NORTHWEST MEDICAL CENTER INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- NORTHWEST MEDICAL CENTER INC (EIN 32-0453405)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-12
- IRS object ID
- 202003179349304205
- Schema version
- 2019v5.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-12T11:47:31-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 454084437 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARREN AVERETT LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 ACTON ROAD | AddressLine1Txt |
| City | BIRMINGHAM | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 35243 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320453405 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWEST MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 2054877726 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1530 US HIGHWAY 43 | AddressLine1Txt |
| City | WINFIELD | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 35594 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JIM DICKINSON | PersonNm |
| Person Title | CHAIRMAN | PersonTitleTxt |
| Phone | 2054877726 | PhoneNum |
| Signature | 2020-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MEGAN RANDOLPH | PreparerPersonNm |
| PTIN | P00989558 | PTIN |
| Phone | 2059794100 | PhoneNum |
| Preparation | 2020-11-11 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 99.4.118.175 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-11 | IPDt |
| IP Tm | 14:29:16 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 476F2095544EC66BFD9F846A02B49E10FDD1659F | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | EAECE24E0AA866986F118FE911069C5045BA6FD0 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JIM DICKINSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1530 US HIGHWAY 43 | AddressLine1Txt |
| City | WINFIELD | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 35594 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $17,411,383 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NORTHWESTMEDCENTER.NET | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2014 | FormationYr |
| Legal Domicile State | AL | LegalDomicileStateCd |
| Activity Or Mission | NORTHWEST MEDICAL CENTER, INC., SEEKS TO IDENTIFY AND SERVE THE PRIMARY HEALTHCARE NEEDS OF INPATIENTS, OUTPATIENTS, SURGICAL, AND ER PATIENTS IN A RURAL ENVIRONMENT. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 308 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $26,071,347 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,828,559 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $310,202 | PYOtherRevenueAmt |
| CY Other Revenue | $582,824 | CYOtherRevenueAmt |
| PY Total Revenue | $26,381,549 | PYTotalRevenueAmt |
| CY Total Revenue | $17,411,383 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,826,894 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,355,191 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $17,904,596 | PYOtherExpensesAmt |
| CY Other Expenses | $10,500,798 | CYOtherExpensesAmt |
| PY Total Expenses | $30,731,490 | PYTotalExpensesAmt |
| CY Total Expenses | $18,855,989 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$4,349,941 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,444,606 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,739,443 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,655,947 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$1,916,504 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | NORTHWEST MEDICAL CENTER, INC., SEEKS TO IDENTIFY AND SERVE THE PRIMARY HEALTHCARE NEEDS OF INPATIENTS, OUTPATIENTS, SURGICAL, AND ER PATIENTS IN A RURAL ENVIRONMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $16,401,680 | ExpenseAmt |
| Revenue | $17,123,670 | RevenueAmt |
| Desc | NORTHWEST MEDICAL CENTER, INC., SEEKS TO IDENTIFY AND SERVE THE PRIMARY HEALTHCARE NEEDS OF INPATIENTS, OUTPATIENTS, SURGICAL, AND ER PATIENTS IN A RURAL ENVIRONMENT. | Desc |
