HUNTSVILLE MEMORIAL HOSITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- HUNTSVILLE MEMORIAL HOSITAL (EIN 20-3069241)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-03
- IRS object ID
- 201121239349300027
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-03T13:17:10-04:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 IVAN ALLEN JR BLVD SUITE 1000 | AddressLine1 |
| City | ATLANTA | City |
| State | GA | State |
| ZIP Code | 30308 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 203069241 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Walker County Hospital Corporation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WALK | NameControl |
| Phone | 9362913411 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 4001 | AddressLine1 |
| City | Huntsville | City |
| State | TX | State |
| ZIP Code | 773424001 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SALLY I NELSON | Name |
| Title | CEO | Title |
| Date Signed | 2011-04-28 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4048748300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUNTSVILLE MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Sally I Nelson | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 Memorial Hospital Drive | AddressLine1 |
| City | Huntsville | City |
| State | TX | State |
| ZIP Code | 77340 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 76004861 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.huntsvillememorial.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2005 | YearFormation |
| State Legal Domicile | TX | StateLegalDomicile |
| Activity Or Mission Description | to provide benevolent and charitable services for the sick, infirm, and afflicted residents of Walker County through the establishment, maintenance, support, and operation of a hospital. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 702 | TotalNbrEmployees |
| Total Nbr Volunteers | 64 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2043713 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2388739 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 71155967 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 73129233 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 131686 | InvestmentIncomePriorYear |
| Investment Income Current Year | 42244 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 981885 | OtherRevenuePriorYear |
| Other Revenue Current Year | 444645 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 74313251 | TotalRevenuePriorYear |
| Total Revenue Current Year | 76004861 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 578131 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 271663 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 28139316 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 30333156 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 40674351 | OtherExpensePriorYear |
| Other Expenses Current Year | 42322917 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 69391798 | TotalExpensesPriorYear |
| Total Expenses Current Year | 72927736 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4921453 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3077125 | RevenuesLessExpensesCY |
| Total Assets BOY | 56283036 | TotalAssetsBOY |
| Total Assets EOY | 57677327 | TotalAssetsEOY |
| Total Liabilities BOY | 27061513 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 26457391 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 29221523 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 31219936 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE PURPOSE OF HUNSTVILLE MEMORIAL HOSPITAL IS TO PROVIDE BENEVOLENT AND CHARITABLE SERVICES FOR THE SICK, INFIRM, AND AFFLICTED RESIDENTS OF WALKER COUNTY THROUGH THE ESTABLISHMENT, MAINTENANCE, SUPPORT, AND OPERATION OF A HOSPITAL. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 63276805 | Expense |
| Grants | 271663 | Grants |
| Revenue | 73129233 | Revenue |
| Description | To provide benevolent and charitable services for the sick, infirm and afflicted residents of Walker County through the establishment, maintenance, support and operation of a hospital. | Description |
| Total Program Service Expense | 63276805 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 18 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 702 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | true | ForeignFinancialAccount |
| Name Of Foreign Country | CJ | NameOfForeignCountry |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Robert E Gray Jr | NamePerson |
