MADISON COUNTY HOSPITAL HEALTH SYSTEMS INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MADISON COUNTY HOSPITAL HEALTH SYSTEMS INC (EIN 59-2319288)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-08-08
- IRS object ID
- 202312209349301676
- Schema version
- 2021v4.0
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-08-08T16:27:45-04:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 580914992 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317081309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 592319288 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADISON COUNTY HOSPITAL HEALTH | BusinessNameLine1Txt |
| Business Name Line2 | SYSTEMS INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MADI | BusinessNameControlTxt |
| Phone | 8509732271 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 224 NW CRANE AVENUE | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 323401400 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PATRICK MCGEE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8509732271 | PhoneNum |
| Signature | 2023-08-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | PATRICK | PersonFirstNm |
| Person Last | MCGEE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WILLIAM EDWARD PHILLIPS | PreparerPersonNm |
| PTIN | P00451499 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2023-08-08 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADISON COUNTY MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TAMMY STEVENS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 224 NW CRANE AVENUE | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 323401400 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,259,785 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MCMH.US | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1938 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITY WHICH IT SERVES. THESE SERVICES INCLUDE ACUTE GENERAL INPATIENT AND OUTPATIENT CARE, SWING BED, ENDOSCOPY, PHYSICAL THERAPY AND OTHER RELATED SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 213 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $5,949,359 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,523,534 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,131,797 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,358,498 | CYProgramServiceRevenueAmt |
| PY Investment Income | $55,147 | PYInvestmentIncomeAmt |
| CY Investment Income | -$43,452 | CYInvestmentIncomeAmt |
| PY Other Revenue | $131,798 | PYOtherRevenueAmt |
| CY Other Revenue | $128,584 | CYOtherRevenueAmt |
| PY Total Revenue | $16,268,101 | PYTotalRevenueAmt |
| CY Total Revenue | $14,967,164 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,376,769 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,448,595 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,515,511 | PYOtherExpensesAmt |
| CY Other Expenses | $7,486,724 | CYOtherExpensesAmt |
| PY Total Expenses | $13,892,280 | PYTotalExpensesAmt |
| CY Total Expenses | $13,935,319 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,375,821 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,031,845 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $21,232,395 | TotalAssetsBOYAmt |
| Total Assets EOY | $21,963,320 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $22,790,038 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $22,491,840 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$1,557,643 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$528,520 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITY WHICH IT SERVES. THESE SERVICES INCLUDE ACUTE GENERAL INPATIENT AND OUTPATIENT CARE, SWING BED, ENDOSCOPY, PHYSICAL THERAPY AND OTHER RELATED SERVICES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $11,769,505 | ExpenseAmt |
| Revenue | $11,358,498 | RevenueAmt |
