PEMISCOT COUNTY MEMORIAL HOSPITAL: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- PEMISCOT COUNTY MEMORIAL HOSPITAL (EIN 43-6004544)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-15
- IRS object ID
- 201843199349315119
- Schema version
- 2017v2.3
- 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 | 2018-11-15T15:49:01-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 436004544 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEMISCOT COUNTY MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % LEIGHA WARD | InCareOfNm |
| Business Name Control | PEMI | BusinessNameControlTxt |
| Phone | 5733591372 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 946 EAST REED ST PO BOX 489 | AddressLine1Txt |
| City | HAYTI | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63851 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JONNA GREEN | PersonNm |
| Person Title | INTERIM ADMINISTRATO | PersonTitleTxt |
| Phone | 5733591372 | PhoneNum |
| Signature | 2018-10-23 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 4178658701 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.126.162 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 43032920183195000023 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2018-11-15 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 35B2FEF9FD89B74F90B63698513A1BB518488CA1 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | AE6E5E46D41BC60DF08B4BEE75B34EFCBA1C7A6F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEMISCOT MEMORIAL HEALTH SYSTEMS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JONNA GREEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 489 | AddressLine1Txt |
| City | HAYTI | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63851 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $38,314,998 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PEMISCOT.ORG | WebsiteAddressTxt |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Other Organization Dsc | POL SUB | OtherOrganizationDsc |
| Formation | 1949 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | THE PRIMARY PURPOSE OF PEMISCOT MEMORIAL HEALTH SYSTEMS IS TO PROVIDE QUALITY HEALTHCARE TO THE COMMUNITY REGARDLESS OF ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 566 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $874,987 | PYContributionsGrantsAmt |
| CY Contributions Grants | $836,540 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $40,483,629 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $37,453,806 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,371,523 | PYInvestmentIncomeAmt |
| CY Investment Income | $21,052 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,500 | PYOtherRevenueAmt |
| CY Other Revenue | $3,600 | CYOtherRevenueAmt |
| PY Total Revenue | $43,731,639 | PYTotalRevenueAmt |
| CY Total Revenue | $38,314,998 | 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 | $20,634,207 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,755,178 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $22,184,344 | PYOtherExpensesAmt |
| CY Other Expenses | $22,325,263 | CYOtherExpensesAmt |
| PY Total Expenses | $42,818,551 | PYTotalExpensesAmt |
| CY Total Expenses | $40,080,441 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $913,088 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,765,443 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $23,739,370 | TotalAssetsBOYAmt |
| Total Assets EOY | $25,549,390 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,855,226 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,430,689 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,884,144 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,118,701 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PEMISCOT MEMORIAL HEALTH SYSTEMS IS COMMITTED TO PROVIDE AN ORGANIZED SYSTEM OF HEALTHCARE SERVICES TO ALL PERSONS WITHIN OUR SERVICE AREA. SEE SCHEDULE O. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $37,487,278 | ExpenseAmt |
| Revenue | $37,453,806 | RevenueAmt |