| Telephone Number | 9364352230 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 Memorial Hospital Drive | AddressLine1 |
| City | Huntsville | City |
| State | TX | State |
| ZIP Code | 77340 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| DANNA GIBSON PHD CPA | |||||||
| Member | 1.0 | X | 0 | 0 | 0 | ||
| DAVID ALLEN PRIER MD | |||||||
| President | 1.0 | X | 0 | 0 | 0 | ||
| NANCY GAERTNER | |||||||
| Member | 1.0 | X | 0 | 0 | 0 | ||
| DON JOHNSON | |||||||
| Member | 1.0 | X | 0 | 0 | 0 | ||
| DALTON D HEATH II MD | |||||||
| Secretary | 1.0 | X | 0 | 0 | 0 | ||
| ROSA VALLES | |||||||
| Member | 1.0 | X | 0 | 0 | 0 | ||
| WAYNE SCOTT | |||||||
| Member | 1.0 | X | 0 | 0 | 0 | ||
| MORRIS JOHNSON | |||||||
| Vice President | 1.0 | X | 0 | 0 | 0 | ||
| TIMOTHY DEAHL MD | |||||||
| Member | 1.0 | X | 0 | 0 | 0 | ||
| MICHAEL D WILLIAMS | |||||||
| MEMBER | 1.0 | X | 0 | 1003732 | 32385 | ||
| SALLY I NELSON | |||||||
| CEO | 40.0 | 347570 | 0 | 71271 | X | ||
| ROBERT E GRAY JR | |||||||
| CFO | 40.0 | 201831 | 0 | 45271 | X | ||
| SUSAN WHITE | |||||||
| CNO | 40.0 | 232933 | 0 | 37752 | X | ||
| DAVID BUTLER | |||||||
| ASSISTANT SECRETARY | 1.0 | 0 | 316455 | 34935 | X | ||
| PHILLIP J MONTALBO | |||||||
| Asst Administrator | 40.0 | 139456 | 0 | 11109 | X | ||
| MARY INGRID DIXON | |||||||
| RN | 40.0 | 113871 | 0 | 10755 | X | ||
| DIANE S STEVENS | |||||||
| Director of HR | 40.0 | 111398 | 0 | 7753 | X | ||
| ROBIN E LANDIS | |||||||
| RN | 40.0 | 107562 | 0 | 11109 | X | ||
| JOHN A HEEMANN JR | |||||||
| Director of IT | 40.0 | 109054 | 0 | 12409 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1363675 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1320187 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 274749 | TotalOtherCompensation |
| Number Individuals GT100 K | 17 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Memorial Hermann Hospital Services | |||||
| 9301 Southwest Fwy | HOUSTON | TX | 770741425 | Management | 928430 |
| Comprehensive Pharmacy Services | |||||
| PO Box 1000 Dept 176 | MEMPHIS | TN | 381480176 | Pharmacy Services | 705776 |
| Dr Thomas Halling | |||||
| 110 Memorial Hospital Dr | HUNTSVILLE | TX | 77340 | Anesthesia Services | 466145 |
| Diversified Clinical Services | |||||
| 4500 Salisbury Road | JACKSONVILLE | FL | 32216 | Wound Care Services | 407368 |
| Affilion | |||||
| 80 E Rio Salado Pkwy Ste 703 | HOUSTON | AZ | 85281 | ER Physicians | 359557 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 21 | NumberOfContractorsGT100K |
| Related Organizations | 959469 | RelatedOrganizations |
| Government Grants | 86127 | GovernmentGrants |
| All Other Contributions | 1343143 | AllOtherContributions |
| Total Contributions | 2388739 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| ROUTINE SERVICES, ANCILLARY SERVICES | 622110 | 72952629 | 72952629 |
| EDUCATION NURSING REVENUE | 621990 | 176604 | 176604 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 73129233 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 42244 | TotalRevenueColumn |
| Exclusion | $42,244 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9420 | TotalRevenueColumn |
| Exclusion | $9,420 | ExclusionAmount |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| CAFETERIA, BILLING RECORDS | 900099 | 372758 | $372,758 |
| other income | 900099 | 62467 | $62,467 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 435225 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 76004861 | TotalRevenueColumn |
| Related Or Exempt Function Income | 73129233 | RelatedOrExemptFunctionIncome |
| Exclusion | $486,889 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 270210 | Total |
| Program Services | 270210 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1453 | Total |
| Program Services | 1453 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 777233 | Total |
| Program Services | 388617 | ProgramServices |
| Management And General | 388616 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23252095 | Total |
| Program Services | 21752523 | ProgramServices |
| Management And General | 1499572 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 919990 | Total |
| Program Services | 836265 | ProgramServices |
| Management And General | 83725 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3481861 | Total |
| Program Services | 3164991 | ProgramServices |
| Management And General | 316870 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1901977 | Total |
| Program Services | 1728886 | ProgramServices |
| Management And General | 173091 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 921915 | Total |