| Total Program Service Expenses | $16,401,680 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | Yes (1) | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 51 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 308 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | 0 | Form8899Filedind |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRACY MARTIN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2054877726 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1530 US HWY 43 | AddressLine1Txt |
| City | WINFIELD | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 35594 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DAVID CORBETT MD | ||||||||
| BOARD MEMBER | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES R MOSS MD | ||||||||
| BOARD MEMBER | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JIM DICKINSON | ||||||||
| CHAIRMAM | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| RANDY PRICE | ||||||||
| BOARD MEMBER | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| RAYMOND SPANN JR | ||||||||
| BOARD MEMBER | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GLENDA REYES | ||||||||
| CFO | 40.00 | 0.00 | $119,974 | $0 | $11,888 | Yes (X) | ||
| MICHAEL ARNO | ||||||||
| CEO (ENDING 06/12/2019) | 40.00 | 0.00 | $199,674 | $0 | $0 | Yes (X) | ||
| ROBERT HENGER | ||||||||
| CEO (BEGINNING 06/17/2019) | 40.00 | 0.00 | $51,926 | $0 | $6,708 | Yes (X) | ||
| JOSEPH WALKER MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $508,320 | $0 | $19,780 | Yes (X) | ||
| MARTIN HAJJAR MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $476,123 | $0 | $19,780 | Yes (X) | ||
| JERILL THOMAS MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $400,259 | $0 | $19,780 | Yes (X) | ||
| DEREK CANNON MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $397,260 | $0 | $0 | Yes (X) | ||
| MUHAMMAD HUSAIN MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $397,176 | $0 | $19,780 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,550,712 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $97,716 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HARRIS MEDICAL HOSPITAL | |||||
| 1180 SATELLITE BLVD | SUWANEE | GA | 300240000 | LOCUM SERVICES | $607,813 |
| NORTHWEST ANESTHESIA | |||||
| 160 ROCKWELL STREET | WINFIELD | AL | 35594 | ANESTHESIA SERVICES | $516,935 |
| TRIMEDEX | |||||
| PO BOX 636129 | CINCINNATI | OH | 452636129 | CONTRACTED MAINTENANCE | $299,017 |
| DIVERSIFIED CLINICAL SERVICES | |||||
| PO BOX 28525 NETWORK PLACE | CHICAGO | IL | 606731285 | CONTRACTED WOUND CARE SERVICES | $247,215 |
| WESTERN HEALTHCARE | |||||
| PO BOX 203152 | DALLAS | TX | 753203152 | LOCUM SERVICES | $163,763 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE FEES | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $16,828,559 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,828,559 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,828,559 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $287,713 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $287,713 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $287,713 | TotalRevenueColumnAmt |
| Exclusion | $287,713 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MISCELLANEOUS | 900099 | $133,461 | $133,461 |
| WELLNESS CENTER | 900099 | $103,414 | $103,414 |
| CAFETERIA & VENDING | 900099 | $58,236 | $58,236 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $295,111 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,411,383 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,123,670 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $287,713 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,198,053 | TotalAmt |
| Program Services | $6,730,416 | ProgramServicesAmt |
| Management And General | $467,637 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,157,138 | TotalAmt |
| Program Services | $1,128,613 | ProgramServicesAmt |
| Management And General | $28,525 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,543 | TotalAmt |
| Program Services | $69,350 | ProgramServicesAmt |
