STRATEGY STUDIO / PUBLIC DATA EXPLORER

MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT FUND: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT FUND (EIN 23-7374256)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-11
IRS object ID
201133159349301803
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)
Timestamp2011-11-11T08:36:39-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line18800 LYRA DRIVE SUITE 450AddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code43240ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237374256EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MCCULLOUGH-HYDE MEMORIAL INC ENDOWMENT FUNDBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMCCUNameControl
Phone5135232111Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 NORTH POPLARAddressLine1
CityOXFORDCity
StateOHState
ZIP Code45056ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN CLEMENTSName
TitleCFOTitle
Phone5135232111Phone
Date Signed2011-10-24DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameNANCY KIRCHNERName
Phone6148852583Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN CLEMENTSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1110 NORTH POPLAR STREETAddressLine1
CityOXFORDCity
StateOHState
ZIP Code45056ZIPCode
FieldValueIRS element (for citing)
Gross Receipts317983GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MHMH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1942YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTO SUPPORT HEALTH, EDUCATIONAL, AND BUILDING PROGRAMS OF MCCULLOUGH-HYDE MEMORIAL HOSPITALActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI79964TotalGrossUBI
Net Unrelated Business Txbl Income21753NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year715537ContributionsGrantsPriorYear
Contributions Grants Current Year104610ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year-197991InvestmentIncomePriorYear
Investment Income Current Year-31224InvestmentIncomeCurrentYear
Other Revenue Prior Year531401OtherRevenuePriorYear
Other Revenue Current Year79964OtherRevenueCurrentYear
Total Revenue Prior Year1048947TotalRevenuePriorYear
Total Revenue Current Year153350TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY18773GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1062692OtherExpensePriorYear
Other Expenses Current Year595997OtherExpensesCurrentYear
Total Expenses Prior Year1062692TotalExpensesPriorYear
Total Expenses Current Year614770TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-13745RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-461420RevenuesLessExpensesCY
Total Assets BOY9399694TotalAssetsBOY
Total Assets EOY10419036TotalAssetsEOY
Total Liabilities BOY789682TotalLiabilitiesBOY
Total Liabilities EOY1268390TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8610012NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY9150646NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSUPPORT THE HOSPITAL WITH HEALTH PROGRAMS, EDUCATION ASSISTANCE, BUILDING AND EQUIPMENT NEEDSMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense199965Expense
DescriptionSUPPORT FOR MHMH DEVELOPMENT OFFICEDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense158815Expense
DescriptionSUPPORT FOR MHMH CAPITAL NEEDSDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense97244Expense
DescriptionSUPPORT FOR EDUCATION PROGRAMSDescription

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense41888Expense
Grants18773Grants
DescriptionSUPPORT FOR HEALTH PROGRAMSDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp41888TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt18773TotalOfOtherProgramServiceGrnt
Total Program Service Expense497912TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds1DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10962NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJAMES MILLER CONTROLLERNamePerson
Telephone Number5135245310TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1110 NORTH POPLAR STREETAddressLine1
CityOXFORDCity
StateOHState
ZIP Code45056ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
JOHN HARLAND MD
TRUSTEE1.00X000
JACK MANN
TRUSTEE1.00X000
WILLIAM DOUGLAS ROSS DO
TRUSTEE1.00X000
THOMAS W SPEH
TRUSTEE1.00X000
SUSAN CROSS LIPNICKY
VICE CHAIRMAN1.00X000
RICHARD M NORMAN
SECRETARY/TREASURER1.00X000
ALAN OAK
TRUSTEE1.00X000
PAIGE WOOD
TRUSTEE1.00X000
WILLIAM RICHARDSON
CHAIRMAN1.00X000
MICHAEL RUDOLPH
TRUSTEE1.00X000
CHRISTOPHER LAUER
CFO40.00019967213771X
PAMELA COLLINS
CPSO40.0001340037627X
TAMMY WOOD
CAO40.00012757213415X
BRYAN HEHEMANN
CEO40.00022448113836X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs685728TotalReportableCompFrmRltdOrgs
Total Other Compensation48649TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions104610AllOtherContributions
Total Contributions104610TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column133409TotalRevenueColumn
Exclusion$133,409ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real79964Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real79964Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column79964TotalRevenueColumn
Unrelated Business Revenue79964UnrelatedBusinessRevenue

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities164633Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-164633Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-164633TotalRevenueColumn
Related Or Exempt Function Income-164633RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column153350TotalRevenueColumn
Related Or Exempt Function Income-164633RelatedOrExemptFunctionIncome
Unrelated Business Revenue79964UnrelatedBusinessRevenue
Exclusion$133,409ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total17500Total
Program Services17500ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total1273Total
Program Services1273ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total56999Total
Program Services11051ProgramServices
Management And General45948ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total19806Total
Management And General19806ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total28025Total
Program Services13325ProgramServices
Management And General14700ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total2117Total
Management And General2117ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total250Total
Management And General250ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total32553Total
Management And General32553ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
TRUST FUNDED DEVELOPMEN163091163091
BUILDING AND FACILITY P158815158815
EDUCATION PROGRAMS9724497244
HEALTH PROGRAM FUNDING3552635526
MINOR EQUIPMENT750750