| Desc | THE HOSPITAL IS A 25-BED CRITICAL ACCESS FACILITY LICENSED BY THE STATE OF FLORIDA THROUGH THE AGENCY FOR HEALTHCARE ADMINISTRATION. THE HOSPITAL OFFERS SERVICES SUCH AS ROUTINE RADIOLOGY, ENDOSCOPY, MAMMOGRAPHY, ULTRASOUND, LABORATORY, RESPIRATORY THERAPY, 24 HOUR EMERGENCY ROOM, SWING BED SERVICES, OUTPATIENT REHABILITATION, AND AN ACUTE CARE SETTING FOR PATIENTS. | Desc |
| Total Program Service Expenses | $11,769,505 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 213 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PATRICK MCGEE | PersonNm |
| Phone | 8509732271 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 224 NW CRANE AVENUE | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 323401400 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| DANIEL PERKINS MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $211,530 | $0 | $32,906 | |||
| LUCILLA STRICKLAND | ||||||||
| NURSE PRACTI | 40.00 | Yes (X) | $214,475 | $0 | $1,618 | |||
| TAMMY STEVENS | ||||||||
| CEO | 40.00 | $182,224 | $0 | $1,369 | 1.00 | Yes (X) | ||
| SARAH ALLEN | ||||||||
| MANAGER | 40.00 | Yes (X) | $102,282 | $0 | $18,804 | |||
| PATRICK MCGEE | ||||||||
| CFO | 40.00 | $105,582 | $0 | $9,784 | 1.00 | Yes (X) | ||
| CYNTHIA BURNETT | ||||||||
| HRO | 40.00 | $81,833 | $0 | $16,159 | Yes (X) | |||
| BRITTANY SELPH | ||||||||
| CNO | 40.00 | $79,522 | $0 | $7,795 | Yes (X) | |||
| JUANITA WEBB FICO | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| BEN HARRIS | ||||||||
| CHAIR | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| KAREN ANNETTE JOHNSON | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| SHIRLEY JOSEPH | ||||||||
| VICE CHAIR | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| ROSA RICHARDSON | ||||||||
| SECRETARY | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| JIM SALE | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $977,448 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $88,435 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CMS IMAGING INC | |||||
| 4050 AZALEA DRIVE | NORTH CHARLESTON | SC | 294057528 | RADIOLOGY | $429,911 |
| MCKESSON | |||||
| PO BOX 936279 | ATLANTA | GA | 31193 | MEDICAL EQUIP | $429,246 |
| SOUTHLAND EMERGENCY MED SVCS | |||||
| PO BOX 5218 | NICEVILLE | FL | 325785218 | ER PHYSICIANS | $276,000 |
| FUKUDA DENSHI USA INC | |||||
| 17725-C NW 65TH ST | REDMOND | WA | 98052 | MEDICAL EQUIP | $227,613 |
| MADISON RADIOLOGY SERVICES PA | |||||
| 3034 NW 66TH BLVD | JENNINGS | FL | 320534246 | RADIOLOGIST | $227,128 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,473,534 | GovernmentGrantsAmt |
| All Other Contributions | $50,000 | AllOtherContributionsAmt |
| Total Contributions | $3,523,534 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICES | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $11,358,498 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,358,498 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,358,498 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,219 | TotalRevenueColumnAmt |
| Exclusion | $22,219 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $226,950 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $292,621 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$65,671 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$65,671 | TotalRevenueColumnAmt |
| Exclusion | -$65,671 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EMPLOYEE LEASE INCOME | 621990 | $66,872 | $66,872 |
| MISCELLANEOUS REVENUE | 621990 | $55,813 | $55,813 |
| DISCOUNTS | 621990 | $3,480 | $3,480 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,419 | TotalRevenueColumnAmt |
| Exclusion | $2,419 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $128,584 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,967,164 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,484,663 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | -$41,033 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $484,268 | TotalAmt |
| Management And General | $484,268 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,189,062 | TotalAmt |
| Program Services | $4,790,483 | ProgramServicesAmt |
| Management And General | $398,579 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,300 | TotalAmt |
| Program Services | $14,125 | ProgramServicesAmt |
| Management And General | $1,175 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $343,093 | TotalAmt |
| Program Services | $316,743 | ProgramServicesAmt |
| Management And General | $26,350 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $416,872 | TotalAmt |
| Program Services | $384,856 | ProgramServicesAmt |
| Management And General | $32,016 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,970 | TotalAmt |
| Management And General | $37,970 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,576 | TotalAmt |
| Management And General | $83,576 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,087,133 | TotalAmt |
| Program Services | $1,911,515 | ProgramServicesAmt |
| Management And General | $175,618 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,939 | TotalAmt |
| Program Services | $1,149 | ProgramServicesAmt |
| Management And General | $7,790 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $789,531 | TotalAmt |
| Program Services | $698,134 | ProgramServicesAmt |
| Management And General | $91,397 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,507 | TotalAmt |
| Program Services | $22,507 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,278,205 | TotalAmt |
| Program Services | $1,000,195 | ProgramServicesAmt |
| Management And General | $278,010 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,212 | TotalAmt |
| Program Services | $28,867 | ProgramServicesAmt |
| Management And General | $1,345 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,643 | TotalAmt |
| Program Services | $10,132 | ProgramServicesAmt |
| Management And General | $4,511 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,160 | TotalAmt |
| Management And General | $9,160 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,444,898 | TotalAmt |
| Program Services | $1,130,633 | ProgramServicesAmt |
| Management And General | $314,265 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,415 | TotalAmt |
| Program Services | $9,931 | ProgramServicesAmt |
| Management And General | $43,484 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $858,679 | $858,679 | |
| REPAIRS & MAINTENANCE | $513,955 | $513,955 | |
| FINES & ASSESSMENTS | $134,426 | $134,426 | |
| LICENSE & FEES | $68,884 | $56,146 | $12,738 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,591 | TotalAmt |
| Program Services | $21,455 | ProgramServicesAmt |
| Management And General | $29,136 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,935,319 | TotalAmt |
| Program Services | $11,769,505 | ProgramServicesAmt |
| Management And General | $2,165,814 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,633 | BOYAmt |
| EOY | $450 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,813,980 | BOYAmt |
| EOY | $6,320,610 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,234,224 | BOYAmt |
| EOY | $860,269 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $442,743 | BOYAmt |
| EOY | $406,126 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $26,995,123 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,619,419 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,054,687 | BOYAmt |
| EOY | $14,375,704 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $677,128 | BOYAmt |
| EOY | $161 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,232,395 | BOYAmt |
| EOY | $21,963,320 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,446,420 | BOYAmt |
| EOY | $1,119,029 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $63,179 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,074,477 | BOYAmt |
| EOY | $20,756,477 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,555 | BOYAmt |
| EOY | $185,978 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $218,586 | BOYAmt |
| EOY | $170,586 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $196,591 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,790,038 | BOYAmt |
| EOY | $22,491,840 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,512,562 | BOYAmt |
| EOY | -$1,619,206 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $954,919 | BOYAmt |
| EOY | $1,090,686 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,557,643 | BOYAmt |
| EOY | -$528,520 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,232,395 | BOYAmt |
| EOY | $21,963,320 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,031,845 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$2,722 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | Yes (true) | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $582 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $582 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS MEMBERSHIP DUES TO STATE ORGANIZATIONS. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THAT ORGANIZATION PARTICIPATES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $954,919 | BeginningYearBalanceAmt |
| Contributions | $1,285,034 | ContributionsAmt |
| Investment Earnings Or Losses | $11,712 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,160,979 | OtherExpendituresAmt |
| End Year Balance | $1,090,686 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $826,471 | BeginningYearBalanceAmt |
| Contributions | $1,290,128 | ContributionsAmt |
| Investment Earnings Or Losses | $1,620 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,163,300 | OtherExpendituresAmt |
| End Year Balance | $954,919 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $695,625 | BeginningYearBalanceAmt |
| Contributions | $1,282,700 | ContributionsAmt |
| Investment Earnings Or Losses | $10,253 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,162,107 | OtherExpendituresAmt |
| End Year Balance | $826,471 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $570,570 | BeginningYearBalanceAmt |
| Contributions | $1,266,087 | ContributionsAmt |
| Investment Earnings Or Losses | $20,379 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,161,411 | OtherExpendituresAmt |
| End Year Balance | $695,625 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $445,198 | BeginningYearBalanceAmt |
| Contributions | $985,898 | ContributionsAmt |
| Investment Earnings Or Losses | $29,690 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $890,216 | OtherExpendituresAmt |
| End Year Balance | $570,570 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $470,000 | OtherCostOrOtherBasisAmt |
| Book Value | $470,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,808,889 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,973,449 | DepreciationAmt |
| Book Value | $10,835,440 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $284,197 | OtherCostOrOtherBasisAmt |
| Depreciation | $140,328 | DepreciationAmt |
| Book Value | $143,869 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,248,422 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,505,642 | DepreciationAmt |
| Book Value | $2,742,780 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $183,615 | OtherCostOrOtherBasisAmt |
| Book Value | $183,615 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,375,704 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD PARTY SETTLEMENTS | Desc |
| Amt | $196,591 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $196,591 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $13,065,025 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$852,139 | OtherRevenueAmt |