| Management And General | $193 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,545 | TotalAmt |
| Program Services | $85,308 | ProgramServicesAmt |
| Management And General | $237 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $974,415 | TotalAmt |
| Program Services | $608,415 | ProgramServicesAmt |
| Management And General | $366,000 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,180,299 | TotalAmt |
| Program Services | $1,143,529 | ProgramServicesAmt |
| Management And General | $36,770 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,056 | TotalAmt |
| Program Services | $25,011 | ProgramServicesAmt |
| Management And General | $15,045 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $531 | TotalAmt |
| Management And General | $531 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,908 | TotalAmt |
| Management And General | $245,908 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $284,804 | TotalAmt |
| Program Services | $33,968 | ProgramServicesAmt |
| Management And General | $250,836 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACT SERVICES | $3,075,597 | $2,964,247 | $111,350 |
| BAD DEBT EXPENSE | $2,879,085 | $2,879,085 | |
| TAXES & ASSESSMENTS | $895,997 | $895,997 | |
| DRUGS & MEDICAL SUPPLIE | $675,092 | $675,092 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,926 | TotalAmt |
| Program Services | $58,646 | ProgramServicesAmt |
| Management And General | $35,280 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,855,989 | TotalAmt |
| Program Services | $16,401,680 | ProgramServicesAmt |
| Management And General | $2,454,309 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $418,348 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,177,756 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $472,727 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $249,063 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,419,014 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,535 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,739,443 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,369,124 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,887 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,135,936 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,655,947 | BOYAmt |
| EOY | $0 | 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 | -$1,916,504 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,916,504 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,739,443 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,444,606 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $3,361,110 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | NWMC IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3). NWMC ADHERES TO THE PROVISIONS OF THE ACCOUNTING STANDARDS CODIFICATION RELATING TO UNCERTAINTY IN INCOME TAXES THAT REQUIRES ENTITIES TO ASSESS THEIR UNCERTAIN TAX POSITIONS FOR THE LIKELIHOOD THAT THEY WOULD BE OVERTURNED UPON INTERNAL REVENUE SERVICE (IRS) EXAMINATION OR UPON EXAMINATION BY STATE TAXING AUTHORITIES. NWMC HAS DETERMINED THAT IT DOES NOT HAVE ANY POSITIONS AT DECEMBER 31, 2019 OR 2018, THAT IT WOULD BE UNABLE TO SUBSTANTIATE. NWMC HAS FILED ITS TAX RETURNS THROUGH DECEMBER 31, 2018. THE TAX RETURNS FOR THE YEARS ENDED DECEMBER 31, 2016, AND THEREAFTER ARE SUBJECT TO AUDIT BY THE TAXING AUTHORITIES. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| Indiv Hospital Tailored Policy | Yes (X) | IndivHospitalTailoredPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,965 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $32,965 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,956,446 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $744,956 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,211,490 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06420 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,989,411 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $744,956 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,244,455 