| Management And General | 921915 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 453022 | Total |
| Management And General | 453022 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 175756 | Total |
| Management And General | 175756 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13331132 | Total |
| Program Services | 10092816 | ProgramServices |
| Management And General | 3238316 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9004558 | Total |
| Program Services | 8769927 | ProgramServices |
| Management And General | 234631 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 995794 | Total |
| Program Services | 160132 | ProgramServices |
| Management And General | 835662 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 145826 | Total |
| Program Services | 145826 | ProgramServices |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 117296 | Total |
| Program Services | 97242 | ProgramServices |
| Management And General | 20054 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 420572 | Total |
| Management And General | 420572 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 861000 | Total |
| Program Services | 861000 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3956200 | Total |
| Program Services | 3956200 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 214572 | Total |
| Management And General | 214572 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PROVISION FOR UNCOLLECT ACCTS | 11008307 | 11008307 | |
| DUES/SUBSCRIPTS/COMM EDU | 109141 | 42410 | 66731 |
| Property/Sales Tax | 69457 | 69457 | |
| OTHER EXPENSES | 538369 | 538369 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72927736 | Total |
| Program Services | 63276805 | ProgramServices |
| Management And General | 9650931 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28830 | BOY |
| EOY | 3375 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9521678 | BOY |
| EOY | 13217757 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9919533 | BOY |
| EOY | 9710494 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 630048 | BOY |
| EOY | 24845 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1477974 | BOY |
| EOY | 1438901 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 930297 | BOY |
| EOY | 1053263 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 52728709 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 34576145 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17951170 | BOY |
| EOY | 18152564 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2740887 | BOY |
| EOY | 2827528 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11800488 | BOY |
| EOY | 10524760 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1282131 | BOY |
| EOY | 723840 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56283036 | BOY |
| EOY | 57677327 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8138134 | BOY |
| EOY | 7191488 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13908013 | BOY |
| EOY | 12511783 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 370860 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4644506 | BOY |
| EOY | 6754120 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27061513 | BOY |
| EOY | 26457391 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29099356 | BOY |
| EOY | 31093442 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 122167 | BOY |
| EOY | 126494 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29221523 | BOY |
| EOY | 31219936 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56283036 | BOY |
| EOY | 57677327 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 700539 | OtherCostOrOtherBasis |
| Book Value | 700539 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15047692 | OtherCostOrOtherBasis |
| Depreciation | 8464745 | Depreciation |
| Book Value | 6582947 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1499578 | OtherCostOrOtherBasis |
| Depreciation | 1050197 | Depreciation |
| Book Value | 449382 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 35166155 | OtherCostOrOtherBasis |
| Depreciation | 24954779 | Depreciation |
| Book Value | 10211376 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 314745 | OtherCostOrOtherBasis |
| Depreciation | 106425 | Depreciation |
| Book Value | 208320 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 18152564 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| PENSION LIABILITY | $5,826,882 |
| ESTIMATED DUE TO THIRD PARTY PAYOR | $583,445 |
| ASSET RETIREMENT OBLIGATION | $343,793 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 6754120 | TotalOfAmounts |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 500. | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3806146 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3806146 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06150 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6630080 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5697192 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 932887 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09200 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 77932 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 77932 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10514158 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5697192 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4816965 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02920 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 51083 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1355 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 49728 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 449720 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 186810 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 262910 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00420 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1781795 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1781795 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02880 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5650 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5650 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2288248 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 188165 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2100083 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03390 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12802406 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5885357 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6917048 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00470 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $3,855,109 | BadDebtExpenseAmount |
| Amount Attributable To | 320336 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 20796577 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 21424631 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -628054 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Walker County Hospital Corporation | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 Memorial Hospital Drive | AddressLine1 |
| City | Huntsville | City |
| State | TX | State |
| ZIP Code | 77340 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Graduated scale up to 500% of FPG to determine discount | IncomeBasedCriteria |
| Annual Community Benefit Expln | Community Hospital Consulting prepares the community benefit report of Walker County Hospital. | AnnualCommunityBenefitExpln |
| Costing Method Used | NONE. | CostingMethodUsed |
| Subsidized Health Services Expln | NONE. | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | Our total expense from Form 990, Part IX, Line 25, Column (A) was $72,927,736. The bad debt expense included in this amount was $11,008,307. This left a total expense of $61,919,429 for purposes of calculating Line 7, Column (F). | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | The Hospital reports patient accounts receivable for services rendered at net realizable amounts from government payers, managed care plans, patients and others. Amounts due from patients include both amounts due from fully uninsured patients and copayments and deductibles for which insured patients are responsible. As a service to the patient, the Hospital bills third-party payers directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. The Hospital provides an allowance for doubtful accounts for estimated losses resulting from payers' inability to make payments on accounts. The Hospital estimates its allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. Accounts are considered delinquent, and subsequently written off as bad debts, based on individual credit evaluation and specific circumstances of the account, estimates it allowance for doubtful accounts based upon a review of outstanding receivables. Bad Debt expenses of $ 11,008,307 included on Form 990, Part IX line 25, column A, were subtracted from total expenses for purposes of calculating the percentage in the column. | BadDebtFootnote |
