of $254,171 and the Rural Health Clinic logged 7,262 visits during the year. 5218319 true true false true false false false false false false true false false true true false false true false false false false false false false false true true false false false false false false false false false false false false false true false false false false false true true true false false true 52 0 true 112 true false false false false false false false false false false false 0 false false false false false false false false false false false X 6 6 false false false false false false false true true false false false false true true true true true true true false false X Debra Miller 8066758700 710 West Main Street Crosbyton TX 79322 Lester Bownds 1.00 X 0 0 457 Kelly Wing 1.00 X 0 0 457 Joan Burke Murray 1.00 X 0 0 457 James Allen Adams 1.00 X 0 0 457 Edward Watson 40.00 X 32468 0 1737 Debra Miller 40.00 X 66988 0 2424 Danny Bryand 60.00 X 106571 0 1502 Danny Brooks Ellison 1.00 X 0 0 457 Carolyn Dewbre 40.00 X 73848 0 2436 Bobby Max Ham 1.00 X 0 0 457 279875 10841 1 false false false Wael Qubzi MD 16002 CR 1765 Lubbock TX 79424 ER Medical 117330 Steve Alley MD PA 536 S Ayrshire Crosbyton TX 79322 ER Med/Phys Svce 436601 Concord Medical Group PO Box 489 Muleshoe TX 79347 ER Medical 259525 3 517321 517321 Vending Machine 722210 10310 10310 Rent Income 532000 16061 16061 Miscellaneous Income 621400 25522 25522 Medical Records Reports 561000 1101 1101 Healthcare Revenue 623000 6006833 6006833 80 80 6059907 5221 5221 0 0 0 94465 22516 71949 71949 71949 0 0 0 0 6654398 6109525 27552 0 0 0 0 182643 76284 106359 0 2597577 2280318 317259 0 149669 132660 17009 199672 163133 36539 0 0 84397 84397 0 0 0 1323466 1205348 118118 4092 3024 1068 522442 468977 53465 0 0 308616 167036 141580 26565 23908 2657 0 0 3080 3080 0 73590 73590 68688 68688 Vending Machine Expense 8622 8622 Postage and Shipping 16041 15215 826 Occupational Injury 3291 3291 Licenses/Dues 7530 7530 Bad Debts 517611 517611 2644 4 2640 6100236 5218319 881917 0 1114537 992959 0 0 560367 564193 0 0 0 127538 116319 0 4500105 3930860 605012 569245 0 0 0 0 1359558 1764982 3767012 4007698 627068 223434 32353 14778 50665 531203 588271 1190624 877148 X 2576388 3130550 2576388 3130550 3767012 4007698 554162 X false true true X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false true false false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description Hospital pays dues to TORCH, a portion of which is utilized for lobbying: TORCH dues $2,500 x 10% = $250. 25570 25570 1908548 1228266 680282 93666 86094 7572 2472321 2616500 -144179 569245 Receivable from Crosbyton Health Svces 935212 Property Tax Receivable 487000 Patients - Overpayment Refund Accounts 7945 Other Receivables 4251 Due from Medicare/Medicaid 331151 A/R - Employees -577 1764982 Other Accrued Liabilities 67765 Deferred Revenue 365250 Accrued Payroll 155256 588271 true true true X false true true false false true true 186257 643579 783124 568533 214591 0.03520 969381 1212112 214591 0.03520 1948 1948 0.00030 830973 830973 0.13620 832921 832921 0.13650 1802302 1212112 1047512 0.17170 true 517611 3530768 4365991 -835223 X true false 1 0 Crosbyton Clinic Hospital

710 W Main Street Crosbyton TX 79322

X X X X Crosbyton Clinic Hospital 1 false true true 200.0000 false true X X X X X X X true true X X X true X true X X X X X true X false true 1 Reeves Rhoades Terrace

640 South Harrison Crosbyton TX 79322

Assisted Living Facility Part V - Explanation of Number of Facility Type The licensed hospital facility listed in Part V is the sole health care facility of the organization. Part VI - States Where Community Benefit Report Filed TX Part VI - Explanation Of How Organization Furthers Its Exempt Purpose The Hospital furthers its exempt purpose in the community by participating in community health fairs and influenza vaccine clinics. Part VI - Community Information The Hospital serves the rural community of Crosby, Dickens, and Motley Counties along with a portion of several other surrounding counties. Part VI - Patient Education of Eligibility for Assistance Signs are posted to inform patients where to apply for indigent assistance. Part VI - Needs Assessment The Hospital assesses the needs of the community through city and county wide meeting with community leaders. Number of Hospital Faciltiy - 0 Part V, Line 21 - Charge Patients Amount Equal Gross Charge for Services All patients are charged the same amount which is the gross charge amount. However, unfunded patients are given a discount at billing time. Number of Hospital Faciltiy - 0 Part V, Line 19d - Other Billing Determination of Individuals Without Insurance All unfunded patients are given a 40% discount prior to sending statements. Number of Hospital Faciltiy - 0 Part V, Line 13g - Other Means Hospital Facility Publicized the Policy Posted on bulletin board in hospital and clinic. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients The Hospital assesses the needs of the community through city and county wide meeting with community leaders. Part III, Line 4 - Bad Debt Expense Excerpt from Audit Note #3: Including bad debts and uncollected accounts, the total amount of uncompensated care was $4,874,559 and $5,135,940 in 2010 and 2009, respectively. Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) Medically indigent patients are considered for charity care on a case-by-case basis and based on a percentage of their income. An asset test is also used to determine eligibility for charity care. The hospital does not offer discounted care, only free charity care. Bobby Max Ham Director 459443 Officer at Depos Bank false Kelly Wing Director 236963 Officer at Depos Bank false Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Organizational governing documents, conflict of interest policy and financial statements are made available to the public upon request. Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The CEO, Board Committee and complete Board of Directors research and review all data provided during the search process. Several reduction layers are involved when more than several candidates are involved. Market data is used to consider compensation levels. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts Verbal and written documentation concerning any conflicts of interest occur during employee review and at fiscal year end. Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process Form 990 is prepared by an independent accounting firm. Senior management considers, completes and finalizes all documentation before filing. Crosbyton Health Services 710 West Main Street Crosbyton TX 79322 752916531 Assisted Living TX 501(c)3 11a Crosbyton Clinic Hospital true false false false true false false false false false false true false false false false false false false Crosbyton Health Services d 935212 Book Value