| Desc | PROVIDING QUALITY HEALTH CARE TO THE COMMUNITY THROUGH THE OPERATION OF A HOSPITAL, LONG-TERM CARE FACILITY, RURAL HEALTH CLINICS AND ADULT AND GERIATRIC PSYCHIATRIC UNITS. | Desc |
| Total Program Service Expenses | $37,487,278 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | Yes (true) | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | 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 | false | TaxExemptBondsInd |
| 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | false | 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 | 67 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 566 | 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 |
| 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 | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | 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 | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | 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 | LEIGHA WARD | PersonNm |
| Phone | 5733593612 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 946 EAST REED | AddressLine1Txt |
| City | HAYTI | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63851 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| RUSSELL GILMORE | ||||||||
| CHAIRMAN | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DELILA SWINGER | ||||||||
| VICE-CHAIRMAN | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TIM GARDNER | ||||||||
| TREASURER | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| STEPHEN REID | ||||||||
| SECRETARY | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| EDDIE BROOKS | ||||||||
| MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| STEVE VANAUSDALL | ||||||||
| MEMBER BEG 05/17 | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| KERRY NOBLE | ||||||||
| CEO/CFO END 07/17 | 40.0 | 0.0 | Yes (X) | $73,208 | $0 | $0 | ||
| LEIGHA WARD | ||||||||
| CFO BEG 07/17 | 40.0 | 0.0 | Yes (X) | $53,337 | $0 | $0 | ||
| JONNA GREEN | ||||||||
| COO BEG 07/17 | 40.0 | 0.0 | Yes (X) | $56,197 | $0 | $0 | ||
| JAMES MARSHALL | ||||||||
| CEO BEG 08/2017 | 40.0 | 0.0 | Yes (X) | $50,032 | $0 | $0 | ||
| GHAITH KHAIR | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $371,413 | $0 | $1,350 | Yes (X) | ||
| LARA HUFFMAN | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $326,250 | $0 | $921 | Yes (X) | ||
| ABDULLAH ARSHAD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $1,314,405 | $0 | $0 | Yes (X) | ||
| BABATUNDE OLADIRAN | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $570,919 | $0 | $25,477 | Yes (X) | ||
| AMY LOCKHERT | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $248,359 | $0 | $976 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,064,120 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $28,724 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | 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 |
|---|---|---|---|---|---|
| GUBIN MEDICAL SERVICES | |||||
| 163 CLOISTER GREEN COVE | MEMPHIS | TN | 38120 | UROLOGY SERVICE | $785,312 |
| HEALTHCARE SERVICES GROUP | |||||
| PO BOX 829677 | PHILADELPHIA | PA | 19182 | HOUSEKEEPING/LAUNDRY | $649,000 |
| SN VITAL PAIN AND ANESTHESIA | |||||
| 11006 LANDON LANE | HOUSTON | TX | 77024 | PAIN MANAGEMENT | $569,882 |
| LASHLEE-RICH | |||||
| PO BOX 483 | HUMBOLDT | TN | 38343 | CONTRACTOR | $1,274,165 |
| JM ANESTHESIA LLC | |||||
| 12661 FOXWOOD POINTE | POPLAR BLUFF | MO | 63901 | ANESTHESIA COVERAGE | $479,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $836,540 | GovernmentGrantsAmt |
| Total Contributions | $836,540 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621400 | $34,179,906 | $34,179,906 |
| MEDICAL RECORDS | 621400 | $18,016 | $18,016 |
| CAFETERIA | 722514 | $65,983 | $65,983 |
| MISCELLANEOUS | 900099 | $773,611 | $773,611 |
| 340B REVENUE | 621400 | $2,416,290 | $2,416,290 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $37,453,806 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,052 | TotalRevenueColumnAmt |