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total821Total
Program Services87ProgramServices
Management And General734ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total614770Total
Program Services497912ProgramServices
Management And General116858ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY349028BOY
EOY490123EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY52194BOY
EOY33990EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY8500EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis736546LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec401723LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY368705BOY
EOY334823EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY8626691BOY
EOY9551600EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3076BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY9399694BOY
EOY10419036EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY789682BOY
EOY1268390EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY789682BOY
EOY1268390EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY6532244BOY
EOY7177347EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY349770BOY
EOY223380EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1727998BOY
EOY1749919EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8610012BOY
EOY9150646EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9399694BOY
EOY10419036EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-461420ReconcilationRevenueExpenses
Reconcilation Other Changes1002053ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
EIN310650283EIN
Type Of Organization509(A)(3)(A)TypeOfOrganization
Listed In Governing Doc0ListedInGoverningDoc
Organized In US1OrganizedInUS
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

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 D IRS990ScheduleD

FieldValueIRS element (for citing)
Number DA Fs Held8NumberDAFsHeld
Donor Advised Contributions41742DonorAdvisedContributions
Grants Paid From Donor Funds138000GrantsPaidFromDonorFunds
Aggregate DAF Value74845AggregateDAFValue
Disclosed Orgs Legal Control1DisclosedOrgsLegalControl
Disclosed For Charitable Purposes1DisclosedForCharitablePurposes

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance8626691BeginningOfYearBalance
Contributions137514Contributions
Investment Earnings Or Losses970829InvestmentEarningsOrLosses
Other Expenditures183434OtherExpenditures
End Of Year Balance9551600EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1355625BeginningOfYearBalance
Contributions372373Contributions
Investment Earnings Or Losses-106739InvestmentEarningsOrLosses
Other Expenditures5854OtherExpenditures
End Of Year Balance1615405EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance8858166BeginningOfYearBalance
Contributions1086641Contributions
Investment Earnings Or Losses-2429378InvestmentEarningsOrLosses
Other Expenditures335316OtherExpenditures
End Of Year Balance7180113EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.79100BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.18600PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.02300TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis87300InvestmentCostOrOtherBasis
Book Value87300BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis604395InvestmentCostOrOtherBasis
Depreciation380362Depreciation
Book Value224033BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis30981InvestmentCostOrOtherBasis
Depreciation9232Depreciation
Book Value21749BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis13870InvestmentCostOrOtherBasis
Depreciation12129Depreciation
Book Value1741BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings334823TotalOfBookValueLandBuildings

Other Securities OtherSecurities (3 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
CASH & CASH EQUIVALENTS217612F
MARKETABLE EQUITY SECURITIES6502990F
GOVERNMENT & CORPORATE OBLIGATIONS2830998F
FieldValueIRS element (for citing)
Total Of Book Value Securities9551600TotalOfBookValueSecurities

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:Identifier
Return ReferencePART V, LINE 4:ReturnReference
ExplanationHEALTH EDUCATION, HOSPITAL EQUIPMENT, COMMUNITY HEALTHExplanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
SANE OF BUTLER COUNTY
PO BOX 390OXFORDOH45056204253386501(C)(3)7500HEALTH CLINIC
OXFORD FREE CLINIC
PO BOX 18818FAIRFIELDOH4501831160403610000HEALTH CLINIC
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required0SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CHRISTOPHER LAUER
01777520137330818700013771021344300
BRYAN HEHEMANN
0220014000446700013836023831700

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11THE 990 IS PROVIDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW AND APPROVAL. THE RETURN IS THEN PRESENTED TO THE ENTIRE BOARD FOR FINAL APPROVAL.
ANNUAL QUESTIONAIRE FROM CORPORATE COMPLIANCE COMMITTEEFORM 990, PART VI, SECTION B, LINE 12C
THE PROCESS FOR DETERMINING COMPENSATION INCLUDES INDEPENDENT CONSULTANT INPUT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY STUDY AND APPROVAL BY THE BOARD.FORM 990, PART VI, SECTION B, LINE 15
THE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 1,002,053.FORM 990, PART XI, LINE 5:
THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1110 N POPLAR STREETAddressLine1
CityOXFORDCity
StateOHState
ZIP Code45056ZIPCode
FieldValueIRS element (for citing)
EIN310650283EIN
Primary ActivitiesHOSPITALPrimaryActivities
Legal Domicile StateOHLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity StatusLINE 3PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1MCCULLOUGH-HYDE MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeOTransactionType