MERCY RESTORATIVE CARE HOSPITAL INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MERCY RESTORATIVE CARE HOSPITAL INC (EIN 75-3054855)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-15
- IRS object ID
- 201811359349308856
- Schema version
- 2016v3.1
- 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 | 2018-05-15T14:10:47-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 425 HOUSTON ST STE 600 | AddressLine1Txt |
| City | FORT WORTH | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76102 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 753054855 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mercy Restorative Care Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MIKE MURRAY | InCareOfNm |
| Business Name Control | MERC | BusinessNameControlTxt |
| Phone | 9729436400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7800 N Dallas Parkway Suite 200 | AddressLine1Txt |
| City | Plano | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75024 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES HILL | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 9729436400 | PhoneNum |
| Signature | 2018-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Melva Scott | PreparerPersonNm |
| PTIN | P01207335 | PTIN |
| Phone | 8173351900 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEE SCHEDULE O | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAMES HILL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7800 N Dallas Parkway STE 200 | AddressLine1Txt |
| City | Plano | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75024 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,463,310 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://CONTINUECARE.ORG/PINEVILLE/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | OUR MISSION IS TO PROVIDE EXCEPTIONAL HEALTHCARE WITH DEDICATION AND COMPASSION TO MEDICALLY COMPLEX EXTENDED STAY PATIENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 255 | TotalEmployeeCnt |
| Total Volunteers | 0 | 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 | $21,560,986 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,448,342 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,196 | PYInvestmentIncomeAmt |
| CY Investment Income | $11,389 | CYInvestmentIncomeAmt |
| PY Other Revenue | $210,288 | PYOtherRevenueAmt |
| CY Other Revenue | $3,579 | CYOtherRevenueAmt |
| PY Total Revenue | $21,775,470 | PYTotalRevenueAmt |
| CY Total Revenue | $16,463,310 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,176,901 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,185,145 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,011,256 | PYOtherExpensesAmt |
| CY Other Expenses | $8,976,008 | CYOtherExpensesAmt |
| PY Total Expenses | $20,188,157 | PYTotalExpensesAmt |
| CY Total Expenses | $18,165,153 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,587,313 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,701,843 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,056,579 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,527,114 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,408,034 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,580,412 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,648,545 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,946,702 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | OUR MISSION IS TO PROVIDE EXCEPTIONAL HEALTHCARE WITH DEDICATION AND COMPASSION TO MEDICALLY COMPLEX EXTENDED STAY PATIENTS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $14,945,497 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $16,448,342 | RevenueAmt |
| Desc | MERCY RESTORATIVE CARE HOSPITAL INC., D/B/A CAROLINAS CONTINUECARE HOSPITAL AT PINEVILLE (CCHP), IS A STAND-ALONE 40-BED LTACH HOUSED IN A MODERN FACILITY THAT WAS CUSTOM DESIGNED TO TREAT CRITICALLY ILL, MEDICALLY COMPLEX PATIENTS. CCHP IS LOCATED IN SOUTHERN CHARLOTTE ON THE CAROLINAS HEALTHCARE SYSTEM PINEVILLE CAMPUS. CCHP IS SPECIFICALLY LICENSED AND ADMINISTERED TO PROVIDE CARE FOR PATIENTS WHO REQUIRE DAILY PHYSICIAN AND STAFF ATTENTION FOR COMPLEX CONDITIONS. CCHP'S EMPLOYEES ARE A DEDICATED TEAM WHO WORK TOGETHER DELIVERING THE BEST POSSIBLE CARE FOR OUR PATIENTS. SINCE CCHP HAS A LONGER LENGTH OF STAY, THE STAFF HAS THE OPPORTUNITY TO KNOW PATIENTS AND FAMILIES. CCHP BELIEVES SPENDING QUALITY TIME MAKES A DIFFERENCE. CCHP IS A SEPARATE YET FULLY LICENSED ACUTE-CARE HOSPITAL WITH THE ABILITY TO PROVIDE INTENSIVE AND COMPLEX MEDICAL TREATMENT. CCHP'S SPECIALTY PROGRAMS ARE SPECIFICALLY DESIGNED TO MEET THE NEEDS OF LONG-TERM, ACUTE-CARE PATIENTS. DURING THE FISCAL YEAR ENDED JUNE 30, 2017, CCHP'S TOTAL PATIENTS ADMITTED WERE 400 AND THE TOTAL NUMBER OF PATIENT CARE DAYS PROVIDED WAS 10,479. THE AVERAGE DAILY CENSUS WAS 28.7 PATIENTS AND THE AVERAGE LENGTH OF STAY OF THE DISCHARGED PATIENTS EXCEEDED 28 DAYS. | Desc |
| Total Program Service Expenses | $14,945,497 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| 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 | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 255 | 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | 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 | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | false | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MIKE MURRAY | PersonNm |
| Phone | 9729431225 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7800 N DALLAS PARKWAY SUITE 200 | AddressLine1Txt |
| City | PLANO | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75024 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Leslie Boney | |||||||||
| Director/Pres. (TERM 10/16) | 1.0 | 39.0 | Yes (X) | Yes (X) | $0 | $316,141 | $36,107 | ||
| Joseph Bowers | |||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Joyce Korzen | |||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Alan Sauber | |||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Michael Williams | |||||||||
| Director (TERM 4/17) | 1.0 | 39.0 | Yes (X) | $0 | $1,194,125 | $32,261 | |||
| Earl Scott Warrick | |||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| COLLIN LANE | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| APRIL MYERS | |||||||||
| DIRECTOR/PRES. (EFF. 10/16) | 1.0 | 39.0 | Yes (X) | Yes (X) | $0 | $228,965 | $38,129 | ||
| JIM Hendrick | |||||||||
| director (Start 4/17) | 1.0 | 39.0 | Yes (X) | $0 | $0 | $0 | |||
| David Butler | |||||||||
| Secretary | 1.0 | 39.0 | Yes (X) | $0 | $410,005 | $30,226 | |||
| JAMES HILL | |||||||||
| TREASURER | 1.0 | 39.0 | Yes (X) | $0 | $318,169 | $36,738 | |||
| DEREK MURZYN | |||||||||
| CEO | 40.0 | 0.0 | $0 | $156,072 | $12,113 | Yes (X) | |||
| Hajrudin Begic | |||||||||
| Registered Nurse | 40.0 | 0.0 | $127,992 | $0 | $0 | Yes (X) | |||
| Janet Combs | |||||||||
| director of rehab | 40.0 | 0.0 | $117,810 | $0 | $0 | Yes (X) | |||
| Kimberly H Singelton | |||||||||
| registered nurse | 40.0 | 0.0 | $112,442 | $0 | $0 | Yes (X) | |||
| Noreen Kipp | |||||||||
| nursing manager | 40.0 | 0.0 | $107,356 | $0 | $0 | Yes (X) | |||
| DEBRA S BROWN | |||||||||
| marketing director | 40.0 | 0.0 | $104,716 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $570,316 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,623,477 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $185,574 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| McDermott Will Emery LLP | |||||
| 444 West Lake Street | CHICAGO | IL | 60606 | legal services | $324,956 |
| Charlotte eye ears nose throat | |||||
| 6035 Fairview Road | CHARLOTTE | NC | 28210 | physician svcs | $125,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INPATIENT REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $16,448,342 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,448,342 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,448,342 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,389 | TotalRevenueColumnAmt |
| Exclusion | $11,389 | 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 |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
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 |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICAL RECORDS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $3,579 | TotalRevenueColumnAmt |
| Exclusion | $3,579 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,579 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,463,310 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,448,342 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $14,968 | 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 | $4,000 | TotalAmt |
| Program Services | $4,000 | ProgramServicesAmt |
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 | $0 | TotalAmt |
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 | $7,190,435 | TotalAmt |
| Program Services | $6,487,930 | ProgramServicesAmt |
| Management And General | $702,505 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,254 | TotalAmt |
| Program Services | $106,429 | ProgramServicesAmt |
| Management And General | $11,825 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,322,622 | TotalAmt |
| Program Services | $1,190,360 | ProgramServicesAmt |
| Management And General | $132,262 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $553,834 | TotalAmt |
| Program Services | $498,451 | ProgramServicesAmt |
| Management And General | $55,383 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $540,000 | TotalAmt |
| Program Services | $540,000 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $282,777 | TotalAmt |
| Program Services | $282,777 | ProgramServicesAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,960 | TotalAmt |
| Program Services | $102,960 | ProgramServicesAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $473 | TotalAmt |
| Program Services | $473 | ProgramServicesAmt |
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 | $3,843,580 | TotalAmt |
| Program Services | $3,707,376 | ProgramServicesAmt |
| Management And General | $136,204 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,001 | TotalAmt |
| Management And General | $12,001 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,558 | TotalAmt |
| Management And General | $63,558 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
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 | $1,392,648 | TotalAmt |
| Management And General | $1,392,648 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,662 | TotalAmt |
| Management And General | $39,662 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
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 | $5,489 | TotalAmt |
| Management And General | $5,489 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,000 | TotalAmt |
| Management And General | $61,000 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $426,961 | TotalAmt |
| Management And General | $426,961 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,158 | TotalAmt |
| Management And General | $180,158 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES | $1,943,540 | $1,943,540 |
| EQUIPMENT LEASES | $101,783 | $101,783 |
| MAINTENANCE CONTRACTS | $72,172 | $72,172 |
| BAD DEBT EXPENSE | -$235,792 | -$235,792 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,038 | TotalAmt |
| Program Services | $143,038 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,165,153 | TotalAmt |
| Program Services | $14,945,497 | ProgramServicesAmt |
| Management And General | $3,219,656 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,796,673 | BOYAmt |
| EOY | $322,607 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,975,745 | BOYAmt |
| EOY | $3,393,412 | 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 | $57,655 | BOYAmt |
| EOY | $47,081 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $554,204 | BOYAmt |
| EOY | $484,949 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,896,570 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,142,313 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,160,682 | BOYAmt |
| EOY | $1,754,257 | 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 | $2,511,620 | BOYAmt |
| EOY | $2,524,808 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,056,579 | BOYAmt |
| EOY | $8,527,114 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,498,518 | BOYAmt |
| EOY | $2,336,954 | 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 | $0 | BOYAmt |
| EOY | $0 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,199,117 | BOYAmt |
| EOY | $1,031,932 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$289,601 | BOYAmt |
| EOY | -$1,788,474 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,408,034 | BOYAmt |
| EOY | $1,580,412 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,648,545 | BOYAmt |
| EOY | $6,946,702 | 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 | $8,648,545 | BOYAmt |
| EOY | $6,946,702 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,056,579 | BOYAmt |
| EOY | $8,527,114 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,701,843 | ReconcilationRevenueExpnssAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $473 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $473 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1i | FormAndLineReferenceDesc |
| Explanation | MERCY RESTORATIVE CARE HOSPITAL, INC. PAID $5,084 TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) IN FISCAL YEAR 2017. THE PORTION OF AHA DUES THAT WERE REPORTED FOR LOBBYING PURPOSES WAS 9.31%. TOTAL DUES PAID AND REPORTED FOR LOBBYING ACTIVITIES WERE $5,084 X 9.31% = $473. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $94,894 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,769 | DepreciationAmt |
| Book Value | $68,125 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,801,676 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,115,544 | DepreciationAmt |
| Book Value | $1,686,132 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $1,754,257 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY PAYABLES | -$1,840,027 |
| ESTIMATED THIRD PARTY SETTLEMENTS | $51,553 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | -$1,788,474 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $86,765 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $86,765 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00470 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $86,765 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $86,765 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00470 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $92,765 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $92,765 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | -$235,792 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $8,570,000 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,502,710 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$932,710 | 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 | Yes (true) | 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 | Carolinas CCH at Pineville | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10648 PARK ROAD | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28210 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://CONTINUECARE.ORG/PINEVILLE/ | WebsiteAddressTxt |
| State License | H0278 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carolinas CCH at Pineville | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (true) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| 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 | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, Section C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Section C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | false | NondisEmergencyCarePolicyInd |
| No Emergency Care | Yes (X) | NoEmergencyCareInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 2 | MERCY RESTORATIVE CARE HOSPITAL, INC. WAS ACQUIRED BY CAROLINAS COMMUNITY CARE ON OCTOBER 1, 2015. |
| Part V, Line 5 | Carolinas ContinueCare Hospital at Pineville (Carolinas CCH at Pineville), formerly Carolinas Specialty Hospital, is a stand-alone 40-bed LTACH located in southern Charlotte on the Carolinas Healthcare System Pineville campus. The hospital serves a community where 12% of the residents have incomes that are below the poverty level. In Mecklenburg County the median income is $56,931. A comprehensive Community Health Needs Assessment (CHNA) was conducted for Carolinas CCH at Pineville during fiscal year 2016. Community input was received during interviews conducted from January 27, 2017 through February 10, 2017. The hospitals study area was defined as Mecklenburg County. Carolinas CCH at Pineville provided Community Hospital Corporation with a list of persons with special knowledge of public health in Mecklenburg County, including public health representatives, not-for-profit organization professionals, charities and other individuals who focus specifically on underrepresented groups. From that list, eleven in depth interviews were conducted using a structured interview guide. Extensive notes were taken during each interview and then quantified based on responses, communities and populations (minority, elderly, un/underinsured, etc.) served, and priorities identified by respondents. Qualitative data from the interviews was also analyzed and reported. Cancer is the leading cause of death in Mecklenburg County and the state (2013-2015). Heart disease is the second leading cause of death in Mecklenburg County and the state (2013-2015). Death rates in Mecklenburg County and the state from both cancer and heart disease remained relatively steady between 2013 and 2015. However, overall mortality rates in Mecklenburg County and North Carolina steadily increased between 2013 and 2015. Deaths from fatal accidents, the fifth leading cause of death in Mecklenburg County and deaths from nephritis, nephrotic syndrome and nephrosis, the seventh leading cause of death in Mecklenburg County, increased between 2013 and 2015. The percentage of the total civilian noninstitutionalized population without health insurance coverage in the county (15.2%) is higher than the state rate (14.4%) and the national rate (13.0%) (2011-2015). In 2014, the percent of adults (age 18+) that experienced a cost barrier to care during the past 12 months in Mecklenburg County (17.0%) was consistent with the state rate (16.0%). Populations that were identified as the most underserved in the community by interviewees were: the elderly, youth, veterans, and un/underinsured populations in the community. These underserved groups were identified as most at risk for inadequate care due to the following: Elderly - Transportation barriers Issues affording health services and medication Lack of long term care resources for low income seniors Difficulty navigating and understanding the health care system Teens/Adolescents High need for maternal services and preventive education Tobacco control Veterans Limited access to health care services Need for more mental and behavioral health care sources Un/Underinsured Lack of access to primary care services and providers Lack of affordable care options Overuse of the Emergency Room / lack of an established medical home Of the individuals providing input, 90.9% represent members of a medically underserved, low-income or minority population in the community, or individuals or organizations serving or representing the interest of such populations. 9.1% of those providing input work for a state, local, tribal or regional governmental public health department with knowledge, information or expertise relevant to the health needs of the community. Organizations Interviewed: -Life SHARE of the Carolinas -Program for All Inclusive Care for the Elderly (PACE) of the Southern Piedmont -Brian Center Reddman -Carolinas Healthcare System -Helping Hands Specialized Transport -Pulmonary & Critical Care Consultants -Mecklenburg County Health Department -Carolinas Healthcare System North East -Carolinas Wound Care Center Part V, Lines 7a & 10a The CHNA can be found on the following website: http://continuecare.org/pineville/community-health-needs-assessment/ Part V, Line 11 The most recently conducted CHNA indicated that there were three main needs in the community served by Carolinas CCH at Pineville. Hospital leadership prioritized those needs and decided to address the first two. OBJECTIVE #1: INCREASE HEALTHY LIFESTYLE EDUCATION AND PREVENTION RESOURCES AT THE HOSPITAL AND IN THE COMMUNITY. 1.A. Carolinas CCH at Pineville will continue to participate in and/or host community health fairs on a regular basis. 1.B. Carolinas CCH at Pineville will continue to provide various health screenings at no cost, such as glucose, pulse oximetry, and blood pressure checks, at its vendor/fair events. 1.C. Carolinas CCH at Pineville will continue to participate in lunch and learn seminar events to educate local health care providers and the community on services offered by the LTAC facility on a regular basis. 1.D. Carolinas CCH at Pineville is available to speak at community events, provide information, or participate in other educational opportunities by request. 1.E. Carolinas CCH at Pineville will continue to offer liaisons to give education on Long Term Acute Care (LTAC) services and patients who may need LTAC services as opportunities arise. 1.F. Carolinas CCH at Pineville will continue to train all clinical staff on BLS and ACLS for all RN and RT staff. 1.G. Carolinas CCH at Pineville will continue to provide meeting space at no cost for support groups and community organizations upon request. 1.H. Carolinas CCH at Pineville will continue to participate in or provide space for meetings held by various local, state and national organizations to share information about services offered at the LTAC facility, such as the Case Management Society of America meeting that includes a keynote speaker who provides education to the audience on a significant health topic within the community. Continuing Education Units (CEUs) may be offered at some of the events. 1.I. Carolinas CCH at Pineville will continue to participate in conferences focused around their patient population's needs, such as the American Case Management Association (ACMA) North Carolina Conference (bi-annually), Case Management Society of America (CMSA) North Carolina Conference (bi-annually), and the Northwest Area Health Education Center (NWAHEC) Annual High Country Conference on Respiratory Care. 1.J. Carolinas CCH at Pineville will continue to partner with and support the local chapter of the American Lung Association. 1.K. Carolinas CCH at Pineville staff will continue to provide board representation for ALA, as well as sponsorship and support for the ALA Climb event to raise money and awareness for ALA within the community 1.L. Carolinas CCH at Pineville will engage in a variety of employee wellness initiatives, including a health plan that is prevention driven. If employees meet certain criteria they will receive a reduction on a portion of their premiums. Other initiatives include: promote employee and family wellness via Accountable Health (formerly Principal Wellness Program); offer Need Specific Special Programs; smoking cessation opportunities; and weight management. 1.M. Carolinas CCH at Pineville will continue to incentivize employees to maintain healthy lifestyles on their health plans through offering a reduction on a portion of their premiums if employees meet certain criteria. 1.N. Carolinas CCH at Pineville will continue to offer the Employee Assistance Program (EAP) through Beacon Health Options to help employees navigate various life challenges. 1.O. Carolinas CCH at Pineville employees have access to the healthier options in the cafeteria, such as a salad bar, as well as nutritional facts for food that is served. 1.P. Carolinas CCH at Pineville will continue to serve as a tobacco-free facility. 1.Q. Carolinas CCH at Pineville will continue to host interdisciplinary team meetings on a weekly basis that include all necessary persons in discussions regarding individual patient care for a more comprehensive, patient-centered approach. Carolinas CCH at Pineville staff encourage family members to attend as well in order to fully understand the needs of the patient. 1.R. Carolinas CCH at Pineville will continue to provide patients' other physicians with a copy of their discharge summaries upon request. 1.S. Carolinas CCH at Pineville will continue to conduct post discharge follow up calls for every patient that has been discharged. For patients that are discharged to their home, a call is placed within the first 24-72 hours to assess the transition home, and to identify and address any issues or problems (i.e., inability to obtain prescriptions, home health care start of care, pain and symptom management, equipment concerns, or effectiveness of discharge planning). Follow up calls are also |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7, COLUMN (F) | COMMUNITY BENEFIT EXPENSE The TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) IS $18,165,153. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS ($235,792) THIS LEFT A TOTAL EXPENSE OF $18,400,945 is a long term acute care hospital, it will have lower percentages than an acute care hospital. |
| PART III, LINE 2 | BAD DEBT COSTING METHODOLOGY THE BAD DEBT COSTING METHODOLOGY VARIES BY PAYER TYPE. FOR MEDICARE, BAD DEBT IS RECORDED WHEN RECOGNIZED TO THE EXTENT OF 35%. MEDICARE REIMBURSES THE ORGANIZATION FOR ALLOWABLE BAD DEBT AT 65%. MEDICARE BAD DEBT RELATES TO THE PRIVATE PAY PORTION OF CARE SUCH AS CO-PAY AND DEDUCTIBLE AMOUNTS. FOR MANAGED CARE, WE RESERVE BAD DEBT WHEN RECOGNIZED AT 100% OF CO-PAY AND DEDUCTIBLE AMOUNTS. |
| PART III, LINE 4 | BAD DEBT EXPENSE FOOTNOTE MERCY RESTORATIVE CARE HOSPITAL, INC. DOES NOT HAVE ITS OWN AUDIT. RATHER, IT IS PART OF COMMUNITY HOSPITAL CORPORATION AND THE BAD DEBT DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS DOES NOT COMPLETELY MATCH THE ORGANIZATION'S PRACTICE. THE BAD DEBT COSTING METHODOLOGY VARIES BY PAYER TYPE. FOR MEDICARE, BAD DEBT IS RECORDED WHEN RECOGNIZED TO THE EXTENT OF 35%. MEDICARE REIMBURSES THE ORGANIZATION FOR ALLOWABLE BAD DEBT AT 65%. MEDICARE BAD DEBT RELATES TO THE PRIVATE PAY PORTION OF CARE SUCH AS CO-PAY AND DEDUCTIBLE AMOUNTS. FOR MANAGED CARE, WE RESERVE BAD DEBT WHEN RECOGNIZED AT 100% OF CO-PAY AND DEDUCTIBLE AMOUNTS. |
| PART III, LINE 8 | COSTING METHODOLOGY THE COSTING METHODOLOGY USED ON LINE 6 COMES FROM THE COST REPORT (INPATIENT PPS COST-TO-CHARGE RATIO COMPUTATION). The shortfall is a community benefit as it is the cost of providing care to the community that is not reimbursed by the medicare program. By providing care to these individuals, the hospital is improving the health of the community. |
| PART III, LINE 9B | Application of collection practices to those qualifying for financial assistance IF A PATIENT OF MERCY RESTORATIVE CARE HOSPITAL, INC. QUALIFIES FOR ITS CHARITY CARE POLICY THE PATIENTS ACCOUNT IS ADJUSTED ACCORDINGLY. PATIENT ACCOUNTS WITH REMAINING BALANCES WILL BE REASSESSED TO DETERMINE THEIR ABILITY TO PAY AND WILL EITHER BE ELIGIBLE TO PARTICIPATE IN A PAYMENT PLAN OR THEIR ACCOUNT BALANCE WILL BE WRITTEN OFF. |
| PART VI, LINE 2 | NEEDS ASSESSMENT MERCY RESTORATIVE CARE HOSPITAL, INC. D/B/A CAROLINAS CONTINUECARE HOSPITAL AT PINEVILLE (THE "HOSPITAL") IS A 40-BED LONG-TERM ACUTE CARE HOSPITAL. THE HOSPITAL WAS INCORPORATED UNDER THE LAWS OF NORTH CAROLINA FOR THE PURPOSE OF PROMOTING AND IMPROVING THE HEALTH STATUS OF THE COMMUNITY BY DEVELOPING AND PROVIDING LONG-TERM ACUTE CARE SERVICES FOR THE BENEFIT OF CITIZENS OF MECKLENBURG AND SURROUNDING COUNTIES. AS REPORTED IN SCHEDULE H, PART V, SECTION B, LINES 1-7, THE HOSPITAL CONDUCTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING 2017. The Carolinas CCH at Pineville Board reviewed and adopted the 2017 Community Health Needs Assessment and Implementation Plan on May 3, 2017. THE HOSPITAL'S CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN THE FINAL REGULATIONS RELEASED DECEMBER 29, 2014. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY. Carolinas CONTINUECARE HOSPITAL AT Pineville WILL BE WORKING TO PROVIDE VARIOUS CHARITABLE SERVICES AND TO CONDUCT VARIOUS COMMUNITY ACTIVITIES TO AND WITHIN THE LOCAL COMMUNITY IN THE NEAR FUTURE. |
| PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PATIENTS AND PERSONS WHO MAY BE BILLED FOR SERVICES ARE INFORMED UPON ADMISSION TO THE HOSPITAL BY A FACE TO FACE VISIT WITH THE HOSPITAL/ADMISSIONS STAFF. THE PATIENT FINANCIAL OBLIGATION IS DISCUSSED WITH THE RESPONSIBLE PARTY. THE HOSPITAL CHARITY CARE POLICY IS DISCUSSED WITH EACH RESPONSIBLE PARTY AND IF IT IS FELT THAT THE PATIENT WOULD QUALIFY FOR THE CHARITY PROGRAM THEN THE NECESSARY DOCUMENTS WOULD BE PRESENTED BY THE RESPONSIBLE PARTY TO THE BUSINESS OFFICE ASSOCIATE FOR REVIEW. |
| PART VI, LINE 4 | COMMUNITY INFORMATION MERCY RESTORATIVE CARE HOSPITAL, INC. (MRC) SERVES PRIMARILY THOSE PATIENTS WHO ARE FROM MECKLENBURG AND THE SURROUNDING COUNTIES OR THOSE WHO HAVE FAMILY SUPPORT FROM MEMBERS LIVING IN THESE COUNTIES. GIVEN THE SPECIALIZED SERVICES MRC REACHES OUT TO ALL OF THE NORTH AND SOUTH CAROLINA COMMUNITITES AS WELL AS SOUTHERN VIRGINIA AND SOUTHERN WEST VIRGINIA. CAROLINAS CONTINUECARE HOSPITAL AT PINEVILLE PRIMARY SERVICE AREA (CABARRUS, NC, GASTON, NC, MECKLENBERG, NC, UNION, NC, AND YORK, SC - 2010 CENSUS) SERVES 1,731,090 RESIDENTS OF WHICH 173,584 ARE GREATER THAN 65 YEARS OF AGE. OUR SECONDARY SERVICE AREA (CHESTER, SC, CLEVELAND, NC, IREDELL, NC, LANCASTER, SC, LINCOLN, NC, ROWAN, NC, AND STANLY, NC - 2010 CENSUS) SERVES 644,585 RESIDENTS OF WHICH 91,555, ARE GREATER THAN 65 YEARS OF AGE. |
| PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH Carolinas ContinueCARE Hospital at Pineville is a community-based LTACH dedicated to serving the needs of the local community by delivering superior services with a collaborative spirit. The hospital is working to provide various charitable services as well as conduct various community activites to and within the local community. The hospital sponsored a healthcare convention and is exploring participating in drive events (ex: toy, food, school supply, and clothing drives). The hospital continues to serve in leadership roles and volunteers with many agencies in the community. Mercy Restorative Care Hospital, Inc. educates patients and families about LTACHs and about what services can be provided in conjunction with community resources through speaking at local events and by providing educational brochures. |
| PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM THE HOSPITAL IS HOUSED IN ANOTHER HOSPITAL BUT THE TWO ARE SEPARATE FOR PURPOSES OF SPONSORSHIP AND COMMUNITY RELATED HEALTHCARE EVENTS. |
| PART VI, LINE 7 | STATE FILING OF COMMUNITY BENEFIT REPORT N/A |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | 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 (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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Leslie Boney | ||||||||||||||
| Director/Pres. (TERM 10/16) | $0 | $117,137 | $0 | $130,462 | $0 | $68,542 | $0 | $15,743 | $0 | $20,364 | $0 | $352,248 | $0 | $5,544 |
| Michael Williams | ||||||||||||||
| Director (TERM 4/17) | $0 | $673,519 | $0 | $312,931 | $0 | $207,675 | $0 | $6,822 | $0 | $25,439 | $0 | $1,226,386 | $0 | $0 |
| David Butler | ||||||||||||||
| Secretary | $0 | $299,424 | $0 | $84,619 | $0 | $25,962 | $0 | $4,920 | $0 | $25,306 | $0 | $440,231 | $0 | $0 |
| APRIL MYERS | ||||||||||||||
| DIRECTOR/PRES. (EFF. 10/16) | $0 | $179,501 | $0 | $20,532 | $0 | $28,932 | $0 | $14,232 | $0 | $23,897 | $0 | $267,094 | $0 | $0 |
| JAMES HILL | ||||||||||||||
| TREASURER | $0 | $232,882 | $0 | $67,850 | $0 | $17,437 | $0 | $6,845 | $0 | $29,893 | $0 | $354,907 | $0 | $0 |
| DEREK MURZYN | ||||||||||||||
| CEO | $0 | $110,901 | $0 | $16,260 | $0 | $28,911 | $0 | $6,357 | $0 | $5,756 | $0 | $168,185 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SUPPLEMENTAL COMPENSATION INFORMATION | SCHEDULE J, PART I, LINE 3 MERCY RESTORATIVE CARE HOSPITAL INC.'S EXECUTIVES ARE EMPLOYED BY ITS WHOLLY-OWNED SUBSIDIARY, COMMUNITY HOSPITAL CONSULTING, WHICH FOLLOWS THE COMPENSATION POLICIES OF COMMUNITY HOSPITAL CORPORATION (CHC). CHC ENGAGED SULLIVAN COTTER TO CONDUCT A COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITIES, AND CURRENT INCUMBENTS' COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. The organization followed the process for the year ended 6/30/17 for its officers, directors, trustees and key employees and other management officials. Schedule J, Part I, Line 4a Severance Payment Leslie Boney, President & Director of Mercy Restorative Care, Inc., received $39,735 in severance payments from a related organization during 2016. Schedule J, Part I, Line 4b NONQUALIFIED RETIREMENT PLAN PARTICIPATION WAS PAID TO: MICHAEL WILLIAMS - $167,421 DAVID BUTLER - $15,750 JAMES HILL - $12,641 LESLIE BONEY - $11,862 |
