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COLORADO-FAYETTE MEDICAL CENTER: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
COLORADO-FAYETTE MEDICAL CENTER (EIN 74-1545266)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201123189349307857
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-14T19:26:13-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

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 Line17901 Woodway Drive Suite 100AddressLine1
CityWacoCity
StateTXState
ZIP Code76712ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN741545266EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COLORADO-FAYETTE MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOLONameControl
Phone9797259531Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 Youens DriveAddressLine1
CityWeimarCity
StateTXState
ZIP Code78962ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSteven GularteName
TitleCEOTitle
Date Signed2011-11-11DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCarol S McIntoshName
Phone2547768244Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSteven GularteNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1400 Youens DriveAddressLine1
CityWeimarCity
StateTXState
ZIP Code78962ZIPCode
FieldValueIRS element (for citing)
Gross Receipts13408657GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.cfmctx.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1966YearFormation
State Legal DomicileTXStateLegalDomicile
Activity Or Mission DescriptionTo provide medical services to the residents of Central Texas, through the operation of an acute-care hospital, long-term care and assisted living facilities, rehabilitation center and two rural health clinics.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees280TotalNbrEmployees
Total Nbr Volunteers10TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year7184ContributionsGrantsPriorYear
Contributions Grants Current Year68300ContributionsGrantsCurrentYear
Program Service Revenue Prior Year16026096ProgramServiceRevenuePriorYear
Program Service Revenue CY13198073ProgramServiceRevenueCY
Investment Income Prior Year10343InvestmentIncomePriorYear
Investment Income Current Year120InvestmentIncomeCurrentYear
Other Revenue Prior Year163864OtherRevenuePriorYear
Other Revenue Current Year142164OtherRevenueCurrentYear
Total Revenue Prior Year16207487TotalRevenuePriorYear
Total Revenue Current Year13408657TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year7181052SalariesEtcPriorYear
Salaries Etc Current Year7031335SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year10231323OtherExpensePriorYear
Other Expenses Current Year7453859OtherExpensesCurrentYear
Total Expenses Prior Year17412375TotalExpensesPriorYear
Total Expenses Current Year14485194TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1204888RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1076537RevenuesLessExpensesCY
Total Assets BOY8665133TotalAssetsBOY
Total Assets EOY7171703TotalAssetsEOY
Total Liabilities BOY8672910TotalLiabilitiesBOY
Total Liabilities EOY8241534TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-7777NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-1069831NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTo provide basic medical and surgical services to the residents of Central Texas, through the operation of a 38 bed acute-care hospital, a 100 bed long-term care facility, an outpatient center, a physical therapy and rehabilitation center, an assisted living facility, and two hospital-based rural health clinics.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Activity Code622000ActivityCode
Expense7416023Expense
Revenue8102494Revenue
DescriptionProvided medical care to residents in Colorado, Fayette and Lavaca counties. The care provided included: 2,344 emergency room visits and 2,932 patient days. Provided charity care in the amount of $335,760.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Activity Code623000ActivityCode
Expense2951354Expense
Revenue3559837Revenue
DescriptionProvided intermediate and heavy nursing home care to residents living in Parkview Manor Nursing Home and Park Place Center, a facility specifically designed for dementia residents.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Activity Code621498ActivityCode
Expense912624Expense
Revenue1211790Revenue
DescriptionProvided outpatient services to residents of Flatonia and Schulenburg, Texas through operation of the Flatonia Community Clinic and Schulenberg Community Clinic. Services included X-Ray and laboratory testing.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense151268Expense
Revenue323952Revenue
DescriptionOperation of a "Type B" assisted living facilityDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp151268TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev323952TotalOfOtherProgramServiceRev
Total Program Service Expense11431269TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
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
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109680NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees280NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
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
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
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
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJERRY PICKETTNamePerson
Telephone Number9797259170TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1400 YOUENS DRAddressLine1
CityWEIMARCity
StateTXState
ZIP Code78962ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
Shirley Schoener
President1.0XX000
David Fike
Vice-President1.0XX000
James Heinrich
Secretary1.0XX000
AE Bill Hassell
Director1.0X000
Ted Stanzel
Director Jan-July1.0X000
James Balcar
Director Jan-Nov1.0X000
Bob Huette
Director Jun-Dec1.0X000
Tommy Brasher
Director Jun-Dec1.0X000
Mark Kloesel
Director Jun-Dec1.0X000
Robert Youens MD
Director Jun-Dec1.0X000
Shannon McBride
CEO Jan-Jun40.0X537780218
Steven Gularte
CEo Jul-Dec40.0X5264000
Chris Mattingly
CFO Jan-Jun40.0X849680456
David Austin
CFO Jun-Oct40.0X5290600
Vicki Lewis
CFO Nov-Dec40.0X888500
Melodie Young
CNO Jan-Jun40.0X6630900
Crystal Curtis
CNO Jul-Dec40.0X4424700
FieldValueIRS element (for citing)
Total Reportable Comp From Org363733TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation674TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Concord Medical Group
313 E Fir DriveMULESHOETX79347ER Physicians479995
Juan Carlos Ortega MD
703 S CollegeWEIMARTX78962RHC Physician194220
Susan Kraemer MD
108 W St CharlesWEIMARTX78962RHC Physician155310
ITA Resources Inc
9821 Katy Frwy Ste 250HOUSTONTX77024Resp Therapists115356
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Government Grants60261GovernmentGrants
All Other Contributions8039AllOtherContributions
Total Contributions68300TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
HOSPITAL PATIENT FEES62199081024948102494
NURSING HOME PATIENT FEES62300035598373559837
CLINICS PATIENT FEES62111012117901211790
ASSISTED LIVING FEES623000323952323952
FieldValueIRS element (for citing)
Total Program Service Revenue13198073TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column70TotalRevenueColumn
Related Or Exempt Function Income70RelatedOrExemptFunctionIncome