| Exclusion | $21,052 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,600 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,600 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,600 | TotalRevenueColumnAmt |
| Exclusion | $3,600 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,314,998 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $37,453,806 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $24,652 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $232,774 | TotalAmt |
| Management And General | $232,774 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,383,088 | TotalAmt |
| Program Services | $13,339,030 | ProgramServicesAmt |
| Management And General | $1,044,058 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $815,106 | TotalAmt |
| Program Services | $750,170 | ProgramServicesAmt |
| Management And General | $64,936 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,276,425 | TotalAmt |
| Program Services | $1,174,737 | ProgramServicesAmt |
| Management And General | $101,688 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,047,785 | TotalAmt |
| Program Services | $964,312 | ProgramServicesAmt |
| Management And General | $83,473 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,473 | TotalAmt |
| Management And General | $27,473 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,981 | TotalAmt |
| Management And General | $129,981 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,189,562 | TotalAmt |
| Program Services | $6,753,034 | ProgramServicesAmt |
| Management And General | $436,528 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,148 | TotalAmt |
| Program Services | $4,738 | ProgramServicesAmt |
| Management And General | $410 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $742,248 | TotalAmt |
| Program Services | $671,462 | ProgramServicesAmt |
| Management And General | $70,786 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $688,709 | TotalAmt |
| Program Services | $633,842 | ProgramServicesAmt |
| Management And General | $54,867 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,951 | TotalAmt |
| Program Services | $68,862 | ProgramServicesAmt |
| Management And General | $15,089 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,191 | TotalAmt |
| Management And General | $195,191 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $604,914 | TotalAmt |
| Program Services | $556,723 | ProgramServicesAmt |
| Management And General | $48,191 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,021 | TotalAmt |
| Program Services | $165,021 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $7,304,395 | $7,304,395 | |
| MEDICAL SUPPLIES & DRUGS | $3,650,602 | $3,650,602 | |
| FRA EXPENSE | $1,183,909 | $1,183,909 | |
| LICENSES, DUES, SUBSCRIPTIONS | $81,040 | $38,786 | $42,254 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $273,119 | TotalAmt |
| Program Services | $227,655 | ProgramServicesAmt |
| Management And General | $45,464 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,080,441 | TotalAmt |
| Program Services | $37,487,278 | ProgramServicesAmt |
| Management And General | $2,593,163 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,205 | BOYAmt |
| EOY | $2,205 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,003,568 | BOYAmt |
| EOY | $2,434,847 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $694,847 | BOYAmt |
| EOY | $685,833 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,796,936 | BOYAmt |
| EOY | $3,111,189 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $332,343 | BOYAmt |
| EOY | $354,682 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,076 | BOYAmt |
| EOY | $80,795 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $27,938,136 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $23,186,203 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,130,115 | BOYAmt |
| EOY | $4,751,933 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,688,280 | BOYAmt |
| EOY | $14,127,906 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,739,370 | BOYAmt |
| EOY | $25,549,390 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,753,890 | BOYAmt |