| Shortfall As Community Benefit | The Medicare shortfall was computed using the annual Medicare cost report for the period 11/01/09 thru 10/31/10. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | WCHC Administrative Policy & Procedure 9020.109 Hospital shall contribute appropriate resources, advocacy and community support to promote the health status of the community, which it serves, within its economic ability to do so. Charity care will be provided to patients with a demonstrated inability to pay. The purpose of this policy is to establish criteria for determining if a patient's account qualifies for a charity care discount. The amount of charity care to be made available, as well as any other changes to this policy shall be assessed and determined by the Hospital's Chief Executive Officer on an annual basis, and will adhere to state guidelines for non-profit facilities, if applicable. The amount of charity care as well as the other terms of this policy may be changed by the Hospital's Chief Executive Officer, subject to the approval of Community Health Corporation. | DebtCollectionPolicy |
| Number Of Facility Type Expln | Walker County Hospital Corporation has one facility that includes the Acute Care Hospital, IP Rehab, Ambulatory Surgery Center, OP Imaging Center, and Rural Health Care Clinic. | NumberOfFacilityTypeExpln |
| Needs Assessment | We have utilized a community needs assessment in the past. This study is conducted using a third party source every three years. We have scheduled a study to be conducted in the Fall of 2011. Our Executive Team and Board of Directors utilize the information gathered in this report to format our strategic plan for next year, as well as a five year plan. This plan details what physician based specialties we would like to recruit for in the next five years and what hospital based services we would like to begin formatting. Huntsville Memorial Hospital has also utilizes a Community Advisory Board. This committee is comprised of twelve members that have various leadership roles throughout our area. The Hospital's Executive team relies on this community to provide feedback on various hospital initiatives. Huntsville Memorial Hospital also produces a community benefit report every three years. This is a chance to evaluate all the services and physicians added through the time span, and the charitable care provided to the community. | NeedsAssessment |
| Patient Education Assistance | The patient is encouraged to apply for charity as early as possible in the account management process. Charity application and qualifications guidelines are given up front in registration. The self pay balances are sent to a Medicaid Eligibility Company, who screens patients from day 1 to day 60. The self pay balances are returned if the company is unable to reach the patient or the patient does not qualify. Self pay balances that are returned are sent to an early out company, who has our charity guidelines, if the patient expresses an inability to pay, they are referred to the hospital for screening. Once a completed application is received and approved, any account balances are adjusted according to the level of charity the patient has qualified for. If the account is with a collection agency, it is returned to the hospital. | PatientEducationAssistance |
| Community Information | Huntsville Memorial Hospital is a Joint Commission-accredited, not-for-profit acute care community hospital. Since 1927, we have provided charitable health care services, delivering quality healthcare to the residents of Walker County and the surrounding communities. Founded in 1835, Huntsville is one of Texas' oldest cities and the home of Sam Houston, the first and third president of the Republic of Texas. We are home to Sam Houston State University and the Texas Department of Criminal Justice (the only state agency with headquarters outside of Austin,). The City of Huntsville is part of Walker County in east Texas, approximately 70 miles north of Houston and 170 miles south of Dallas via Interstate 45. It is on Texas Highway 30 (west to Bryan-College Station) and Highway 190 (east to Livingston). Other cities in Walker County include New Waverly and Riverside. Huntsville covers 31 square miles, while Walker County includes 790 square miles. The population of Huntsville is 35,078, New Waverly is 950, and Riverside is 425. The population in Walker County is 61,758. Walker County is located near Lake Livingston and Lake Conroe and is surrounded by the Sam Houston National Forest. Walker County is proud to host a culturally diverse community. The population density is 78 people per square mile (30/km). There are 21,099 housing units at an average density of 27 per square mile (10/km). The racial makeup of the county is 67.9% White, 23.88% Black or African American, 0.35% Native American, 0.77% Asian, 0.05% Pacific Islander, 4.42% from other races, and 1.41% from two or more races. 14.11% of the population are Hispanic or Latino of any race. | CommunityInformation |