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)
Real25714Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real25714Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column25714TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other50Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other50Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column50TotalRevenueColumn
Related Or Exempt Function Income50RelatedOrExemptFunctionIncome

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 ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA & VENDING SALES7222107940179401
LIFELINE6216101972119721
MEDICAL RECORDS/SUPPLIES56100029242924

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column14404TotalRevenueColumn
Related Or Exempt Function Income14404RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue116450TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column13408657TotalRevenueColumn
Related Or Exempt Function Income13314643RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

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)
Total364407Total
Program Services0ProgramServices
Management And General364407ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5111357Total
Program Services3934775ProgramServices
Management And General1176582ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1152304Total
Program Services834507ProgramServices
Management And General317797ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total403267Total
Program Services289754ProgramServices
Management And General113513ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total86470Total
Management And General86470ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total55033Total
Management And General55033ManagementAndGeneral

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)
Total2107834Total
Program Services2056824ProgramServices
Management And General51010ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total37660Total
Program Services98ProgramServices
Management And General37562ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2217647Total
Program Services2042728ProgramServices
Management And General174919ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total124162Total
Program Services31894ProgramServices
Management And General92268ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total610724Total
Program Services556405ProgramServices
Management And General54319ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total28577Total
Program Services23502ProgramServices
Management And General5075ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total8766Total
Program Services3625ProgramServices
Management And General5141ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total330042Total
Management And General330042ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total570120Total
Program Services570120ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total134065Total
Program Services43510ProgramServices
Management And General90555ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBTS10172271017227
MAINTENANCE & REPAIRS28961527763911976
CREDENTIALING71757175
CONTRIBUTIONS257257
COMMUNITY SVCE183183