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06590 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,146 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,146 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,944 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,944 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,090 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,090 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,000,501 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $744,956 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,255,545 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06650 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $6,618,602 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $234,672 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,821,432 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,271,430 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $550,002 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | NORTHWEST MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1530 US HIGHWAY 43 | AddressLine1Txt |
| City | WINFIELD | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 35594 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.NORTHWESTMEDCENTER.NET | WebsiteAddressTxt |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWEST MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | 0 | CHNAConductedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.NORTHWESTMEDCENTER.NET | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.NORTHWESTMEDCENTER.NET | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.NORTHWESTMEDCENTER.NET | 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 |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | NORTHWEST MEDICAL CENTER, INC | FormAndLineReferenceDesc |
| Explanation | PART V, SECTION B, LINE 20E: THE HOSPITAL: PROVIDES PATIENTS WITH WRITTEN NOTICE OF IMPENDING ECAS (EXTRAORDINARY COLLECTION ACTIONS) AND A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AT LEAST 30 DAYS BEFORE INITATING THOSE ECAS; MAKES A REASONABLE EFFORT TO ORALLY NOTIFY INDIVIDUALS ABOUT THE FAP AND FAP APPLICATION PROCESS; AND PROCESSES INCOMPLETE AND COMPLETE FAP APPLICATIONS. | ExplanationTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - NWMC-WINFIELD PHYSICIANS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1530 US HIGHWAY 43 | AddressLine1Txt |
| City | WINFIELD | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 35594 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | FAMILY MEDICINE PHYSICIAN FACILITY | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LN 7 COL(F): | ACCOUNTS ARE EVALUATED FOR COLLECTABILITY ON A MONTHLY BASIS USING AGED PAYOR ACCOUNT CLASSIFICATIONS AND HISTORICAL COLLECTION EXPERIENCE. |
| PART III, LINE 2: | ACCOUNTS ARE EVALUATED FOR COLLECTABILITY ON A MONTHLY BASIS USING AGED PAYOR ACCOUNT CLASSIFICATIONS AND HISTORICAL COLLECTION EXPERIENCE. |
| PART III, LINE 3: | ACCOUNTS ARE EVALUATED FOR COLLECTABILITY ON A MONTHLY BASIS USING AGED PAYOR ACCOUNT CLASSIFICATIONS AND HISTORICAL COLLECTION EXPERIENCE. |
| PART III, LINE 4: | ACCOUNTS ARE EVALUATED FOR COLLECTABILITY ON A MONTHLY BASIS USING AGED PAYOR ACCOUNT CLASSIFICATIONS AND HISTORICAL COLLECTION EXPERIENCE. |
| PART III, LINE 8: | AS A NON-PROFIT ORGANIZATION, THE HOSPITAL ACCEPTS ALL PATIENTS REGARDLESS OF INSURANCE COVERAGE (OR LACK THEREOF) OR THE PATIENT'S ABILITY TO PAY. AMOUNTS REPORTED ARE BASED ON THE MEDICARE COST REPORT, WHICH IS PREPARED USING THE AUDITED TRIAL BALANCE AND IN ACCORDANCE WITH ALL APPLICABLE RULES AND REGULATIONS. |