| Community Building Activities | N/A | CommunityBuildingActivities |
| Other Information | Huntsville Memorial Hospital's commitment to charitable care goes back to the 1927 hospital charter promising "benevolent and charitable" services for the "sick and infirm." Our goal is to educate and build awareness, promoting healthy lifestyles in Walker County. We believe in giving back to the community through a number of valuable health resources such as educational materials, hands-on classes and informative events. On a monthly basis, the hospital holds free community education sessions that are open to the public. These forums provide citizens a chance to detect a health threat at its earliest, most treatable stage or a way to learn more about a loved one's illness. Each session features a local physician as the key speaker and is also associated with a medical screening. Not only do we provide advanced care with a friendly touch, we also focus on giving back to the great community of Walker County each and every year. We provide reduced- or no-cost care for those with financial challenges. We educate and produce top-notch nurses through our accredited Joe G. Davis School of Vocational Nursing. We recruit expert physicians into our open medical staff. Under the leadership of our Board of Directors, and through the dedication of our professional health care staff, Huntsville Memorial Hospital is setting the standard in quality health care today. Huntsville Memorial Hospital is also able to gain valuable insight from local community leaders who serve on our Foundation Board and Community Advisory Board. The Huntsville Memorial Hospital Medical Clinic was established in 1992 to meet the primary health care needs of the residents of Walker County. It is an ambulatory acute care clinic that provides care for patients of all ages. Services include pediatric care, adolescent medicine and adult medicine. | OtherInformation |
| Affiliated Health Care System | As a testament to the quality health care services that Huntsville Memorial Hospital provides, we are recognized as an affiliate of Memorial Hermann, a health care network serving the greater Houston area. Huntsville Memorial operates under a close team of leaders known as the Executive Team, which are all employees of Memorial Hermann. Led by Chief Executive Officer Sally Nelson, the team philosophy is "to provide" friendly health care services, while continuing to exceed the expectations of the community." | AffiliatedHealthCareSystem |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HMH Physicians Organization | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 Memorial Hospital Drive | AddressLine1 |
| City | Hunstville | City |
| State | TX | State |
| ZIP Code | 77340 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 760500960 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 183161 | AmountOfCashGrant |
| Purpose Of Grant | Contribution | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | true | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | true | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SALLY I NELSON | |||||||||||||
| 260243 | 0 | 85215 | 0 | 2112 | 0 | 52431 | 0 | 18840 | 0 | 418841 | 0 | 7837 | 0 |
| ROBERT E GRAY JR | |||||||||||||
| 138861 | 0 | 43156 | 0 | 19814 | 0 | 31508 | 0 | 13763 | 0 | 247102 | 0 | 4631 | 0 |
| SUSAN WHITE | |||||||||||||
| 120308 | 0 | 46124 | 0 | 66501 | 0 | 31485 | 0 | 6267 | 0 | 270685 | 0 | 36779 | 0 |
| PHILLIP J MONTALBO | |||||||||||||
| 130745 | 0 | 8618 | 0 | 93 | 0 | 0 | 0 | 11109 | 0 | 150565 | 0 | 0 | 0 |
| MICHAEL D WILLIAMS | |||||||||||||
| 0 | 595995 | 0 | 268869 | 0 | 138868 | 0 | 17200 | 0 | 15185 | 0 | 1036117 | 0 | 0 |
| DAVID BUTLER | |||||||||||||
| 0 | 244450 | 0 | 69153 | 0 | 2852 | 0 | 16747 | 0 | 18188 | 0 | 351390 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Compensation Information | Identifier |
| Return Reference | SCHEDULE J, PART I | ReturnReference |