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total-171698Total
Program Services-258514ProgramServices
Management And General86816ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total14485194Total
Program Services11431269ProgramServices
Management And General3053925ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY259006BOY
EOY187111EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY38862BOY
EOY32614EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2200337BOY
EOY1156594EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY20745BOY
EOY38289EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY437510BOY
EOY443590EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY113303BOY
EOY108643EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis19498451LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec14293709LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5595250BOY
EOY5204742EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY120BOY
EOY120EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8665133BOY
EOY7171703EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2382249BOY
EOY2292567EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY6290661BOY
EOY5948967EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8672910BOY
EOY8241534EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-7777BOY
EOY-1069831EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-7777BOY
EOY-1069831EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8665133BOY
EOY7171703EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1076537ReconcilationRevenueExpenses
Reconcilation Other Changes14483ReconcilationOtherChanges
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 OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$3,355OtherActivitiesAmount
Total Lobbying Expenditures IIB3355TotalLobbyingExpendituresIIB

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierOther Activities DescriptionIdentifier
Return ReferencePart II-B, Line 1iReturnReference
ExplanationThe hospital pays dues to organizations, a portion of which is designated for lobbying: AHA dues $4,309 x 26.13% = $1,126 THA dues $7,621 x 25.98% = 1,979 TORCH dues $2,500 x 10.00% = 250 _____ $3,355Explanation

Schedule D IRS990ScheduleD

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

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis317144OtherCostOrOtherBasis
Book Value317144BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis19181307OtherCostOrOtherBasis
Depreciation14293709Depreciation
Book Value4887598BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis0OtherCostOrOtherBasis
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings5204742TotalOfBookValueLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48 DisclosureIdentifier
Return ReferencePart X, Line 2ReturnReference
ExplanationManagement 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.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
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 Expense231165TotalCommunityBenefitExpense
Net Community Benefit Expense231165NetCommunityBenefitExpense
Percent Of Total Expense0.01600PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense583042TotalCommunityBenefitExpense
Direct Offsetting Revenue573166DirectOffsettingRevenue
Net Community Benefit Expense9876NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense814207TotalCommunityBenefitExpense
Direct Offsetting Revenue573166DirectOffsettingRevenue
Net Community Benefit Expense241041NetCommunityBenefitExpense
Percent Of Total Expense0.01670PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense814207TotalCommunityBenefitExpense
Direct Offsetting Revenue573166DirectOffsettingRevenue
Net Community Benefit Expense241041NetCommunityBenefitExpense
Percent Of Total Expense0.01670PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$641,463BadDebtExpenseAmount
Amount Reimbursed By Medicare5900360AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare5874191CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall26169MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Colorado-Fayette Medical CenterBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1400 Youens DrAddressLine1
CityWeimarCity
StateTXState
ZIP Code78962ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Colorado-Fayette Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Needs Assessment Conducted10NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiesfalseOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
On RequestXOnRequest
Other MethodXOtherMethod
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
All Needs AddressedfalseAllNeedsAddressed
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent275.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Attached To InvoicesXAttachedToInvoices
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Collection ActivitiestrueCollectionActivities
LawsuitXLawsuit
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Other Actions TakenXOtherActionsTaken
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargestrueGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities4NumberOfOtherFacilities

Other Facilities OtherFacilities (4 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Parkview Manor Nurs & Rehab
206 N Smith StWeimarTX78962Skilled and nursing care home
The Homestead
302 Youens DrWeimarTX78962Assisted living center
Schulenburg Community Clinic
511 SummitSchulenbergTX78956Rural health clinic
Flatonia Community Clinic
113 W South Main StFlatoniaTX78941Rural health clinic