| PART III, LINE 9B: | NORTHWEST MEDICAL CENTER OFFERS FINANCIAL ASSISTANCE TO PATIENTS AND GUARANTORS PURSUANT TO ITS FINANCIAL ASSISTANCE POLICY, WHICH IS BASED ON THE CURRENT FEDERAL POVERTY GUIDELINES (FPG). THOSE APPROVED FOR FINANCIAL ASSISTANCE ARE ELIGIBLE FOR DISCOUNTS APPLIED TO BALANCES OWED AFTER INSURANCE, AS WELL AS SELF-PAY BALANCES REMAINING AFTER THE UNINSURED DISCOUNT IS APPLIED. IF THE PATIENT'S FAMILY INCOME IS BETWEEN 0%-150% OF THE FEDERAL POVERTY GUIDELINES, A 100% DISCOUNT (CHARITY CARE) IS PROVIDED. IF THE PATIENT'S FAMILY INCOME IS BETWEEN 150%-250% OF THE FEDERAL POVERTY GUIDELINES, A 60% DISCOUNT (FINANCIAL ASSISTANCE) IS PROVIDED. IF THE PATIENT'S FAMILY INCOME IS BETWEEN 251%-300% OF THE FEDERAL POVERTY GUIDELINES, A 40% DISCOUNT (FINANCIAL ASSISTANCE) IS PROVIDED. THE FINANCIAL ASSISTANCE POLICY IS PUBLICIZED IN PATIENT REGISTRATION AREAS, BILLING STATEMENTS, AND ON THE HOSPITAL'S WEBSITE. PATIENTS NOT ELIGIBLE FOR CHARITY CARE OR WHO HAVE A BALANCE OWED AFTER THE APPLICATION OF CHARITY CARE OR UNINSURED DISCOUNT ARE SENT STATEMENTS AND/OR COLLECTION LETTERS AT LEAST EVERY 30 DAYS UNTIL THE BALANCE OWED IS PAID OR LONGER-TERM PAYMENT ARRANGEMENTS ARE MADE. ACCOUNTS THAT DO NOT HAVE SUFFICIENT PAYMENT ARRANGEMENTS ESTABLISHED ARE ELIGIBLE FOR OUTSIDE COLLECTIONS. ALL PATIENTS ARE NOTIFIED OF POSSIBLE COLLECTION ASSIGNMENT AT LEAST 30 DAYS BEFORE AN ASSIGNMENT IS MADE. IF A PATENT REQUESTS FINANCIAL ASSISTANCE AFTER STATEMENTS ARE SENT, THE ACCOUNT IS PLACED ON HOLD UNTIL A DETERMINATION OF ELIGIBILITY IS MADE. |
| PART VI, LINE 2: | THE HOSPITAL PERFORMS OUTREACH SERVICES AND PROVIDES HEALTH EDUCATION OPPORTUNITIES FOR THE COMMUNITY. FEEDBACK FROM THESE EFFORTS ALONG WITH THE EVALUATION OF THE PATIENTS SERVED ARE CONSIDERED IN ASSESSING THE COMMUNITY'S HEALTH CARE NEEDS.PART V, SECTION B, LINE 3:ON AUGUST 14, 2019, PRIOR TO THE ORGANIZATION'S YEAR END, NORTHWEST MEDICAL CENTER EXECUTED AN ASSET TRANSFER AND ASSIGNMENT AND ASSUMPTION AGREEMENT TO EFFECTIVELY TRANSFER ALL OF ITS ASSETS, LIABILITIES AND ACTIVITIES TO THE HEALTHCARE AUTHORITY OF WINFIELD, ALABAMA. THE HOSPITAL FACILITY WILL CONTINUE TO OPERATE AND CONDUCT ITS PROGRAMS THROUGH THE HEALTHCARE AUTHORITY, A POLITICAL SUBSIDIARY EXEMPT UNDER 115. AT THIS TIME, NORTHWEST MEDICAL CENTER CEASED OPERATING A HOSPITAL FACILITY AND THE REQUIREMENTS OF 501(R) NO LONGER APPLY THEREFORE, A COMMUNITY HEALTH NEEDS ASSESSMENT WAS NOT COMPLETED FOR THE YEAR ENDED DECEMBER 31, 2019. |
| PART VI, LINE 3: | INPATIENT SELF-PAY PATIENTS ARE SCREENED BY FINANCIAL COUNSELORS DURING THEIR STAY UPON APPLICATION BY THE PATIENT OR GUARANTOR. OUTPATIENT SERVICES ARE ALSO ELIGIBLE FOR FINANCIAL ASSISTANCE OR CHARITY UPON APPLICATION BY THE PATIENT OR GUARANTOR. SIGNAGE AT ALL REGISTRATION AREAS, MONTHLY STATEMENTS, AND THE WEBSITE REFERENCE PHONE NUMBERS TO CALLFOR FINANCIAL ASSISTANCE. |
| PART VI, LINE 4: | NORTHWEST MEDICAL CENTER PRIMARILY SERVES RESIDENTS OF WINFIELD, AL, INCLUDING THE COUNTIES OF MARION AND FAYETTE. THIS IS A RURAL COMMUNITY WITH A POPULATION BELOW 5,000 AND APPROXIMATELY 14% OF THE POPULATION FALLS BELOW THE POVERTY LINE. THE POPULATION IS PREDOMINANTLY CAUCASIAN (92%, AS OF THE MOST RECENT CENSUS). |
| PART VI, LINE 5: | THE HOSPITAL HAS A COMMUNITY BOARD OF VOLUNTEER DIRECTORS AND IS SERVED BY AN OPEN MEDICAL STAFF. THE FACILITY IS ALSO SUPPORTED BY LOCAL VOLUNTEERS. THE HOSPITAL ACTIVELY RECRUITS PRIMARY CARE PHYSICIANS AND SPECIALISTS TO MEET MEDICAL NEEDS IN THE COMMUNITY. IN ADDITION, THE HOSPITAL PERFORMS OUTREACH SERVICES AND PROVIDES HEALTH EDUCATION OPPORTUNITIES FOR THE COMMUNITY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL ARNO | ||||||||||||||
| CEO (ENDING 06/12/2019) | $173,480 | $0 | $0 | $0 | $26,194 | $0 | $0 | $0 | $0 | $0 | $199,674 | $0 | $0 | $0 |
| JOSEPH WALKER MD | ||||||||||||||
| PHYSICIAN | $508,320 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,780 | $0 | $528,100 | $0 | $0 | $0 |
| MARTIN HAJJAR MD | ||||||||||||||
| PHYSICIAN | $446,423 | $0 | $29,700 | $0 | $0 | $0 | $0 | $0 | $19,780 | $0 | $495,903 | $0 | $0 | $0 |
| JERILL THOMAS MD | ||||||||||||||
| PHYSICIAN | $393,859 | $0 | $6,400 | $0 | $0 | $0 | $0 | $0 | $19,780 | $0 | $420,039 | $0 | $0 | $0 |
| DEREK CANNON MD | ||||||||||||||
| PHYSICIAN | $395,760 | $0 | $1,500 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $397,260 | $0 | $0 | $0 |
| MUHAMMAD HUSAIN MD | ||||||||||||||