| EOY | $5,265,708 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,277 | BOYAmt |
| EOY | $6,272 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,527,405 | BOYAmt |
| EOY | $3,701,603 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,567,654 | BOYAmt |
| EOY | $5,457,106 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,855,226 | BOYAmt |
| EOY | $14,430,689 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,884,144 | BOYAmt |
| EOY | $11,118,701 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,884,144 | BOYAmt |
| EOY | $11,118,701 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,739,370 | BOYAmt |
| EOY | $25,549,390 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,765,443 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (true) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | false | FSAuditedInd |
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (true) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $137,742 | OtherCostOrOtherBasisAmt |
| Book Value | $137,742 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,618,223 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,480,788 | DepreciationAmt |
| Book Value | $1,137,435 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,347,384 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,650,279 | DepreciationAmt |
| Book Value | $2,697,105 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $834,787 | OtherCostOrOtherBasisAmt |
| Depreciation | $55,136 | DepreciationAmt |
| Book Value | $779,651 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,751,933 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| NET PENSION ASSET | $11,287,886 |
| RESIDENT TRUST FUND | $5,673 |
| OTHER RECEIVABLES | $788,199 |
| DEFERRED PENSION PLAN | $2,046,148 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $14,127,906 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO THIRD PARTY | $3,108,037 |
| DEFERRED INFLOWS - PENSION PLAN | $2,349,069 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,457,106 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART IV, LINE 2B | FormAndLineReferenceDesc |
| Explanation | RESIDENT TRUST FUND: THE ORGANIZATION HOLDS RESIDENT FUNDS THAT HAVE BEEN SET ASIDE FROM MEDICAID FOR PERSONAL EXPENSES OF PATIENTS. FAMILY MEMBERS AND PATIENTS MAY ALSO MAKE ADDITIONAL DEPOSITS INTO THE ACCOUNTS FOR ADDITIONAL EXPENSES, AS AVAILABLE AND NECESSARY. | ExplanationTxt |
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 |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | false | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| 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 | $420,620 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $420,620 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01280 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,507,867 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,874,415 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,633,452 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04980 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,928,487 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,874,415 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,054,072 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06260 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $163,306 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $163,306 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $163,306 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $163,306 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,091,793 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,874,415 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,217,378 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06760 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,577 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,577 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $195 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $195 | NetCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,772 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,772 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $7,304,395 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $2,103,666 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $11,130,634 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,310,898 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,819,736 | 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 (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 | PEMISCOT MEMORIAL HEALTH SYSTEMS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 946 EAST REED | AddressLine1Txt |
| City | HAYTI | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63851 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PEMISCOT.ORG | WebsiteAddressTxt |
| State License | 15-57 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEMISCOT MEMORIAL HEALTH SYSTEMS | 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 |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| 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 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200. | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| 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 | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| 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 |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, LINE 5 | COMMUNITY INPUT: INTERVIEWS WITH STAKEHOLDERS WERE CONDUCTED IN DECEMBER 2016 OVER THE PHONE. STAKEHOLDERS WERE DETERMINED BASED ON THEIR: A) SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH, B) THEIR AFFILIATION WITH LOCAL GOVERNMENT, SCHOOL AND INDUSTRY OR C) THEIR INVOLVEMENT WITH UNDERSERVED AND MINORITY POPULATIONS. ALL INTERVIEWS WERE CONDUCTED USING A STANDARD QUESTIONNAIRE. A COPY OF THE INTERVIEW INSTRUMENT IS INCLUDED IN THE APPENDICES. A SUMMARY OF THEIR OPINIONS IS REPORTED WITHOUT JUDGING THE TRUTHFULNESS OR ACCURACY OF THEIR REMARKS. COMMUNITY LEADER PROVIDED COMMENTS ON THE FOLLOWING ISSUES: - HEALTH AND QUALITY OF LIFE FOR RESIDENTS OF THE PRIMARY COMMUNITY IN RELATION TO THE CURRENT STRATEGIES IMPLEMENTED. - THOUGHTS ON HOW CURRENT PROGRAMS ARE IMPROVING HEALTH AND QUALITY OF LIFE FOR RESIDENTS OF THE PRIMARY COMMUNITY OR IDENTIFYING PROGRAMS DONE BY OTHERS THAT ADDRESS SIMILAR NEEDS. - OPINIONS REGARDING IN NEW NEEDS OR HEALTH ISSUES THAT AFFECT PEMISCOT COUNTY RESIDENTS AND THE TYPES OF SERVICES THAT ARE IMPORTANT FOR ADDRESSING THESE NEW ISSUES. THIS TECHNIQUE DOES NOT PROVIDE A QUANTITATIVE ANALYSIS OF THE LEADERS' OPINIONS, BUT REVEALS SOME OF THE FACTORS AFFECTING THE VIEWS AND SENTIMENTS ABOUT OVERALL HEALTH AND QUALITY OF LIFE WITHIN THE COMMUNITY. REPRESENTATIVES FROM THE COMMUNITY WHO WERE INCLUDED IN THE KEY INFORMANT INTERVIEW PROCESS WORKED FOR THE VARIOUS TYPES OF ORGANIZATIONS AND AGENCIES (SEE APPENDIX FOR A DETAILED LIFT OF PARTICIPANTS). THESE HEALTH CARE AND NON-HEALTH CARE PROFESSIONALS PROVIDED INSIGHT INTO THE HEALTH STATUS OF THE HOSPITAL THROUGH A SEVEN-QUESTION INTERVIEW (REFER TO THE APPENDIX FOR FULL INTERVIEW PROCESS). |
| SCHEDULE H, PART V, SECTION B, LINE 7A, 10A & 16A | WEBSITE FOR CHNA, IMPLEMENTATION STRATEGY AND FINANCIAL ASSISTANCE POLICY: https://www.pemiscot.org/copy-of-request-medical-records |
| SCHEDULE H, PART V, LINE 11 | ADDRESSING SIGNIFICANT NEEDS: THE MOST SIGNIFICANT/PREVALENT NEEDS IDENTIFIED IN THE ORGANIZATIONS MOST RECENT CHNA WERE AS FOLLOWS: HEART DISEASE CANCER STROKE LUNG DISEASE PRIMARY CARE PHYSICIANS / PEDIATRICIANS MENTAL HEALTH PROVIDERS LOW-INCOME POPULATION HEALTH CARE TRANSPORTATION / ACCESS TO CARE DRUG OVERDOSE ADULT SMOKING CHILDREN IN POVERTY CHILDREN IN SINGLE-PARENT HOUSEHOLDS ADULT OBESITY DENTISTS PREVENTABLE HOSPITAL STAYS UNINSURED TEEN BIRTH RATE SEXUALLY TRANSMITTED INFECTIONS MAMMOGRAPHY SCREENING ACCESS TO EXERCISE OPPORTUNITIES PHYSICAL INACTIVITY VIOLENT CRIME RATE FOOD ENVIRONMENT INDEX ALCOHOL-IMPAIRED DRIVING DEATHS DIABETIC SCREEN RATE EXCESSIVE DRINKING HOSPITAL LEADERSHIP REVIEWED THE IDENTIFIED NEEDS REPORTED IN THE TABLE ABOVE. THROUGH DISCUSSION AND DEBATE, LEADERSHIP IDENTIFIED PRIORITIES THE HOSPITAL SHOULD FOCUS ON FOR CALENDAR YEARS 2017-2018. AS A RESULT OF THE ANALYSIS ABOVE THE FOLLOWING AREAS WERE IDENTIFIED AS PRIORITY AREAS ON WHICH WE WILL FOCUS. ACCESS TO SERVICES AND HEALTHY LIVING: 1. PRIMARY CARE PHYSICIANS AND PEDIATRICIANS 2. MENTAL HEALTH PROVIDERS 3. LOW-INCOME AND UNINSURED HEALTH CARE SERVICES 4. TRANSPORTATION AND ACCESS TO CARE CHRONIC DISEASE MANAGEMENT AND PREVENTION: 1. HEART DISEASE 2. CANCER 3. STROKE 4. LUNG DISEASE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 9 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| PEMISCOT MEMORIAL NURSING HOME | ||||
| 946 EAST REED | HAYTI | MO | 63851 | OUTPATIENT PHYSICIAN CLINIC |
| PEMISCOT PRIMARY CARE CENTER | ||||
| 907 EAST REED | HAYTI | MO | 63851 | OUTPATIENT PHYSICIAN CLINIC |
| DOCTOR'S CLINIC | ||||
| 106 WEST 12 | CARUTHERSVILLE | MO | 63830 | OUTPATIENT PHYSICIAN CLINIC |
| BOOTHEEL PRIMARY CARE - KENNETT | ||||
| 200 STATE ROUTE VV | KENNETT | MO | 63857 | OUTPATIENT PHYSICIAN CLINIC |
| PEMISCOT CONVENIENT CARE CLINIC | ||||
| 946 EAST REED | HAYTI | MO | 63851 | OUTPATIENT PHYSICIAN CLINIC |
| PORTAGEVILLE PRIMARY CARE CENTER | ||||
| 314 EAST MAIN | PORTAGEVILLE | MO | 63873 | OUTPATIENT PHYSICIAN CLINIC |
| BOOTHEEL PRIMARY CARE - CARUTHERSVILLE | ||||
| 1502 WARD AVENUE | CARUTHERSVILLE | MO | 63830 | OUTPATIENT PHYSICIAN CLINIC |
| BOOTHEEL PRIMARY CARE - HAYTI | ||||
| 310 EAST MAIN | HAYTI | MO | 63851 | OUTPATIENT PHYSICIAN CLINIC |
| BOOTHEEL PRIMARY CARE - STEELE | ||||
| 213 5 WALNUT | STEELE | MO | 63877 | OUTPATIENT PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7, COLUMN F | PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 FOR THE FORM 990, WAS REDUCED BY BAD DEBT EXPENSE OF $7,304,395. |
| SCHEDULE H, PART I, LINE 7 | COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEET 1 AND 6. WORKSHEET 3 USED ACTUAL COST METHODS FROM THE ORGANIZATION'S COST REPORT. |
| SCHEDULE H, PART II | COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION PROVIDED COMMUNITY SUPPORT THROUGH AN R-3 PARTY AND TRUST OR TREAT, WHICH CONTRIBUTED TO YOUTH DEVELOPMENT AND SUPPORT. THE ORGANIZATION PARTICIPATED IN THE HAYTI JOB FAIR TO PROMOTE WORKFORCE DEVELOPMENT. MEMBERS OF THE ORGANIZATION'S MANAGEMENT ARE MEMBERS OF THE HAYTI ROTARY AND THE DUES ASSOCIATED WITH THIS MEMBERSHIP ARE REPORTED AS ECONOMIC DEVELOPMENT. |
| SCHEDULE H, PART III, SECTION A, LINE 2 | BAD DEBT EXPENSES: LINE 2 WAS CALCULATED USING THE BAD DEBT EXPENSE PER THE REVIEWED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: THE ORGANIZATION HAS ESTIMATED THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY FOR LINE 3 BASED ON CENSUS DATA SHOWING 28.8% OF THE POPULATION IN ITS SERVICE AREA FALLING BELOW THE FEDERAL POVERTY GUIDELINES. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | BAD DEBT EXPENSE FOOTNOTE: A FOOTNOTE TO THE FINANCIAL STATEMENTS READS NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD PARTY PAYERS AND OTHERS FOR SERVICES RENDERED. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS ON THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. LAWS AND REGULATIONS GOVERNING THE MEDICARE AND MEDICAID PROGRAMS ARE EXTREMELY COMPLEX AND SUBJECT TO INTERPRETATION; AS A RESULT THERE IS AT LAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALITY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT: GENERAL NEEDS ASSESSMENT IS PERFORMED BY THE BOARD OF DIRECTORS AND MANAGEMENT, WHO REGULARLY MEET WITH LOCAL PROVIDERS TO ASSESS COMMUNITY NEEDS AND DEVELOP STRATEGIES FOR ADDRESSING THESE NEEDS. APPROPRIATE PROGRAMS ARE IMPLEMENTED AS A RESULT. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: PATIENTS ARE ASKED UPON ADMISSION IF THEY WOULD LIKE TO APPLY FOR ASSISTANCE. A CASEWORKER MAKES IN-ROOM VISITS TO THOSE WHO APPLY AND ASSISTS IN ENROLLMENT IN ANY PROGRAMS FOR WHICH THE PATIENT QUALIFIES. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION: THE HOSPITAL SERVES PEMISCOT, EASTERN DUNKLIN, AND SOUTHERN NEW MADRID COUNTIES OF SOUTHEAST MISSOURI. PEMISCOT COUNTY'S MEDIAN HOUSEHOLD INCOME WAS $39,964 WHEN LAST MEASURED IN 2014, WITH 28.8% PERSONS LIVING BELOW THE POVERTY LEVEL. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH: THE HOSPITAL SENDS EMPLOYEES TO WORK AT LOCAL HEALTH FAIRS, INCLUDING CHECKING BLOOD PRESSURE AND BASIC LAB WORK. ONE DOCTOR HAS STARTED A NEW PROGRAM TO ADDRESS TEEN PREGNANCY. THE HOSPITAL ALSO PROVIDES EMPLOYEES TO ADMINISTER FLU SHOTS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GHAITH KHAIR | ||||||||||||||
| PHYSICIAN | $371,413 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $1,350 | $0 | $372,763 | $0 | $0 | $0 |
| LARA HUFFMAN | ||||||||||||||
| PHYSICIAN | $326,250 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $921 | $0 | $327,171 | $0 | $0 | $0 |
| ABDULLAH ARSHAD | ||||||||||||||
| PHYSICIAN | $350,214 | $0 | $964,191 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $1,314,405 | $0 | $0 | $0 |
| BABATUNDE OLADIRAN | ||||||||||||||
| PHYSICIAN | $283,233 | $0 | $287,686 | $0 | $0 | $0 | $0 | $0 | $25,477 | $0 | $596,396 | $0 | $0 | $0 |
| AMY LOCKHERT | ||||||||||||||
| PHYSICIAN | $248,359 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $976 | $0 | $249,335 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | NON-FIXED PAYMENTS: PHYSICIANS MAY BE ELIGIBLE TO RECEIVE AN INCENTIVE PAY BONUS BASED ON PRODUCTIVITY VOLUME. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 1 | ORGANIZATION'S MISSION: PEMISCOT MEMORIAL HEALTH SYSTEMS IS COMMITTED TO PROVIDE AN ORGANIZED SYSTEM OF HEALTHCARE SERVICES TO ALL PERSONS WITHIN OUR SERVICE AREA WITHOUT REGARD TO AGE, SEX, RACE, SEXUAL ORIENTATION, COLOR, NATIONAL ORIGIN, CREED, FINANCIAL STATUS, PHYSICAL OR MENTAL CHALLENGE. DEMAND FOR EXPANSION OF EXISTING OR INITIATION OF NEW PROGRAMS AND SERVICES ARE EVALUATED ON AN ONGOING BASIS RESULTING IN INCREMENTAL IMPROVEMENTS IN THE DEGREE OF QUALITY OF SERVICES RENDERED IN DIRECT RESPONSE TO THE CHANGING HEALTHCARE NEEDS OF THE COMMUNITY. PEMISCOT MEMORIAL HEALTH SYSTEMS STRIVES TO WORK IN COLLABORATION WITH LOCAL, STATE AND FEDERAL ORGANIZATIONS TO ENSURE ACCESS TO PRIMARY CARE FOR ALL RESIDENTS WITH SPECIAL EMPHASIS ON PREVENTATIVE HEALTH AND WELLNESS. WE DILIGENTLY WORK TO MAINTAIN OUR FINANCIAL STRENGTH IN ORDER THAT WE REMAIN A PROMINENT PROVIDER OF MEDICAL SERVICES FOR THE REGION. |
| FORM 990, PART IV, LINE 20B | AUDITED FINANCIAL STATEMENTS: THE ORGANIZATION IS ATTACHING THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31, 2012. AS THESE ARE THE MOST RECENT AUDITED FINANCIAL STATEMENTS. THE 2017 FINANCIAL STATEMENTS ARE REVIEWED FINANCIAL STATEMENTS RATHER THAN AUDITED FINANCIAL STATEMENTS. |
| FORM 990, PART VI, SECTION A, LINES 6 & 7A | MEMBERS: ANY VACANCY ON THE BOARD IS FILLED BY APPOINTMENT BY THE PEMISCOT COUNTY COURT. THE APPOINTEE HOLDS THE OFFICE UNTIL THE NEXT ELECTION, OR WHEN THE SUCCESSOR IS ELECTED. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF FORM 990: THE FORM IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM USING INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT AND MANAGEMENT. FORM 990 WILL BE PROVIDED TO THE BOARD OF DIRECTORS AT THE REGULAR SCHEDULED BOARD MEETING FOLLOWING THE FILING OF THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | COMPENSATION REVIEW: THE COMPENSATION OF THE CEO, CFO, AND COO IS REVIEWED AND APPROVED BY THE BOARD AND DOCUMENTED IN THE MINUTES. THE BOARD USES MHA EXECUTIVE SURVEY DATA TO COMPARE COMPENSATION TO LIKE ORGANIZATIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT AVAILABILITY: GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:5548289 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:523874 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MAINTENANCE AGREEMENTS TOTAL FEES:508318 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:332000 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:COLLECTION AGENCIES TOTAL FEES:132517 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTING TOTAL FEES:106913 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LAB SERVICES TOTAL FEES:37651 |