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Bad Debt ExpensePart III, Section A, Line 4Excerpt from Audit Note #3: Including bad debts and uncollected accounts, the total amount of uncompensated care was $6,576,996 and $8,759,705 in 2010 and 2009, respectively.
Costing MethodologyPart III, Section B, Line 8Cost to charge ratio is used to determine the amount reported on line 6.
Collection PolicyPart III, Section B, Line 9bThe collection policy currently does not contain explicit provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. However, provisions are detailed in the Charity Care Policy.
Community Health Needs AssessmentPart V, Section B, Line 3To gain input from the community, the hospital sent assessment surveys to local schools and businesses, Health Fair participants, patients of all hospital-related facilities and a select sample of employees.
Needs Assessment AvailabilityPart V, Section B, Line 5cIn addition to making the needs assessment available upon request, the assessment was mailed to interested community groups that had participated in the survey.
Identification of Community NeedsPart V, Section B, Line 7The hospital did not address all of the needs identified in its most recently conducted Needs Assessment because many of the community needs are beyond the financial means of the hospital at this time.
Actions before Initiating Collection ActionsPart V, Section B, Line 17eOther actions the hospital took before initiating collection actions included notifying patients through telephone conversations if possible.
Determination of Amounts BilledPart V, Section B, Line 19dThe hospital determined the amounts billed to individuals who did not have insurance covering emergency or other medically necessary care by using a thirty percent discount intended to approximate the average insurance payment.
Gross Service Charge AmountPart V, Section B, Line 21The hospital charges all patients the same amount regardless of source of payment. Uninsured patients who do not qualify for charity or indigent programs are offered a discount at the point of service.
Needs AssessmentPart VI, Line 2The organization assesses the health care needs of the community through informal observation and community feedback in addition to its formal Community Health Needs Assessment.
Patient Education of Eligibility for AssistancePart VI, Line 3The organization informs and educates patients about their eligbility for assistance under governmental programs or under the charity care policy through written and verbal communication as a part of collection efforts.
Community InformationPart VI, Line 4The organization primarily serves a rural community in Colorado, Fayette and Lavaca Counties. This area specifically includes the towns of Weimar, Schulenburg and Flatonia in addition to numerous smaller communities.
Promotiion of Community HealthPart VI, Line 5The organization furthers its exempt purpose of promoting the health of the community by offering health fairs, immunization programs, education programs, charity care, support groups and pediatric, adult and senior outreach programs. Additional forms of community involvement include: attendance at City Council, Commissioner's Court and School Board meetings; assistance to other not-for-profit organizations such as Parents as Teachers and the American Cancer Society; and recruitment of specialty physicians to the area.
STATE FILING OF COMMUNITY BENEFIT REPORT990 SCHEDULE H, PART VITX,

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Discontinued OperationsForm 990, Part III, Line 3Immediately following the end of the year, effective January 1, 2011, the Hospital discontinued Nursing Home and Assisted Living operations. However, these operations were conducted during the entire 2010 tax year.
Form 990 Review processForm 990, Part VI, Line 11Form 990 is prepared by an independent accounting firm. The preparation and review of the form is a joint process by the CFO and accounting firm.
Conflicts of InterestForm 990, Part VI, Line 12cBoard members and officers are required annually to sign a statement affirming compliance with the conflict of interest policy. When a conflict of interest arises, it must be disclosed to the Board and the person is excused from voting on related matters.
Compensation ReviewForm 990, Part VI, Line 15bThe Board of Directors evaluate the CEO's performance, review the area market comparisons for salaries and vote on level of merit increase. Other top management officials are evaluated by their supervisors on performance. Area market studies and recommended merit increases are sent to the CEO for approval.
Organization DocumentsForm 990, Part VI, Line 19Organizational governing documents, conflict of interest policy and financial statements are made available to the public upon request.`
Other Changes in Net AssetsForm 990, Part XI, Line 5There was a transfer of net assets in the amount of $14,483 from supporting organization Colorado Fayette Medical Foundation to the Medical Center for the purpose of funding operations.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Colorado-Fayette Medical Foundation IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1400 Youens DrAddressLine1
CityWeimarCity
StateTXState
ZIP Code78962ZIPCode
FieldValueIRS element (for citing)
EIN742527874EIN
Primary ActivitiesFin AssistancPrimaryActivities
Legal Domicile StateTXLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status11cPublicCharityStatus
Controlled OrgtrueControlledOrg
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 OrgtrueLoansOrGuaranteesFromOtherOrg
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
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 OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Colorado-Fayette Medical FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeeTransactionType
Amount Involved79217AmountInvolved