| PHYSICIAN | $377,176 | $0 | $20,000 | $0 | $0 | $0 | $0 | $0 | $19,780 | $0 | $416,956 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4A | FormAndLineReferenceDesc |
| Explanation | MICHAEL ARNO, CEO, DEPARTED THE ORGANIZATION ON JUNE 12, 2019 AND RECEIVED SEVERANCE PAYMENTS TOTALING $26,194. | ExplanationTxt |
Schedule N IRS990ScheduleN
Disposition Of Assets Detail DispositionOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | TRANSFER OF ASSETS TO HEALTHCARE AUTHORITY OF WINFIELD, AL | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2019-08-14 | DistributionDt |
| Fair Market Value Of Asset | -$3,361,110 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | FMV | MethodOfFMVDeterminationTxt |
| EIN | 824749088 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHCARE AUTHORITY OF WINFIELD AL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7530 US HIGHWAY 43 | AddressLine1Txt |
| City | WINFIELD | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 35594 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | POLITICAL SUBSIDIARY | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | Yes (1) | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | Yes (1) | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2Ind |
| Receive Compensation2 | 0 | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 2E: | FormAndLineReferenceDesc |
| Explanation | PERSON(S) INVOLVED: 2A: JIM DICKINSON, JAMES R. MOSS, MD, RAYMOND SPANN, JR, RANDY PRICE, & DAVID CORBETT, MD2B: ALL EMPLOYEES AND INDEPENDENT CONTRACTORS WILL BECOME EMPLOYEES AND INDEPENDENT CONTRACTORS OF THE HEALTHCARE AUTHORITY OF WINFIELD, ALABAMA | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 3 | ON AUGUST 14, 2019 NORTHWEST MEDICAL CENTER ADOPTED AN ASSET TRANSFER AND ASSIGNMENT AND ASSUMPTION AGREEMENT TO EFFECTIVELY TRANSFER ALL OF ITS ASSETS, LIABILITIES AND ACTIVITIES TO THE HEALTHCARE AUTHORITY OF WINFIELD, ALABAMA. THE ORGANIZATION WILL CONTINUE TO OPERATE AND CONDUCT ITS PROGRAMS THROUGH THE HEALTHCARE AUTHORITY. |
| FORM 990, PART VI, SECTION A, LINE 4 | ON AUGUST 14, 2019 NORTHWEST MEDICAL CENTER EXECUTED AN ASSET TRANSFER AND ASSIGNMENT AND ASSUMPTION AGREEMENT TO EFFECTIVELY TRANSFER ALL OF ITS ASSETS, LIABILITIES AND ACTIVITIES TO THE HEALTHCARE AUTHORITY OF WINFIELD, ALABAMA. THE ORGANIZATION WILL CONTINUE TO OPERATE AND CONDUCT ITS PROGRAMS THROUGH THE HEALTHCARE AUTHORITY. |
| FORM 990, PART VI, SECTION B, LINE 11B | DUE TO COVID-19 RESTRICTIONS, THE NOVEMBER 2020 BOARD MEETING WAS CANCELLED. THE FORM 990 WAS REVIEWED BY THE CHAIRMAIN AND CFO. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS DISCUSSED IN PERSON WITH EACH POTENTIAL BOARD MEMBER. WHEN MANAGEMENT BECOMES AWARE OF A POTENTIAL CONFLICT, IT IS DISCUSSED IN DEPTH WITH UPPER MANAGEMENT AND THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD VOTED ON ALL COMPENSATION AS PART OF THEIR ANNUAL BUDGET PROCESS, WHICH INCLUDES A REVIEW OF ALL POTENTIAL RAISES AND COMPARISON OF COMPARABLE COMPENSATION DATA. |
| FORM 990, PART VI, SECTION C, LINE 19 | AS A GENERAL RULE, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ANY WRITTEN REQUEST BY THE PUBLIC WOULD BE REVIEWED AND ACTED UPON BY THE BOARD. |
| FORM 990, PART XI, LINE 9: | TRANSFER OF ASSETS TO THE HEALTHCARE AUTHORITY OF WINFIELD, AL 3,361,110. |
| FORM 990, PART XII, LINE 2C | THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS FUNCTION HAS NOT CHANGED FROM PRIOR YEARS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHCARE AUTHORITY OF WINFIELD AL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7530 HIGHWAY 43 | AddressLine1Txt |
| City | WINFIELD | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 35594 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 824749088 | EIN |
| Primary Activities | HOSPITAL OWNERSHIP | PrimaryActivitiesTxt |
| Legal Domicile State | AL | LegalDomicileStateCd |
| Exempt Code Section | HCA | ExemptCodeSectionTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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