| SCHEDULE J, PART I, LINE 7 | COMPENSATION CONTINGENT ON NET EARNINGS A PORTION OF THE DISCRETIONARY INCENTIVE COMPENSATION PROGRAM WAS BASED ON THE CONSOLIDATED EBIDA OF CHC. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DOING BUSINESS AS | FORM 990, BOX C MERCY RESTORATIVE CARE HOSPITAL, INC. IS DOING BUSINESS AS CAROLINAS CONTINUECARE HOSPITAL AT PINEVILLE. DESCRIPTION OF MANAGEMENT ARRANGEMENT FORM 990, PART VI, QUESTION 3 CHC COMMUNITY CARE, LLC PROVIDES CERTAIN FINANCIAL, TECHNICAL AND MANAGERIAL SUPPORT SERVICES TO THE HOSPITAL. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 THE SOLE SHAREHOLDER OF MERCY RESTORATIVE CARE HOSPITAL, INC. IS CAROLINAS COMMUNITY CARE, LLC ("CARCC"). DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, QUESTION 7A THE SOLE SHAREHOLDER SHALL MAINTAIN A MINORITY VOTING INTEREST OF THE BOARD OF DIRECTORS. ANY DIRECTOR MAY BE REMOVED AT ANY TIME, WITH OR WITHOUT CAUSE BY THE SOLE MEMBER. THE BOARD OF DIRECTORS SHALL BE COMPRISED OF 5 VOTING DIRECTORS PLUS 2 NON-VOTING EX-OFFICIO DIRECTORS. |
| DESCR CLASSES OF PERSONS/DECISIONS REQUIRING APPR/TYPE OF VOTING RIGHTS | FORM 990, PART VI, QUESTION 7B THE BOARD OF DIRECTORS MAY RECOMMEND, BUT SHALL NOT, WITHOUT EXPRESS WRITTEN CONSENT OF THE SOLE MEMBER, HAVE THE POWER TO TAKE ANY OF THE FOLLOWING ACTIONS: 1. ANY FUNDAMENTAL CHANGE IN THE MISSION OR PHILOSOPHY OF THE HOSPITAL 2. THE INCURRANCE OF DEBT, INCLUDING WITHOUT LIMITATION, BORROWINGS, GUARANTEES, LOANS, ENCUMBRANCES, OPERATING LEASES, PURCHASE OF LEASE OF REAL ESTATE, AND CAPITAL LEASES 3. ANY MERGER OR CONSOLIDATION TO WHICH THE HOSPITAL IS A PARTY 4. THE SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE HOSPITAL 5. POLICY CHANGES PERTAINING TO CHARITY CARE 6. APPOINTMENT AND REMOVAL OF CORPORATE DIRECTORS 7. ANY RELEASE OR CANCELLATION OF INDIVIDUAL CLAIMS IN EXCESS OF $25,000 |
| GOVERNING BODY | FORM 990, PART VI, QUESTION 8B THERE WERE NO COMMITTEES OF THE GOVERNING BODY. |
| DESCRIBE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 | FORM 990, PART VI, QUESTION 11B THE DETAILED REVIEW OF THE FORM 990 IS CONDUCTED BY THE HOSPITAL'S MANAGEMENT FOLLOWING THE PREPARATION AND REVIEW OF THE RETURN BY THE ORGANIZATION'S PAID PREPARER. AN ELECTRONIC COPY OF THE FINAL FORM 990 IS EMAILED TO EACH BOARD MEMBER PRIOR TO FILING WITH THE IRS. |
| DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST | FORM 990, PART VI, QUESTION 12C THE ORGANIZATION FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS ADOPTED BY ITS SOLE MEMBER, CAROLINAS COMMUNITY CARE, LLC, WHICH IN TURN FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS ADMINISTERED BY ITS PARENT, COMMUNITY HOSPITAL CORPORATION (CHC), WHICH REQUIRES ALL OFFICERS, DIRECTORS, KEY EMPLOYEES, HIGHLY COMPENSATED EMPLOYEES AND OTHER MANAGEMENT OFFICIALS ("COVERED PERSONS") TO DISCLOSE POTENTIAL CONFLICTS. THE ORGANIZATION'S BOARD FORMALLY ADOPTED CHC'S CONFLICT OF INTEREST POLICY FOR THE YEAR ENDED 6-30-15. PURSUANT TO THE POLICY, A DISCLOSURE STATEMENT IS CIRCULATED ANNUALLY TO COVERED PERSONS IN WHICH THE INDIVIDUAL MUST DISCLOSE TRANSACTIONS THAT MAY RESULT IN A CONFLICT. COVERED PERSONS ARE ALSO ENCOURAGED TO NOTIFY THE BOARD, APPROPRIATE MANAGEMENT PERSONNEL, CHIEF COMPLIANCE OFFICER, GENERAL COUNSEL OR THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BODY AS NECESSARY. WHEN NECESSARY, THE BOARD CHAIR OR APPROPRIATE BOARD COMMITTEE MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND RECOMMEND ALTERNATIVES TO THE APPLICABLE TRANSACTION OR ARRANGEMENT OR OTHERWISE DETERMINE IF THE CONFLICT CAN BE RESOLVED. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER THE CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION, AND WHETHER IT IS REASONABLE. THE GOVERNING BOARD OR COMMITTEE MAKES THE DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. ANY MEMBER OF THE BOARD OPERATING UNDER A CONFLICT IS NOT PERMITTED TO BE PRESENT OR OTHERWISE PARTICIPATE IN THE VOTE ON ANY MATTER TO WHICH THE CONFLICT RELATES. IF THE GOVERNING BOARD OR COMMITTEE OF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND AFTER INVESTIGATION THE BOARD OR COMMITTEE DETERMINES THAT THE COVERED PERSON FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE ORGANIZATION TAKES APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION, WHICH MAY INCLUDE, TERMINATION OF THE INDIVIDUAL'S MEMBERSHIP, EMPLOYMENT OR CONTRACT. |
| OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN | FORM 990, PART VI, QUESTIONS 15A & 15B THE ORGANIZATION FOLLOWS THE COMPENSATION POLICY OF COMMUNITY HOSPITAL CORPORATION (CHC). CHC ENGAGED SULLIVAN COTTER TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITIES AND CURRENT INCUMBENTS' COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. THE ORGANIZATION FOLLOWED THE PROCESS FOR THE YEAR ENDED 6-30-17 FOR ITS OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES AND OTHER MANAGEMENT OFFICIALS. THIS PROCESS IS PERFORMED EACH YEAR PRIOR TO THE ANNUAL EMPLOYEE EVALUATION PROCESS, WHICH ENDS ON OCTOBER 1ST OF EACH YEAR. |
| GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AVAILABLE TO PUBLIC | FORM 990, PART VI, QUESTION 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE AT ITS BUSINESS OFFICE UPON REQUEST. |
| OVERSIGHT OR SELECTION PROCESS | FORM 990, PART XII, QUESTION 2C THE AUDIT COMMITTEE OF COMMUNITY HOSPITAL CORPORATION, WHICH IS THE PARENT ORGANIZATION OF MERCY RESTORATIVE CARE HOSPITAL, INC. IS RESPONSIBLE FOR OVERSEEING THE EXTERNAL AUDIT OF THE CONSOLIDATED FINANCIALS. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES TOTAL FEES:2920936 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:922644 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (23 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SOUTHWEST COMMUNITY HOSPITAL INC | ||||||||||
| 7800 N DALLAS PKWY STE 200 | PLANO | TX | 75024 | 752725353 | SUPPORT ORG | TX | 501(C)(3) | 12C-III-FI | CHC | false |
| YOAKUM COMMUNITY HOSPITAL | ||||||||||
| 1200 CARL RAMERT DRIVE | YOAKUM | TX | 77995 | 742323822 | HOSPITAL | TX | 501(C)(3) | 3 | CHC | false |
| CONTINUECARE HOSPITAL OF TYLER | ||||||||||
| 800 E DAWSON STREET | TYLER | TX | 75701 | 200991990 | HOSPITAL | DE | 501(C)(3) | 3 | CCC | false |
| CONTINUECARE HOSPITAL OF SOUTHEAST TEXAS | ||||||||||
| 7800 N DALLAS PKWY STE 200 | PLANO | TX | 75024 | 201150480 | HOSPITAL | TX | 501(C)(3) | 3 | CCC | false |
| ST MARK'S MEDICAL CENTER | ||||||||||
| ONE ST MARKS PLACE | LA GRANGE | TX | 78945 | 743019849 | HOSPITAL | TX | 501(C)(3) | 3 | CHC | false |
| CHC COMMUNITY CARE LLC | ||||||||||
| 7800 N DALLAS PKWY STE 200 | PLANO | TX | 75024 | 371485773 | SUPPORT ORG | DE | 501(C)(3) | 12C-III-FI | CHC | false |
| CONTINUECARE HOSPITAL OF MIDLAND | ||||||||||
| 4214 ANDREWS HIGHWAY | MIDLAND | TX | 79703 | 463053684 | HOSPITAL | DE | 501(C)(3) | 3 | CCC | false |
| CONTINUECARE HOSPITAL HENDRICK MED CTR | ||||||||||
| 1900 PINE STREET 5TH FLOOR | ABILENE | TX | 79601 | 463607347 | HOSPITAL | DE | 501(C)(3) | 3 | CCC | false |
| CONTINUECARE HOSPITAL AT BAKERSFIELD | ||||||||||
| 7800 N DALLAS PKWY STE 200 | PLANO | TX | 75024 | 465236524 | HOSPITAL | DE | 501(C)(3) | 3 | CCC | false |
| CONTINUECARE HOSP BAP HLT MADISONVILLE | ||||||||||
| 900 Hospital Drive 4th Floor | Madisonville | KY | 42431 | 465033192 | HOSPITAL | DE | 501(C)(3) | 3 | CCC | false |
| CONTINUECARE HOSP AT BAP HLT PADUCAH | ||||||||||
| 2501 Kentucky Avenue 5th Fl | Paducah | KY | 42003 | 465032999 | HOSPITAL | DE | 501(C)(3) | 3 | CCC | false |
| CONTINUECARE HOSPITAL AT BAPTIST HEALTH | ||||||||||
| 1 TRILLIUM WAY | CORBIN | KY | 40701 | 200925675 | HOSPITAL | KY | 501(C)(3) | 3 | CCC | false |
| CRAWLEY MEMORIAL HOSPITAL | ||||||||||
| 706 KINGS STREET | KINGS MOUNTAIN | NC | 28086 | 560691100 | HOSPITAL | NC | 501(C)(3) | 3 | CAR CC | false |
| CAROLINAS COMMUNITY CARE LLC | ||||||||||
| 7800 N DALLAS PKWY STE 200 | PLANO | TX | 75024 | 465590355 | SUPPORT ORG | DE | 501(C)(3) | 12B-II | CHC | false |
| JELLICO COMMUNITY HOSPITAL INC | ||||||||||
| 188 Hospital Lane | Jellico | TN | 37762 | 620924706 | HOSPITAL | TN | 501(C)(3) | 3 | CHC | false |
| CONTINUECARE HOSPITAL AT ODESSA INC | ||||||||||
| 500 W 4th Street | Odessa | TX | 79761 | 473539943 | HOSPITAL | DE | 501(C)(3) | 3 | CCC | false |
| COMMUNITY HOSPITAL CORPORATION | ||||||||||
| 7800 N DALLAS PKWY STE 200 | PLANO | TX | 75024 | 752638469 | SUPPORT ORG | TX | 501(C)(3) | 12C-III-FI | NA | false |
| BAPTIST HOSPITALS OF SOUTHEAST TEXAS | ||||||||||
| POST OFFICE BOX 1591 | BEAUMONT | TX | 77704 | 741303720 | HOSPITAL | TX | 501(C)(3) | 3 | SWCH INC | false |
| BAPTIST PHYSICIAN NETWORK | ||||||||||
| 3080 COLLEGE STREET | BEAUMONT | TX | 77701 | 760453250 | PRIMARY CARE | TX | 501(C)(3) | 3 | BHSET | false |
| YOAKUM COMMUNITY HOSPITAL FOUNDATION | ||||||||||
| 1200 CARL RAMERT DRIVE | YOAKUM | TX | 77995 | 453609830 | SUPPORT ORG | TX | 501(C)(3) | 12A-I | YCH | false |
| BHSETX FOUNDATION | ||||||||||
| 810 HOSPITAL DRIVE 235 | BEAUMONT | TX | 77701 | 611557670 | SUPPORT ORG | TX | 501(C)(3) | 7 | BHSET | false |
| CONTINUECARE HOSPITAL AT PALMETTO HEALTH | ||||||||||
| 7800 N DALLAS PKWY STE 200 | PLANO | TX | 75024 | 813048423 | HOSPITAL | TX | 501(C)(3) | 3 | CAR CC | false |
| RURAL AND COMMUNITY HEALTHCARE COLLABRAT | ||||||||||
| 7800 N DALLAS PKWY STE 200 | PLANO | TX | 75024 | 814337246 | SUPPORT ORG | TX | 501(C)(3) | 7 | CHC | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Critical Access HospCoalition | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 120 G St NW STE 1000 | AddressLine1Txt |
| City | WA | CityNm |
| State Abbreviation | DC | StateAbbreviationCd |
| ZIP | 11111 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | hosp. coalition | PrimaryActivitiesTxt |
| Legal Domicile State | DE | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | na | BusinessNameLine1Txt |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY HEALTH ASSURANCE SPC LTD | |||||||||||||
| POB 69GT | GRAND CAYMAN | CJ | captive insurance | CJ | CHC | C Corp | false | ||||||
| COMMUNITY HOSPITAL CONSULTING | |||||||||||||
| MGMT CONSULTING | CHC | C Corp | false | 7800 N DALLAS PARKWAY 200 | PLANO | TX | 75024 | 204710183 | TX | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Community Hospital Corporation | ||
| P | $1,990,846 | cost |
| CHC Community Care LLC | ||
| p | $630,814 | Cost |
| CHC Community Care LLC | ||
| o | $347,448 | Cost |
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