| Explanation | Pursuant to the management agreement between Walker County Hospital Corporation d/b/a Huntsville Memorial Hospital ("HMH") and Memorial Hermann Hospital Services ("MHHS"), the salaries of Sally I. Nelson, Robert E. Gray, Jr., and Susan White are paid by MHHS. HMH pays MHHS a management fee to cover the salaries of these individuals for serving as officers of HMH. Schedule J, Part I, Line 4B Nonqualified Retirement Plan participation was paid to: Michael D. Williams - $141,726 David Butler - $10,204 Schedule J, Part I, Line 6a Eligible management is paid a "DIPG" payment in 2009, or a Management Incentive Program. The DIPG program consisted of HMH Goals based on hospital wide initiatives in Operational Excellence, Quality, Patient Satisfaction, Employee Satisfaction and Growth. Under the DIPG Program, each Department director was assigned three individual goals agreed upon with their senior manager. The hospital also had to meet Earnings Before Interest, Depreciation & Amortization earnings level for the Department Directors to be eligible for payout and the total payout to them was based on their final Achievement level. Schedule J, Part I, Line 6B A portion of the discretionary incentive compensation program was based on the consolidated EBITDA of CHC. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF MANAGEMENT ARRANGEMENT | FORM 990, PART VI, QUESTION 3 | VHA SW (CHC) THE SOLE CORPORATE MEMBER OF WALKER COUNTY HOSPITAL CORPORATION, TOGETHER WITH MEMORIAL HERMANN HOSPITAL SYSTEM (MHHS), ALSO A TEXAS NONPROFIT CORPORATION, MANAGE THE OPERATIONS OF THE HOSPITAL THROUGH AN OPERATING AGREEMENT WITH AN INITIAL TERM EXPIRING ON JUNE 30, 2009, THAT WAS AUTOMATICALLY RENEWED ON THAT DATE THROUGH JUNE 30, 2010. THE MANAGEMENT AGREEMENT PROVIDES THAT MHHS WILL PROVIDE DAY-TO-DAY OPERATION MANAGEMENT OF THE HOSPITAL WITH CHC PROVIDING CERTAIN FINANCIAL, TECHNICAL AND MANAGERIAL SUPPORT SERVICES TO THE HOSPITAL. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 VHA SOUTHWEST COMMUNITY HEALTH CORPORATION (CHC) IS THE SOLE MEMBER. DESCRIPTION OF CLASES OF PERSONS AND THE NATURE OF THEIR RIGHTS PART VI, LINE 7A VHA SOUTHWEST COMMUNITY HEALTH CORPORATION (CHC), AS THE SOLE MEMBER HAS THE RIGHT TO APPOINT THE INITIAL BOARD MEMBERS. ANY DIRECTOR MAY BE REMOVED, WITH OR WITHOUT CAUSE, AT ANY TIME BY THE AFFIRMATIVE VOTE OF TWO-THIRDS OF THE MEMBERS OF THE BOARD OF DIRECTORS. UPON THE REMOVAL OR VACANCY OF A DIRECTOR DESIGNATED BY CHC, CHC MAY DESIGNATE THE SUCCESSOR DIRECTOR. IF ANY OTHER DIRECTOR IS REMOVED OR VACATES THE POSITION, A REPLACEMENT DIRECTOR MAY BE ELECTED WITH AN AFFIRMATIVE VOTE OF THE MAJORITY OF THE DIRECTORS. CLASES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS PART IV, LINE 7B AMENDMENT OF THE BYLAWS REQUIRES THE APPROVAL OF VHA SOUTHWEST COMMUNITY HEALTH CORPORATION. OTHERWISE, THE BOARD OF DIRECTORS GENERALLY MANAGES THE AFFAIRS OF THE ORGANIZATION. |
| DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 | FORM 990, PART VI, QUESTION 11A | THE DETAILED REVIEW OF THE FORM 990 IS CONDUCTED BY THE CFO FOLLOWING THE PREPARATION AND REVIEW OF THE RETURN BY THE ORGANIZATION'S PAID PREPARER. AN ELECTRONIC COPY OF THE FINAL FORM 990 IS EMAILED TO EACH BOARD MEMBER PRIOR TO FILING WITH THE IRS. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C THE ORGANIZATION FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS ADMINISTERED BY ITS PARENT, VHA SOUTHWEST COMMUNITY HEALTH CORPORATION (CHC), WHICH REQUIRES ALL OFFICERS, DIRECTORS, KEY EMPLOYEES, HIGHLY COMPENSATED EMPLOYEES AND OTHER MANAGEMENT OFFICIALS ("COVERED PERSONS") TO DISCLOSE POTENTIAL CONFLICTS. PURSUANT TO THE POLICY, A DISCLOSURE STATEMENT IS CIRCULATED ANNUALLY TO COVERED PERSONS IN WHICH THE INDIVIDUAL MUST DISCLOSE TRANSACTIONS THAT MAY RESULT IN A CONFLICT. COVERED PERSONS ARE ALSO ENCOURAGED TO NOTIFY THE BOARD, APPROPRIATE MANAGEMENT PERSONNEL, CHIEF COMPLIANCE OFFICE, GENERAL COUNSEL, OR THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BODY AS NECESSARY. WHEN NECESSARY, THE BOARD CHAIR OR APPROPRIATE BOARD COMMITTEE MAY APPOINT A DISINTERESTED PERSON(S) OR COMMITTEE TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND RECOMMEND ALTERNATIVES TO THE APPLICABLE TRANSACTION OR ARRANGEMENT OR OTHERWISE DETERMINE IF THE CONFLICT CAN BE RESOLVED. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLY UNDER THE CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION, AND WHETHER IT IS REASONABLE. THE GOVERNING BOARD OR COMMITTEE MAKES THE DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. ANY MEMBER OF THE BOARD OPERATING UNDER A CONFLICT IS NOT PERMITTED TO BE PRESENT OR OTHERWISE PARTICIPATE IN THE VOTE ON ANY MATTER TO WHICH THE CONFLICT RELATES. IF THE GOVERNING BOARD OR COMMITTEE OF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND AFTER INVESTIGATION THE BOARD OR COMMITTEE DETERMINES THAT THE COVERED PERSON FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE ORGANIZATION TAKES APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION, WHICH MAY INCLUDE, TERMINATION OF THE INDIVIDUAL'S MEMBERSHIP, EMPLOYMENT, OR CONTRACT. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN PART VI, LINE 15A AND 15B THE ORGANIZATION FOLLOWS THE COMPENSATION POLICY OF THE PARENT ORGANIZATION, VHA SOUTHWEST COMMUNITY HEALTH CORPORATION (CHC). CHC ENGAGED SULLIVAN COTTER TO CONDUCT A COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO ON JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITY, AND CURRENT INCUMBENTS' COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. THIS PROCEDURE WAS FOLLOWED FOR YEAR ENDED 6/30/10 FOR ALL OFFICERS, DIRECTORS, AND TOP MANAGEMENT EMPLOYEES. AVAIL OF GOV DOC, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC PART VI, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTERET POLICY AVAILABLE AT ITS BUSINESS OFFICE UPON REQUEST. AVERAGE RELATED HOURS DISCLOSURE FORM 990, PART VII, SECTION A, COLUMN B ESTIMATED HOURS WORKED BY OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES AT RELATED ENTITIES: DAVID BUTLER: BAPTIST HOSPITALS OF SE TEXAS - 1 HOUR CHC COMMUNITY CARE - 1 HOUR CONTINUECARE HOSPITAL OF TYLER - 1 HOUR HMH PHYSICIANS ORGANIZATION - 1 HOUR VHASW COMMUNITY HEALTH CORPORATION - 38 HOURS YOAKUM COMMUNITY HOSPITAL - 1 HOUR COMMUNITY HOSPITAL CONSULTING, INC. - 1 HOUR SOUTHWEST COMMUNITY HOSPITAL - 0.01 HOURS DAVID ALLEN PRIER: HMH PHYSICIANS ORGANIZATION - 1 HOUR MICHAEL D. WILLIAMS: BAPTIST HOSPITALS OF SE TEXAS - 1 HOUR CHC COMMUNITY CARE - 1 HOUR CONTINUECARE HOSPITAL OF CARSON TAHOE - 1 HOUR CONTINUECARE HOSPITAL OF TYLER - 1 HOUR VHASW COMMUNITY HEALTH CORPORATION - 30 HOURS YOAKUM COMMUNITY HOSPITAL - 1 HOUR COMMUNITY HOSPITAL CONSULTING, INC. - 6 HOUR SOUTHWEST COMMUNITY HOSPITAL - 0.01 HOUR |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (12 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| BAPTIST HOSPITALS OF SE TEXAS | |||||||||
| POST OFFICE BOX 1591 | BEAUMONT | TX | 77704 | 741303720 | HOSPITAL | TX | 501( C)(3) | 3 | SW CH INC |
| BAPTIST PHYSICIAN NETWORK | |||||||||
| 3080 COLLEGE STREET | BEAUMONT | TX | 77701 | 760453250 | PRIMARY CARE | TX | 501( C)(3) | 3 | BP HSP SETX |
| ARTESIA GENERAL HOSPITAL | |||||||||
| 702 NORTH 13TH STREET | ARTESIA | NM | 88210 | 742851819 | HOSPITAL | NM | 501( C)(3) | 3 | NA |
| LAIRD MEMORIAL HOSPITAL | |||||||||
| 5801 TENNYSON PKWY STE 550 | PLANO | TX | 75024 | 020643367 | HOSPITAL | TX | 501( C)(3) | 3 | NA |
| HMH PHYSICIAN ORGANIZATION | |||||||||
| 3000 INTERSTATE 45 | HUNSTVILLE | TX | 77340 | 760500960 | HOSPITAL | TX | 501( C)(3) | 3 | WCHC DBA HM |
| SOUTHWEST COMMUNITY HOSPITAL INC | |||||||||
| 5801 TENNYSON PKWY STE 550 | PLANO | TX | 75024 | 752725353 | HOSPITAL | TX | 501( C)(3) | 3 | NA |
| YOAKUM COMMUNITY HOSPITAL | |||||||||
| 1200 CARL RAMERT DRIVE | YOAKUM | TX | 77995 | 742323822 | HOSPITAL | TX | 501( C)(3) | 3 | NA |
| CONTINUECARE HOSPITAL OF TYLER | |||||||||
| 800 E DAWSON STREET | TYLER | TX | 75701 | 200991990 | HOSPITAL | TX | 501( C)(3) | 3 | CHC CM CARE |
| CONTINUECARE HOSPITAL OF SE TEXAS | |||||||||
| 5801 TENNYSON PKWY STE 550 | PLANO | TX | 75024 | 201150480 | HOSPITAL | TX | 501( C)(3) | 3 | CHC CM CARE |
| CONTINUECARE HOSPITAL OF CARSON TAHOE | |||||||||
| 5801 TENNYSON PKWY STE 550 | PLANO | TX | 75024 | 261635881 | HOSPITAL | TX | 501( C)(3) | 3 | CHC CM CARE |
| CHC COMMUNITY CARE LLC | |||||||||
| 5801 TENNYSON PKWY STE 550 | PLANO | TX | 75024 | 371485773 | SUPPORT ORG | TX | 501( C)(3) | 11C | NA |
| HUNSTVILLE MEMORIAL HOSPITAL AUXILIARY | |||||||||
| 3000 INTERSTATE 45 | HUNSTVILLE | TX | 77340 | 741508450 | SUPPORT ORG. | TX | 501( C)(3) | 9 | NA |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressForeign/AddressLine1 | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Primary ActivityPrimaryActivity | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Legal Domicile StateLegalDomicileState |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Community Health Assurance SPC LTD | ||||||||||||
| CAYMAN ISLANDS GRAND CAYMAN | CJ | POB 69GT | Captive Insurance | CJ | N/A | C Corp | ||||||
| CHC ACQUISITION CORP | ||||||||||||
| CONSULTING | N/A | C Corp | 5801 TENNYSON PARKWAY STE 550 | PLANO | TX | 75024 | 752750360 | TX | ||||
| Community Hospital Consulting Inc | ||||||||||||
| Mgmt Consulting | N/A | C Corp | 5801 Tennyson Parkway Ste 550 | Plano | TX | 75024 | 204710183 | TX | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HMH Physician Organization | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | B | TransactionType |
| Amount Involved | 183161 | AmountInvolved |