| Revenue Not Reported | -$852,139 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,917,164 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,050,000 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,050,000 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $14,967,164 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $13,083,180 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $13,083,180 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $852,139 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $852,139 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $13,935,319 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 2, PART V, LINE 4 | THESE FUNDS ARE HELD BY MADISON COUNTY AND REPRESENT THE SURTAX COLLECTED FOR THE PURPOSE OF PAYMENT OF HOSPITAL REVENUE BOND PRINCIPAL AND INTEREST. |
| SCHEDULE D, PAGE 3, PART X | THE DISTRICT IS A GOVERNMENTAL ENTITY AND IS EXEMPT FROM INCOME TAXES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN CONSIDERED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION EXEMPT FROM INCOME TAXES, EXCEPT ON UNRELATED BUSINESS INCOME, UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOSPITAL APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE HOSPITAL ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF SEPTEMBER 30, 2022 AND 2021 OR FOR THE YEARS THEN ENDED. THE HOSPITAL'S TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. |
| SCHEDULE D, PAGE 4, PART XI, LINE 2D | INTEREST EXPENSE -852,139 |
| SCHEDULE D, PAGE 4, PART XI, LINE 4B | CAPITAL CONTRIBUTIONS 1,050,000 |
| SCHEDULE D, PAGE 4, PART XII, LINE 4B | INTEREST EXPENSE 852,139 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 1.250000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | false | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $223,788 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $223,788 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01610 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,645,573 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,777,409 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,869,361 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,777,409 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $223,788 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01610 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,157 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,157 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,157 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,157 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,874,518 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,777,409 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $228,945 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01640 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,666,902 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $5,909,318 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,890,450 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $18,868 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | false | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADISON COUNTY MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 224 NW CRANE AVENUE | AddressLine1Txt |
| City | MADISON | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 323401400 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MCMH.US | WebsiteAddressTxt |
| State License | 4346 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | SWING BED SNF | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADISON COUNTY MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 20 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.MCMH.US | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.MCMH.US | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 125.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.MCMH.US | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.MCMH.US | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.MCMH.US | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, MADISON COUNTY MEMORIAL HOSPITAL - PART V, LINE 3E | THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IS IDENTIFIED AND THE METHODOLOGY FOR PRIORITIZING EACH NEED IS DESCRIBED ON PAGES 11-13 OF THE 2020 CHNA. |
| FACILITY 1, MADISON COUNTY MEMORIAL HOSPITAL - PART V, LINE 5 | MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) PROCESS AN OVERVIEW OF THE MAPP PROCESS HAS BEEN SHARED AND SERVES AS A RESOURCE TO CLASSIFY THE PRIORITIES OF THE COMMUNITY AND TO IDENTIFY RESOURCES TO DEVELOP COMMUNITY ACTION. THIS STRATEGIC PLANNING TOOL, DRIVEN BY THE COMMUNITY, IS CONDUCTED TO ASSESS THE HEALTH WITHIN THE COMMUNITY. THE PURPOSE IS TO IDENTIFY ISSUES AND TO IMPROVE PUBLIC WELLBEING. THE MAPP PROCESS ALTERS HOW WE SEE PUBLIC HEALTH PLANNING AND CREATES A HEALTH MODEL FOCUSED ON THE COMMUNITY AT LARGE. DUE TO COVID-19, THE MAPP PROCESS WAS CONDUCTED VIRTUALLY WITH PARTICIPATION FROM AGENCIES THROUGHOUT THE AREA TO VIEW PRESENTATIONS, PROVIDE FEEDBACK, AND SIGN UP TO PARTICIPATE IN CHIP COMMITTEES OVER THE NEXT THREE YEARS. AS TRADITIONALLY IMPLEMENTED, THE MADISON COUNTY DEPARTMENT OF HEALTH AND MCMH CONDUCTED THE COMMUNITY ASSESSMENT SURVEY (CAS) DURING THE FIRST QUARTER OF 2020. A RANDOM LIST OF ADDRESSES WAS PULLED BY THE CITY CLERK TO IDENTIFY A DIVERSE MIX OF AGE, ETHNICITY, AND GENDER. POSTCARDS WERE SENT OUT TO ADVISE COMMUNITY MEMBERS ABOUT THE UPCOMING SURVEY. A MAILER WAS DISTRIBUTED WITH THE SURVEY AND INCLUDED A RETURN STAMPED ENVELOPE. LAST, A REMINDER WAS MAILED TO FURTHER ENCOURAGE PARTICIPATION. AN ANALYSIS OF THIS ASSESSMENT IS CURRENTLY UNDER REVIEW BY DOH-M. DUE TO THEIR EXPANDED ROLE IN COVID TESTING AND TRACKING THE CAS IS GOING TO BE DISTRIBUTED DURING THE PLANNING MEETING IN JANUARY 2021. THE MAPP PROCESS WAS ENRICHED TO INCLUDE EXPANDED PARTICIPATION WITH THE MADISON COUNTY DEVELOPMENT COUNCIL (MCDC) IN A STUDY WITH UNIVERSITY OF FLORIDA (UF) TO UNITE A DIVERSE GROUP OF STAKEHOLDERS IN A COLLABORATIVE EFFORT TO REVIEW THE STRENGTHS, WEAKNESSES, CHALLENGES, AND OPPORTUNITIES. THIS TOO INCLUDED A COMMUNITY ASSESSMENT SURVEY THAT ASKED SIMILAR BUT DIFFERENT QUESTIONS. AN EXCERPT IS PROVIDED IN THE ATTACHMENTS. THIS PROCESS BEGAN IN 2019 AND IS ACTIVE TODAY. FEEDBACK WAS OBTAINED FROM 171 SURVEY PARTICIPANTS. A COMMUNITY FORUM WAS HELD ON MARCH 28, 2019 AT THE CHURCH OF GOD IN MADISON COUNTY, WHERE APPROXIMATELY 90 PEOPLE ATTENDED TO PARTICIPATE IN DISCUSSIONS, BREAKOUT SESSIONS, AND PRIORITY VOTING. CONSEQUENTLY, MANY OF THE THEMES BUILT INTO THE EFFORTS OF THIS STAKEHOLDER GROUP ARE DESIGNED TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. THE SURVEY WAS DISTRIBUTED AND PUBLISHED ON-LINE UTILIZING THE MADISON COUNTY CHAMBER OF COMMERCE SURVEY MONKEY ACCOUNT. THE LINK WAS SHARABLE THROUGH WEBSITES, E-MAIL, AND SOCIAL NETWORKING. HARD COPIES WERE AVAILABLE FOR THOSE WITHOUT ACCESS TO INTERNET. RUNNING TIME FOR THE SURVEY WAS JANUARY 2019 TO MARCH 10, 2019. THE PURPOSE OF THE SURVEY WAS TO DETERMINE MADISONS GREATEST CHALLENGES. THESE CHALLENGES WERE USED AS A FOUNDATION FOR DISCUSSION AT THE COMMUNITY FORUM. |
| FACILITY 1, MADISON COUNTY MEMORIAL HOSPITAL - PART V, LINE 6B | THE DEPARTMENT OF HEALTH IN MADISON COUNTY AND THE MADISON COUNTY MEMORIAL HOSPITAL HAVE COLLABORATED TO PRODUCE THE 2020 COMMUNITY HEALTH NEEDS ASSESSMENT FOR MADISON COUNTY. THIS MEETS THE REQUIREMENTS FOR BOTH ENTITIES TO INVOLVE THE COMMUNITY IN A PARTICIPATORY PROCESS TO PLAN HEALTH PRIORITIES FOR THE NEXT THREE YEARS. |
| FACILITY 1, MADISON COUNTY MEMORIAL HOSPITAL - PART V, LINE 11 | WHILE ALL OF THE HEALTH INDICATORS ARE IMPORTANT, THE COMMUNITY PARTICIPANTS WERE ASKED TO CHOOSE THREE AREAS THAT WOULD BE ADDRESSED BY THE DEVELOPMENT OF THE 2021-2023 COMMUNITY HEALTH IMPROVEMENT PLAN. PARTICIPANTS VOTED DURING THE COMMUNITY HEALTH ASSESSMENT AND THE AREAS CHOSEN TO ADDRESS WERE CHRONIC DISEASES, SOCIAL DETERMINANTS OF HEALTH, AND BEHAVIORAL & MENTAL HEALTH. MCMH HAS LIMITED RESOURCES AND DEFERS OTHER IDENTIFIED NEEDS TO ORGANIZATIONS BETTER EQUIPPED TO DEAL WITH THE ISSUES. THE INDIVIDUAL COMMUNITY ORGANIZATIONS WILL CONTINUE TO ADDRESS OTHER ISSUES, SUCH AS INFRASTRUCTURE AND PUBLIC SAFETY, TOURISM, RECREATION AND NATURAL RESOURCES BOTH SEPARATELY AND AS AN INTEGRATED ENTITY WHEN APPLICABLE. |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7 | COSTS FOR PART I, LINE 7A AND 7B WERE DETERMINED USING THE RCC CALCULATED IN WORKSHEET 2. OTHER COSTS WERE OBTAINED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. |
| SCHEDULE H, PART III, LINE 2 | AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT HAVE BEEN MADE. SEE FOONTNOTE 2 IN THE ATTACHED AUDITED FINANCIAL STATMENTS. |
| SCHEDULE H, PART III, LINE 4 | THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON AN EVALUATION OF THE OVERALL COLLECTABILITY OF THE ACCOUNTS RECEIVABLE. AS ACCOUNTS ARE KNOWN TO BE UNCOLLECTIBLE, THE ACCOUNTS ARE CHARGED AGAINST THE ALLOWANCE. |
| SCHEDULE H, PART III, LINE 8 | MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. |
| SCHEDULE H, PART III, LINE 9B | FOR PATIENTS WHO QUALIFY FOR CHARITY CARE AND FULL FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY, THERE IS NO FINANCIAL OBLIGATION AND THE ACCOUNT IS WRITTEN OFF. FOR THOSE WHO QUALIFY FOR PARTIAL FINANCIAL ASSISTANCE, COLLECTION PROCEDURES FOLLOW THE SAME PROCESS AS ALL OTHER PATIENTS WHO ARE RESPONSIBLE FOR UNPAID BALANCES. |
| SCHEDULE H, PART VI, LINE 2 | THE HOSPITAL COLLABORATES WITH NUMEROUS NOT-FOR-PROFIT AGENCIES AND PROGRAMS TO EXTEND AND STRENGTHEN OUR MISSION. THE ORGANIZATION CONTINUALLY CONDUCTS VARIOUS TYPES OF ASSESSMENTS TO DETERMINE THE COMMUNITY'S NEEDS FOR HEALTH AND PERSONAL SUPPORT SERVICES. BOTH THE CHNA AND IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING WEBSITE ADDRESS: HTTPS://WWW.MCMH.US/MORE/HEALTH-IMPROVE/ |
| SCHEDULE H, PART VI, LINE 3 | THE HOSPITAL HAS CLEARLY WRITTEN FINANCIAL ASSISTANCE POLICIES POSTED IN THE BUSINESS OFFICE, ER REGISTRATION AREA, AND OUTPATIENT REGISTRATION AREA. SIGNS ARE PROMINENTLY POSTED ON THE AVAILABILITY OF FREE AND FINANCIAL AID. PATIENT EDUCATION ON THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAMS ARE CONDUCTED DURING REGISTRATION AND/OR THROUGH FLOOR VISITS BY CASE MANAGERS AND COLLECTIONS REPRESENTATIVES FOR PATIENTS THAT HAVE CONCERNS IN MEETING THE FINANCIAL OBLIGATIONS FOR SERVICES PROVIDED. |
| SCHEDULE H, PART VI, LINE 4 | THE ORGANIZATION SERVES POPULATIONS WITHIN MADISON COUNTY, INCLUDING THE CITIES OF MADISON, GREENVILLE, PINETTA, AND LEE, FLORIDA. MADISON COUNTY'S POPULATION OF APPROXIMATELY 19,420, HAS A MEDIAN AGE OF 45, A MEDIAN HOUSEHOLD INCOME OF 37,037, PERSONS LIVING IN POVERTY 22.7%, AND IS 54% CAUCASIAN, 40% AFRICAN AMERICAN, 6% HISPANIC AND THE REMAINING PERCENTAGE OTHER. |
| SCHEDULE H, PART VI, LINE 5 | THE ORGANIZATION'S VOLUNTEER BOARD IS COMPOSED OF COMMUNITY MEMBERS WITH DIVERSE PROFESSIONAL AND COMMUNITY SERVICE BACKGROUNDS. THE HOSPITAL OPERATES A FULL-TIME EMERGENCY ROOM WHICH ACCEPTS ALL IN NEED OF EMERGENCY MEDICAL TREATMENT, REGARDLESS OF ABILITY TO PAY. MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. EXCESS FUNDS FROM OPERATIONS ARE REINVESTED INTO THE HOSPITAL'S SERVICES AND EXPANSION OR REPLACEMENT OF FACILITIES AND EQUIPMENT. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| DANIEL PERKINS MD | ||||
| PHYSICIAN | $200,330 | $11,200 | $32,906 | $244,436 |
| LUCILLA STRICKLAND | ||||
| NURSE PRACTITIONER | $204,275 | $10,200 | $1,618 | $216,093 |
| TAMMY STEVENS | ||||
| CEO | $172,024 | $10,200 | $1,369 | $183,593 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADISON COUNTY HEALTH AND HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | SERIES 2014 BONDS | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 592319288 | BondIssuerEIN |
| CUSIP | NONENONEN | CUSIPNum |
| Bond Issued | 2014-10-30 | BondIssuedDt |
| Issue Price | $22,543,400 | IssuePriceAmt |
| Purpose | PAYOFF SERIES 2012 NOTES PAYABLE THAT WERE USED FOR NEW HOSPITAL CONSTRUCTION. | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,741,000 | RetiredAmt |
| Total Proceeds | $22,543,400 | TotalProceedsAmt |
| Other Spent Proceeds | $22,543,400 | OtherSpentProceedsAmt |
| Substantial Completion | 2015 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (true) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | false | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | false | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | Yes (true) | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | false | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | false | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PURPOSE OF ISSUE DESCRIPTION | FormAndLineReferenceDesc |
| Explanation | MADISON COUNTY HEALTH AND HOSPITAL PAYOFF SERIES 2012 NOTES PAYABLE THAT WERE USED FOR NEW HOSPITAL CONSTRUCTION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 7A | MEMBERS OF THE MADISON COUNTY HEALTH AND HOSPITAL BOARD (DISTRICT), A STATUTORY SPECIAL DISTRICT ORGANIZED UNDER SECTION 2003-333 OF THE LAWS OF FLORIDA FOR THE PURPOSE OF PROVIDING PUBLIC HEALTH CARE SERVICES, SERVE AS DIRECTORS OF THE FILING ORGANIZATION. THE DISTRICT HAS A SEVEN-MEMBER GOVERNING BOARD THAT IS APPOINTED BY THE GOVERNOR OF THE STATE OF FLORIDA. |
| FORM 990, PAGE 6, PART VI, LINE 7B | AS THE MADISON COUNTY HEALTH AND HOSPITAL BOARD (DISTRICT), THE TAXING AUTHORITY, SHARE THE SAME BOARD MEMBERS AS THE FILING ORGANIZATION, ALL ACTIONS AND DECISIONS ARE SUBJECT TO THE APPROVAL OF THE DISTRICT BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS REVIEWED BY THE HOSPITAL'S CFO BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. A COPY OF THE FORM 990 WILL BE AVAILABLE TO BE REVIEWED BY THE BOARD MEMBERS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE PERFORMANCE IMPROVEMENT DIRECTOR OF MCMH, DEBBIE THOMAS, SERVES AS THE CORPORATE COMPLIANCE OFFICER. THE CONFLICT OF INTEREST POLICY IS PART OF THE MADISON COUNTY HOSPITAL HEALTH SYSTEMS, INC.S CODE OF CONDUCT. THE CONFLICT POLICY INCLUDES ALL EMPLOYEES, HOSPITAL BOARD MEMBERS, AND VOLUNTEERS. ALL EMPLOYEES, BOARD MEMBERS, AND VOLUNTEERS MUST INFORM ADMINISTRATION ABOUT ALL POSSIBLE CONFLICTS OF INTEREST. IF ANY CONFLICT OF INTEREST POSSIBLY EXISTS IN THE ORGANIZATION, THE CORPORATE COMPLIANCE OFFICER WILL MAKE SENIOR MANAGEMENT AND THE CORPORATE COMPLIANCE BOARD AWARE IMMEDIATELY. THE DETERMINATION OF A CONFLICT IS REVIEWED BY HOSPITAL SENIOR MANAGEMENT (AND FURTHER DISCUSSED AT THE QUARTERLY CORPORATE COMPLIANCE MEETING IF NEEDED FOR FURTHER DETERMINATION). AFTER A DETERMINATION IS MADE OF A CONFLICTS EXISTENCE, SENIOR MANAGEMENT TAKES WHATEVER ACTION NECESSARY TO SOLVE THE PROBLEM INCLUDING DISCIPLINARY ACTION AND/OR TERMINATION. THE ADMINISTRATION/SENIOR MANAGEMENT DETERMINATION PROCESS WILL NOT INCLUDE ANY HOSPITAL MEMBER WHO IS PART OF THE CONFLICT. ALL CONFLICT INFORMATION WILL BE DELIVERED TO AND SHARED WITH THE CORPORATE COMPLIANCE TEAM AT THE QUARTERLY CORPORATE COMPLIANCE MEETING. BOARD DIRECTORS ABIDE BY A CONFLICT OF INTEREST POLICY, THE TERMS OF WHICH ARE SET FORTH IN THE BYLAWS. BOARD MEMBERS ARE PROHIBITED FROM VOTING IN AN OFFICIAL CAPACITY ON ANY MEASURES WHICH WOULD INURE TO PRIVATE GAIN OR LOSS, WHETHER DIRECT OR INDIRECT. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS WHO USE AN INDUSTRY AVERAGE GUIDE AS A REFERENCE TO DETERMINE EQUITABLE COMPENSATION. MINUTES OF THE BOARD MEETINGS, INCLUDING THOSE IN WHICH COMPENSATION IS DISCUSSED ARE KEPT ON A REGULAR BASIS. THIS COMPENSATION DETERMINATION WAS LAST PERFORMED IN JULY 2021. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR 748,165 96,022 0 PROFESSIONAL FEES 1,163,350 0 0 PURCHASED SERVICES 0 79,596 0 TOTAL 1,911,515 175,618 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MADISON CO HLTH & HOSPITAL DISTRICT | ||||||||||
| 224 NW CRANE AVENUE | MADISON | FL | 323401400 | 592319288 | TAX AUTHOR | FL | 501C3 | 3 | NA | false |
| FRIENDS OF THE HOSPITAL INC | ||||||||||
| 224 NW CRANE AVENUE | MADISON | FL | 323401400 | 272007199 | FOUNDATION | FL | 501C3 | 7 | NA | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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